ABSTRACT
Pachydermodactyly (PDD) is a rare, benign form of digital fibromatosis that is characterized by asymptomatic soft tissue swellings on the back and side of the proximal interphalangeal joint areas of the fingers. We report three cases of young male patients who presented with bilateral swelling of the fingers. Histopathologic examination showed epidermal hyperplasia with acanthosis and hyperkeratosis. Collagen fibers in the reticular dermis were thickened and irregularly arranged, and deposition of mucin in the dermis was observed. Since pachydermodactyly usually affects adolescent males with joint swelling, it is often confused with rheumatologic diseases. Here, we report three cases diagnosed with pachydermodactyly based on clinical manifestations and histopathological examination.
Subject(s)
Adolescent , Humans , Male , Collagen , Dermis , Fibroma , Fingers , Hyperplasia , Joints , MucinsABSTRACT
Ichthyosis is a heterogeneous group of hereditary or acquired skin disorders, characterized by increased stratum corneum production. Several systemic diseases and many drugs can occasionally cause acquired ichthyosis. We report a case of statin-induced ichthyosis in which the causality between statin and ichthyosis was found possible by using the Naranjo scale. A 79-year-old woman presented with pruritic skin lesions on both legs that appeared erythematous, scaly, and cracked. A clinical diagnosis of acquired ichthyosis was made and the statin was suspected as the cause. The skin lesions improved after 6 weeks of dose reduction of the statin.
Subject(s)
Aged , Female , Humans , Diagnosis , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Ichthyosis , Leg , SkinABSTRACT
BACKGROUND: Although the incidence of chronic urticaria in children is increasing, research on the disease is limited. OBJECTIVE: We aimed to study the clinical and etiological characteristics of chronic urticaria in pediatric patients. METHODS: From July 2013 to December 2016, patients with chronic urticaria aged less than 18 years answered questionnaires regarding their symptoms and provoking factors or specific exposures related to the disease. Some patients were also investigated with physical provocation and/or laboratory tests. RESULTS: A total of 74 patients (male to female ratio, 1.0) with a mean age of 11.1 years (range, 1.1~18.7 years) were evaluated. The severity of urticaria was classified into mild (23.0%), moderate (43.2%), and severe (33.8%) according to the patient rating scale. Twenty-one patients (28.4%) had a previous history of atopic disease. Some patients reported accompanying angioedema (18.9%) and general symptoms, such as fatigue (14.9%) and nausea or vomiting (8.1%). The etiology was identified in 14 patients (18.9%): 9 patients had dermographic urticaria, 3 patients had cholinergic urticaria, 1 patient had cold urticaria, and 1 patient had dermographic combined with cholinergic urticaria. Results of thyroid autoantibody and antinuclear antibody tests were positive in 4 patients (30.8%) and 13 patients (27.7%), respectively. Remission rates at 1, 2, and 3 years after the onset of chronic urticaria symptoms were 40.6%, 50.7%, and 52.2%, respectively. A mild urticaria severity score and the presence of angioedema seemed to be good prognostic factors for the remission of chronic urticaria. CONCLUSION: Based on the results of this single-center study, further investigation is warranted to determine the incidence, etiology, and distinct features of chronic urticaria in children compared to those in adults.
Subject(s)
Adult , Child , Female , Humans , Angioedema , Antibodies, Antinuclear , Fatigue , Incidence , Nausea , Prognosis , Thyroid Gland , Urticaria , VomitingABSTRACT
BACKGROUND: Demodicosis is a parasitic skin disease caused by Demodex mites, and the determination of mite density per square centimeter is important to diagnose demodicosis. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd). However, no study has previously compared these two methods with respect to clinical types and distribution patterns of demodicosis. OBJECTIVE: The aim of this study was to compare the value of SSSB and DME findings in reference to the clinical types and distribution patterns of demodicosis. METHODS: The medical records of 35 patients diagnosed with demodicosis between December 2011 and June 2015 were retrospectively reviewed. Demodicosis was classified according to four clinical types (pityriasis folliculorum, rosacea type, acne type, and perioral type) and three distribution patterns (diffuse pattern, U-zone pattern, and T-zone pattern). Two samples, one for SSSB and one for DME, were obtained from a lesion of each patient. RESULTS: In all patients, mean Dd and the proportion with a high Dd (>5D/cm²) by DME (14.5±3.3, 80.0%, respectively) were higher than by SSSB (5.5±1.3, 37.1%, respectively; p<0.01, p=0.02, respectively). In terms of clinical types, for rosacea type, mean Dd and proportion with a high Dd by DME (12.4±3.5, 84.6%, respectively) were significantly greater than those determined by SSSB (3.6±1.2, 23.1%; p=0.04, p=0.04, respectively). In terms of distribution pattern, for the diffuse pattern, mean Dd and the proportion with a high Dd by DME (17.5±3.7, 100%, respectively) were significantly higher than those determined by SSSB (6.0±2.7, 26.7%; p<0.01, p<0.01, respectively). CONCLUSION: The results of our study revealed that DME is a more sensitive method for detecting Demodex than SSSB, especially in patients with diffuse pattern and suspected rosacea type. Further research is needed to confirm this finding.
Subject(s)
Humans , Acne Vulgaris , Biopsy , Medical Records , Methods , Mites , Retrospective Studies , Rosacea , Skin Diseases, Parasitic , SkinABSTRACT
Sorafenib is an oral, multi-targeted tyrosine kinase inhibitor with anti-angiogenic and anti-proliferative activity. It is approved for the treatment of unresectable hepatocellular and advanced renal carcinomas. Cutaneous toxicity is relatively common in patients receiving sorafenib. The most frequent cutaneous side effect is the hand-foot syndrome. Other adverse skin reactions include facial erythema, acral erythema, erythema multiforme, subungual splinter hemorrhage, stomatitis, and alopecia. In Korea, two cases of scrotal and perianal dermatitis after sorafenib therapy were reported. We report a 54-year-old male patient with a 2-week history of scrotal eczema who had been treated for chronic hepatitis type B, liver cirrhosis, and hepatocellular carcinoma. After 2 weeks of oral sorafenib (800 mg/day) administration, thick, scaly patches appeared on his scrotum. A skin biopsy specimen from these lesions revealed superficial dermal perivascular lymphocytic and neutrophilic infiltration, and dilatation of the lymphatics in the superficial dermis. The lesions improved after treatment with a topical and systemic steroid for 2 weeks. Herein, we report a rare case of scrotal erythema associated with sorafenib.
Subject(s)
Humans , Male , Middle Aged , Alopecia , Biopsy , Carcinoma, Hepatocellular , Dermatitis , Dermis , Dilatation , Eczema , Erythema Multiforme , Erythema , Hand-Foot Syndrome , Hemorrhage , Hepatitis, Chronic , Korea , Liver Cirrhosis , Neutrophils , Protein-Tyrosine Kinases , Scrotum , Skin , StomatitisABSTRACT
Woringer-Kolopp disease, also known as localized pagetoid reticulosis, is a rare variant of mycosis fungoides that presents as a solitary localized hyperkeratotic patch or plaque on the extremities and follows a benign course. Effective treatments for Woringer-Kolopp disease include skin-directed therapies such as topical nitrogen mustard, high-potency topical steroids, and phototherapy. Surgical excision has been pursued in cases of small, localized lesions. A 39-year-old man presented with a 3-month history of an asymptomatic plaque on his hand. Physical examination showed a 10-mm-diameter solitary round erythematous hyperkeratotic plaque with a slightly raised edge on the dorsum of his left hand. A skin biopsy revealed that numerous atypical lymphocytes had infiltrated the upper dermis and expanded into the epidermis with a pagetoid pattern. These atypical pagetoid cells were strongly positive for CD3, CD8, and T-cell intracellular antigen-1; focally positive for CD4; and negative for CD20, CD30, and CD56. A subsequent general examination revealed no evidence of systemic involvement and the lesion was treated with surgical excision. Here we report a rare case of Woringer-Kolopp disease.
Subject(s)
Adult , Humans , Biopsy , Dermis , Epidermis , Extremities , Hand , Lymphocytes , Mechlorethamine , Mycosis Fungoides , Pagetoid Reticulosis , Phototherapy , Physical Examination , Skin , Steroids , T-LymphocytesABSTRACT
BACKGROUND: Excessive exposure to reactive oxygen species (ROS) or decreased antioxidants leads to damage of proteins, lipids, and DNA. Previous studies suggest that oxidative stress may be important in the pathogenesis of atopic dermatitis. OBJECTIVE: To investigate whether oxidative stress is increased in atopic dermatitis patients compared to a normal control group, we examined DNA damage, lipid peroxidation, ROS production and antioxidant expression. METHODS: Patients with atopic dermatitis (n=16; mean Scoring Atopic Dermatitis [SCORAD] index=53.06) were investigated compared to a normal control group (n=25). To examine DNA damage in the cellular level, we performed comet assays on lymphocytes and granulocytes taken from patients and control group. To measure lipid peroxidation products, urine and plasma malondialdehyde (MDA) levels were analyzed. To examine intracellular redox in lymphocytes, ROS were measured using flow cytometry. Expression of superoxide dismutase (SOD) 1, 2 antioxidants were analyzed using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Atopic dermatitis patients showed severe DNA damage compared to the control group in both lymphocytes (1.89 and 1.51, respectively, p0.05), plasma MDA levels were significantly increased in atopic dermatitis patients compared to controls (1.45 and 0.80 microM/g respectively, p<0.005). ROS production by activated lymphocytes was increased in atopic dermatitis patients compared to controls. SOD 1, 2 were expressed in all atopic dermatitis patients without significant increase compared to controls. CONCLUSION: Increased DNA damage, lipid peroxidation and ROS production in lymphocytes as indices of oxidative stress were observed in moderate to severe atopic dermatitis patients compared to normal control. Although precise mechanism of oxidative stress on the pathogenesis of atopic dermatitis is not defined yet, decreasing ROS exposure or augmenting antioxidant defenses may be alternative therapeutic approaches for atopic dermatitis.
Subject(s)
Humans , Antioxidants , Comet Assay , Dermatitis, Atopic , DNA , DNA Damage , Flow Cytometry , Granulocytes , Lipid Peroxidation , Lymphocytes , Malondialdehyde , Oxidation-Reduction , Oxidative Stress , Plasma , Polymerase Chain Reaction , Reactive Oxygen Species , Reverse Transcription , Superoxide DismutaseABSTRACT
Even though atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, its treatment remains a challenge in clinical practice, with most approaches limited to symptomatic, unspecific anti-inflammatory, or immunosuppressive treatments. Many studies have shown AD to have multiple causes that activate complex immunological and inflammatory pathways. However, aeroallergens, and especially the house dust mite (HDM), play a relevant role in the elicitation or exacerbation of eczematous lesions in many AD patients. Accordingly, allergen-specific immunotherapy has been used in AD patients with the aim of redirecting inappropriate immune responses. Here, we report three cases of refractory AD sensitized to HDM who were treated with sublingual immunotherapy.
Subject(s)
Humans , Dermatitis, Atopic , Desensitization, Immunologic , Immunotherapy , Pyroglyphidae , Skin Diseases , Sublingual ImmunotherapyABSTRACT
Perineurioma is a rare benign peripheral nerve sheath tumor, composed uniformly of perineurial cells. Soft tissue perineurioma primarily arises within the subcutaneous tissue of extremities and trunk as a painless solitary nodule, and should be distinguished from dermatofibroma, neurofibroma, dermatofibrosarcoma protuberans, meningioma and so on. A 25 year-old female is presented with three small asymptomatic papules on the third left finger which were found 3 years ago. Punch biopsy was performed on all of the papules. Microscopic examination demonstrated well-demarcated tumor within dermis, and proliferation of spindle cells with wavy nuclei and elongated bipolar cytoplasmic process, arranged in a whorled pattern. According to immunohistochemical analysis, the tumor cell showed positivity for epithelial membrane antigen, but negativity for S-100 protein, factor XIIIa, CD34, and smooth muscle actin. The diagnosis of soft tissue perineurioma was being made. We report this rare case of perineurioma presented as multiple papules localized within dermis of the digit.
Subject(s)
Female , Humans , Actins , Biopsy , Cytoplasm , Dermatofibrosarcoma , Dermis , Extremities , Factor XIIIa , Fingers , Histiocytoma, Benign Fibrous , Immunohistochemistry , Meningioma , Mucin-1 , Muscle, Smooth , Nerve Sheath Neoplasms , Neurofibroma , Peripheral Nerves , S100 Proteins , Subcutaneous TissueABSTRACT
BACKGROUND: Melasma is an acquired, symmetrical hypermelanosis that occurs on sun-exposed areas of the skin. It has significant emotional and psychological effects on those affected with the condition. Melasma Quality of Life Scale (MELASQOL) is a specific questionnaire to identify the most impaired areas of melasma patient's life. OBJECTIVE: Our purpose of this study is to investigate the changing of MELASQOL after the treatment of melasma. METHODS: A total of 27 volunteers with melasma were enrolled in this 8-week treatment study. The patients were instructed to apply an arbutin-containing cream, once a day for 8 weeks. The assessment of outcomes included the colorimetric value (L*) and MELASQOL score. RESULTS: The arbutin-containing cream group increased more in the colorimetric values (L*) after the 8-week treatment (p<0.01). The MELASQOL score was decreased (p=0.02). No significant adverse reactions were observed. CONCLUSION: The treatment of melasma improves the QOL of melasma patients.