Journal of Dermatology最新文献

Tinea corporis, a superficial fungal skin infection of the trunk and extremities, typically presents as scaly, erythematous plaques with an active border. However, atypical presentations, especially those caused by uncommon dermatophytes, can complicate diagnosis. Here, we report an unusual case presenting with an oyster-like (rupioid) lesion on the right shoulder, a presentation not previously documented. Molecular analysis of the internal transcribed spacer (ITS) region of ribosomal DNA identified Nannizzia incurvata, a rare dermatophyte within the Nannizzia gypsea complex. The patient was successfully treated with a four-week course of oral itraconazole and topical terbinafine. This case underscores the importance of recognizing unusual clinical presentations and using molecular techniques for accurate pathogen identification. Understanding the characteristics and clinical significance of this uncommon pathogen in human infections will contribute to better diagnosis and management strategies.

Ocular mucous membrane pemphigoid (MMP) presents a significant diagnostic challenge because of the typically low positivity rate of serum antibody. While direct immunofluorescence (DIF) of conjunctival biopsies yields a high positivity rate, its invasiveness limits routine application. To address this, we explored tear fluid—which contains detectable immunoglobulin G (IgG) and can be collected safely and minimally invasively—as an alternative sample source for immunological testing. This pilot study reports the first case of tear fluid–based indirect immunofluorescence (IIF) using oral mucosal tissue to evaluate disease activity in ocular MMP. A man in his 60s presented with ocular pain, conjunctival hyperemia, and erosions. He had a prior MMP diagnosis based on low-titer serum anti-BP180NC16a antibody, histopathology, DIF, and serum IIF. During the second exacerbation, serum anti-BP180NC16a antibody was negative, and serum-based IIF showed no linear deposition of IgG and C3. Tear fluid testing revealed linear IgG deposition along the basement membrane zone (BMZ) of oral mucosa, with titers of 1:20 (left eye) and 1:320 (right eye), correlating with clinical asymmetry. Control testing yielded negative results. Following remission, tear fluid–based IIF showed no IgG reactivity, indicating a correlation with disease activity. Notably, serum-based IIF using oral mucosa was negative, while tear fluid–based IIF demonstrated clear IgG positivity, suggesting higher sensitivity in detecting ocular disease. In conclusion, tear fluid–based IIF using oral mucosa represents a novel and potentially more sensitive method for evaluating ocular MMP, warranting further validation.

We investigated nailfold videocapillaroscopy (NVC) findings in antisynthetase syndrome (ASyS) and compared patterns among six anti-aminoacyl-tRNA synthetase (anti-ARS) antibody (Ab) subtypes. In this retrospective study of 66 Japanese patients positive for anti-Jo-1, EJ, PL-7, PL-12, KS, or OJ Abs, seven NVC abnormalities were assessed: enlarged capillaries, reduced capillaries, hemorrhages, capillary ramifications, disorganization of the vascular array, loss of capillaries, and giant capillaries. Enlarged capillaries, reduced capillaries, and hemorrhages were common overall; in contrast, patients with anti-KS Abs exhibited significantly fewer abnormalities, particularly hemorrhages (25% vs. 75%–100% in other groups; p < 0.05). Capillary ramifications, disorganization, and capillary loss were rare across all subtypes. Although ASyS patients may present with similar clinical manifestations, NVC findings vary among anti-ARS Ab subtypes; anti-KS Ab identifies a subset with milder microvascular involvement. Recognizing anti-ARS Ab specificity may help interpretation of vascular heterogeneity in ASyS.

An octogenarian man developed a recurrent cheek lesion 8 years after surgical resection. Although the histopathological features resembled those of endocrine mucin-producing sweat gland carcinoma (EMPSGC), small tumor nests lacking mucinous carcinoma components infiltrated the surrounding adipose tissue and striated muscle. This infiltrative morphology is inconsistent with the pushing invasion described by the WHO classification. To our knowledge, this is the first report of EMPSGC demonstrating this distinct growth pattern, the clinical significance of which remains unclear.

Drug-induced severe cutaneous adverse reactions (SCARs) are rare but potentially life-threatening drug-induced hypersensitivity reactions. Current understanding of the drug risks associated with SCARs is limited, emphasizing the need for more research to identify and understand medications that may trigger these reactions. This study aimed to identify risk factors and suspect drugs associated with SCARs. Disproportionality analysis was conducted through the case–control design using the FDA Adverse Event Reporting System (FAERS) database of drug-induced SCARs. The reporting odds ratios (ROR) were used to analyze reports of drug-induced SCARs from January 1, 2004, to March 31, 2025. Least absolute shrinkage and selection operator (LASSO), and multivariable regression analyses were conducted to identify risk factors associated with SCARs. Bonferroni correction was applied to adjust for multiple comparisons. A total of 103 337 drug-induced SCARs cases were identified. The median patient age was 57.00 years (IQR 37.00–70.00), with a nearly equal sex distribution (49.26% female, 40.57% male). Disproportionality analysis identified 415 drugs with positive signals for drug-induced SCARs. Logistic regression identified older age, male sex, and 114 drugs as independent risk factors for drug-induced SCARs, including amlodipine (adjusted ROR = 2.89), bisoprolol (adjusted ROR = 3.52), and losartan (adjusted ROR = 2.77). In the non-Asian population, the strongest signals were observed for allopurinol (adjusted ROR = 98.52), cefotaxime (adjusted ROR = 68.52), and lamotrigine (adjusted ROR = 38.59), whereas apalutamide (adjusted ROR = 14.57), ipilimumab (adjusted ROR = 3.24), and acetylsalicylic acid (adjusted ROR = 2.85) were detected only in Asians. The median time to onset (TTO) of drug-induced SCARs was 14 days (IQR 4–47). The Asian population had a significantly shorter TTO compared to the non-Asian population (p < 0.001). This study uses FAERS data to analyze risk factors for drug-induced SCARs, emphasizing early identification and discontinuation of suspected drugs to enhance patient safety.