ABSTRACT
Verrucous carcinoma is a rare, low-grade, well-differentiated variant of squamous cell carcinoma. It occurs mainly on the soles, but has also been reported in other locations, including the buttocks, hand, anus, and genitalia. A 38-year-old woman presented with an asymptomatic skin lesion of the nipple. She first noticed the lesion three months prior. A solitary, cauliflower-shaped, black polypoid mass was observed on her right nipple.Histopathological examination revealed a superficial lesion resembling verruca vulgaris. It was composed of relatively well-differentiated cells with severe epidermal proliferation, and some tumor cells were observed in the dermis. The final diagnosis was verrucous carcinoma. Complete excision of all the lesions was performed. The patient had no recurrence. We report an interesting case of verrucous carcinoma that occurred at a relatively rare site; only one previous report of verrucous carcinoma associated with the breast or nipple was found.
ABSTRACT
Background@#The aryl hydrocarbon receptor (AHR) and autophagy are both important to maintain skin homeostasis.However, they are also involved in skin disorders. So far, their roles in psoriasis pathogenesis are unknown. @*Objective@#We studied the immunohistochemical and gene expression of AHR, CYP1A1, and microtubule-associated protein light chain 3 (LC3) in lesional skin of psoriasis patients to determine correlations among them. @*Methods@#We included 24psoriasis patients and ten healthy volunteers. Skin biopsies were collected. AHR, CYP1A1, and LC3 protein expression was examined by immunohistochemistry, immunofluorescence, and western blotting. AHR, CYP1A1, LC3, ATG5, BECN1 and Nrf2 mRNA levels were measured by quantitative polymerase chain reaction. @*Results@#AHR and CYP1A1 protein expression were higher in psoriasis lesional skin than in normal skin. LC3 protein expression was lower in psoriasis lesions than in normal controls. AHR and CYP1A1 protein expression in psoriasis lesions showed significant positive correlations with mean epidermal thickness and inflammatory cell density. Significant negative correlations were noted between LC3 protein expression in psoriasis lesions and the mean epidermal thickness or inflammatory cell density. A significant negative correlation was found between AHR and LC3 expression in psoriatic skin. AHR, CYP1A1 and Nrf2 mRNA expression were upregulated while LC3, ATG5, and BECN1 mRNA were down-regulated, in psoriatic lesional skin compared with normal controls. @*Conclusion@#AHR and autophagy could play a role in psoriasis pathogenesis by modifying epidermal hyperproliferation and inflammation. AHR and autophagy regulation are potential therapeutic targets in chronic inflammatory skin diseases.
ABSTRACT
Verrucous carcinoma is a rare, low-grade, well-differentiated variant of squamous cell carcinoma. It occurs mainly on the soles, but has also been reported in other locations, including the buttocks, hand, anus, and genitalia. A 38-year-old woman presented with an asymptomatic skin lesion of the nipple. She first noticed the lesion three months prior. A solitary, cauliflower-shaped, black polypoid mass was observed on her right nipple.Histopathological examination revealed a superficial lesion resembling verruca vulgaris. It was composed of relatively well-differentiated cells with severe epidermal proliferation, and some tumor cells were observed in the dermis. The final diagnosis was verrucous carcinoma. Complete excision of all the lesions was performed. The patient had no recurrence. We report an interesting case of verrucous carcinoma that occurred at a relatively rare site; only one previous report of verrucous carcinoma associated with the breast or nipple was found.
ABSTRACT
Background@#Skin diseases characterized by epithelial barrierdysfunction show altered sphingolipid metabolism,which results in changes in the stratum corneum intercellularlipid components and structure. Under pathological conditions,1-deoxysphingolipids form as atypical sphingolipidsfrom de novo sphingolipid biosynthesis. @*Objective@#Thisstudy investigated the potential role of 1-deoxysphingolipidsin skin barrier dysfunction secondary to X-ray and ultravioletB (UVB) irradiation in vitro and in vivo. It was also evaluatedchanges in the expression of 1-deoxysphingolipids in lesionalhuman skin of atopic dermatitis. @*Methods@#In thisstudy, the changes in these 1-deoxysphingolipids levels ofskin and serum samples were investigated in skin barrier dysfunctionassociated with X-ray and UVB irradiation in vitroand in vivo. @*Results@#Increased 1-deoxysphingolipids were observed in cultured normal human epidermal keratinocytesafter X-ray irradiation. X-ray or UVB irradiation increased theproduction of 1-deoxysphingosine in a reconstituted 3-dimensional(3D) skin model. Interestingly, treatment with aphysiological lipid mixture (multi-lamellar emulsion containedpseudoceramide), which can strengthen the epidermalpermeability barrier function, resulted in decreased1-deoxysphingosine formation in a reconstituted 3D skinmodel. Further investigation using a hairless mouse modelshowed similar preventive effects of physiological lipid mixtureagainst 1-deoxysphingosine formation after X-ray irradiation.An increased level of 1-dexoysphingosine in the stratumcorneum was also observed in lesional skin of atopic dermatitis. @*Conclusion@#1-deoxysphingosine might be a novelbiomarker of skin barrier dysfunction and a physiological lipidmixture treatment could prevent 1-deoxysphingosine productionand consequent skin barrier dysfunction.
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Background@#Several epidemiological studies have shownthat the atopic tendency increases in the obese population. @*Objective@#The aim of this study was to confirm the effect ofweight reduction on improvement of atopic dermatitis (AD)symptoms and to investigate the relationship between AD severityand the level of serum adipokines. @*Methods@#Forty subjectswho were AD outpatients were recruited for this study.Obese patients were divided into a weight maintenancegroup and weight reduction group. During the study period,patient information was collected that included measuredbody mass index (BMI), Eczema Area and Severity Index(EASI), and visual analogue scale for pruritus. Adiponectin,leptin, eosinophil count, and total immunoglobulin E werealso tested. @*Results@#In the weight reduction group, there wasa significant improvement in the EASI score, however, no significantimprovement was determined in the weight maintenancegroup. BMI and EASI showed positive correlation.The adiponectin level was lower in AD patients compared tohealthy controls, and it was significantly lower in obese patients compared with normal weight patients. Serum levels ofleptin were significantly different among control, obese patientgroup, and normal weight patient group. There was nostatistically significant relationship between serum adipokinelevel and EASI. @*Conclusion@#In our study, weight reductionwas associated with significant improvement of ADsymptoms. Related adipokine levels were significantly differentamong the control, normal weight AD patient group, andobese AD patient group.
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Chlorpheniramine maleate is commonly used antihistamine. Since antihistamines are the main therapeutic agents for symptomatic treatment of urticaria, anaphylaxis to antihistamines may lead to errors in diagnosis and treatment. We report a case of anaphylaxis induced by chlorpheniramine maleate confirmed by intradermal test. A 35-year-old female experienced history of anaphylaxis after intramuscular injection of chlorpheniramine maleate. Skin prick test was negative, but intradermal test was positive. Patient also experienced mild dizziness after intradermal test and refused to perform any further evaluation such as oral challenge test. Anaphylaxis for chlorpheniramine maleate is very rare but should be considered.
Subject(s)
Adult , Female , Humans , Anaphylaxis , Chlorpheniramine , Diagnosis , Dizziness , Histamine Antagonists , Injections, Intramuscular , Intradermal Tests , Skin , UrticariaABSTRACT
Lymphangiomas are rare benign congenital lymphatic malformations. They can be divided into three groups: cutaneous lymphangioma circumscriptum (CLC), cavernous, and cystic. CLC is the most common type, and rarely occurs with cavernous or cystic lymphangioma under the lesion. Here, we describe the case of a 9-year-old girl who presented with an asymptomatic vesicular lesion on her back. She was finally diagnosed with CLC by clinical manifestations, dermoscopic findings, and histologic findings. Seven years ago, there was a history of surgical operation in the department of general surgery, and the surgery was soft tissue cystic lymphangioma removal surgery. There was no skin lesion for seven years after surgery, but one occurred a month ago. Herein, we present a case of CLC that occurred after a long interval after surgery for soft tissue cystic lymphangioma.
Subject(s)
Child , Female , Humans , Dermoscopy , Lymphangioma , Lymphangioma, Cystic , SkinABSTRACT
Many of the patients visit the doctors because of itching sensation. Itching is an unpleasant sensation. In the epidermal keratinocytes, various neurotransmitters and receptors are related itching. The itch signal is mainly transmitted through the lateral spinal ganglion-derived nerve fibers extending to the lower epidermis. Many mediators such as histamine are involved in the itching pathway. It can be helpful in the treatment of patients having itching sensation with a lot of new therapies from the basic medication such as antihistamines. Also, many drugs are currently under study.
Subject(s)
Humans , Epidermis , Histamine , Histamine Antagonists , Keratinocytes , Nerve Fibers , Neurotransmitter Agents , Pruritus , SensationABSTRACT
No abstract available.
Subject(s)
Female , Humans , Young Adult , Dermatitis, Atopic , Weight LossABSTRACT
BACKGROUND: Atopic dermatitis (AD) is related to a deficiency of delta-6-desaturase, an enzyme responsible for converting linoleic acid to gamma-linolenic acid (GLA). Evening primrose oil (EPO) as a source of GLA has been of interest in the management of AD. OBJECTIVE: The aim of this randomized, double-blinded, placebo-controlled clinical study is to evaluate the efficacy and safety of EPO in Korean patients with AD. METHODS: Fifty mild AD patients with an Eczema Area Severity Index (EASI) score of 10 or less were enrolled and randomly divided into two groups. The first group received an oval unmarked capsule containing 450 mg of EPO (40 mg of GLA) per capsule, while placebo capsules identical in appearance and containing 450 mg of soybean oil were given to the other group. Treatment continued for a period of four months. EASI scores, transepidermal water loss (TEWL), and skin hydration were evaluated in all the AD patients at the baseline, and in months 1, 2, 3, and 4 of the study. RESULTS: At the end of month 4, the patients of the EPO group showed a significant improvement in the EASI score (p=0.040), whereas the patients of the placebo group did not. There was a significant difference in the EASI score between the EPO and placebo groups (p=0.010). Although not statistically significant, the TEWL and skin hydration also slightly improved in the EPO patients group. CONCLUSION: We suggest that EPO is a safe and effective medicine for Korean patients with mild AD.
Subject(s)
Humans , Capsules , Clinical Study , Dermatitis, Atopic , Eczema , gamma-Linolenic Acid , Linoleic Acid , Linoleoyl-CoA Desaturase , Oenothera biennis , Skin , Soybean Oil , WaterABSTRACT
Many of the patients visit the doctors because of itching sensation. Itching is an unpleasant sensation. In the epidermal keratinocytes, various neurotransmitters and receptors are related itching. The itch signal is mainly transmitted through the lateral spinal ganglion-derived nerve fibers extending to the lower epidermis. Many mediators such as histamine are involved in the itching pathway. It can be helpful in the treatment of patients having itching sensation with a lot of new therapies from the basic medication such as antihistamines. Also, many drugs are currently under study.
ABSTRACT
BACKGROUND: Rosacea is associated with chronic systemic disease. However, research is lacking in Asian countries. OBJECTIVE: To evaluate the association between rosacea and cardiovascular diseases (CVDs) related systemic comorbidities, and the use of antihypertensive and antihyperlipidemic drugs in Korea. METHODS: A five-year retrospective study, using hospital database, was conducted in five medical centers for five years. Totally 1,399,528 patients were evaluated. RESULTS: The overall frequency for diagnosed rosacea was 0.18% over five years (2,536 rosacea patients). Patients with diabetes and patients with dyslipidemia were more likely to have rosacea (odd ratio [OR] 2.724, 95% confidence interval [CI] 1.295~5.730, p=0.016; OR 1.788, 95% CI 1.445~2.212, p < 0.001). Patients with CVD were less likely to have rosacea (OR 0.431, 95% CI 0.244~0.760, p=0.003). Patients with α-blocker prescriptions and patients with β-blocker prescriptions showed a tendency diagnosed with rosacea frequently (OR 1.963, 95% CI 1.200~3.212, p=0.006; OR 3.939, 95% CI 3.512~4.419, p < 0.001). Patients with [beta]-hydroxy-[beta]-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, and those with fibrate, were prone to have rosacea (OR 1.599, 95% CI 1.390~1.839, p < 0.001; OR 1.660, 95% CI 1.056~2.609, p=0.026). As adjusted results, among the patients who took HMG-CoA reductase inhibitor without dyslipidemia, rosacea was less likely to be diagnosed (OR 0.780, 95% CI 0.620~0.982, p=0.034). CONCLUSION: Rosacea is associated with chronic diseases and drugs.