Analysis of Treatment Methods and Prognosis for Patients with Extramammary Paget’s Disease for 20 Years at a Single Tertiary Medical Institution: Carcinoembryonic Antigen as a Risk Factor for Metastasis / 대한피부과학회지

Background@#Extramammary Paget’s disease (EMPD) is a rare cutaneous malignancy of anogenital lesions. @*Objective@#To investigate the long-term prognosis of patients with EMPD and the results of various treatment methods for 20 years. @*Methods@#We retrospectively reviewed the medical records of 80 patients with biopsy-proven EMPD at Chonnam National University Hospital during the last 20 years from 2000 to 2019. @*Results@#The most common treatment option was excision in male patients (75.0%). However, for female patients, nonsurgical treatments, such as topical imiquimod (29.1%) or radiation therapy (20.8%), were mostly applied. In the long-term follow-up, 10 patients (12.5%) were diagnosed with systemic metastasis. The most common metastatic site was the lymph nodes, followed by the bone. Among patients with metastasis, 66.7% showed elevated serum carcinoembryonic antigen (CEA) levels, whereas none of the non-metastatic patients showed elevated CEA levels. Negative surgical margins were not associated with systemic metastasis but were associated with local recurrence. @*Conclusion@#Systemic metastasis of EMPD is significantly associated with serum CEA levels. Therefore, more rigorous follow-up, including imaging studies, is required for patients with a poor prognosis.

Keratinocytes-Derived Reactive Oxygen Species Play an Active Role to Induce Type 2 Inflammation of the Skin: A Pathogenic Role of Reactive Oxygen Species at the Early Phase of Atopic Dermatitis

Background@#Atopic dermatitis (AD) is characterized by chronic, relapsing skin inflammation (eczema) with itchy sensation. Keratinocytes, which are located at the outermost part of our body, are supposed to play important roles at the early phase of type 2 inflammation including AD pathogenesis. @*Objective@#The purpose of this study was to evaluate whether keratinocytes-derived reactive oxygen species (ROS) could be produced by the allergens or non-allergens, and the keratinocytes-derived ROS could modulate a set of biomarkers for type 2 inflammation of the skin. @*Methods@#Normal human epidermal keratinocytes (NHEKs) were treated with an allergen of house dust mites (HDM) or a non-allergen of compound 48/80 (C48/80). Then, biomarkers for type 2 inflammation of the skin including those for neurogenic inflammation were checked by reverse transcriptase-polymerase chain reaction and western immunoblot experiments. @*Results@#HDM or C48/80 was found to upregulate expression levels of our tested biomarkers, including type 2 T helper-driving pathway (KLK5, PAR2, and NF κ B), epithelial-cell-derived cytokines (thymic stromal lymphopoietin, interleukin [IL]-25, IL-33), and neurogenic inflammation (NGF, CGRP). The HDMor C-48/80-induced expression levels of the biomarkers could be blocked by an antioxidant treatment with 5 mM N-acetyl-cysteine. In contrast, pro-oxidant treatment with 1 mM H2O2 could upregulate expression levels of the tested biomarkers in NHEKs. @*Conclusion@#Our results reveal that keratinocytes-derived ROS, irrespective to their origins from allergens or non-allergens, have a potential to induce type 2 inflammation of AD skin.

Clinical Features of Staphylococcal Scalded Skin Syndrome Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus in Changwon City, Korea, during 2006 and 2015

PURPOSE: We investigated the clinical features and epidemiology of staphylococcal scalded skin syndrome (SSSS) from year 2006 to 2015 in Changwon city, Korea. METHODS: We reviewed medical records of 69 patients diagnosed with SSSS from year 2006 to 2015. Antibiotic susceptibility testing was performed by agar dilution method. Methicillin-resistant Staphylococcus aureus (MRSA) was phenotypically identified by oxacillin susceptibility testing and genotypically confirmed by the existence of the mecA gene. RESULTS: The median age of patients was 2.0 years (range 0.2–6 years). Three (4.3%), 53 (76.8%), and 13 (18.9%) patients showed the generalized type, the intermediate type, and the abortive type, respectively. Patients occurred throughout the year, but most patients occurred between July and October. MRSA was isolated from 54 of the 60 patients regardless of the clinical types. All patients recovered without any complications. CONCLUSIONS: There was a constant occurrence of SSSS patients caused by MRSA in Changwon area during 2006 and 2015. It is needed to constantly monitor the occurrence of patients with SSSS.