Rosa Kim, Bo Ram Kwon, Ji Yeon Byun, You Won Choi, Hae Young Choi, Sanghui Park, Min Young Lee
A 44-year-old male presented with 7 months history of nonpruritic round oozing plaques on the extremities and red papules on the trunk. The lesions were resistant to topical and oral steroid prescribed at the other local clinics. Histopathological examination showed parakeratosis with acanthosis and rete ridge elongation as well as spongiotic intraepidermal blisters and dense dermal infiltration of small to medium sized atypical lymphoid cells. Immunohistochemical analysis revealed the lymphocyte infiltrate to be predominantly CD4+ T cells, with CD4/CD8 ratio to be greater than 10:1. Infiltration of large cells that were CD30+ were also noted. This histopathologic findings are consistent with vesicular mycosis fungoides (MF). He was prescribed with narrow-band ultraviolet B twice per week and topical steroid, combined with interferon-α injection for 5 weeks, and his skin lesions significantly faded and were flattened. Vesicular MF is associated with poor prognosis, but our patient was able to show benign course of disease thanks to timely diagnosis. One must consider vesicular MF as a differential for recalcitrant eczematous lesions.
{"title":"A Case of Vesicular Mycosis Fungoides.","authors":"Rosa Kim, Bo Ram Kwon, Ji Yeon Byun, You Won Choi, Hae Young Choi, Sanghui Park, Min Young Lee","doi":"10.5021/ad.20.100","DOIUrl":"https://doi.org/10.5021/ad.20.100","url":null,"abstract":"<p><p>A 44-year-old male presented with 7 months history of nonpruritic round oozing plaques on the extremities and red papules on the trunk. The lesions were resistant to topical and oral steroid prescribed at the other local clinics. Histopathological examination showed parakeratosis with acanthosis and rete ridge elongation as well as spongiotic intraepidermal blisters and dense dermal infiltration of small to medium sized atypical lymphoid cells. Immunohistochemical analysis revealed the lymphocyte infiltrate to be predominantly CD4<sup>+</sup> T cells, with CD4/CD8 ratio to be greater than 10:1. Infiltration of large cells that were CD30<sup>+</sup> were also noted. This histopathologic findings are consistent with vesicular mycosis fungoides (MF). He was prescribed with narrow-band ultraviolet B twice per week and topical steroid, combined with interferon-α injection for 5 weeks, and his skin lesions significantly faded and were flattened. Vesicular MF is associated with poor prognosis, but our patient was able to show benign course of disease thanks to timely diagnosis. One must consider vesicular MF as a differential for recalcitrant eczematous lesions.</p>","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"374-377"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/b3/ad-34-374.PMC9561296.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Corresponding Author Yang Wang Department of Dermatology and Venerology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing 100034, China Tel: +86-10-83572350, Fax: +86-10-66551216, E-mail: yangwang_dr@bjmu.edu.cn https://orcid.org/0000-0001-7805-2861 Dear Editor: Hydroa vacciniforme (HV)-like lymphoproliferative disease (LPD) is associated with chronic active Epstein-Barr virus (CAEBV) infection. It ranges from classic and severe/systemic HV to HV-like lymphoma (HVLL). Cutaneous manifestations include vesiculopapules, bullae, ulcers, and facial swelling. HVLL usually has a long clinical course with spontaneous resolution but may progress to more severe and lifethreatening conditions. We report a rare case of HV-like LPD that evolved from classic HV to orogenital ulcerations. A 17-year-old Chinese boy presented with a 2-month history of painful orogenital swelling and ulcerative lesions without constitutional symptoms. He was diagnosed with classic HV at age 2 years, based on the typical papulovesicular eruptions on his face and photosensitivity. The symptoms spontaneously resolved 2 years before without recurrence, leaving facial varioliform scars (Fig. 1A). Physical examination revealed marked swelling on the lower lip and massive erosions with ulcerations on the scrotum (Fig. 1A, B). No lymphadenopathy was observed. A skin biopsy from the lower lip showed diffuse infiltrates of atypical lymphoid cells throughout the dermis, with remarkable epidermotropism (Fig. 2A). Immunohistochemical analysis revealed CD3+++, CD4+++, Granzyme B++, and TIA1+++ infiltrating lymphocytes, consistent with
{"title":"A Case of Hydroa Vacciniforme-Like Lymphoproliferative Disorder Presenting As Orogenital Ulcerations.","authors":"Yingyi Li, Yang Wang","doi":"10.5021/ad.20.199","DOIUrl":"https://doi.org/10.5021/ad.20.199","url":null,"abstract":"Corresponding Author Yang Wang Department of Dermatology and Venerology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing 100034, China Tel: +86-10-83572350, Fax: +86-10-66551216, E-mail: yangwang_dr@bjmu.edu.cn https://orcid.org/0000-0001-7805-2861 Dear Editor: Hydroa vacciniforme (HV)-like lymphoproliferative disease (LPD) is associated with chronic active Epstein-Barr virus (CAEBV) infection. It ranges from classic and severe/systemic HV to HV-like lymphoma (HVLL). Cutaneous manifestations include vesiculopapules, bullae, ulcers, and facial swelling. HVLL usually has a long clinical course with spontaneous resolution but may progress to more severe and lifethreatening conditions. We report a rare case of HV-like LPD that evolved from classic HV to orogenital ulcerations. A 17-year-old Chinese boy presented with a 2-month history of painful orogenital swelling and ulcerative lesions without constitutional symptoms. He was diagnosed with classic HV at age 2 years, based on the typical papulovesicular eruptions on his face and photosensitivity. The symptoms spontaneously resolved 2 years before without recurrence, leaving facial varioliform scars (Fig. 1A). Physical examination revealed marked swelling on the lower lip and massive erosions with ulcerations on the scrotum (Fig. 1A, B). No lymphadenopathy was observed. A skin biopsy from the lower lip showed diffuse infiltrates of atypical lymphoid cells throughout the dermis, with remarkable epidermotropism (Fig. 2A). Immunohistochemical analysis revealed CD3+++, CD4+++, Granzyme B++, and TIA1+++ infiltrating lymphocytes, consistent with","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"389-391"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/3d/ad-34-389.PMC9561305.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang-Hoon Lee, Hee-Seok Seo, Seong Jun Seo, Chang-Deok Kim, Seung-Phil Hong
Background: Reduced lipid content in the stratum corneum is a major cause of skin-barrier dysfunction in various pathological conditions. Promoting lipid production is a potential strategy to improve skin-barrier function. Recent evidence supports the beneficial effects of adiponectin on lipid metabolism and senescence in keratinocytes.
Objective: This study aimed to investigate whether plant extracts can enhance skin-barrier function.
Methods: We screened fruit and herb extracts that enhance the lipid synthesis of keratinocytes via AMP-activated protein kinase (AMPK) activation and SIRT1 signaling in the adiponectin pathway. The levels of major lipid synthesis enzymes and transcription factors as well as epidermal barrier lipids involved in adiponectin-associated epidermal barrier formation were evaluated in the herbal extracts- or adiponectin-treated human epidermal keratinocyte and equivalent models. The mRNA expression of major lipid synthesis enzymes increased following treatment with Lycii Fructus , Prunus tomentosa , and Melia toosendan extracts.
Results: The expression of transcription factors SIRT1, liver X receptor α, peroxisome proliferator-activated receptors (PPARs), and sterol regulatory element-binding proteins (SREBPs) were upregulated. Levels of free fatty acids, cholesterol, and ceramides were elevated. The expression of keratinocyte differentiation markers increased. In particular, among fruit extracts with a detectable effect, Melia toosendan induced the highest expression of lipid synthase.
Conclusion: These results indicate that Melia toosendan is a promising candidate for improving skin-barrier function.
{"title":"Screening of Plant-Derived Natural Extracts to Identify a Candidate Extract Capable of Enhancing Lipid Synthesis in Keratinocytes.","authors":"Sang-Hoon Lee, Hee-Seok Seo, Seong Jun Seo, Chang-Deok Kim, Seung-Phil Hong","doi":"10.5021/ad.21.288","DOIUrl":"https://doi.org/10.5021/ad.21.288","url":null,"abstract":"<p><strong>Background: </strong>Reduced lipid content in the stratum corneum is a major cause of skin-barrier dysfunction in various pathological conditions. Promoting lipid production is a potential strategy to improve skin-barrier function. Recent evidence supports the beneficial effects of adiponectin on lipid metabolism and senescence in keratinocytes.</p><p><strong>Objective: </strong>This study aimed to investigate whether plant extracts can enhance skin-barrier function.</p><p><strong>Methods: </strong>We screened fruit and herb extracts that enhance the lipid synthesis of keratinocytes via AMP-activated protein kinase (AMPK) activation and SIRT1 signaling in the adiponectin pathway. The levels of major lipid synthesis enzymes and transcription factors as well as epidermal barrier lipids involved in adiponectin-associated epidermal barrier formation were evaluated in the herbal extracts- or adiponectin-treated human epidermal keratinocyte and equivalent models. The mRNA expression of major lipid synthesis enzymes increased following treatment with <i>Lycii Fructus</i> , <i>Prunus tomentosa</i> , and <i>Melia toosendan</i> extracts.</p><p><strong>Results: </strong>The expression of transcription factors SIRT1, liver X receptor α, peroxisome proliferator-activated receptors (PPARs), and sterol regulatory element-binding proteins (SREBPs) were upregulated. Levels of free fatty acids, cholesterol, and ceramides were elevated. The expression of keratinocyte differentiation markers increased. In particular, among fruit extracts with a detectable effect, <i>Melia toosendan</i> induced the highest expression of lipid synthase.</p><p><strong>Conclusion: </strong>These results indicate that <i>Melia toosendan</i> is a promising candidate for improving skin-barrier function.</p>","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"331-339"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/d0/ad-34-331.PMC9561301.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Corresponding Author Hyun Jeong Park Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea Tel: +82-2-3779-1230, Fax: +82-2-783-7604, E-mail: hjpark@catholic.ac.kr https://orcid.org/0000-0002-0138-9885 Dear Editor: Hand-foot-mouth disease (HFMD) is a infection caused by Enterovirus and Coxsackievirus that predominantly affects children and symptoms include an erythematous maculopapular or vesicular eruption localized on palms, soles, and perioral skin. Immunocompetent adults recently showed an atypical erythema multiforme (EM)-like eruption. EM is characterized by annular eruption caused by a hypersensitivity reaction from infections such as herpes simplex and mycoplasma pneumonia. Also, unusual viral pathogens Coxsackievirus A6 or A10 have been reported with HFMD, leading to more severe disease course. A 38-year-old male was presented with a pruritic, erythematous maculopapular targetoid eruption on both hands, feet, and trunk for one week (Fig. 1). Initially, he experienced malaise and mild fever before the skin eruption, which did not involve oral mucosa. Blood chemistry tests, rapid plasma reagin, human immunodeficiency virus, and hepatitis serology were normal. Histopathological examination of a macule on his left arm showed neutrophils presented with focal necrosis in upper epidermis and vacuolar alteration in the dermoepidermal junction (Fig. 2). Initially, the patient was misdiagnosed with EM due to clinical exam findings of targetoid lesions. But the additional laboratory examination showed all positive titers of A B
{"title":"Hand-Foot-Mouth Disease Mimicking Erythema Multiforme in an Immunocompetent Adult.","authors":"Yujin Jung, Yu Ri Woo, Miri Kim, Hyun Jeong Park","doi":"10.5021/ad.20.026","DOIUrl":"https://doi.org/10.5021/ad.20.026","url":null,"abstract":"Corresponding Author Hyun Jeong Park Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea Tel: +82-2-3779-1230, Fax: +82-2-783-7604, E-mail: hjpark@catholic.ac.kr https://orcid.org/0000-0002-0138-9885 Dear Editor: Hand-foot-mouth disease (HFMD) is a infection caused by Enterovirus and Coxsackievirus that predominantly affects children and symptoms include an erythematous maculopapular or vesicular eruption localized on palms, soles, and perioral skin. Immunocompetent adults recently showed an atypical erythema multiforme (EM)-like eruption. EM is characterized by annular eruption caused by a hypersensitivity reaction from infections such as herpes simplex and mycoplasma pneumonia. Also, unusual viral pathogens Coxsackievirus A6 or A10 have been reported with HFMD, leading to more severe disease course. A 38-year-old male was presented with a pruritic, erythematous maculopapular targetoid eruption on both hands, feet, and trunk for one week (Fig. 1). Initially, he experienced malaise and mild fever before the skin eruption, which did not involve oral mucosa. Blood chemistry tests, rapid plasma reagin, human immunodeficiency virus, and hepatitis serology were normal. Histopathological examination of a macule on his left arm showed neutrophils presented with focal necrosis in upper epidermis and vacuolar alteration in the dermoepidermal junction (Fig. 2). Initially, the patient was misdiagnosed with EM due to clinical exam findings of targetoid lesions. But the additional laboratory examination showed all positive titers of A B","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"392-393"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/5f/ad-34-392.PMC9561299.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji Ha Yoon, Joon Woo Jung, Eun Joo Park, Kwang Joong Kim, Kwang Ho Kim
Dear Editor: A 34-year-old Korean man having Ankylosing spondylitis (AS) presented with a 1-month history of lesions on his entire body. We received the patient’s consent form about publishing all photographic materials. Numerous erythematous papules, pustules, and papulosquamous plaques on approximately 25% of the body surface area (Fig. 1). He had been treated with infliximab bimonthly after 2005 for AS, but infliximab had been switched to adalimumab two months before, due to loss of efficacy. After switch, skin eruption aggravated even after application of topical corticosteroid. Results of laboratory examinations were mostly normal. The results of his histopathological examination are shown in Fig. 2. Thick hyperkeratosis, confluent parakeratosis, and elongated rete ridges accompanied by focal spongiosis and exocytosis at the epidermis were noted. Superficial perivascular lymphohistiocytic infiltration was observed in the dermis. Based on clinical manifestations and histopathological findings, adalimumab-induced psoriasiform dermatitis was diagnosed. Clinical progress is summarized in Supplementary Fig. 1. Adalimumab was halted,
{"title":"A Case of Adalimumab-Induced Psoriasiform Dermatitis in an Ankylosing Spondylitis Patient: Unusual Progression after Adalimumab Retreatment.","authors":"Ji Ha Yoon, Joon Woo Jung, Eun Joo Park, Kwang Joong Kim, Kwang Ho Kim","doi":"10.5021/ad.20.094","DOIUrl":"https://doi.org/10.5021/ad.20.094","url":null,"abstract":"Dear Editor: A 34-year-old Korean man having Ankylosing spondylitis (AS) presented with a 1-month history of lesions on his entire body. We received the patient’s consent form about publishing all photographic materials. Numerous erythematous papules, pustules, and papulosquamous plaques on approximately 25% of the body surface area (Fig. 1). He had been treated with infliximab bimonthly after 2005 for AS, but infliximab had been switched to adalimumab two months before, due to loss of efficacy. After switch, skin eruption aggravated even after application of topical corticosteroid. Results of laboratory examinations were mostly normal. The results of his histopathological examination are shown in Fig. 2. Thick hyperkeratosis, confluent parakeratosis, and elongated rete ridges accompanied by focal spongiosis and exocytosis at the epidermis were noted. Superficial perivascular lymphohistiocytic infiltration was observed in the dermis. Based on clinical manifestations and histopathological findings, adalimumab-induced psoriasiform dermatitis was diagnosed. Clinical progress is summarized in Supplementary Fig. 1. Adalimumab was halted,","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"396-398"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/3b/ad-34-396.PMC9561303.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: YouTube is one of the most popular video-sharing websites in Korea, but incorrect or biased information is not properly regulated. Acne is common in adolescents and young adults who are familiar with YouTube. Thus, misleading information about isotretinoin in YouTube videos could distort the perception of treatment.
Objective: We evaluated the quality of information about isotretinoin in YouTube videos.
Methods: The keywords searched on YouTube Korea on July 1, 2020 were: isotretinoin, Roaccutane, and Isotinone. The DISCERN tool was used to evaluate the reliability and quality of information, and eight items were used to evaluate scientific accuracy and comprehensiveness: mechanism, indications, dose regimen, contraindications, side effects, blood tests, drug interactions, and pregnancy-related issues.
Results: The number of videos searched was 728. After excluding duplicate or inappropriate videos, 164 videos were analyzed. In the DISCERN tool, the mean overall quality score was 2.24 on a 5-point scale from 1 to 5. The mean score in the 8-issue-criteria, a 3-point scale from 0 to 2, was 0.61. Particularly, indications, blood tests, and drug interactions were poorly addressed in YouTube videos. Medical personnel offer better video quality than non-medical personnel. However, no significant difference in quality existed between the videos of dermatologists and those of other medical personnel. The quality score was not correlated with the popularity of the video.
Conclusion: YouTube videos covering isotretinoin showed poor overall quality. Content quality did not have a significant correlation with popularity, so incorrect information could be propagated on YouTube.
{"title":"Evaluation of YouTube Videos about Isotretinoin as Treatment of Acne Vulgaris.","authors":"Byeong Chang Ko, Sik Haw","doi":"10.5021/ad.21.143","DOIUrl":"https://doi.org/10.5021/ad.21.143","url":null,"abstract":"<p><strong>Background: </strong>YouTube is one of the most popular video-sharing websites in Korea, but incorrect or biased information is not properly regulated. Acne is common in adolescents and young adults who are familiar with YouTube. Thus, misleading information about isotretinoin in YouTube videos could distort the perception of treatment.</p><p><strong>Objective: </strong>We evaluated the quality of information about isotretinoin in YouTube videos.</p><p><strong>Methods: </strong>The keywords searched on YouTube Korea on July 1, 2020 were: isotretinoin, Roaccutane, and Isotinone. The DISCERN tool was used to evaluate the reliability and quality of information, and eight items were used to evaluate scientific accuracy and comprehensiveness: mechanism, indications, dose regimen, contraindications, side effects, blood tests, drug interactions, and pregnancy-related issues.</p><p><strong>Results: </strong>The number of videos searched was 728. After excluding duplicate or inappropriate videos, 164 videos were analyzed. In the DISCERN tool, the mean overall quality score was 2.24 on a 5-point scale from 1 to 5. The mean score in the 8-issue-criteria, a 3-point scale from 0 to 2, was 0.61. Particularly, indications, blood tests, and drug interactions were poorly addressed in YouTube videos. Medical personnel offer better video quality than non-medical personnel. However, no significant difference in quality existed between the videos of dermatologists and those of other medical personnel. The quality score was not correlated with the popularity of the video.</p><p><strong>Conclusion: </strong>YouTube videos covering isotretinoin showed poor overall quality. Content quality did not have a significant correlation with popularity, so incorrect information could be propagated on YouTube.</p>","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"340-348"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/48/ad-34-340.PMC9561295.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Da-Ae Yu, Se Hee Min, Jaeryong Song, Jong Seo Park, Hanjae Lee, Jungyoon Ohn, Kyu Han Kim
Background: Topical timolol is widely used for treatment of superficial infantile hemangioma (IH). However, little is known about factors that affect the response to topical timolol treatment.
Objective: This study aimed to investigate the efficacy, safety, and predictive value for good response to topical timolol for IH.
Methods: A retrospective review of medical records and clinical photos of 328 patients with IH treated with topical timolol 0.5% solution was conducted. Serial clinical photographs were compared with those at the initial visit using a 100-mm visual analogue scale (VAS). Treatment response was defined as an improvement of at least 75% from baseline in IH lesions within 12 months of treatment.
Results: Overall, IH patients treated with topical timolol showed significant improvement from baseline, showing that the final VAS score within 12 months of treatment was 69.7±20.4. The multivariable logistic regression analysis showed age at initiation of treatment (p=0.007), length of gestation and fetal growth (p=0.03), depth (p=0.01), and flexural area (p=0.007) were significantly associated with treatment response. Only four patients (1.1%) reported local irritation.
Conclusion: This study demonstrated that topical timolol treatment was an effective and well-tolerated treatment for IHs. Physicians are encouraged to consider several patient- or lesional factors that might affect treatment response to achieve better clinical outcomes.
{"title":"Good Clinical Responders to Topical Timolol in Patients with Infantile Hemangiomas: A 7-Year Retrospective Study of 328 Korean Patients.","authors":"Da-Ae Yu, Se Hee Min, Jaeryong Song, Jong Seo Park, Hanjae Lee, Jungyoon Ohn, Kyu Han Kim","doi":"10.5021/ad.21.203","DOIUrl":"https://doi.org/10.5021/ad.21.203","url":null,"abstract":"<p><strong>Background: </strong>Topical timolol is widely used for treatment of superficial infantile hemangioma (IH). However, little is known about factors that affect the response to topical timolol treatment.</p><p><strong>Objective: </strong>This study aimed to investigate the efficacy, safety, and predictive value for good response to topical timolol for IH.</p><p><strong>Methods: </strong>A retrospective review of medical records and clinical photos of 328 patients with IH treated with topical timolol 0.5% solution was conducted. Serial clinical photographs were compared with those at the initial visit using a 100-mm visual analogue scale (VAS). Treatment response was defined as an improvement of at least 75% from baseline in IH lesions within 12 months of treatment.</p><p><strong>Results: </strong>Overall, IH patients treated with topical timolol showed significant improvement from baseline, showing that the final VAS score within 12 months of treatment was 69.7±20.4. The multivariable logistic regression analysis showed age at initiation of treatment (<i>p</i>=0.007), length of gestation and fetal growth (<i>p</i>=0.03), depth (<i>p</i>=0.01), and flexural area (<i>p</i>=0.007) were significantly associated with treatment response. Only four patients (1.1%) reported local irritation.</p><p><strong>Conclusion: </strong>This study demonstrated that topical timolol treatment was an effective and well-tolerated treatment for IHs. Physicians are encouraged to consider several patient- or lesional factors that might affect treatment response to achieve better clinical outcomes.</p>","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"360-369"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/f0/ad-34-360.PMC9561300.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jae-Ho Lee, Ji-An Uh, Joong-Ho Kim, Ho-Young Kim, Myoung-Shin Kim, Un-Ha Lee, Soo-Kyung Lee
Trigeminal trophic syndrome (TTS) is a rare condition characterized by anesthesia, paresthesia, and facial ulceration involving the trigeminal dermatome secondary to self-manipulation of the skin after a peripheral or central injury to the trigeminal nerve or its branches. Differential diagnosis of TTS includes conditions presenting with chronic facial ulceration, such as various infectious diseases, malignancy, vasculitis, pyoderma gangrenosum and dermatitis artefacta. We report a case of postherpetic TTS and highlight the importance of early diagnosis and prompt treatment of this condition, which may commonly be misdiagnosed.
{"title":"Postherpetic Trigeminal Trophic Syndrome: A Case Report.","authors":"Jae-Ho Lee, Ji-An Uh, Joong-Ho Kim, Ho-Young Kim, Myoung-Shin Kim, Un-Ha Lee, Soo-Kyung Lee","doi":"10.5021/ad.20.145","DOIUrl":"https://doi.org/10.5021/ad.20.145","url":null,"abstract":"<p><p>Trigeminal trophic syndrome (TTS) is a rare condition characterized by anesthesia, paresthesia, and facial ulceration involving the trigeminal dermatome secondary to self-manipulation of the skin after a peripheral or central injury to the trigeminal nerve or its branches. Differential diagnosis of TTS includes conditions presenting with chronic facial ulceration, such as various infectious diseases, malignancy, vasculitis, pyoderma gangrenosum and dermatitis artefacta. We report a case of postherpetic TTS and highlight the importance of early diagnosis and prompt treatment of this condition, which may commonly be misdiagnosed.</p>","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 5","pages":"378-381"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/cc/ad-34-378.PMC9561291.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
in the management of various chronic dermatitis a chronic inflammatory skin disease, an immune-mediated inflammatory disease . AD has a lot of infectious complications due to immune dysregulation and skin barrier defects, and it has been reported that the frequency of organ involvement, such as urinary tract infection (UTI), sore throat, ear and simple skin infections, has increased 2-5 . In the case of severe AD, systemic immunosuppressants are widely used, and, as concerns over infectious diseases are recently rising, it is necessary to confirm these complications 6 . Therefore, in this study, we analyzed the association between AD and extracutaneous infections (UTI, pneumonia, otitis media, and sinusitis) in children and ado-lescents based on large-scale data. this a in quartiles pneumonia,
{"title":"Association of Childhood Atopic Dermatitis with Extracutaneous Infections Based on the Nationwide Cross-Sectional Study in Korea.","authors":"Hee Jae Park, Mira Choi","doi":"10.5021/ad.20.249","DOIUrl":"https://doi.org/10.5021/ad.20.249","url":null,"abstract":"in the management of various chronic dermatitis a chronic inflammatory skin disease, an immune-mediated inflammatory disease . AD has a lot of infectious complications due to immune dysregulation and skin barrier defects, and it has been reported that the frequency of organ involvement, such as urinary tract infection (UTI), sore throat, ear and simple skin infections, has increased 2-5 . In the case of severe AD, systemic immunosuppressants are widely used, and, as concerns over infectious diseases are recently rising, it is necessary to confirm these complications 6 . Therefore, in this study, we analyzed the association between AD and extracutaneous infections (UTI, pneumonia, otitis media, and sinusitis) in children and ado-lescents based on large-scale data. this a in quartiles pneumonia,","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 4","pages":"315-317"},"PeriodicalIF":1.6,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/c1/ad-34-315.PMC9365646.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40683673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Editor: A 70s male smoker (20 cigarettes/day for 23 years) and human T-lymphotropic virus type 1 (HTLV-1) carrier, developed painful nodular erythema in both wrist joints, the lower extremities and in the testes, each of which underwent 1-month cycles of repeating spontaneous regression and recurrence without any medications. He presented to our hospital 4 months after the initial symptom appeared (data not shown). A biopsy of a representative lesion revealed thrombosis in the deep dermis without leukocytoclastic vasculitis (Fig. 1A). There was neither fibrinoid necrosis nor a granulomatous lesion. A diagnosis of thrombophlebitis migrans was made. The white blood cell count (9,580/μl; normal range 2,950~ 8,970/μl) was increased, with 3% abnormal lymphocytes. Southern blot analysis of peripheral blood revealed an HTLV1 provirus DNA monoclonal band. Serum levels of C-reactive protein (3.57 mg/dl; normal range <0.21 mg/dl), soluble interleukin-2 receptor (2,498 U/ml; normal range 145~519 U/ml) and immunoglobulin A (459 mg/dl; normal range 110~410 mg/dl) also were increased. Because of a history of atrial fibrillation he was taking warfarin, therefore, prothrombin time international-normalized ratio was moderately prolonged (2.13; normal range 0.9~1.1). Protein C, protein S, antithrombin III, and fibrin/fibrinogen degradation products were within normal limits under transient heparinization after interruption of warfarin. Lupus anticoagulant, anticardiolipin antibodies, rapid plasma reagin test, treponema pallidum hemagglutination test and several tumor markers (i.e., squamous cell carcinoma antigen, α-fetoprotein, carcinoembryonic antigen, prostate specific antigen, carbohydrate antigen 19-9) were all negative or within the normal range. Computed tomography (CT) of the total body except for extremities and CT angiography revealed neither a solid mass nor vessel stenosis. His human leukocyte antigen (HLA) alleles were HLA-A*24, A*31, B*07, B*35, which are not associated with Behçet disease. He was diagnosed as smoldering adult T-cell leukemia-lymphoma (ATL) according to the Shimoyama criteria at the initial diagnosis. The clinical course of the present case is described in Fig. 2. Oral administration of rivaroxaban was started instead of warfarin and, thereafter, thrombophlebitis resolved with no further recurrence. Around the disappearance of thrombophlebitis, erythematous maculopapular eruptions were noted to be scattered over the entire body (data not shown); this was followed by HTLV-1-associated arthropathy, and lung disease. Findings of histological findings including immunohistochemical analysis of erythematous areas were consistent with those of ATL (Fig. 1B). His disease status changed to intermediate types between Received July 6, 2020 Revised November 10, 2020 Accepted December 19, 2020
{"title":"Thrombophlebitis Migrans As the Prodrome of Adult T-Cell Leukemia-Lymphoma.","authors":"Haruna Matsuda-Hirose, Yuko Nashimoto, Aki Tanabe, Masao Ogata, Masao Iwao, Kazuhiro Mizukami, Haruto Nishida, Yutaka Hatano","doi":"10.5021/ad.20.184","DOIUrl":"https://doi.org/10.5021/ad.20.184","url":null,"abstract":"Dear Editor: A 70s male smoker (20 cigarettes/day for 23 years) and human T-lymphotropic virus type 1 (HTLV-1) carrier, developed painful nodular erythema in both wrist joints, the lower extremities and in the testes, each of which underwent 1-month cycles of repeating spontaneous regression and recurrence without any medications. He presented to our hospital 4 months after the initial symptom appeared (data not shown). A biopsy of a representative lesion revealed thrombosis in the deep dermis without leukocytoclastic vasculitis (Fig. 1A). There was neither fibrinoid necrosis nor a granulomatous lesion. A diagnosis of thrombophlebitis migrans was made. The white blood cell count (9,580/μl; normal range 2,950~ 8,970/μl) was increased, with 3% abnormal lymphocytes. Southern blot analysis of peripheral blood revealed an HTLV1 provirus DNA monoclonal band. Serum levels of C-reactive protein (3.57 mg/dl; normal range <0.21 mg/dl), soluble interleukin-2 receptor (2,498 U/ml; normal range 145~519 U/ml) and immunoglobulin A (459 mg/dl; normal range 110~410 mg/dl) also were increased. Because of a history of atrial fibrillation he was taking warfarin, therefore, prothrombin time international-normalized ratio was moderately prolonged (2.13; normal range 0.9~1.1). Protein C, protein S, antithrombin III, and fibrin/fibrinogen degradation products were within normal limits under transient heparinization after interruption of warfarin. Lupus anticoagulant, anticardiolipin antibodies, rapid plasma reagin test, treponema pallidum hemagglutination test and several tumor markers (i.e., squamous cell carcinoma antigen, α-fetoprotein, carcinoembryonic antigen, prostate specific antigen, carbohydrate antigen 19-9) were all negative or within the normal range. Computed tomography (CT) of the total body except for extremities and CT angiography revealed neither a solid mass nor vessel stenosis. His human leukocyte antigen (HLA) alleles were HLA-A*24, A*31, B*07, B*35, which are not associated with Behçet disease. He was diagnosed as smoldering adult T-cell leukemia-lymphoma (ATL) according to the Shimoyama criteria at the initial diagnosis. The clinical course of the present case is described in Fig. 2. Oral administration of rivaroxaban was started instead of warfarin and, thereafter, thrombophlebitis resolved with no further recurrence. Around the disappearance of thrombophlebitis, erythematous maculopapular eruptions were noted to be scattered over the entire body (data not shown); this was followed by HTLV-1-associated arthropathy, and lung disease. Findings of histological findings including immunohistochemical analysis of erythematous areas were consistent with those of ATL (Fig. 1B). His disease status changed to intermediate types between Received July 6, 2020 Revised November 10, 2020 Accepted December 19, 2020","PeriodicalId":8233,"journal":{"name":"Annals of Dermatology","volume":"34 4","pages":"312-314"},"PeriodicalIF":1.6,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/23/ad-34-312.PMC9365648.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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