Solitary nodule of angiolymphoid hyperplasia with eosinophilia of the back masquerading as pyogenic granuloma.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare chronic inflammatory disorder of unknown etiology that most commonly presents as painless lymphadenopathy or subcutaneous masses in the head and neck region. The pathogenesis of the disease is not yet clear. The differential diagnosis is determined using characteristic histological features, such as significant vascular proliferation, lymphocytes and eosinophil inflammation in the dermis. Here is presented the case of a patient with a solitary nodule of ALHE masquerading as pyogenic granuloma (PG). A 47 year-old male patient was admitted with an isolated lump on the right side of the back, which had been present for ~6 months; the nodule appeared to have characteristics of PG and was ~1.8×1.0 cm2 in diameter. To the best of our knowledge, this is the first case report regarding ALHE arising in the back. The present report discusses the manifestation, histopathological features and treatment of the case.

Factors Associated with Development of Vitiligo in Patients with Halo Nevus.

BACKGROUND: Halo nevus (HN) has been shown to be associated with vitiligo, but no standard signs are currently available to identify HN patients at risk of vitiligo, and the relevant data obtained in previous studies are somewhat conflicting. This study aimed to identify factors affecting the presence of vitiligo in HN patients. METHODS: We performed a retrospective study on consecutive patients with HN at the First Affiliated Hospital of Sun Yat-sen University between January 2011 and December 2016. Detailed demographic and clinical data were collected to identify the factors associated with the presence of vitiligo in this cohort of patients using uni- and multi-variate logistic regression analyses. RESULTS: A total of 212 HN patients were included, 101 of whom had vitiligo-associated HN (HNV). Univariate analysis indicated that a personal history of thyroid diseases was positively associated with HNV (odds ratio [OR] = 10.761, P = 0.025), while the onset age of HN was negatively associated with HNV (OR = 0.537, P = 0.026). Multivariate analysis demonstrated that the Koebner phenomenon (KP; OR = 10.632, P < 0.0001), multiple HN (OR = 3.918, P < 0.0001), and a familial history of vitiligo (OR = 3.222, P = 0.014) were independent factors associated with HNV. CONCLUSIONS: HN without vitiligo has clinical features distinct from HN associated with vitiligo. HN patients with KP, multiple lesions, or familial history of vitiligo are more likely to develop vitiligo and therefore should be monitored for clinical signs of such accompanied conditions.

Lupus Panniculitis as an Initial Manifestation of Systemic Lupus Erythematosus: A Case Report.

Lupus erythematosus panniculitis (LEP) is a variant of chronic cutaneous lupus erythematosus (CCLE). Reported cases of LEP lesions before the diagnosis of systemic lupus erythematosus (SLE) were very rare; only 9 cases have been reported, to the best of our knowledge. We now describe the case of a 19-year-old male patient, with an overall review of the English literature. In the earliest stage of the present case, nodules and ulcers involved his left leg and face, with no other accompanied symptoms. The skin lesions disappeared after treatment with methylprednisolone, 16 mg/d for 1 month. Seven months after discontinuing methylprednisolone, the cutaneous nodules and ulcers on his back recurred and were accompanied by fever, hair loss, and polyarthritis. Blood tests revealed leucopenia, positive antinuclear antibody and Smith antibody, and proteinuria. Histopathological findings were most consistent with LEP. This was followed sequentially by the diagnosis of SLE. The patient improved again after treatment with methylprednisolone and cyclophosphamide.Patients with LEP should have regular follow-ups because the development of SLE is possible. Early diagnosis and proper treatment is pivotal to improve the prognosis of such patients.

The Expression Status and Prognostic Value of Cancer Stem Cell Biomarker CD133 in Cutaneous Squamous Cell Carcinoma.

IMPORTANCE: The CD133 protein has been considered a key biomarker of cancer stem cells in various cancers. However, the expression status and prognostic significance of CD133 in cutaneous squamous cell carcinoma (cSCC) are poorly understood. OBJECTIVE: To investigate the expression of cancer stem cell biomarker CD133 in cSCC tissue and its effect on clinicopathological features and outcomes in patients with cSCC. DESIGN, SETTING, AND PARTICIPANTS: Immunohistochemistry was performed on a tissue microarray to investigate the expression levels of CD133 in cSCC tissue. Receiver operating characteristic curve analysis, Kaplan-Meier plots, and a Cox proportional hazards regression model were applied to analyze the data. Samples were obtained from the archives of the First Affiliated Hospital, Sun Yat-Sen University Cancer Center, and Guangzhou Institute of Dermatology and Venerology. In total, 165 paraffin-embedded clinicopathological samples from 165 patients were obtained from the archives of hospitals between June 1, 1996, and December 31, 2010. Follow-up data were available for these cases. MAIN OUTCOMES AND MEASURES: The CD133 expression in cSCC tissue, correlation of CD133 expression with clinicopathological features of cSCC, and association of CD133 expression with prognosis in patients with cSCC. RESULTS: Based on the receiver operating characteristic curves, the cutoff value for high CD133 expression was defined as greater than 65% of tumor cells positively stained. High CD133 expression was observed in 50.9% (84 of 165) of the cSCC samples and in 16.7% (5 of 30) of adjacent nonmalignant epithelial tissue samples (P = .001). High CD133 expression was positively correlated with poorly differentiated cSCC (48.0% [73 of 84] for well to moderately differentiated vs 84.6% [11 of 84] for poorly differentiated, P = .01) and with advanced tumor stage (45.5% [55 of 84] for stage I-II vs 65.9% [29 of 84] for stage III, P = .02). In univariable survival analysis, high CD133 expression was correlated with poor prognosis (mean survival, 63.4 vs 95.7 months; P < .001). In multivariable analysis, CD133 expression was an independent prognostic factor for cSCC (hazard ratio, 1.9152; 95% CI, 1.1950-3.3495; P = .02). CONCLUSIONS AND RELEVANCE: High CD133 expression is associated with poorly differentiated and advanced-stage cSCC. High CD133 expression was also correlated with poor prognosis in patients with cSCC. It may serve as a useful biomarker to predict prognosis in patients with cSCC.

A case report of atypical scrotal leiomyoma.

Scrotal leiomyoma is a benign tumor derived from the scrotal dartos muscle; it is rare in clinical findings. The cause of the disease is not yet clear. Here, we present the case of a patient with no typical clinical features, but with some typical pathological changes. A middle-aged male patient saw a doctor for paroxysmal itching and burning of the scrotum. The physical examination revealed 3 × 5-cm(2), ill-defined, pink plaques, an uneven surface, and basal infiltration with pigmentation defects in the center. Pathology results showed dermal spindle cells in nodular hyperplasia. The nucleus was round at both ends, a perinuclear halo could be seen, and staining was positive for actin and negative for S100. Therefore, the diagnosis of scrotal myoma was made.

Polycystic ovary syndrome in patients with epilepsy: a study in 102 Chinese women.

PURPOSE: The incidence of polycystic ovary syndrome (PCOS) increases in women with epilepsy (WWE), which appears to vary with ethnicity. This study was conducted to determine the incidence and risk factors of PCOS in Chinese WWE. METHODS: The study was carried out in 102 of 139 Chinese WWE at reproductive ages, with 32 receiving valproic acid (VPA), 40 receiving other antiepileptic drugs (AEDs), and 30 without AEDs therapy. PCOS was defined as having 2 or more of the following components: polycystic ovaries, hyperandrogenism, and amenorrhoea or oligomenorrhoea (a/oligomenorrhoea). RESULTS: One or more isolated components of PCOS were found in 56 (54.9%) patients, with 29 (28.4%) having polycystic ovaries, 20 (19.6%) with a/oligomenorrhea, 7 (6.9%) with hyperandrogenism, and 13 (12.7%) with defined PCOS. Their average age at the start of seizure was 13.8±6.5 years, younger than that of patients without these disorders (16.9±8.6 years, p<0.05). VPA therapy increased the incidence of PCOS (11/32, 34.4%), in addition to increased blood levels of testosterone and luteinizing hormone (LH) as well as LH to FSH (follicle-stimulating hormone) ratio. No significant relationship was found between the incidence of PCOS and the type, duration, or frequency of seizures in these WWE. CONCLUSION: There is an increased incidence of PCOS in Chinese WWE at reproductive ages, by more than 2 times of that in the general population. Risk factors include seizures starting at a young age and VPA therapy.

5-aminolevulinic acid-mediated photodynamic therapy on cervical condylomata acuminata.

OBJECTIVE: The aim of this study was to evaluate the efficacy of 5-aminolevulinic acid-mediated photodynamic therapy (PDT) on cervical condylomata accuminate (CA) and to determine the ultrastructural changes of the lesion after treatment. BACKGROUND DATA: Although there are many methods to treat cervical CA, a high recurrence rate and cervical scars are troublesome problems. MATERIALS AND METHODS: Forty-eight patients with cervical CA were treated with topical 20% ALA gel followed by PDT through a cylindrical fiber with a wavelength of 630 nm of laser light. The treatment was repeated 7 days later if the lesion had not been removed completely. Eight cases were biopsied before and after treatment, and the biopsied lesions were evaluated by electron microscopy. RESULTS: After the first PDT treatment, the cervical condylomatous lesions were removed completely in 62.5% (30/48). The complete response (CR) rate was 95.8% (46/48) after three treatments. The recurrence rate was 4.4% at the 12-month follow-up. Electron microscopy revealed that ALA-PDT damaged proliferative keratinocytes of CA lesions while the surrounding normal tissue injury was less damaged. CONCLUSIONS: ALA-PDT is an effective and minimally invasive treatment for cervical CA.

[Effects of Salvia miltiorrhiza on Chlamydia trachomatis mice of salpingitis].

OBJECTIVE: To study the effects of Salvia miltiorrhiza on treatment of Chlamydia trachomatis salpingitis (CTS) and fibrosis. METHOD: A mouse model for CTS was estahlished in C3H/He by intravaginal inoculation. after 3 weeks mice were randomly divided into 3 groups. Only Azithromyxin was given orally, Azithromyxin and early S. miltiorrhiza given, or Azithromyxin and later S. miltiorrhiza given. After 10 weeks, observe the change of oviduct of mice, observe the histopathologic change and analysis collagen histochemical index. RESULT: 3 Treatment groups induce tubal occlusion and hydrosalpinx decreased and the collagen histochemical index decreased significantly than those of no treatment given (P < 0.05). Early S. miltiorrhiza given group induce tubal occlusion and hydrosalpinx decreased and the collagen histochemical index decreased significantly than only Azithromyxin group or later S. miltiorrhiza given group (P <0.05). CONCLUSION: When we treat CTS genital infection with Azithromyxin, if we can give S. miltiorrhiza treatment as early as possible, it may decrease tubal occlusion and hydrosalpinx. significantly inhibit fibrosis maybe one of its pharmacologic mechanismin.