Potential Role of Cytosolic RNA Sensor MDA5 as an Inhibitor for Keratinocyte Differentiation in the Pathogenesis of Psoriasis

Background@#Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood. @*Objective@#The purpose of this study is to uncover possible roles of MDA5 in psoriasis. @*Methods@#Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus. @*Results@#As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes. @*Conclusion@#These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.

Potential Role of Cytosolic RNA Sensor MDA5 as an Inhibitor for Keratinocyte Differentiation in the Pathogenesis of Psoriasis

Background@#Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood. @*Objective@#The purpose of this study is to uncover possible roles of MDA5 in psoriasis. @*Methods@#Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus. @*Results@#As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes. @*Conclusion@#These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.

Eosinophilic Panniculitis Following the Subcutaneous Injection of Exenatide Extended-Release

Exenatide extended-release was recently developed as an antidiabetic drug; it acts as a glucagon-like peptide-1 receptor agonist. A 54-year-old male visited our clinic complaining of a subcutaneous tender nodule on his left thigh that had developed over the course of 1 week. The patient had received exenatide extended-release injections for 5 months to treat diabetes. A histopathologic examination showed septal and lobular panniculitis with lymphohistiocyte and eosinophil infiltration. The patient was diagnosed with eosinophilic panniculitis (EP) due to exenatide extended- release injection. EP is a rare type of panniculitis characterized by a prominent infiltrate of eosinophils in the subcutaneous fat layer. It is a histologic reaction pattern that is associated with various clinical conditions. Among the injection- site reactions reported in exenatide extended-release users, injection-site nodules occur infrequently. Clinicians who treat diabetics who use exenatide extended-release should be aware of the possible occurrence of injection-site nodules.

Possible Role of Lysine Demethylase 2A in the Pathophysiology of Psoriasis

Background@#Psoriasis is a common chronic inflammatory skin disease. The development of psoriasis is dependent on many intercellular events such as innate immunity and T cell-mediated inflammation. Furthermore, genetic factors are strongly implicated in the pathophysiology of psoriasis. Although a variety of susceptible genes are identified, it is likely that many important genes remain undisclosed. @*Objective@#The aim of this study is to investigate the possible role of lysine demethylase 2A (KDM2A) in the pathophysiology of psoriasis. @*Methods@#We examined the expression of KDM2A using a well established imiquimod-induced psoriasiform dermatitis model. @*Results@#Immunohistochemistry analysis showed that expression of KDM2A was increased in imiquimod-induced psoriasiform dermatitis. Consistent with this result, KDM2A level was markedly increased in the epidermis of psoriatic patient. When keratinocytes were stimulated with TLR3 agonist poly(I:C), KDM2A was increased at both the mRNA and protein levels. Poly(I:C) increased the expression of psoriasis-related cytokines including tumor necrosis factor-α, interleukin-8, and CCL20, and KDM2A inhibitor daminozide enhanced the poly(I:C)-induced cytokine expression. Finally, topical co-application of imiquimod and daminozide exacerbated the imiquimod-induced psoriasiform dermatitis. @*Conclusion@#Together, these results suggest that KDM2A is increased to negatively regulate the inflammatory reaction of epidermal keratinocytes in psoriasis.

A Case of Sacrococcygeal Chordoma / 대한피부과학회지

No abstract available.

Immunohistochemical Study of O-GlcNAcylation in Human Skin Tumors / 체질인류학회지

O-linked beta-N-acetylglucosamine modification is an important post-translational modification, emerging as a novel regulatory mechanism in various cellular events. Recently, several studies have shown that O-GlcNAcylation plays an essential role in human breast, lung, and colon cancers. With regard to skin cancers, the role of O-GlcNAcylation has yet to be elucidated. To investigate whether O-GlcNAcylation is linked to human skin tumor development, immunohistochemical analysis was performed to investigate the presence of O-GlcNAcylation in various skin tumors. We evaluated the levels of O-GlcNAcylation, O-GlcNAc transferase, and O-GlcNAcase in 29 benign tumors, 12 premalignant tumors, and 26 malignant tumors in skin. Compared to the benign tumors, premalignant and malignant tumors had increased patterns of O-GlcNAcylation. In addition, the O-GlcNAc transferase and O-GlcNAcase levels were higher in premalignant and malignant tumors than in benign tumors. Interestingly, O-GlcNAcase levels were significantly increased in premalignant tumors compared to benign and malignant tumors. These results suggest that O-GlcNAcylation of proteins may play an important role in the development of human skin tumors.

Unusual Opening Site of Odontogenic Fistula / 대한피부과학회지

No abstract available.

The Effect of Powders and Moisturizers on SLS Irritated, Intertriginous Skin / 대한피부과학회지

BACKGROUND: Intertrigo is a form of contact dermatitis of skin folds of the body, for which a large variety of topical medications may be recommended. Application of a suitable barrier preparation is the cornerstone for the prevention and treatment for the intertrigo. OBJECTIVE: There is a notable absence of controlled trials to support and guide the use of barrier preparations for intertrigo. METHODS: We evaluated the effect of powders and moisturizers with non-invasive measuring methods on irritated skin reactions induced by sodium lauryl sulphate in the sintertriginous skin of 21 healthy volunteers. After skin irritation for 24 hours with patch test of 1% sodium lauryl sulphate on both axilla, we applied a powder and a moisturizer respectively. Evaluation was done at 2 weeks by transepidermal water loss, electrical capacitance. RESULTS: TEWL values of the moisturizer treated side were significantly lower than that of the powder treated side. Water holding capacity values of the moisturizer treated side were significantly higher than that of the powder treated side. CONCLUSION: These results suggest that topical application of a moisturizer might improve the disruption of permeability barrier function of intertrigo. We suggest this experimental model for further barrier preparation efficacy testing of intertrigo.

An Apocrine Hydrocystoma Combined with a Dermoid Cyst / 대한피부과학회지

An apocrine hydrocystoma is a translucent cystic nodule that looks like adenomatous cystic proliferation of an apocrine gland, which originated from a hair germ. Dermoid cyst is a cystic teratoma that contains developmentally mature skin appendages, such as hair follicles, sweat glands, and other tissues derived from the ectoderm. Many investigators believe that dermoid cysts re originated from the ectoderm, specifically the hair germ cells. A 58-year-old woman was presented with a purple, asymptomatic, dome-shaped nodule on her right lower eyelid that had been slowly increasing in size for several years. Histopathological examination revealed two well-demarcated cysts: one was lined with stratified squamous epithelium with mature hair and sebaceous glands and the other contained large cystic spaces, which papillary projections extended. We report a rare case of a dermoid cyst, combined with an apocrine hydrocystoma, occurring in the right lower eyelid.

Erosive Adenomatosis of the Nipple / 대한피부과학회지

Erosive adenomatosis of the nipple is a rare, benign neoplasm, currently thought to originate from the terminal lactiferous ducts and subareolar breast tissue. Clinically, erosive adenomatosis of the nipple is often indistinguishable from that of mammary Paget's disease, and it could be misdiagnosed as intraductal carcinoma as it has a similar histological finding. We present the case of a 36-year-old woman who had a unilateral erythematous induration of the nipple that contained a palpable, firm nodule. It had first been noticed 2 years earlier. The surface was occasionally crusted, and there was a bloody discharge. Histopathological examination showed irregular, dilated tubular structures, which were lined by a peripheral layer of cuboidal cells and a luminal layer of the columnar cells that demonstrated decapitation secretion at their luminal border.

Maximal Points of Head's Zone in Fixed Drug Eruption

The principles determining the primary localization of lesions in fixed drug eruption (FDE) are still unknown. Studies investigating the predilection areas in FDE have indicated drug-related, trauma-related, or inflammation-related specific site involvement, as well as visceracutaneous reflex-related specific site involvement. The importance of viscerocutaneous reflexes for the location of dermatoses was first recognized in the 1960s. Head's zones are viscerocutaneous reflex projection fields on the skin that extend over certain dermatomes and possess a reflex-associated maximal point. Recently, in a Turkish collective of patients, three women with the primary location of FDE lesions on the maximal points of Head's zones were presented. We also experienced 3 cases with FDE where the lesions were located at specific sites (buttocks), the so-called maximal points of Head's zones, which are known to be the most active dermatomal areas of an underlying visceral pathology. An underlying internal disturbance (ureter stone, pyelonephritis and chronic pelvic inflammatory disease) was found in all 3 patients, corresponding to the organ-related maximal point of Head's zones in each case. In conclusion, the primary location of FDE lesions on the maximal points of Head's zones revealed relevant organ disorders with corresponding projection fields.

Vesicles in Chronic Graft-versus-host Disease / 대한피부과학회지

Chronic graft-versus-host disease (GVHD) usually presents 100 days after allogenic bone marrow transplantation. Chronic GVHD cutaneous lesions are characterized by lichenoid or sclerodermoid variants. Vesicles, a common presentation in patients with acute GVHD, rarely appear in chronic GVHD. We report a case of a 49-year-old man who presented with bilateral vesicles on lower extremities. He was diagnosed with myelodysplastic syndrome 2 years before and was taking oral cyclosporine after the allogenic bone marrow transplantation. Six months post-transplantation, lichenoid and sclerodermoid lesions developed on his entire body and he was diagnosed with chronic GVHD and eosinophilic fasciitis. A biopsy of the vesicles revealed detached lower margins of the epidermis, necrotized keratinocytes, and infiltration of lymphocytic inflammatory cells. Administration of oral prednisolone alleviated the patient's symptoms. This is an interesting case showing a new pattern of vesicle appearance after development of typical chronic GVHD lesions.

A Case of Auricular Ossification

Ectopic ossification refers to the process of new bone formation in sites that normally do not ossify. The auricle is composed of elastic cartilage, and hence is a pliable structure. Auricular ossification is a rare condition that might be caused by injurious processes, including frostbite, physical trauma, and inflammation as well as processes related to metabolic or endocrine disorders. Here, we report a case of unilateral auricular ossification in a 53-year-old Korean man who had previously rubbed his ear repeatedly with his hand.

Partial Parotidectomy as a Conservative Procedure for the Parotid Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Most of parotid glands tumors, including pleomorphic adenoma and Warthin's tumor, are benign tumors. The method of surgical treatment for benign tumors of the parotid glands has not yet been rationalized. Even in the case of the most frequently occuring tumor, pleomorphic adenoma, the surgical treatments have been varied over the years, with superficial parotidectomy now being the most widely accepted form of the treatment. Conservative partial parotidectomy has been shown to be a reliable option with a successful outcom and a lower complication rate compared with the classic superficial parotidectomy. The aim of this study is to evaluate the advantages of partial parotidectomy in benign parotid tumors by comparing it with the superficial and total parotidectomy. MATERIALS AND METHOD: Of the 84 parotiectomies performed from 1993 to 2001 at Hanyang University hospital, 31 were classic superficial parotidectomies, 14 were total parotidectomies, and 39 were partial parotidectomies. All of the tumors in this study were benign tumor, most of them being pleomorphic adenoma and Warthin's tumor. A retrospective review was performed based on the patient records and their continued documentation by the practice. RESULTS: Partial parotidectomy took less time to perform (60 to 270 minutes) and caused less risk of facial nerve injuries although it was not significant. The procedure also has its cosmetic advantages. No recurrence occurred after partial and superficial parotidectomy in benign tumors. CONCLUSION: Partial parotidectomy might be the reliable option for benign parotid tumors as it has the advantages of reduced risk of facial injuries, less operating time, and apparently no increased recurrence of benign tumors.

Angiogenesis in the Head and Neck Squamous Cell Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Angiogenesis is a necessary process for solid tumor to grow in human body, and thought to play an important role in metastasis. In some solid tumor such as the breast cancer and prostatic cancer, the angiogenesis is thought to be one of the most significant prognostic factors that predict the patient survival rate and metastasis. The purpose of this study is to define the significance of angiogenesis in the head and neck squamous cell carcinoma (HNSCC). SUBJECTS AND METHOD: We measured the microvascular density (MVD) using immunohistochemistry with anti-CD34 antibody in 40 HNSCC. The maximal and average MVD was compared with the clinical parameters such as stage, cervical lymph node metastasis, recurrence, and survival rate, obtained through the retrospective review of the medical records. RESULTS: 1) The maximal and average MVD correlated with overall stage, T stage and N stage statistically. The MVD were increased according to the increasement of the T and N stage. 2) The maximal and average MVD showed a significant relationship with 3 year survival rate. 3) There were no relationship between maximal and average MVD and local or regional recurrence. CONCLUSION: The maximal and average MVD may be a significant prognostic factors which can predict the survival rate of the patients with HNSCC.

Surgical Treatment of Tuberculous Cervical Abscess / 대한이비인후과학회지

BACKGROUND: Tuberculous cervical lymphadenitis is presently well controlled with surgical treatment and medication. In the case of tuberculous cervical abscess, variable treatment modalities are introduced by many authors. MATERIALS AND METHODS: In our cases, surgical treatments such as incision and drainage, mass excision and selective neck dissection, combined with chemotherapy were performed in 15 patients with tuberculous cervical abscesses. The results were reviewed retrospectively. RESULTS: The results showed that in cases of simple drainage, a second operation was required to excise the residual infected tissues which were caused by persistent sinus discharge. In the case of mass excision, some local problems occurred, albeit less commonly. In both groups, local wound problems took up a lot of time and effort for treatment. In cases of selective neck dissection, which is a more wide excision around the abscess, there were no recurrence nor any local wound problems. Tuberculous cervical abscess treated with selective neck dissection showed better surgical outcomes with low morbidity and no severe complications. CONCLUSIONS: Therefore, we recommend a wide excision as a therapeutic modality in cases of tuberculous cervical abscess.

Clinical Evaluation of Cholesteatoma Using Computerized Tomogram / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Computerized tomography (CT) is the method of choice in radiologic diagnostic evaluation of cholesteatoma, since it reveals the presence of soft tissue mass and erosion of bony structure. Also CT enable us to predict the route of cholesteatoma extension, so we hope to hypothesize the unknown pathogenesis of cholesteatoma indirectly. MATERIALS AND METHODS: Preoperative CT and surgical treatment were performed on 80 patients with acquired cholesteatoma from 1996 to 1998 at otolaryngology department in Hanyang University Hospital. The charts and CT findings of the patients were retrospectively reviewed and analyzed according to types of cholesteatoma and its location and extension route. RESULTS: Pars flaccida cholesteatoma is the highest incidence of cholesteatoma and it is possible to predict the direction of progression of cholesteatoma using CT in most cases. Sensitivity of destruction of ossicles and semicircular canal in CT is over 96%. Incidence of obstruction of tympanic isthmus and eustachian tube is higher in pars flaccida cholesteatoma than in pars tensa cholesteatoma. CONCLUSION: Temporal bone CT is a very useful tool to evaluate the clinical characteristics and predict the pathogenesis of cholesteatoma by evaluating of extension route of it.