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Richard Alexis

Publications and source records attributed to Richard Alexis.

2 recordsLinked to original sources

Managing isolated subglottic juvenile xanthogranuloma without tracheostomy: case report and review of literature.

Juvenile Xanthogranuloma (JXG) is a dendritic cell related histiocytic disorder which usually presents in the first year of life as a solitary cutaneous granuloma. Isolated presentation in the upper airway is very rare but can result in severe respiratory distress, especially in young children. We present the case of a 5-month-old male with an isolated subglottic JXG lesion. Endoscopic excision provided symptomatic relief and avoided the need for tracheostomy. The lesion has completely resolved 17 months later. Surgical excision without tracheostomy was the treatment of choice in two of the four additional cases of upper airway JXG presented in the literature. JXG has an excellent prognosis with spontaneous regression over time. Histology alone is frequently inadequate to differentiate JXG from the more common Langerhans Cell Histiocytosis (LCH), which carries a much less favorable prognosis. The evolving field of immunohistochemistry provides an essential tool to establish the correct diagnosis. The typical phenotype of JXG is Factor XIIIa+/Fascin+/CD68+/CD163+/CD14+/CD1a-/S100-.

Airway Obstruction↗

Human botfly infestation presenting as peri-auricular mass.

To report a new cause of peri-auricular mass in children: cutaneous myiasis-botfly infestation. Case report. The human botfly (Dermatobia hominis) is found in the tropics of Central and South America. However, cases of infestation are uncommon in the United States. We present the case of a 5-year-old girl with cutaneous myiasis in order to expand the differential diagnosis for a peri-auricular mass in children. In our report, the parasite was initially identified as sparganum, but was later reclassified by the center for disease control and prevention (CDC) as a botfly larva. Parasitic infection should be considered with a newly noted head and neck mass, and cutaneous myiasis should be included in the differential diagnosis. Cutaneous myiasis has not been previously reported in the literature describing the peri-auricular region as the site of occurrence. Furthermore, when an unusual parasite is extracted from a lesion, it should be confirmed by an authority such as CDC for definitive diagnosis, so appropriate plan of care and follow up can be instituted.

Animals↗