Pub Date : 2022-10-01DOI: 10.4103/1027-8117.361417
P. Hou, Chaw-Ning Lee, Tak-Wah Wong, T. Hsu, Cheng-Lin Wu, J. Lee
Background: Perianal Paget disease (PPD), an uncommon extramammary Paget disease, is characterized by intraepidermal pagetoid spread of atypical Paget cells in the perianal skin. PPDs can be primary or secondary. Secondary PPDs have poorer prognosis due to progression of the underlying anorectal carcinoma. Objectives: We analyzed the clinicopathological features of PPDs to determine the primary versus secondary PPD. Methods: We reviewed the clinicopathological features, including evidence of underlying anorectal carcinomas, tumor immunoprofiles, treatments, and outcomes of 8 cases of PPD diagnosed in our department during 1992–2019. Results: Colonoscopy was performed in 6 cases; rectal adenocarcinoma and anal canal adenocarcinoma were detected in 2 cases each. Three patients had local recurrence(s). Based on the detection of underlying anorectal cancers and immunoprofiles, 2 cases were classified as primary (one with perianal squamous cell carcinoma), 4 secondary, and 2 inconclusive for primary or secondary PPD. The immunoprofiles were CK7(+)/CK20(−)/GCDFP-15(−)/CDX2(−) in the primary PPDs; CK7(+/−)/CK20(+)/GCDFP-15(−)/CDX2(+) in the secondary and inconclusive PPDs. Eventually, all patients with secondary PPD died of the disease; one primary PPD and one inclusive PPD cases died of unrelated causes. Conclusion: We report the clinicopathological features of 8 cases of PPD in Taiwanese and first describe differential CK7 expression in the epidermal and dermal tumor cells in 2 cases of secondary PPDs, which may provide a clue to the diagnosis of secondary PPD. Since an underlying anorectal carcinoma in PPDs may be undetectable by colonoscopy, it is essential to consider anoscopy and/or anal canal mucosal biopsy to search for an occult anorectal carcinoma.
{"title":"A clinicopathological study of perianal paget disease: A single center-based cohort study and literature review","authors":"P. Hou, Chaw-Ning Lee, Tak-Wah Wong, T. Hsu, Cheng-Lin Wu, J. Lee","doi":"10.4103/1027-8117.361417","DOIUrl":"https://doi.org/10.4103/1027-8117.361417","url":null,"abstract":"Background: Perianal Paget disease (PPD), an uncommon extramammary Paget disease, is characterized by intraepidermal pagetoid spread of atypical Paget cells in the perianal skin. PPDs can be primary or secondary. Secondary PPDs have poorer prognosis due to progression of the underlying anorectal carcinoma. Objectives: We analyzed the clinicopathological features of PPDs to determine the primary versus secondary PPD. Methods: We reviewed the clinicopathological features, including evidence of underlying anorectal carcinomas, tumor immunoprofiles, treatments, and outcomes of 8 cases of PPD diagnosed in our department during 1992–2019. Results: Colonoscopy was performed in 6 cases; rectal adenocarcinoma and anal canal adenocarcinoma were detected in 2 cases each. Three patients had local recurrence(s). Based on the detection of underlying anorectal cancers and immunoprofiles, 2 cases were classified as primary (one with perianal squamous cell carcinoma), 4 secondary, and 2 inconclusive for primary or secondary PPD. The immunoprofiles were CK7(+)/CK20(−)/GCDFP-15(−)/CDX2(−) in the primary PPDs; CK7(+/−)/CK20(+)/GCDFP-15(−)/CDX2(+) in the secondary and inconclusive PPDs. Eventually, all patients with secondary PPD died of the disease; one primary PPD and one inclusive PPD cases died of unrelated causes. Conclusion: We report the clinicopathological features of 8 cases of PPD in Taiwanese and first describe differential CK7 expression in the epidermal and dermal tumor cells in 2 cases of secondary PPDs, which may provide a clue to the diagnosis of secondary PPD. Since an underlying anorectal carcinoma in PPDs may be undetectable by colonoscopy, it is essential to consider anoscopy and/or anal canal mucosal biopsy to search for an occult anorectal carcinoma.","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74757576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.4103/1027-8117.360036
D. Dalimunthe, D. Sinambela, S. Lubis
Mycobacterium leprae causes leprosy and can impair peripheral nerves. If nerve function is damaged and is not treated immediately and effectively, it can cause disability. Hence, early detection of peripheral neuropathy is critical. Toronto Clinical Scoring System (TCSS) is a simple neuropathy assessment instrument for diabetic neuropathy, chemotherapy-induced peripheral neuropathy, and human immunodeficiency virus neuropathy. Therefore, TCSS is expected to be an alternative tool for diagnosing leprosy neuropathy. This study aims to determine the diagnostic value of TCSS in leprosy neuropathy. This is a cross-sectional observational study with 40 participants. The TCSS and Semmes–Weinstein Monofilament tests were used to assess neuropathy. The diagnostic analysis showed that the sensitivity was 85.7%, specificity was 84.2%, positive predictive value was 85.7%, negative predictive value was 84.2%, positive likelihood ratio (LR+) was 5.42, negative (LR-) was 0.17, accuracy was by 85%, and area under curve value of 93.2%. The optimal cut-off point score of TCSS is ≥6. It can be concluded that TCSS is an alternative diagnostic tool with a high accuracy value and can be used as a routine examination for the early detection of leprosy neuropathy.
{"title":"Toronto clinical scoring system: A promising diagnostic tool in leprosy neuropathy","authors":"D. Dalimunthe, D. Sinambela, S. Lubis","doi":"10.4103/1027-8117.360036","DOIUrl":"https://doi.org/10.4103/1027-8117.360036","url":null,"abstract":"Mycobacterium leprae causes leprosy and can impair peripheral nerves. If nerve function is damaged and is not treated immediately and effectively, it can cause disability. Hence, early detection of peripheral neuropathy is critical. Toronto Clinical Scoring System (TCSS) is a simple neuropathy assessment instrument for diabetic neuropathy, chemotherapy-induced peripheral neuropathy, and human immunodeficiency virus neuropathy. Therefore, TCSS is expected to be an alternative tool for diagnosing leprosy neuropathy. This study aims to determine the diagnostic value of TCSS in leprosy neuropathy. This is a cross-sectional observational study with 40 participants. The TCSS and Semmes–Weinstein Monofilament tests were used to assess neuropathy. The diagnostic analysis showed that the sensitivity was 85.7%, specificity was 84.2%, positive predictive value was 85.7%, negative predictive value was 84.2%, positive likelihood ratio (LR+) was 5.42, negative (LR-) was 0.17, accuracy was by 85%, and area under curve value of 93.2%. The optimal cut-off point score of TCSS is ≥6. It can be concluded that TCSS is an alternative diagnostic tool with a high accuracy value and can be used as a routine examination for the early detection of leprosy neuropathy.","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87538698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.4103/1027-8117.359339
Tsun-Hao Hsu, Tsung-En Huang, Yi-Teng Hung, Yi-Jiun Su, W. Hung, Pei‐Lun Sun
{"title":"Disseminated fusariosis with endophthalmitis in a patient with acute myeloid leukemia","authors":"Tsun-Hao Hsu, Tsung-En Huang, Yi-Teng Hung, Yi-Jiun Su, W. Hung, Pei‐Lun Sun","doi":"10.4103/1027-8117.359339","DOIUrl":"https://doi.org/10.4103/1027-8117.359339","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85595294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.4103/1027-8117.365590
M. Akiyama
As predisposing factors and pathogenic mechanisms of inflammatory keratinization disorders of the skin have become increasingly elucidated in recent years, a number of inflammatory keratinization disorders are now known to have the excessive activation of innate immunity as their pathogenesis. Autoinflammation-associated pathogeneses have been clarified in patients with generalized pustular psoriasis (GPP), pityriasis rubra pilaris (PRP) type V, and familial keratosis lichenoides chronica (KLC). Thus, based on these findings, in 2017, we proposed the clinical entity “autoinflammatory keratinization disease (AiKD),” which comprehensively includes inflammatory keratinization disorders with pathogenic mechanisms related to autoinflammation (the excessive activation of innate immunity). In 2017, GPP and associated diseases, PRP type V, and familial KLC came to be considered as AiKDs. In addition to these diseases, hidradenitis suppurative, porokeratosis, keratosis linearis with ichthyosis congenita and sclerosing keratoderma syndrome, and AiKDs with hepatitis and autism have been newly recognized as AiKDs. The concept of AiKD may contribute to the selection of novel treatment methods. For example, recognizing hidradenitis suppurativa precisely as an AiKD has resulted in the application of adalimumab, an anti-tumor necrosis factor alpha antibody, as a treatment. The concept of AiKD is thought to be useful toward our accurate understanding of the pathogeneses of inflammatory keratinization disorders and our choice of appropriate treatment methods. As the pathogenic mechanisms of inflammatory keratinization disorders are further elucidated, it is presumed that the number of keratinization diseases whose pathogeneses are associated with autoinflammation will increase and that the number of diseases recognized as AiKDs will grow more and more.
{"title":"Autoinflammatory keratinization diseases: The concept, diseases involved, and pathogeneses","authors":"M. Akiyama","doi":"10.4103/1027-8117.365590","DOIUrl":"https://doi.org/10.4103/1027-8117.365590","url":null,"abstract":"As predisposing factors and pathogenic mechanisms of inflammatory keratinization disorders of the skin have become increasingly elucidated in recent years, a number of inflammatory keratinization disorders are now known to have the excessive activation of innate immunity as their pathogenesis. Autoinflammation-associated pathogeneses have been clarified in patients with generalized pustular psoriasis (GPP), pityriasis rubra pilaris (PRP) type V, and familial keratosis lichenoides chronica (KLC). Thus, based on these findings, in 2017, we proposed the clinical entity “autoinflammatory keratinization disease (AiKD),” which comprehensively includes inflammatory keratinization disorders with pathogenic mechanisms related to autoinflammation (the excessive activation of innate immunity). In 2017, GPP and associated diseases, PRP type V, and familial KLC came to be considered as AiKDs. In addition to these diseases, hidradenitis suppurative, porokeratosis, keratosis linearis with ichthyosis congenita and sclerosing keratoderma syndrome, and AiKDs with hepatitis and autism have been newly recognized as AiKDs. The concept of AiKD may contribute to the selection of novel treatment methods. For example, recognizing hidradenitis suppurativa precisely as an AiKD has resulted in the application of adalimumab, an anti-tumor necrosis factor alpha antibody, as a treatment. The concept of AiKD is thought to be useful toward our accurate understanding of the pathogeneses of inflammatory keratinization disorders and our choice of appropriate treatment methods. As the pathogenic mechanisms of inflammatory keratinization disorders are further elucidated, it is presumed that the number of keratinization diseases whose pathogeneses are associated with autoinflammation will increase and that the number of diseases recognized as AiKDs will grow more and more.","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81713418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.4103/1027-8117.363059
Y. Tsai, Chun-Bing Chen, Tzong-Yun Ger
{"title":"Radiation recall dermatitis triggered by the AstraZeneca COVID-19 vaccine: A case report and literature review","authors":"Y. Tsai, Chun-Bing Chen, Tzong-Yun Ger","doi":"10.4103/1027-8117.363059","DOIUrl":"https://doi.org/10.4103/1027-8117.363059","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82637283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.4103/1027-8117.362563
Tsung-Fu Tsai, C. Ng
{"title":"A report of stable segmental vitiligo with exacerbations following Oxford–AstraZeneca and MVC-COV1901 COVID-19 vaccinations","authors":"Tsung-Fu Tsai, C. Ng","doi":"10.4103/1027-8117.362563","DOIUrl":"https://doi.org/10.4103/1027-8117.362563","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75873192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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