DermAtlas: Online Dermatology Image Library dermatology image,gynecomastia,Klinefelter syndrome,prolapsed uterus,uterus, prolapsed,uterus, prolapsed,uterus, prolapsed,Crohn disease,inflammatory bowel disease

© 2001-2010, DermAtlas	*Image Name:*	klinefelter_syndrome_2_100213	*File Type:*	jpg
	*Diagnosis:*	GYNECOMASTIA / KLINEFELTER SYNDROME	*Category:*	genodermatosis/genetic disorder / endocrine disorder / dysmorphology
	*Body Site:*	genital / penis testicle / scrotum	*Age:*	47 years
	*Contributor:*	Amr Gohar, MRCPS Glasgow
	*Description:*	small testicles (4 ml measured by orchidometer)
	*Comments:*	A 47-year old man who was recently married for the third time was evaluated for erectile dysfunction which had been marked over the past few years and failed to respond to oral phosphodiesterase-5 inhibitors (PDE5i). He failed to impregnate his previous two wives. On examination, the tall (190 cm) patient’s testicles were found to be small and firm (4 ml measured by orchidometer). Bilateral gynaecomastia was evident. He had fructose positive azoospermia though the seminal fructose was found to be low (8.1 µmol/ejaculate). Gonadotropins were markedly elevated. Total and free testosterone were very low. Karyotype testing showed 47, XXY. Diagnosis of Klinefelter’s syndrome was made. Testosterone replacement therapy did not significantly improve his erectile dysfunction which was successfully treated with combined testosterone replacement therapy and oral sildenafil. It should be noted that a threshold serum testosterone level is required to achieve full efficacy with PDE5i. Klinefelter’s syndrome was named after Harry Klinefelter, an endocrinologist at Massachusetts General Hospital, in 1942 who thought it was an endocrine disorder due to lack of a second testicular hormone that he postulated but was unable to identify. The postulated hormone, inhibin, was isolated later. The 47, XXY karyotype characteristic of Klinefelter syndrome was first described in Scotland in 1959.
	*Related Images:*	All related Images klinefelter_syndrome_3_100213 klinefelter_syndrome_1_100213

© 2001-2010, DermAtlas	*Image Name:*	PROLAPSED_Uterus_3_090828	*File Type:*	jpg
	*Diagnosis:*	PROLAPSED UTERUS / UTERUS, PROLAPSED	*Category:*	obstetrics (pregnancy related) and gynecology
	*Body Site:*	vulva (labia) / genital diaper area	*Age:*	66 years
	*Contributor:*	Liudmila Bedricovschi
	*Description:*	large pink mass with overlying scale and telangiectasias
	*Comments:*	This 66-year-old woman complained of heaviness, fullness or "falling out" in the vaginal area. The patient also complained of backache, inability to control urination and vaginal pain and bleeding. The cervix and vaginal epithelium became dry, scaly and ulcer. These findings are consistend with third-degree prolapse (sometimes referred to as total prolapse) when the entire uterus is outside the vagina. Treatment is surgical.
	*Related Images:*	All related Images PROLAPSED_Uterus_1_090828 PROLAPSED_Uterus_2_090828

© 2001-2010, DermAtlas	*Image Name:*	PROLAPSED_Uterus_2_090828	*File Type:*	jpg
	*Diagnosis:*	PROLAPSED UTERUS / UTERUS, PROLAPSED	*Category:*	obstetrics (pregnancy related) and gynecology
	*Body Site:*	vulva (labia) / genital diaper area	*Age:*	66 years
	*Contributor:*	Liudmila Bedricovschi
	*Description:*	large pink mass with overlying scale and telangiectasias
	*Comments:*	This 66-year-old woman complained of heaviness, fullness or "falling out" in the vaginal area. The patient also complained of backache, inability to control urination and vaginal pain and bleeding. The cervix and vaginal epithelium became dry, scaly and ulcer. These findings are consistend with third-degree prolapse (sometimes referred to as total prolapse) when the entire uterus is outside the vagina. Treatment is surgical.
	*Related Images:*	All related Images PROLAPSED_Uterus_1_090828 PROLAPSED_Uterus_3_090828

© 2001-2010, DermAtlas	*Image Name:*	PROLAPSED_Uterus_1_090828	*File Type:*	jpg
	*Diagnosis:*	PROLAPSED UTERUS / UTERUS, PROLAPSED	*Category:*	obstetrics (pregnancy related) and gynecology
	*Body Site:*	vulva (labia) / genital diaper area	*Age:*	66 years
	*Contributor:*	Liudmila Bedricovschi
	*Description:*	large pink mass with overlying scale and telangiectasias
	*Comments:*	This 66-year-old woman complained of heaviness, fullness or "falling out" in the vaginal area. The patient also complained of backache, inability to control urination and vaginal pain and bleeding. The cervix and vaginal epithelium became dry, scaly and ulcer. These findings are consistend with third-degree prolapse (sometimes referred to as total prolapse) when the entire uterus is outside the vagina. Treatment is surgical.
	*Related Images:*	All related Images PROLAPSED_Uterus_2_090828 PROLAPSED_Uterus_3_090828

© 2001-2010, DermAtlas	*Image Name:*	crohn_disease_1_090905	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE	*Category:*	granulomatous disorder / gastrointestinal disorder / cutaneous sign of systemic disease
	*Body Site:*	genital / scrotum penis / perineum diaper area / groin	*Age:*	5 years
	*Contributor:*	Adrianna Jackson
	*Description:*	firm rubbern non-pitting edema with surrounding red papules and pustules
	*Comments:*	This 5-year-old boy had a history of progressive swelling of the scrotum and penis for 6 months. He was growing and developing normally. Although the involved area was only moderately tender, he was extremely uncomfortable as the swelling increased and had difficulty walking. He also had chronic constipation with overflow diarrhea intermittently.
	*Related Images:*	All related Images crohn_disease_6_090905 crohn_disease_5_090905 crohn_disease_4_090905 crohn_disease_3_090905 crohn_disease_2_090905

© 2001-2010, DermAtlas	*Image Name:*	crohn_disease_2_090905	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE	*Category:*	granulomatous disorder / gastrointestinal disorder / cutaneous sign of systemic disease
	*Body Site:*	genital / scrotum penis / perineum diaper area / groin	*Age:*	5 years
	*Contributor:*	Adrianna Jackson
	*Description:*	firm rubbern non-pitting edema with surrounding red papules and pustules
	*Comments:*	This 5-year-old boy had a history of progressive swelling of the scrotum and penis for 6 months. He was growing and developing normally. Although the involved area was only moderately tender, he was extremely uncomfortable as the swelling increased and had difficulty walking. He also had chronic constipation with overflow diarrhea intermittently.
	*Related Images:*	All related Images crohn_disease_6_090905 crohn_disease_5_090905 crohn_disease_4_090905 crohn_disease_3_090905 crohn_disease_1_090905

© 2001-2010, DermAtlas	*Image Name:*	crohn_disease_3_090905	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE	*Category:*	granulomatous disorder / gastrointestinal disorder / cutaneous sign of systemic disease
	*Body Site:*	genital / scrotum penis / perineum diaper area / groin	*Age:*	5 years
	*Contributor:*	Adrianna Jackson
	*Description:*	firm rubbern non-pitting edema with surrounding red papules and pustules
	*Comments:*	This 5-year-old boy had a history of progressive swelling of the scrotum and penis for 6 months. He was growing and developing normally. Although the involved area was only moderately tender, he was extremely uncomfortable as the swelling increased and had difficulty walking. He also had chronic constipation with overflow diarrhea intermittently.
	*Related Images:*	All related Images crohn_disease_6_090905 crohn_disease_5_090905 crohn_disease_4_090905 crohn_disease_2_090905 crohn_disease_1_090905

© 2001-2010, DermAtlas	*Image Name:*	crohn_disease_4_090905	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE	*Category:*	granulomatous disorder / gastrointestinal disorder / cutaneous sign of systemic disease
	*Body Site:*	genital / scrotum penis / perineum diaper area / groin	*Age:*	5 years
	*Contributor:*	Jakki Junkins-Hopkins
	*Description:*	fThe specimen shows loose aggregates o fepithelioid histiocytes and multinucleated giant cells within the dermis and subcutaneous tissue. These are also noted amidst the skeletal muscle bundles towards the base of of the biopsy. There is an associated lymphocytic infiltrate within the dermis and epidermis. The epidermis shows exocytosis of lymphocytes and spongiosis.
	*Comments:*	The clinical-pathologic featuers favor cutaneous Crohns disease. Stains for fungi, acid fast bacilli, and spirochetes were negative.
	*Related Images:*	All related Images crohn_disease_6_090905 crohn_disease_5_090905 crohn_disease_3_090905 crohn_disease_2_090905 crohn_disease_1_090905

© 2001-2010, DermAtlas	*Image Name:*	crohn_disease_5_090905	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE	*Category:*	granulomatous disorder / gastrointestinal disorder / cutaneous sign of systemic disease
	*Body Site:*	genital / scrotum penis / perineum diaper area / groin	*Age:*	5 years
	*Contributor:*	Jakki Junkins-Hopkins
	*Description:*	fThe specimen shows loose aggregates o fepithelioid histiocytes and multinucleated giant cells within the dermis and subcutaneous tissue. These are also noted amidst the skeletal muscle bundles towards the base of of the biopsy. There is an associated lymphocytic infiltrate within the dermis and epidermis. The epidermis shows exocytosis of lymphocytes and spongiosis.
	*Comments:*	The clinical-pathologic featuers favor cutaneous Crohns disease. Stains for fungi, acid fast bacilli, and spirochetes were negative.
	*Related Images:*	All related Images crohn_disease_6_090905 crohn_disease_4_090905 crohn_disease_3_090905 crohn_disease_2_090905 crohn_disease_1_090905

© 2001-2010, DermAtlas	*Image Name:*	crohn_disease_6_090905	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE	*Category:*	granulomatous disorder / gastrointestinal disorder / cutaneous sign of systemic disease
	*Body Site:*	genital / scrotum penis / perineum diaper area / groin	*Age:*	5 years
	*Contributor:*	Jakki Junkins-Hopkins
	*Description:*	fThe specimen shows loose aggregates o fepithelioid histiocytes and multinucleated giant cells within the dermis and subcutaneous tissue. These are also noted amidst the skeletal muscle bundles towards the base of of the biopsy. There is an associated lymphocytic infiltrate within the dermis and epidermis. The epidermis shows exocytosis of lymphocytes and spongiosis.
	*Comments:*	The clinical-pathologic featuers favor cutaneous Crohns disease. Stains for fungi, acid fast bacilli, and spirochetes were negative.
	*Related Images:*	All related Images crohn_disease_5_090905 crohn_disease_4_090905 crohn_disease_3_090905 crohn_disease_2_090905 crohn_disease_1_090905