Engineering affinity agents for the detection of hemi-methylated CpG sites in DNA.

Wild-type methyl-CpG-binding domain (MBD) proteins specifically bind symmetrically methylated DNA sequences, and assays have been developed that use these proteins for profiling DNA methylation. Here, we use directed evolution in the yeast surface display format to identify a new protein variant that binds hemi-methylated CpG dinucleotides.

Kimura disease: CT and MR imaging findings.

BACKGROUND AND PURPOSE: KD is a rare chronic inflammatory disorder of unknown etiology. The purpose of this study was to evaluate the CT and MR imaging findings of KD in the head and neck. MATERIALS AND METHODS: We retrospectively reviewed the CT (n = 21) and MR (n = 9) images obtained in 28 patients (24 males and 4 females; mean age, 32 years; age range, 10-62 years) with histologically proved KD in the head and neck. RESULTS: In these 28 patients, CT and MR images demonstrated a total of 52 non-nodal lesions, 1-8 cm in greatest diameter, in the head and neck. The lesions were unilateral in 11 patients and bilateral in 17 patients. Eleven patients had a solitary lesion, and 17 patients had 2-4 lesions. The parotid and/or periparotid area was the most frequent location, with 36 lesions in 23 patients. The margin of the lesions was well-defined in 1 and ill-defined in 51 cases. Compared with the adjacent muscle, the MR signal intensity of all lesions was iso- to slightly hyperintense on T1-weighted images and hyperintense on T2-weighted images. Most of the lesions demonstrated mild or moderate enhancement on postcontrast CT scans and moderate or marked enhancement on postcontrast MR images. MR images also showed tubular signal-intensity voids in 7 of 13 lesions. Associated lymphadenopathy was demonstrated in 23 patients, usually bilaterally. CONCLUSIONS: Multiple ill-defined enhancing masses within and around the parotid gland with associated regional lymphadenopathy are characteristic CT and MR imaging findings of KD in the head and neck.

A multicenter trial of the efficacy and safety of 0.03% tacrolimus ointment for atopic dermatitis in Korea.

BACKGROUND: Atopic dermatitis is a chronically relapsing, common inflammatory skin disease, which significantly affects quality of life negatively in many respects. Topical steroids are the mainstay of atopic dermatitis treatment but they carry the risk of local side effects. A topical formulation of tacrolimus, a macrolide calcineurin inhibitor, has recently been developed. OBJECTIVE: To evaluate the efficacy and safety of 0.03% tacrolimus ointment for the treatment of moderate to severe atopic dermatitis in Korea. METHODS: An open, non-comparative, multi-center study with 4 weeks' follow-up was performed. A total of 180 patients (aged 2-57 years old) were enrolled. Tacrolimus ointment (0.03%) was applied to all involved areas twice daily. Efficacy was evaluated by an investigator's global assessment, the eczema area and severity index score, and by the patient's assessment of pruritus and clinical response at baseline, and after weeks 1, 2 and 4. Dermatology life quality index (DLQI), children's DLQI (CDLQI) and toddler's DLQI were assessed at baseline and at week 4. The safety assessment included monitoring all adverse events and clinical laboratory values. RESULTS: All efficacy parameters were improved. The mean EASI (eczema area and severity index) score was 19.7 at baseline and reduced to 8.0 at the end of the study. Moderate improvement was observed by the investigator's global assessment after 4 weeks' treatment. A marked decrease of pruritus was observed, and mild or moderate improvement was observed by patients' global assessments after the treatment period. Significant benefits in terms of quality of life in adults and children with atopic dermatitis were obtained. The most common adverse events associated with tacrolimus treatment were transient skin burning sensation (45.3%) and pruritus (41.6%) at the site of application. CONCLUSION: 0.03% tacrolimus ointment should be considered effective and safe in both Korean children and adults with moderate to severe atopic dermatitis.

Kikuchi-Fujimoto disease with papulopustular skin manifestations.

Kikuchi-Fujimoto disease commonly presents with cervical lymphadenopathy accompanied by fever, myalgia, neutropaenia, and rarely cutaneous eruption. Most cutaneous lesions present as erythematous macules, papules, plaques, nodules, or ulcers on the upper part of the body such as trunk, upper extremities, and face. We present a case of Kikuchi-Fujimoto disease with a papulopustular eruption on the whole body including the lower extremities.

A case of Trichosporon cutaneum folliculitis and septicaemia.

Trichosporon cutaneum, a saprophytic fungal organism normally found in the soil, has been increasingly recognized as a cause of life-threatening systemic illness in immunosuppressed patients including those with leukaemia. Cutaneous involvement occurs in about 30% of patients with T. cutaneum septicaemia although disseminated folliculitis has not been described to our knowledge. We now describe a case of T. cutaneum follicultis due to fungaemia in a neutropenic patient.

Myxoid plexiform fibrohistiocytic tumour.

Plexiform fibrohistiocytic tumour is a low-grade malignant mesenchymal neoplasm of myofibroblastic origin with the capacity for biphasic differentiation toward a fibroblastic or histiocyte-like morphology. We report a case of this rare tumour presenting as a tender subcutaneous nodule on the scalp of a 58-year-old man. Histopathological examination revealed multinodular biphasic proliferation of fibroblast-like and histiocyte-like cells with a few osteoclast-like giant cells. This case is notable for the rare myxoid changes, which may reflect a different behaviour of this tumour when occurring in older people.

Two cases of late onset Ota's naevus.

Ota's naevus is among the dermal melanocytoses that show a distinct pattern involving skin innervated by the trigeminal nerve. Most cases present at birth or manifest clinically in early childhood. Cases of acquired lesions in adult onset have been reported rarely. We present two cases of late onset Ota's naevus which were confirmed by skin biopsies. Both patients underwent Q-switched alexandrite laser treatment with a dose of 8.0 J/cm2 given four or five times at 6 weekly intervals and showed some improvement.

Coexistence of CD30-positive anaplastic large cell lymphoma and mycosis fungoides.

Primary cutaneous T-cell lymphomas, including lymphomatoid papulosis, mycosis fungoides and CD30+ anaplastic large cell lymphoma (ALCL) overlap clinicopathologically and form part of a spectrum of lymphoproliferative disorders. There have been several case reports of these diseases coexisting. We describe a 59-year-old Korean man who presented with a recurrent, solitary CD30+ ALCL of 25 years' duration as well as patch stage mycosis fungoides of 11 years' duration. Such occurrences may represent different clinical manifestations of the same clonal T-cell abnormality, and provide further insight into the pathogenesis of these related disorders.

CD30-positive T-cell-rich pseudolymphoma induced by gold acupuncture.

Cases of pseudolymphoma induced by intradermal gold injection or gold piercing have previously been described. Most of these cases showed the histopathological finding of B-lymphocyte predominant lymphocytoma cutis. We describe a patient with gold acupuncture-induced T-cell-rich pseudolymphoma. Some T cells showed positive staining with CD30. The lesions responded to an intralesional injection of triamcinolone acetonide.

Periungal hyperpigmentation induced by cisplatin.

A number of anticancer drugs are known to produce pigmentary changes affecting the skin or nails. Among them, cisplatin (cis-diamminedichloroplatinum)-induced hyperpigmentation has been described previously in only two cases. We describe an unusual case with hyperpigmentation confined to periungal areas of the hands and feet after treatment with cisplatin.

Cutaneous dissemination of nasal NK/T-cell lymphoma with bone marrow, liver and lung involvement.

We describe a 32-year-old Korean man with a primary nasal natural killer (NK)/T-cell lymphoma (NKTCL). Combination chemotherapy and radiotherapy resulted in initial complete remission. However, cutaneous dissemination to the trunk and proximal extremities occurred 16 months later and further investigations revealed involvement of the liver, lymph nodes, lung and bone marrow. Nasal CD56+ NKTCL is mostly localized to the nasal area but also shows a predilection for other sites, such as skin. Cutaneous dissemination may be an indicator of widespread metastasis to internal organs and is consistently fatal.

Widespread skin-limited adult Langerhans cell histiocytosis: long-term follow-up with good response to interferon alpha.

Langerhans cell histiocytosis (LCH) most frequently involves bone, but also involves the skin in 40% of cases; in 10% of patients it is limited to the skin. Cutaneous findings of skin-limited LCH are scaly papules, vesicles, nodules, tumours with erosion, ulceration, or crusting and/or purpura. We report a case of widespread adult-onset LCH confined to skin in which topical carmustine, photochemotherapy, systemic steroids, and 2-chlorodeoxyadenosine were only partially effective. However, longer remission was achieved by the use of subcutaneous interferon-alpha2b.

Cutaneous endometriosis: a combination of medical and surgical treatment.

Cutaneous and subcutaneous endometriosis occurs most commonly as a secondary process in scars after abdominal or pelvic surgical procedures including hysterectomy, cesarean sections and episiotomy. Simple excision is the recommended management and local recurrence after adequate excision is uncommon. A 32-year-old woman presented with a 5-cm firm tumor on the right perineum. There was cyclical bleeding and fluctuation in size. She was initially treated with subcutaneous goserelin acetate. The lesion decreased in size and was then successfully excised 4 months later.