Patch granuloma annulare is a rare type of granuloma annulare. Histopathologically, patch granuloma annulare shows interstitial infiltration of histiocytes. In our case, immunohistochemical analyses demonstrated CD68-negative, CD163-positive M2 macrophages infiltration in an interstitial pattern.
In systemic connective tissue disorders, eccrine sweat glands are frequently attacked by immune cells, as evidenced by pathological observations.
Sweating affects vascular activity through the autonomic nervous system, while few studies have reported sweating ability in systemic connective tissue disorders or the relationship between sweating ability and Raynaud's phenomenon caused by sympathetic hyperreactivity.
We performed the quantitative sudomotor axon reflex test on 85 patients diagnosed with systemic sclerosis, mixed connective tissue disease, systemic lupus erythematosus, Sjogren's syndrome, and dermatomyositis. Evaluations were performed once in summer and once in winter. We investigated the relationship between the axon reflex sweat volume or the reaction time and Raynaud's phenomenon assessed by a Raynaud's condition score, skin symptoms such as nailfold capillary changes, skin sclerosis severity, digital ulcers, chilblains, subcutaneous calcifications, and telangiectasia, and patient background.
Most patients did not show a decrease in sweating compared to healthy participants, but patients with systemic sclerosis who were positive for anti-RNA polymerase III antibodies showed little or no sweating. One in three patients showed less sweating in summer than in winter, which is the opposite of the normal seasonal variation. Although no relationship was observed between the sweat volume and the total Raynaud's condition scores, patients with pain had more sweating than those without pain.
This is the first exploratory observational study of sweating ability in patients with systemic connective tissue disorders, revealing several clinical factors associated with acetylcholine-induced sweating.
Psoriasiform drug eruption is defined as condition similar to psoriasis triggered by drug administration, including de novo development of psoriasis or exacerbation of pre-existing psoriasis. Herein, we describe a 52-year-old Japanese woman, who developed disseminated psoriasiform lesions following administration of temozolomide, a remedy for glioblastoma, although cutaneous adverse events by this drug was very rare. In addition, we assume that altered inflammatory signals associated with psoriasis, such as activation of signal transducer and activator of transcription 3 (STAT3), might be involved in the underlying pathomechanism of drug eruption caused by temozolomide.
Cerebellar metastasis from malignant melanoma of the inner canthus was resected. The patient was subsequently treated with ipilimumab and has remained disease-free 6 years, however, developed sarcoidosis.
A. Facial swelling during a hereditary angioedema (HAE) attack. B. Computed tomography image of the abdomen with intestinal edema during an HAE attack. C. Histogram of the frequency of monthly HAE attacks during self-administration of icatibant. The asterisk indicates when HAE attacks were treated by on-demand injection of plasma-derived C1 inhibitor at the emergency room.
The coronavirus disease 2019 (COVID-19) vaccine is positively changing the health crises of this pandemic and is currently essential to overcome the COVID-19 pandemic. The vaccine shows high efficacy against the infection and impairs the severity of symptoms. However, this vaccination is associated with concerns, such as vaccine-associated adverse reactions, which are currently highlighted issues for clinicians. We experienced two cases of mild cutaneous adverse reaction following COVID-19 vaccine administration, which was successfully controlled by prior administration of the antihistamine agent fexofenadine 3 days before COVID-19 vaccination for 7 days.
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