ABSTRACT
BACKGROUND: Thiopurine S-methyltransferase (TPMT) is an important enzyme in the metabolism of thiopurines including azathioprine (AZA), 6-mercaptopurine, and 6-thioguanine. TPMT genotyping is widely used for screening of AZA-related toxicity during routine clinical practice in Korea. However, the data of TPMT genotypes and its AZA-related toxicity have not been studied in the field of dermatology. OBJECTIVE: The aim of this study was to evaluate the genetic basis of TPMT polymorphism in Korean dermatologic patients and subsequently to investigate the relationship between mutant TPMT and adverse responses to AZA treatment. METHODS: This study was retrospective, single-center study. One hundred forty-nine Korean dermatologic patients who underwent TPMT screening test were included. Each patient's medical records, the result of TPMT screening test, dose and treatment period of AZA, and side effects, were reviewed. Laboratory tests were assessed at each visit in order to monitor adverse drug reactions. Leukopenia grading was used in accordance with the common terminology criteria for adverse events (CTCAE) ver. 4.03. RESULTS: Behçet's disease was the leading disorder among the patients. The frequency of TPMT mutation was 4.0% (6/149) among the participants in this study. Four of the six patients with genetic alterations were treated with a low-dose AZA regimen, but no AZA-related adverse events were observed. CONCLUSION: Our results suggest that 1) TPMT polymorphisms in Korean dermatologic patients are similar to those previously reported in Asian patients with the most common mutant allele being TPMT*3C and 2) AZA can be used in the patients with these polymorphisms under a careful dosing regimen.
Subject(s)
Humans , Mercaptopurine , Alleles , Asian People , Azathioprine , Behcet Syndrome , Dermatology , Drug-Related Side Effects and Adverse Reactions , Genotype , Korea , Leukopenia , Mass Screening , Medical Records , Metabolism , Retrospective Studies , ThioguanineABSTRACT
Quadrivalent human papillomavirus (HPV) vaccine has been reported to be significantly associated with Behçet's disease (BD). However, no reports have described HPV infection as a possible cause for the development of BD. The objective of this study was to evaluate whether anti-HPV immunoglobulin G (IgG) antibody titer is increased in BD. Serum samples from 93 Korean BD patients, who fulfilled the diagnostic criteria of the International Study Group for BD, were used in an enzyme-linked immunosorbent assay (ELISA). The clinical activity of BD was evaluated at the time of blood sampling. HPV-16 L1 virus-like particle (VLP) antigen was used in this study for the ELISA. Patients with BD had significantly higher antibody titers against HPV-16 (optical density [OD], 0.210–3.675; mean 0.992) than that of healthy controls (OD, 0.248–0.762; mean 0.517; P < 0.001). Using a receiver operating characteristic (ROC) analysis, a cut-off value of 0.578 OD for the anti-HPV antibody titer was determined that differentiated BD patients from healthy controls. When we compared the clinical features of BD between the 2 groups, articular involvement of BD was more likely in patients with an anti-HPV-16 antibody titer < 0.578 OD (P = 0.035). In addition, patients with an anti-HPV-16 antibody titer < 0.578 were significantly younger than those with a titer ≥ 0.578 OD. HPV itself may be a possible extrinsic triggering infectious agent causing the development of BD.
ABSTRACT
Paraneoplastic pemphigus is a rare, life-threatening autoimmune mucocutaneous blistering disease associated with underlying neoplasia, commonly lymphoproliferative tumors. Herein we report a case of paraneoplastic pemphigus with a unique autoantibody profile associated with a malignant thymoma. A 56-year-old female patient presented with relapsing oral ulcerations accompanied by erythematous papules and patches on her extremities for 2 months. Skin and mucosal biopsies identified interface dermatitis with lichenoid lymphocytic infiltration in the upper dermis. Immunoblotting and enzyme-linked immunosorbent assays revealed that the patient had multiple autoantibodies against desmoglein 1, desmocollin 1, 2, 3, laminin gamma-1, envoplakin, and periplakin. The skin lesions completely healed following thymectomy and systemic corticosteroid therapy, but the oral ulcerations persisted through a follow-up period of over 2 years.
Subject(s)
Female , Humans , Middle Aged , Autoantibodies , Biopsy , Blister , Dermatitis , Dermis , Desmoglein 1 , Enzyme-Linked Immunosorbent Assay , Extremities , Follow-Up Studies , Immunoblotting , Laminin , Oral Ulcer , Paraneoplastic Syndromes , Pemphigus , Skin , Thymectomy , ThymomaABSTRACT
No abstract available.
Subject(s)
Carbon Dioxide , Carbon , Cicatrix , Lasers, Gas , Methods , ThyroidectomyABSTRACT
Primary ductal adenocarcinoma of the lacrimal gland (PDALG) is a rare tumor accounting for less than 2% of all tumors arising within the orbit. It is classified as a high-grade malignant epithelial tumor due to its variable biologic behavior and aggressive clinical course. Due to its rare incidence, the clinicopathologic profile is poorly identified and generally dependent on the few available reports and case series. Metastatic lesion of PDALG presenting as a skin lesion is very rare with only one previously reported case. We report here a case of metastatic PDALG that presented with cutaneous features. This case illustrates that such a rare malignant tumor may present to dermatologists, requiring prompt diagnosis and management with a multidisciplinary approach.
Subject(s)
Adenocarcinoma , Carcinoma , Diagnosis , Incidence , Lacrimal Apparatus , Orbit , SkinABSTRACT
No abstract available.
Subject(s)
Humans , Interferon-alpha , Interferons , Melanoma , UlcerABSTRACT
No abstract available.
Subject(s)
Humans , Activins , Telangiectasia, Hereditary Hemorrhagic , TelangiectasisABSTRACT
No abstract available.
Subject(s)
Humans , Activins , Telangiectasia, Hereditary Hemorrhagic , TelangiectasisABSTRACT
BACKGROUND: The incidence of skin tumors has been increasing over the past few years due to an aging population, environmental changes, and improved access to medical institutions. OBJECTIVE: To report the rate of relapse and complications after surgical treatment, and suggest appropriate ways of treating benign skin tumors. METHODS: We performed a retrospective review of 846 patients with benign skin tumors who were diagnosed and treated by a single dermatosurgeon. RESULTS: Of the 846 patients, 18 (2.1%) developed local recurrence. Epidermal cysts (15/390) were the most common skin condition, followed by lipomas (2/149). The recurrence rate of epidermal cysts showed no statistical difference when treatment options and the presence of inflammation or suppuration at the first visit were considered. Six patients (0.7%, 6/846) had one of the complications such as persistent inflammation over one month, severe pain, secondary infection, or skin necrosis. All the lipomas following recurrence or those with complications were located in the intramuscular or submuscular area of the forehead, which were easily localized by sonography. CONCLUSION: Surgery is a valuable method for the treatment of benign skin tumors with low rates of complication and relapse. For better outcomes after treatment, dermatologists should attempt to remove these tumors completely and consider the use of imaging studies before treatment.
Subject(s)
Humans , Aging , Coinfection , Epidermal Cyst , Forehead , Incidence , Inflammation , Korea , Lipoma , Necrosis , Recurrence , Retrospective Studies , Skin , SuppurationABSTRACT
BACKGROUND: Biodegradable microneedle technology is a recently developed method to deliver medical and pharmaceutical medications into the skin, and is expected to yield better treatment results than topical application methods. OBJECTIVE: To evaluate the efficacy of hyaluronic acid (HA)-based microneedle patches and epidermal growth factor (EGF)-containing microneedle patches on periorbital wrinkle improvement. METHODS: A 20-week randomized, double-blind study was performed. Twenty-five Korean patients with periorbital wrinkles and a wrinkle severity rating scale (WSRS) score above 2 were enrolled into the study. The patients completed the study using the two different types of patches on each side of the designated periorbital wrinkles area every other day for 8 weeks. Patients were requested for an additional 12-week follow up. Wrinkle improvements were assessed by WSRS score, subjective patient satisfaction score, and imaging analysis using the visiometer, corneometer, cutometer, and mexameter, respectively (Courage&Khazaka, Cologne, Germany). RESULTS: Both the HA-based microneedle patch and EGF-containing HA-based microneedle patch had positive effects on WSRS score, patient satisfaction levels, and corneometer result with statistically significant differences. No significant side effects were noticed. CONCLUSION: With respect to efficacy, no statistical difference between the two groups were noted, indicating that the anti-wrinkle effects of the microneedle patch may solely be due to the HA rather than the EGF.
Subject(s)
Humans , Double-Blind Method , Epidermal Growth Factor , Follow-Up Studies , Hyaluronic Acid , Patient Satisfaction , SkinABSTRACT
Lupus miliaris disseminatus faciei (LMDF) is a chronic inflammatory disorder primarily affecting the face. A 22-year-old man presented with facial skin lesions. Physical examination revealed scattered pin-head sized erythematous to yellowish papules. Skin biopsy from the erythematous papule showed keratinous material in the layers of the thin epithelium and caseous necrosis with adjacent epitheloid granuloma and giant cells. After mechanical extractions of milium-like inflamed papules, skin lesions improved leaving an atrophic scar. LMDF was initially thought to be associated with tuberculosis infection but today it is considered a variant of rosacea. However, there have been reports of LMDF in association with epidermal cysts or milium, suggesting an abnormal immune response to the pilosebaceous unit may play a role. Damage to the pilosebaceous unit that is further complicated by milium rupture may induce inflammation resulting in LMDF. We suggest that milium or epidermal cysts may also attribute to the pathogenesis of LMDF although further studies are needed.