RESUMO
Anagen effluvium is an abrupt loss of hair in its growing phase due to an event that impairs the mitotic or metabolic activity of the hair follicle. Anagen effluvium is commonly associated with the administration of chemotherapy, radiation, and drugs as well as exposure to toxic chemicals. However, alopecia due to the administration of anti-tuberculosis drugs has rarely been reported in the literature. A 50-year-old female was diagnosed with intestinal tuberculosis and was started on anti-tuberculosis therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide. After starting the treatment, erythematous to brown patches appeared all over her body, which was followed by diffuse hair loss on the scalp and body. Hair examination showed intact inner and outer root sheaths with fully pigmented hair bulbs, and histopathological examination of a scalp biopsy showed vacuolar degeneration in the interfollicular epidermis and perifollicular infiltration of mononuclear cells and eosinophils. The condition was diagnosed as anagen effluvium with drug eruption, and a potent corticosteroid lotion was prescribed for scalp application twice a day. After complete hair loss, the anti-tuberculosis medications were withdrawn, and hair regrowth started 4 months later. Here, we report a rare case of anagen effluvium with generalized drug eruption due to anti-tuberculosis medication.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Alopecia , Biópsia , Toxidermias , Tratamento Farmacológico , Eosinófilos , Epiderme , Etambutol , Cabelo , Folículo Piloso , Isoniazida , Pirazinamida , Rifampina , Couro Cabeludo , TuberculoseRESUMO
IgG4-related disease (IgG4-RD) is a new disease entity characterized by elevated serum IgG4 and infiltration of IgG4+ plasma cells in tissue. IgG4-RD can involve various organs, and skin could also be affected. The manifestations of IgG4-related skin disease (IgG4-RSD) are not characteristic, however it usually presents with multiple erythematous nodules or plaques with itching sensation. We report two cases of IgG4-RSD. Histological studies of these cases revealed infiltration of numerous plasma cells and mononuclear cells in the entire dermis. Some plasma cells were strongly positive for IgG4 stain. IgG4-RSD is a treatable disease with systemic corticosteroids. Thus, clinicians should obtain a biopsy and identify IgG4-positive cells for an accurate diagnosis.
Assuntos
Corticosteroides , Biópsia , Derme , Diagnóstico , Imunoglobulina G , Plasmócitos , Prurido , Sensação , Dermatopatias , PeleRESUMO
No abstract available.
Assuntos
Carcinoma de Células Escamosas , Células Epiteliais , PoroceratoseRESUMO
No abstract available.
Assuntos
Linfadenite , Glândula Parótida , Tuberculose Cutânea , Tuberculose dos LinfonodosRESUMO
BACKGROUND: Scabies is an old and common contagious skin disease. The incidence of scabies has decreased through the economic growth of Korea. However, recent outbreaks in medical facilities have created a suspicion that the infection of scabies is an emerging public health problem. OBJECTIVE: We evaluated the epidemiological and clinical aspects of patients diagnosed with scabies in Korea. This prospective study follows the retrospective study already performed by the same authors in 2011. METHODS: A multicenter, prospective study of scabies was performed at 25 hospitals in Korea. We included 914 patients who were diagnosed with scabies. Microscopic examination revealed scabies mites or eggs, or clinical improvement after treatment. Patients were asked to provide information on scabies, especially regarding the contact source, and the physicians examined them. RESULTS: Of the participants, 432 patients were men and 482 were women. Patients aged younger than 10 years and 60~69 years were the most common groups. Scabies more commonly affected patients during the fall and winter. Of the patients, 68.0% were thought to be infected at their homes, followed by nursing homes or hospitals (25.7%), and 31.6% through contact with other patients or, occasionally, staff members, including caregivers. CONCLUSION: We confirmed that scabies is an emerging threat in institutions, especially medical facilities. In addition, we suggest that public and in-hospital education is essential to minimize the problems associated with scabies.
Assuntos
Feminino , Humanos , Masculino , Cuidadores , Surtos de Doenças , Desenvolvimento Econômico , Educação , Ovos , Estudos Epidemiológicos , Epidemiologia , Incidência , Coreia (Geográfico) , Ácaros , Casas de Saúde , Óvulo , Estudos Prospectivos , Saúde Pública , Escabiose , DermatopatiasRESUMO
BACKGROUND: Scabies is one of the common skin diseases observed in developing countries. The incidence of scabies has decreased dramatically since the late 1980s in Korea. However, recent outbreaks in nursing homes or hospitals have been raising public health concerns. OBJECTIVE: We intended to evaluate the epidemiological and clinical aspects of patients diagnosed with scabies in Korea. In particular, we tried to investigate the changing trend of contact sources in our society. METHODS: A multi-center cross sectional study was performed at 25 hospitals in Korea. We included 1,539 patients who were diagnosed with scabies. These patients showed scabies mites or eggs under microscopic examination, or clinical improvement after treatment. Their medical records with information of contact sources were reviewed. RESULTS: Six hundred and ninety-three patients were males and 826 were females. Patients' age from 70 to 79 was the most common followed by patients below 10 years of age. More patients were found in the fall and winter months. 66.7% of patients were thought to be infected at their homes which were situated next to nursing homes or hospitals (23.1%). Place of infection could not be verified in 39.3% of patients. 25.8% of patients were suggested to be infected through contact with medical staff or patients from hospitals or nursing homes. CONCLUSION: We confirmed that the contact sources of scabies are changing in our society; nursing homes and hospitals are emerging sources of infection. The majority of patients are old or very young who are vulnerable to many diseases. Therefore, dermatologists should pay attention to new contact sources and appropriate care of patients.
Assuntos
Feminino , Humanos , Masculino , Países em Desenvolvimento , Surtos de Doenças , Ovos , Hipogonadismo , Incidência , Coreia (Geográfico) , Prontuários Médicos , Corpo Clínico , Ácaros , Doenças Mitocondriais , Casas de Saúde , Oftalmoplegia , Óvulo , Saúde Pública , Estudos Retrospectivos , Escabiose , DermatopatiasRESUMO
Trichothiodystrophy is a rare autosomal recessive disorder and it is caused by reduced levels of high-sulfur amino acids and most particularly cystine in hair shafts. The patients with trichothiodystrophy show a broad range of clinical phenotypes from only hair involvement to multisystem abnormalities. A 7-year-old girl visited the clinic with a complaint of short, sparse and slow-growing hair, which had been presented since birth. The patient's hair showed characteristic dark and light banding, which gave a "tiger tail" appearance under light microscopy, and polarization and cuticular degeneration were seen under the scanning microscopy. Evaluation of the mineral density in the patient's hair shaft showed a low level of sulfur. We herein report on a case of trichothiodystrophy with sulfur-deficiency in the hair shafts.
Assuntos
Criança , Humanos , Aminoácidos , Cistina , Cabelo , Luz , Microscopia , Parto , Fenótipo , Enxofre , Síndromes de TricotiodistrofiaRESUMO
Scedosporium apiospermum is a rising opportunistic fungus that may infect immunocompetent individuals and may cause often fatal disease among the increasing immunosuppressed patient population. This pathogen is typically difficult to treat because of its particular resistance to commonly used antimycotic drugs. We describe an 83-year-old male patient with a history of long-term corticosteroid treatment for chronic prurigo simplex, who developed multiple suppurative nodules on a erythematous plaque at the right forearm. Histological examinations revealed granulomatous infiltration with hyphae and spores in dermis and fungal cultured isolation for definitive diagnosis showed S. apiospermum. Treatment was started with oral fluconazole, but skin lesions were getting worse. Then patient was treated with 200 mg of intravenouse itraconazole daily. Skin lesions showed a marked improvement after 1 week, and completely healing after 3 weeks.
Assuntos
Idoso de 80 Anos ou mais , Humanos , Masculino , Derme , Fluconazol , Antebraço , Fungos , Hifas , Itraconazol , Metilmetacrilatos , Poliestirenos , Prurigo , Scedosporium , Pele , EsporosRESUMO
Bier's spots present as vascular mottling, and this consists of small, irregular macules surrounded by a red to cyanotic background. The macules most commonly occur on the arms and legs of young adults, but they may also appear on the trunk. They are considered a vascular anomaly, with vasoconstriction in the pale areas and vasodilatation in the erythematous skin. Although Bier's spots are occasionally discovered in young adults, they are still a challenge to differentiate from other hypopigmentation disorders. We report here on two cases of Bier's spots on the extremities and trunk of 2 young adults.
Assuntos
Adulto , Humanos , Masculino , Adulto Jovem , Braço , Extremidades , Hipopigmentação , Perna (Membro) , Pele , Vasoconstrição , VasodilataçãoRESUMO
Panniculitis generally indicates a group of diseases whose hallmark is fibrous thickening and chronic inflammation of subcutaneous fat. Various factors seem to induce a similar pathological histology, and morphological differences can be found among the patients diagnosed with the same disease. Paraneoplastic causes account for 3~10% of the cases of panniculitis. The commonest causes of cancer associated panniculitis are hematological malignancies and mostly lymphomas. In this case, we confirmed acute myeloid leukemia by a blood test and bone marrow examination, and with considering the clinical aspects and pathological findings of the skin lesion, and we finally diagnosed the patient as having panniculitis, which seems to be related with acute myeloid leukemia. The obvious clinical symptoms or pathophysiological features of this rare type of panniculitis are not yet fully known, and so making the differential diagnosis is needed to distinguish this malady from erythema nodosum, erythema induratum and various connective tissue disorders with accompanying erythematous subcutaneous nodules. We diagnosed this very rare and interesting case of paraneoplastic panniculitis that seemed to be generated from acute myeloid leukemia. We report here on this case and we review the relevant literature.
Assuntos
Humanos , Exame de Medula Óssea , Tecido Conjuntivo , Diagnóstico Diferencial , Eritema Endurado , Eritema Nodoso , Neoplasias Hematológicas , Testes Hematológicos , Inflamação , Leucemia Mieloide Aguda , Linfoma , Paniculite , Pele , Gordura SubcutâneaRESUMO
Systemic corticosteroid arrests the progression of vitiligo and leads to repigmentation, but it may produce side effects. It has been reported that the maximum effect for corticosteroid can be achieved without major side effects when it is used at high doses over a short period of time. Recently, narrowband UVB has been used to treat vitiligo. However, there have been no reports on the effectiveness for a combined treatment with narrowband UVB and systemic corticosteroid. We encountered 2 cases of vitiligo patients who had rapid and effective repigmentation after combination therapy with high dose methylprednisolone and narrowband UVB. Intravenous high dose (25 mg/kg) of methylprednisolone for 3 days was followed by narrowband UVB once or twice weekly. After 2 months, rapid improvements were seen in both patients with >75% repigmentation. Combination treatment with high dose methylprednisolone therapy and narrowband UVB may be an effective therapeutic option for vitiligo.