ABSTRACT
BACKGROUND: Demodicosis is a parasitic skin disease caused by Demodex mites, and the determination of mite density per square centimeter is important to diagnose demodicosis. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd). However, no study has previously compared these two methods with respect to clinical types and distribution patterns of demodicosis. OBJECTIVE: The aim of this study was to compare the value of SSSB and DME findings in reference to the clinical types and distribution patterns of demodicosis. METHODS: The medical records of 35 patients diagnosed with demodicosis between December 2011 and June 2015 were retrospectively reviewed. Demodicosis was classified according to four clinical types (pityriasis folliculorum, rosacea type, acne type, and perioral type) and three distribution patterns (diffuse pattern, U-zone pattern, and T-zone pattern). Two samples, one for SSSB and one for DME, were obtained from a lesion of each patient. RESULTS: In all patients, mean Dd and the proportion with a high Dd (>5D/cm²) by DME (14.5±3.3, 80.0%, respectively) were higher than by SSSB (5.5±1.3, 37.1%, respectively; p<0.01, p=0.02, respectively). In terms of clinical types, for rosacea type, mean Dd and proportion with a high Dd by DME (12.4±3.5, 84.6%, respectively) were significantly greater than those determined by SSSB (3.6±1.2, 23.1%; p=0.04, p=0.04, respectively). In terms of distribution pattern, for the diffuse pattern, mean Dd and the proportion with a high Dd by DME (17.5±3.7, 100%, respectively) were significantly higher than those determined by SSSB (6.0±2.7, 26.7%; p<0.01, p<0.01, respectively). CONCLUSION: The results of our study revealed that DME is a more sensitive method for detecting Demodex than SSSB, especially in patients with diffuse pattern and suspected rosacea type. Further research is needed to confirm this finding.
Subject(s)
Humans , Acne Vulgaris , Biopsy , Medical Records , Methods , Mites , Retrospective Studies , Rosacea , Skin Diseases, Parasitic , SkinABSTRACT
Sorafenib is an oral, multi-targeted tyrosine kinase inhibitor with anti-angiogenic and anti-proliferative activity. It is approved for the treatment of unresectable hepatocellular and advanced renal carcinomas. Cutaneous toxicity is relatively common in patients receiving sorafenib. The most frequent cutaneous side effect is the hand-foot syndrome. Other adverse skin reactions include facial erythema, acral erythema, erythema multiforme, subungual splinter hemorrhage, stomatitis, and alopecia. In Korea, two cases of scrotal and perianal dermatitis after sorafenib therapy were reported. We report a 54-year-old male patient with a 2-week history of scrotal eczema who had been treated for chronic hepatitis type B, liver cirrhosis, and hepatocellular carcinoma. After 2 weeks of oral sorafenib (800 mg/day) administration, thick, scaly patches appeared on his scrotum. A skin biopsy specimen from these lesions revealed superficial dermal perivascular lymphocytic and neutrophilic infiltration, and dilatation of the lymphatics in the superficial dermis. The lesions improved after treatment with a topical and systemic steroid for 2 weeks. Herein, we report a rare case of scrotal erythema associated with sorafenib.
Subject(s)
Humans , Male , Middle Aged , Alopecia , Biopsy , Carcinoma, Hepatocellular , Dermatitis , Dermis , Dilatation , Eczema , Erythema Multiforme , Erythema , Hand-Foot Syndrome , Hemorrhage , Hepatitis, Chronic , Korea , Liver Cirrhosis , Neutrophils , Protein-Tyrosine Kinases , Scrotum , Skin , StomatitisABSTRACT
Woringer-Kolopp disease, also known as localized pagetoid reticulosis, is a rare variant of mycosis fungoides that presents as a solitary localized hyperkeratotic patch or plaque on the extremities and follows a benign course. Effective treatments for Woringer-Kolopp disease include skin-directed therapies such as topical nitrogen mustard, high-potency topical steroids, and phototherapy. Surgical excision has been pursued in cases of small, localized lesions. A 39-year-old man presented with a 3-month history of an asymptomatic plaque on his hand. Physical examination showed a 10-mm-diameter solitary round erythematous hyperkeratotic plaque with a slightly raised edge on the dorsum of his left hand. A skin biopsy revealed that numerous atypical lymphocytes had infiltrated the upper dermis and expanded into the epidermis with a pagetoid pattern. These atypical pagetoid cells were strongly positive for CD3, CD8, and T-cell intracellular antigen-1; focally positive for CD4; and negative for CD20, CD30, and CD56. A subsequent general examination revealed no evidence of systemic involvement and the lesion was treated with surgical excision. Here we report a rare case of Woringer-Kolopp disease.