Modulation of Melanogenesis by Heme Oxygenase-1 via p53 in Normal Human Melanocytes / 전남의대학술지

As a key regulator of melanogenesis, p53 controls microphthalmia-associated transcription factor (MITF) and tyrosinase expression. The anti-oxidant enzyme heme oxygenase-1 (HO-1) is induced by various forms of cellular stress and diverse oxidative stimuli. However, few studies have examined the role of HO-1 in melanogenesis. Therefore, the aim of this study was to determine the role of HO-1 in melanogenesis and the mechanism underlying this relationship. Cultures of normal human melanocytes were treated with the HO-1 inducer cobalt protoporphyrin (CoPP) or the HO-1 inhibitor zinc protoporphyrin (ZnPP). We then measured the melanin content of the cells. Additional analyses consisted of Western blotting and RT-PCR. The results showed that the cellular melanin content was increased by CoPP and decreased by ZnPP. The Western blot and RT-PCR analyses showed that CoPP increased p53, MITF and tyrosinase levels, and ZnPP reduced all of them. The knockdown of p53 by siRNA transfection was followed by large decreases in the expression levels of p53, MITF and tyrosinase at 3 h of transfection. The presence of CoPP or ZnPP had no significant increased or decreased effects on MITF and tyrosinase levels from 15 h in the siRNA transfectants. Our results suggest that HO-1 modulates melanogenesis in human melanocytes via a p53-dependent pathway.

A Case of Foreign Body Granuloma Caused by Subcutaneous Injection of Leuprorelin Acetate / 대한피부과학회지

Leuprorelin acetate is a synthetic analog of luteinizing hormone-releasing hormone (LHRH). Recently, hormone-dependent tumors (prostate cancer and breast cancer) have been treated without surgery using this LHRH agonist. A 74-year-old man presented with a subcutaneous tumor in the abdomen. He had received a subcutaneous injection of depot leuprorelin acetate 2 months previously and radiotherapy for prostate cancer. The subcutaneous tumor was totally excised. Histopathologic findings revealed necrosis of fat tissue, many granulomatous nodules composed of giant cells with vacuoles in the dermis and subcutis, and inflammatory cell infiltrates, including mainly lymphohistiocytes. A diagnosis of foreign body granuloma due to depot injection of leuprorelin acetate was made. He revisited our hospital after 1 month with a subcutaneous tumor on his Lt. upper arm. He had received a subcutaneous injection of leuprorelin acetate 1 week ago on that site. We treated it with intralesional triamcinolone injection. Here, we report a case of granulomatous reaction due to leuprorelin acetate injection, which produced subcutaneous nodules.

Modulation of Melanogenesis by Heme Oxygenase-1 via p53 in Normal Human Melanocytes / 전남의대학술지

As a key regulator of melanogenesis, p53 controls microphthalmia-associated transcription factor (MITF) and tyrosinase expression. The anti-oxidant enzyme heme oxygenase-1 (HO-1) is induced by various forms of cellular stress and diverse oxidative stimuli. However, few studies have examined the role of HO-1 in melanogenesis. Therefore, the aim of this study was to determine the role of HO-1 in melanogenesis and the mechanism underlying this relationship. Cultures of normal human melanocytes were treated with the HO-1 inducer cobalt protoporphyrin (CoPP) or the HO-1 inhibitor zinc protoporphyrin (ZnPP). We then measured the melanin content of the cells. Additional analyses consisted of Western blotting and RT-PCR. The results showed that the cellular melanin content was increased by CoPP and decreased by ZnPP. The Western blot and RT-PCR analyses showed that CoPP increased p53, MITF and tyrosinase levels, and ZnPP reduced all of them. The knockdown of p53 by siRNA transfection was followed by large decreases in the expression levels of p53, MITF and tyrosinase at 3 h of transfection. The presence of CoPP or ZnPP had no significant increased or decreased effects on MITF and tyrosinase levels from 15 h in the siRNA transfectants. Our results suggest that HO-1 modulates melanogenesis in human melanocytes via a p53-dependent pathway.

Imatinib-induced DRESS Syndrome in Gastrointestinal Stromal Tumor / 대한피부과학회지

No abstract available.

Lepromatous Leprosy Misdiagnosed as Rheumatoid Arthritis / 대한피부과학회지

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae and may manifest variable symptoms and signs. A 63-year-old woman developed multiple erythematous subcutaneous nodules on her trunk and extremities and experienced arthralgia. She had been receiving treatment for rheumatoid arthritis. On physical examination, she had atrophy of the hypothenar and thenar muscles, a claw hand, and peripheral neuropathy. Systemic symptoms were accompanied by fatigue, myalgia, malaise, and appetite loss. Histologic examination showed large foamy histiocytes forming granulomas, and numerous acid-fast bacilli and globi were detected on Fite stain. We report lepromatous leprosy mimicking rheumatoid arthritis to highlight the typical manifestation of leprosy mimicking other diseases.

The Efficacy of Intense Pulsed Light for Treating Erythematotelangiectatic Rosacea Is Related to Severity and Age

BACKGROUND: Rosacea is a chronic cutaneous disease. Therapeutic modalities should be chosen based on the identified sub-types and clinical features in each patient. Vascular lasers, including intense pulsed light (IPL), are reportedly safe and effective in treating erythematotelangiectatic rosacea (ETR). OBJECTIVE: In this study, we assess the comparative efficacy of IPL related to several factors including clinical severity and the age of patients with ETR. METHODS: Patients with ETR were classified into two groups according to the National Rosacea Society Severity Guideline. Severity score and erythema index (EI) were measured using a clinical scorecard and mexameter. For additional evaluation of therapeutic efficacy, investigator and patient global assessments (IGA, PGA) were checked. Efficacy of IPL was analyzed according to severity score, EI, IGA, and PGA related to sex, age, lactic acid stinging test, and severity. RESULTS: Analyses of the efficacy of IPL according to severity score, EI, IGA, and PGA based on sex, age, lactic acid stinging test, and severity revealed significant differences with age and severity only. CONCLUSION: This study supports the efficacy of IPL treatment for patients with ETR. IPL may be more effective in patients with more severe ETR and in younger patients with ETR.

Majocchi's Granuloma Arising in Previous Burn Area / 대한의진균학회지

Majocchi's granuloma is deep dermatophyte infections rarely form ulceration, nodules and abscesses and usually occur in immunocompromised patients. Although progression of deep dermatophytosis may be induced by the use of topical or systemic steroids, immunosuppression may not be found in some cases. We report a case of Majocchi's granuloma arising in previous burn area, who had pruritic erythematous macules, patches and papules on the left forearm for 7 months. KOH mount was negative. Histopathological examination showed granulomatous reaction and numerous hyphae and spore in the dermis, and the organism was identified as Trichophyton rubrum on tissue culture. The patient was treated with 2 times of itraconazole pulse therapy and then terbinafine (250 mg/day) for 4 weeks, resulting in the clearing of the lesion.

Refractory Plaque Psoriasis Treated with a Combination of Etanercept and Low Dose Methotrexate / 대한피부과학회지

Etanercept has been proven to be highly effective to moderate severe plaque psoriasis. Alternative biologics or combination therapies of etanercept with other systemic agents have been recommended to patients who are unable to be controlled by etanercept monotherapy. A 50-year-old woman, who did not respond to conventional therapy of psoriasis for 9 years, was treated with etanercept at a schedule of 50 mg doses per week. Psoriatic lesions were remarkably improved within two weeks after etanercept monotherapy, but skin lesions aggravated again 8 weeks after treatment. Then, she was treated with 50 mg etanercept in combination with 5 mg methotrexate per week. Psoriatic lesions were successfully controlled by the combination therapy for 6 weeks, followed by etanercept monotherapy without relapse for the past 13 months. We report the first Korean case of refractory psoriasis, which could be successfully controlled by combination therapy of etanercept with low doses of methotrexate.

Placenta increta presenting as postabortal uterine mass and hemoperitoneum in the first trimester: A case report / 대한산부인과학회지

Placenta increta is one of lethal complications of pregnancy characterized by invasion of placenta villi into the underlying myometrium and usually presented in early postpartum period with difficult placental removal and massive bleeding. Placenta increta may complicate first and early second-trimester pregnancy loss causing profuse post-curettage hemorrhage but the lesion is rarely found and hard to diagnose. We experienced a case of hemoperitoneum caused by implanted chorionic villi on the uterine serosa regurged from uterine cavity, 6weeks after artificial abortion at gestational age of 5 weeks and 5 days.

A case of adenofibroma of uterine cervix / 대한산부인과학회지

Adenofibromas of the uterine cervix, which are classified as benign tumors of mixed epithelium and mesenchymal cells, are extremely rare. Most common symptom is usually abnormal genital bleeding. It is very difficult to diagnose preoperatively. Recommended method of treatment is total hysterectomy, because it usually recurs. We experienced a case of adenofibroma of the uterine cervix with increased CA125, so report it with a review of the literature.

The effects of the number of normal vaginal deliveries to the function of low urogenital system / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to evaluate if the number of normal vaginal deliveries influences lower urogenital system function and the incidence of incontinence. MATERIALS AND METHODS: The POP-Q (Pelvic Organ Prolapse Quantitation) examination was performed in 217 premenopausal women who visited our hospital for routine check up. They were asked to fill in the Bristol female lower urinary tract symptom (BFLUTS) and self-report questionnaire for fecal incontinence and constipation assessment questionnaires. Exclusion criteria included patients with a history of pelvic surgery, BMI >25, chronic lung disease, cardiovascular disease, colon disease or smoking. RESULTS: There was a significant difference between the vaginal delivery group and none vaginal delivery group in the point Aa, Ba, Ap, Bp and Tvl in POP-Q (P<0.05). The patients were classified into four groups (0, 1, 2,above 3) according to the number of vaginal deliveries, and the incidences of fecal incontinence were 4%, 29%, 32%, 26% in each group, respectively. The incidence of fecal incontinence was significantly lower (P<0.05) in those who did not deliver vaginally, while no difference was observed in the number of vaginal deliveries. The BFLUTS-IS (incontinence symptom) score was higher in the patients with higher number of vaginal deliveries (P<0.05). There were also more patients with sexual dysfunction as was shown by the BFLUTS-sex questionnaire (P<0.05) in those patients with higher number of vaginal deliveries. CONCLUSION: We observed that the number of vaginal delivery is significantly associated with the incidence of fecal and urinary incontinence, and also that it was a major cause of disorders of the pelvic floor and sexual dysfunction.

A case of protruded subserosal myoma through pelvic floor in pregnancy / 대한산부인과학회지

Myoma is the most common tumor in gynecologic field. As ultrasonography because popular in antenatal care, the more cases of myoma and those adverse effects during pregnancy are more frequently detected. The management of myoma during pregnancy is conservative, but in rare circumstances, surgical intervention including myomectomy may be required. We have experienced a case of protruded subserosal myoma with the uterine cervix in midtrimester of pregnancy. The patient was managed surgically by transvaginal myomectomy and had successfully maintained pregnancy. We report a case of protruded subserosal myoma through pelvic floor in pregnancy with brief review of literatures.