RESUMO
An 18-year-old male visited our department complaining of recurrent episodes of an itchy rash after hand washing, showering/bathing, drinking water, and getting rain-soaked. He was diagnosed with aquagenic urticaria after a water provocation test and histopathologic examination. Five months of antihistamine treatment successfully prevented further wheal formation. Aquagenic urticaria is a very unusual form of physical urticaria caused by contact with water. It manifests as pruritic small wheals surrounded by erythema within 30 minutes of exposure. The condition can be diagnosed by a water provocation test. Systemic antihistamines are the first-line treatment, with anticholinergics, phototherapy, or barrier cream used alternatively or additionally. Four cases of aquagenic urticaria have been reported in Korea, but no histopathologic evaluation was reported in the English or Korean literature. Herein, we provide both a case report of aquagenic urticaria diagnosed by the water provocation test and histopathologic examination results for this patient.
Assuntos
Adolescente , Humanos , Masculino , Antagonistas Colinérgicos , Água Potável , Eritema , Exantema , Desinfecção das Mãos , Antagonistas dos Receptores Histamínicos , Coreia (Geográfico) , Fototerapia , Urticária , ÁguaRESUMO
Pemphigoid gestationis, also known as herpes gestationis, is a rare blistering disease associated with pregnancy, caused by autoantibody to the basement membrane component. It occurs in the second or third trimester of pregnancy or directly after delivery, as erythematous, urticarial papules, and plaques on the whole body, which aggravate to vesicles and bullae with severe pruritus. Histopathologically, subepidermal blisters and eosinophilic spongiosis are shown, and linear deposition of C3 in the dermoepidermal junction is seen on direct immunofluorescence assay. We present the case of 35-year-old woman who was diagnosed with pemphigoid gestationis, with the involvement of the uncommon site of the face.
Assuntos
Adulto , Feminino , Humanos , Gravidez , Membrana Basal , Vesícula , Eosinófilos , Técnica Direta de Fluorescência para Anticorpo , Penfigoide Gestacional , Penfigoide Bolhoso , Terceiro Trimestre da Gravidez , PruridoRESUMO
Microsporum(M.) gypseum, a geophilic dermatophyte, causes dermatophytosis that is characterized by rapid development and resolution. M. gypseum infection is rare due to its low infectivity, and there have been no previous case reports of infection with this dermatophyte after scratch injury by a dog. Here, we report a case of annular, scaly, erythematous plaques on the right ankle of a 5-year-old female patient after being scratched on the leg by a dog. Histopathological examination showed fungal hyphae on the stratum corneum. M. gypseum was identified by tissue culture and polymerase chain reaction. She was treated with sertaconazole cream. In this case, M. gypseum may have been transferred to the scratched area from contaminated soil or from the claws of the dog.
Assuntos
Animais , Pré-Escolar , Cães , Feminino , Humanos , Tornozelo , Arthrodermataceae , Casco e Garras , Hifas , Perna (Membro) , Microsporum , Reação em Cadeia da Polimerase , Solo , TinhaRESUMO
Lichen planus is a chronic inflammatory disease that mainly involves the skin and oral mucosa. We report the case of a 57-year-old female who presented with a 6-week history of localized violaceous papules on her back and both extremities. Prior to presentation, she had received acupuncture on her back and both extremities, and 2 weeks later skin lesions occurred along the treated area. From the histopathologic findings of the lesion, the patient was diagnosed with lichen planus and treated with intralesional and topical corticosteroids. Dermatologic diseases such as atypical mycobacterial infection, foreign body granuloma and contact urticaria associated with traditional Korean medicine treatments have been reported. To the best of our knowledge, there has been only one report of eruptive lichen planus triggered by acupuncture in English literature to date. Herein, we report this rare and interesting case of lichen planus related to acupuncture.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Acupuntura , Corticosteroides , Extremidades , Granuloma de Corpo Estranho , Líquen Plano , Líquens , Mucosa Bucal , Pele , UrticáriaRESUMO
Congenital self-healing reticulohistiocytosis is a variant of cutaneous Langerhans cell histiocytosis seen in newborns. It is characterized by generalized brownish to erythematous papules or nodules that resolve spontaneously within several weeks to months, without involvement of other organs. Erythematous erosive patches or vesicles are rare clinical features of congenital self-healing reticulohistiocytosis; only 11 cases have been reported in the literature. A newborn female presented with erythematous erosive patches and vesicles on the whole body without systemic symptoms. Histopathologically, multiple lymphocytes and histiocytic cells with kidney shaped nuclei were observed in the dermis. Immunohistochemical stain showed positive reactions for CD1a and S100 in histiocytic cells in the dermis. All lesions involuted spontaneously within a month without treatment. Here we report a rare case of congenital self-healing reticulohistiocytosis presenting as erythematous erosive patches and vesicles, with a literature review.
Assuntos
Feminino , Humanos , Recém-Nascido , Derme , Histiocitose de Células de Langerhans , Rim , LinfócitosRESUMO
Vitiligo is a chronic disorder characterized by depigmented macules which can slowly enlarge with the concurrent development of new lesions. Although autologous suction blister epidermal grafting is an established technique for the treatment of recalcitrant, stable vitiligo, the donor tissue graft is not easy to fix at the recipient site, especially in areas such as the joints, face, cutaneous folds, hands, feet, and hair-bearing areas. Therefore, various methods of donor tissue fixation have been attempted. We report two cases of vitiligo treated with suction blister epidermal grafting, with fibrin tissue adhesion. The first case is that of 16-year-old female patient presented with hypopigmented patches on the forehead and frontal scalp area. The other case is that of 32-year-old female patient presented with hypopigmented patches on the chin. We treated them with phototherapy for 1~4 years; however, the lesions were recalcitrant. Therefore, we tried treatment with a suction blister epidermal graft. Because graft fixation is difficult at the recipient sites, fibrin glue was sprayed on the grafts. Thereafter, we applied a porous silicone wound contact layer over the graft area and applied sterile gauze dressing that was left for a week. One week after the procedure, firm fixation of the donor tissue was observed in both cases. Fibrin glue seemed to improve the graft fixation, providng protection against infection and an optimal environment for wound healing. This report suggests that the application of an epidermal graft with fibrin glufixation, can provide the best result in the surgical treatment of stable vitiligo.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Bandagens , Vesícula , Queixo , Fibrina , Adesivo Tecidual de Fibrina , Pé , Testa , Mãos , Articulações , Fototerapia , Couro Cabeludo , Silicones , Transplante de Pele , Sucção , Aderências Teciduais , Doadores de Tecidos , Fixação de Tecidos , Transplantes , Vitiligo , Cicatrização , Ferimentos e LesõesRESUMO
Scar sarcoidosis is a rare variant of cutaneous sarcoidosis that develops from an inactive scar. Scars due to various traumas including surgery, vaccines, cosmetic tattoos, and herpes zoster have been reported to be associated with sarcoidosis. Subcutaneous nodules are the most common clinical feature in Korean cutaneous sarcoidosis followed by papules and erythema. Non-caseating granulomas with a sparse lymphocytic infiltrate that are referred to as "naked granulomas" are the characteristic histopathological feature of cutaneous sarcoidosis. Two female patients aged 45 and 61 years presented with subcutaneous nodules on both blepharoplasty scars. A 46-year-old female also presented with subcutaneous nodules on scars on the palm and perineum obtained subsequent to trauma and episiotomy, respectively. Chest radiography showed bilateral hilar lymphadenopathy in the third patient. A diagnosis of sarcoidosis was made in all 3 patients based on clinical and histopathological findings with the exclusion of other granulomatous diseases. Herein, we report 3 cases of scar sarcoidosis arising from various types of traumatized skin.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Blefaroplastia , Cicatriz , Diagnóstico , Episiotomia , Eritema , Granuloma , Herpes Zoster , Doenças Linfáticas , Períneo , Radiografia , Sarcoidose , Pele , Tórax , VacinasRESUMO
No abstract available.
Assuntos
Humanos , Terapia de Imunossupressão , Mycobacterium chelonaeRESUMO
No abstract available.
Assuntos
Cadeias Leves de Imunoglobulina , Linfoma de Zona Marginal Tipo Células BRESUMO
Cheilitis granulomatosa, a rare disease of unknown cause, is characterized clinically by recurrent or persistent swelling of the lip. Histopathologically, the dermis contains non-necrotizing granuloma, lymphangiectasia, and perivascular lymphocytic infiltration. Treatment of cheilitis granulomatosa is difficult, due to its unknown etiology. Several therapeutic methods have been attempted, including systemic and intralesional corticosteroids, oral metronidazole, non-steroidal anti-inflammatory drugs (NSAIDs), hydroxychloroquine, and surgical reduction, but unfortunately no treatment method has yet proven reliable.
Assuntos
Corticosteroides , Queilite , Derme , Granuloma , Hidroxicloroquina , Lábio , Síndrome de Melkersson-Rosenthal , Métodos , Metronidazol , Minociclina , Doenças RarasRESUMO
Erythrokeratodermia variabilis is an autosomal-dominant inherited disease associated with a mutation in gap junction beta (GJB) 3 and 4. It shows two characteristic features: migratory and irregularly shaped erythematous lesions usually accompanied by a burning sensation and fixed, symmetrically located hyperkeratotic plaques. A 6-year-old boy had developed erythematous scaly patches with a geographic pattern on the entire body at age 1, and the lesions had migrated with an irregular pattern. Accompanying hyperkeratotic plaque developed on the trunk and both legs when he was 4 years old. As he grew older, the erythematous patches progressively disappeared and the hyperkeratotic plaque dominantly remained. His family history was unidentifiable because he was adopted at birth. Pathologic findings showed hyperkeratosis and superficial perivascular inflammation. Based on the clinical and pathologic features, we diagnosed erythrokeratodermia variabilis in this patient. Herein, we report a case of erythrokeratodermia variabilis showing gradual disappearance of erythema.
Assuntos
Criança , Humanos , Masculino , Queimaduras , Eritema , Eritroceratodermia Variável , Junções Comunicantes , Inflamação , Perna (Membro) , Parto , SensaçãoRESUMO
BACKGROUND: While adapalene and benzoyl peroxide have both been demonstrated to be effective for the treatment of acne vulgaris, they can also cause skin irritation, resulting in patient incompliance. In addition, the irritation may be severe when adapalene is co-administered with benzoyl peroxide. OBJECTIVE: The intention of this study was to evaluate the efficacy and safety of adapalene 0.1%-benzoyl peroxide 2.5% fixed-dose combination gel, and adapalene 0.1% gel monotherapy, for the treatment of mild to moderate acne. Any changes in the skin barrier function were also measured. METHODS: A total of 52 patients applied adapalene-benzoyl peroxide gel or adapalene gel once daily. The changes in lesion counts, investigator's global assessment, patient satisfaction, and adverse events were recorded for 6 weeks. The biophysical profiles of the skin, including transepidermal water loss and redness, were measured for 3 weeks. RESULTS: Both agents were effective for the treatment of acne lesions. Adapalene-benzoyl peroxide showed a faster onset of action than adapalene, especially on inflammatory lesions. However, at week 6, both agents showed a similar effect in reducing lesion counts. While most patients in both groups experienced skin irritation from week 1, this gradually reduced. Likewise, the changes in transepidermal water loss and redness showed peak rates at week 1 and 2, but decreased over time. CONCLUSION: Adapalene-benzoyl peroxide gel is effective for the treatment of acne with a safety profile comparable to adapalene gel. The skin irritation experienced may be associated with the changes in skin barrier disruption, which lasts for 1~2 weeks.