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  1. Article: Intrathoracic kidney: An unusual cause of shortness of breath.

    Farrugia, Stephanie / Gauci, Jonathan / Bartolo, Kyra / Micallef, Josef

    British journal of hospital medicine (London, England : 2005)

    2023  Volume 84, Issue 8, Page(s) 1

    MeSH term(s) Humans ; Dyspnea/etiology ; Kidney/diagnostic imaging
    Language English
    Publishing date 2023-08-08
    Publishing country England
    Document type Journal Article
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2023.0124
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  2. Article ; Online: Nodular vasculitis (erythema induratum) associated with systemic minocycline.

    Farrugia, Stephanie / Cachia, Monique / Betts, Alexandra / Clark, Eileen

    The Australasian journal of dermatology

    2023  Volume 65, Issue 2, Page(s) 167–170

    Abstract: A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations ... ...

    Abstract A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations showed deranged liver function test with positive ANA and mixed antinuclear factor (ANF) pattern. A skin biopsy was in keeping with a diagnosis of nodular vasculitis. Her skin lesions and liver function test improved within 3 months of stopping the minocycline treatment. This case report raises the awareness that minocycline could be a potential cause of nodular vasculitis, patients on minocycline should be closely monitored and minocycline should ideally not be prescribed for more than 12 weeks, given the possible adverse effects.
    MeSH term(s) Female ; Humans ; Adult ; Erythema Induratum ; Minocycline/adverse effects ; Skin/pathology ; Acne Vulgaris/complications ; Vasculitis/chemically induced ; Vasculitis/drug therapy ; Vasculitis/complications
    Chemical Substances Minocycline (FYY3R43WGO)
    Language English
    Publishing date 2023-12-06
    Publishing country Australia
    Document type Case Reports ; Journal Article
    ZDB-ID 138052-7
    ISSN 1440-0960 ; 0004-8380
    ISSN (online) 1440-0960
    ISSN 0004-8380
    DOI 10.1111/ajd.14195
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 236: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  3. Article ; Online: A myoglobin cast-astrophe: a case of severe rhabdomyolysis with AKI secondary to carbimazole use.

    Gauci, Maria Angela / Mizzi, Sylvano / Farrugia, Stephanie

    Journal of nephrology

    2023  Volume 37, Issue 2, Page(s) 519–521

    MeSH term(s) Humans ; Acute Kidney Injury/chemically induced ; Antithyroid Agents/adverse effects ; Carbimazole/adverse effects ; Myoglobin/blood ; Rhabdomyolysis/chemically induced ; Severity of Illness Index
    Chemical Substances Antithyroid Agents ; Carbimazole (8KQ660G60G) ; Myoglobin
    Language English
    Publishing date 2023-09-28
    Publishing country Italy
    Document type Case Reports ; Letter ; Journal Article
    ZDB-ID 1093991-x
    ISSN 1724-6059 ; 1120-3625 ; 1121-8428
    ISSN (online) 1724-6059
    ISSN 1120-3625 ; 1121-8428
    DOI 10.1007/s40620-023-01783-w
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3369: Show issues Location:
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  4. Article ; Online: Palmar Digital Vein Thrombosis: A Case Report and Review of 36 Cases.

    Farrugia, Stephanie / Cachia, Monique / Degaetano, James / Boffa, Michael J

    European journal of case reports in internal medicine

    2022  Volume 9, Issue 9, Page(s) 3552

    Abstract: Thrombosis of the palmar digital veins is relatively rare, typically reported in women aged 35-65 years and most commonly occurring on the fourth digit. Clinical presentation varies and the lesion can present on the fingers or the palms of the hands. ... ...

    Abstract Thrombosis of the palmar digital veins is relatively rare, typically reported in women aged 35-65 years and most commonly occurring on the fourth digit. Clinical presentation varies and the lesion can present on the fingers or the palms of the hands. Diagnosis may be suspected clinically and confirmed on histology and radiologically. The condition can be managed conservatively or surgically. A 58-year-old woman presented with a 3-month history of a tender, skin-coloured nodule on her right palm. This was surgically excised, and the histopathological diagnosis was a thrombosed varix. As no underlying medical issues were raised on further testing, it was thought that her thrombosed varix was likely secondary to repeated trivial mechanical trauma, given that she was a housewife. A literature review yielded 36 cases of thrombosed varix, including our case. Most cases (85.3%) occurred in females, and the mean age of patients was 51.67 years, with two-thirds of patients between 35 and 65 years of age. The fourth digit and the proximal interphalangeal joint were the most commonly affected sites, respectively. Although rare, doctors should consider the possibility of a thrombosed varix when presented with tender and raised nodules on the palms or fingers.
    Learning points: Thrombosis of the palmar digital veins is rare but can occur secondary to mechanical trauma and hypercoagulable states.Physicians should consider the possibility of a thrombosed varix when presented with a tender, raised and firm nodule on the hand or fingers, especially since some cases may be associated with hypercoagulable states which can have more serious sequelae.
    Language English
    Publishing date 2022-09-21
    Publishing country Italy
    Document type Journal Article
    ISSN 2284-2594
    ISSN (online) 2284-2594
    DOI 10.12890/2022_003552
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Scleroderma Secondary to Pembrolizumab: A Case Report and Review of 19 Cases of Anti-PD-1-Induced Scleroderma.

    Farrugia, Stephanie / Mercieca, Liam / Betts, Alexandra / Refalo, Nick / Boffa, Michael J

    Case reports in oncology

    2023  Volume 16, Issue 1, Page(s) 846–856

    Abstract: Immune checkpoint inhibitors are increasingly being used to treat various malignancies. Despite their efficacy, they are known to potentially cause immune-related adverse effects, including dermatological manifestations. A rare cutaneous immune-related ... ...

    Abstract Immune checkpoint inhibitors are increasingly being used to treat various malignancies. Despite their efficacy, they are known to potentially cause immune-related adverse effects, including dermatological manifestations. A rare cutaneous immune-related adverse effect is scleroderma, which has been reported to occur with anti-programmed cell death-1 (PD-1) agents such as pembrolizumab and nivolumab. This may present with skin tightening and hardening at any point during or after immunotherapy. We present the case of a 54-year-old Caucasian woman who, following 16 doses of pembrolizumab for breast cancer, developed clinical features of scleroderma confirmed on histology. She was initially treated with oral corticosteroids, followed by oral psoralen-UVA, with poor response, but eventually improved with methotrexate. A literature review revealed 12 other cases of scleroderma following pembrolizumab treatment and 6 cases of scleroderma following nivolumab treatment. Males and females were both affected, and their ages ranged from 33 to 81 years. Scleroderma developed at different stages of pembrolizumab or nivolumab therapy. Although scleroderma is not commonly drug-induced, anti-PD-1 agents may be a rare cause and it is important to elicit an accurate drug history, including immunotherapy, in such cases.
    Language English
    Publishing date 2023-09-06
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2458961-5
    ISSN 1662-6575
    ISSN 1662-6575
    DOI 10.1159/000533373
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  6. Article ; Online: Dark perifollicular macules and granulomatous rosacea secondary to vandetanib.

    Farrugia, Stephanie / Cassar, Paula / Betts, Alexandra / Mercieca, Liam / Boffa, Michael J

    International journal of dermatology

    2023  Volume 63, Issue 2, Page(s) 210–212

    MeSH term(s) Humans ; Rosacea/chemically induced ; Rosacea/diagnosis ; Rosacea/drug therapy ; Skin ; Skin Abnormalities
    Language English
    Publishing date 2023-11-29
    Publishing country England
    Document type Case Reports
    ZDB-ID 412254-9
    ISSN 1365-4632 ; 0011-9059 ; 1461-1244
    ISSN (online) 1365-4632
    ISSN 0011-9059 ; 1461-1244
    DOI 10.1111/ijd.16950
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    In stock of ZB MED Cologne/Königswinter

    Ui VI Zs.189: Show issues Location:
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  7. Article ; Online: Unusual case of soft palate and uvula haematoma in a patient on anticoagulant drugs.

    Farrugia, Stephanie / Sapiano, Karl / Sciberras, Robert

    BMJ case reports

    2020  Volume 13, Issue 12

    Abstract: A 91-year-old Caucasian man on warfarin for atrial fibrillation presented in view of sudden-onset haemoptysis with fresh bleeding with clots immediately after having eaten a piping-hot traditional cheesecake (pastizz) and burning the soft-palate of his ... ...

    Abstract A 91-year-old Caucasian man on warfarin for atrial fibrillation presented in view of sudden-onset haemoptysis with fresh bleeding with clots immediately after having eaten a piping-hot traditional cheesecake (pastizz) and burning the soft-palate of his mouth. The haemoptysis had resolved by the time that the patient had arrived to hospital. On examination, a 2 cm by 2 cm dark red, solitary mass could be seen just anterior to the uvula. This was not causing any pain or discomfort to the patient. Blood results were mostly unremarkable except for a raised international normalised ratio (INR) of 3.53. The patient was administered 5 mg vitamin K orally in attempt to lower the INR level and warfarin was subsequently omitted for 7 days. He was also prescribed oral steroids on discharge. The lesion resolved in 7 days and warfarin was restarted then with no further consequences.
    MeSH term(s) Aged, 80 and over ; Anticoagulants/adverse effects ; Atrial Fibrillation/drug therapy ; Blood Coagulation/drug effects ; Burns/diagnosis ; Burns/etiology ; Food/adverse effects ; Hematoma/diagnosis ; Hematoma/drug therapy ; Hematoma/etiology ; Hemoptysis/drug therapy ; Hemoptysis/etiology ; Hot Temperature/adverse effects ; Humans ; International Normalized Ratio ; Male ; Palate, Soft/blood supply ; Palate, Soft/injuries ; Uvula/blood supply ; Uvula/injuries ; Vitamin K/administration & dosage ; Warfarin/adverse effects
    Chemical Substances Anticoagulants ; Vitamin K (12001-79-5) ; Warfarin (5Q7ZVV76EI)
    Language English
    Publishing date 2020-12-22
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-236513
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  8. Article ; Online: Retiform Purpura of the Lower Limbs Associated with Levamisole-Adulterated Cocaine.

    Farrugia, Stephanie / Micallef, Daniel / Pisani, David / Betts, Alexandra / Vella, Sandro / Boffa, Michael J

    European journal of case reports in internal medicine

    2022  Volume 9, Issue 4, Page(s) 3353

    Abstract: A young man was treated in hospital for sepsis, disseminated intravascular coagulation and multi-organ failure. He was a regular intranasal cocaine user up to 1 day prior to symptom onset. Clinical examination revealed extensive retiform purpura ... ...

    Abstract A young man was treated in hospital for sepsis, disseminated intravascular coagulation and multi-organ failure. He was a regular intranasal cocaine user up to 1 day prior to symptom onset. Clinical examination revealed extensive retiform purpura affecting both his lower limbs. Skin biopsy revealed widespread thrombosis in the small- and medium-sized vessels of the mid dermis and the subcutaneous fat with surrounding leucocytoclasis. There was also extensive ischaemic necrosis of the upper reticular and papillary dermis and focal ischaemic necrosis of the epidermis. These findings were in keeping with a thrombotic vasculopathy with associated cutaneous ischaemic necrosis, likely associated with levamisole-adulterated cocaine (LAC). An autoimmune screen showed extremely raised levels of anti-B2-glycoprotein IgM, IgG and anti-cardiolipin IgG antibodies, usually seen in antiphospholipid syndrome (APS). The literature describes how APS could be secondary to various underlying conditions, including LAC, and that levamisole toxicity may mimic APS and hence be missed.
    Learning points: Levamisole is a common adulterant found in cocaine; the resultant toxicity can present with cutaneous manifestations, namely retiform purpura and skin necrosis, similar to antiphospholipid syndrome.Patients presenting with such features should be asked about illicit drug use, specifically cocaine, and investigated by screening urine for drugs of abuse and serum antihuman elastase antibody when possible.
    Language English
    Publishing date 2022-04-28
    Publishing country Italy
    Document type Journal Article
    ISSN 2284-2594
    ISSN (online) 2284-2594
    DOI 10.12890/2022_003353
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