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
Bowen's disease is a squamous cell carcinoma in situ and has the potential to progress to a squamous cell carcinoma. The authors treated two female patients (a 39-year-old and a 41-year-old) with Bowen's disease in the vulva area using topical photodynamic therapy (PDT), involving the use of 5-aminolaevulinic acid and a light-emitting diode device. The light was administered at an intensity of 80 mW/cm2 for a dose of 120 J/cm2 biweekly for 6 cycles. The 39-year-old patient showed excellent clinical improvement, but the other patient achieved only a partial response. Even though one patient underwent a total excision 1 year later due to recurrence, both patients were satisfied with the cosmetic outcomes of this therapy and the partial improvement over time. The common side effect of PDT was a stinging sensation. PDT provides a relatively effective and useful alternative treatment for Bowen's disease in the vulva area.
Subject(s)
Adult , Female , Humans , Bites and Stings , Bowen's Disease , Carcinoma, Squamous Cell , Photochemotherapy , Recurrence , Sensation , VulvaABSTRACT
Perineurioma is a rare benign peripheral nerve sheath tumor, composed uniformly of perineurial cells. Soft tissue perineurioma primarily arises within the subcutaneous tissue of extremities and trunk as a painless solitary nodule, and should be distinguished from dermatofibroma, neurofibroma, dermatofibrosarcoma protuberans, meningioma and so on. A 25 year-old female is presented with three small asymptomatic papules on the third left finger which were found 3 years ago. Punch biopsy was performed on all of the papules. Microscopic examination demonstrated well-demarcated tumor within dermis, and proliferation of spindle cells with wavy nuclei and elongated bipolar cytoplasmic process, arranged in a whorled pattern. According to immunohistochemical analysis, the tumor cell showed positivity for epithelial membrane antigen, but negativity for S-100 protein, factor XIIIa, CD34, and smooth muscle actin. The diagnosis of soft tissue perineurioma was being made. We report this rare case of perineurioma presented as multiple papules localized within dermis of the digit.
Subject(s)
Female , Humans , Actins , Biopsy , Cytoplasm , Dermatofibrosarcoma , Dermis , Extremities , Factor XIIIa , Fingers , Histiocytoma, Benign Fibrous , Immunohistochemistry , Meningioma , Mucin-1 , Muscle, Smooth , Nerve Sheath Neoplasms , Neurofibroma , Peripheral Nerves , S100 Proteins , Subcutaneous TissueABSTRACT
Pityriasis rubra pilaris (PRP) is a chronic papulosquamous disorder of unknown etiology, which may pose therapeutic challenges. There is currently no universally effective treatment for PRP, and some cases are resistant to multiple topical and systemic therapies. Systemic retinoids, methotrexate, several immunosuppressive agents and phototherapy have all been used with varying degrees of success. Recently, a few reports have appeared in the literature, concerning the use of biologics in combination therapies and/or in refractory PRP cases. We report a case of PRP similar to type II with juvenile onset, which was recalcitrant to traditional topical and systemic therapy. He was successfully treated with anti-TNF-alpha monoclonal antibody, infliximab. The patient showed resolution with minimal disease activity, and was maintained on acitretin and emollients. The response to infliximab in our patient and in the previously reported cases confirms a role of anti-TNF-alpha therapy as an effective option in the treatment of PRP.
Subject(s)
Humans , Acitretin , Antibodies, Monoclonal , Emollients , Immunosuppressive Agents , Methotrexate , Phototherapy , Pityriasis , Pityriasis Rubra Pilaris , Retinoids , Skin Diseases, Papulosquamous , InfliximabABSTRACT
Reed syndrome is an autosomal dominantly inherited disease with incomplete penetrance that is characterized by uterine and cutaneous leiomyoma. While the skin tumors are relatively uncommon and benign, women of affected families often develop uterine leiomyoma with associated infertility, pain and bleeding. Here, we report a case of Reed syndrome in a family with multiple cutaneous and uterine leiomyomas. A 30-year-old woman had not only multiple cutaneous leiomyomatosis on cheek and neck, but also uterine multiple leiomyoma. Her mother had lesions that the multiple cutaneous leiomyomatosis on both shoulders and underwent myomectomy for a huge uterine leiomyoma at the age of 45. Her older sister also underwent myomectomy for uterine leiomyoma.
Subject(s)
Adult , Female , Humans , Cheek , Hemorrhage , Infertility , Leiomyoma , Leiomyomatosis , Mothers , Neck , Penetrance , Shoulder , Siblings , SkinABSTRACT
Eccrine angiomatous hamartoma (EAH) is a rare benign disease that is characterized by an abnormal proliferation of eccrine glands and vascular elements. It is generally congenital, but it can appear before puberty. It usually presents as a single plaque or nodule, but multiple patch-like lesions are also possible. EAH is mostly asymptomatic, but it is sometimes associated with pain or hyperhidrosis. It generally does not require aggressive treatment, but the lesion can be excised due to pain, enlargement and cosmetic reasons. A 3-week-old Korean female presented with a hemorrhagic skin lesion on the right foot since birth. There was no specific birth history. The lesion first appeared on the third toe of the right foot and quickly spread to almost half of the right foot. Histopathology examination revealed acanthosis in the epidermis and a proliferation of eccrine ducts, glands and capillaries. The eccrine glands were immunohistochemically-positive for carcinoembryonic antigen.
Subject(s)
Female , Humans , Capillaries , Carcinoembryonic Antigen , Cosmetics , Eccrine Glands , Epidermis , Foot , Hamartoma , Hemorrhage , Hyperhidrosis , Parturition , Puberty , Reproductive History , Skin , ToesABSTRACT
Pemphigus vegetans is a rare variant of pemphigus vulgaris and is characterized by vegetating lesions in the inguinal folds and mouth and by the presence of autoantibodies against desmoglein 3. Two clinical subtypes of pemphigus vegetans exist, which are initially characterized by flaccid bullae and erosions (the Neumann subtype) or pustules (the Hallopeau subtype). Both subtypes subsequently develop into hyperpigmented vegetative plaques with pustules and hypertrophic granulation tissue at the periphery of the lesions. Oral administration of corticosteroids alone does not always induce disease remission in patients with pemphigus vegetans. We report here on a 63-year-old woman with pemphigs vegetans. She had a 2-year history of vegetating, papillomatous plaques on the inguinal folds and erosions of the oral mucosa. The enzyme-linked immunosorbent assay was positive for anti-desmoglein 3, but it was negative for anti-desmoglein 1. She was initially treated with systemic steroid, but no improvement was observed. The patient was then successfully treated with a combination of systemic steroid and dapsone with a good clinical response.
Subject(s)
Female , Humans , Middle Aged , Administration, Oral , Adrenal Cortex Hormones , Autoantibodies , Blister , Dapsone , Desmoglein 3 , Enzyme-Linked Immunosorbent Assay , Granulation Tissue , Mouth , Mouth Mucosa , PemphigusABSTRACT
PURPOSE: A nationwide hepatitis B vaccination publicity campaign and program was launched in 1988 in Korea. This survey was designed to evaluate the recent changes of the positive rates of hepatitis B surface antigen and antibody in sampled preschool children living in Seoul, 1995. METHODS: Study population consisted of 218 preschool children aged 2 to 5 years. Most of them had been immunized against hepatitis B in accordance with the schedule in early infancy. Blood samples were tested for HBsAg, HBsAb and HBcAb by radioimmunoassay. RESULTS: Of 218 children, 214(98.2%) had received hepatitis B vaccination. Two of 218(0.9%) was surface antigen positive. The positive rates of HBsAb in age groups were 68.2, 73.6, 71.6, and 66.7% from 2 to 5 years, respectively (mean 70.6%). They showed no significant difference with aging. One(0.6%) of 154 who were HBsAb positive was HBcAb positive. CONCLUSIONS: Most of the children who were HBsAb positive acquired the antibodies by immunization, and vertical transmission is rare recently. Our findings suggest that the effective administration of vaccination with the help of publicity campaign lowers HBV transmission and increases positive rate of HBsAb.