A Case of Squamous Cell Carcinoma Treated with Photodynamic Therapy with Ablative Carbon Dioxide Fractional Laser

No abstract available.

Cutaneous Lupus Erythematosus Presenting as Localized Grouped Papules Mimicking Herpes Zoster on the Back

No abstract available.

Metastatic Blue Nevus-Like Melanoma Detected by Liquid-Based Catheterized Urine Cytology

Primary or metastatic malignant melanoma can mimic benign blue nevus in rare cases, making the diagnosis challenging. Herein, we report an exceptionally rare case of blue nevus-like melanoma and its blue nevus-like metastasis which was detected by catheterized urine cytology. The patient presented with blue-colored papuloplaques on his temple which were diagnosed as blue nevus-like melanoma on punch biopsies. While he was admitted for administration of chemotherapy, hematuria was detected. Catheterized urine cytology revealed singly scattered oval to spindle-shaped pigmented cells with a moderate degree of variation in shape and size. Many of them had small nuclei with indiscernible to inconspicuous nucleoli while only a few cells showed nuclear enlargement and nuclear hyperchromasia, which could be diagnostic pitfalls. Most of the cells on the smear were positive for HMB45 immunostaining, which confirmed the diagnosis of metastatic blue nevus-like melanoma. To the best of our knowledge, the present case is the first report describing cytomorphologic findings of blue nevus-like metastasis of melanoma in the urine specimen.

Clinical, Histopathological, and Immunohistochemical Differences between Men and Women with Psoriasis According to Disease Severity: Possible Role of Estrogen / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic inflammatory skin disorder histopathologically characterized by epidermal hyperplasia, vascular proliferation, and inflammatory infiltrates. It runs a less severe course in women than in men. The role of estrogen in the pathogenesis of psoriasis remains unclear. OBJECTIVE: We investigated the clinicohistopathological differences between men and women with psoriasis and examined whether serum estrogen levels and immunohistochemical findings correlate with gender and disease severity. METHODS: We retrospectively reviewed the medical records of 500 patients with psoriasis. Among these patients, 60 who consented to participate in the study were classified into four groups as follows: 10 men showing psoriasis on < 10% of their body surface area (BSA) with psoriasis area severity index (PASI) < 10; 20 men showing psoriasis on ≥10% of their BSA with PASI≥10; 10 women showing psoriasis on < 10% of their BSA with PASI < 10; and 20 women showing psoriasis on ≥10% of their BSA with PASI ≥10. Serum estrogen levels were measured using radioimmunoassay. Immunohistochemical staining of skin biopsy tissues was performed using ERα, ERβ, and CCL5. RESULTS: Men diagnosed with psoriasis showed higher BSA and PASI scores than women. Women aged ≥60 years showed higher BSA and PASI scores than women aged < 60 years. There were no histological differences between the four groups. Serum estrogen levels were higher in the patients presenting with mild psoriasis, as well as in women. ERα, ERβ, and CCL5 showed a stronger staining tendency in patients with more severe psoriasis. CONCLUSION: Gender influences the severity of psoriasis, and estrogen plays an important role. This finding is explained by the fact that estrogen decreases inflammation in psoriasis possibly via its action on estrogen receptors in epidermal keratinocytes.

Localized Grouped Basaloid Follicular Hamartoma on the Chest of an Adult

No abstract available.

Concurrent Linear Immunoglobulin A Dermatosis, Hashimoto Thyroiditis, and Immunoglobulin A Nephropathy in an Adult

No abstract available.

Prurigo Pigmentosa after Injection Lypolysis with Phosphatidylcholine and Deoxycholate / 대한피부과학회지

No abstract available.

Eosinophilic Annular Erythema Localized to the Palms and the Soles

No abstract available.

Recurrence of Tuberculosis after Resuming a TNF-Inhibitor in a Patient with Crohn's Disease / 대한내과학회지

The use of tumor necrosis factor inhibitors (TNFi) increases a patient's risk of developing tuberculosis (TB). There is no consensus on whether restarting a TNFi after treating an active TB infection caused by previous TNFi exposure is safe. We report the first case of TB recurrence after recommencing a TNFi in a 37-year-old woman with a history of active TB infection caused by previous TNFi treatment.

Secondary amyloidosis complication of Crohn disease treated with infliximab / 영남의대학술지

Secondary systemic (AA) amyloidosis is a severe complication of progressed Crohn disease (CD) characterized by the deposition of amyloid A in body organs and tissues. Various therapeutic approaches have been recommended, however there is still no effective treatment. Recently, several case reports have demonstrated the effects of anti-tumor necrosis factor-alpha therapy in patients with AA amyloidosis associated with CD. We report on a 35-year-old female patient with CD complicated by AA amyloidosis in the gastrointestinal tract and renal involvement, who was treated with infliximab. The infliximab therapy improved the gastrointestinal symptoms and decreased the serum creatinine.

Malignant mesothelioma mistaken for tuberculous pleurisy / 영남의대학술지

Malignant mesothelioma is a common, primary tumor that can invade pleura, and is associated with previous exposure to asbestos. However, it poses considerable difficulties regarding its diagnosis and treatment, and thus, accurate history taking with respect to exposure to asbestos, and radiologic and pathologic examinations are essential. In addition, the involvement of a multidisciplinary team is recommended in order to ensure prompt and appropriate management using a framework based on radiotherapy, chemotherapy, surgery, and symptom palliation with end-of-life care. Because lymphocyte-dominant, exudative pleural effusion can occur in malignant mesothelioma, adenosine deaminase values may be elevated, which could be mistaken for tuberculous pleurisy, and lead to an incorrect diagnosis and suboptimal treatment. The authors describe a case of malignant mesothelioma initially misdiagnosed as tuberculous pleurisy. As evidenced by the described case, malignant mesothelioma should be considered during the differential diagnosis of patients with lymphocyte-dominant, exudative pleural effusion with a pleural lung lesion.

Significance of residual renal function for phosphate control in chronic hemodialysis patients

BACKGROUND: The aim of this study was to compare mineral metabolism between anuric and nonanuric chronic hemodialysis patients, and determine the differences in phosphate control between the two groups. METHODS: A total of 77 chronic hemodialysis patients were enrolled in this cross-sectional study from January 2012 to February 2012. Patient demographics, laboratory findings, medication histories, and vascular calcification scores were collected. We divided the patients into anuric and nonanuric groups according to the residual renal function and then compared their clinical features. Multivariate binary regression analysis was used in each group to determine the independent factors related to phosphate control. RESULTS: The mean patient age was 59.27+/-13.95 years, and 57.1% of patients were anuric. In anuric patients, dialysis vintage was significantly longer, but the mean Kt/V was not different between groups. Serum phosphate, fibroblast growth factor (FGF)-23, and Ca/P products were significantly higher, and 1,25(OH)2D3 levels were significantly lower in the anuric patients, although the intact parathyroid hormone and 25(OH)D levels were not different. In anuric patients, LnFGF-23 [hazard ratio (HR) 2.894, 95% confidence interval (CI) 1.294-6.474, P=0.010] was an independent factor predictive of phosphate control. However, in the nonanuric patients, glomerular filtration rate (HR 0.409, 95% CI 0.169-0.989, P=0.047) and blood urea nitrogen (HR 1.090, 95% CI 1.014-1.172, P=0.019) were independent factors predictive of phosphate control. CONCLUSION: In chronic hemodialysis patients, preservation of residual renal function is a significant determinant of phosphate control, and the factors associated with phosphate control is different depending on the residual renal function status. In the anuric patients, FGF-23 is most significantly associated with phosphate control; however, glomerular filtration rate and blood urea nitrogen are more important than FGF-23 in the nonanuric HD patients.

A Case of Polyostotic Fibrous Dysplasia Masquerading as a Mulptile Bone Metastases / 계명의대학술지

Fibrous dysplasia is a benign, bony abnormality that is usually asymptomatic. A 41-year-old male with minimal symptoms presented at this hospital with abnormal findings incidentally seen in his ribs on the chest radiograph. A skeletal survey showed numerous, osteolytic lesions throughout multiple bones. Diagnostic processes for malignancy of undefined primary origin (MUO) were performed in order to identify the underlying primary neoplasm, although abnormal findings were not seen except for multiple bone lesions. A computed tomography guided bone biopsy was performed on his left rib. The final diagnosis was fibrous dysplasia. This case demonstrates that fibrous dysplasia should be considered in the differential diagnosis in young patients with multiple, osteolytic lesions and without a prior history suggesting malignancy.

The stress of weaning influences serum levels of acute-phase proteins, iron-binding proteins, inflammatory cytokines, cortisol, and leukocyte subsets in Holstein calves

The purpose of our study was to investigate changes in immunological parameters induced by weaning stress (including milk restriction) in calves. Fifteen Holstein calves were subjected to weaning at 6 weeks of age. Blood samples were collected at -14, -7, -2, 1, 3, and 5 days post-weaning (DPW; 0 DPW = 42 days). Weaning caused significant (p < 0.01) increases in the neutrophil (NE):lymphocyte (LY) ratio at 5 DPW with a significant (p < 0.05) reduction of LYs. The concentration of acute-phase proteins (haptoglobin and serum amyloid A) also increased significantly (p < 0.05) at 3 and 5 DPW compared to -2 DPW. Levels of the iron-binding protein lactoferrin decreased significantly (p < 0.05) after weaning. Serum tumor necrosis factor-alpha and cortisol levels were elevated (p < 0.05) at 3 DPW, while those of serum interferon-gamma decreased (p < 0.05) at 1 and 3 DPW compared to levels observed before weaning. Weaning significantly (p < 0.05) decreased the percentage of CD25+ T cells in the peripheral blood. In conclusion, weaning stress affected the NE:LY ratio along with the levels of acute phase proteins, lactoferrin, cortisol, and inflammatory cytokines in the peripheral blood of calves. Weaning stress may induce an acute phase response possibly through the elevation of cortisol production and modulation of inflammatory cytokines.