Localized Scleroderma-like Reaction Induced by Doxifluridine / 대한피부과학회지

Exogenous factors, including environmental substances and drugs, are known to induce scleroderma-like reactions. Various scleroderma-like reactions induced by anti-cancer drugs have recently been reported. This is the first report that doxifluridine (Didox), an oral prodrug of the antineoplastic agent 5-fluorouracil (5-FU), induced a localized sclerderma-like reaction. A 51-year-old woman was referred to our clinic with multiple pearly, shiny patches on both her breasts, her pelvis and her back. After surgical excision and radiation therapy due to her right breast cancer, she took Didox for 7 months. A skin biopsy specimen revealed that the dermal collagen thickening extended even to the subcutaneous tissue. The routine laboratory tests were within the normal ranges and the tests for antinuclear antibody (ANA), anti SS-A antibody, anti SS-B antibody and anti U1-RNP antibody were all negative. After discontinuation of Didox, the lesions gradually improved. Based on these finding, we diagnosed this case as a localized scleroderma-like reaction induced by doxifluridine and we should pay attention to detect this adverse effect of the long term use of doxifluridine.

A Case of Amniotic Band Syndrome / 대한피부과학회지

The amniotic band syndrome is a collection of fetal malformations associated with fibrous band that appears to entangle or entrap various fetal part, in utero, leading to deformation, malformation or disruption. Its pathogenesis has been debated in the literature for many years. The associated anomalies vary from minor limb anomalies to major craniofacial defects and visceral defects. We experienced a case of limb anomalies due to amniotic band and present the findings with a brief review of literature.

A Case of the Generalized Type of Acquired Dermal Melanocytosis with ABNOM and Acquired Bilateral Nevus of Ito-like Macules / 대한피부과학회지

Dermal melanocytosis is histologically characterized by the presence of ectopic melanocytes in the dermis. Mongolian spots, nevus of Ota, nevus of Ito and blue nevus are the most common types and these are usually present at birth or in early childhood. However, it has been reported that several types of dermal melanocytosis could appear in adult life. We report here on an unusual case of acquired dermal melanocytosis occurring in a 51 year-old female. She had bilaterall brownish or slate-bluish pigmented patches on the face and the posterior auricular, supraclavicular, scapular and back areas. The skin biopsy specimen taken from the upper back revealed scattered, darkly pigmented, spindle-shaped cells and dendritic cells containing abundant golden brown pigment in the dermis.

Three Cases of Allopurinol-induced DRESS Syndrome / 대한피부과학회지

Allopurinol (4-hydroxypyrazolo-[3,4-d]pyrimidine) is an effective and widely used xanthine oxidase inhibitor administered in the treatment of hyperuricemic states such as gout. Allopurinol-induced DRESS (Drug rash with eosinophilia and systemic symptoms) syndrome is characterized by hematologic abnormalities, especially eosinophilia and mononucleosis-like atypical lymphocytosis, skin rash, fever, lymph node enlargement and single or multiple organ involvement, which starts within 8 weeks after the initiation of therapy. We report three cases of allopurinol-induced DRESS syndrome who developed erythematous skin eruption six weeks, nine weeks and seven weeks, respectively, after allopurinol therapy. The clinical, laboratory and histologic findings of these patients were compatible with allopurinol-induced DRESS syndrome.