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Background@#Bier’s spots represent a distinct pattern of speckled vascular mottling composed of small, irregular anemic macules. This phenomenon is common and easily reproducible by placing an extremity in a dependent position when mild venous stasis is created. @*Objective@#This study aimed to investigate the clinical manifestations of multiple anemic macules, Bier’s spots, and analyze its association with other underlying conditions in hospital outpatients. @*Methods@#Between 2015∼2020, we reviewed clinical data of 18 patients diagnosed with Bier’s spots at our hospital. Analysis was performed to assess patient’s demographics, presentation, and treatment. @*Results@#A total of 18 patients were included, and 10 (55.6%) were males. Lesions on both sides of the extremities were more common in 11 patients (61.1%), with four (22.2%) and two (11.1%) only on the upper and lower sides, respectively. Symptoms included itching in six patients (33.3%), numbness in two (11.1%), tenderness in one (5.6%), and asymptomatic in 11 (61.1%). The symptoms often accompanied hypertension, atopic dermatitis, and dyslipidemia. Histopathologic findings showed perivascular inflammation in six biopsy specimens, lymphocytic infiltration in four (66.7%), and papillary dermal vascular dilatation in three (50.0%). Calcium channel blockers and antihistamines were used for treatment in 13 patients (72.2%). @*Conclusion@#The result shows clinical manifestations of Bier’s spots and a possibility of association with various underlying diseases. Optimum treatment for Bier’s spots has not been defined, and because most cases are asymptomatic, no treatment is required. Therefore, this study will be a valuable data of Bier’s spots for dermatologists.
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Marjolin’s ulcer is a malignant skin tumor that arises at the site of scars, chronic ulcerations, inflammations, and fistulas after a long latent period. These tumors are mostly squamous cell carcinomas; however, other types of malignancies, such as basal cell carcinoma, malignant melanoma, and sarcoma rarely occur. Marjolin’s ulcer have aggressive characteristics, and local recurrence and lymph node metastasis rates are higher than those of cutaneous primary tumors. Herein, we report an unusual case of squamous cell carcinoma at the site of an arteriovenous fistula ulcer treated with repeated radical operation and skin graft.
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Eosinophilic annular erythema (EAE) is an uncommon, recurrent eosinophilic cutaneous disease, and its etiology has not been clearly elucidated. Clinically, EAE occurs mainly in the form of annular or round erythematous, edematous plaques on the trunk or extremities. Histopathologically, it is characterized by superficial and deep perivascular inflammatory cell infiltration composed of lymphocytes and eosinophils. Based on this, some studies have stated that EAE is not an isolated rare disease but rather a spectrum that shares features similar to Wells syndrome. Herein, we report a case of EAE in a 28-year-old female patient. The clinical features were recurrent annular, erythematous patch on the both extremities. Histopathologic examination demonstrated superficial infiltrates of lymphocytes and eosinophils in the dermis. Based on the clinical and histological features, this case was diagnosed as EAE.
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Purpose@#This study aimed to develop and validate a predictive model for the assessment of clinically significant prostate cancer (csPCa) in men, prior to prostate biopsies, based on bi-parametric magnetic resonance imaging (bpMRI) and clinical parameters. @*Materials and Methods@#We retrospectively analyzed 300 men with clinical suspicion of prostate cancer (prostate-specific antigen [PSA] ≥ 4.0 ng/mL and/or abnormal findings in a digital rectal examination), who underwent bpMRI-ultrasound fusion transperineal targeted and systematic biopsies in the same session, at a Korean university hospital. Predictive models, based on Prostate Imaging Reporting and Data Systems scores of bpMRI and clinical parameters, were developed to detect csPCa (intermediate/high grade [Gleason score ≥ 3+4]) and compared by analyzing the areas under the curves and decision curves. @*Results@#A predictive model defined by the combination of bpMRI and clinical parameters (age, PSA density) showed high discriminatory power (area under the curve, 0.861) and resulted in a significant net benefit on decision curve analysis. Applying a probability threshold of 7.5%, 21.6% of men could avoid unnecessary prostate biopsy, while only 1.0% of significant prostate cancers were missed. @*Conclusion@#This predictive model provided a reliable and measurable means of risk stratification of csPCa, with high discriminatory power and great net benefit. It could be a useful tool for clinical decision-making prior to prostate biopsies.