ABSTRACT
After anaplastic large-cell lymphoma (ALCL) was first described by Stain in 1985, there have been several histological variants of ALCL reported. There are classified histological subtypes of ALCL, such as lymphohistiocytic, small cell, Hodgkin-like, composite pattern, and other less common variants including neutrophil-rich ALCL. A 63-year-old male patient presented with erythematous exophytic mass on the left lower leg. In the past, his condition had been diagnosed as abdominal primary cutaneous ALCL (pcALCL), which recurred as systemic ALCL (sALCL) in the left bronchus. After treatment, he achieved complete remission. Histopathologic examination showed large-sized pleomorphic, anaplastic mitotic tumor cells, several neutrophils, and a few lymphocytes. Neutrophil-rich ALCL is a rare histological variant of ALCL. It is characterized by the presence of CD30-positive anaplastic tumor cells with numerous neutrophil infiltrations. Neutrophil-rich ALCL responds well to treatment but tends to recur. There were four cases reported to have recurrent neutrophilrich ALCL. All cases were diagnosed with neutrophil-rich pcALCL prior to recurrence.Three cases had local recurrence, and only one case relapsed as sALCL. Herein, we present the first case of neutrophil-rich ALCL recurring as sALCL twice.
ABSTRACT
Background@#Alopecia areata (AA) is common non-scarring hair loss disease. Sleep distrubance has been regarded as a triggering or aggravating factor for AA. However, objective evaluation of sleep disturbance and its clinical effect on AA has not been clearly demonstrated. @*Objective@#This study investigated objective sleep evaluation tool for AA patients and their clinical correlation. @*Methods@#Patients presenting with new-onset AA or recurrences of pre-existing AA were included, and those who reported sleep disturbance in the preliminary survey were designated as the sleep disturbance group (SD group). Sleep quality was investigated for them using three self-administered questionnaires: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleep Scale (ESS). Demographic information and clinical features of AA were analyzed according to sleep quality. @*Results@#A total of 400 participants were enrolled, and 53 were categorized into the SD group. The incidence of stressful events was significantly higher in the SD group (54.7%) than in the non-SD group (25.1%) (p<0.001). Based on the PSQI, 77.3% of participants were objective poor sleepers (score of 5 or more), and they showed a significantly higher incidence of stressful events compared to good sleepers (p=0.019). The proportion of poor sleepers was significantly lower in patients with mild AA (S1) than in those with moderate to severe AA (S2~S5) (p=0.045). @*Conclusion@#This study demonstrated a positive correlation among stress, SD, and AA. The degree of SD was objectively represented by the PSQI score, showing different scores according to AA severity.
ABSTRACT
Background@#Patients with rosacea usually suffer from skin irritations, such as itching, stinging, burning, and pain.These symptoms may be related to the skin barrier function disruption. @*Objective@#We investigated the skin barrier functions in patients with mild to moderate rosacea and the associated improvements based on the skin care habit modifications and treatment modalities. @*Methods@#We analyzed the data on transepidermal water loss (TEWL) and stratum corneum hydration (SCH) of skin lesions in 27 patients with rosacea and healthy skin of 29 control subjects. We compared the results of TEWL and SCH based on sex, age, type of rosacea, skin care habits, and the treatment modalities. @*Results@#The skin in the patients with rosacea exhibited increased TEWL and decreased SCH compared with that in control subjects. Male patients showed increased TEWL and decreased SCH compared to female patients. Combination therapy with systemic minocycline and topical metronidazole improved the skin barrier functions. Patients with better skin care habits presented better skin barrier functions and clinical improvement. @*Conclusion@#Patients with rosacea, especially those with poor skin care habits, showed reduced skin barrier functions. Appropriate skin care habits with cleansers and moisturizers are recommended for the management of rosacea.