Résumé
The picosecond lasers have shown to effectively treat tattoo pigments that are intractable to previous multiple Q-switched (QS) laser treatments. Therefore we hypothesized that a picosecond laser would show better efficacy with minimal adverse events in the treatment of melasma and post-inflammatory hyperpigmentation (PIH) that are difficult to treat with conventional QS lasers. Two patients with melasma and one patient with PIH were treated with a Picosecond 755-nm Alexandrite Laser (Cyanosure, USA). All patients were Korean with skin type IV and no longer responding to QS laser treatments. Laser treatment was well tolerated in all the patients. Adverse events such as PIH were not reported during 8 weeks of follow up period. After the multiple treatment sessions, one patient reported fair improvement and two patients reported good improvement. Consistent with the clinical results, ex vivo skin model irradiated with a Picosecond 755-nm Alexandrite Laser also showed decreased epidermal keratinocyte necrosis compared with the 532-nm QS Neodymium-Doped Yttrium Aluminium Garnet Laser (Lutronic, Korea) yet decreased melanin content. In conclusion, the Picosecond 755-nm Alexandrite Laser may be useful for effective treatment of intractable melasma and PIH with fewer adverse events in dark Asian skin.
Sujets)
Humains , Asiatiques , Études de suivi , Hyperpigmentation , Kératinocytes , Lasers à solide , Mélanines , Mélanose , Nécrose , Peau , YttriumRésumé
BACKGROUND: Melasma is a common acquired hyperpigmentation disorder that predominantly affects the face. It frequently occurs in women with darker skin types and severely impacts quality of life. OBJECTIVE: To characterize the clinicoepidemiological features and triggering or aggravating factors of melasma in Korean patients. METHODS: This cross-sectional study was conducted at the dermatology clinics of five university hospitals in Korea. Between January 2011 and August 2012, 411 patients with melasma completed a questionnaire about the clinical and aggravating factors associated with their melasma. RESULTS: The study population consisted of 400 women and 11 men aged 22~73 years (mean age, 42.8±9.92 years). Triggering or aggravating factors were sun exposure (68.4%), pregnancy (27.0%), and emotional stress (24.8%). Interestingly, 61.1% of patients complained of sensitive/inflammatory features such as erythema, itching, and a stinging sensation. Dryness was the most common aggravating factor, followed by erythema/redness and itching/stinging. Concomitant pigmentary disorders included post-inflammatory hyperpigmentation in 15.1% of patients, followed by pigmented contact dermatitis, and acquired bilateral nevus of Ota-like macules. CONCLUSION: It is well known that sun exposure and hormonal changes are the most common triggers of melasma; however, sensitive/inflammatory features may aggravate melasma in East Asian patients. Therefore, these individual and racial differences should be considered in the prevention and treatment of melasma.
Sujets)
Femelle , Humains , Mâle , Grossesse , Asiatiques , Morsures et piqûres , Études transversales , Eczéma de contact , Dermatologie , Érythème , Hôpitaux universitaires , Hyperpigmentation , Corée , Mélanose , Naevus , Prurit , Qualité de vie , Sensation , Peau , Système solaire , Stress psychologiqueRésumé
BACKGROUND: Melanoma is a malignant neoplasm originating from melanocytes. It has been recently suggested that syndecan-2 may contribute to the aggressive phenotype and metastatic potential of melanoma in cell line studies. However, there is no quantitative analysis of syndecan-2 expression using human melanoma tissue. OBJECTIVE: This study aimed to examine the specific expression of syndecan-2 in human melanoma tissue. METHODS: A total of 35 sections of formalin-fixed, paraffin-embedded tissues were investigated for syndecan-2 expression using immunohistochemical staining. Also, a total of 6 tissues and two kinds of cell lines were analyzed by reverse-transcriptase polymerase chain reaction (RT-PCR) and western blot. RESULTS: Immunohistochemical staining of 23 cases of melanoma tissue was done, and in 5 cases (21.7%), strong expression of syndecan-2 was seen. Also, syndecan-2 was detected in human melanoma tissue and MNT-1 melanoma cells by RT-PCR and western blot analysis. CONCLUSION: We suggest that syndecan-2 expression is increased in melanoma compared to nevus. The results of this study may help to explain the clinical features of melanoma and syndecan-2.
Sujets)
Humains , Technique de Western , Lignée cellulaire , Mélanocytes , Mélanome , Naevus , Naevus pigmentaire , Phénotype , Réaction de polymérisation en chaîne , Syndécane-2Résumé
Rosai-Dorfman disease or sinus histiocytosis with massive lymphadenopathy is an idiopathic, benign, histiocytic proliferative disease involving lymph nodes and extranodal sites. A 52-year-old woman presented with a 2-year history of multiple non-tender, erythematous nodules on her face. The initial punch biopsy showed lymphoid follicle-like aggregation of CD20 positive lymphocytes in the papillary dermis consisting of primary cutaneous marginal zone B-cell lymphoma. She underwent a 3-month course of radiotherapy, but the lesions progressed. The re-biopsy specimen revealed marked histiocytes with positive CD68 and S-100 proteins. The patient was treated with prednisolone and isotretinoin to which she responded slightly. Repeated histopathologic examinations enable us to make a definite diagnosis. Differentiating these two disorders as early as possible is crucial for appropriate treatment.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Biopsie , Derme , Diagnostic , Histiocytes , Histiocytose sinusale cytophagique , Isotrétinoïne , Noeuds lymphatiques , Lymphocytes , Lymphome B de la zone marginale , Prednisolone , Radiothérapie , Protéines S100Résumé
Granular parakeratosis is a recently recognized disorder of keratinization that is usually confined to intertriginous areas. The histopathologic features are distinctive and diagnostic. Rarely, histopathologic variants such as follicular granular parakeratosis and granular parakeratosis of eccrine ostia have been described. In this report, we describe a rare case of granular parakeratosis mostly confined to eccrine ostia.
Sujets)
Glandes eccrines , Kératines , Cou , ParakératoseRésumé
BACKGROUND: Dermatologic comorbidities can be the clue for the diagnosis and treatment of systemic conditions and a need for dermatological expert opinion is increased. OBJECTIVE: To analyze the patterns and to quantify the dermatologic consultations referred by the department of obstetrics and gynecology (OBGY). METHODS: We retrospectively studied the data from 479 cases referred by OBGY for a dermatologic consultation during a three-year period in a tertiary hospital. RESULTS: The most common skin disorder was pregnancy-related dermatoses (29.77%) in obstetric inpatients, while cutaneous infection (33.33%) was the most frequent in gynecologic inpatients. The distribution of the skin disorders in consulted OBGY inpatients was consistent with the previous reports. However, there were some differences, such as high proportion of infectious disease. Infectious skin diseases were significantly more frequent (p<0.001) in the chemotherapy group of gynecologic inpatients compared to that of the non-chemotherapy group, viral infection being the most common. In addition, superficial fungal infection accounted for the same proportion as the viral infection (37.50% each) among obstetrical inpatients. Maculopapular or urticarial eruption (51.52%) was the most common type of chemotherapy-related adverse drug reaction. CONCLUSION: This study revealed the distribution of skin disorders in patients referred by OBGY for dermatologic consultation. Furthermore, it could be helpful as an educational material to assist cooperation between dermatology and OBGY.
Sujets)
Humains , Maladies transmissibles , Comorbidité , Dermatologie , Expertise , Gynécologie , Patients hospitalisés , Obstétrique , Orientation vers un spécialiste , Études rétrospectives , Peau , Maladies de la peau , Infections de la peauRésumé
Collagenomas, or connective tissue nevi of the collagen type, are hamartomatous growths of otherwise normal collagen. They are divided into two groups: the inherited form that contains familial cutaneous collagenoma and shagreen patches in tuberous sclerosis, and the acquired form that contains eruptive collagenoma and isolated collagenoma. Among them, isolated plantar collagenoma with a cerebriform appearance is a relatively rare type of connective tissue nevus. It has been described as one of the major skin findings in Proteus syndrome. We present an unusual case of acquired isolated plantar collagenoma presenting as cerebriform hyperplasia, which was not associated with Proteus syndrome.
Sujets)
Collagène , Tissu conjonctif , Hyperplasie , Naevus , Syndrome de Protée , Peau , Complexe de la sclérose tubéreuseRésumé
There have been a small number of recent case reports of patients with erythematous patches around the joints, which histopathologically showed histiocytic aggregations in the dermal vessels. Intralymphatic histiocytosis (ILH) is a rare group of skin diseases that are characterized by the proliferation of histiocytes in a lymphatic vessel lumen, and this is thought to arise as a benign reaction to certain stimuli such as rheumatoid arthritis. The pathogenesis of this intralymphatic proliferation of histiocytes and the reasons they commonly present on the arms are still unknown. We report on a case of ILH with arthritis in a 68-year old female who had no underlying disease, and the ILH presented as irregular erythematous patches on the left antecubital area and these patches demonstrated the distinctive histopathological features of intralymphatic histiocytosis.
Sujets)
Femelle , Humains , Bras , Arthrite , Polyarthrite rhumatoïde , Glycosaminoglycanes , Histiocytes , Histiocytose , Articulations , Vaisseaux lymphatiques , Maladies de la peauRésumé
Dermatofibroma is a common benign fibrohistiocytic tumor. It can occur anywhere on the body surface, but it has a propensity for the extremities. However, dermatofibroma may show a wide variety of clinicopathologic variants and so it is often misdiagnosed. Our case was a 13-year-old male who presented with a 1-year history of a solitary skin-colored hyperkeratotic nodule on the right sole. The nodule had recurred after topical therapy for viral wart. Histopathologic examination of the patient's lesion revealed a poorly circumscribed nodular tumor composed of collagen bundles, fibroblasts and histocytes, which was all consistent with plantar dermatofibroma.