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Purpose@#Endocrine therapy is the first-line treatment recommended for patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer without visceral crisis. However, this recommendation has not been followed clinically because of efficacy issues. In this study, the survival of patients with HR-positive/HER2-negative metastatic breast cancer was evaluated based on the following first-line treatment regimens: the combination of palbociclib plus letrozole, conventional endocrine therapy, or chemotherapy. @*Methods@#Medical records were reviewed for this retrospective analysis. Patients with HR-positive/HER2-negative metastatic breast cancer were included. Progression-free survival (PFS) and overall survival (OS) were compared based on first-line treatment regimens. @*Results@#A total of 184 patients were included in the analysis. The first-line treatments were palbociclib plus letrozole in 46 patients (25.0%), endocrine therapy in 40 patients (21.7%), and chemotherapy in 98 patients (53.3%). The PFS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=3.43, p<0.001) and chemotherapy (hazard ratio=2.88, p=0.001) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.430). The OS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=5.34, p=0.009) and chemotherapy (hazard ratio 4.23, p=0.043) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.451). @*Conclusion@#The combination regimen of palbociclib and letrozole could be recommended as the first-line treatment of choice in patients with HR-positive/HER2-negative metastatic breast cancer.
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Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory dermatosis presenting as white papules and atrophic patches in the anogenital region. Extragenital LSA is rare and commonly affects the neck, thighs, and the trunk. A 68-year-old woman presented with a well-demarcated, whitish linear plaque on the forehead that was observed several months prior to presentation. A biopsy specimen showed hyperkeratosis and thinning of the epidermis and homogenization of collagen in the papillary dermis with a subepidermal cleft. Mild periappendageal lymphocytic infiltration and eccrine gland atrophy secondary to thickening of collagen bundles were observed in the deep dermis. Based on the clinical and histopathological findings, this patient was diagnosed with extragenital LSA and concomitant morphea along the Blaschko's lines.
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Anciano , Femenino , Humanos , Atrofia , Biopsia , Colágeno , Dermis , Glándulas Ecrinas , Epidermis , Frente , Liquen Escleroso y Atrófico , Líquenes , Cuello , Esclerodermia Localizada , Enfermedades de la Piel , MusloRESUMEN
BACKGROUND: Tranexamic acid (TXA), a plasmin inhibitor, has been used orally or via intradermal injection to treat melasma; however, there are limited studies regarding efficacy and safety of topical application of TXA. OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of topical tranexamic acid in treatment of melasma. METHODS: We enrolled 25 female volunteers with melasma in a split-face trial lasting 10 weeks. Patients were instructed to apply cream containing tranexamic acid on only the right side of their face every night without application on the other side. The pigmentary index (PI) using API-100 and Melasma Area and Severity Index (MASI) were measured at 0, 5, and 10 weeks. Patient satisfaction questionnaires and safety evaluation by a dermatologist were performed at each follow-up visit. RESULTS: Twenty-five patients completed the study, and we noted reduction in both, mean MASI and PI scores. The mean MASI score was 7.75±5.10 at baseline, 6.72±4.25 at week 5, and 6.26±3.76 at week 10 p=0.008). The mean PI score on the right side of the face was 40.56±22.51 at baseline, 29.96±16.62 at week 5, and 26.88±15.97 at week 10. The PI on the right side of the face decreased by 26.1% (p<0.001) at week 5 and 33.7% (p<0.001) at week 10 compared to the baseline. Mean PI score on the unaffected side of the face was 40.56±22.60 at baseline, 37.48±17.79 at week 5, and 34.68±16.44 at week 10, although this reduction was not statistically significant (p=0.146). Only mild irritation occurred in two patients, no other serious adverse events were noted, and patients were generally satisfied with their results. CONCLUSION: Topical TXA can be considered a safe and effective option in the treatment of melasma.
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Femenino , Humanos , Antifibrinolíticos , Estudios de Seguimiento , Inyecciones Intradérmicas , Melanosis , Satisfacción del Paciente , Ácido Tranexámico , VoluntariosRESUMEN
Multiple myeloma (MM) can be defined as a malignancy with monoclonal plasma cell proliferation. A 66-year-old man presented with pruritic erythematous to purplish plaque grouped nodule with black pigmentations and purpura on the right forearm. The patient was diagnosed with MM about five years prior to the visit at our hospital. Erythematous plaque on his right arm grew rapidly in size over one month and appeared about seven months after the fracture surgery. Skin biopsy showed multiple plasma cell infiltration with monoclonality for lambda light chain, which was consistent with cutaneous plasmacytoma. The patient refused to be treated and died two months later. We herein report an interesting case of cutaneous plasmacytoma at the surgical site of fracture repair.
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Anciano , Humanos , Brazo , Biopsia , Antebrazo , Mieloma Múltiple , Metástasis de la Neoplasia , Pigmentación , Células Plasmáticas , Plasmacitoma , Púrpura , PielRESUMEN
Eccrine squamous syringometaplasia (ESS) is a histologically distinctive skin eruption occurring predominantly in acral or intertriginous areas presenting as erythematous macules, papules or patches. The etiology of ESS remains unclear, but it is usually reported in patients receiving chemotherapy for various malignant neoplasms. To date, only two cases of ESS associated with non-steroidal anti-inflammatory drugs (NSAIDs), which has distinctive clinical features and pathogenesis, have been reported in the literature. Herein, we report a rare and interesting case of ESS associated with pelubiprofen, a recently developed NSAID, which appeared after pelubiprofen therapy and resolved spontaneously after discontinuing the medication.
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Humanos , Dermatitis Fototóxica , Quimioterapia , Metaplasia , PielRESUMEN
Grover disease (GD), also referred to as transient or persistent acantholytic dermatosis, is an acquired pruritic papular or papulovesicular eruption characterized histopathologically by focal acantholysis and dyskeratosis. Because GD resembles several generalized papular diseases, the diagnosis of GD is a clinical challenge, particularly when dermatologists meet patients without papular eruptions. We experienced two elderly men showing eczematoid plaques with severe pruritus on their backs. Histopathological examinations revealed a focal acantholysis, spongiosis, and dyskeratosis, a pattern consistent with GD. We report two cases of GD with clinical features of nonspecific eczematous dermatosis.
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Anciano , Humanos , Masculino , Acantólisis , Diagnóstico , Prurito , Enfermedades de la PielRESUMEN
Grover disease (GD), also referred to as transient or persistent acantholytic dermatosis, is an acquired pruritic papular or papulovesicular eruption characterized histopathologically by focal acantholysis and dyskeratosis. Because GD resembles several generalized papular diseases, the diagnosis of GD is a clinical challenge, particularly when dermatologists meet patients without papular eruptions. We experienced two elderly men showing eczematoid plaques with severe pruritus on their backs. Histopathological examinations revealed a focal acantholysis, spongiosis, and dyskeratosis, a pattern consistent with GD. We report two cases of GD with clinical features of nonspecific eczematous dermatosis.
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Anciano , Humanos , Masculino , Acantólisis , Diagnóstico , Prurito , Enfermedades de la PielRESUMEN
Annular elastolytic giant cell granuloma is a rare form of granulomatous dermatosis, characterized clinically by annular plaques with slightly elevated margins, and histopathologically by the phagocytosis of elastic fibers by multinucleated giant cells. It typically occurs in sun-exposed areas of the skin in middle-aged women. However, some cases involving unexposed areas have been described. A 57-year-old man had erythematous plaques on both palms accompanied by a sensation of heat for 2 weeks. Histopathological examination revealed granulomatous infiltration with multinucleated giant cells and elastophagocytosis, which is consistent with annular elastolytic giant cell granuloma. Herein we report an interesting case of annular elastolytic giant cell granuloma that occurred on non-sun-exposed skin, palms.
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Femenino , Humanos , Persona de Mediana Edad , Tejido Elástico , Células Gigantes , Granuloma de Células Gigantes , Calor , Fagocitosis , Sensación , Piel , Enfermedades de la PielRESUMEN
No abstract available.
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Síndrome del Dedo Azul , Coagulación Intravascular DiseminadaRESUMEN
Segmental neurofibromatosis is a rare form of neurofibromatosis that is characterized by neurofibromas and/or café au lait macules, limited to one region of the body. The neurofibromas of segmental neurofibromatosis are most commonly occupied by either a cervical or a thoracic dermatome. Segmental neurofibromatosis on the face is extremely rare, and only 10 cases have been described so far. Herein, we report a case of segmental neurofibromatosis on the V1 dermatome for its rarity and unusual location.
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Neurofibroma , Neurofibromatosis , Neurofibromatosis 1 , Nervio TrigéminoRESUMEN
Kaposi's sarcoma is a multifocal proliferative vascular tumor involving the skin and other organ and psoriasis is a chronic cutaneous disease with papules and plaques with white scale. Development of Kaposi's sarcoma in psoriasis patients has been reported rarely. A 71-year-old man presented with multiple brownish to violaceous plaques on both feet and arms which were found 4 months ago. The biopsy confirmed Kaposi's sarcoma. The patient was diagnosed with psoriasis vulgaris 10 years ago and Kaposi's sarcoma lesions developed between psoriatic plaques. We herein report a rare case of simultaneous occurrence of Kaposi's sarcoma and psoriasis vulgaris which need quite different treatment.
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Anciano , Humanos , Brazo , Biopsia , Pie , Psoriasis , Sarcoma de Kaposi , PielRESUMEN
No abstract available.
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BACKGROUND: Ulnar nerve palsy leads to thumb-web depression, hypothenar flattening, and inter-digital depression in patients with leprosy. To camouflage these deformities, patients used to inject paraffin or silicone oil into the areas of muscle atrophy associated with thumb-web depression and hypothenar flattening. After several years and decades, paraffinomas eventually resulted in extensive inflammatory fibrosis and recalcitrant recurrent ulcers at the injection sites. OBJECTIVE: The aim of this study is to compare the results of different surgical treatments for paraffinomas in patients with leprosy, and to find out the most effective treatment method that has a low recurrence rate. METHODS: Between January 2000 and December 2012, 47 patients with paraffinomas who had visited the Korean Hansen Welfare Association Hospital were enrolled to participate in the study. The number of paraffinomas was 56, and the mean age of the patients was 73 years. A retrospective evaluation of the cosmetic results and recurrence rate was performed. RESULTS: Of the 56 surgically treated paraffinomas, 30 lesions were treated using primary closure, 20 lesions were treated with skin graft, and 6 lesions were treated with skin flap. The cosmetic outcomes, which were assessed using a four-point grading scale, were excellent in 10.7% (6/56), good in 25% (14/56), fair in 38% (21/56), and poor in 28% (15/56) of the patients. There were no significant differences among the three surgical procedures with respect to the cosmetic results. The recurrence rate was 33% (10/31) in the primary closure group, 50% (10/20) in the skin graft group, and 17% (1/6) in the skin flap group. There were no significant differences in the recurrence rate among the three surgical procedures. CONCLUSION: The extensive and aggressive curettage of lesions is very important to reduce recurrence rate. When the older age of the patients is considered in conjunction with the simplicity of the operation and the total operation time, primary closure is considered the treatment of choice both cosmetically and practically.