Adipose-Derived Stem Cells Improve Efficacy of Melanocyte Transplantation in Animal Skin

Vitiligo is a pigmentary disorder induced by a loss of melanocytes. In addition to replacement of pure melanocytes, cocultures of melanocytes with keratinocytes have been used to improve the repigmentation outcome in vitiligo treatment. We previously identified by in vitro studies, that adipose-derived stem cells (ADSCs) could be a potential substitute for keratinocytes in cocultures with melanocytes. In this study, the efficacy of pigmentation including durability of grafted melanocytes and short-term safety was examined in the nude mouse and Sprague-Dawley rat after grafting of primary cultured human melanocytes, with or without different ratios of primary cultured human ADSCs. Simultaneous grafting of melanocytes and ADSCs, which were separately cultured and mixed on grafting at the ratios of 1:1, 1:2, or 1:3, showed better efficacy than that of pure melanocytes. Grafting of melanocytes cocultured with ADSCs resulted in a similar outcome as the grafting of cell mixtures. Skin pigmentation by melanocytes : ADSCs at the ratios of 1:1 and 1:2 was better than at 1:3. No significant difference was observed between the 1-week and 2-week durations in coculturing. Time-course microscopic examination showed that the grafted melanocytes remained a little longer than 6-week post-grafting. No inflammatory cell infiltration was observed in the grafted skin and no melanocytes were detectable in other organs. Collectively, grafting of melanocytes and ADSCs was equally safe and more effective than grafting of melanocytes alone. Despite the absence of significant differences in efficacy between the group of 1:1 and that of 1:2 ratio, 1:2 ratio for 1-week coculturing may be better for clinical use from the cost-benefit viewpoint.

A Case of Fixed Drug Eruption Due to Doxycycline and Erythromycin Present in Food

A fixed drug eruption (FDE) is not difficult to diagnose, given its clinical characteristics. However, the causative agent can be difficult to identify, particularly when the patient denies ingestion of any drugs. To the best of our knowledge, we present herein the first reported case of an FDE caused by antibiotics taken in food; doxycycline and erythromycin contained in pork and fish. A 57-year-old female experienced repeated episodes of well-demarcated erythematous patches covering her entire body. She denied taking any medications, but she thought that the lesions appeared after consuming pork and/or fish. An oral provocation test showed positive results for doxycycline and erythromycin, commonly used antibiotics in live-stock farming and in the fishing industry. Because of the antibiotics' thermostability, cooking does not guarantee the elimination of residual drugs. From the patient's history, we concluded that doxycycline and erythromycin contained in the pork and fish that she ate were the cause of the FDE.

Vitiligo Lesions Improved after Oral Cyclosporine in a Patient with Vitiligo and Atopic Dermatitis / 대한피부과학회지

Vitiligo is an acquired cutaneous disorder of pigmentation with no definite etiology. Although there are a number of treatment modalities including phototherapy, topical corticosteroids and topical immunomodulators, few studies on the effect of systemic cyclosporine for the treatment of vitiligo have been conducted. We have experienced the improvement of vitiligo lesions after 8 months of systemic administration of cyclosporine (2.5~3.3 mg/kg/day) in a patient with vitiligo and atopic dermatitis. We believe this case report warrants further investigations of cyclosporine for the treatment of vitiligo in terms of mechanisms and clinical outcomes as well.

Aplasia Cutis Congenita in Two Siblings / 대한피부과학회지

Aplasia cutis congenita is a rare congenital condition, characterized by localized absence of epidermis, dermis, and in some cases, subcutaneous tissues. About 80% of the patients with aplasia cutis congenita have involvement of the scalp. Aplasia cutis congenita, not involving the scalp, appears to be linear lesions with a symmetrical pattern of distribution on the trunk and limbs. Most reported cases are sporadic, but a few cases have been reported to have familial occurrence. There is no unifying theory for the pathogenesis and etiology. Herein, we report a 1-day-old female infant and her 4-year-old sister with unilateral aplasia cutis congenita on their legs. No similar conditions and other associated congenital anomalies were found in their family. There was no sign of teratogenic causes, such as intrauterine infections, drugs or chemical agents.

Papular Elastolytic Giant Cell Granuloma Occurring on Non-sun-exposed Skin / 대한피부과학회지

Papular elastolytic giant cell granuloma is an unusual variant of annular elastolytic giant cell granuloma, characterized by the development of asymptomatic, multiple, small erythematous papules on both sun-exposed and non-sun-exposed area. Histopathologically, it shows a granulomatous infiltration, accompanied by the absence of the elastic tissue and phagocytosis of elastic fibers by multinucleated giant cell. An 83-year-old man was presented with a 1 year history of multiple erythematous papules on his abdomen and lower legs. Histopathologic finding showed a non-palisading granulomatous infiltration with multinucleated giant cells and engulfing elastic fibers. We, herein, report an unusual case of papular elastolytic giant cell granuloma, which occurred on non-sun-exposed skin.

Pacinian Neuroma on the Tips of Fingers / 대한피부과학회지

Pacinian neuroma, also known as hyperplasia and/or hypertrophy of pacinian corpuscles is a rare skin condition usually occurring in the hand. Although it is known to cause pain and tenderness on the affected skin, asymptomatic cases have also been reported. We report a 46-year-old male monk who presented with asymptomatic skin lesions of paler color than the adjacent normal skin on the tips of the fingers of both hands. The 3 mm punch biopsy conducted on the lesion showed an increased number of onion bulb-like structures with a nerve fiber in each center. The patient was diagnosed with pacinian neuroma and has been under regular follow up without treatment.

Nonpigmenting Fixed Drug Eruption due to Codeine / 대한피부과학회지

Fixed drug eruption is a distinctive and clinically recognizable entity that is characterized by well-demarcated erythematous plaques recurring in exactly the same sites as on previous occasions. Unlike the pigmenting form of fixed drug eruption, nonpigmenting fixed drug eruption leaves no pigmentation when it resolves. We now report the case of a 44-year-old man who presented with diffuse ill-defined erythematous patches on both hands, feet and lower legs with a burning sensation, which is considered an atypical manifestation for fixed drug eruption. The patient had a history of similar skin lesions developing after medications on the corresponding regions. The patch test with suspected drugs showed negative reactions on both lesions and unaffected sites. The lesions were reproduced on the oral provocation test with codeine and resolved without pigmentation. The patient was diagnosed with nonpigmenting fixed drug eruption due to codeine.

Atypical Fibroxanthoma Masquerading as Xanthogranuloma / 대한피부과학회지

Atypical fibroxanthoma is an uncommon spindle cell tumor that has a clinically benign course despite the presence of bizarre xanthoma cells. A 90-year-old female presented with a 2-month history of an ulcerative plaque on the right cheek. The initial punch biopsy revealed a benign histological appearance with prominent xanthomatous cells, but the specimen excised afterwards showed malignant features with a spindle and epithelioid cell proliferation with pleomorphism and atypia. The tumor cells stained positively for vimentin and CD68, they were partially positive for CD99 and CD10 and they were negative for CD34, S100, p63, desmin and actin. We report here on a case of atypical fibroxanthoma masquerading as xanthogranuloma.