Résumé
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.
Résumé
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.
Sujets)
Sujet âgé , Femelle , Humains , Atrophie , Biopsie , Collagène , Derme , Glandes eccrines , Épiderme , Front , Lichen scléroatrophique , Lichens , Cou , Sclérodermie localisée , Maladies de la peau , CuisseRésumé
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.
Sujets)
Sujet âgé , Humains , Bras , Biopsie , Avant-bras , Myélome multiple , Métastase tumorale , Pigmentation , Plasmocytes , Plasmocytome , Purpura , PeauRésumé
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.
Sujets)
Humains , Dermatite phototoxique , Traitement médicamenteux , Métaplasie , PeauRésumé
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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Femelle , Humains , Antifibrinolytiques , Études de suivi , Injections intradermiques , Mélanose , Satisfaction des patients , Acide tranéxamique , BénévolesRésumé
No abstract available.
Sujets)
Syndrome de l'orteil bleu , Coagulation intravasculaire disséminéeRésumé
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.
Sujets)
Neurofibrome , Neurofibromatoses , Neurofibromatose de type 1 , Nerf trijumeauRésumé
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.
Sujets)
Sujet âgé , Humains , Mâle , Acantholyse , Diagnostic , Prurit , Maladies de la peauRésumé
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.
Sujets)
Sujet âgé , Humains , Mâle , Acantholyse , Diagnostic , Prurit , Maladies de la peauRésumé
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.
Sujets)
Sujet âgé , Humains , Bras , Biopsie , Pied , Psoriasis , Sarcome de Kaposi , PeauRésumé
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.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Tissu élastique , Cellules géantes , Granulome à cellules géantes , Température élevée , Phagocytose , Sensation , Peau , Maladies de la peauRésumé
Terbinafine is a highly effective oral antifungal agent that is used to treat dermatophyte infections of the skin and nails. Although generally well tolerated, common side effects of terbinafine include nausea, vomiting, abdominal pain, urticarial or erythematous eruptions, and pruritus. Taste disturbance is a rare side effect of terbinafine, occurring in 0.6%approximately2.8% patients taking the drug orally. Here, we report the case of a 67-year-old man who complained of taste disturbance and loss of appetite 1 month after starting terbinafine treatment for onychomycosis. Low body mass index and advanced age are considered predisposing factors for the development of terbinafine-induced taste disturbance. As the proportion of elderly population is increasing, the frequency in use of the prescription of drugs such as terbinafine for the elderly is also increasing. Therefore, clinicians should be aware of this unfamiliar and uncommon adverse effect associated with the antifungal agent, terbinafine and should perform careful follow-up of elderly patients with low BMI taking this medication, as they may become depressed or alter their food intake in response to a decrease or loss of taste sensation.
Sujets)
Sujet âgé , Humains , Douleur abdominale , Appétit , Arthrodermataceae , Indice de masse corporelle , Causalité , Consommation alimentaire , Études de suivi , Nausée , Onychomycose , Ordonnances , Prurit , Sensation , Peau , VomissementRésumé
In Korea, physician assistants (PAs) have emerged owing to the shortage of medical residents, especially in the surgical departments of tertiary hospitals. In addition, the Korean Ministry of Health and Welfare has been planning to reduce the number of medical residents. Hence, training hospitals decided to hire PAs to replace medical residents. PAs can perform a large part of residents' time-consuming job. However, PAs are not a common type of workforce in the field of dermatology. The aim of this study is to compare the roles of dermatology specialist, resident, PAs, and registered nurse (RN), and discuss the limitations and futures of PAs in the field of dermatology. Moreover, in Korea, the legal definition and status of PAs are absent or, if present, inconsistent. Between PAs and other positions such as residents, registered nurses, and nurse specialists, lies an unsettled conflict. Therefore, if PAs are employed, a more precise complement is needed.
Sujets)
Humains , Protéines du système du complément , Dermatologie , Corée , Assistants médecins , Spécialisation , Centres de soins tertiairesRésumé
In Korea, physician assistants (PAs) have emerged owing to the shortage of medical residents, especially in the surgical departments of tertiary hospitals. In addition, the Korean Ministry of Health and Welfare has been planning to reduce the number of medical residents. Hence, training hospitals decided to hire PAs to replace medical residents. PAs can perform a large part of residents' time-consuming job. However, PAs are not a common type of workforce in the field of dermatology. The aim of this study is to compare the roles of dermatology specialist, resident, PAs, and registered nurse (RN), and discuss the limitations and futures of PAs in the field of dermatology. Moreover, in Korea, the legal definition and status of PAs are absent or, if present, inconsistent. Between PAs and other positions such as residents, registered nurses, and nurse specialists, lies an unsettled conflict. Therefore, if PAs are employed, a more precise complement is needed.