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Background@#Alopecia areata is an autoimmune disease that presents as non-scarring hair loss and can affect all age groups. The clinical course of alopecia areata is unpredictable. @*Objective@#This study aimed to analyze the characteristics, treatment response, and relapse rate of alopecia areata in patients of different ages with long-term follow-up. @*Methods@#The medical records of 121 patients diagnosed with alopecia areata were retrospectively reviewed, and their prognosis was assessed on the basis of various indices. @*Results@#A total of 121 patients, including 24 cases of childhood-onset, 83 adult-onset, and 14 late-onset alopecia areata, were analyzed. In the first episode, 72.7%, 14.7%, and 9.9% of patients had mild, moderate, and severe alopecia areata, respectively. A significant and complete response was observed in 66.7%, 89.2%, and 100% of childhood-onset, adult-onset, and late-onset patients, respectively. The duration of the initial episode showed a negative correlation with age. The overall frequency of relapse was 47.1%, whichc significantly declined with time, with a majority (63.3%) of relapses occurring in the first year. Younger age at initial presentation and thyroid diseases were strongly associated with poor prognosis. @*Conclusion@#Younger patients showed a tendency of poor prognosis regardless of the prognostic factors. A longer follow-up period might be required for the younger onset patients.
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Metastatic skin cancers are a relatively uncommon malignant tumor. Visceral tumors such as breast, lung, and colon cancers are commonly found to be the primary origin. Cutaneous metastasis with esophageal cancer is exceedingly rare, accounting for less than one percent of all skin metastasis. Here, we report a case of cutaneous metastatic squamous cell carcinoma that originated from esophageal carcinoma. The patient was a 48-year-old male who complained of a 2-cm-sized non-tender, skin-colored nodule on his left lower back. Positron emission tomography-computed tomography (PET-CT) showed focal fluorodeoxyglucose (FDG) uptake in the lesion. In the histopathological examination, the tumor cells stained positive for epithelial membrane antigen (EMA) and cytokeratin 5/6 (CK5/6), which was consistent with squamous cell carcinoma. This case suggests that patients who have been treated for primary esophageal carcinoma should undergo a skin biopsy to rule out metastatic skin cancer if the tumor appears to be suspicious.
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Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.
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Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.
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Localized cutaneous argyria is a rare condition in which the skin changes into blue-grey spots due to the absorption of silver. The lesions need to be differentiated from other pigmentary disorders and require radiographic and histological examination for more accurate diagnosis. Scanning electron microscopy and energy dispersive x-ray spectroscopy can be a confirmatory tool in the evaluation of silver elements in biopsy tissue. This report shows the localized cutaneous argyria in earlobe of a 21-year-old woman who wears silver earrings for 10 years.
Assuntos
Feminino , Humanos , Adulto Jovem , Absorção , Argiria , Biópsia , Diagnóstico , Orelha , Microscopia Eletrônica de Varredura , Nevo Azul , Prata , Pele , Espectrometria por Raios XRESUMO
An atypical teratoid/rhabdoid tumor (AT/RT) is a rare malignancy occurring in the first few years of life. This tumor shows rapid growth, a poor response to treatment, and poor prognosis. Cutaneous metastases presents as hamartomatous lesions mimicking skin tags. Immunohistochemical examination shows varied patterns of expression based on the sites of the body affected. Integrase interactor-1 (INI-1) gene sequencing and loss of expression of INI-1 observed with immunostaining can confirm AT/RT. In our patient, the skin lesion was identified at birth. Histopathological examination of the skin lesion could not establish an accurate diagnosis. Two months later, the patient presented with a brain tumor. Immunohistochemical examination of the brain lesion revealed complete loss of INI-1 expression in tumor cells, and the lesion was diagnosed as AT/RT. After that, we can detect the loss of INI-1 expression in the skin on the back. We report a rare case of AT/RT affecting the brain with cutaneous metastasis diagnosed with immunohistochemical staining.
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Humanos , Encéfalo , Neoplasias Encefálicas , Diagnóstico , Integrases , Metástase Neoplásica , Parto , Prognóstico , PeleRESUMO
Gouty ulcer can be caused by the accumulation of clumps of uric acid in body tissues that lead to acute or chronic inflammation at sites of accumulation. Furthermore, tophi-inhibiting granulation tissue may form a canal that channels microbial infection from the underlying involved joint space, and thus, presents the risk of osteomyelitis development. Accordingly, gouty ulcer must be treated appropriately. In this case, refractory wounds on gouty ulcers at the left shin and left radial ankle were treated by surgical debridement. Negative-pressure wound therapy was used successfully to prevent post-operative delayed wound healing.