ABSTRACT
BACKGROUND@#Exposure and sensitization to fungal allergens can evoke the development and worsen allergic diseases. Many patients with allergies show multiple positive reactions to different allergens.@*OBJECTIVE@#The purpose of this study was to analyze the relationship between fungal allergens that are mostly found in South Korea and other positive reactions to the allergens of the multiple allergosorbent simultaneous test chemiluminescent assay (MAST-CLA).@*METHODS@#We enrolled 1,040 (588 men, 452 women) patients who showed positive reactions to three fungi, namely, Alternaria alternata, Aspergillus fumigatus, and Cladosporium herbarum, using MAST-CLA at Daegu Catholic University Medical Center from January 2010 to July 2017. The epidemiology and relationship between positive reactions to multiple fungal allergens and positive reactions to the allergens of the MAST-CLA were investigated.@*RESULTS@#A. alternata was the most common fungal species, followed by C. herbarum and A. fumigatus (78.8% vs. 52.1% vs. 20.1%). Patients who showed positive reactions to all fungal allergens had 4.97 other antigens on average. Statistically significant results were obtained when comparing positive reactions to all fungal allergens to other allergens (Spearman correlation coefficient = 0.129, p < 0.05).@*CONCLUSION@#Patients should be educated on allergic diseases caused by other antigens if they are sensitized to fungal antigens.
ABSTRACT
Punctate leukoderma is characterized of the destruction of melanocytes after chemical of physical damage. In addition, the term is broadly used to describe hypopigmented lesions induced in vitiligo patients after psolaren administration with ultraviolet A and in psoriasis patients with repetitive ultraviolet B phototherapy. The Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser in treating melasma is frequently reported to be associated with the cause. A 44-year-old woman presented to the department with numerous confetti-like hypopigmented macules on both cheeks for over a year. Weekly treatment of 1,064 nm Qswitched Nd:YAG laser (2.0–3.4 J, 8 mm spot-size) therapy at a non-dermatologic clinic had induced both hyperpigmentation and hypopigmentation lesions. Biopsy performed at both hyperpigmented and hypopigmented lesions revealed variable melanin pigmentation with segmental loss and infiltration of pigment incontinence. The patient was diagnosed with punctate leukoderma and was directed for narrow-band ultraviolet B phototherapy. Herein, we report a case of punctate leukoderma after inadvertent use of 1,064 nm Q-switched Nd:YAG laser.
Subject(s)
Adult , Female , Humans , Aluminum , Biopsy , Cheek , Hyperpigmentation , Hypopigmentation , Melanins , Melanocytes , Melanosis , Phototherapy , Pigmentation , Psoriasis , Vitiligo , YttriumABSTRACT
Halo nevus and vitiligo are known to be associated with immunologic defect that result in typical skin lesions. Random shapes and sizes of whitish patches, depending on the type, are featured in vitiligo. Halo, on the other hand, presents by surrounding the previous pigmented lesion leaving a whitish-halo-like appearance. The mechanisms underlying these entities remain to be elucidated. Various immunological responses along with biomechanical activities suggest causal relationship between the two diseases. A 6-year-old male patient was recently presented with multiple whitish patches on the various parts of the body in a Koebner phenomenon manner. A noticeable hairy congenital melanocytic nevus surrounded a well-demarcated halo of depigmentation was also observed. Clinical and pathological findings were conclusive of as halo nevus with multiple concurrent vitiligo. The pathogenic relationship between the two entities must be underlined since the nature of disease progression is associated and the respective management may also be altered accordingly.