RESUMEN
The patient was a 12-year-old girl with linear scleroderma distributed on the right abdomen, dorsal aspect of the right thigh, lower leg and foot. The initial regimen of oral prednisolone and methotrexate, or i.v. methylprednisolone failed in the treatment of the scleroderma. Then bath psoralen and ultraviolet A therapy (bath-PUVA) therapy of 0.2 J-4.0 J/cm(2) daily to total doses 62.8 J/cm(2) combined with oral prednisolone was started. After bath-PUVA therapy, regression of the skin sclerosis was observed, the possible mobile range of the right ankle was increased and histological examination confirmed improvement of the sclerosis. The successful results of bath-PUVA therapy in this case suggest its utility for localized scleroderma.
Asunto(s)
Ficusina/administración & dosificación , Terapia PUVA , Esclerodermia Localizada/tratamiento farmacológico , Administración Cutánea , Articulación del Tobillo/efectos de los fármacos , Articulación del Tobillo/fisiología , Articulación del Tobillo/fisiopatología , Baños , Niño , Terapia Combinada , Femenino , Fibrosis , Humanos , Metotrexato/administración & dosificación , Metotrexato/uso terapéutico , Metilprednisolona/administración & dosificación , Metilprednisolona/uso terapéutico , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Esclerodermia Localizada/diagnóstico , Esclerodermia Localizada/patología , Resultado del TratamientoRESUMEN
Three cases of athlete's nodule on the feet are reported. In case 1, a 30-year-old man, who had been an amateur football player, presented with nodules on the lateral side of the feet and on the right lateral malleolus with a duration of 1 year. In case 2, a 22-year-old man, who had participated in karate and track-and-field, presented with nodules on the lateral side of the feet and on the right lateral malleolus with a duration of 10 years. In case 3, a 25-year-old man, who had skied, presented with a nodule on the right lateral malleolus with a duration of 4 years. The biopsy specimens from the lesion demonstrated hyperkeratosis, acanthosis of the epidermis and thickness of the dermis. In 1991, Cohen et al. proposed the concept of athlete's nodule which indicated an acquired cutaneous nodule caused by chronic stimuli with sports. Histopathology of the athlete's nodule shows hypertrophy of the epidermis and dermis. To the best of our knowledge the term "athlete's nodule" has not been used in Japan, but it is a useful term to refer to the lesion induced by athletics or the use of sporting equipment.