Adenodermatofibroma possessing dilated glandular structures with eccrine features: A case study.

Adenodermatofibroma is a newly recognized variant of dermatofibroma characterized by dense proliferation of fibroblasts and histiocytes admixed with dilated glandular structures showing apocrine secretion. Only five cases of adenodermatofibroma have been reported to date. We report an additional case of adenodermatofibroma on the back of a 67-year-old female. In addition to the dilated glandular structures, nondilated eccrine units were present at the upper periphery of the lesion, above which the normal eccrine glands reside. Although decapitation secretion was observed in the nondilated eccrine units at the upper periphery of the lesion, this was not observed in the dilated glandular structures. The inner cells of the dilated glandular structures were S-100 positive, similar to those of the secretory portion of eccrine glands. We considered the glandular structures in our patient were derived from the entrapped eccrine units. We suggest that the term "apocrine metaplasia" be applied to eccrine units showing decapitation secretion.

Real-world data on the efficacy and safety of apremilast in Japanese patients with plaque psoriasis.

Background: Real-world data differ from clinical trial data. Although some real-world data regarding apremilast use for psoriasis treatment has been reported in Western countries, no such data has been reported in Asian countries. Objective: To study the efficacy, including Psoriasis Area and Severity Index (PASI) and drug survival, and safety of apremilast in Japanese patients with psoriasis. Methods: Data on all the patients treated with apremilast in Kurume University Hospital between May 2017 and June 2018 were retrieved, with June 30 2018, as the data lock date. Efficacy was analyzed by PASI50, PASI75, and PASI90; drug survival by Kaplan-Meier analysis; and drug safety by the proportion of adverse events (AEs). Results: Fourteen of 42 (33.3%) patients achieved PASI75/90; 16 (32%) patients had discontinued apremilast by the data lock date. Drug survival at week 28 was 70%. No serious AEs were reported; the most prevalent one was loose stools/diarrhea (60%), followed by nausea (38%). The most common reason for apremilast discontinuation was primary/secondary failure. Conclusions: Apremilast is safe and effective in Japanese patients with psoriasis. Higher occurrence of loose stools/diarrhea was noted in our cohort than that reported in Western real-world studies on apremilast.