<b>Effective Treatment of Five Cases of Facial Erythema and Flushing Using </b><b>Orento</b> / 日本東洋医学雑誌

The use of orento for dermatosis is commonplace. We report herein the effective treatment of five cases of facial erythema and flushing using orento, based on the observation of heat symptom patterns in the upper part of the body and cold symptoms in the middle part of the body. Few reports have described specific symptoms of upper heat and middle cold ; however, interpreting ‘facial erythema and flushing exacerbated by warming',‘red face', ‘hot flashes', ‘hot sweats' and ‘yellow fur on the tongue' as “upper heat” , and ‘preference for warm drinks', ‘diarrhea exacerbated by cold drinks', and ‘objective coldness in the epigastric region' as “middle cold” enabled the application of orento for dermatosis in our experience.

The Effects of Peroxisome Proliferator Activated Receptor alpha (PPARalpha) Activator on Patients with Facial Erythema / 대한피부과학회지

BACKGROUND: Long-term use of topical steroids for inflammatory skin diseases can induce complications, and efforts to find a better treatment are being continued. Peroxisome proliferator activated receptor alpha (PPARalpha) suppresses the skin's inflammatory reaction, maintains the homeostasis of the skin, and plays an important role in skin barrier function. OBJECTIVE: This study analyzed the effects of a skin moisturizer containing PPARalpha activator on various inflammatory skin diseases causing facial erythema and evaluated the observed improvements. METHODS: The PPARa activator used for this study is composed of supercritical extracts from Euryale ferox, Euphorbia lathyris, and Rosa multiflora, which showed significant effects in the transactivation assay compared to Wy14643. Moisturizer containing PPARalpha was applied to the faces of 31 patients with symmetric facial erythema, with PPARalpha applied on one-half of the face and a control moisturizer on the other half of the face twice a day for 2 weeks. The percentage of erythema index, erythema index, skin hydration, and transepidermal water loss was checked to evaluate treatment effect. Both patients and clinicians each assessed the improvement of erythema on both sides of a patient's face. RESULTS: Moisturizer containing PPARalpha agonist significantly improved erythema index measured with Mexameter MX18(R) and percentage of erythema index by polarization color imaging system (DermaVision-PRO(R)) (p<0.05). However, there was no significant improvement in skin hydration and transepidermal water loss. Improvement of erythema was also shown on both the patient and clinician graded assessments. CONCLUSION: Topical PPARalpha agonist applied during clinical practice was relatively safe and effective. This can be applied clinically to various inflammatory skin diseases causing erythema.

Sarcoma histiocítico cutâneo: neoplasia rara e de difícil diagnóstico / Cutaneous histiocytic sarcoma: a rare and difficult to diagnose neoplasm

Os sarcomas cutâneos são tumores raros, altamente agressivos e de diagnóstico muitas vezes difícil para o dermatologista. Apresentamos o caso de uma mulher branca, de 78 anos, com nódulo eritêmato-violáceo de crescimento rápido em ombro esquerdo, descrito inicialmente como melanoma amelanótico à histologia, conduzida como tal e, após estudo imuno-histoquímico, ausência de marcadores para lesões melanocíticas e expressão de CD45RB (antígeno leucocitário humano) e CD68 (proteína lisossomal) possibilitaram diagnóstico final de sarcoma histiocítico.

Rosácea: mais que um rosto vermelho / Rosacea: more than a red face

A rosácea é uma doença cutânea crônica comum, de etiologia desconhecida, que ocorre mais comumente em indivíduos de meia-idade. As manifestações cutâneas incluem eritema facial transitória ou persistente, telangiectasia, edema, pápulas, pústulas e que são geralmente confinados à porção central da face. Os medicamentos tópicos e sistêmicos são eficazes para o tratamento da rosácea. Casos persistentes podem ser tratados por via oral com metronidazol, tetraciclina ou isotretinoína. Este artigo relata um paciente com rosácea tratado com isotretinoína oral.

Sorafenib (Nexavar(R), BAY 43-9006)-induced Hand-foot Skin Reaction with Facial Erythema

Sorafenib (Nexavar(R), BAY 43-9006) is a novel, orally administered multi-kinase inhibitor that has recently been approved for the treatment of metastatic renal cell carcinoma. It is also used to delay disease progression in patients with advanced solid organ malignancies and metastatic melanoma. Sorafenib is associated with a relatively high incidence of dermatologic adverse events. The commonly occurring dermatologic adverse events associated with sorafenib include hand-foot skin reaction, facial erythema, splinter subungual hemorrhages, alopecia, pruritus and xerosis. We report here on a case of a 50-year-old man who was diagnosed with metastatic hepatocellular carcinoma. He developed both facial erythema and hand-foot skin reaction after the administration of sorafenib.

Importance of the Patch Test for Patients with Recurrent Facial Erythema / 대한피부과학회지

BACKGROUND: One of the most frequent symptoms encountered at a dermatology out patient clinic is recurrent or persistent facial erythema (red face). The face is exposed to many allergens including metals, cosmetic ingredients and environmental pollutants, therefore, it is very difficult to treat recurrent or persistent facial erythema patients if they are sensitized by these allergens. Although facial erythema could be a manifestation of various diseases, there have only been a limited number of clinical studies. OBJECTIVE: To find out how often patients with recurrent facial erythema were sensitized by contact allergens. METHODS: A total of 136 patients with recurrent or persistent facial erythema were enrolled and the patch test was done. RESULTS: First clinical impressions were allergic contact dermatitis, rosacea, atopic dermatitis, steroid induced rosacea or seborrheic dermatitis in order of frequency. Patch test was performed on 84 patients, and 70 patients (83.3%) showed positivity to one or more antigens. Common antigens included nickel sulfate, cobalt chloride, and fragrance mix in the standard patch tests, and octyl galate, thimerosal, and dodecyl galate in the cosmetic series patch tests. CONCLUSION: Based on our results, we strongly recommend patch test for patients with recurrent or persistent facial erythema.

A Case of Systemic Lupus Erythematodes (SLE) Treated with Sho-saiko-to-go-Oren-gedoku-to-ka-Yokuinin, Whose Antinuclear Antibody Became Negative with the Improvement of the Skin Symptom / 日本東洋医学雑誌

A 26-year-old woman who was diagnosed with mild SLE came to our hospital with the complaints about cutaneous eruptions on her face, head and back, as well as alopecia. We treated her with Sho-saiko-to-go-Oren-gedoku-to-ka-Yokuinin. After that, skin symptoms such as erythema, alopecia and photosensitivity disappeared, and an antinuclear antibody, which had shown 640 times at the first medical examination, became negative about two years later. In addition, the skin symptoms did not relapse and the antinuclear antibody rose very little even though the patient received no further medication for the next year. Our reseach found no other case reports of SLE whose antinuclear antibodies became negative only by Kampo treatment and who was treated with Sho-saiko-to-go-Oren-gedoku-to or its modified formulations.<br>Overall, it seemed to be an interesting case, and it suggests that Kampo medicine may be valuable in treating some cases of mild SLE, and may make steroid treatments unnecessary in the early stages of SLE before the diagnosis has been established.