Two Cases of Antituberculosis Drug-induced Hypersensitivity Syndrome / 대한피부과학회지

Drug-induced hypersensitivity syndrome is a rare, but severe, life-threatening disease with multiorgan failure. Aromatic antiepileptic drugs are frequent causes of this syndrome. The association of the human herpes virus-6 has been recently reported in patients with drug-induced hypersensitivity syndrome. We report two patients who were diagnosed as having antituberculosis drug-induced hypersensitivity syndrome based on clinical course and laboratory data. In addition, human herpes virus-6 DNA was detected by polymerase chain reaction in peripheral blood mononuclear cells and the serum. There was a favorable outcome after discontinuation of the causative drug, plus corticosteroid therapy. After the treatment, human herpes virus-6 DNA was not detected by polymerase chain reaction. This is the first report of antituberculosis drug-induced hypersensitivity syndrome associated with reactivation of human herpes virus-6.

A Case of Nail-patella Syndrome / 대한피부과학회지

Nail-patella syndrome (NPS) is a rare autosomal dominant disorder characterized by fingernail dysplasia, hypoplastic or absent patellae, dislocation of the radial head, and bony protuberances of the iliae, also known as iliac horns. It results from a heterogenous loss of function or mutations in the transcription factor (LMX1b). Herein, we report a rare case of nail-patella syndrome in an 18 month-old female.

Squamous cell carcinoma of the finger and toe / 대한피부과학회지

BACKGROUND: Squamous cell carcinoma of the finger and toe is a relatively rare disorder which has often been misdiagnosed for years before definite diagnosis. Squamous cell carcinoma of the finger has usually been found to be associated with type 16 human papillomavirus (HPV). OBJECTIVES: To describe the clinical and histological features of 12 squamous cell carcinomas of the finger and toe, and to evaluate these lesions for the presence of HPV. METHOD: The clinical and histological features were reviewed. Immunohistochemical staining and PCR were performed in paraffin embedded tissue sections for detection of the presence of HPV infection. RESULTS: Patients presented with an erosive or a verrucous papule. Histologically, 2 lesions demonstrated bowenoid features, 9 lesions demonstrated well differentiated squamous cell carcinoma, and 1 lesion demonstrated verrucous carciroma-like features. By immunohistochenical staining and PCR, we could not demonstrate any evidence of HPV infection in any of the cases. The affected digit was amputated in 10 cases, and complete excision of the skin lesion was done in 2 cases. CONCLUSION: Squamous cell carcinoma of the finger and toe is not as rare as has been implied by early literature. It is important to carry out the skin biopsy from all recalcitrant lesions of the finger and toe.

A Case of Pyoderma Gangrenosum Treated with Topical Tacrolimus and Oral Cyclosporin / 대한피부과학회지

Pyoderma gangrenosum is a chronic inflammatory skin disease, characterized by the recurring destructive and painful skin ulcers. Although the mainstay of therapy is the systemic administration of high doses of corticosteroids, many other treatment modalities have been widely used. Recently, there have been several reports of the successful treatment of pyoderma gangrenosum using topical tacrolimus. We report a successful treatment of pyoderma gangrenosum with combination therapy of topical tacrolimus and systemic cyclosporin.

Recurrent Annular Erythema in the Patients with Sj gren's Syndrome and/or Lupus Erythematosus-like Features / 대한피부과학회지

BACKGROUND: Recurrent annular erythema associated with anti-Ro (SSA) or anti-La (SSB) antibodies has been recognized as a unique cutaneous manifestation of Sj gren's syndrome or Sj gren's syndrome/SLE overlap syndrome in Orientals. OBJECTIVE: The purpose of this study was to evaluate the clinical, histological and serological aspects of recurrent annular erythema in the korean patients with Sj gren's syndrome and/or lupus erythematosus-like features. METHODS: This clinical investigation was carried out on 6 outpatients with this disorder who had visited Department of Dermatology, Seoul National University Hospital, from January 1996 to December 2003. RESULTS: These patients (four females, two males; range of age, 24-60 years, median 45 years) had relatively well demarcated annular erythematous plaques mainly on trunk and extremities. Two-thirds of the patients were anti-Ro positive and one-third was anti-La positive. Biopsy specimens revealed a moderate degree of perivascular and periappendageal lymphocytic infiltration throughout dermis. Other features to suggest LE were not demonstrated. Four patients were treated with oral hydroxychloroquine with good response. CONCLUSION: Although all 6 patients showed annular erythema associated with anti-Ro or anti-La antibodies, only two could be diagnosed as Sj gren's syndrome/SLE overlap syndrome. The other four presented with LE-like features such as photosensitivity, nephropathy and arthralgia.