ABSTRACT
Mastocytosis is characterized by an accumulation of mast cells in various organs, most frequently in the skin. A solitary mastocytoma is a clinical variant of cutaneous mastocytosis. It is defined as a localized collection of mast cells in the skin without evidence of extracutaneous organ involvement. Here we report on a 2-year-old female patient presenting with Solitary erythematous bulla on her lower back. The patient had a history of spinal tap on the lower back for evaluation of meningitis at 5 months of age, which resulted in trauma at the site. Histopathology showed mast cells infiltrating the papillary and reticular dermis and metachromatic purple cytoplasmic granules seen with Giemsa staining. As a result, the patient was diagnosed with a solitary bullous mastocytoma and administered antihistamine. The patient showed complete remission at 3 months. Herein, we report a rare case of solitary bullous mastocytoma occurring at a trauma site.
Subject(s)
Child, Preschool , Female , Humans , Azure Stains , Cytoplasmic Granules , Dermis , Mast Cells , Mastocytoma , Mastocytosis , Mastocytosis, Cutaneous , Meningitis , Skin , Spinal PunctureABSTRACT
BACKGROUND: Few studies have compared the efficacy, cosmetic outcomes, and adverse events between 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and methyl aminolevulinate-PDT (MAL-PDT) for actinic keratoses (AKs) in Asian ethnic populations with dark-skin. OBJECTIVE: We retrospectively compared the long-term efficacy, recurrence rates, cosmetic outcomes, and safety of ALA-PDT versus MAL-PDT for facial AKs in Koreans. METHODS: A total of 222 facial AKs in 58 patients were included in this study. A total of 153 lesions (29 patients) were treated with 5-ALA, and 69 lesions (29 patients) with MAL. ALA and MAL creams were applied for 6 hours and 3 hours, respectively; the lesions were then illuminated with a halogen lamp at 150 J/cm2 for ALA-PDT and a diode lamp at 37 J/cm2 for MAL-PDT. RESULTS: The complete response rates of ALA-PDT and MAL-PDT were 56.9% and 50.7%, respectively, with no significant difference at 12 months after treatment. No significant difference in recurrence rates was observed between the 2 PDT modalities at either 6 or 12 months after treatment. There was no significant difference in the cosmetic outcomes between the 2 treatment modalities at 12 months after PDT. However, ALA-PDT caused significantly more painful than MAL-PDT (p=0.005). The adverse events were mild to moderate, transient, and self-limiting for both modalities. CONCLUSION: MAL-PDT was similar to ALA-PDT in terms of long-term efficacy, recurrence rates, cosmetic outcomes, and adverse events; however, it was a significantly less painful procedure than ALA-PDT in our study.
Subject(s)
Humans , Asian People , Follow-Up Studies , Keratosis, Actinic , Photochemotherapy , Recurrence , Retrospective StudiesABSTRACT
Palisaded neutrophilic and granulomatous dermatitis (PNGD) is characterized histopathologically by the presence of granulomatous inflammation with or without leukocytoclastic vasculitis. It has been associated with multiple systemic diseases, particularly autoimmune conditions like rheumatoid arthritis and Behcet's disease. We report a 52-year-old woman with rheumatoid arthritis who presented with a single, non-tender, rapidly growing nodule on her right elbow. Histologic examination of the nodule revealed degenerated collagen, neutrophils, neutrophilic dust, fibrin, and mucin present in the centers of the palisades of histiocytes throughout the dermis. Herein, we report the abrupt onset of PNGD in a patient with rheumatoid arthritis.
Subject(s)
Female , Humans , Middle Aged , Arthritis, Rheumatoid , Collagen , Dermatitis , Dermis , Dust , Elbow , Fibrin , Histiocytes , Inflammation , Mucins , Neutrophils , VasculitisABSTRACT
BACKGROUND: Hair growth is spontaneously activated from quiescent bulge stem cells or is activated from precocious anagen. Upon spontaneous activation of hair growth or activation induced by nuclear factor of activated T cells c1 (NFATc1) inhibitors, NFATc1 expression is lost and cyclin dependent kinase (CDK4) repression is relieved. OBJECTIVE: The purpose of this study was to investigate the mechanisms of cyclosporine as a hair cycle regulator in the treatment of Alopecia areata (AA). METHODS: In this study, we planned to investigate the hair growing properties of cyclosporine in vitro conditions. Briefly, the effects of different concentrations of cyclosporine (200, 500, 1,000, 2,000 mmol) on the growth of cultured hair follicles were examined through the expression of NFATc1 and CDK4. RESULTS: NFATc1 was downregulated and CDK4 expression was upregulated especially in the bulge areas, outer root sheath and hair bulb matrix cells as the concentration of cyclosporine increased. CONCLUSION: Cyclosporine induces CDK4 expression by NFATc1 suppression, which acts to relieve repressed CDK4, resulting in hair growth. In conclusion, cyclosporine is one of the candidates as a therapeutic agent for the treatment of hair loss.
Subject(s)
Alopecia Areata , Cyclins , Cyclosporine , Hair Follicle , Hair , Phosphotransferases , Repression, Psychology , Stem Cells , T-LymphocytesABSTRACT
BACKGROUND: The incidence of cutaneous malignant tumors, especially basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM), has continuously increased in Korea. However, there has been little research into the distribution and incidence of malignant skin tumors in the south-eastern part of Korea. OBJECTIVE: The purpose of this study was to analyze recent trends in incidence and clinical patterns of cutaneous malignant tumors in Busan city and the eastern Gyeongnam Province. METHODS: We reviewed 714 cases of cutaneous malignant tumors that include BCC, SCC, and MM from January 1996 to December 2010 at the Department of Dermatology in Dong-A University Hospital. RESULTS: The average annual incidence of cutaneous malignant tumors among the total number of outpatients was 1.18% and has continuously increased from 0.63% to 1.91% over the last 15 years (1996~2010). In particular, the average annual incidence of BCC and SCC has markedly increased from 0.35% and 0.25% to 0.94% and 0.79%, respectively. The most common cutaneous malignant tumor was BCC (48.32%), followed by SCC (41.18%) and MM (10.50%). The mean age of onset in patients who had been diagnosed with cutaneous malignant tumors was 65.07 years (males: 62.04, females: 67.87). There was a similar incidence between males and females in cutaneous malignant tumors (1:1.08). The most common site of cutaneous malignant tumors was the face (66.25%); the cheek (34.04%) was the most preferential site on the face, followed by the nose (30.23%). CONCLUSION: The incidence of cutaneous malignant tumors has gradually increased in Busan city and the eastern Gyeongnam Province, which was relatively higher than the incidence in other areas. It was thought to be due to the higher proportion of the elderly than in other areas of the country and skin cancer centers in our hospital.
Subject(s)
Aged , Female , Humans , Male , Age of Onset , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Cheek , Dermatology , Incidence , Korea , Melanoma , Nose , Outpatients , Skin , Skin Neoplasms , Statistics as TopicABSTRACT
The other generalized type of epidermolysis bullosa simplex (EBS) is a genetic blistering skin disease, caused by a mutation of the genes encoding keratin 5 and 14. EBS starts at birth and is characterized by generalized blisters following a minor trauma that heals with hyperpigmentation. A 19-year-old man presented with 19-year history of multiple erythematous vesicles in a herpetiform arrangement on the trunk, axilla, and thigh with post-inflammatory hyper-pigmentations. On light and electron microscopy, the biopsy specimen showed intraepidermal blisters that formed within the basal keratinocyte. The serum from a patient with bullous pemphigoid antibody and laminin 5 antibody showed the linear deposition at the floor of the blister on immunofluorescence mapping study. On the basis of our clinical, microscopic, and immunofluorescence findings, we diagnosed the patient as having a generalized type of EBS. Herein, we report on an interesting case of the other generalized type of EBS.
Subject(s)
Humans , Axilla , Biopsy , Blister , Cell Adhesion Molecules , Epidermolysis Bullosa , Epidermolysis Bullosa Simplex , Floors and Floorcoverings , Fluorescent Antibody Technique , Hyperpigmentation , Keratin-5 , Keratinocytes , Laminin , Light , Methylmethacrylates , Microscopy, Electron , Parturition , Pemphigoid, Bullous , Polystyrenes , Skin Diseases , ThighABSTRACT
BACKGROUND: This study was conducted to clarify the frequency of the BRAF mutation in primary melanomas and its correlation with clinicopathologic parameters. METHODS: We analyzed the frequency of BRAF mutation in patients with primary cutaneous melanoma (n=58) or non-cutaneous one (n=27) by performing dual priming oligonucleotide-based multiplex real-time polymerase chain reaction to isolate and to purify the DNA from the formalin-fixed and paraffin-embedded tumors. RESULTS: The BRAF mutation was found in 17.2% (10/58) of patients with primary cutaneous melanoma and 11.1% (3/27) of those with non-cutaneous melanoma. The frequency of BRAF mutation was not correlated with any clinicopathologic parameters with the exception of the patient age. The frequency of the BRAF mutation was significantly higher in patients younger than 60 years as compared with those older than 60 years (p=0.005). CONCLUSIONS: Compared with previous reports, our results showed that the frequency of the BRAF mutation was relatively lower in patients with primary cutaneous melanoma. Besides, our results also showed that the frequency of the BRAF mutation had an inverse correlation with the age. Further studies are warranted to exclude methodological bias, to elucidate the difference in the frequency of the BRAF mutation from the previous reports from a Caucasian population and to provide an improved understanding of the molecular pathogenesis of malignant melanoma.
ABSTRACT
BACKGROUND: This study was conducted to clarify the frequency of the BRAF mutation in primary melanomas and its correlation with clinicopathologic parameters. METHODS: We analyzed the frequency of BRAF mutation in patients with primary cutaneous melanoma (n=58) or non-cutaneous one (n=27) by performing dual priming oligonucleotide-based multiplex real-time polymerase chain reaction to isolate and to purify the DNA from the formalin-fixed and paraffin-embedded tumors. RESULTS: The BRAF mutation was found in 17.2% (10/58) of patients with primary cutaneous melanoma and 11.1% (3/27) of those with non-cutaneous melanoma. The frequency of BRAF mutation was not correlated with any clinicopathologic parameters with the exception of the patient age. The frequency of the BRAF mutation was significantly higher in patients younger than 60 years as compared with those older than 60 years (p=0.005). CONCLUSIONS: Compared with previous reports, our results showed that the frequency of the BRAF mutation was relatively lower in patients with primary cutaneous melanoma. Besides, our results also showed that the frequency of the BRAF mutation had an inverse correlation with the age. Further studies are warranted to exclude methodological bias, to elucidate the difference in the frequency of the BRAF mutation from the previous reports from a Caucasian population and to provide an improved understanding of the molecular pathogenesis of malignant melanoma.
ABSTRACT
Erythema annulare centrifugum (EAC), first described by Darier in 1916, is characterized by annular, circinate, gyrate or serpiginous lesions. Although the pathogenesis of EAC is not fully understood, it is considered to be a hypersensitivity reaction to a wide variety of etiological factors, including autoimmune diseases, internal malignancies, drugs, infections, and pregnancy. To the best our knowledge, no case of EAC associated with Candida guilliermondii infection has ever been published in the Korean medical literature, and there have been a few reported cases associated with Candida albicans in other countries. Herein, we report on a rare and interesting case of EAC in a 62-year-old female patient with Candida guilliermondii infection.
Subject(s)
Female , Humans , Middle Aged , Pregnancy , Aminocaproates , Autoimmune Diseases , Candida , Candida albicans , Erythema , HypersensitivityABSTRACT
Lipoblastoma is a rare, benign tumor arising from embryonic fat tissues that continue to proliferate in the postnatal period. So, lipoblastoma occurs almost exclusively in infants and children younger than 3 years of age. Published reports showed that 70~90% of cases occur before the age of 3. Histopathologically, lipoblastoma, mimicking liposarcoma, was composed of well-defined lobulated fat tissue with multilobulated lipoblasts, undifferentiated mesenchymal cells, such as stellate or spindle cells and minimal myxoid stromas. The diagnosis of lipoblastoma is important because its management differs from that of lipoma and liposarcoma. To our knowledge, there are only a few reports of lipoblastoma in the Korean dermatologic literature. Herein, we present an interesting and atypical case of lipoblastoma in 68-year-old woman.
Subject(s)
Aged , Child , Female , Humans , Infant , Lipoblastoma , Lipoma , LiposarcomaABSTRACT
BACKGROUND: T cells and dendritic cells (DCs) are more observed in the psoriatic lesion. Inflammatory DCs stimulate T cell differentiation (Th1 or Th17 cells) by producing IL-12 and IL-23 in psoriasis. Th1 expresses CCR5, while CCR6 is expressed by Th17. CCL20, the ligand of CCR6, is expressed mostly in keratinocytes to play an important role in the migration of Th17 cells. Transforming growth factor (TGF)beta inhibits the inflammatory cytokines and induces fibrosis. But, there are still controversies about the role of TGFbeta1 in psoriasis. OBJECTIVE: The purpose of this study is to clarify the pathogenesis of psoriasis by comparing the expression patterns of CD11c/IL-23, CCR5/CCR6, CCR6/CCL20, CD11c, IFN-gamma, and TGFbeta1 among overall lesional assessment (OLA) 1, 3, 5, and the control group. METHODS: We performed CD11c/IL-23, CCR5/CCR6, CCR6/CCL20 double-immunofluorecence and immunohistochemistry of CD11c, IFN-gamma, and TGFbeta1 after classifying the severity of the lesion in 1, 3, 5 with OLA score. RESULTS: As OLA score increased, the infiltration of CD11c+IL-23+ cells, CCR5+ cells, and CCR6+ cells and the expression of CCL20 also showed a significant increase. While IFN-gamma+ cells also increased with the OLA score, TGFbeta1 showed positivity usually in the increased vascular endothelial cells and the number of TGFbeta1+ vascular endothelial cells increased with OLA score. CONCLUSION: From the results, the interaction among the dendritic cell-effector T cell, and cytokine derived from the cells, and chemokine/chemokine receptor was confirmed to be important in pathogenesis of psoriasis. It was also confirmed that TGFbeta1 is not only important at neoangiogenesis, but at inflammatory angiogenesis in psoriasis.
Subject(s)
Cell Differentiation , Cytokines , Dendritic Cells , Endothelial Cells , Fibrosis , Immunohistochemistry , Interleukin-12 , Interleukin-23 , Keratinocytes , Psoriasis , T-Lymphocytes , Th17 Cells , Transforming Growth FactorsABSTRACT
Chilblain lupus erythematosus (LE) is a rare, chronic form of cutaneous LE (CLE), which presents mostly in women as erythematous to violaceous plaques on the acral areas and face, precipitated by cold and damp climates. It may be accompanied by discoid LE (DLE) lesions or other forms of CLE. Up to 20% of patients develop systemic LE (SLE). Although two missense mutations in TREX1, encoding the 3'-5' repair exonuclease 1, were described in familial chilblain LE, the pathogenesis of sporadic chilblain LE remains unknown. To our knowledge, there are a few reports of chilblain LE in the Korean dermatologic literature. Herein, we present a rare and interesting case of sporadic chilblain LE in 71-year-old man and review the Korean literatures.
Subject(s)
Aged , Female , Humans , Chilblains , Climate , Cold Temperature , Exodeoxyribonucleases , Lupus Erythematosus, Cutaneous , Mutation, MissenseABSTRACT
Pityriasis rotunda is an uncommon dermatosis characterized by asymptomatic, multiple, widely distributed, round or oval-shaped, hyperpigmented or hypopigmented, fine, scaly patches. They typically involve the abdomen, the trunk and extremities. Histopathologic findings are consistent with ichthyosis vulgaris, such as hyperkeratosis, hypogranulosis or agranulosis, hyperpigmentation of the basal layer in epidermis, and perivascular lymphohistiocytic infiltration in the dermis. Although the etiology of the disease remains unknown, it has been associated with a variety of underlying systemic diseases including infectious diseases, hormonal disorders, malignancies, and chronic disorders. One clinical case has been reported about the occurrence of the disease during pregnancy of a 24-year-old african woman, but there is only one reported case of exacerbation of the disease during pregnancy in Korea. Herein, we report a case of pityriasis rotunda occurring during pregnancy.