RESUMEN
Mechanic's hand is often seen in the fingers of patients with dermatomyositis and is frequently associated with anti-aminoacyl-transfer RNA synthetase autoantibodies and interstitial lung disease. We analysed the clinical symptoms of 50 patients with dermatomyositis who had visited our department, 26 of whom also had mechanic's hand. A histological examination was carried out in 16 of the 26 cases, which revealed hyperkeratosis in all cases and colloid bodies in the epidermis in 15 cases. The number of cases of interstitial lung disease in patients with mechanic's hand (22/26, 85%) was significantly higher than that in those without mechanic's hand (12/24, 50%) (P < 0.05). Mechanic's hand is an important skin lesion of dermatomyositis, and increases the likelihood of interstitial lung disease.
RESUMEN
A 67-year-old woman with rheumatoid arthritis (RA) treated with systemic prednisolone and methotrexate over 20 years developed eruptive molluscum contagiosums on the trunk and extremities. Investigation revealed lung cancer 2 years later. Newly development of molluscum contagiosums ceased after the surgical operation of lung cancer. Immunologic dysfunctions have been shown in RA, and especially patients under long-term methotrexate therapy are susceptible to miscellaneous skin conditions. Eruptive molluscum contagiosums are induced in association with hematologic malignancies such as lymphoma, leukemia, and HIV infection; however, it is important to investigate internal malignancies, not only hematologic malignancies but also solid cancers, when patients with RA under immunosuppressive therapies presented eruptive or disseminated molluscum contagiosums.
Asunto(s)
Artritis Reumatoide/patología , Neoplasias Pulmonares/patología , Molusco Contagioso/patología , Anciano , Antirreumáticos/uso terapéutico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/terapia , Femenino , Humanos , Huésped Inmunocomprometido , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/terapia , Metotrexato/uso terapéutico , Molusco Contagioso/complicaciones , Molusco Contagioso/terapia , NeumonectomíaRESUMEN
Metastatic skin tumors present with a variety of clinical manifestations. We herein present two cases of metastases to the scalp, invading the skull, which showed epidermoid cyst-like appearances.
Asunto(s)
Carcinoma Hepatocelular/secundario , Neoplasias Endometriales/patología , Neoplasias Hepáticas/patología , Sarcoma Estromático Endometrial/secundario , Cuero Cabelludo/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/secundario , Anciano , Anciano de 80 o más Años , Quiste Epidérmico/patología , Femenino , Humanos , MasculinoAsunto(s)
Artritis Reumatoide/complicaciones , Artritis Reumatoide/patología , Úlcera de la Pierna/patología , Úlcera Cutánea/patología , Femenino , Humanos , Úlcera de la Pierna/complicaciones , Persona de Mediana Edad , Úlcera Cutánea/complicaciones , Úlcera Cutánea/inmunología , Insuficiencia Venosa/complicaciones , Insuficiencia Venosa/inmunología , Insuficiencia Venosa/patologíaRESUMEN
Cutaneous lesions of sarcoidosis present with various manifestations including specific and non-specific cutaneous lesions. Ichthyosiform sarcoidosis is a rare form of cutaneous sarcoidosis, presenting with asymptomatic, adherent, polygonal scales, mainly appearing on the lower limbs. Ichthyosiform sarcoidosis has a predilection for dark-skinned races, and cases affecting Japanese patients have rarely been reported in English literature. We herein describe three Japanese cases of ichthyosiform sarcoidosis on the lower limbs. All of the patients were female, with an age range of 57-69 years old. Histologically, sarcoidal granulomas were located in the mid- to lower dermis. All cases had scar sarcoidosis on the knees. Furthermore, Case 1 presented with papular sarcoidosis on the back, and Case 3 presented with subcutaneous nodules on the buttock as well as erythema nodosum-like lesions on the lower legs. All patients had lung sarcoidosis, but ocular sarcoidosis was seen in only Case 2. Case 3 showed Heerfordt syndrome with facial nerve paralysis. Histological features showed that the granular layers were scarcely detected in the overlying epidermis; however, filaggrin expression was not decreased. Sarcoidal granulomas accumulated around the sweat glands in one case, whereas those features were not detected in the other two cases. In conclusion, ichthyosiform cutaneous sarcoidosis may be overlooked or misdiagnosed as xerotic dry skin which is frequently found in elderly people, and ichthyosiform cutaneous lesions may be more prevalent than previously estimated.
Asunto(s)
Ictiosis/diagnóstico , Sarcoidosis/diagnóstico , Piel/patología , Anciano , Dorso , Biopsia , Nalgas , Femenino , Proteínas Filagrina , Humanos , Extremidad Inferior , Persona de Mediana Edad , Sarcoidosis/patologíaAsunto(s)
Quimiocina CXCL1/sangre , Psoriasis/sangre , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , NeutrófilosAsunto(s)
Arteritis/diagnóstico , Lupus Eritematoso Sistémico/complicaciones , Enfermedades Raras/diagnóstico , Enfermedades Cutáneas Vasculares/diagnóstico , Adulto , Arteritis/inmunología , Arteritis/patología , Biopsia , Femenino , Humanos , Lupus Eritematoso Sistémico/inmunología , Persona de Mediana Edad , Enfermedades Raras/inmunología , Enfermedades Raras/patología , Piel/irrigación sanguínea , Piel/inmunología , Piel/patología , Enfermedades Cutáneas Vasculares/inmunología , Enfermedades Cutáneas Vasculares/patologíaRESUMEN
BACKGROUND: Although the etiology of Behçet's disease (BD) is still unknown, neutrophils are implicated in its pathogenesis. Growth-related oncogene-α (GRO-α) is a potent chemoattractant and activator for neutrophils. OBJECTIVE: To determine the role of GRO-α in the pathogenesis of BD, we investigated serum GRO-α levels in patients with BD. MATERIALS AND METHODS: Sera from patients with BD (n=57) and control subjects (n=26) were measured by enzyme-linked immunosorbent assay. Serum levels of GRO-α were compared with clinical symptoms. RESULTS: Patients with BD had significantly elevated serum GRO-α levels compared with healthy controls (121.7±79.2pg/ml vs. 75.9±20.6pg/ml, P<0.01). Concerning the subgroups of BD, serum GRO-α levels in active patients with BD (n=35) were significantly higher than in inactive patients with BD (n=22; 139.0±92.8 pg/ml vs. 94.3±36.2pg/ml, P<0.05). Also, as seen in previous studies, serum interleukin-8 levels in patients with BD (52.4±81.8pg/ml) were significantly higher than in controls (13.9±19.7pg/ml, P<0.01). Enhanced GRO-α levels correlated with clinical symptoms such as erythema nodosum. CONCLUSION: Our results indicate that serum levels of GRO-α are elevated in patients with active stage BD, suggesting that GRO-α may serve as a reliable marker for disease activity of BD.