Ramsay hunt syndrome with multiple cranial nerve involvement: A rare case

Ramsay Hunt Syndrome (RHS) is characterized by vesicles in external auditory canal, ear discomfort, and facial nerve palsy in the periphery. RHS which affects multiple cranial nerve involvement has rarely happened. This study is about RHS case that affect right multiple cranial nerves VI, VIII, IX, X. A 46-year old male patient complaint of crust and pain from right ear lobe. There were complaints of decreased hearing ability, tinnitus, difficulty to swallow, double vision, incapability of closing the right eyelid, and a facial slight palsy to the right. Multiple yellowish crusts and erosions were identified. Tzanck and Polymerase Chain Reaction test were not performed. Patient was diagnosed RHS with right multiple cranial nerves VI, VIII, IX, X, received Acyclovir and Prednisone tablets for 7 days. Patient improved. This finding showed that a detailed history taking, physical and additional examinations are required for accurate diagnosis for RHS multiple cranial nerve involvement

Wide excision of Basal Cell Carcinoma on the upper extremity: A case report

Basal cell carcinoma (BCC) is the most common skin cancer, usually occurring in the sun-exposed area, such as the head and neck, but also seen in less common areas like the upper or lower extremities. The initial treatment of BCC lesions is completing tumor removal. One of the standard therapy for BCC is wide surgical excision, as it is highly efficacious. A 76-year-old female patient complained of a wounded blackish lump on the left upper extremity for about 2 years. It started small, then grew bigger. Complained of itchiness, but no pain. The lump easily bled when accidentally touched. Dermatology examination identified a hyperpigmented nodule about 1.5 cm, with a clear border, irregular raised edges, slightly rough surface, and erosion. A dermoscopy examination showed short-fine telangiectasia, blue-grey ovoid nests, and ulceration. The patient was diagnosed with suspected BCC and underwent biopsy, also wide excision surgery. Histopathology showed pigmented BCC. One month later, surgery proved a good result. Selecting appropriate therapy in BCC should be given to reduce the recurrence rate. The common treatment for BCC is wide surgical excision, because of its association with a low recurrence rate and the ability to confirm residual tumor pathologically. In conclusion, wide excision surgery is one of the effective therapy options for BCC