ABSTRACT
Azathioprine is an immunosuppressive drug that has been widely used in dermatology for the treatment of immunobullous diseases. Myelosuppression is the most important side effect and requires close observation of the complete blood cell count. The clinical findings of myelosuppression include general weakness, poor oral intake, nausea, dyspnea, and pallor. It can occur within several weeks to years after initial azathioprine treatment; thus, a weekly full blood count for the first 4 weeks, followed by reduced frequency of monitoring to a minimum of once every 3 months is recommended. If the myelosuppression is not treated properly, it can lead to fever, secondary infection, sepsis, and even death. Herein, we present three educational cases for dermatologists to order to underline the risk of myelosuppression during azathioprine treatment.
Subject(s)
Azathioprine , Blood Cell Count , Coinfection , Dermatology , Dyspnea , Fever , Nausea , Pallor , SepsisABSTRACT
Chicken pox is highly contagious and occurs most often in childhood. In normal children, systemic symptoms are usually mild and serious complications are rare. But in adults, especially in immunocompromised patients, it is more likely to be associated with life-threatening complications such as pneumonia, encephalitis and sepsis. A 38-year-old woman was admitted due to headache, fever and multiple umbilicated vesicles on face, trunk and both extremities for 3 days. She underwent chemotherapy for the breast cancer 20 days prior to admission. Based on typical clinical presentation and skin biopsy, she was diagnosed with chicken pox. Despite 5 days of intensive intravenous antiviral therapy (Acyclovir® 30 mg/kg/day), fever and headache continued and epigastric pain occurred. Finally, the patient was recovered from varicella after additional 7 days of antiviral therapy. Generally, old age or immunocompromised hosts have declined cellular immunity, so the incidence of chicken pox is higher and the clinical course is more severe. Herein, we report a case of chicken pox in the patient who underwent chemotherapy for breast cancer, requiring intensive treatment and close observation for systemic symptoms.
Subject(s)
Adult , Child , Female , Humans , Biopsy , Breast Neoplasms , Chickenpox , Chickens , Drug Therapy , Encephalitis , Extremities , Fever , Headache , Immunity, Cellular , Immunocompromised Host , Incidence , Pneumonia , Sepsis , SkinABSTRACT
Reactive perforating collagenosis (RPC) is one of a range of essential perforating disorders. Two types have been recognized: the childhood or inherited form, and the adult or acquired form. Acquired RPC is usually associated with systemic disease, especially diabetes mellitus and/or renal failure. Lesions of acquired perforating collagenosis are usually smaller than 1 cm, but lesions of the giant variant of acquired perforating collagenosis are larger than 2 cm. We present a case of the giant variant of acquired perforating collagenosis, which has not previously been documented in Korea.
Subject(s)
Adult , Humans , Diabetes Mellitus , Kidney Failure, Chronic , Korea , Renal InsufficiencyABSTRACT
Pyoderma gangrenosum (PG) is rare, chronic, painful ulcerative skin disorder frequently associated with various systemic diseases. Clinical presentation in PG is generally classified into 4 types including ulcerative, bullous, pustular, and vegetative. The ulcerative type of PG is associated with inflammatory bowel disease such as ulcerative colitis, Crohn's disease, arthritis, and monoclonal gammanopathy. On the other hand the bullous type of PG is known to be associated with lymphoproliferative disorders. However it is rare for both types of bullous and ulcerative PG to occur simultaneously in the same patient. We report a rare case of PG showing bullous and ulcerative types that developed simultaneously on a 44-year-old Korean female patient with ulcerative colitis.
Subject(s)
Adult , Female , Humans , Arthritis , Colitis, Ulcerative , Crohn Disease , Hand , Inflammatory Bowel Diseases , Lymphoproliferative Disorders , Pyoderma , Pyoderma Gangrenosum , Skin , UlcerABSTRACT
Oculocutaneous albinism (OCA) is a heterogeneous autosomal recessive disorder with reduction or complete absence of melanin in the skin, hair, eyes and combined with eye disorder, such as nystagmus and strabismus. OCA is including four types, from OCA 1 to OCA 4. OCA 1 is the most frequent, and produced by the loss of function of melanocytic enzyme tyrosinase, resulting from mutations of the tyrosinase (TYR) gene. We report a case of 2-year-old Korean toddler OCA 1A patient with white skin, hair, eyelashes, and eyebrows. TYR gene mutation, fully translucent pinkish irises, with skin that does not tan, was also observed.
Subject(s)
Humans , Albinism, Oculocutaneous , Eye , Eyebrows , Eyelashes , Hair , Iris , Melanins , Monophenol Monooxygenase , Child, Preschool , Skin , Strabismus , Triacetoneamine-N-OxylABSTRACT
Pityriasis amiantacea is a disease of scalp that presents with asbestos-like thick scales attached to the hair shaft proximal portion. It is considered to reaction of scalp to many inflammatory processes, such as psoriasis, seborrheic dermatitis, tinea capitis, atopic dermatitis, lichen planus, bacterial infection, and pityriasis rubra pilaris. The control of underlying disease is important to treat pitryriasis amiantacea, and there are no guidelines. Here, we report a case of a 17-year-old female who had no improvement for the general seborrheic dermatitis treatments, but displayed remarkable results after isotretinoin.
Subject(s)
Adolescent , Female , Humans , Bacterial Infections , Dermatitis, Atopic , Dermatitis, Seborrheic , Hair , Isotretinoin , Lichen Planus , Pityriasis , Pityriasis Rubra Pilaris , Psoriasis , Scalp , Tinea Capitis , Weights and MeasuresABSTRACT
Extramammary Paget's disease (EMPD) is a uncommon neoplastic condition of apocrine gland-bearing skin and its occurrence in combination with Bowen's disease is very rare. The most common site of involvement is the vulva, although perineal, perianal, scrotal and penile skin may also be affected. EMPD is usually not combined with Bowen's disease. We report an interesting case of EMPD combined with Bowen's disease, which was confirmed by immunohistochemical stain.
Subject(s)
Bowen's Disease , Paget Disease, Extramammary , Skin , VulvaABSTRACT
An isotopic response is the occurrence of a new skin disorder at the site of another, unrelated, or already healed skin disease. The most common course of an isotopic response is a herpes zoster disease. Verrucous hyperplasia is known as a reactive hyperplastic condition, characterized morphologically by numerous, warty, coalescent papules and plaques. We report here on a case of verrucous hyperplasia developed at the site of healed herpes zoster, which is an unusual type of isotopic response.
Subject(s)
Herpes Zoster , Hyperplasia , Skin , Skin DiseasesABSTRACT
BACKGROUND: Cyclin D1 has a key function in cell proliferation. Bcl-xL has anti-apoptotic effects that can protect against cell death. However, it is still largely unknown whether these proteins play important roles in development of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). OBJECTIVE: The purpose of this study was to investigate the expression of cyclin D1 and Bcl-xL in both of these carcinomas. METHODS: In this study, we examined expression levels of cyclin D1 and Bcl-xL in both carcinomas by immunohistochemistry, immunofluorescence and Western blot analysis. RESULTS: We found increased expression of both proteins in BCC and SCC using immunohistochemistry. Moreover, expression of cyclin D1 and Bcl-xL were increased in both carcinomas relative to normal skin or seborrheic keratosis in Western blot analysis. BCC showed greater increases in expression of cyclin D1 and Bcl-xL on peripheral lesions compared to the center of tumor nests. CONCLUSION: That expression of cyclin D1 and Bcl-xL were increased in BCC and SCC, suggests that progression of the cell cycle combined with inhibition of apoptosis contributes to the carcinogenesis of BCC and SCC.
Subject(s)
Apoptosis , Blotting, Western , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Cell Cycle , Cell Death , Cell Proliferation , Cyclin D1 , Cyclins , Fluorescent Antibody Technique , Immunohistochemistry , Keratosis, Seborrheic , Proteins , SkinABSTRACT
Kaposi's sarcoma (KS) is divided into four types as classic KS, AIDS-associated KS, African endemic KS and iatrogenic KS. Classic KS is most common on the distal portion of the lower extremities. KS sometimes develops on the hand, but there is currently no report of KS on the finger in Korea. Human herpes virus 8 (HHV-8) plays as a key role in development of KS and it is necessary for the development of KS, but it is not sufficient by itself. So, other etiologic factors such as environmental and racial factors, gender and the immune state have recently been considered as being involved with the development of KS. We present here a rare case of KS that developed on the finger of a 44-year-old male who had hepatocellular carcinoma due to hepatits B virus infection.
Subject(s)
Adult , Humans , Male , Carcinoma, Hepatocellular , Fingers , Hand , Herpesvirus 1, Cercopithecine , Korea , Liver , Liver Neoplasms , Lower Extremity , Sarcoma, Kaposi , VirusesABSTRACT
Sweet syndrome is an acute reactive disorder characterized by the abrupt onset of skin lesions, dense infiltration of neutrophils in the dermis on skin biopsy and associated systemic features such as fever, leukocytosis, and increase of C-reactive protein and erythrocyte sedimentation rate. The condition responds well to corticosteroid therapy. Most skin lesions are in the form of erythematous tender papules or nodules, while pustules are uncommon. We herein report a rare case of a 57-year-old male with erythematous tender pustules on the face, finally diagnosed as pustular Sweet syndrome.
Subject(s)
Humans , Male , Middle Aged , Adjustment Disorders , Biopsy , Blood Sedimentation , C-Reactive Protein , Dermis , Fever , Leukocytosis , Neutrophils , Skin , Sweet SyndromeABSTRACT
Tinea capitis is the most common fungal infection in children. Microsporum canis is a zoophilic dermatophyte and it is the most common pathogen of tinea capitis and sometimes it makes a kerion celsi. Microsporum canis infection is commonly acquired from direct contact with animals. We report here on an outbreak of tinea capitis by Microsporum canis in the nursery school.
Subject(s)
Animals , Child , Humans , Arthrodermataceae , Microsporum , Nurseries, Infant , Schools, Nursery , Tinea CapitisABSTRACT
Tinea cruris is a superficial dermatophyte infection of the groin. It is the second most common dermatophytosis. Scrotal dermatophystosis develops in low frequency in spite of extensive infection in nearby sites such as groin and thigh. The lesions are usually finely scaly and faint erythematous patch. In our case, the patient presented with erythematous lichenified plaques on the scrotum and groin. It was definitely diagnosed as dermatophytosis caused by Trichophyton rubrum. Although scrotal fungal infection is rare, dermatophyte infection should be suspected in cases with scaly lesions on the scrotum.