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Acne fulminans shows severe inflammatory changes in acne lesions and is accompanied by systemic symptoms, such as fever and myalgia. Acne fulminans can leave scars, which can profoundly affect patients’ quality of life and require proper treatment. Herein, we present a case of acne fulminans that occurred after COVID-19 vaccination in a 15-year-old male patient. Considering no signs of infection, new drug administration, and immunological factors that can cause acne fulminans other than COVID-19 vaccination and the short time interval between the time of vaccination and the acne fulminans outbreak, acne fulminans is thought to have been caused by COVID-19 vaccination. Oral steroid and isotretinoin treatment was initiated, and 3 months after the treatment, acne lesions recovered to pre-COVID-19 vaccination status, with no exacerbated episode until 6 months follow-up.
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Background@#Adiponectin is an adipose-derived hormone that plays a role in various metabolic diseases. We previously demonstrated that adiponectin inhibits melanin synthesis through adenosine monophosphate-activated protein kinase (AMPK) activation in melanocytes. However, melanocytes can be affected by neighboring keratinocytes, and the effect of adiponectin on these functional units has not been investigated. @*Objective@#We investigated the effect of adiponectin on melanogenesis in co-cultured models of normal human melanocytes (NHMs), normal human keratinocytes (NHKs), and human dermal fibroblasts (HDFs), and the effect of adiponectin on melanin content in human skin tissues. @*Methods@#Quantitative real-time polymerase chain reaction (qPCR) was performed for tyrosinase and microphthalmia-associated transcription factor (MITF). The degree of phosphorylation of AMPK, cAMP response element binding protein (CREB), and AKT was evaluated by western blot assay, and Fontana-Masson staining was performed on cultured human skin tissues. @*Results@#Adiponectin decreased the melanin content in the co-culture models of NHMs with NHKs, NHMs with HDFs, and NHMs with both NHKs and HDFs. qPCR revealed that both tyrosinase and MITF were decreased after adiponectin treatment in the co-culture system. Following adiponectin treatment, AMPK was activated in all cell groups; however, the phosphorylation of CREB was decreased in HDFs and NHKs. The phosphorylation of AKT was decreased in only NHMs. In the experiment with human skin tissues cultured ex vivo, the densitometric analysis of Fontana-Masson staining revealed that adiponectin treatment reduced the melanin level of ultraviolet-irradiated human skin tissues. @*Conclusion@#Adiponectin inhibited melanogenesis in both co-culture models and human skin tissues ex vivo.
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A capillary hemangioma is a vascular tumor with small capillary sized vascular channel. Multiple capillary hemangioma in relation with drugs have been rarely reported. Here in, we report a case of multiple capillary hemangioma in patient diagnosed with chronic myeloid leukemia who received tyrosine kinase inhibitors (TKIs). Histopathological findings have shown capillary proliferation in the upper dermis, which is consistent with capillary hemangioma. Since TKIs can paradoxically activate the MEK/ERK pathway which is required for angiogenesis, we presumed that the lesions as the cutaneous side effects of TKIs.
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A capillary hemangioma is a vascular tumor with small capillary sized vascular channel. Multiple capillary hemangioma in relation with drugs have been rarely reported. Here in, we report a case of multiple capillary hemangioma in patient diagnosed with chronic myeloid leukemia who received tyrosine kinase inhibitors (TKIs). Histopathological findings have shown capillary proliferation in the upper dermis, which is consistent with capillary hemangioma. Since TKIs can paradoxically activate the MEK/ERK pathway which is required for angiogenesis, we presumed that the lesions as the cutaneous side effects of TKIs.
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Keratoacanthomas (KAs) are epithelial skin tumors characterized by rapid growth and spontaneous regression, with histopathologic features similar to those of cutaneous squamous cell carcinoma (SCC). KA arising after the use of anti-programmed cell death protein 1 (PD1) and anti-transforming growth factor beta (TGF-β) antibody have been reported. The patient in the present case was administered a new anti-cancer drug under clinical trial, which comprised anti-PD-ligand 1 (PD-L1) and anti-TGF-β antibodies. Nine months after the drug was used, a hyperkeratotic nodular lesion appeared on the patient's left arm. As a result of histopathologic examination by excision of the corresponding lesion, it was diagnosed as KA.
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BACKGROUND: Postinflammatory hyperpigmentation (PIH) is one of the most common adverse effects associated with dermatologic procedures, especially those for cosmetic purposes. Low fluence Q-Switched Nd:YAG laser (LFQS) has been widely used for this condition in the field, but reports in the literature are scarce. OBJECTIVE: We aimed to evaluate the clinical benefit and limitation of LFQS in the treatment of PIH after cosmetic procedures. METHODS: Patients with PIH after laser treatment were enrolled in the study. Patients were treated with LFQS at an interval of 2 to 3 weeks. Photographs were taken. Objective measurement included erythema and melanin indices at the same site. Two blinded assessors graded the degree of improvement using a photograph based on a quartile scale (0~3). Patient satisfaction after treatment was also reported. RESULTS: A total of 45 patients were included in the analysis. Patients received 10 treatment sessions. Patients who started LFQS treatment within 3 months after the causal event showed a better treatment outcome. Those who had a higher erythema index before treatment tended to respond less to the treatment. CONCLUSION: LFQS may be a good treatment modality for patients with PIH. Earlier treatment can provide rapid resolution and better clinical results. However, for patients with PIH combined with intense erythema, LFQS may not be the first choice to consider in the clinical field.
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Humanos , Eritema , Hiperpigmentação , Melaninas , Satisfação do Paciente , Resultado do TratamentoRESUMO
CD30+ lymphoproliferative disorders (LPD) represent a spectrum of T-cell lymphoma including lymphomatoid papulosis and anaplastic large cell lymphoma (ALCL). Epidermis overlying cutaneous CD30+ LPD often shows epidermal hyperplasia, hyperkeratosis, crusting, and ulceration and it is difficult to distinguish from carcinoma such as keratoacanthoma (KA) or squamous cell carcinoma (SCC). Several cases of pseudocarcinomatous hyperplasia mimicking KA or SCC in CD30+ LPD have been reported. The relationship between CD30+ LPD and epithelial proliferations has not yet well understood. It was reported that a variety of mediators, including epidermal growth factor (EGF), transforming growth factor-α and EGFR from CD30+ LPD could attribute to epidermal hyperplasia. However, separate and distinct SCC occurring in CD30+ LPD has rarely been reported. Herein, we present a rare case of coexistence of SCC and cutaneous ALCL located on the same region.
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Carcinoma de Células Escamosas , Fator de Crescimento Epidérmico , Epiderme , Células Epiteliais , Hiperplasia , Ceratoacantoma , Linfoma , Linfoma Anaplásico de Células Grandes , Linfoma Anaplásico Cutâneo Primário de Células Grandes , Linfoma de Células T , Papulose Linfomatoide , Transtornos Linfoproliferativos , ÚlceraRESUMO
BACKGROUND: Traditionally, interferon-gamma (IFN-gamma) was regarded as a pro-inflammatory cytokine, however, recent reports suggested role of IFN-gamma in immune tolerance. In our previous report, we could induce tolerance to male antigen (HY) just by male islet transplantation in wild type C57BL/6 mice without any immunological intervention. We tried to investigate the influence of IFN-gamma deficiency on tolerance induction by male islet transplantation. METHODS: To examine the immunogenicity of male tissue in the absence of IFN-gamma, we transplanted male IFN-gamma knock-out (KO) skin to female IFN-gamma KO mice. Next, we analyzed male IFN-gamma KO islet to streptozotocin-induced diabetic female IFN-gamma KO mice. And, we checked the functionality of grafted islet by graft removal and insulin staining. RESULTS: As our previous results in wild type C57BL/6 mice, female IFN-gamma KO mice rejected male IFN-gamma KO skin within 29 days, and did not reject male IFN-gamma KO islet. The maintenance of normal blood glucose level was dependent on the presence of grafted male islet. And the male islet recipient did not reject 2nd challenge of male islet graft also. CONCLUSION: Deficiency of IFN-gamma does not have influence on the result of male skin graft and male islet transplantation. Conclusively, male islet transplantation induced T cell tolerance is not dependent on the presence of IFN-gamma.