ABSTRACT
Colloid degeneration of the skin is a rare, distinct clinicopathological entity characterized by the deposition of colloid material in the dermis. Nodular colloid degeneration (NCD) is a clinical variant of colloid degeneration of the skin. Herein, we report the case of a 40-year-old woman who presented with a 3-year history of multiple asymptomatic yellowish-brown, indurated papules and plaques on her forehead. Histopathologic examination of the lesion revealed deposition of amorphous pale pink homogenous colloid material with irregular clefts, fissures, and scattered pyknotic nuclei in the upper dermis. The material was negative for Congo red staining, and periodic acid-Schiff and Masson's trichrome staining revealed positive reactivity. Scattered fragmented elastic fibers were present in the colloid material on Verhoeff—Van Gieson staining. The patient was diagnosed with NCD. We propose that NCD should be considered in the differential diagnosis of long-standing facial nodules and plaques.
Subject(s)
Adult , Female , Humans , Colloids , Congo Red , Dermis , Diagnosis, Differential , Elastic Tissue , Forehead , SkinABSTRACT
No abstract available.
Subject(s)
Fingers , Leg Ulcer , Leg , Scleroderma, Systemic , UlcerABSTRACT
No abstract available.
Subject(s)
Acupuncture , Mycobacterium chelonae , Mycobacterium , Nontuberculous MycobacteriaABSTRACT
A case of cutaneous lesions on the left lower leg caused by Curvularia species in an 80-year-old immunocompetent woman is described in this report. The etiological agent was identified as Curvularia species based on its colonial and microscopic morphology in pure tissue culture. The lesions healed after a 9-week regimen of oral itraconazole and topical lanoconazole.
Subject(s)
Aged, 80 and over , Female , Humans , Itraconazole , Leg , PhaeohyphomycosisABSTRACT
BACKGROUND: The atopic dermatitis (AD) can limit a patient's physical and psychosocial development as well as lower their overall quality of life (QOL), including sleep quality. OBJECTIVE: The purpose of this study was to evaluate the relationships between clinical disease severity, QOL and sleep quality in children and adults with AD. METHODS: The SCORing atopic dermatitis (SCORAD) was examined to evaluate the severity of AD in fifty adult AD patients and 50 children AD patients. A questionnaire based on the children's sleep habits questionnaire (CSHQ) and the children's dermatology life quality index (CDLQI) were used to evaluate QOL and sleep disturbance in children AD patients. The Pittsburgh sleep quality index (PSQI) and dermatology life quality index (DLQI) were used in adult AD patients. RESULTS: The SCORAD and CSHQ score, the SCORAD and CDLQI score and the CSHQ and CDLQI score demonstrated significant correlations. The SCORAD and PSQI score showed no significant correlation. However, there were significant correlations between the SCORAD and DLQI score and the PSQI and DLQI score. CONCLUSION: Increasing severity of AD affects sleep quality in child AD patients. In adults, even though the total score of the sleep questionnaire is not associated with the severity of AD, two components of sleep questionnaire are associated with the severity of AD. There is a significant correlation between sleep quality and QOL in both children and adults. Therefore, we suggest that evaluating the sleep quality as well as clinical severity of the disease is necessary in the management of AD patients.
Subject(s)
Adult , Child , Humans , Dermatitis, Atopic , Dermatology , Quality of LifeABSTRACT
BACKGROUND: Hair and nails are known to be related in their origin and anatomical structures, and they are similar in their structure and growth pattern. Nail changes were first reported to be associated with alopecia areata (AA) in 1898. One of the clinical features of AA is nail abnormalities, and these are found in 7% to 66% of patients with AA. OBJECTIVE: We evaluated the frequency, clinical presentation, and associated factors of nail changes in patients with AA. METHODS: A prospective study of 121 patients with AA was performed. The diagnosis of AA was made on clinical grounds. Patients' medical history was obtained, and thorough examinations were performed. Patients with other diseases associated with nail changes were all excluded from the study. The association between the clinical features of patients with AA and the prevalence of nail changes was evaluated using logistic regression analysis. RESULTS: Of the 121 patients, 40 (33%) presented with nail changes. In multivariable analysis, younger age (compared with ≥19 years old; odds ratio [OR] 3.663, 95% confidence interval [CI] 1.094~12.346, p=0.035), chronicity (disease duration ≥2 years; OR 2.852, 95% CI 1.230~6.613, p=0.015), and disease subtype (alopecia totalis and alopecia universalis); OR 5.846, 95% CI 1.078~31.717, p=0.041) were identified as independent factors associated with nail changes in patients with AA. Among the nail abnormalities identified, nail pitting was the most common, observed in 20 patients (50%). Trachyonychia was present in 7 patients (16%), leukonychia in 7 (16%), and Beau line in 5 (11%). Other changes were also observed, including melanonychia, onycholysis, absence of lunula, and onychoschizia. CONCLUSION: In conclusion, younger age, chronicity, and disease subtype (alopecia totalis and alopecia universalis) were shown to be independent relevant indicators of the nail changes in patients with AA.
Subject(s)
Humans , Alopecia Areata , Alopecia , Diagnosis , Hair , Logistic Models , Nails, Malformed , Odds Ratio , Onycholysis , Prevalence , Prospective StudiesABSTRACT
BACKGROUND: Vitamin D insufficiency could be associated with the prevalence of atopic dermatitis (AD). OBJECTIVE: To examine vitamin D status and the relations between serum 25-hydroxyvitamin D levels, SCORAD score, serum LL-37 level, and body mass index (BMI) in Korean AD patients, and to explore whether these associations differ between adults and children. METHODS: Serum 25-hydroxyvitamin D levels, serum LL-37, and clinical features were analyzed in a total of 72 Korean patients with AD (39 adults and 33 children) and 140 healthy control subjects (70 adults and 70 children). RESULTS: Serum 25-hydroxyvitamin D levels were significantly reduced in children with AD (15.06+/-4.64 ng/ml) compared with normal children in the control group (16.25+/-6.60 ng/ml) (p=0.036). Significant inverse correlations were found between BMI and 25-hydroxyvitamin D level (r=-0.315, p=0.007) and between the SCORAD score and serum LL-37 level (r=-0.3, p=0.011) in the total AD patients. CONCLUSION: The results showed that serum vitamin D levels were lower in children with AD than in healthy children; however, the same relation was not observed between adults with AD and healthy adults. Serum 25-hydroxyvitamin D concentration was not significantly correlated with AD severity or serum LL-37 levels in our study population.
Subject(s)
Adult , Child , Humans , Body Mass Index , Dermatitis, Atopic , Prevalence , Vitamin DABSTRACT
We report a case of Majocchi's granuloma in a 71-year-old immunocompetent male patient, who presented with a 6-month history of mass with multiple erythematous nodules and indurated plaques with scale on the left cheek. Even though the lesion strongly suggested cutaneous tumor, the histopathologic findings were consistent with the Majocchi's granuloma, showing numerous hyphae, perifolliculitis and granulomatous inflammation with central abscess formation in the dermis. Trichophyton rubrum was isolated from the biopsy specimen fungus culture. The cutaneous lesion was treated with oral administration of itraconazole (200 mg/day) and topical lanoconazole cream for 4 weeks, and successfully treated.
Subject(s)
Aged , Humans , Male , Abscess , Administration, Oral , Biopsy , Cheek , Dermis , Fungi , Granuloma , Hyphae , Inflammation , Itraconazole , TrichophytonABSTRACT
Histiocytoid Sweet syndrome (HSS) is a recently described rare variant of acute febrile neutrophilic dermatosis. HSS is clinically characterized by painful inflammatory plaques or nodules with high fever and neutrophilia. About 20% of HSS patients also have an associated malignancy, most commonly of hematologic origin. Histopathologically, HSS is characterized by dense histiocytic infiltration with prominent upper dermal edema, and little neutrophil infiltration. A 69-year-old female presented with a 1-week history of painful erythematous plaques on both elbows accompanied by fever. She was diagnosed with acute pyelonephritis and treated with ciprofloxacin for 2 weeks. Routine laboratory tests showed elevated white blood cell count (predominantly neutrophils), erythrocyte sedimentation rate, C-Reactive Protein, and a mildly elevated liver function test. Peripheral blood smears were normal. Histopathologic examination showed papillary dermal edema and diffuse interstitial infiltration of histiocytoid cells. Immunohistochemical studies revealed that the histiocytoid cells were positive for CD 68 and myeloperoxidase. After treatment with systemic glucocorticoids, the skin lesions and fever gradually resolved. Based on the clinical and histopathologic examination, we diagnosed HSS with no evidence of a hematologic disorder. Herein, we report an unusual case of HSS without associated bone marrow dysplasia.
Subject(s)
Aged , Female , Humans , Blood Sedimentation , Bone Marrow , C-Reactive Protein , Ciprofloxacin , Edema , Elbow , Fever , Glucocorticoids , Leukocyte Count , Liver Function Tests , Neutrophil Infiltration , Peroxidase , Pyelonephritis , Skin , Sweet SyndromeABSTRACT
BACKGROUND: Acquired perforating dermatosis (APD) is histopathologically characterized by transepidermal elimination of materials from the upper dermis. APD can be divided into four diseases: Kyrle's disease, perforating folliculitis, elastosis perforans serpiginosa, and reactive perforating collagenosis. APD is usually associated with systemic diseases, especially diabetes mellitus or chronic renal failure. So far, there have only been a few Korean studies of APD, which have a limited number of patients. OBJECTIVE: The aim of this study is to evaluate the clinical and histopathologic characteristics of 30 cases of APD and to examine the association with systemic diseases. METHODS: We retrospectively reviewed the medical records and biopsy specimens of 30 patients who were diagnosed with APD. RESULTS: The mean age was 55.5 years, and the average duration of the lesion was 7.8 months. The lower extremities (73.3%) were the most frequently occurring sites of the lesion. Twenty-five patients (83.3%) had pruritus, and Koebner's phenomenon was present in 11 patients. Patients of 63.3% had at least one systemic disease. Diabetes mellitus (n=17, 56.7%) and chronic renal failure (n=10, 33.3%) were the most commonly associated conditions. Most patients received topical steroids (93.3%) and antihistamines (80.0%). The most common histopathologic type was reactive perforating collagenosis (n=23, 73.3%). CONCLUSION: In this study, most patients had a systemic association to the diseases. Therefore, we suggest that further evaluation is necessary for patients who present with APD. This includes reviewing patient's comprehensive past medical history, clinical exam, and additional diagnostic testing to check for the possibility of associated systemic diseases.