ABSTRACT
BACKGROUND: Self-inflicted dermatosis is a kind of self-inflicted skin disease. Most Vietnam veterans from Korea have visited the Veterans Hospitals for dermatological examination to determine the relationship between their skin diseases and Agent Orange. We were suspicious of the possibility that several Vietnam veterans intentionally produced their own skin lesions. OBJECTIVE: We conducted this study to determine the clinical characteristics of self-inflicted dermatoses of Korean Vietnam veterans. METHODS: From January, 1999 to December, 2007, a total 24 Vietnam veterans who were diagnosed as having self-inflicted dermatoses during their dermatological examinations at our hospital were included in this study. We investigated their clinical presentation, the laboratory examinations, the pathologic examinations, the medical records and the associated diseases. RESULTS: Itching was the most common subjective complaint and the duration of the itching was as follows; 20 to 30 yrs (50.0%), 1 to 10 yrs (25.0%), 10 to 20 yrs (20.8%) etc. The skin lesions were all multiple, and the involved area was as follows; upper extremities (83.3%), trunk (75.0%), lower extremities (70.8%) etc. There were two categories of clinical skin presentation. The first was the cases with lesion that were thought to be made by physical trauma such as stinging or excoriation, and the second more common cases had lesions that were thought to be made by chemical agents (70.8%). These cases resembled allergic or toxic irritant dermatitis and the lesions were composed of vesicles, erosions, ulcers and crusts that were within an arm's reach. Only 4 cases admitted to intentionally inflicting their skin lesions because of intense itching, and the others denied that they made the skin lesions by themselves. Skin biopsies were carried out in 19 of the total 24 cases, and the most common finding was spongiotic dermatitis (57.8%). CONCLUSION: This study showed the distribution and characteristics of self-inflicted dermatoses, and the study provides fundamental data for dermatologists to assess patients with self-inflicted dermatoses.
Subject(s)
Humans , 2,4,5-Trichlorophenoxyacetic Acid , 2,4-Dichlorophenoxyacetic Acid , Biopsy , Bites and Stings , Citrus sinensis , Dermatitis , Dermatitis, Irritant , Hospitals, Veterans , Intention , Korea , Lower Extremity , Medical Records , Pruritus , Skin , Skin Diseases , Polychlorinated Dibenzodioxins , Ulcer , Upper Extremity , Veterans , VietnamABSTRACT
Syringomas confined to the distal extremities are very rare. A 62-year-old man presented with an 8-month history of multiple, light brown, flat-topped papules on both forearms and the dorsa of the hands. Histopathologic examination showed multiple dilated eccrine ducts lined by two rows of epithelial cells. There has currently been less than 10 reported cases of syringoma confined to both forearms and the dorsa of the hands in the world medical literature.
Subject(s)
Humans , Middle Aged , Epithelial Cells , Extremities , Forearm , Hand , Light , SyringomaABSTRACT
Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma. It is regarded as an undifferentiated pleomorphic sarcoma with an unproven histogenesis. It most commonly occurs in the skeletal muscles of the extremities or the retroperitoneum of adults. It often metastasizes to the lungs, lymph nodes, bones and liver, but rarely to the skin. We report here a case of malignant fibrous histiocytoma that metastasized to the skin.
Subject(s)
Adult , Humans , Extremities , Histiocytoma, Malignant Fibrous , Liver , Lung , Lymph Nodes , Muscle, Skeletal , Neoplasm Metastasis , Sarcoma , SkinABSTRACT
BACKGROUND: Claudins are integral membrane proteins at tight junctions of simple epithelium and have an important role in cell-cell adhesion and barrier function. Their altered expression modifies the biological function and behavior of epithelial cells. OBJECTIVE: The purpose of this study was to observe the distribution and the degree of expression of claudin-1 during fetal skin development. METHODS: The expression of claudin-1 in the fetal skin was analyzed after immunohistochemical stain was performed on paraffin embedded tissue of sole and scalp of 34 human fetuses, ranging from 10 to 39 weeks of gestational age, using anti-human monoclonal antibody against the claudin-1. RESULTS: Claudin-1 appeared strongly in the sole skin at the 12th week of gestation thereafter expressed more in middle layer in epidermis of the sole and the scalp. Inner root sheaths and early hair germ cells were strongly positive in fetal hair development. Eccrine gland epithelium was positive in later stages. Focal positive expression in superficial layer and strong in middle layer were noted in oral mucosa side of the lip. CONCLUSION: Claudin-1 showed slightly different expression in skin and oral mucosa and has a important role in the development of tight junction and barrier formation in skin and mucosa during fetal stage.
Subject(s)
Humans , Pregnancy , Claudin-1 , Claudins , Eccrine Glands , Epidermis , Epithelium , Fetus , Germ Cells , Gestational Age , Hair , Lip , Membrane Proteins , Mouth Mucosa , Mucous Membrane , Paraffin , Scalp , Skin , Tight JunctionsABSTRACT
Sorafenib (Nexavar(R)) is an oral multikinase inhibitor that was recently approved for use in metastatic renal cancer. It is currently undergoing investigation for the treatment of locally advanced renal cancer and in other tumor types. It has a broad spectrum of activity in treating multiple tyrosine kinases, including angiogenic factors VEGFR and PDGFR. Common cutaneous toxicities experienced with sorafenib include facial and scalp erythema, hand-foot syndrome, splinter hemorrhages, and alopecia. We report a case of a 57 year-old man diagnosed as renal cell carcinoma with distant metastaisis, who developed a leukocytoclastic vasculitis on the extremities after use of sorafenib.
Subject(s)
Alopecia , Angiogenesis Inducing Agents , Carcinoma, Renal Cell , Erythema , Extremities , Hand-Foot Syndrome , Hemorrhage , Kidney Neoplasms , Niacinamide , Phenylurea Compounds , Phosphotransferases , Scalp , Tyrosine , Vasculitis , Vasculitis, Leukocytoclastic, CutaneousABSTRACT
BACKGROUND: The epidermis and adnexal epithelium might express different types of keratin (K) during fetal development. OBJECTIVE: The objective is to observe the distribution of K8/18 in the skin of fetuses and to find out the distinction of expressions of K8/18 during fetal development. METHODS: Immunohistochemical analysis was applied to the skin of the scalp and sole of 42 fetuses ranging from 10 to 39 weeks of gestation. Immunohistochemical staining with monoclonal antibodies with CAM5.2 using LSAB kit against K8/18 was conducted. RESULTS: In the skin of the scalp, K8/18 was expressed in the periderm and basal layer of epidermis from the 10th week to the 31st week of fetal gestation. K8/18 was expressed in the hair germ, bulge and basal cells of fetal the infundibulum and sebaceous glands. Root sheath cells were weakly positive but matrix cells were negative. The expression of K8/18 was negative in the basal layer of the sole. Merkel cells, which are located in the basal layer and upper dermis, were positive from the 12th week of gestation. Terminal eccrine ducts and acinar cells were positive after the 20th week of gestation. CONCLUSION: K8/18 in the skin of the scalp and sole of fetuses were expressed in different ways. The expression of K8/18 in the basal cells of the sole were negative while basal cells of the epidermis of the scalp were positive transiently from the 12th to the 31st week of gestation. Early hair germ cells and bulge cells were expressed strongly in hair follicles. Terminal eccrine ducts and acini were expressed strongly in the eccrine gland. Merkel cells located in the basal layer and papillary dermis also express K8/18.
Subject(s)
Pregnancy , Acinar Cells , Antibodies, Monoclonal , Dermis , Eccrine Glands , Epidermis , Epithelium , Fetal Development , Fetus , Germ Cells , Hair , Hair Follicle , Merkel Cells , Molecular Weight , Scalp , Sebaceous Glands , SkinABSTRACT
While leprosy is usually a chronic disease, leprosy reactions may lead to acute problems. These reactions most often occur after initiation of therapy, but can also develop before treatment. We report a case of leprosy type 1 reaction as the first manifestation of borderline tuberculoid leposy. The patient was a 71-year-old woman who had never received treatment for leprosy. She developed multiple erythematous, swollen lesions on has face, extremities and trunk within a few weeks and suffered from paresthesia, numbness and tenderness on those sites. General symptoms were accompanied by fever, malaise, fatigue and loss of appetite. Histological examination revealed multiple tuberculoid granulomas along with neurovascular bundles. A few acid-fast bacilli were detected on AFB stain. The disease was classified as borderline tuberculoid leprosy. The acute neuritis followed by skin lesions represented leprosy with type 1 reaction.
Subject(s)
Aged , Female , Humans , Appetite , Chronic Disease , Extremities , Fatigue , Fever , Granuloma , Hypesthesia , Leprosy , Leprosy, Paucibacillary , Neuritis , Paresthesia , SkinABSTRACT
Cutaneous metastasis from the papillary thyroid carcinoma is rare. An otherwise asymptomatic 57-year-old man presented with a 3 year history of a steadily-enlarging scalp nodule. The histopathologic features showed a complicated pattern of follicular architecture formed by papilliform fibrovascular stroma. The tumor cells stained positive for thyroglobulin. A subsequent thyroid sonogram revealed multiple nodules in both lobes and resection of the thyroid gland identified papillary thyroid carcinoma. The solitary scalp nodule was presenting sign of an occult thyroid carcinoma. We report a case of cutaneous metastasis from the papillary thyroid carcinoma.
Subject(s)
Humans , Middle Aged , Neoplasm Metastasis , Scalp , Thyroglobulin , Thyroid Gland , Thyroid NeoplasmsABSTRACT
No abstract available.