Comparative study of treatment methods for benign lichenoid keratosis of the face.

Benign lichenoid keratosis is one of the most common skin lesions that develop on the faces of middle-aged women. This study aimed to find an effective treatment method for benign lichenoid keratosis. A total of 49 patients, who had a positive diagnosis during 2010-2018, were enrolled in the study. An Investigator's Global Assessment of the lesion was done using the 5-point visual analog scale to evaluate treatment efficacy. After excluding subjects who did not have a follow-up photograph, 38 subjects were given an Investigator's Global Assessment score. Combination therapy using laser and a topical agent was useful in the management of benign lichenoid keratosis on the face. Ablative laser was effective for immediate improvement of the lesion, whereas non-ablative laser was also useful and showed several benefits over ablative laser. Optimal treatment should be decided after considering the patient's preference, compliance with treatment regimen, and skin type.

A Case of Herpes Zoster Granulomatous Dermatitis: Report of Wolf's Isotopic Response.

Wolf's isotopic response refers to the occurrence of a novel skin disease at the site of a preceding treated or untreated skin disease. Although the most common preceding skin disease was found to be herpes zoster (HZ), HZ-related dermatological phenomena are not well known in the literature. We report a case of HZ granulomatous dermatitis in a 77-year-old female with a previous history of hypertension, diabetes mellitus, chronic kidney disease, and HZ. She presented with a 3-month history of a pruritic skin lesion on her right thigh. The location of the lesion was consistent with a previous HZ site. Histopathological examination revealed lympho- histiocytic infiltration in the superficial dermis, forming a granulomatous structure. Based on clinical and histopathological findings, we made a diagnosis of granulomatous dermatitis at a previous HZ site. We assumed that the lesion arose from an isotopic response of Wolf. The patient was treated with topical steroids for 3 months and showed clearance of the lesion and symptom. We suggest that treatment should be based on the individual disease, which in our case was topical steroid.

A Rare Case of Transient Friction Melanosis of the Finger: A Case Report.

Friction melanosis (FM) is an acquired pigmented disease that is caused by recurrent mechanical stress. There is no previous report explaining the presence of tiny brown-colored particles confined to the corneal layer. We describe a case of a rare form of FM of the finger that showed a relatively transient clinical course. A 17-year-old Korean female presented with a 5-month history of an asymptomatic localized hyperpigmented patch on the tip of the right index finger. The dermoscopic examination revealed homogenous globular pattern, which favored pigmentation over hemorrhage. Histopathologically, hyperkeratosis and acanthosis with lymphohistiocytic infiltration of the superficial dermis were noted on hematoxylin and eosin staining; however, there was neither a definite increase in melanophages in the upper dermis nor melanocytic proliferation in the basal layer. Per high-power field, multiple brown-colored tiny particles were scattered in the corneal layer. The particles were not dyed by Fontana-Masson stain, iron stain, and S-100. We questioned the patient about the presence of irritation and found that she had bought new shoes at the time of the onset. She was habituated to placing her fingers in her shoes while wearing them because they were slightly tight. The lesion disappeared spontaneously a week after the cause of friction was eliminated. Altogether, we encountered a rare form of FM that occurred in a rare location with a transient clinical course. Further cases on pigmentation restricted to finger tips might reveal the origin of the particles.

Differential histopathological and immunohistochemical findings between palmar psoriasis and chronic hand eczema.

BACKGROUND: The differential diagnosis between palmar psoriasis (PP), chronic hand dermatitis (CHE), and hyperkeratotic hand dermatitis (HHD) is challenging. OBJECTIVES: We sought to distinguish the histopathological and immunohistochemical characteristics between PP, CHD, and HHD. MATERIALS & METHODS: Hands, clinically diagnosed with PP, CHD, or HHD, were further evaluated using skin biopsy sections based on haematoxylin and eosin staining and immunohistochemical analysis for ß-defensin 2 and interleukin-36γ. RESULTS: Confluent parakeratosis, absent granular layer, and psoriasiform epidermal hyperplasia were more common in PP and HHD relative to CHE. The level of ß-defensin 2 expression in the stratum corneum and interleukin-36γ in the stratum granulosum was higher in PP and HHD relative to CHD. CONCLUSION: Considering the similarities of histopathological and immunohistochemical findings, HHD may be an inflammatory disorder with a pathogenesis similar to that of PP, rather than CHD.

Botulinum toxin type A suppresses pro-fibrotic effects via the JNK signaling pathway in hypertrophic scar fibroblasts.

Hypertrophic scar is a dermal fibroproliferative disease characterized by the overproduction and deposition of extracellular matrix, and the hyperproliferation and enhanced angiogenesis of fibroblasts, along with their enhanced differentiation to myofibroblasts. Botulinum toxin type A shows potential for prevention of hypertrophic scar formation; however, its effectiveness in attenuating skin fibrosis and the related mechanism are unclear. In this study, human scar fibroblasts were cultured and stimulated with botulinum toxin type A, and the changes in fibroblast proliferation, migration, and protein expression of pro-fibrotic factors were evaluated with colorimetric, scratch, and enzyme-linked immunosorbent assays and western blotting, respectively. Botulinum toxin type A treatment decreased the proliferation and migration of human scar fibroblasts compared with those of untreated controls. Protein expression levels of pro-fibrotic factors (transforming growth factor ß1, interleukin-6, and connective tissue growth factor) were also inhibited by botulinum toxin type A, whereas the JNK phosphorylation level was increased. Activation of the JNK pathway demonstrated the inhibitory effects of the toxin on human scar fibroblast proliferation and production of pro-fibrotic factors, suggesting that the suppressive effects of botulinum toxin type A are closely associated with JNK phosphorylation. Overall, this study showed that botulinum toxin type A has a suppressive effect on extracellular matrix production and scar-related factors in human scar fibroblasts in vitro, and that regulation of JNK signaling plays an important role in this process. Our results provide a theoretical basis, at the cellular level, for the therapeutic use of botulinum toxin type A.