ABSTRACT
BACKGROUND: Acquired bilateral nevus of Ota-like macules (ABNOM) is a dermal pigmented lesion common in individuals of Oriental origin. The Q-switched Nd:YAG laser (QSNYL) has been used successfully to treat a variety of benign, dermal, pigmented lesions, including nevus of Ota lesions. The similarity between ABNOM and nevus of Ota suggested that QSNYL may also be effective in the former. OBJECTIVE: To determine the efficacy and side-effect profiles of QSNYL treatment of ABNOM in Korean patients. METHODS: Of 42 Korean patients with ABNOM, 29 were treated with QSNYL (1,064 nm, 3 mm spot size, fluence 8~9.5 J/cm2), for up to 10 sessions each. Clinical photographs were taken before and after treatment. Lesion clearance was graded and complications such as hyperpigmentation, scarring, hypopigmentation, and erythema were assessed. RESULTS: Of the 29 treated patients, 19 (66%) showed excellent or good results. Of the patients who were treated more than 3 times, 76% showed good to excellent results. Two patients experienced post-laser hyperpigmentation (PLH), which persisted for more than one month, but no patient experienced persistent erythema or hypertrophic scarring. CONCLUSION: QSNYL is safe and effective in the treatment of ABNOM in Korean patients. Short-interval repetitive treatment is especially useful in improving therapeutic results and reducing PLH.
Subject(s)
Humans , Cicatrix , Cicatrix, Hypertrophic , Erythema , Hyperpigmentation , Hypopigmentation , Laser Therapy , Nevus , Nevus of OtaABSTRACT
Cell growth characterized by cell cycle progression is regulated by cyclin-dependent kinase (CDK). CDKs are activated by binding cyclins such as cyclin A, cyclin B, cyclin D1, and cyclin E. Proliferative indices such as Ki-67 and proliferative cell nuclear antigen (PCNA) are known to be correlated with the mitotic index and were reported to have increased in the lesional psoriatic skin in previous reports. In this study, we investigated the expression of cyclins and proliferative indices (cyclin A, cyclin B, cyclin D1, cyclin E, Ki-67, and PCNA) in the psoriatic epidermis before and after cyclosporin therapy (3mg/kg/day 12 wks). Cyclin A, Ki-67, and PCNA were 1+ to 2+ positive before treatment but showed positive staining in only a few cells after treatment. Cyclin B and cyclin E were also moderate-to-strongly positive before treatment and became only weakly positive after treatment. Cyclin D1 was expressed only in a few cells and was negative after treatment. Taken together, cyclosporin may have an anti-proliferative effect on keratinocytes which was demonstrated by reduction of the proliferative indices such as Ki-67 and PCNA. The mechanism of the anti-proliferative effect may be through the inhibition of the cell cycle progression. Cyclin A, cyclin B and cyclin E are amongst the targeted cell cycle modulators, whereas cyclin D1 seems to be less induced in the lesional psoriatic epidermis, both before and after cyclosporin therapy.
Subject(s)
Cell Cycle , Cyclin A , Cyclin B , Cyclin D1 , Cyclin E , Cyclins , Cyclosporine , Epidermis , Keratinocytes , Mitotic Index , Phosphotransferases , Proliferating Cell Nuclear Antigen , Psoriasis , SkinABSTRACT
The keratinocytes in human epidermis are replaced by a population of stem cells located in the basal layer of the epidermis and one candidate stem cell marker is the transcription factor p63. We studied the expression of p63, immunohistochemically, in various hyperproliferative skin diseases (10 poorly differentiated metastatis squamous cell carcinomas (SCCs), 10 non-metastatic primary cutaneous SCCs, 10 cases of Bowen's diseases, 10 actinic keratosis, and 10 melanomas) and also observed the change of p63 expression in psoriasis after cyclosporine treatment. p63 was normally expressed in basal layer cells. Poorly-differentiated metastatic SCC showed the highest expression in most of the tumor cells, while psoriasis, actinic keratosis, Bowen's disease and primary SCC showed an increased expression in the basal and suprabasal area compared to in normal epidermis. The cyclosporine treatment in psoriasis reduced the expression of p63 to a normal level. This data suggests that p63 expression may influence tumor cell differentiation and proliferation without a direct tumorigenesis effect in epithelial tissue.
Subject(s)
Humans , Bowen's Disease , Carcinogenesis , Carcinoma, Squamous Cell , Cell Differentiation , Cyclosporine , Epidermis , Keratinocytes , Keratosis, Actinic , Psoriasis , Skin Diseases , Skin , Stem Cells , Transcription FactorsABSTRACT
BACKGROUND: Neuroimmunocutaneous system alteration can be responsible for the induction and maintenance of the inflammatory process of psoriasis. OBJECTIVE: This study was carried out to examine the expression of Substance P (SP), calcitonin gene-related peptide (CGRP), somatostatin (SOM), neutral endopeptidase (NEP), SP receptor, and CGRP receptor in psoriatic lesions. METHODS: A skin biopsy was obtained from 10 psoriatic patients and 10 normal control subjects. Confocal laser scanning microscopy was performed. RESULTS: The SP and CGRP receptors consistently increased in psoriatic lesions, compared to the normal controls. CONCLUSION: The increased expression of neuropeptides and their receptors may be involved in the pathogenesis of psoriasis.
Subject(s)
Humans , Biopsy , Calcitonin Gene-Related Peptide , Microscopy, Confocal , Neprilysin , Neuropeptides , Psoriasis , Receptors, Calcitonin Gene-Related Peptide , Receptors, Neuropeptide , Skin , Somatostatin , Substance PABSTRACT
Endometriosis is defined as the abnormal growth of endometrial tissue outside the uterine cavity, but in rare cases may also occur on the skin. Cutaneous endometriosis frequently develops at the site of a prior abdominal or pelvic procedure, although apparent spontaneous occurrence has been reported. We present a case of non-symptomatic, cutaneous endometriosis in the episiotomy scar. The patient had no evidence of concurrent pelvic endometriosis.
Subject(s)
Female , Humans , Cicatrix , Endometriosis , Episiotomy , SkinABSTRACT
Congenital self-healing reticulohistiocytosis is a variant of Langerhans cell histiocytosis, and shows spontaneous resolution within 3-4 months. Histopathologically, it is characterized by epidermotropic infiltrates of histiocytes with kidney-shaped nuclei and abundant eosinophilic cytoplasm. We present a female new-born baby with congenital, multiple, erythematous papules containing some vesicles. A skin biopsy showed typical features of Langerhans cell histiocytosis. Her skin lesion is healed spontaneously within 2 months, without scarring.
Subject(s)
Female , Humans , Biopsy , Cicatrix , Cytoplasm , Eosinophils , Histiocytes , Histiocytosis, Langerhans-Cell , SkinABSTRACT
A solitary acantholytic acanthoma is a benign tumor which presents as a solitary asymptomatic, keratotic papule or nodule. The acantholysis, implied in the term, is the histologic hallmark. It may mimic pemphigus vulgaris, pemphigus vegetans, or Hailey-Hailey disease, but displays no evidence of these disorders. We report a case of isolated acantholytic acanthoma in a 78-year-old man, where the histologic feature is focal acantholytic dyskeratosis.
Subject(s)
Aged , Humans , Acantholysis , Acanthoma , Pemphigus , Pemphigus, Benign FamilialABSTRACT
Tumid lupus erythematosus (TLE) is a variant of cutaneous lupus erythematosus. Most patients who present with these skin lesions are young women. The condition clinically resembles polymorphous light eruption, reticulated erythematous mucinosis, or gyrate erythema. Histopathologically, the lesions resemble classic lupus erythematosus because of their superficial and deep lymphohistiocytic inflammatory infiltrates and dermal mucin. However, unlike classic lupus erythematosus, there is little or no epidermal or dermo-epidermal involvement. Antinuclear antibody test results are usually negative. We report a case of TLE and discuss the differential diagnosis.
Subject(s)
Female , Humans , Antibodies, Antinuclear , Diagnosis, Differential , Erythema , Lupus Erythematosus, Cutaneous , Mucinoses , Mucins , SkinABSTRACT
Wells' syndrome, or eosinophilic cellulitis, is characterized clinically by an acute dermatitis resembling cellulitis, which evolves into violaceous plaques that resolve spontaneously without scarring. The histopathologic features show dermal eosinophil infiltration and development of characteristic `flame figure'. Wells' syndrome has been described mainly in adults, and less than 20 childhood cases have been reported. We herein report a case of Wells' syndrome in a 3-year-old boy.
Subject(s)
Adult , Child , Child, Preschool , Humans , Male , Cellulitis , Cicatrix , Dermatitis , EosinophilsABSTRACT
Epidermolytic acanthoma is a rare benign tumor, which may occur in both isolated and disseminated forms. Clinically, this asymptomatic lesion resembles a verruca or molluscum. Histopathologically, it is characterized by epidermolytic hyperkeratosis, also referred to as granular degeneration. We, herein, report a case of isolated epidermolytic acanthoma on the scrotum in a 36-year-old man for its rarity in Korean dermatologic literature.
Subject(s)
Adult , Humans , Acanthoma , Hyperkeratosis, Epidermolytic , Scrotum , WartsABSTRACT
BACKGROUND: Human hair usually emerges from the scalp in groups of 2 or 3-hair units. Hair densities and grouping patterns in androgenetic alopecia (AGA) patients are known to be different from those in normal adults, but no comparative study has ever before been made in Korea. Therefore we have developed some technical improvements on phototrichogram methodology to evaluate the differences between these two groups. BACKGROUND: Objectives: This study was performed to quantify Koreans' hair characteristics at each site (vertex, occipital, temporal) of the scalp according to the age and to compare the differences of hair characteristics of AGA and normal adults using phototrichogram. METHODS: Hairs in the precisely defined circle at each (vertex, temporal, occipital) site of the scalp in 37 AGA male patients and 15 healthy male volunteers were evaluated according to age. Each circumscribed area of the scalp, centered with a dot tattoo to ensure reproducibility, was photographed just after shaving, and named 'primary image'. Two days later, the same area was again photographed, and named 'secondary image', from which the hair density and the grouping pattern of hair follicular units were determined by the image analyzer program. RESULTS: The results can be summarized as follows: 1. In normal adult males, the range of hair density was 117~13/cm2~140~16/cm2, with the hair density of the occiput being significantly higher than that of the temple. No significant differences in hair density were shown between vertex and occiput. 2. In AGA male patients, the range of hair density was 102~23/cm2-137~17/cm2, and the differences of the hair density between vertex and occiput were statistically significant. 3. The numbers of grouped hair units per square centimeter in the non-bald adult male group ranged from 59~11/cm2 to 73~14/cm2. The most common grouped hair unit was a 2-hair unit, followed by a 1-hair unit and a 3-hair unit group. 4. In the AGA group, the numbers of grouped hair units per square centimeter ranged from 57~6/cm2 to 72~12/cm2, showing no significance with the control group. The most common grouped hair unit was a 1-hair unit, followed by a 2-hair unit and a 3-hair unit group. CONCLUSIONS: The AGA group compared remarkably with the normal adult male group, showing a lower hair density with a larger proportion of 1-grouped hair units. Based on the data about hair density and hair grouping patterns in AGA patients, surgeons can estimate the area of donor scalp with the most probable number of follicular units in hair trans-plantation procedures.