Résumé
BACKGROUND: The clinical efficacy of cyclosporine in the treatment of atopic dermatitis is well documented. However, the optimal dose regimen has not yet been established, and there are few published data about the factors related with relapse after cyclosporine therapy. OBJECTIVE: The purpose of this study was to provide clues for the proper use of cyclosporine and identify contributing factors for relapse in atopic dermatitis. METHODS: We performed a retrospective analysis of 174 patients with atopic dermatitis who had been treated with cyclosporine in our clinic between January 2007 and January 2012. RESULTS: The mean starting dose of cyclosporine was 4.8 mg/kg, and the relief of symptoms was initially achieved with a dose of 5.0 mg/kg. Treatments were continued for 137.2 days with a cumulative dose of 388.0 mg/kg. After discontinuation of cyclosporine, 79/167 (47.3%) patients experienced a relapse, and the duration of remission was 288.6 days. In a multiple regression analysis, serum IgE (p=0.015), starting dose of cyclosporine (p=0.010), and maintenance therapy (p<0.001) were independent and significant factors related to relapse; the relapse and serum IgE, starting dose of cyclosporine showed negative relationship, and maintenance therapy considerably reduced the recurrence rate (odds ratio, 0.04). CONCLUSION: Our results indicate that higher starting dose of cyclosporine may decrease the relapse rate in atopic dermatitis. In the post-cyclosporine period, subsequent maintenance therapy should also be considered for sustained remission. At the beginning of cyclosporine therapy, initial serum IgE would be a good laboratory index for predicting the risk of relapse.
Sujets)
Humains , Ciclosporine , Eczéma atopique , Immunoglobuline E , Récidive , Études rétrospectivesRésumé
Bowen's disease, one of squamous cell carcinoma in situ, typically presents as a discrete, slowly enlarging, pink to erythematous thin plaque with well-demarcated, irregular borders and overlying scale or crust. Several clinicohistopathologic variants have been illustrated to date, but there have never been reported to Bowen's disease manifesting with pedunculated tumor. Herein, we report an interesting presentation of pedunculated Bowen's disease on the right groin. In the resected tumor specimen, human papillomavirus type 68, one of the mucosal high-risk human papillomavirus, was demonstrated.
Sujets)
Humains , Maladie de Bowen , Carcinome épidermoïde , AineRésumé
Pityriasis rotunda (PR) is a rare disease characterized by persistent, sharply defined, oval, scaly patches of dry skin, localized mainly on the trunk and extremities. Its etiology remains unknown. However, several reports suggest that it is a form of acquired ichthyosis vulgaris or a skin manifestation of systemic disease, such as malnutrition, chronic illness, hepatic disease, and malignancies. Although a variety of treatment modalities, including topical lactic acid, urea, tars, emollients, and corticosteroid, have been applied to it, their efficacies are not satisfactory. Herein, we report a case of PR in a healthy man who was successfully treated with oral and topical retinoids.
Sujets)
Maladie chronique , Émollient , Membres , Ichtyose , Ichtyose vulgaire , Acide lactique , Malnutrition , Pityriasis , Maladies rares , Rétinoïdes , Peau , Manifestations cutanées , Goudrons , UréeRésumé
Pityriasis rotunda (PR) is a rare disease characterized by persistent, sharply defined, oval, scaly patches of dry skin, localized mainly on the trunk and extremities. Its etiology remains unknown. However, several reports suggest that it is a form of acquired ichthyosis vulgaris or a skin manifestation of systemic disease, such as malnutrition, chronic illness, hepatic disease, and malignancies. Although a variety of treatment modalities, including topical lactic acid, urea, tars, emollients, and corticosteroid, have been applied to it, their efficacies are not satisfactory. Herein, we report a case of PR in a healthy man who was successfully treated with oral and topical retinoids.
Sujets)
Maladie chronique , Émollient , Membres , Ichtyose , Ichtyose vulgaire , Acide lactique , Malnutrition , Pityriasis , Maladies rares , Rétinoïdes , Peau , Manifestations cutanées , Goudrons , UréeRésumé
Depigmented halos surrounding cutaneous lesions have been the common description of many diseases, including benign melanocytic nevus, acquired blue nevi, malignant melanoma and neurofibromatosis. To the best of our knowledge, a halo around seborrheic keratosis has not been reported in the Korean dermatologic literature, and only two cases have been described abroad. Though vitiligo is known to be frequently associated with this halo phenomenon, the exact etiopathogenesis of vitiligo and the halo phenomenon is still unknown. Herein, we report on a case of halo seborrheic keratosis in a patient with vitiligo.
Sujets)
Humains , Kératose séborrhéique , Mélanome , Neurofibromatoses , Naevus bleu , Naevus pigmentaire , VitiligoRésumé
Diffuse-type giant cell tumor of tendon sheath is an uncommon subtype of giant cell tumor of tendon sheath that shows destructive proliferation of synovial-like mononuclear cells, admixed with multinucleate giant cells, foam cells, siderophages and inflammatory cells. This tumor is commonly located in the periarticular soft tissues of knee, thigh and foot, but on rare occasions it can be purely subcutaneous or intramuscular. Diffuse-type giant cell tumor of tendon sheath affecting the buttock is extremely rare and only two cases, periarticular and intramuscular, have been described in the literature. We report the case of a 63-year-old male with diffuse-type giant cell tumor on the subcutaneous tissue of buttock.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Fesses , Cellules spumeuses , Pied , Tumeurs à cellules géantes , Cellules géantes , Genou , Tissu sous-cutané , Tendons , CuisseRésumé
Myxoid and round cell liposarcoma is a variant of liposarcoma characterized by a morphologic continuum in which tumor progression from low-grade myxoid to high-grade hypercellular or round cell areas may be observed. A 28-year old man presented with a painful skin colored subcutaneous mass on his left flank. The skin lesion was discovered about two months ago. Computed tomography revealed a well-defined tumor in the subcutaneous area without significant lymphadenopathy. A histopathologic study showed a nonencapsulated nodular growing tumor mass under the deep dermis composed of a mixture of atypical proliferating lipoblasts in a prominent myxoid stroma, occasional uniform round to oval shaped primitive nonlipogenic mesenchymal cells and plexiform, chicken wire shaped capillaries. Based on these findings, we diagnosed this case as myxoid and round cell liposarcoma. Because liposarcomas are large tumors of the deep subcutis or deeper soft tissue, they rarely come to the attention of the dermatologist. However, liposarcoma should be of concern, especially when rapid growing subcutaneous tumors are shown.