ABSTRACT
BACKGROUND: Dermatofibroma (DF) comprises a heterogeneous group of mesenchymal tumors, with fibroblastic and histiocytic elements present in varying proportions. The cell of origin of DF has been investigated, but remains unclear. OBJECTIVE: The present study attempted to investigate the expression of leukocyte-specific protein 1 (LSP1), a marker of fibrocytes, in DF. Additionally, we evaluated the effectiveness of LSP1 in the differential diagnosis of DF from dermatofibrosarcoma protuberans (DFSP). METHODS: Immunohistochemical staining was performed on 20 cases of DF using antibodies against LSP1, CD68, and factor XIIIa (FXIIIa). In addition, the expression of LSP1 and FXIIIa was evaluated in 20 cases of DFSP. RESULTS: Eighteen of 20 cases (90%) of DF stained positive for LSP1, with variation in the intensity of expression. CD68 was positive in 10 cases (50%), and FXIIIa was expressed in all cases of DF. There were differences between the regional expression patterns of the three markers in individual tumors. In contrast, only 2 of 20 cases of DFSP expressed LSP1, and none of DFSP cases stained positive for FXIIIa. CONCLUSION: The LSP1-positive cells in DF could potentially be fibrocyte-like cells. FXIIIa and CD68 expression suggests that dermal dendritic cells and histiocytes are constituent cells of DF. It is known that fibrocytes, dermal dendritic cells and histiocytes are all derived from CD14+ monocytes. Therefore, we suggest that DF may originate from CD14+ monocytes. Additionally, the LSP1 immunohistochemical stain could be useful in distinguishing between DF and DFSP.
Subject(s)
Antibodies , Dermatofibrosarcoma , Diagnosis , Diagnosis, Differential , Factor XIIIa , Fibroblasts , Histiocytes , Histiocytoma, Benign Fibrous , Langerhans Cells , MonocytesABSTRACT
No abstract available.
Subject(s)
Cyclosporine , Necrobiosis Lipoidica , Necrobiotic DisordersABSTRACT
BACKGROUND: There exists a treatment challenge with periungual warts. Topical immunotherapy with diphenylcyclopropenone (DPCP) has recently been reported to be an effective treatment for recalcitrant warts, including periungual types. OBJECTIVE: We aimed to evaluate the effectiveness and preference of topical immunotherapy with DPCP in treating periungual warts. METHODS: Twenty-seven patients with periungual warts who were treated with DPCP immunotherapy (2007 through 2010; Dongguk University Ilsan Hospital, Goyang, Korea) were retrospectively recruited. Other treatment modalities were also used in some patients. Lesions were grouped into the types according to the following locations: proximal nail fold, lateral nail fold and hyponychium. Total and group clearance rates as well as treatment periods according to location and disease duration were evaluated. A patient questionnaire was performed to assess the satisfaction for the treatments in those who received multiple therapies. RESULTS: Total success rates were 85% (by subjects) and 91% (by individual lesions). Success rate and treatment period for proximal nail fold type seemed more desirable than other locations. Success rate decreased and treatment period increased as disease duration increased. The questionnaire revealed a significantly higher satisfaction rate for DPCP immunotherapy than for cryotherapy and pulsed-dye laser. CONCLUSION: Topical immunotherapy with DPCP is an effective and preferred method in the treatment of periungual warts.
Subject(s)
Humans , Cryotherapy , Cyclopropanes , Immunotherapy , Retrospective Studies , Warts , Surveys and QuestionnairesABSTRACT
A fixed drug eruption (FDE) is not difficult to diagnose, given its clinical characteristics. However, the causative agent can be difficult to identify, particularly when the patient denies ingestion of any drugs. To the best of our knowledge, we present herein the first reported case of an FDE caused by antibiotics taken in food; doxycycline and erythromycin contained in pork and fish. A 57-year-old female experienced repeated episodes of well-demarcated erythematous patches covering her entire body. She denied taking any medications, but she thought that the lesions appeared after consuming pork and/or fish. An oral provocation test showed positive results for doxycycline and erythromycin, commonly used antibiotics in live-stock farming and in the fishing industry. Because of the antibiotics' thermostability, cooking does not guarantee the elimination of residual drugs. From the patient's history, we concluded that doxycycline and erythromycin contained in the pork and fish that she ate were the cause of the FDE.
Subject(s)
Female , Humans , Anti-Bacterial Agents , Cooking , Doxycycline , Drug Eruptions , Eating , ErythromycinABSTRACT
Aplasia cutis congenita is a rare congenital condition, characterized by localized absence of epidermis, dermis, and in some cases, subcutaneous tissues. About 80% of the patients with aplasia cutis congenita have involvement of the scalp. Aplasia cutis congenita, not involving the scalp, appears to be linear lesions with a symmetrical pattern of distribution on the trunk and limbs. Most reported cases are sporadic, but a few cases have been reported to have familial occurrence. There is no unifying theory for the pathogenesis and etiology. Herein, we report a 1-day-old female infant and her 4-year-old sister with unilateral aplasia cutis congenita on their legs. No similar conditions and other associated congenital anomalies were found in their family. There was no sign of teratogenic causes, such as intrauterine infections, drugs or chemical agents.
Subject(s)
Female , Humans , Infant , Dermis , Ectodermal Dysplasia , Epidermis , Extremities , Leg , Child, Preschool , Scalp , Siblings , Subcutaneous TissueABSTRACT
Papular elastolytic giant cell granuloma is an unusual variant of annular elastolytic giant cell granuloma, characterized by the development of asymptomatic, multiple, small erythematous papules on both sun-exposed and non-sun-exposed area. Histopathologically, it shows a granulomatous infiltration, accompanied by the absence of the elastic tissue and phagocytosis of elastic fibers by multinucleated giant cell. An 83-year-old man was presented with a 1 year history of multiple erythematous papules on his abdomen and lower legs. Histopathologic finding showed a non-palisading granulomatous infiltration with multinucleated giant cells and engulfing elastic fibers. We, herein, report an unusual case of papular elastolytic giant cell granuloma, which occurred on non-sun-exposed skin.
Subject(s)
Aged, 80 and over , Humans , Abdomen , Elastic Tissue , Giant Cells , Granuloma, Giant Cell , Leg , Phagocytosis , SkinABSTRACT
Vitiligo is an acquired cutaneous disorder of pigmentation with no definite etiology. Although there are a number of treatment modalities including phototherapy, topical corticosteroids and topical immunomodulators, few studies on the effect of systemic cyclosporine for the treatment of vitiligo have been conducted. We have experienced the improvement of vitiligo lesions after 8 months of systemic administration of cyclosporine (2.5~3.3 mg/kg/day) in a patient with vitiligo and atopic dermatitis. We believe this case report warrants further investigations of cyclosporine for the treatment of vitiligo in terms of mechanisms and clinical outcomes as well.
Subject(s)
Humans , Adrenal Cortex Hormones , Cyclosporine , Dermatitis, Atopic , Immunologic Factors , Phototherapy , Pigmentation , VitiligoABSTRACT
Most cases of delayed skin reactions attributed to non-ionic iodinated contrast media, reported to date, have been maculopapular rash, which frequently occurs on the trunk and proximal region of the extremities. Only few cases of fixed drug eruption caused by non-ionic iodinated contrast media have been reported. A 48-year-old man developed multiple sharply marginated, hyperpigmented, oval patches on the trunk and extremities after receiving iodixanol (Visipaque(R), GE healthcare, USA). The patch test was carried out with a panel of the available iodinated non-ionic contrast media, but did not induce a positive reaction to any of the tested contrast media. The provocation test was carried out with iodixanol as 1/10 of the amount administered during the procedure that caused the reaction. On the following morning, the lesions increased in size and number. We report a case of iodixanol-induced fixed drug eruption, diagnosed by a systemic provocation test.
Subject(s)
Contrast Media , Delivery of Health Care , Drug Eruptions , Exanthema , Extremities , Patch Tests , Skin , Triiodobenzoic AcidsABSTRACT
BACKGROUND: Adipose-derived stem cells (ASCs) are mesenchymal stem cells that have recently been applied to tissue repair and regeneration. Keratinocytes and dermal fibroblasts play key roles in cutaneous wound healing. OBJECTIVE: We investigated the paracrine effects of ASCs on HaCaT cells (i.e., immortalized human keratinocytes) and human dermal fibroblasts to explore the mechanism of the effects of ASCs on cutaneous wound healing. METHODS: HaCaT cells and primary cultured human dermal fibroblasts were treated with 50% conditioned medium of ASCs (ASC-CM). Viability, in vitro wound healing, and fibroblast-populated collagen lattice contraction assays were conducted, and reverse transcription-polymerase chain reaction (RT-PCR) for the type I procollagen alpha1 chain gene was performed. RESULTS: The proliferation of HaCaT cells and fibroblasts was increased by ASC-CM in the viability assay. ASC-CM promoted in vitro wound healing of HaCaT cells and increased the contraction of the fibroblast-populated collagen lattice. RT-PCR showed that the transcription of the type I procollagen alpha1 chain gene in fibroblasts was upregulated by ASC-CM. CONCLUSION: The stimulatory effect of ASC on cutaneous wound healing may be partially mediated by paracrine effects of ASCs on other skin cells. Application of ASCs or ASC-derived molecules could be an innovative therapeutic approach in the treatment of chronic wounds and other conditions.
Subject(s)
Humans , Adipose Tissue , Collagen , Collagen Type I , Contracts , Culture Media, Conditioned , Fibroblasts , Keratinocytes , Mesenchymal Stem Cells , Regeneration , Skin , Stem Cells , Wound HealingABSTRACT
Papular elastorrhexis is a rare cutaneous disorder that occurs predominantly during adolescence. The disorder is characterized by asymptomatic indurated white or flesh papules showing decreased and fragmented elastic fibers in the dermis. We herein report on a 12-year-old girl with multiple asymptomatic white, nonfollicular, firm papules scattered on the extremities and trunk. Histological examination revealed focal areas showing increased layers of collagen fibers and decreased and fragmented elastic fibers in the upper dermis.
Subject(s)
Adolescent , Child , Humans , Collagen , Dermis , Diagnosis, Differential , Elastic Tissue , Extremities , NevusABSTRACT
Verrucous carcinoma is an unusual, non-metastasizing, distinct variant of squamous cell carcinoma composed of four subtypes according to the site of occurrence: oral type, anogenital type, plantar type, and other cutaneous sites. Oral type verrucous carcinoma usually shows slow progression with a low incidence of metastases. Treatment of verrcous carcinoma is challenging; multiple medical and surgical therapies are often attempted, with limited success. We reported on 2 cases of verrucous carcinoma of the lip treated with topical imiquimod and debulking therapy.
Subject(s)
Aminoquinolines , Carcinoma, Squamous Cell , Carcinoma, Verrucous , Cryotherapy , Incidence , Lasers, Gas , Lip , Neoplasm MetastasisABSTRACT
Pityriasis rotunda is a rare disease characterized by round to oval, sharply defined, hypopigmented or hyperpigmented, scaly patches of variable number and size located trunk and extremity. The etiology is unknown but it has been associated with a variety of systemic illnesses, such as tuberculosis, malnutrition and malignancy. The first case was a 28-year-old male who presented with a 2-year history of multiple round shaped hyperpigmented patches on the trunk. The second-case was a 38-year-old female who presented with a 2-month history of circular, sharply defined multiple patches with ichthyosiform scaling on the trunk. Both patients had no systemic disease or familial history. We experienced 2 cases of pityriasis rotunda on the trunk without underlying systemic illnesses or familial association.
Subject(s)
Adult , Female , Humans , Male , Extremities , Ichthyosis , Malnutrition , Pityriasis , Rare Diseases , TuberculosisABSTRACT
Fixed drug eruption is a distinctive and clinically recognizable entity that is characterized by well-demarcated erythematous plaques recurring in exactly the same sites as on previous occasions. Unlike the pigmenting form of fixed drug eruption, nonpigmenting fixed drug eruption leaves no pigmentation when it resolves. We now report the case of a 44-year-old man who presented with diffuse ill-defined erythematous patches on both hands, feet and lower legs with a burning sensation, which is considered an atypical manifestation for fixed drug eruption. The patient had a history of similar skin lesions developing after medications on the corresponding regions. The patch test with suspected drugs showed negative reactions on both lesions and unaffected sites. The lesions were reproduced on the oral provocation test with codeine and resolved without pigmentation. The patient was diagnosed with nonpigmenting fixed drug eruption due to codeine.
Subject(s)
Adult , Humans , Burns , Codeine , Drug Eruptions , Foot , Hand , Leg , Patch Tests , Pigmentation , Sensation , SkinABSTRACT
Atypical fibroxanthoma is an uncommon spindle cell tumor that has a clinically benign course despite the presence of bizarre xanthoma cells. A 90-year-old female presented with a 2-month history of an ulcerative plaque on the right cheek. The initial punch biopsy revealed a benign histological appearance with prominent xanthomatous cells, but the specimen excised afterwards showed malignant features with a spindle and epithelioid cell proliferation with pleomorphism and atypia. The tumor cells stained positively for vimentin and CD68, they were partially positive for CD99 and CD10 and they were negative for CD34, S100, p63, desmin and actin. We report here on a case of atypical fibroxanthoma masquerading as xanthogranuloma.
Subject(s)
Aged, 80 and over , Female , Humans , Actins , Biopsy , Cheek , Desmin , Diagnosis, Differential , Epithelioid Cells , Ulcer , Vimentin , XanthomatosisABSTRACT
Contact vitiligo with allergic contact dermatitis is a rare condition. Early diagnosis of contact vitiligo is imperative, as it could halt the progression of depigmentation, unlike idiopathic vitiligo. We herein report a case of contact vitiligo with allergic contact dermatitis due to para-phenylenediamine.
Subject(s)
Dermatitis, Allergic Contact , Early Diagnosis , Phenylenediamines , VitiligoABSTRACT
Pacinian neuroma, also known as hyperplasia and/or hypertrophy of pacinian corpuscles is a rare skin condition usually occurring in the hand. Although it is known to cause pain and tenderness on the affected skin, asymptomatic cases have also been reported. We report a 46-year-old male monk who presented with asymptomatic skin lesions of paler color than the adjacent normal skin on the tips of the fingers of both hands. The 3 mm punch biopsy conducted on the lesion showed an increased number of onion bulb-like structures with a nerve fiber in each center. The patient was diagnosed with pacinian neuroma and has been under regular follow up without treatment.
Subject(s)
Humans , Male , Middle Aged , Biopsy , Fingers , Follow-Up Studies , Hand , Hyperplasia , Hypertrophy , Nerve Fibers , Neuroma , Onions , Pacinian Corpuscles , SkinABSTRACT
Cutaneous focal mucinosis is a rare condition that manifests with asymptomatic small white to flesh-colored papules on the face, neck, trunk and extremities. Johnson and Helwig first described it in 1961 and it is histologically characterized by localized accumulation of mucin in the upper and mid-dermis with scattered spindle-shaped fibroblasts. We report here on a case of cutaneous focal mucinosis that presented as a nodule with several small papules on it on the face.