ABSTRACT
BACKGROUND: The optimal management of cutaneous herpes simplex virus (HSV) and varicella zoster virus (VZV) infections requires rapid and accurate diagnostic methods. Direct immunofluorescence (DIF) is known to be rapid and sensitive, but fresh samples are needed to ensure accuracy. OBJECTIVE: We investigated the usefulness of DIF and polymerase chain reaction (PCR) in patients with HSV and VZV infections. METHODS: From January 2012 to August 2013, a total of 134 patients (53 patients with HSV and 81 patients with VZV) were included in this study. Tissue smears were collected from the base of fresh vesicular lesions, and each IF slide was stained with an FITC-conjugated VZV-specific and HSV-specific monoclonal antibody. Viral DNA amplification by PCR was also examined. We compared the positivity rates of DIF and PCR according to virus type and skin lesion duration. RESULTS: The overall positivity rate of PCR (94.0%) was higher than that of DIF (79.1%), and this difference was statistically significant (p<0.0001). DIF was positive in 67.9% and 86.4% of HSV and VZV cases, respectively, and this difference was statistically significant p<0.0001). The positivity rate of DIF decreased in skin lesions older than 7 days; however, PCR showed no significant differences in positivity rates according to skin lesion duration. CONCLUSION: DIF is a rapid and discriminating test for early lesions of HSV and VZV. PCR is an especially sensitive test for old lesions, and aids in making a definitive diagnosis when combined with DIF.
Subject(s)
Humans , Diagnosis , DNA, Viral , Fluorescent Antibody Technique, Direct , Herpes Simplex , Herpesvirus 3, Human , Polymerase Chain Reaction , Simplexvirus , SkinABSTRACT
Kaposi sarcoma is a lympho-angioproliferative disease of the skin and viscera. Because the natural history of Kaposi sarcoma is variable, the assessment of therapy may be difficult and optimal therapy has yet to be determined. Pentoxifylline has been used to treat various dermatologic diseases, but its effectiveness in Kaposi sarcoma has not been reported. We now report a case of Kaposi sarcoma in a 76-year-old man who improved after treatment with oral pentoxifylline.
Subject(s)
Aged , Humans , Natural History , Pentoxifylline , Sarcoma, Kaposi , Skin , VisceraABSTRACT
Kaposi sarcoma is a lympho-angioproliferative disease of the skin and viscera. Because the natural history of Kaposi sarcoma is variable, the assessment of therapy may be difficult and optimal therapy has yet to be determined. Pentoxifylline has been used to treat various dermatologic diseases, but its effectiveness in Kaposi sarcoma has not been reported. We now report a case of Kaposi sarcoma in a 76-year-old man who improved after treatment with oral pentoxifylline.
Subject(s)
Aged , Humans , Natural History , Pentoxifylline , Sarcoma, Kaposi , Skin , VisceraABSTRACT
Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is an autosomal dominant disorder of the fibrovascular tissue. It is characterized by the classic triad of mucocutaneous telangiectasias, recurrent hemorrhages, and familial occurrence. The cutaneous manifestation appear clinically as punctuate, linear, or splinter-like telangiectasias of the upper body, oral, and nasal mucous membranes, and nail beds. A 73-year-old woman presented with purpuric, punctuate, and tiny macules on the finger tips of both hands and the tongue. The skin lesions were discovered about 50 years previously. She had a family history of cutaneous telangiectasia. Also, she had episodes of recurrent epistaxis, gastrointestinal bleeding, and anemia. The gastroendoscopy revealed gastric angiodysplasia of the fundus and body of the stomach. The histopathologic study showed dilated capillaries lined by flat endothelial cells in the papillary dermis. From these findings, we diagnosed this case as hereditary hemorrhagic telangiectasia, which has rarely been reported in the dermatologic literature.
Subject(s)
Aged , Female , Humans , Anemia , Angiodysplasia , Capillaries , Dermis , Endothelial Cells , Epistaxis , Fingers , Hand , Hemorrhage , Mucous Membrane , Nails , Skin , Stomach , Telangiectasia, Hereditary Hemorrhagic , Telangiectasis , TongueABSTRACT
BACKGROUND: Acute and persistent pain are the most significant clinical manifestations of herpes zoster. It has been suggested that the demographic and clinical characteristics of patients with herpes zoster at the time of presentation predict the duration and severity of pain on long-term follow-up. However, the association between pain in herpes zoster and emotional factors such as depression and anxiety has been less well investigated. OBJECTIVE: The purpose of this study was to correlate the characteristics of pain with clinical, demographic, and emotional factors in herpes zoster patients. METHODS: Ninety-seven patients with herpes zoster and 105 healthy controls were recruited from the department of dermatology at a university-affiliated hospital. Depression and anxiety levels were assessed using the Beck Depression Inventory and Beck Anxiety Inventory. We compared severity of initial pain and duration of pain by age, depression, and anxiety. RESULTS: The levels of depression and anxiety were higher in herpes zoster patients compared to controls (p <0.05). There were no significant differences by age, depression, or anxiety. The duration of pain increased with increasing age, depression, and anxiety (p <0.05). Stratified analyses showed that the association between pain duration and increasing depression and anxiety was significant in the young age group (p <0.05), but not significant in the old age group. CONCLUSION: This study suggests that age, depression, and anxiety are the main correlates of pain duration in patients with herpes zoster. Therefore, depression and anxiety should not be ignored in the management of herpes zoster patients.
Subject(s)
Humans , Anxiety , Depression , Dermatology , Follow-Up Studies , Herpes ZosterABSTRACT
Several clinical variants of bullous pemphigoid have been described (e.g. generalized, vesicular, nodular, polymorphic, vegetans, and localized). Dyshidrosiform pemphigoid is an unusual form of the localized variant of bullous pemphigoid, and was first described in 1979. It presents with a localized, persistent, vesicobullous eruption similar to dyshidrosiform dermatitis. Herein, we report a case of dyshidrosiform pemphigoid which presented with bullae localized to both the palms and soles.
Subject(s)
Dermatitis , Pemphigoid, BullousABSTRACT
Divided nevus of the eyelids is a rare form of congenital melanocytic nevus that involves the upper and lower eyelids of one eye. About 34 cases in both children and adults at present have been reported, but no case of divided nevus of the eyelids has previously been reported in the literature so far in Korea. A 12-year-old girl presented with a congenital divided nevus of the upper and lower lid. The histology of the pigmented plaque on the lower lid was confirmed to be that of a benign compound nevus. We, herein, report a case of divided nevus of the eyelids.