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Background@#Eosinophilic cellulitis, also known as Wells’ syndrome, is an uncommon skin disease characterized by recurrent pruritic polymorphous plaques or nodules. There is limited knowledge in the Korean literature regarding the clinical characteristics and course of eosinophilic cellulitis. @*Objective@#To investigate the clinical and histological features of eosinophilic cellulitis in Korean patients. @*Methods@#In this case series study, we retrospectively reviewed the electronic medical records of patients diagnosed with eosinophilic cellulitis at our institutions from 2004 to 2022. We also analyzed the literature published in dermatology and internal medicine journals in Korea. @*Results@#A total of 17 patients were included in this study (age, 39.4±21.8 years; 12 male [70.6%]), with an average disease duration of 4.4 months. We identified six clinical variants, with the typical plaque type being the most common (33.3%), followed by the papulonodular type (22.2%). Eosinophilia was observed in 78.6% of patients, and a flame figure, which is a typical histopathological feature of eosinophilic cellulitis, was observed in 52.9% of patients. Systemic and topical steroids and antihistamines were used as first-line treatment with generally favorable results (82.4%), followed by antibiotics (35.3%), cyclosporine (23.5%), and topical calcineurin inhibitors (23.5%).The recurrence rate during the mean follow-up period of 21.8 months was 29.4%. @*Conclusion@#Eosinophilic cellulitis can present with various clinical manifestations, and flame figures do not appear in all cases; therefore, clinical and histological correlations are critical for accurate diagnosis of patients with eosinophilic cellulitis.
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As global life expectancy increases, an interest in maintaining health and beauty in old age has increased. As a barrier organ, the skin is an ideal model for studying both genetically-programmed (intrinsic) and environmentallyinduced (extrinsic) aging.Current Concepts: Among the extrinsic aging factors, solar ultraviolet radiation is the most important, accounting for 80% of facial skin aging. Other nongenetic factors include air pollution, cigarette smoke, nutrition, temperature, sleep, and stress. Through complex interplay, genome, exposome and microbiome all contribute to skin aging. Intrinsic aging causes thinning of the skin and fine wrinkles, while extrinsic aging leads to thick rubbery skin texture, deep wrinkles and dyspigmentation in exposed areas. Fibroblast senescence is a fundamental mechanism of skin aging, with these cells persisting and exhibiting a senescence-associated secretory phenotype which secrets proinflammatory cytokines. Chronic low-level inflammation associated with aging, termed inflamm-aging, is exacerbated by oxidative damage caused by extrinsic factors.Discussion and Conclusion: Understanding the pathogenesis of skin aging may help in developing anti-aging strategies in general. In addition to applying sunscreen every morning and retinoic acid every night, taking antioxidant-rich foods and maintaining a healthy lifestyle are all important for preventing skin aging.
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Eccrine nevus is an extremely rare benign cutaneous hamartoma that usually occurs in childhood and adolescence. It has a wide range of clinical manifestations, and histological findings reveal a proliferation of structurally normal eccrine ducts. Herein, we present a case of eccrine nevus on the neck of an 8-year-old girl. Our literature review reveals that the head and neck region is a rare anatomical location for eccrine nevus as it has a predilection for extremities. Our review also suggests that overlying skin changes are common in eccrine nevus regardless of accompanying localized hyperhidrosis.
ABSTRACT
As global life expectancy increases, an interest in maintaining health and beauty in old age has increased. As a barrier organ, the skin is an ideal model for studying both genetically-programmed (intrinsic) and environmentallyinduced (extrinsic) aging.Current Concepts: Among the extrinsic aging factors, solar ultraviolet radiation is the most important, accounting for 80% of facial skin aging. Other nongenetic factors include air pollution, cigarette smoke, nutrition, temperature, sleep, and stress. Through complex interplay, genome, exposome and microbiome all contribute to skin aging. Intrinsic aging causes thinning of the skin and fine wrinkles, while extrinsic aging leads to thick rubbery skin texture, deep wrinkles and dyspigmentation in exposed areas. Fibroblast senescence is a fundamental mechanism of skin aging, with these cells persisting and exhibiting a senescence-associated secretory phenotype which secrets proinflammatory cytokines. Chronic low-level inflammation associated with aging, termed inflamm-aging, is exacerbated by oxidative damage caused by extrinsic factors.Discussion and Conclusion: Understanding the pathogenesis of skin aging may help in developing anti-aging strategies in general. In addition to applying sunscreen every morning and retinoic acid every night, taking antioxidant-rich foods and maintaining a healthy lifestyle are all important for preventing skin aging.
ABSTRACT
Eccrine nevus is an extremely rare benign cutaneous hamartoma that usually occurs in childhood and adolescence. It has a wide range of clinical manifestations, and histological findings reveal a proliferation of structurally normal eccrine ducts. Herein, we present a case of eccrine nevus on the neck of an 8-year-old girl. Our literature review reveals that the head and neck region is a rare anatomical location for eccrine nevus as it has a predilection for extremities. Our review also suggests that overlying skin changes are common in eccrine nevus regardless of accompanying localized hyperhidrosis.
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Background@#The clinical features of inflammatory papulardermatoses of the face are very similar. Their clinical manifestationshave been described on the basis of a small numberof case reports and are not specific. @*Objective@#This studyaimed to use computer-aided image analysis (CAIA) to comparethe clinical features and parameters of inflammatorypapular dermatoses of the face and to develop a formalizeddiagnostic algorithm based on the significant findings. @*Methods@#The study included clinicopathologically confirmedinflammatory papular dermatoses of the face: 8 casesof eosinophilic pustular folliculitis (EPF), 13 of granulomatousperiorificial dermatitis-lupus miliaris disseminatusfaciei (GPD-LMDF) complex, 41 of granulomatous rosacea-papulopustular rosacea complex (GR-PPR) complex,and 4 of folliculitis. Clinical features were evaluated, andarea density of papular lesions was quantitatively measuredwith CAIA. Based on these variables, we developed a predictivemodel for differential diagnosis using classificationand regression tree analysis. @*Results@#The EPF group showedlesion asymmetry and annular clusters of papules in all cases.The GPD-LMDF complex group had significantly higher perioculardensity. The GR-PPR complex group showed a higherarea density of unilateral cheek papules and the highest total area density. According to the predictive model, 3 variableswere used for differential diagnosis of the 4 diseasegroups, and each group was diagnosed with a predictedprobability of 67%∼100%. @*Conclusion@#We statisticallyconfirmed the distinct clinical features of inflammatory papulardermatoses of the face and proposed a diagnostic algorithmfor clinical diagnosis.
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Subject(s)
Aged , Humans , Male , Biopsy , Bowen's Disease , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Dermis , Epidermis , Extremities , Mitosis , Phenobarbital , ThighABSTRACT
Hair follicle nevus (HFN) is a rare, benign, follicular hamartoma that most frequently presents as a congenital nodule on the face. We experienced a rare case of HFN on the neck of a 14-year-old boy and performed a pilot immunohistochemical study with cytokeratin 19 (CK19) to compare the staining pattern of hair follicles in HFN and its differential diagnoses, accessory tragus, cervical chondrocutaneous branchial remnants (CCBR) and trichofolliculoma. With hematoxylin and eosin stain, HFN showed numerous tiny hair follicles in the dermis with several sebaceous and eccrine glands, and perifollicular fibrous thickening. With CK19 stain, some hair follicles in HFN and CCBR showed positive expression, a few hair follicles in accessory tragus showed weak expression, and no hair follicles in trichofolliculoma showed expression. The present report supports the view that HFN, accessory tragus and CCBR are within the same spectrum of hamartomas.
Subject(s)
Adolescent , Humans , Male , Dermis , Diagnosis, Differential , Eccrine Glands , Eosine Yellowish-(YS) , Hair Follicle , Hair , Hamartoma , Hematoxylin , Keratin-19 , Neck , NevusABSTRACT
Atopic dermatitis is a common chronic, relapsing skin disorder, and many patients with atopic dermatitis use complementary and alternative medicine instead of consulting a certified dermatologist. Herein, we report the case of a 38-year-old woman with severe eczema herpeticum who had been treated with herbal medicine and acupuncture for her atopic dermatitis. Herbal medicine and acupuncture are the most frequent types of alternative medicine that Korean patients rely on. However, the effectiveness of these treatments in atopic dermatitis remains unclear as there is a great lack of scientific evidence supporting it. As atopic dermatitis can cause potentially fatal secondary infections such as eczema herpeticum, dermatologists should put great effort into communicating with and educating the patients and in guiding them to choose the most appropriate treatment plan for managing their atopic dermatitis.
Subject(s)
Adult , Female , Humans , Acupuncture , Coinfection , Complementary Therapies , Dermatitis, Atopic , Eczema , Herbal Medicine , Kaposi Varicelliform Eruption , SkinABSTRACT
Although a few reports have noted the concurrent presentation of morphea and vitiligo at distinctly separate sites in the same patient, it is extremely rare that these two conditions occur at the same sites in a patient. We report the case of a 10-year-old Korean girl with morphea and vitiligo and those lesions occurred at the same sites and progressed simultaneously. An autoimmunity and a cutaneous mosaicism was considered to be involved in such an unique presentation as the pathogenesis is concerned.
Subject(s)
Child , Female , Humans , Autoimmunity , Mosaicism , Scleroderma, Localized , VitiligoABSTRACT
No abstract available.
Subject(s)
Dermoscopy , Hair Diseases , Microscopy, Electron, Scanning , PruritusABSTRACT
BACKGROUND: Bacterial skin infections occur secondarily in conditions involving a vulnerable skin barrier such as atopic eczema, as well as primarily such as impetigo. They are mainly caused by Staphylococcus aureus and Streptococci. Recently, the prevalence of methicillin-resistant S. aureus has been increasing. OBJECTIVE: To determine the characteristics of community-acquired bacterial skin infections, to observe their antibiotic susceptibility patterns, and to evaluate factors contributing to the treatment response. METHODS: We retrospectively reviewed outpatients under 30 years old from 2010 to 2015, from whom we had taken skin swabs for antibiotic susceptibility testing. We collected clinical and microbiological characteristics from the medical records. RESULTS: We evaluated the culture results of 197 patients and reviewed their medical records. Overall, 86.3% (n=170) of the patients responded to the initial treatment regimen. S. aureus was the most commonly isolated pathogen (52.6%) and showed a high resistance rate to penicillin (90.9%) and oxacillin (36.3%). In the multivariable logistic regression analysis, resistance to 3 or more antibiotics (p=0.044), culture amounts described as “many” (p=0.040), and non-systemic antibiotic use (p < 0.001) were significantly associated with lower treatment response. However, methicillin resistance was not associated with lower treatment response both in univariable and multivariable analyses. CONCLUSION: Among young patients, S. aureus was the most predominant pathogen present in bacterial skin infections. Resistance to high numbers of antibiotics and the use of non-systemic antibiotics were associated with lower treatment response. First-generation cephalosporins may be the most effective first-line empirical regimen for bacterial skin infections treated in outpatient settings, regardless of methicillin resistance.
Subject(s)
Humans , Anti-Bacterial Agents , Cephalosporins , Dermatitis, Atopic , Impetigo , Logistic Models , Medical Records , Methicillin Resistance , Outpatients , Oxacillin , Penicillins , Prevalence , Retrospective Studies , Skin Diseases, Infectious , Skin , Staphylococcus aureusABSTRACT
Pagetoid Bowen disease is a histological variant of Bowen disease which demonstrates large pale staining cells (pagetoid cells). It requires differential diagnosis from other cutaneous malignancies with similar patterns, such as extramammary Paget's disease (EMPD) and Pagetoid melanoma in situ. Herein, we report a case of Pagetoid Bowen disease which was initially misdiagnosed as ectopic EMPD.