Effects of gonadotropin-releasing hormone agonist treatment on final adult height in boys with idiopathic central precocious puberty

Purpose@#There are few reports on the therapeutic effects of gonadotropin-releasing hormone agonists in boys with central precocious puberty, and studies reported in Korea are very rare. We aimed to assess the significance of clinical factors and the effects of gonadotropin-releasing hormone agonist treatment on final adult height in boys diagnosed with central precocious puberty. @*Methods@#We retrospectively evaluated the medical records of 18 boys treated for idiopathic central precocious puberty between 2007 and 2018 at Chosun University Hospital. Gestational age, birth weight, and parental height were assessed at the initial visit. Chronological age, bone age, bone age/chronological age ratio, height and height standard deviation scores, predicted adult height, body mass index, and hormone levels were assessed during the treatment period. @*Results@#At the time of diagnosis, the chronological age was 9.9±0.6 years, the bone age was 11.6±1.0 years, and the bone age/chronological age ratio was 1.20±0.1. The bone age/chronological age ratio decreased significantly to 1.12±0.1 at the end of treatment (P<0.05). The luteinizing hormone/follicular stimulating hormone ratios were 3.4±1.2, 0.6±0.4, and 0.6±1.0 at the start of treatment, after 1 year of treatment, and at the end of treatment, respectively. After gonadotropin-releasing hormone agonist treatment, the final adult height reached 172.0±4.8 cm compared to the target height range of 171.0±4.0 cm. @*Conclusion@#In boys with central precocious puberty, gonadotropin-releasing hormone agonist treatment improved growth potential.

Relationship between final adult height and birth weight after gonadotropin-releasing hormone agonist treatment in girls with central precocious puberty

Purpose@#The clinical significance of birth weight relative to gestational age in girls with central precocious puberty is unclear. This study sought to compare clinical parameters such as final adult height (FAH) and menarche onset after treatment with gonadotropin-releasing hormone agonist (GnRHa) on birth weight in girls with central precocious puberty treated. @*Methods@#This retrospective study reviewed data of 69 girls with precocious puberty who had reached their FAH in a long-term trial of GnRHa treatment between January 2007 and December 2017. The subjects were divided into small for gestational age (SGA) (n=19) and appropriate for gestational age (AGA) (n=50) groups. @*Results@#When starting GnRHa treatment, bone age was 10.9±0.9 and 10.3±0.8 years in the SGA and AGA groups, respectively (P<0.05). The predicted adult height (PAH) (established according to the Bayley-Pinneau average table) and advanced PAH (established according to the Bayley-Pinneau advanced table) were 151.5±4.8 cm and 155.8±4.9 cm in the SGA group, respectively, and 153.4±5.3 cm and 159.0±6.0 cm in the AGA group. After treatment, no significant difference in bone age was found between the groups. The time to menarche after treatment was 12.5±7.6 and 21.1±12.3 months in the SGA and AGA groups, respectively (P<0.05). FAH in the SGA and AGA groups was 161.0±4.7 cm and 161.6±5.0 cm, respectively, without a significant difference. @*Conclusion@#SGA girls with precocious puberty have increased bone age and earlier menarche relative to AGA girls. However, no difference in FAH after treatment was found between these groups.

Pityriasis rosea-like Drug Eruption Induced by Imatinib Mesylate (Gleevec(TM))

Imatinib mesylate (Gleevec(TM), STI571), a selective inhibitor of BCR-ABL, c-Kit, and platelet-derived factor receptor, has been used to treat chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors. Although its use has been associated with various adverse cutaneous reactions, pityriasis rosea-like drug eruptions are rare. Here, we report a case of pityriasis rosea-like drug eruption that developed following the administration of imatinib mesylate to treat CML.

Lipoma of the Tongue / 대한피부과학회지

Lipoma is the most common benign mesenchymal neoplasm composed of mature fat. Although lipoma can occur in any part of the body, it is infrequently found in the oral cavity. Especially, lipoma of the tongue is rare and there have been no previous reports of this in the Korean dermatology literature. Lingual lipoma, which accounts for 0.3% of all tongue neoplasm, is typically described as well-circumscribed, submucosal mass and it is located on the lateral border of the anterior two-thirds of the tongue surface. We herein report on a rare case of lipoma of the tongue that occurred in a 77-year old male patient.

Identification of Cutaneous Mycobacterium massiliense Infections Associated with Repeated Surgical Procedures

Mycobacterium massiliense, an emerging pathogen that is increasingly reported as a causative agent in infections occurring during medical procedures, is difficult to be identified using conventional methods. Here we report the case of a cutaneous M. massiliense infection that was associated with repeated surgical procedures and that was identified via a comparative sequence analysis of rpoB and hsp65. The patient showed a substantial response to treatment with a combination of antimicrobial therapies consisting of clarithromycin, amikacin, and cefoxitin for 6 months.

Expression Profiling of Calcium Induced Genes in Cultured Human Keratinocytes

Terminal differentiation of skin keratinocytes is a vertically directed multi-step process that is tightly controlled by the sequential expression of a variety of genes. To examine the gene expression profile in calcium-induced keratinocyte differentiation, we constructed a normalized cDNA library using mRNA isolated from these calcium-treated keratinocytes. After sequencing about 10,000 clones, we were able to obtain 4,104 independent genes. They consisted of 3,699 annotated genes and 405 expressed sequence tags (ESTs). Some were the genes involved in constituting epidermal structures and others were unknown genes that are probably associated with keratinocytes. In particular, we were able to identify genes located at the chromosome 1q21, the locus for the epidermal differentiation complex, and 19q13.1, another probable locus for epidermal differentiation-related gene clusters. One EST located at the chromosome 19q13.1 showed increased expression by calcium treatment, suggesting a novel candidate gene relevant to keratinocyte differentiation. These results demonstrate the complexity of the transcriptional profile of keratinocytes, providing important clues on which to base further investigations of the molecular events underlying keratinocyte differentiation.

Localized Scleroderma-like Reaction Induced by Doxifluridine / 대한피부과학회지

Exogenous factors, including environmental substances and drugs, are known to induce scleroderma-like reactions. Various scleroderma-like reactions induced by anti-cancer drugs have recently been reported. This is the first report that doxifluridine (Didox), an oral prodrug of the antineoplastic agent 5-fluorouracil (5-FU), induced a localized sclerderma-like reaction. A 51-year-old woman was referred to our clinic with multiple pearly, shiny patches on both her breasts, her pelvis and her back. After surgical excision and radiation therapy due to her right breast cancer, she took Didox for 7 months. A skin biopsy specimen revealed that the dermal collagen thickening extended even to the subcutaneous tissue. The routine laboratory tests were within the normal ranges and the tests for antinuclear antibody (ANA), anti SS-A antibody, anti SS-B antibody and anti U1-RNP antibody were all negative. After discontinuation of Didox, the lesions gradually improved. Based on these finding, we diagnosed this case as a localized scleroderma-like reaction induced by doxifluridine and we should pay attention to detect this adverse effect of the long term use of doxifluridine.

Angiolymphoid Hyperplasia with Eosinophilia That Was Possibly Induced by Vaccination in a Child

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vasoproliferative disease of an unknown cause involving the skin or subcutaneous tissue of the head and neck, and particularly around the ear. It predominantly affects Caucasian adults during the third and fourth decades and it very rarely occurs in children. We experienced a case of ALHE in a 2-year-old Korean boy who had a firm, pruritic, skin-colored, subcutaneous nodule on his right upper arm. The histopathological findings were compatible with ALHE and they showed prominent vascular changes with epitheloid or histiocytoid endothelial cells surrounded by inflammatory cells, including a large proportion of eosinophils. This unusual distribution of the lesion and the young age of the patient may be associated with vaccination.

A Clinical Study of 263 Patients with Childhood Vitiligo / 대한피부과학회지

BACKGROUND: Vitiligo is an acquired pigmentary disorder and half of these patients experience disease onset during childhood. The psychosocial complications of vitiligo can be substantial, and especially for children. There has been no study that has compared the clinical features according to the symmetry of the vitiligo lesions of patients with childhood vitiligo. OBJECTIVE: The purpose of this study is to evaluate the clinical aspects and distribution of the vitiligo lesions according to the symmetry in patients with childhood vitiligo. METHODS: The clinical characteristics and distribution of the vitiligo lesions according to the symmetry were investigated in the 263 childhood patients who were diagnosed with vitiligo at the Dermatology Department of our University Hospital from January 1991 to August 2008. RESULTS: Of the 263 patients, 133 (50.6%) had the asymmetric vitiligo lesions, 76 (28.9%) had the symmetric lesions and 54 (20.5%) had the multiple lesions. Of the patients with asymmetric vitiligo lesions, 91 (34.6%) had the localized lesions and 42 (16.0%) had the segmental lesions. The most common site of the vitiligo lesions was the face (54.8%). In case of the vitiligo lesions on the scalp, face and neck, the asymmetric type was predominant. The lesions on the scalp and the face showed a lesser tendency to spread to other sites. CONCLUSION: Childhood vitiligo showed the higher prevalence of asymmetric vitiligo lesions. It is expected that the asymmetric type of childhood vitiligo, and especially that on the scalp and the face, may have a favorable clinical course.

A Case of Bullous Lichen Sclerosus et Atrophicus / 대한피부과학회지

Lichen sclerosus et atrophicus (LSA) is a benign, chronic inflammatory dermatosis that usually affects the female genitalia. It may also involve any other areas, and it is rarely seen on the face, oral mucosa and palm and sole. The lesion of LSA primarily occurs as a whitish or yellowish papule, and later it becomes a well-defined plaque. However, bullous LSA, which has a localized or generalized form, occurs as a rare variant of LSA. The exact prevalence of bullous LSA is uncertain. It generally involves not only the genitalia, which is vulnerable to trauma, but also extragenital sites. We present here a case of extragenital LSA with bullae on the upper back of a 33-year-old female. Histologic examination revealed hyperkeratosis, atrophy, vacuolar alteration of the basal layer and homogenization of the collagen in the upper dermis. In addition, increased collagen bundles and lymphocytic infiltration around the vessels in the lower dermis were also noted.

A Case of Amniotic Band Syndrome / 대한피부과학회지

The amniotic band syndrome is a collection of fetal malformations associated with fibrous band that appears to entangle or entrap various fetal part, in utero, leading to deformation, malformation or disruption. Its pathogenesis has been debated in the literature for many years. The associated anomalies vary from minor limb anomalies to major craniofacial defects and visceral defects. We experienced a case of limb anomalies due to amniotic band and present the findings with a brief review of literature.

A Case of Erythema Nodosum-like Eruptions as a Manifestationof Azathioprine Hypersensitivity / 대한피부과학회지

Azathioprine is an immunosuppressant that has been widely used in the prevention of organ post-transplantation rejection, rheumatoid arthritis, inflammatory bowel disease and myasthenia gravis. The adverse effects reported with this drug have been classified as early events that include fever, hypotension, vasculitis and erythema nodosum-like eruptions or as late events that include bone marrow depression, nausea and vomiting. Although erythema nodosum-like eruptions could be useful for recognition of azathioprine hypersensitivity, this eruption has not yet been reported in Korean dermatological literature. We report, herein, a 68-year-old female with myasthenia gravis, who presented with tender, erythema nodosum-like eruptions on both upper and lower extremities 14 days after the first administration of azathioprine. Her symptoms improved 2 days after discontinuation of azathioprine and healed with no scarring change.

The 3-dimensional attachment of human periodontal ligament fibroblasts on periodontally involved root surface following treatment with EDTA: A SEM study in vitro / 대한치주과학회지

This study evaluated the possibility of the 3-dimensional attachment of human periodontal ligament fibroblasts to a periodntally involved root surface after an EDTA treatment in vitro. The human PDL fibroblasts were isolated from the middle third of the root of periodontally healthy teeth extracted for orthodontic reasons. The cells were cultured in a medium containing Dulbecco's modified Eagle medium supplemented with 10% fetal bovine serum at 37degrees C in humidified air containing 5% CO2. Eight single-rooted teeth were obtained from patients diagnosed with periodotitis. After scaling and root planing, four teeth were etched with 24% ethylenediaminetetracetic acid (EDTA) for two minutes (Experimental group). The other four teeth were not treated with EDTA and were used as the control group. The human PDL fibroblasts were placed in the total root surface and cultured for 4 weeks. The teeth were fixed in 2.5% glutaraldehyde in PBS before preparation for the scanning electron microscopy (SEM) examination. The human PDL fibroblasts showed a healthy morphology on the root surfaces treated with EDTA (Experimental group) and a relatively unhealthy appearance on the treated root surfaces (Control group). This suggests that EDTA favorably affects the 3-dimensional attachment of human PDL fibroblasts cultured on the root surfaces, which may play an important role in periodontal healing and regeneration.