A Granulomatous Drug Eruption Induced by Entecavir

Entecavir (Baraclude(R), Bristol-Myers Squibb) is a potent and selective antiviral agent that has demonstrated efficacy in patients with chronic hepatitis B. The most frequent adverse events attributed to entecavir include increased alanine aminotransferase, upper respiratory tract infection, headache, abdominal pain, cough, pyrexia, fatigue, and diarrhea. Although quite a few randomized double-blind studies including ones investigating adverse events along with these general symptoms have been reported, few cases of cutaneous adverse events have been described in detail. We demonstrate a case of granulomatous drug eruption as a cutaneous adverse event induced by entecavir.

Induction of Melanogenesis by Rapamycin in Human MNT-1 Melanoma Cells

BACKGROUND: Melanogenesis is one of the characteristic parameters of differentiation in melanocytes and melanoma cells. Specific inhibitors of phosphatidylinositol 3-kinase (PI3K), such as wortmannin and LY294002, stimulate melanin production in mouse and in human melanoma cells, suggesting that PI3K and mammalian target of rapamycin (mTOR) might be involved in the regulation of melanogenesis. OBJECTIVE: The involvement of the mTOR pathway in regulating melanogenesis was examined using human MNT-1 melanoma cells, and the effects of the potent inhibitor of mTOR, rapamycin, in the presence or absence of alpha-melanocyte-stimulating hormone (alpha-MSH) were evaluated. METHODS: In cells treated with rapamycin, cell viability, melanin content, and tyrosinase (TYR) activity were measured and compared with untreated controls. Protein levels of TYR, tyrosinase-related protein (TYRP)-1, TYRP-2, and microphthalmia-associated transcription factor (MITF) were also analyzed by Western blot. RESULTS: In rapamycin-treated cells, the melanin content increased concomitantly with an elevation in TYR activity, which plays a major role in melanogenesis. There was also an up-regulation of TYR, TYRP-1, and MITF proteins. Combined treatment with rapamycin or wortmannin and alpha-MSH increased melanogenesis more strongly than alpha-MSH alone. CONCLUSION: Rapamycin-induced melanin formation may be mediated through the up-regulation of TYR protein and activity. Furthermore, rapamycin and wortmannin, inhibitors of mTOR and PI3K, respectively, have co-stimulatory effects with alpha-MSH in enhancing melanogenesis in melanocyte cells.

Inflammatory Disseminated Superficial Porokeratosis in a Patient with Choledocholithiasis / 대한피부과학회지

Disseminated superficial porokeratosis (DSP) is an autosomal dominant specific disorder of keratinization. Clinically, the lesions show a sharply demarcated and hyperkeratotic plaque with central atrophy, with a predilection for the extensor surface of the extremities. Unusual cases of DSP accompanied by severe pruritus have been reported as "eruptive pruritic papular porokeratosis" or "inflammatory DSP." Histopathologically, inflammatory DSP is characterized by the presence of cornoid lamella with a dense infiltration of lymphocytes in the perivascular area of the upper dermis. Here we report a case of inflammatory DSP in an 80-year-old man with choledocholithiasis.

Pityriasis Rosea-Like Rash Secondary to Intravesical Bacillus Calmette-Guerin Immunotherapy

No abstract available.

A Study of Clinical Aspects of Scabies / 대한피부과학회지

BACKGROUND: Scabies is a contagious parasitic infestation, which causes an allergic reaction to mites. Despite a decrease in the prevalence of scabies, there is still a significantly great infestation rate among the elderly. OBJECTIVE: The purpose of the study is to evaluate the clinical aspects of scabies patients in the last 6 years. METHODS: A total of 133 out-patients, who were diagnosed as scabies in the department of dermatology from January, 2006 to December, 2011, were analyzed retrospectively. RESULTS: Scabies patients accounted for 0.28% of all new patients (133/47,249). The ratio of male to female was 0.60 to 1. The mean age of the patients was 48.4 years old. Of the participating patients, 35.3% were over 65 years old. There was no seasonal variation in the occurrence. The most common cutaneous lesions were pruritic papule and burrow. The most common suspected routes of infection were hospitalization infection (54.9%), and occupational infection in the hospital or residential home for the elderly (23.3%). The mean time to be required to diagnose scabies was 78.8 days. The mean time to diagnose scabies in people who work in the hospital or residential home for the elderly was 58.0 days. CONCLUSION: The study provides useful data on the prevalence and characteristics of scabies.

Stevens-Johnson Syndrome Induced by Vandetanib

Vandetanib is a once-daily oral anticancer drug that selectively inhibits key signaling pathways in cancer by targeting vascular endothelial growth factor receptors, epidermal growth factor receptors tyrosine kinase, and rearranged during transfection-dependent tumor cell proliferation and survival. The most frequently reported adverse events attributed to vandetanib include diarrhea, elevated aminotransferase, asymptomatic corrected QT interval prolongation, and hypertension. Though a number of randomized, doubleblind studies, including cutaneous adverse events attributed to vandetanib, have been reported along with these general symptoms, no case of Stevens-Johnson syndrome (SJS) has been reported. This paper demonstrates a case of SJS induced by vandetanib.

Pemphigus Erythematosus / 대한피부과학회지

Pemphigus is a group of blistering autoimmune diseases that affect the skin and mucous membranes with autoantibodies against desmoglein. Among the pemphigus subtypes, pemphigus erythematosus is one of the rare lupus-like variant subtypes of pemphigus that shares common clinical and histopathological manifestations with systemic lupus erythematosus. The lesions appear clinically as erythematous erosive patches on the face in a butterfly distribution, and they manifest subcorneal acantholysis histopathologically. There is concomitant basement membrane zone deposition of immunoglobulin and complement in lesional skin in addition to intercellular space staining in the epidermis. Two cases of pemphigus erythematosus have been reported domestically. Here, we report a case of pemphigus erythematosus in an 18-year old woman.

A Nevus Comedonicus in the Genital Area / 대한피부과학회지

Nevus comedonicus is an uncommon skin disorder that clinically appears as linear groups of open comedones. A 6-year-old female patient presented with a nevus comedonicus accompanied by an epidermal nevus in her genital area. The histopathologic finding showed an atrophic, cystically dilated hair follicle containing abundant keratinous debris. She was treated with oral antibiotics. We report here on an unusual case of nevus comedonicus that occurred in the genital area.

Angiolymphoid Hyperplasia with Eosinophilia on the Palm

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon dermal angioproliferating tumor, characterized by red to brown papules or nodules on the head and neck, though also occurring in the mouth, trunk, extremities and inguinal area. The palm is a very unusual site for ALHE, and there have been very few cases reported globally thus far. ALHE can be pruritic and painful and histopathologic findings show vascular proliferation with infiltration of eosinophils and lymphocytes in the dermis. Plump endothelial cells protrude into the lumen. We report a case of ALHE occurring at an unusual site, the right palm, in a 62-year-old man, who had suffered from a solitary pinkish-colored, central depressed round hyperkeratotic plaque on his palm for 4 years. On the basis of clinical and histopathologic data, a diagnosis of ALHE was made. To our knowledge, this is the first report of ALHE on the palm in Korean dermatologic literature.