ABSTRACT
Merkel cell carcinoma (MCC), a rare cutaneous neuroendocrine carcinoma, is most common in sun-exposed areas of aged individuals. Merkel cell polyomavirus (MCPyV) is one causative agent of MCC. Cases of MCC concurrent with other skin tumors, especially squamous cell carcinoma, are rarely reported. Immunohistochemical staining is performed using antibodies to the MCPyV large-T antigen (CM2B4) only in select cases. To date, no cases of MCPyV have been reported in Korea. Here we report a case of MCC concurrent with squamous cell carcinoma in an aged man and discuss the pathogenesis of the case through CM2B4 staining.
ABSTRACT
PELVIS syndrome describes the constellation of perineal hemangioma, external genitalia malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus, and skin tag. A 2-month-old girl presented with infantile hemangioma on her perineum and genitalia with imperforate anus, rectovaginal fistula and perineal skin tag at birth. Under the impression of PELVIS syndrome, consequential spinal sonography was conducted and revealed an intrasacral meningocele without clinical neurologic deficit. The anorectal malformation was surgically corrected, she was taking oral propranolol for the cutaneous lesion, and she showed improvement and no complications.
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Background@#Alopecia areata (AA) is a chronic disease with an unpredictable disease course and severe psychological impact. @*Objective@#To provide evidence- and consensus-based insights regarding the treatment of patients with AA in Korea. @*Methods@#We searched for relevant studies on the topical and device-based treatment of AA in the literature from inception until May 2021. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statements, and an agreement of 75% or greater was considered as consensus. @*Results@#Currently, there remains a scarcity of topical treatments, which is supported by robust evidence from a number of high-quality randomized controlled trials. Current evidence supports the efficacy of topical corticosteroids, corticosteroid intralesional injection, and contact immunotherapy in AA patients. Topical corticosteroids and contact immunotherapy are recommended for pediatric AA. A consensus was achieved in 6 out of 14 (42.8%), and 1 out of 5 (20.0%) statements pertaining to topical and device-based treatments in AA, respectively. The expert consensus was from a single country, and the study may not cover all the treatments used. @*Conclusion@#The present study provides up-to-date, evidence-based treatment guidelines for AA based on the consensus reached among experts after considering regional healthcare circumstances, adding diversity to the previous guidelines.
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Background@#Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual. @*Objective@#To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea. @*Methods@#We searched for relevant studies from inception to May 2021 regarding the systemic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus. @*Results@#Current evidence supports the efficacy of systemic corticosteroids, oral cyclosporine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively. @*Conclusion@#The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.
ABSTRACT
For all suspected, clinical, or confirmed cases of scabies, treatment should be initiated. Affected patients should be adequately isolated, and high-risk groups with close contact histories should be treated irrespective of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and patient’s health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments are topical 10% crotamiton and oral ivermectin. Following treatment completion, a follow-up visit at 2 and 4 weeks is recommended to monitor therapeutic response. Treatment failure is considered when scabies mites or burrows are detected, upon development of new clinical characteristics, or upon aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control should be rendered to reduce the transmission of scabies.
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Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 people/yr in 2010 to approximately 30,000 people/yr in 2021. However, outbreaks have been consistently observed in residential facilities, such as nursing facilities, particularly among the older population. The clinical manifestations of scabies vary depending on a patient’s age, health status, number of mites, and transmission route. Typical clinical presentations of classic scabies include intense nocturnal pruritus and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. Unlike classic scabies, older adults with immunodeficiency or neurological disorders exhibit hyperkeratotic scaly lesions or an atypical distribution with mild-to-non pruritus (crusted scabies). Diagnosis of scabies is based on clinical symptoms and results of diagnostic tests aimed at identifying the presence of the parasite. Although a close contact history and characteristic clinical findings are suggestive of scabies, confirmation of diagnosis requires detection of scabies mites, eggs, or scybala.This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution in vivo imaging techniques.
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Background@#Pediatric alopecia areata (AA) can affect the quality of life (QoL) of patients and their family members. Research on the QoL and burden on family members in pediatric AA is limited. @*Objective@#This nationwide multicenter questionnaire study described the QoL and burden of the family members of patients with pediatric AA. @*Methods@#This nationwide multicenter questionnaire study enrolled AA patients between the ages of 5 and 18 years from March 1, 2017 to February 28, 2018. Enrolled patients and their parents completed the modified Children’s Dermatology Life Quality Index (CDLQI) and the modified Dermatitis Family Impact (mDFI). The disease severity was measured using the Severity of Alopecia Tool (SALT) survey scores. @*Results@#A total of 268 patients with AA from 22 hospitals participated in this study. Our study found that the efficacy and satisfaction of previous treatments of AA decreased as the severity of the disease increased. The use of home-based therapies and traditional medicines increased with the increasing severity of the disease, but the efficacy felt by patients was limited. CDLQI and mDFI scores were higher in patients with extensive AA than those with mild to moderate AA. The economic and time burden of the family members also increased as the severity of the disease increased. @*Conclusion@#The severity of the AA is indirectly proportional to the QoL of patients and their family members and directly proportional to the burden. Physicians need to understand these characteristics of pediatric AA and provide appropriate intervention to patients and their family members.
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Background@#Chondroid syringoma (CS) is an uncommon benign neoplasm of the head and neck seen in middle-aged to elderly individuals. Histopathologically, chondroid syringoma displays nests of cuboidal epithelial cells embedded in a matrix. It is classified as both a tubular branching lumina type and a small tubular lumina type and may exhibit a wide range of differentiation and metaplastic changes in the epithelial and stromal components. @*Objective@#To investigate the correlation between the clinical and histopathologic features of chondroid syringoma. @*Methods@#We evaluated the electronic medical records, clinical photographs, and histopathological slides of 17 patients diagnosed with chondroid syringoma. @*Results@#CS in the terminal hair skin tended to have larger lesions (p=0.036). Tumors in terminal hair skin demonstrated significantly more follicular differentiation (p=0.044) than those in the vellus hair skin. CS arising on the scalp tended to have more osseous metaplasia compared to those arising on non-scalp areas (p=0.022). @*Conclusion@#This study showed that the clinical and histopathological features of CS can differ depending on its location.
ABSTRACT
Vulvar melanosis (VM) is clinically characterized by asymmetric macules or patches of varying size with a tan to black color and irregular borders. VM is more commonly found among perimenopausal women with a median age of 42 years. The exact pathogenesis of VM is not well understood. The proposed etiological factors for VM include oral contraceptive use, infection with human papillomavirus, and chronic inflammatory skin diseases such as lichen sclerosus et atrophicus. Histologic examination can easily differentiate mucosal lentiginosis from melanoma, but VM superimposed on a background of anogenital lichen sclerosus, both clinically and histologically, may mimic malignant melanoma. There have been two cases of VM associated with Dowling-Degos disease in the Korean dermatologic literature. To the best of our knowledge, this is the first case of VM associated with lichen sclerosus et atrophicus in the Korean dermatologic literature.
ABSTRACT
Background@#Chondroid syringoma (CS) is an uncommon benign neoplasm of the head and neck seen in middle-aged to elderly individuals. Histopathologically, chondroid syringoma displays nests of cuboidal epithelial cells embedded in a matrix. It is classified as both a tubular branching lumina type and a small tubular lumina type and may exhibit a wide range of differentiation and metaplastic changes in the epithelial and stromal components. @*Objective@#To investigate the correlation between the clinical and histopathologic features of chondroid syringoma. @*Methods@#We evaluated the electronic medical records, clinical photographs, and histopathological slides of 17 patients diagnosed with chondroid syringoma. @*Results@#CS in the terminal hair skin tended to have larger lesions (p=0.036). Tumors in terminal hair skin demonstrated significantly more follicular differentiation (p=0.044) than those in the vellus hair skin. CS arising on the scalp tended to have more osseous metaplasia compared to those arising on non-scalp areas (p=0.022). @*Conclusion@#This study showed that the clinical and histopathological features of CS can differ depending on its location.
ABSTRACT
Vulvar melanosis (VM) is clinically characterized by asymmetric macules or patches of varying size with a tan to black color and irregular borders. VM is more commonly found among perimenopausal women with a median age of 42 years. The exact pathogenesis of VM is not well understood. The proposed etiological factors for VM include oral contraceptive use, infection with human papillomavirus, and chronic inflammatory skin diseases such as lichen sclerosus et atrophicus. Histologic examination can easily differentiate mucosal lentiginosis from melanoma, but VM superimposed on a background of anogenital lichen sclerosus, both clinically and histologically, may mimic malignant melanoma. There have been two cases of VM associated with Dowling-Degos disease in the Korean dermatologic literature. To the best of our knowledge, this is the first case of VM associated with lichen sclerosus et atrophicus in the Korean dermatologic literature.
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Background@#Androgenetic alopecia (AGA) is the most common cause of hair loss in adults. Topical application of the fermented extract of medicinal plants promoted hair growth through stimulation of the telogen to anagen transition in a mouse model. However, controlled studies are necessary to evaluate the efficacy of the topical application of the fermented extract solution in humans. @*Objective@#We aimed to assess the efficacy and safety of topical poly-gamma glutamic acid hydrogel nanoparticlebased fermented extract of a medicinal plant solution (PGA solution) in terms of the clinical improvements in patients with AGA. @*Methods@#This 24-week, randomized, double-blinded, placebo-controlled, single-center clinical trial enrolled 50 patients with AGA (36 men and 14 women); the participants were treated with either PGA solution or placebo twice daily for 24 weeks. Efficacy was evaluated by a phototrichogram (total hair count per 1 cm 2 ), patient’s subjective assessments, and investigator’s subjective assessments of clinical improvements in overall hair regrowth. Any adverse reactions were reported during the study. @*Results@#At week 24, compared with baseline, the PGA solution group showed a significantly increased hair density compared to the placebo group (7.24±2.52/cm 2 vs. 1.53±1.39/cm 2 , p＜0.0001). The average hair density after 24 weeks was 129.90±23.04/cm 2 and 115.32±20.35/cm 2 in the PGA solution group and the placebo group, respectively.There was no adverse reaction over the 24-week period. @*Conclusion@#PGA solution may provide a safe and effective adjunctive treatment for patients with AGA.
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Syringoid eccrine carcinoma (SEC) is a rare cutaneous malignant tumor thought to be derived from eccrine sweat glands. It is usually present in the scalp and face and often occurs in the fourth to seventh decades of life. A 76-year-old female patient visited our department with a 3-year history of a lesion showing a 5×4 cm-sized erythematous firm plaque with ulceration on her right shoulder. Histological findings revealed a tumor consisting of numerous proliferating tubular structures with two layers of basaloid cells with cellular atypia. Some ductal structures showed a tadpole appearance. Based on these findings, the final diagnosis was SEC. The patient was treated with slow Mohs micrographic surgery and a full-thickness skin graft and did not show any recurrence during the follow-up period of 6 months. Herein, we report a very rare case of a 76-year-old woman diagnosed with SEC that developed on the right shoulder.
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Lymphedema refers to inflammation that occurs in a part of the body owing to impaired lymphatic transport. Lymphedema arises as a consequence of a malformation or malfunction of the lymphatic system. It commonly occurs on the face, vulva, and penis and can cause superficial lesions known as lymphangiectasia. Common presenting symptoms include pain, pruritus, oozing of lymphatic fluid, sexual dysfunction, and infection. Prolonged lymphedema can lead to fibrosis and epidermal hyperplasia with verrucous hyperkeratosis. In rare cases, the lymphedema may mimic a skin tumor. We report the case of a 69-year-old woman who presented with erythematous oozing papules and hard nodules on the vulva, which mimicked a fibrous tumor.
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Primary cutaneous nodular amyloidosis is a rare variant of primary cutaneous amyloidosis and manifests as nodular, light-chain, amyloid deposits that are localized to the skin. The pathogenesis of the disease is still unclear. It usually originates in the lower extremities, face, scalp, and genitals and presents clinically as waxy, yellowish erythematous colored nodules. Histological characteristics include diffuse homogenous eosinophilic deposits in the dermis or subcutaneous regions along with interspersed plasma cells. We report a case of a 72-year-old man who presented with fissured, erythematous, waxy nodules on the bilateral lip angles. To the best of our knowledge, this is the first case report of primary cutaneous nodular amyloidosis of the lip angles in Korean dermatological literature.
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BACKGROUND: Recent studies have reported that glucosamine (GlcN) showed therapeutic effects in allergic diseases such as asthma and rhinitis, and its mechanisms include the suppression of T helper type 2 immune responses and the nuclear factor-κB pathway. OBJECTIVE: We aimed to investigate the effect of GlcN on atopic dermatitis (AD) in an animal model. METHODS: Twenty-five BALB/c mice were divided into five groups (groups A~E). Group A was the phosphate-buffered saline (PBS)-treated group without AD induction. Group B was the PBS control group with AD induction. Groups C to E were the AD induction groups, which were treated with three different doses of GlcN (10 mg, 20 mg, and 40 mg, respectively). Histopathological examination was performed after GlcN administration. Interleukin (IL)-4, IL-13, and IL-17 cytokine levels were measured by enzyme-linked immunosorbent assay using skin biopsy specimens. Serum total immunoglobulin E (IgE) concentrations were measured before and after administration with GlcN or PBS. RESULTS: Clinical dermatitis scores decreased with increasing GlcN dose (p<0.001). Concentrations of tissue IL-13 and IL-17 decreased after GlcN administration (each group: p=0.002 and p<0.001, respectively), but the concentrations of tissue IL-4 did not show differences across groups. Serum IgE levels tended to be lower after GlcN administration (p=0.004). Histopathological scores were not significantly different among groups B~E (p=0.394). CONCLUSION: GlcN improved AD symptoms and decreased tissue IL-13, IL-17, and serum total IgE levels in an animal model.
Subject(s)
Animals , Mice , Allergy and Immunology , Anti-Allergic Agents , Asthma , Biopsy , Dermatitis , Dermatitis, Atopic , Enzyme-Linked Immunosorbent Assay , Glucosamine , Immunoglobulin E , Immunoglobulins , Interleukin-13 , Interleukin-17 , Interleukin-4 , Interleukins , Models, Animal , Rhinitis , Skin , Therapeutic UsesABSTRACT
No abstract available.
Subject(s)
Animals , Alopecia Areata , Alopecia , Lasers, Excimer , Models, AnimalABSTRACT
Immunoglobulin A (IgA) pemphigus is a rare variant of an autoimmune bullous disease with IgA antibodies. IgA pemphigus is divided into 2 major subtypes: the subcorneal pustular dermatosis (SPD) type and intraepidermal neutrophilic (IEN) dermatosis type. We documented a case of an 18-year-old woman with recurrent generalized blisters and pustules that were especially severe in the intertriginous areas. Some half-and-half blisters and coalesced pustules in an annular pattern with crusts were simultaneously observed. A biopsy specimen from one of the half-and-half blister lesions showed intraepidermal separation with multiple neutrophils. Direct immunofluorescence staining revealed lace-like intercellular deposition of IgA in the entire epidermis. IgA antibody deposits were also observed in the patient's serum. The eruptions cleared with systemic steroids and colchicine 0.6 mg for 1 week, and the patient remained in partial remission at the 8-month follow-up. Herein, we report a case of IEN-type IgA pemphigus, clinically mimicking SPD with half-and-half blisters.
Subject(s)
Adolescent , Female , Humans , Antibodies , Biopsy , Blister , Colchicine , Epidermis , Fluorescent Antibody Technique, Direct , Follow-Up Studies , Immunoglobulin A , Immunoglobulins , Neutrophils , Pemphigus , Skin Diseases , Skin Diseases, Vesiculobullous , SteroidsABSTRACT
No abstract available.
Subject(s)
Carcinoma, Squamous Cell , Epithelial Cells , HemangiosarcomaABSTRACT
No abstract available.