Case Reports in Dermatological Medicine最新文献

Hair shaft abnormalities, often linked to genetic or acquired conditions, present significant treatment challenges with limited and inconsistent therapeutic success. This report describes an eight-year-old female with severe hair shaft abnormality, unresponsive to standard treatments, including topical minoxidil and platelet-rich plasma therapy, who demonstrated marked improvement following a single session of adipose tissue (AT)-derived exosome therapy. The exosomes were administered via intradermal scalp injections, resulting in significant enhancement in hair structure, strength, and growth within 3 months, with no adverse effects observed. AT-derived exosomes, leveraging mechanisms such as Wnt/β-catenin activation and vascular endothelial growth factor expression, hold substantial promise for promoting hair follicle regeneration. This case highlights the potential of exosome therapy as an innovative and effective treatment for hair shaft abnormalities, emphasizing the need for further clinical studies to validate its efficacy and safety.

Squamous cell carcinoma (SCC) of the vulva is caused by disturbances in the proliferation and differentiation of the squamous epithelium, which can be associated with human papillomavirus (HPV) infection. Vulvar SCC is usually caused by high-risk HPV types, although there are some cases that are caused by low-risk HPV types. The clinical manifestations of vulvar SCC vary, one of which can resemble anogenital warts. A case of vulvar SCC was reported in a 75-year-old woman with a lesion that appeared as a yellowish-white papillomatous plaque on the vulva. From the history taking, it was found that the skin disorder had a chronic course. A skin biopsy was performed on the patient and from histopathological examination found hyperplastic, parakeratotic, and acanthotic stratified squamous epithelial cells with koilocytosis. In addition, there was evidence of tumor cell invasion in the connective tissue stroma with polymorphic and hyperchromatic nuclei, supporting a diagnosis of well-differentiated vulvar SCC. Genotyping polymerase chain reaction revealed the presence of HPV types 6 and 11 deoxyribonucleic acid. The risk of malignancy in low-risk HPV must be considered, especially in the elderly. HPV-dependent SCC caused by low-risk HPV types 6 and 11, though uncommon but still possible, with clinical manifestations that resemble anogenital warts.

Facial pigmentation disorders such as ephelides (commonly known as freckles) and solar lentigines are chronic dermatological conditions associated with sun exposure that can impact cosmetic appearance. This case report presents low-level laser therapy (LLLT) as an effective intervention for two different pigmentary disorders in Syrian women: one with ephelides and another with solar lentigines. The first case involved a 34-year-old woman with Fitzpatrick skin type II presenting with facial ephelides, while the second case featured a 49-year-old woman with Fitzpatrick skin type III diagnosed with solar lentigo. Both patients underwent 12 sessions from June 1 to August 1, 2023, using a red diode laser (660 nm) at a power density of 15.6 mW/cm² and a dose of 5.6 J/cm², applied for 6 min per session, with one pass per treatment area. The results demonstrated a marked reduction in pigmentation intensity and lesion size, with no reported side effects or lesion recurrence during a 1-year follow-up. These results suggest that LLLT may serve as an effective and safe therapeutic modality for selected facial pigmentary disorders.

Traumatic tattoos result from foreign particles embedding into the dermis, often following industrial accidents or explosions. Among available treatments, including laser therapy and surgical excision, dermabrasion remains a cost-effective and widely accessible option. We present the case of a 49-year-old female construction supervisor who sustained extensive facial traumatic tattooing from the explosion of a hydraulic cement mixer. Clinical examination identified deeply embedded cement particles with localized erythema and edema on the left face. Following stabilization, she underwent acute dermabrasion under general anesthesia, employing staged removal of superficial and partial dermal layers to optimize particle clearance while preserving viable tissue. At 3-month follow-up, the patient demonstrated substantial reduction of pigmentation, minimal scarring, and high satisfaction. Dermabrasion, traditionally applied to superficial dermal lesions, proved particularly effective in this acute context by limiting chronic pigmentation, fibrosis, and textural irregularities. Compared to laser therapy, which requires multiple sessions and carries risk of incomplete clearance in particulate-laden wounds, or surgical excision, which may cause contour deformity, dermabrasion offers immediate, broad-surface intervention with relatively low morbidity. This case underscores dermabrasion's value as a first-line modality for acute traumatic tattoos, especially where resources constrain advanced laser platforms. Prompt recognition and intervention are critical to outcome, and while further research should refine timing, technique, and adjunctive care, dermabrasion remains a pragmatic, effective option in managing acute dermal trauma with embedded particulate matter.

We report the case of a three-month-old boy presenting with dystrophic nails, hyperhidrosis, congenital natal teeth, and milia-like lesions on the nose, without a family history of pachyonychia congenita (PC). Genetic testing confirmed a heterozygous pathogenic mutation (c.275A > G) in the KRT17 gene, establishing the diagnosis of PC Type II. PC is a rare genetic disorder affecting keratinization, with variable clinical manifestations that can complicate early recognition. This case highlights the importance of molecular testing and dermatologic expertise in diagnosing and managing PC.

Xanthelasma palpebrarum (XP) is a benign condition of the eyelid skin, characterized by the appearance of well-defined, bilateral, yellow-colored papules or plaques in the periorbital area. Although patients often seek dermatological consultation for cosmetic reasons, the associated medical implications, especially in younger individuals, hold significant medical importance. XP can be treated through various methods such as surgical removal, trichloroacetic acid (TCA) 70% application, cryotherapy, and laser procedures. Among the laser therapies (CO₂, pulsed dye laser, and Er:YAG), which have proven effective due to their convenient application and fewer complications, the Er:YAG laser stands out for its potential to deliver faster recovery, fewer pigmentation changes, minimal scarring, and a shorter period of postlaser redness. This study evaluated Er:YAG laser for XP in four cases. Three laser sessions effectively treated the lesions, leading to patient satisfaction despite incomplete clearance, with no recurrence in 12 months and no side effects. The study concluded that Er:YAG laser is preferred over other lasers for this condition due to its superior healing profile.

Erythrodermic psoriasis (EP) is a severe type of psoriasis that requires immediate and effective treatment to prevent serious complications. Although recommended as first-line treatment for EP, conventional systemic disease-modifying antirheumatic drugs (csDMARDs) such as methotrexate and/or cyclosporine can sometimes be ineffective or undesirable, hence the use of biologics. However, in cases of refractory disease, biologics may be combined with methotrexate to boost efficacy and optimize outcomes without compromising safety and tolerability.

Reticular erythematous mucinosis (REM) is a rare dermatological condition characterized by erythematous, reticulated patches and plaques with a slightly infiltrated appearance. REM is classified among cutaneous mucinoses, which are characterized by the accumulation of mucin in the subcutaneous tissues, leading to the formation of characteristic reticulated patches on the skin. The pathogenesis is still debated, but the association with sun exposure seems to play an important role. We present the case of a 54-year-old individual with a history of recurrent erythema on the chest and back. The patient came to our attention in 2007 due to a worsening of symptoms after sun exposure. On clinical examination, the patient presented with pruritic, erythematous patches with a reticulated appearance. A biopsy was performed, which showed the presence of a moderate lymphocytic infiltrate in the dermis, with a perivascular and periappendageal distribution, consisting mainly of T lymphocytes, and deposits of mucin in the superficial dermis, dissecting the collagen bundles. A diagnosis of REM was made, and the patient began treatment with hydroxychloroquine 200 mg per day, with rapid improvement of symptoms. Considering the resolution of symptoms, the therapy was discontinued after 3 months. The patient remained in remission until the following summer when the condition recurred, requiring a new cycle of hydroxychloroquine therapy. The patient has experienced recurrences over the past 15 years during the summer, which responded to hydroxychloroquine therapy, consistently achieving rapid symptom resolution without ever experiencing loss of efficacy or side effects.

Granuloma annulare is a noninfectious, granulomatous skin disorder that typically presents as symmetrical, asymptomatic, annular, or arciform plaques with slightly raised edges, often found on the back of the hands or feet. This report highlights the successful use of tofacitinib in treating resistant/generalized granuloma annulare in a 66-year-old male with a known history of hepatitis B, demonstrating its potential as an effective therapeutic option.

Pachydermodactyly (PDD) is a rare, underdiagnosed benign condition characterized by asymmetrical, bilateral fusiform swellings of the hands' proximal interphalangeal (PIP) joints. In this type of digital fibromatosis, cutaneous thickening is thought to occur due to repetitive mechanical irritation. Furthermore, due to its striking clinical appearance, PDD is commonly overlooked or misdiagnosed as other inflammatory arthropathies or pachydermoperiostosis. In addition, because of its elusive nature and resemblance to more serious conditions, clinicians should be aware of this condition. Herein, we present a case of PDD and discuss the differential diagnoses to improve recognition and prevent misdiagnosis.