Juvenile Dermatomyositis Presenting as Deep Skin Ulcerations as an Initial Manifestation / 대한피부과학회지

Juvenile dermatomyositis is a common idiopathic inflammatory myopathy in childhood and is characterized by symmetric proximal muscle weakness and specific cutaneous manifestations. We here report on a 12-year-old boy who presented with violaceous maculopatches with multiple deep skin ulcerations on the right arm and lower back 4 months ago. One month after the initial visit, he had difficulty climbing stairs and elevating his arms above the head. Laboratory tests showed elevation of the serum levels of skeletal muscle enzymes, and electromyogram and muscle biopsy indicated myopathy. Histopathological analysis of the ulceration indicated necrotizing vasculitis and calcification. Based on these findings, his condition was diagnosed as juvenile dermatomyositis. We believe that this case is unique because of the difficulty in diagnosing the condition, as skin ulceration is a rare cutaneous manifestation of dermatomyositis.

Effect of zinc oxide oil care on perianal skin ulceration in elderly patients / 现代临床护理

Objective To investigate the effect of zinc oxide oil care on perianal skin ulceration in elderly patients.Methods A total of 90 elderly fecal incontinence patients with perianal skin ulceration were randomized into the observation group(n=48)and the control group(n=42):The former received zinc oxide oil treatment and the latter were treated with mupirocin ointment.Perianal skin injury was evaluated in all the patients and the treatment effect between two groups were statistically analyzed after one week.Result The total effective rate in the observation group(93.8%)was significantly higher than that in the control group(71.4%)(χ2=8.036,P<0.01).Conclusions Management of perianal skin ulceration in bedridden elderly patients with zinc oxide oil may produce better effect.

A Rare Case of Suspected Dystrophic Epidermolysis Bullosa Pruriginosa

Inherited epidermolysis bullosa (EB) encompasses over 30 phenotypes or genotypes. A characteristic feature of all types of EB is the presence of recurrent blistering or erosions, the result of even minor traction to this tissues. There are four major types of inherited EB: EB simplex (EBS), junctional EB (JEB), dystrophic EB (DEB), and Kindler syndrome. These differ not only phenotypically and genotypically but more importantly by the site of ultrastructural disruption or cleavage. Dystrophic epidermolysis bullosa (DEB) is a rare mechanobullous genodermatosis inherited either with autosomal dominant or recessive pattern and characterized by fragility, blistering and scarring of the skin and mucous membranes. Blistering is due to abnormalities in anchoring fibrils (AF), microstructures mainly composed of type VII collagen (COLLVII), which contributes to the maintaining of dermal-epidermal adhesion. Most cases are sporadic, but a few show autosomal dominant or autosomal recessive pattern of inheritance. Microscopic studies of EB pruriginosa show typical findings of dystrophic EB, and it has been postulated that itching lesions of EB pruriginosa could represent an abnormal dermal reactivity of some subjects to their inherited bullous disorder. The study of the molecular basis of dominant dystrophic EB (classical) and EB pruriginosa shows that both diseases are caused by a missense glycine substitution mutation by different amino acids in the same codon of COL 7A (G2028R and G2028A)

Neonatal lupus erythematosus presenting as multiple photosensitive annular plaques with skin atrophy

Neonatal lupus erythematosus (NLE) is an autoimmune disease affecting the fetus as a result of transplacental transfer of anti-Ro autoantibodies. Typically, it presents in the first few months of life with an annular form of subacute cutaneous lupus erythematosus. We report an infant of NLE presenting at birth with multiple annular erythematous plaques with skin atrophy involving the face, head, and upper trunk. Histopathology of skin biopsy was consistent with subacute cutaneous lupus. The mother was clinically free of disease and had no family history of autoimmune disease. Serology (extranuclear antigens) was positive in both the baby and the mother. This is a rare presentation of a rare disease.

Cutis marmorata telangiectatica congenita

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital disorder with persistent cutis marmorata, telengiectasia, and phlebectesia, which may be associated with cutaneaus atrophy and ulceration of the involved skin. We herewith report a three month old male baby with CMTC at birth involving left side of the face, upper limbs, both flanks, and left gluteal and left leg with ulceration over the extensor aspects of the left knee joint. The baby had a reticulated bluish purple skin changes all over the body including the face and limb. Although it resembled physiological cutis marmorata, it was strikingly pronounced and defi n i t e ly was unvarying and permanent. A variety of vascular malformation has been described along with this disorder. Etiology is not very clear. Prognoses in uncomplicated cases are good.

Identification and AHLs Detection of Dominant Bacterium of Sea Cucumber (Apostichopus japonic) Infected with the Skin Ulceration Syndrom / 微生物学通报

The skin ulceration syndrome of sea cucumber is a kind of desease induced by bacterium.In order to investigate the bacterium of infected sea cucumber and detect the N-acyl-homoserine lactones(AHLs) se-cretion of the bacterium,7 bacterial strains were isolated from the infected sea cucumber.These strains were identified by physiological-biochemical characteristics and 16S rDNA sequence.Results show that strain C6 belongs to Tenacibaculum,strain 4 belongs to Shewanella putrefaciens group,strain TB belongs to Vibrio,strain BP2,BP3,BP4 and BP6 belong to Pseudoalteromonas,respectively.AHLs were detected with strain Agrobacterium tumefaciens KYC55.Among these bacterial strains,strain C6,4,TB,BP3 and BP4 can se-cret AHLs,while strain BP2 and BP6 can’t.And the AHLs activity differs,from the highest to the lowest are 4,TB,BP4,BP3 and C6.