ABSTRACT
Rosacea fulminans is an extreme form of rosacea characterized by a rapid onset and fulminating course with prominent erythema, pustules,and cysts on the face. It can have an impact on obstetrical outcomes, and its treatments may have limitations during pregnancy. A 33-year-old woman and a 22-year-old woman presented with rosacea fulminans during the first pregnancy andwere treated with erythromycin and prednisone, respectively. After delivery, there was a significant improvement in the lesion. Rosacea fulminans recurred during the second pregnancy, but the skin lesions showed better progression. Rosacea fulminans can causesevere distress and different outcomes of pregnancy. It is recommended to consult about the risk of recurrence in future pregnancies.
ABSTRACT
Palisaded neutrophilic and granulomatous dermatitis (PNGD) is an uncommon skin eruption and characterized histopathologically by the presence of granulomatous inflammation with or without leukocytoclastic vasculitis. PNGD is known to be associated with various immune-mediated connective tissue diseases such as rheumatoid arthritis and lupus erythematosus. However, to our knowledge, a case of PNGD in a patient with Behçet’s disease is extremely rare and only one case has been reported in foreign literature to date. Herein, we report an unusual case of a 60-year-old female with Behçet’s disease who presented multiple erythematous to flesh-colored papules on the extremities, buttocks, and ear lobes and was diagnosed with PNGD. After the treatment of systemic corticosteroids, colchicine and azathioprine, the skin lesions and oral ulcers improved. The patient is under observation without recurrence of skin lesions for 6 months.
ABSTRACT
Background@#Actinic keratosis (AK) is a common skin disease caused by exposure to ultraviolet light that can progress to invasive squamous cell carcinoma. Ingenol mebutate (IM), a novel agent for field therapy of AK, has been widely used, but research on its effectiveness has focused more on Caucasian rather than Asian people. @*Objective@#The effectiveness and local skin reaction of IM gel treatment in Koreans were investigated through long-term follow-up. @*Methods@#We retrospectively reviewed 17 patients histopathologically diagnosed with AK on the face/scalp and treated with IM gel (0.015%) between 2015 and 2017. The clinical efficacy and local skin reactions were assessed from medical records. The long-term effects of IM gel treatment were evaluated after 6 months of treatment. Results: Nine of the 17 (52.9%) subjects had a complete response at day 57. Although the patients developed erythema (100%), flaking/scaling (76%), crusting (47%), swelling (64%), vesiculation/pustulation (70%), and erosion/ ulceration (35%) as a local skin reactions at day 4, most of these reactions had disappeared at day 57. Most of the patients (76.5%) complained of pain or irritation as side effects. The long-term efficacy was assessed in two patients with a complete response at day 57 and the complete response was sustained for all patients at 6 months. @*Conclusion@#IM seems to be an effective field therapy for multiple AK lesions with short-term use and stability. Further studies are needed on the effects of IM therapy in the Korean population.
ABSTRACT
Systemic anaplastic large cell lymphoma (ALCL) is an aggressive CD30-positive non-Hodgkin lymphoma. The most common clinical manifestations of systemic ALCL are solitary or multiple large nodular tumoral lesions confined to one body compartment. A sporotrichoid pattern, temporally occurring distally to proximally, is extremely rare. We herein describe a case of CD30-positive, ALK-negative systemic ALCL in a 68-year-old man with multiple nodules and tumors that exhibited a linear distribution and sporotrichoid pattern.
ABSTRACT
Although the exact etiology of cutaneous angiosarcoma remains unclear, MYC gene amplification has been recently discovered as a new pathogenesis. MYC is a proto-oncogene, and aberration of MYC signaling in malignancies is associated with tumor metastasis, recurrence, and mortality. Moreover, upregulation of the miRNA polycistron, miR-17-92 cluster, were confirmed in both cutaneous angiosarcoma and multiple myeloma with MYC amplification. The correlation between MYC and miRNA expression is predictable as the coincident aberrant phenotype in two diseases. Moreover, the exploiting MYC dependency may be an attractive disease-specific strategy for the diagnosis and treatment of patients who are unaware of the causes of cutaneous angiosarcoma. Herein, a rare case of cutaneous angiosarcoma of the foot, which is also the first case of cutaneous angiosarcoma accompanied by multiple myeloma, has been described.
Subject(s)
Humans , Diagnosis , Foot , Genes, myc , Hemangiosarcoma , MicroRNAs , Mortality , Multiple Myeloma , Neoplasm Metastasis , Phenotype , Proto-Oncogenes , Recurrence , Up-RegulationABSTRACT
Elephantiasis nostras verrucosa (ENV) is an uncommon condition caused by repeated inflammation and lymphatic obstruction. It occurs mainly in the lower extremities and is characterized by skin changes, including hyperkeratotic mossy papules and plaques, non-pitting edema, and cobblestone-like appearances. ENV can be diagnosed based on its typical clinical manifestations (pseudoepitheliomatous hyperplasia with enlarged lymphatic spaces, fibrous tissue proliferation, and chronic inflammation) and by skin biopsy. Although ENV is difficult to treat, reduction of lymphedema and use of keratolytic agents may be helpful. To our knowledge, only three cases of ENV have been reported. However, the case of ENV treated with oral acitretin has not been reported in domestic literatures. Therefore, we report the case of a 45-year-old woman who developed ENV. She had a past history of cellulitis and was successfully treated with oral acitretin.
Subject(s)
Female , Humans , Middle Aged , Acitretin , Biopsy , Cellulitis , Edema , Elephantiasis , Hyperplasia , Inflammation , Keratolytic Agents , Lower Extremity , Lymphedema , SkinABSTRACT
Allergic contact dermatitis is an inflammatory condition associated with periorbital erythema, edema, and pruritus. The periorbital skin is relatively thin compared with the skin over other facial areas; therefore, it is vulnerable to allergen penetration and may show a variety of cutaneous manifestations. Recently, vision enhancement surgery is a widely performed procedure, and the prevalence of senile cataract and glaucoma is increasing. The prevalence of periocular allergic contact dermatitis is increasing secondary to the growing use of topical ophthalmic medications. Several studies in Korea have reported periocular allergic contact dermatitis secondary to the use of topical ophthalmic medications including latanoprost (Latano®), fluorometholone (Tolon®), polymyxin B (Terramycin®), atropine sulfate (Atropine®), neomycin sulfate (Cambison®), and befunolol hydrochloride (Bentos®), among others. However, ofloxacin (Effexin®)-induced allergic contact dermatitis has not been reported in the domestic and/or foreign literature. We report a case of periocular allergic contact dermatitis secondary to the use of ofloxacin ophthalmic ointment.
Subject(s)
Atropine , Cataract , Dermatitis, Allergic Contact , Edema , Erythema , Fluorometholone , Glaucoma , Korea , Neomycin , Ofloxacin , Polymyxin B , Prevalence , Pruritus , SkinABSTRACT
Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder. It is histopathologically characterized by the presence of coronoid lamellae and clinically by lesions showing central atrophy with elevated borders. Squamous cell carcinoma originating in the classical Mibelli subtype of porokeratosis is well-documented; however, few reports have described squamous cell carcinoma in DSAP lesions. We report the case of a 76-year-old woman with DSAP who developed Bowen's disease, actinic keratosis, and keratoacanthoma on her face.
Subject(s)
Aged , Female , Humans , Atrophy , Bowen's Disease , Carcinoma, Squamous Cell , Keratoacanthoma , Keratosis, Actinic , Porokeratosis , SkinABSTRACT
Recent genomewide association studies of large samples have identified genes that are associated with blood pressure. The Global Blood Pressure Genetics (Global BPgen) and Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) consortiums identified 14 loci that govern blood pressure on a genomewide significance level, one of which is CASZ1 confirmed in both Europeans and Asians. CASZ1 is a zinc finger transcription factor that controls apoptosis and cell fate and suppresses neuroblastoma tumor growth by reprogramming gene expression, like a tumor suppressor. To validate the function of CASZ1 in blood pressure, we decreased Casz1 mRNA levels in mice by siRNA. Casz1 siRNA reduced mRNA levels by 59% in a mouse cell line. A polyethylenimine-mixed siRNA complex was injected into mouse tail veins, reducing Casz1 mRNA expression to 45% in the kidney. However, blood pressure in the treated mice was unaffected, despite a 55% reduction in Casz1 mRNA levels in the kidney on multiple siRNA injections daily. Even though Casz1 siRNA-treated mice did not experience any significant change in blood pressure, our study demonstrates the value of in vivo siRNA injection in analyzing the function of candidate genes identified by genomewide association studies.
Subject(s)
Animals , Humans , Mice , Aging , Apoptosis , Asian People , Blood Pressure , Cell Line , Cohort Studies , Gene Expression , Genome , Heart , Kidney , Neuroblastoma , RNA, Messenger , RNA, Small Interfering , Transcription Factors , Veins , Zinc FingersABSTRACT
C-terminal SRC kinase (CSK) is a ubiquitously expressed, cytosolic enzyme that phosphorylates and inactivates several SRC family protein tyrosine kinases. Recent genomewide association studies have implicated CSK in the regulation of blood pressure. The current study aim is to determine the blood pressure association of the genes regulated by CSK down-regulation. The CSK mRNA expression was downregulated in vascular smooth muscle cells using small interfering RNA (siRNA). CSK mRNA levels fell by 90% in cells that were treated with CSK siRNA; the RNA from these cells was examined by microarray using the Illumina HumanRef-8 v3 platform, which comprises 24,526 reference mRNA probes. On treatment with CSK siRNA, 19 genes were downregulated by more than 2-fold and 13 genes were upregulated by more than 2-fold. Three (CANX, SLC30A7, and HMOX1) of them revealed more than 3 fold differential expression. Interestingly, the HMOX1 SNPs were associated with diastolic blood pressure in the 7551 Koreans using Korea Association REsource data, and the result was supported by the other reports that HMOX1 linked to blood vessel maintenance. Among the remaining 29 differentially expressed genes, seven (SSBP1, CDH2, YWHAE, ME2, PFTK1, G3BP2, and TUFT1) revealed association with both systolic and diastolic blood pressures. The CDH2 gene was linked to blood pressures. Conclusively, we identified 32 differentially expressed genes which were regulated by CSK reduction, and two (HOMX1 and CDH2) of them might influence the blood pressure regulation through CSK pathway.