Paradoxical Flare of Psoriasis after Ustekinumab Therapy

No abstract available.

A Case of Rapidly Progressive Kaposi's Sarcoma Induced by Systemic Corticosteroid Therapy / 대한피부과학회지

Kaposi's sarcoma (KS) is a vascular neoplasm originating from vascular and lymphatic endothelial cells. Iatrogenic KS mainly develops in organ transplant patients or after receiving immunosuppressive therapy. An 81-year-old man presented with multiple dark-purplish nodules, plaques, and patches on the right leg for 3 weeks. Previously, the patient was treated with prednisolone 10∼30 mg/day for chronic obstructive pulmonary disease for 3 months, and percutaneous transluminal angioplasty was performed 1 month previously for the treatment of peripheral arterial occlusive disease. A biopsy specimen of the nodule showed closely packed spindle cells forming slit-like vascular structures, which were consistent with KS. Despite the dosage reduction of prednisolone for treatment, the skin lesions progressed aggressively throughout the entire body, and the patient died after 5 months. We report a case of iatrogenic prednisolone-associated KS rapidly progressing to the entire body shortly thereafter.

Split-face Comparison of Pulse-in-pulse Type Intense Pulsed Light Versus Low-fluence Multi-pass 1064 nm Q-switched Nd:YAG Laser in the Treatment of Facial Melasma / 대한피부과학회지

BACKGROUND: Melasma, a common chronic pigmentary disorder, is resistant to various treatments. Recently, pulse-in-pulse type of intense pulsed light (PIP IPL) has been introduced as a treatment for melasma. It can emit multiple peaks during one pulse wave to deliver photothermal energy more effectively with gentle and even low energy so that complications are minimal. OBJECTIVE: The purpose of this study was to compare the efficacy and safety of PIP IPL to low-fluence, multi-pass, Q-switched Nd:YAG laser in the treatment of facial melasma. METHODS: Fifteen female patients with melasma who had Fitzpatrick skin type III or IV were enrolled in this study between November 2014 and April 2015. Patients underwent 6 sessions of treatment at an interval of 1 week. One half of each patient's face was treated with 2 passes of PIP IPL with a fluence of 13~15 J/cm₂. The other half of the face was treated with 4 passes of Q-Switched Nd:YAG laser with a fluence of 1.6~1.8 J/cm₂. Results were evaluated at every visit, including modified Melasma Area and Severity Index (MASI) score, subject's global assessment, and investigator's global assessment. RESULTS: Modified MASI scores were significantly (p<0.05) reduced in both groups after 6 treatment sessions. Q-Switched Nd:YAG laser treatment was more effective than PIP IPL for the treatment of melasma, although the two treatments did not significantly (p=0.44) differ in effectiveness. However, the discomfort levels of patients in the PIP IPL group following procedures were significantly lower compared to those in the Q-Switched Nd:YAG group. CONCLUSION: The current investigation demonstrated that PIP IPL treatment for melasma in Korean women was not inferior to collimated low fluence Q-switched Nd:YAG laser treatment.

Factors Affecting the Results of Direct Immunofluorescence in Patients with Bullous Pemphigoid / 대한피부과학회지

BACKGROUND: The diagnosis of bullous pemphigoid is made based on clinical, histologic, and immunofluorescence features. OBJECTIVE: The purpose of this study was to analyze the factors that may affect the positivity and intensity of direct immunofluorescence (DIF) in patients with bullous pemphigoid. METHODS: We performed a retrospective review of 41 cases of bullous pemphigoid at Ilsan Paik Hospital between January 2008 and December 2014. We investigated the positivity of DIF, immunofluorescence intensity of C3, age, sex, biopsy sites, extent of disease, duration of disease, and the degree of inflammatory cell infiltration. RESULTS: Twenty-seven of 41 (65.9%) cases had positive DIF results for either IgG or C3, and 14 of 41 (34.1%) had negative DIF results for both IgG and C3. Twenty-one cases (51.2%) of IgG and 25 cases (61.0%) of C3 had characteristic linear C3 deposition on the dermo-epidermal junction. Disease duration influenced DIF positivity (p<0.05). Although a higher positive rate of DIF was observed in biopsy specimens taken from the upper extremities than in those from other sites, the difference was not statistically significant. Sex, age, extent of disease, and the degree of inflammatory cell infiltration were not significantly associated with the positivity of DIF. There was no relationship between fluorescence intensity of C3 and the degree of inflammatory cell infiltration. CONCLUSION: This study suggests that the long duration of disease (more than 10 days) may increase the positivity of DIF. Age, sex, biopsy site, extent of disease, and the degree of inflammatory cell infiltration had no influence on DIF positivity.

A Case of Papular Mycosis Fungoides: A New Clinical Variant of Early Mycosis Fungoides

No abstract available.

Neonatal Lupus Erythematosus in an Infant Born to an Asymptomatic Mother with Anti-SSA/SSB Antibodies / 대한피부과학회지

Neonatal lupus erythematosus (NLE) is a rare autoimmune disease that has a clinical spectrum of cutaneous, cardiac, and systemic abnormalities in neonates. It is caused by transplacental passage of maternal anti-Ro and/or anti-La autoantibodies, which result in skin lesions such as subacute cutaneous lupus erythematosus, congenital heart block, and liver function and hematologic abnormalities. We report a case of NLE in a 31-day-old female infant who was born to a clinically asymptomatic mother with anti-SSA/Ro and anti-SSB/La antibodies. The baby presented with multiple erythematous patches and annular plaques on the face and trunk. The skin biopsy showed slight follicular plugging, focal hydropic degeneration of the basal epidermis and mild edema, telangiectasia, and perivascular and interstitial lymphohistiocytic infiltration in the upper dermis. Her serological tests were positive for antinuclear antibody (ANA), anti-SSA/Ro, and anti-SSB/La. These findings are consistent with NLE. The mother also had a positive autoantibody profile for ANA, anti-SSA/Ro, and anti-SSB/La without clinical symptoms.

Neonatal Lupus Erythematosus in an Infant Born to an Asymptomatic Mother with Anti-SSA/SSB Antibodies / 대한피부과학회지

Neonatal lupus erythematosus (NLE) is a rare autoimmune disease that has a clinical spectrum of cutaneous, cardiac, and systemic abnormalities in neonates. It is caused by transplacental passage of maternal anti-Ro and/or anti-La autoantibodies, which result in skin lesions such as subacute cutaneous lupus erythematosus, congenital heart block, and liver function and hematologic abnormalities. We report a case of NLE in a 31-day-old female infant who was born to a clinically asymptomatic mother with anti-SSA/Ro and anti-SSB/La antibodies. The baby presented with multiple erythematous patches and annular plaques on the face and trunk. The skin biopsy showed slight follicular plugging, focal hydropic degeneration of the basal epidermis and mild edema, telangiectasia, and perivascular and interstitial lymphohistiocytic infiltration in the upper dermis. Her serological tests were positive for antinuclear antibody (ANA), anti-SSA/Ro, and anti-SSB/La. These findings are consistent with NLE. The mother also had a positive autoantibody profile for ANA, anti-SSA/Ro, and anti-SSB/La without clinical symptoms.

A Case of Neutrophilic Dermatosis of the Hands on Both Palms / 대한피부과학회지

Neutrophilic dermatosis of the hands is a rare, peculiar variant of acute febrile neutrophilic dermatosis (Sweet syndrome). It initially appears on the hands and possibly spreads to other locations. Clinically, neutrophilic dermatosis of the hands tends to occur as tender erythematous plaques, pustules, and bullae that are limited to the dorsal hands and fingers. Histopathologically, vasculitis has been observed in pustular lesions on the dorsal hands. Therefore, the terms "pustular vasculitis of the dorsal hands" and "neutrophilic dermatosis of the dorsal hands" were suggested initially. Here, we report a case of neutrophilic dermatosis of the hands in a 77-year-old woman who presented with painful well-demarcated plaques and macules on both palms without dorsal hand involvement. Histopathological findings showed leukocytoclastic vasculitis in the erythematous lesion on the palm.

Telomerase Activity in Endometrium According to Menstrual Cycle / 대한산부인과학회잡지

OBJECTIVE: Recently, telomerase activity was found in normal physiologically regenerating cells as well as cancer cells or germ cells. Human endometrium is also physiologically regenerating tissues and undergoes regular and dynamic changes during the menstrual cycle. So the authors examined normal human endometrial tissues for telomerase activity according to menstrual cycle. METHOD: In the current study, 66 normal human endometrial tissues were analyzed for telomerase activity by a radioisotope polimerase chain reaction-based telomeric repeat amplification protocol assay. RESULTS: Of 27 proliferative phase endometrial samples, 22(81%) expressed telomerase activity, whereas 10 of 23(43%) secretory phase sample, 2 of 10(10%) postmenopausal sample, 1 of 6(17%) pregnant endometrial sample did(P<0.05). 4 of 27(15%) endometrial samples in the proliferative phase expressed high telomerase activity after 100-fold dilution of extract, whereas 1 of 23(4%) from secretory phase, none of the 10 postmenopausal and 6 pregnant endometrial samples did. The highest activity was observed in late proliferative phase. CONCLUSION: This study indicates that normal endometrium expresses telomerase, the activity of which changes dramatically and regularly during the course of the menstrual cycle.

Maternal Weight Gain Pattern and Birth Weight / 영남의대학술지

Maternal weight gain during pregnancy has been consistently associated with infant birth weight and pregnancy outcome. Our purpose was to determined the relationship between maternal weight gain pattern and birth weight. Consequently, maternal weight gain is monitored carefully and is encouraged during prenatal care in order to improve pregnancy outcome. Our study group included both 424 uncomplicated women and infant delivered at the Yeungnam University Hospital between 1993-1996. All recorded prenatal weight gain measurements were used to estimate maternal trimester weight gain, pattern of gain (based on low versus not-low gain at each trimester), and total gain at delivery. Multiple linear regression analysis was used to assess the relationship between these weight gain measurements and fetal birth weight. Each kilogram of maternal gain in the first, second, and third trimesters was associatedwith statistically related to the increase in fatal birth weight by 31.3, 19.0, and 24.5g, respectively. When compaired with the pattern of gain that was not low in any trimester, patterns with low gain in the first trimesters were associated with significant decreases in birth weight, but no important change in birth weight was seen for the group whose gains were not low in the first trimester. The results suggest that specific patterns of maternal weight gain, particularly weight gain during the first trimester, are related to fetal birth weight.