Etanercept-induced Leukocytoclastic Vasculitis / 대한피부과학회지

Leukocytoclastic vasculitis is a small vessel inflammatory disease mediated mostly by deposition of immune complexes. Etanercept (Enbrel(R)) is widely used not only for rheumatic disorders such as ankylosing spondylitis but also for dermatological diseases including psoriasis. Adverse drug reactions including pruritus, angioedema, and skin cancer have been reported. A 35-year-old female presented with palpable purpuric patches that developed on both lower legs 10 months after etanercept administration. A skin biopsy showed characteristic features of leukocytoclastic vasculitis, including perivascular infiltration of neutrophils and lymphocytes with leukocytoclasia and fibrinoid necrosis of the vessel wall. The patient was treated with oral and topical steroids, and the response was excellent and rapid. The patient was administered etanercept to control underlying ankylosing spondylitis. The skin lesions disappeared gradually after 4 weeks, and no other lesions were seen. The number of patients using etanercept has been increasing thus, the possibility of leukocytoclastic vasculitis in patients using etanercept should be considered.

Annular Erythema Associated with Anti-Ro/La Antibody Occurring in Plantar Area / 대한피부과학회지

Recurrent annular erythema associated with anti-Ro/La antibody is a diagnostic term for annular erythemas that usually occurs in the face and the upper extremities of patients with positive anti-Ro/La antibodies. They have been reported in patients with Sjogren's syndrome, lupus erythematosus, or Sjogren's syndrome/systemic lupus erythematosus syndrome. Recently, there have been cases without any underlying autoimmune diseases. We, hereby, report an annular erythema, associated with anti-Ro/La antibody occurring in both soles, which is an unusual location for this disease.

Kaposi's Sarcoma in a Patient with Iatrogenic Cushing's Syndrome / 대한피부과학회지

Kaposi's sarcoma (KS) is a multifocal proliferative vascular tumor involving cutaneous and extra-cutaneous tissues. KS has been reported in patients treated with immunosuppressive agents for autoimmune diseases. However, KS has rarely been reported in patients with iatrogenic Cushing's syndrome. A 77-year-old woman was evaluated with multiple asymptomatic violaceous nodules and plaques on both lower legs. She had been diagnosed with iatrogenic Cushing's syndrome and had been treated with low-dose corticosteroid replacement therapy for >10 years. A histopathologic study showed extensive vascular proliferation in the dermis with spindle-shaped cells. Immunohistochemical staining for CD31, CD34, human herpesvirus (HHV)-8, and D2-40 was positive. We hereby report a case of KS in a patient with iatrogenic Cushing's syndrome.

Pedunculated Sclerotic Fibroma Resembling Soft Fibroma / 대한피부과학회지

Sclerotic fibroma is a rare skin neoplasm that can occur seen sporadically or in association with Cowden's disease. Clinically, it presents as asymptomatic flesh-colored or pinkish slow-growing papules or nodules with a wide anatomical distribution. We report a rare case of pedunculated type of sclerotic fibroma resembling soft fibroma, which has not been reported in Korea.

Purple Glove Syndrome Caused by Intravenous Phenytoin Injection / 대한피부과학회지

Purple glove syndrome (PGS) is a rare complication of intravenous phenytoin use that is poorly understood and potentially serious. The characteristic features of PGS are pain, edema, and discoloration at the injection site that spreads to the distal limbs. Diagnosis of PGS can be made from clinical presentation, and treatment is usually restricted to conservative therapy. A 7-year-old girl was treated with phenytoin for epilepsy and was referred to our department for violaceous color change and edema on intravenous injection site of the left hand. It was consistent with PGS, and to our knowledge, it is first report in Korea.

Poststeroid Panniculitis in an Adult / 대한피부과학회지

Poststeroid panniculitis is a very rare complication of corticosteroid therapy, and this is characterized by firm subcutaneous nodules on the cheek, neck or upper trunk within days or weeks following rapid systemic steroid tapering or cessation in childhood. It can be identified by the clinical features and a history of using steroid, and if necessary, with a biopsy. There have been just 2 reported cases in adulthood, one was an autopsy case of a 28-year woman and another was a 60-year-old man after massive administration of corticosteroids for congestive heart failure. Herein, we report a case of panniculitis accompanied by Cushing's syndrome in an adult after long-term misuse of systemic steroid for rosacea.