Asunto(s)
Cuero Cabelludo/patología , Neoplasias de las Glándulas Sudoríparas/congénito , Neoplasias de las Glándulas Sudoríparas/patología , Adenomas Tubulares de las Glándulas Sudoríparas/congénito , Adenomas Tubulares de las Glándulas Sudoríparas/patología , Humanos , Recién Nacido , Masculino , Cuero Cabelludo/cirugíaAsunto(s)
Dermatitis Atópica/genética , Ictiosis Ampollosa de Siemens/genética , Proteínas de Filamentos Intermediarios/genética , Queratina-2/genética , Adolescente , Adulto , Dermatitis Atópica/complicaciones , Proteínas Filagrina , Humanos , Ictiosis Ampollosa de Siemens/complicaciones , Inmunoglobulina E/sangre , Lactante , Recién Nacido , MasculinoAsunto(s)
Terapia por Acupuntura/efectos adversos , Argiria/etiología , Migración de Cuerpo Extraño/diagnóstico por imagen , Ventrículos Cardíacos , Agujas/efectos adversos , Terapia por Acupuntura/instrumentación , Terapia por Acupuntura/métodos , Anciano , Resultado Fatal , Femenino , Migración de Cuerpo Extraño/complicaciones , Humanos , Espectrometría por Rayos X/métodosAsunto(s)
Tuberculosis Cutánea/diagnóstico , Tuberculosis Miliar/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico por imagen , Anciano de 80 o más Años , Femenino , Articulación de la Cadera/diagnóstico por imagen , Humanos , Nariz , Tomografía Computarizada por Rayos X , Tuberculosis Cutánea/microbiología , Tuberculosis Miliar/microbiología , Tuberculosis Osteoarticular/diagnóstico por imagen , Tuberculosis Pulmonar/microbiologíaRESUMEN
Hereditary lactate dehydrogenase (LDH) M-subunit deficiency is very rare and we have found reports of close to a dozen cases in the published work, two of which were associated with pustular psoriasis-like lesions. We report a third case of pustular psoriasis-like eruptions associated with LDH M-subunit deficiency, which occurred 24 years after the diagnosis of LDH M-subunit deficiency. These cases indicate that abnormal activity of LDH can induce pustular psoriatic lesions in the long term. Some patients with symptoms of hereditary LDH M-subunit deficiency have antecedent annular scaly plaque lesions, that resemble psoriatic lesions. We discuss a hypothesis to explain this scenario.
Asunto(s)
L-Lactato Deshidrogenasa/deficiencia , L-Lactato Deshidrogenasa/genética , Psoriasis/genética , Enfermedades Raras/genética , Eliminación de Secuencia , Adulto , Secuencia de Aminoácidos/genética , Biopsia , Exones/genética , Femenino , Glucocorticoides/uso terapéutico , Humanos , Inmunohistoquímica , Isoenzimas/deficiencia , Isoenzimas/genética , Lactato Deshidrogenasa 5 , Prednisolona/uso terapéutico , Psoriasis/tratamiento farmacológico , ARN Mensajero/genética , Análisis de Secuencia de ADN , Análisis de Secuencia de ARN , Piel/patología , Factores de Tiempo , Valina/genéticaAsunto(s)
Carcinoma Mucoepidermoide/genética , Proteínas de Unión al ADN/genética , Neoplasias Faciales/genética , Proteínas Nucleares/genética , Neoplasias de la Parótida/genética , Factores de Transcripción/genética , Anciano , Carcinoma Mucoepidermoide/metabolismo , Neoplasias Faciales/metabolismo , Femenino , Fusión Génica , Factor Estimulante de Colonias de Granulocitos/metabolismo , Humanos , Neoplasias de la Parótida/metabolismo , Pronóstico , TransactivadoresRESUMEN
Pemetrexed, which is used for the treatment of non-small cell lung carcinoma and malignant mesothelioma, induces cutaneous adverse reactions in approximately 20% of patients. There are also reports of the induction of fibrosing disorders. We describe a case of pemetrexed-induced scleroderma-like conditions in the lower legs of a patient whose pulmonary carcinoma has been relatively well controlled, with prolongation of the dose interval, in spite of the discomfort in both his legs. Skin biopsy revealed dermal fibrosis and dilated lymph vessels in the dermis, but lymphocytic infiltration around the lymph vessels, in contrast to the blood vessels, was minimal. Immunohistochemical staining revealed that the major subsets of T cells that had infiltrated around blood vessels were CD3 and CD45Ro, but no B cells were detected. High serum levels of interleukin (IL)-4 and IL-6 suggested that T cells, which secrete these cytokines, may be involved in the pathogenesis of this condition. Magnetic resonance imaging of the lower extremities revealed muscular and fascial involvement. Several chemotherapeutic agents, such as taxanes, gemcitabine and bleomycin, are known to induce scleroderma-like changes, and we should also keep the side-effects of pemetrexed in mind when we encounter patients with fibrosing conditions.
Asunto(s)
Antineoplásicos/efectos adversos , Neoplasias Encefálicas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/terapia , Neoplasias Pulmonares/terapia , Pemetrexed/efectos adversos , Esclerodermia Localizada/inducido químicamente , Antineoplásicos/administración & dosificación , Antineoplásicos/uso terapéutico , Biopsia , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/secundario , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Quimioradioterapia , Cisplatino/uso terapéutico , Quimioterapia de Consolidación , Dermis/patología , Fibrosis , Humanos , Quimioterapia de Inducción , Interleucina-4/metabolismo , Interleucina-6/metabolismo , Pierna , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Metástasis Linfática , Masculino , Persona de Mediana Edad , Pemetrexed/administración & dosificación , Pemetrexed/uso terapéutico , Tomografía de Emisión de Positrones , Fármacos Sensibilizantes a Radiaciones/uso terapéutico , Esclerodermia Localizada/sangre , Esclerodermia Localizada/diagnóstico , Linfocitos T/metabolismo , Tomografía Computarizada por Rayos X , Vinblastina/análogos & derivados , Vinblastina/uso terapéutico , VinorelbinaRESUMEN
Pigmented cosmetic dermatitis-like (Riehl's melanosis-like) pigmentation was reported in three of 27 patients with primary Sjögren's syndrome. But case reports of such eruptions are rare. We describe three cases of such eruptions associated with primary Sjögren's syndrome or anti-SSA antibody and possible associations with specific types of human leukocyte antigen (HLA) and infiltrating lymphocytes. These middle-aged Japanese women had reticular facial pigmentation and histopathological examination revealed interface dermatitis, melanophages, and dense lymphocytic infiltration around hair follicles and sweat ducts. HLA typing revealed common antigenic equivalents or genetic typing of HLA-A2, DR52, DPA1(02:02) and DPB1(05:01). Immunohistochemical staining revealed major subsets of T cells to be CD8 and CD45RO. Some Foxp3- and few IL17-positive cells were found in strong contrast to the major CD4 subset of infiltrated T cells in annular erythema associated with Sjögren's syndrome. Apparently, our patients' pigmentation represented a specific etiology associated with primary Sjögren's syndrome or anti-SSA antibody.
Asunto(s)
Anticuerpos Antinucleares/sangre , Dermatitis/inmunología , Dermatitis/patología , Síndrome de Sjögren/patología , Anciano , Dermatitis/etiología , Femenino , Prueba de Histocompatibilidad , Humanos , Persona de Mediana Edad , Trastornos de la Pigmentación/etiología , Trastornos de la Pigmentación/inmunología , Trastornos de la Pigmentación/patología , Síndrome de Sjögren/complicaciones , Síndrome de Sjögren/inmunologíaAsunto(s)
Linfoma de Células B Grandes Difuso/complicaciones , Síndromes Paraneoplásicos/complicaciones , Pénfigo/complicaciones , Anciano , Autoanticuerpos/metabolismo , Vesícula/complicaciones , Vesícula/patología , Femenino , Humanos , Linfoma de Células B Grandes Difuso/patología , Síndromes Paraneoplásicos/inmunología , Síndromes Paraneoplásicos/patología , Pénfigo/inmunología , Pénfigo/patologíaRESUMEN
Aim: There has been no indicator that allows an early quantitative evaluation of the severity of a mamushi snake (Gloydius blomhoffii) bite. Because the number of severe mamushi bite cases is much fewer than non-severe cases, a formal case-control study is difficult. Therefore, we tried to generate a preliminary quantitative, real-time index for its severity by referring to published reports of severe mamushi bite cases. Methods: We enrolled patients who presented with a mamushi bite and visited our outpatient clinic. Severe cases were collected from published works. Creatinine kinase levels and white blood cell counts of non-severe and severe cases were compared and analyzed. Results: There was a lag time of 10 h before the creatinine kinase level began to rise. The speed of the increase was higher in severe cases than in non-severe cases, and severe cases were recognized as those showing speeds of above 250 IU/L/h. White blood cell counts increased earlier than creatinine kinase levels without any lag time. Severe cases were recognized as those with the counts of over 1,000 × (h) + 6,000 [/µL] before 5 h and 300 × (h) + 10,000 [/µL] after 5 h. Conclusion: We herein present the creatinine kinase level and white blood cell count trends and demonstrate preliminary cut-off equations. The trends for both parameters serve as quantitative indicators of the severity of a mamushi bite until a large scale case-control study is achieved.
Asunto(s)
Adenocarcinoma/cirugía , Liquen Plano/patología , Síndromes Paraneoplásicos/diagnóstico , Penfigoide Ampolloso/patología , Neoplasias del Recto/cirugía , Adenocarcinoma/complicaciones , Adenocarcinoma/patología , Anciano de 80 o más Años , Biopsia con Aguja , Colectomía/métodos , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Liquen Plano/complicaciones , Liquen Plano/tratamiento farmacológico , Síndromes Paraneoplásicos/terapia , Penfigoide Ampolloso/complicaciones , Penfigoide Ampolloso/tratamiento farmacológico , Neoplasias del Recto/complicaciones , Neoplasias del Recto/patología , Medición de Riesgo , Resultado del TratamientoRESUMEN
We performed skin cancer screenings for 2 or 3 days annually from 2006 through 2013 in Oita Prefecture, Japan. Screening of approximately 3000 people in total allowed us to identify and treat several skin cancers, including five cases of malignant melanoma, four of squamous cell carcinoma, 16 of basal cell carcinoma, 11 of Bowen's disease, 17 of actinic keratosis, one of extramammary Paget's disease and one of metastatic breast carcinoma. The sensitivity and specificity for the category defined by an identified lesion associated with risk of cancer and requiring further examination (category C) were 92.7% and 95%, respectively. We cannot estimate the outcome of our skin cancer screenings in terms of cancer mortality because of the small number of subjects examined and the brief follow-up period. However, we did estimate the effectiveness of these screenings in terms of stages or sizes of cancerous lesions. The relative numbers of subjects with malignant melanoma at various clinical stages, identified during skin cancer screenings and during a routine visit to our hospital, were significantly different. We also compared, statistically, the sizes of lesions in Bowen's disease that were found during cancer screenings and during a direct visit to our hospital. The former lesions were smaller than the latter. Our data suggest the benefits of our skin cancer screenings and the importance of campaigns and education to encourage people to visit dermatologists for the detection of skin cancers at an early stage.