ABSTRACT
Porocarcinoma is a malignancy of the eccrine sweat gland. It may arise de novo or develop from pre-existing poroma and hidroacanthoma simplex. A 56-year-old woman was presented with a pinkish plaque on her left posterior thigh. She was diagnosed with hidroacanthoma simplex 6 years ago, and the same lesion had changed in size and shape. Histopathology revealed intraepidermal proliferation of small-sized basaloid cells, continuing to the proliferation of large polygonal tumor cells. This malignant transformation was consistent with the change in p53 expression pattern. The patient underwent wide excision with clear resection margin, and no evidence of recurrence was noted. We highlight this case in that the transition from hidroacanthoma simplex to porocarcinoma in situ was confirmed in the same tissue, as demonstrated by immunohistochemical staining.
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Background@#Alopecia areata (AA) is a non-scarring, autoimmune, inflammatory hair loss on the scalp and/or the body. The disease affects both adults and children, but there are limited data on AA in children compared to AA in adults. @*Objective@#The purpose of this retrospective study was to evaluate the clinical characteristics and psychiatric dynamics of pediatric AA and its correlation with underlying diseases from 2007 to 2017. @*Methods@#A retrospective study was performed on 187 outpatients under 14 years of age who were diagnosed with alopecia areata in the Alopecia Clinic of the Department of Dermatology at Myongji Hospital from March 2007 to February 2017. @*Results@#The proportion of pediatric patients with alopecia areata was 16.8% (187/1112). Clinically, alopecia areata was found in 171 patients (91.4%); alopecia totalis, 10 patients (5.3%); and alopecia universalis, 6 patients (3.2%). The ratio of male (85; 45.5%) to female (102; 54.5%) patients was 1:1.2. Alopecia areata was observed most frequently in patients of school age (105 patients; 56.1%), and the duration was less than 1 year in most cases (75.9%). A family history of alopecia areata was observed in 11.2% of the patients (21/187). The patients most susceptible to the disease were only children, eldest children, those who were overloaded with school work, and those with deficient parent–child relationships, including familial discord. A single bald patch was observed in 50.3% of the patients, and the most commonly associated disease was atopic dermatitis (36 patients; 46.2%). @*Conclusion@#We analyzed several clinical features of pediatric AA, including epidemiology, clinical characteristics, and associated diseases. This study provides useful data for future research regarding AA in children.
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Background@#While many studies have investigated the epidemiology and clinical features of female pattern hair loss (FPHL), few of these are long-term studies. @*Objective@#This study evaluated and compared a large cohort of long-term FPHL patients to short-term FPHL patients from other studies. @*Methods@#A retrospective chart review was conducted at the Alopecia Clinic of the Department of Dermatology in Myongji Hospital of 982 FPHL patients during a 10-year period from March 2007 to February 2017. @*Results@#The 3,549 alopecia patients included 2,342 (66.0%) with androgenetic alopecia (AGA) patients; among them, 982 (27.7%) had FPHL. Patients in their 30s (24.6%) were the most affected group of FPHL patients, followed by those in their 20s (21.7%), 40s (20.3%), 50s (13.8%), and teenagers (9.2%). The FPHL patients included 301 (30.5%) with a paternal familial predisposition, 136 (13.7%) with a maternal familial predisposition, and 70 (7.0%) with both familial predispositions. The FPHL patients were classified according to the Ludwig classification as type 1 (62.7%), type 2 (33.2%), or type 3 (3.9%). Abnormalities in serum total cholesterol levels and triglyceride levels were observed in 70 (14.3%) of 488 patients, and in 49 (21.2%) of 231 patients, respectively. The most common comorbid conditions were seborrheic dermatitis, followed by hypertension, hyperlipidemia, thyroid diseases, diabetes mellitus, polycystic ovarian syndrome (PCOS), and anemia. When seborrheic dermatitis is excluded, thyroid diseases and PCOS were most common in patients in their 20s and 30s. Hypertension, hyperlipidemia, and diabetes mellitus were most common in patients in their 40s. @*Conclusion@#Compared to studies from 20∼30 years ago, the proportion of FPHL patients among total alopecia patients appeared to increase significantly. In addition, the proportion of teenage patients has also increased, likely due to early puberty.
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Serum sickness-like reaction (SSLR) is an abnormal self-limited reaction that can cause fever, myalgia, fatigue, lymphadenopathy, arthralgia, and skin rashes. Its etiology is yet unknown; however, SSLR often develops in patients with hepatitis B and after drug and vaccination administration. SSLR's typical cutaneous manifestations include polycyclic, erythematous wheal-like or plaque-like lesions. A 47-year-old male hepatitis B carrier visited our emergency department with high fever and multiple annular erythematous plaques with clear centers on his trunk and upper and lower extremities. The patient's hematologic laboratory results indicated an acute exacerbation of hepatitis B, and his symptoms correlated with those of SSLR. Here, we report a case of SSLR in a patient with an acute exacerbation of hepatitis B with clinical, hematological, and histopathological evidence.
Subject(s)
Humans , Male , Middle Aged , Arthralgia , Emergency Service, Hospital , Exanthema , Fatigue , Fever , Hepatitis B , Hepatitis , Lower Extremity , Lymphatic Diseases , Myalgia , VaccinationABSTRACT
BACKGROUND: To date, numerous studies have investigated the epidemiology and clinical characteristics of male pattern hair loss (MPHL). OBJECTIVE: The purpose of this study was to evaluate a large number of long-term MPHL patients and to compare them to shorter term ones from other studies. METHODS: We retrospectively reviewed charts of patients diagnosed with MPHL during a 10-year period at the alopecia clinic at the Department of Dermatology of Myongji Hospital. RESULTS: Among 3,549 alopecia patients who had visited the hospital's alopecia clinic, 1,360 were patients demonstrating MPHL (38.3%). The most frequent age group was patients in their 20's (30.1%) followed by those in their 30's (28.2%), 40's (17.2%), 50's (9.9%), and teenagers (8.9%). There were 599 MPHL patients (44.0%) with a paternal familial predisposition, 182 (13.4%) with a maternal familial predisposition, and 118 (8.7%) with familial predisposition on maternal and paternal sides. MPHL was classified based on the Norwood-Hamilton classification: type 2 (20.0%), type 3v (19.4%), and type 3a (16.3%) were the most frequent. Abnormalities in total serum cholesterol were found in 15.1% patients and triglycerides in 36.1% of patients. The most common comorbidity was seborrheic dermatitis, followed by hypertension, hyperlipidemia, diabetes mellitus, and gastrointestinal diseases. CONCLUSION: This study demonstrated that the period of MPHL diagnosis and treatment becomes earlier in age and milder regarding MPHL type, which may be due to early puberty in teenagers.
Subject(s)
Adolescent , Humans , Male , Alopecia , Cholesterol , Classification , Comorbidity , Dermatitis, Seborrheic , Dermatology , Diabetes Mellitus , Diagnosis , Epidemiology , Gastrointestinal Diseases , Hair , Hyperlipidemias , Hypertension , Puberty , Retrospective Studies , TriglyceridesABSTRACT
BACKGROUND: A growth factor cocktail (GFC) including fibroblast growth factor 9 (FGF9) in combination with microneedling is an effective and safe treatment for patients with androgenetic alopecia (AGA). However, there is a lack of studies evaluating its effects based on microneedle depth. OBJECTIVE: This study aimed to evaluate the effects of a GFC including FGF9 on hair growth in patients with AGA, and compare the differences in efficacy according to microneedle depth. METHODS: The study was performed on patients with AGA who were treated with topical GFC including FGF9 with microneedling once every 2 weeks for 3 months. The scalp was divided into right and left sides, and treated with GFC including FGF9 (right side) and normal saline (left side). The microneedle depth was 0.8 mm for both sides. A total of 22 patients (11 males and 11 females) were enrolled. GFC including FGF9 was topically applied with a microneedle medical device. Treatment efficacy was evaluated through phototrichogram and digital photograph analyses after 6 repeated treatments for 3 months. RESULTS: The phototrichogram images showed that 3 months of treatment with GFC including FGF9 with microneedling increased hair density (27.4±4.4/cm²) and diameter (2.7±2.7 µm); increases in hair density (5.7±4.4/cm²) and diameter (2.2±2.3 µm) were also seen in the region of the scalp that received normal saline. These results were statistically significant (p < 0.05). The treatment effect was not significantly different between microneedle depths of 0.8 mm (used in this study) and 0.5 mm (used in our previous study) in terms of both hair density and hair diameter. CONCLUSION: GFC including FGF9 with microneedling is an effective and safe treatment for patients with AGA. According to the results of this study and our previous report, we believe that microneedle depths of 0.5∼0.8 mm can sufficiently stimulate the scalp to increase drug-delivery.
Subject(s)
Humans , Male , Alopecia , Fibroblast Growth Factor 9 , Fibroblast Growth Factors , Fibroblasts , Hair , Scalp , Therapeutic Uses , Treatment OutcomeABSTRACT
Eruptive vellus hair cysts (EVHCs) are small, red- or brown-colored cystic papules that usually occur on the chest and proximal extremities of children and adults. Histologically, these small cysts are observed in the mid-dermis and contain multiple hair shafts and keratinous material. Pathogenesis of EVHC has not been completely understood. A 40-year-old man with mental retardation presented with multiple bluish papules on his back. A biopsy specimen showed features of eruptive vellus hair cysts. We report a case of EVHC that occurred at an unusual site in a patient with mental retardation.
Subject(s)
Adult , Child , Humans , Biopsy , Extremities , Hair , Intellectual Disability , ThoraxABSTRACT
Terra firma-forme dermatosis (TFFD) is a bizarre, acquired and idiopathic dermatosis that etiology has still not been fully defined. It is characterized by the presence of asymptomatic, brownish dirt-like lesion maybe due to disorder of keratinization. These lesions cannot be removed with ordinary cleansing. Therefore, TFFD can be differentiated from dermatosis neglecta. Patient was a 17-year-old man with brownish lesions on his face for 1 month. The patient had a history of regular washing habit with soap and water. The lesions were asymptomatic however due to cosmetic reasons, the patient wanted to treat his skin lesions. Punch biopsy revealed hyperkeratosis and fungal spore are in stratum corneum. Salicylic acid peeling with alcohol base was performed on the patient's face. The skin lesions disappeared completely on gentle swabbing with peeling. In this point, the diagnosis of TFFD could be considered. Since, this disease can be confused with dermatosis neglecta, we report this case with literature review.
Subject(s)
Adolescent , Humans , Biopsy , Diagnosis , Salicylic Acid , Skin , Skin Diseases , Soaps , Spores, Fungal , WaterABSTRACT
Terra firma-forme dermatosis (TFFD) is a bizarre, acquired and idiopathic dermatosis that etiology has still not been fully defined. It is characterized by the presence of asymptomatic, brownish dirt-like lesion maybe due to disorder of keratinization. These lesions cannot be removed with ordinary cleansing. Therefore, TFFD can be differentiated from dermatosis neglecta. Patient was a 17-year-old man with brownish lesions on his face for 1 month. The patient had a history of regular washing habit with soap and water. The lesions were asymptomatic however due to cosmetic reasons, the patient wanted to treat his skin lesions. Punch biopsy revealed hyperkeratosis and fungal spore are in stratum corneum. Salicylic acid peeling with alcohol base was performed on the patient's face. The skin lesions disappeared completely on gentle swabbing with peeling. In this point, the diagnosis of TFFD could be considered. Since, this disease can be confused with dermatosis neglecta, we report this case with literature review.
Subject(s)
Adolescent , Humans , Biopsy , Diagnosis , Salicylic Acid , Skin , Skin Diseases , Soaps , Spores, Fungal , WaterABSTRACT
BACKGROUND: Growth factor treatment in combination with microneedling in androgenetic alopecia (AGA) patients is safe and effective. However, there is a lack of studies examining the effect of treatment according to the depth of the microneedle. OBJECTIVE: The aim was to evaluate differences in efficacy according to the depth of microneedle. METHODS: This study was performed on 6 male and 5 female AGA patients who were treated with topical growth factor cocktail (GFC) with microneedling every 2 weeks for 3 months. The scalp was divided into right and left sides and treated with microneedle depths of 0.5 and 0.3 mm, respectively. GFC was topically applied using a microneedle medical device. Treatment efficacy was evaluated by phototrichogram and digital photograph analysis on 6 repeated treatments for 3 months. RESULTS: Phototrichogram of the 0.5- and 0.3-mm-treated sides of the scalp showed 19 and 12 cm2 increase in hair density and 2.6- and 1.8-µm increase in hair diameter, respectively. These results were statistically significant (p0.05). CONCLUSION: GFC treatment with microneedling is effective and safe and a microneedle depth of 0.5 mm appears to be more effective than that of 0.3 mm. More research is necessary to confirm these results and determine the most effective depth for microneedling by investigating various depths.