bluuebunny/crossref_metadata_2025 huggingface dataset:
An Assessment of the Malignant Potential of Actinic Keratoses and Bowen's Disease: p53 and PCNA Expression Pattern Correlate with the Number of Desmosomes
Authors: Ramzi Saeef Taher , Maruno Motoyoshi , Khaskhely Noor Mohammad , Khan Mohammed Abul Kasem , Takamiyagi Atsushi , Uezato Hiroshi , Nonaka Shigeo
Published: July 2014

Actinic keratoses (AK) and Bowen's disease (BD), both intraepidermal skin tumors, have a potential progression to squamous cell carcinoma (SCC). To evaluate the malignant potential of AK and BD, the expression pattern of p53 protein and proliferating cell nuclear antigen (PCNA) were examined in five types of AK and BD by immunohistochemistry. The ultrastructural difference of epidermal cells between AK and BD lesions was investigated. In the study of p53 and PCNA expression, the atrophic and acantholytic types of AK showed lower positive rates compared to others. These two types did not demonstrate all layers expression pattern. The number of desmosomes of the epidermal cells was significantly reduced in BD, and in the bowenoid and hypertrophic types of AK compared with other types of AK. The number of hemi‐desmosomes showed greatest reduction in BD and the bowenoid type of AK. On the basis of our findings, it is hypothesized that atrophic and acantholytic types of AK may have the lowest, and the bowenoid type of AK and BD may have the highest, malignant potential.
Uremic Pruritus: A Clinical Study of Maintenance Hemodialysis Patients
Authors: Szepietowski Jacek C. , Sikora Magdalena , Kusztal Mariusz , Salomon Joanna , Magott Maria , Szepietowski Tomasz
Published: July 2014

Uremic pruritus is one of the most bothersome symptoms in patients with chronic renal failure. Its pathogenesis remains unclear. The aim of this study was to evaluate the frequency of uremic pruritus in hemodialysis patients and to correlate its presence and intensity with several clinical parameters. One hundred thirty patients on maintenance hemodialysis were included into the study. The intensity of pruritus was assessed by two methods: visual analog scale and specially adapted questionnaire scoring method. A significantly positive correlation (p<0.00001) was demonstrated between the two methods for evaluating pruritus. Uremic pruritus was found in 40.8% of patients. An additional 36.1% of patients reported pruritus to have been present in the past during the renal disease period. Itching was generalized in 19% of patients; the remaining subjects suffered from scattered pruritus (50%) or pruritus in a single location (31%). A significant positive relationship (p<0.02) was demonstrated between the total score of pruritus and duration of the hemodialysis period. Severity of pruritus and sleep disturbance caused by itching also significantly correlated (p<0.05) with the duration of hemodialysis. Patients hemodialysed on polysulphone membranes more commonly suffered from pruritus than those on hemophane (p<0.04) or cuprophane (p<0.03) dialysis membranes. A marked relationship was demonstrated between the intensity of xerosis and prevalence of pruritus. Significantly more patients with very rough skin had pruritus compared to those with rough skin (p<0.05) and those with slightly dry skin (p<0.02). Itching was more common in female patients (p<0.04), but patient age, underlying renal disease and erythropoietin intake did not correlate with the incidence or intensity of pruritus.
Elevation of IL‐6 in ATL Patient with a Pathological Fracture
Authors: Anzai Saburo , Takayasu Susumu , Fujiwara Sakuhei , Tateyama Masamichi , Taira Hirohumi , Takashita Mitsuhiro
Published: July 2014

Hypercalcemia and osteolytic bone lesion are important complications in the prognosis of patients with adult T cell leukemia/lymphoma (ATL). We report a 61‐year‐old Japanese woman who died of ATL and had multiple osteolytic lesions and pathological fractures of her extremities. Highly increased serum levels of Interleukin‐6 (IL‐6) and a parathyroid hormone‐related protein (PTHrP) together with a high level of serum calcium observed at the time of fractures suggested their contribution to the formation of the bone lesions.
Chemotherapy of Disseminated Cutaneous Classic Kaposi's Sarcoma with Vinblastine
Authors: Turk H. Mehmet , Buyukberber Suleyman , Camci Celalettin , Inaloz H. Serhat , Sari Ibrahim , Kirtak Necmettin , Uner Aytug
Published: July 2014

Classic Kaposi's Sarcoma (KS) is a rare indolent cutaneous malign proliferative disease affecting predominantly elderly men of Mediterranean and Jewish origin. Classic KS generally does not require treatment for a prolonged time. Systemic therapy is indicated for patients with advanced disease. We present here a 78‐year‐old woman with disseminated cutaneous classic KS who was successfully treated with single agent vinblastine. Vinblastine is very effective, less toxic and less costly in the treatment of elderly patients with disseminated classic KS.
Seventeen Cases of Alopecia Areata: Combination of SADBE Topical Immunotherapy with Other Therapies
Authors: Morita Kazumasa , Nakamura Motonobu , Nagamachi Miyako , Kishi Tatsuo , Miyachi Yoshiki
Published: July 2014

Topical immunotherapy is effective for severe alopecia areata. However, there are patients with alopecia areata refractory to topical immunotherapy alone. We tried SADBE (squaric acid dibutylester) topical immunotherapy combined with topical dry ice cryotherapy, carpronium chloride (a parasympathetic nerve stimulant) and/or oral cepharanthin (a biscoclaur alkaloid) in alopecia areata refractory to topical SADBE. Seventeen patients with alopecia areata (3 multiple, 3 ophiasis, 5 totalis and 6 universalis) were treated with SADBE in our department in 1999 to 2001. In 3 cases (2 multiple and 1 universalis) out of the 17 cases, cosmetically acceptable regrowth of hair was observed in several months with topical SADBE alone. In the other 14 cases, the SADBE therapy alone for several months (mean: 6.9 months) resulted in no or poor regrowth of hair. However, with subsequent combination therapy of topical SADBE for several months (mean: 7.6 months), satisfactory regrowth of hair was observed in 6 of the 14 cases. Our cases indicate that combination therapy of topical SADBE with other therapies can be a choice for alopecia areata which is refractory to topical SADBE therapy alone.
Depression Circumstantially Related to the Administration of Finasteride for Androgenetic Alopecia
Authors: Altomare Gianfranco , Capella Giovanni Luigi
Published: July 2014

In this paper we report 19 patients (14 males, 5 females; mean age 28.16 years ± 7.68 SD) out of a series of 23 (17 males, 5 females) who developed a mood disturbance (moderate to severe depression) during treatment with finasteride, 1 mg/day orally, for androgenetic alopecia (Hamilton subtypes III–V; Ludwig subtypes I–II). Depression, which significatively impaired sociofamilial relations, sleep and eating behaviour, was associated to marked anxiety in some cases, developed after 9–19 weeks of treatment with finasteride, and promptly resolved after suspension of the drug. Two patients accepted reintroduction of the drug, and depression relapsed within 2 weeks. Depression as an adverse effect of finasteride has been reported only once. Further studies are needed to confirm our circumstantial observations, which are based on a retrospective series of patients.
A Monoclonal Antibody Established from the Immunization of Basal Cell Carcinoma (BCC) Tissues Reacts to the Intercellular Space of BCC and Hair Follicles
Authors: Kore‐eda Satoshi , Matsuyoshi Norihisa , Ueda Masamichi , Horiguchi Yuji , Miyachi Yoshiki , Imamura Sadao
Published: July 2014

To detail the histogenetic relationship between basal cell carcinoma (BCC) and hair follicles, a monoclonal antibody, coded as MMKB‐1 and established from immunization of mice by human basal cell carcinoma (BCC) tissues, was immunohistochemically studied in tissues of BCC and squamous cell carcinoma (SCC) of the skin, as well as in normal human skin tissues. On 1M‐NaCl‐split normal human skin tissues, it reacted against both the epidermal and the dermal sides of the basement membrane zone (BMZ). This monoclonal antibody reacted to the BMZ and intercellular space (ICS) of the solid, superficial, and fibrosing types of BCC cell nests, but, in SCC tumor cell nests, it reacted exclusively to the BMZ. Immunoelectron microscopic studies revealed that the corresponding antigen of the monoclonal antibody was distributed in the hemidesmosomes and the anchoring fibrils along the BMZ of the normal human skin and the desmosomes of the BCC cell nest. The monoclonal antibody also reacted to the ICS of the lower outer root sheath and hair matrix. We discussed the histogenesis of BCC and hair follicles, referring to the results of the staining patterns of MMKB‐1 monoclonal antibody and to other studies suggesting a histogenetic relationship between BCC and hair follicles.
Evaluation of Cosmetic Tattooing in Localised Stable Vitiligo
Authors: Mahajan Bharat Bhushan , Garg Geeta , Gupta Rajesh Rani
Published: July 2014

Thirty patients with localised stable vitiligo were selected from the Out Patient Department for cosmetic tattooing. Of them, 19 cases (63.3%) had skin patches, 9 cases (30%) had mucosal patches, and 2 cases (6.7%) had both skin and mucosal involvement. After complete clinical evaluation, cosmetic tattooing was performed on these patients, and they were followed up for 6 months. As results, 23 cases (76.7%) had excellent color matching, 2 cases (6.7%) had good color matching, and 5 cases (16.6%) had pigment shedding. Excellent results were seen in all mucosal patches. Dark complexion cases showed better results than fair complexion ones.
Aneurysmal Fibrous Histiocytoma Showing Transition from Factor XIIIa‐Positive to ‐Negative
Authors: Inui Shigeki , Itami Satoshi , Yoshikawa Kunihiko
Published: July 2014

A 39‐year‐old woman visited us because of a subcutaneous induration on her forehead of 7 months' duration. The tumor was tender, firm, and colored blue‐black. Microscopically, the tumor was composed of fibroblastic and histiocytic cells showing no atypicality. In some part intra‐ or extracellular haemosiderin was diffusely seen. There were some blood‐filled spaces of varying size without endothelial lining. From these findings, this case was diagnosed as aneurysmal fibrous histiocytoma (AFH), a variant form of dermatofibroma. Immunohistochemical analysis showed that factor XIIIa‐positive histiocytic cells were distributed in the area without haemosiderin, but such cells were absent in the area with its deposition. Furthermore, the cells near the blood‐filled space showed transition from factor XIIIa‐positive to ‐negative, suggesting that the stromal instability induced by the attenuation of factor XIII may lead the formation of the blood‐filled spaces in AFH.
Childhood Bullous Pemphigoid Following Hepatitis B Immunization
Authors: Erbagci Zülal
Published: July 2014

Bullous pemphigoid (BP) is an acquired autoimmune bullous disorder which predominantly affects the elderly. It is very rare in children. There are approximately 50 reported cases of childhood BP. Although the cause of childhood BP is unknown, drug intake and vaccination have been incriminated in some cases. A total of 13 patients with BP (10 adults and 3 infants) have been described to be related to various vaccines and tetanus toxoid booster. However, no case related to hepatitis B vaccination has previously been reported. Our case of childhood BP developed one week after hepatitis B immunization in a Turkish caucasian child. This case suggests that the hepatitis B surface antigen can function as the triggering factor for BP by inducing a nonspecific immune reactivation which unmasks subclinical BP or by stimulating a specific antibody production that may cross–react with BP antigens.
Carney Complex: Report of a Japanese Case Associated with Cutaneous Superficial Angiomyxomas, Labial Lentigines, and a Pituitary Adenoma
Authors: Takahashi Hiroyuki , Hida Tokimasa
Published: July 2014

We report the case of a 12‐year‐old female patient who manifested multiple cutaneous angiomyxomas and labial pigmented lesions. Although the familial history was not confirmed in the present case, autosomal dominant inheritance has been reported to be involved in the pathogenesis of this condition. In addition to the cutaneous complications, magnetic resonance (MR) images revealed the presence of a pituitary adenoma, which provoked an elevation of serum growth hormone (GH) level. On the other hand, no significant symptoms such as cardiac myxoma, myxoid fibroadenoma of the breast, or adrenocortical complaints suggesting Cushing syndrome, were detected. In the Japanese literature, only a few cases of this disorder have been described in the form of brief reports. There have been only a few similar cases described in the dermatological field, except for one report diagnosed as Carney complex in 1990. Therefore, the present case seems to be the first Japanese case of typical Carney complex manifesting major clinical complications, including angiomyxomas, lentigines, and a pituitary adenoma, which induced endocrine overactivity.
Cutaneous Nocardiosis Developing around Gravel Inserted during a Traffic Injury
Authors: Gyotoku Takashi , Kayashima Ken‐ichi , Nishimoto Katsutaro , Ono Tomomichi
Published: July 2014

A 65‐year‐old Japanese woman with nocardial mycetoma which developed five years after a compound bone fracture of the left foot due to a traffic accident was reported. During this accident, two small pieces of gravel had entered her foot. Nocardia asteroides, which had been attached to the gravel, was probably inserted 5 years previously during the trauma. The lesion did not respond to oral minocycline and trimethoprim‐sulfamethoxazole and was finally removed surgically; she has been free from recurrences for one year, of follow‐up.
Efficacy of Oral Minocycline and Hyperthermic Treatment in a Case of Atypical Mycobacterial Skin Infection by Mycobacterium marinum
Authors: Hisamichi Katsuya , Hiruma Masataro , Yamazaki Masashi , Matsushita Akiko , Ogawa Hideoki
Published: July 2014

We report a case of atypical mycobacterial dermal infection caused by M. marinum, which was effectively treated with oral administration of minocycline and local hyperthermic treatment using chemical pocket warmers. A daily oral dose of 200 mg of minocycline was given, and local hyperthermic treatment was applied every evening for 5–6 hours with a disposable chemical pocket warmer. After 2.5 months of therapy, the lesion healed completely with scar formation. At 24 months after the completion of treatments, there is no sign of recurrence.
A Novel Nonsense Mutation at E106 of the 2B Rod Domain of Keratin 14 Causes Dominant Epidermolysis Bullosa Simplex
Authors: Gu Li‐Hong , Ichiki Yoshiro , Sato Miki , Kitajima Yasuo
Published: July 2014

Epidermolysis bullosa simplex (EBS) is classified into three main types and is caused, in most cases, by missense mutations in the genes encoding keratin (K) 5 and K14. In this study, we clinically, ultrastructurally, immunohistochemically, and molecularly studied a patient with a dominant EBS, Köbner type. Using sequence analysis of genomic DNA, a novel K14 nonsense mutation was identified. A heterozygous mutation G1231T of KRT14 was found to be associated with the disease in the patient. The mutation created a premature stop codon (amino acid codon 411, residue 106 of the 2B helix) in the K14 molecule. This residue lies in a highly conserved region and was recently found to be absolutely required for molecular stability and intermediate filament assembly in K5 and K14. The E411X (E106X) heterozygous ablation, missing the last 16 amino acid residues of the 2B and the entire tail domain of K14, led to disease but did not result in clumping of keratin filaments. It is the first premature stop codon mutation of K14 found in dominant EBS.
Facial Steatocystoma Multiplex Associated with Pilar Cyst and Bilateral Preauricular Sinus
Authors: Sardana Kabir , Sharma Ravi C. , Jain Anubhav , Mahajan Supriya
Published: July 2014

A 30‐year‐old male presented with multiple, yellowish to skin‐colored, firm to soft nodules on the forehead, temple, postauricular area and neck for the previous seven years. Examination of the scalp revealed a single, soft, cystic swelling on the occiput and the patient complained of occasional discharge from two, 0.1 × 0.1 cm, openings in front of both ears. Histopathology of the facial lesion was suggestive of steatocystoma multiplex, while that of the scalp revealed a pilar cyst. An otorhinolaryngeal evaluation confirmed the presence of bilateral pre‐auricular sinus. We present this previously unreported pilosebaceous hamartoma, constituting facial steatocystomas and pilar cyst, associated with bilateral preauricular sinus.
An Unusual Nail Presentation in Marfan's Syndrome
Authors: Nallegowda Mallikarjuna , Yadav Shiva Lal , Singh Upinderpal , Singh Manoj Kumar , Tejaswi Trilokraj
Published: July 2014

Skin and nail lesions are very rare in Marfan's syndrome. We reported a 14‐year‐old boy who presented with pterygium in the nails of both the upper and lower limbs with chest deformity along with other features of Marfan's syndrome. Histopathological findings revealed hyperkeratosis with a scant perivascular inflammatory infiltrate. It was not clear whether this case is the first presentation of pterigium in Marfan's syndrome or congenital lichen planus. To our knowledge, this kind of feature is the first Marfan's syndrome case of its kind.
A Keratin 10 Gene Mutation (Arg156Cys) in a Japanese Patient with Bullous Congenital Ichthyosiform Erythroderma
Authors: Saeki Hidehisa , Hattori Naoko , Mitsui Hiroshi , Adachi Makoto , Imakado Sumihisa , Ishibashi Yasumasa , Tamaki Kunihiko
Published: July 2014

We described a 19‐year old Japanese female with bullous congenital ichthyosiform erythroderma (BCIE) and examined the keratin gene mutation. Physical examination disclosed generalized erythema, ichthyosiform skin with scales, and erosions without palmoplantar keratoderma. Histological examination revealed hyperkeratosis with vacuolar degeneration in the granular layer of the epidermis. Sequence analysis demonstrated a C to G transition at the first position of codon 156 in the keratin 10 gene. The amino acid at codon 156 was deduced to have changed from arginine to cystine. Substitution from arginine to cysteine at codon 156 of the K 10 gene is assumed to be fatal for keratin filament assembly regardless of racial or ethnic difference.
Hot Pop Brown Spot: Erythema Ab Igne Induced by Heated Popcorn
Authors: Donohue Kevin G. , Nahm Walter K. , Badiavas Evangelos , Li Lucy , Pedvis‐Leftick Anita
Published: July 2014

Erythema ab igne is caused by chronic heat exposure and presents with reticulated pigmentation. Although various causes of erythema ab igne have been reported, in the United States, its incidence has been declining due to the advent of central heating. When seen, it is usually in the setting of local applications of a heated source, such as a hot water bottle, to treat muscular or arthritic pains. We report a novel cause of erythema ab igne occurring in a patient with chronic arthritic pains. This patient applied popcorn kernels, heated in a microwave, to his right wrist and knee for 30 minutes at a time for over four months.
Calciphylaxis with Peau D'Orange Induration and Absence of Classical Features of Purpura, Livedo Reticularis and Ulcers
Authors: Nahm Walter K. , Badiavas Evangelos , Touma Dany J. , Wilkel Caroline S. , Falanga Vincent
Published: July 2014

Calciphylaxis is an ill‐defined syndrome that is commonly associated with chronic renal failure. Its heterogeneous clinical features include painful livedo reticularis‐like purpuric patches and plaques, vesicles, irregularly shaped ulcers, and black eschars. Despite demonstration of extensive vascular arteriolar calcification in this syndrome, its exact pathogenesis remains unknown. Here, we report a case of calciphylaxis presenting with indurated plaques without the usual clinical picture of livedo reticulate purpura, ulcers or necrotic eschars. This case provides an opportunity to review the clinical spectrum of calciphylaxis and to discuss the therapeutic approaches and pathogenesis of this syndrome from deep intra‐wall vascular calcification to the resulting infarctions of adjacent tissues.
Juxta‐Clavicular Beaded Lines in a Kidney Transplant Patient Receiving Immunosuppressants
Authors: Lee Mi‐Woo , Park Su‐Kil , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyourg
Published: July 2014

Juxta‐clavicular beaded lines (JCBL) are unique malformations of sebaceous glands or a variant of sebaceous hyperplasia with characteristic clinical features (1,2). We describe a patient with JCBL, who received immunosuppressants following kidney transplantation. To our knowledge, our patient is the first case of JCBL in a kidney transplant recipient.
Multiple Cutaneous Metastases from Carcinoma of the Penis
Authors: Khandpur Sujay , Reddy Belum Siva Nagi , Kaur Harji
Published: July 2014

A 65‐year‐old male patient with carcinoma of the penis in association with bilateral inguinal lymphadenopathy and widespread cutaneous dissemination is described. Histopathological examination of the primary tumor and metastatic sites was suggestive of undifferentiated squamous cell carcinoma. The patient was administered combination chemothrapy using cisplatin, methotrexate, and bleomycin with a good response after three cycles. The case is unique because of the rapid onset and widespread nature of skin metastasis and rare presentation.
A Case of Cutaneous Ganglioneuroma Developing within a Lesion of Seborrheic Keratosis
Authors: Ohno Sayoko , Horiguchi Yuji , Shintaku Masayuki
Published: July 2014

A 67‐year‐old man noticed on the abdominal skin a coin‐sized verrucous plaque, in which a small granulation‐like lesion developed several weeks before the first consultation at our clinic. The histology of the biopsied granulation‐like lesion showed a well demarcated, but not associated with the collagenous capsule, mass of proliferating eosinophilic cells, consisting of intervening spindle‐shaped Schwann cells and mature ganglion cells scattered in the tumor nest. We diagnosed this tumor nest as a ganglioneuroma, which rarely develops in the skin tissue. The simply resected surrounding verrucous lesion was histologically seborrheic keratosis.
Chromoblastomycosis: Report of Two Cases from Nepal
Authors: Agarwalla Arun , Khanal Basudha , Garg Vijay K. , Agrawal Sudha , Jacob Mary , Rani Sudha , Deb Manorama
Published: July 2014

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue caused by dematiaceous fungi. The first case, a 67‐year‐old male farmer, presented with itchy hyperkeratotic, scaly plaques with scarring and black dots on the lateral aspects of his left arm and dorsum of his left hand of 28 years duration. The case was clinically diagnosed as chromoblastomycosis. The second case, a 75‐year‐old farmer, presented with erythematous, crusted, scaly plaques on the dorsum of the left foot of 30 years duration. Initially, a clinical diagnosis of lupus vulgaris was made, but treatment with anti tuberculosis therapy showed no improvement. On the basis of histopathological examinations of skin biopsies and isolation of fungus on culture, both cases were diagnosed as chromoblastomycosis. To the best of our knowledge, these two cases are the first case reports of chromoblastomycosis from Nepal and are presented for their academic interest.
Severe Angioedema Induced by Angiotensin Converting Enzyme Inhibitors: Role of Precipitating Factors
Authors: Kaur Sukhjot , Thami Gurvinder P. , Srinivasan Vadivelu , Singh Ram , Kanwar Amrinder J.
Published: July 2014

Angiotensin converting enzyme inhibitors like captopril, enalapril, lisinopril, trandopril and ramipril may rarely induce a life threatening angioedema. We present two cases of severe angioedema induced by enalapril and ramipril along with possible precipitating factors observed in these patients. The importance of prompt recognition and early management of such cases is emphasized.
Erythema Annulare Centrifugum Following Pancreatico‐Biliary Surgery
Authors: Thami Gurvinder P. , Sachdeva Atul , Kaur Sukhjot , Mohan Harsh , Kanwar Amrinder J.
Published: July 2014

Annular erythemas are distinct cutaneous eruptions associated with a variety of causes. Occurrence of erythema annulare centrifugum, a variant of annular erythemas, in the immediate post‐operative period in a patient with surgical intervention in the gall bladder and pancreas region is being described for the first time. Its probable association with surgical trauma is discussed.
Segmentally Distributed Neurofibromatosis Associated with Adenocarcinoma of the Colon
Authors: Kim Seong Eon , Heo Eun‐Phil , Yoon Te‐Jin , Kim Tae‐Heung
Published: July 2014

Neurofibromatosis can be associated with various malignancies, but an association with adenocarcinoma is extremely rare. A 61‐year‐old man who had been diagnosed with adenocarcinoma of the hepatic flexure of the colon was referred for segmentally located, multiple café‐au‐lait spots and tumors on his back and axillary freckles for 40 years. Histopathologic examination of the tumor was consistent with the neurofibromatosis. We report an unusual case of type I neurofibromatosis associated with adenocarcinoma of the colon that was clinically similar to segmental neurofibromatosis.
Malignant Melanoma of the Buttock Presenting as a Buruli Ulcer
Authors: Mwanatambwe Milanga , Yajima Mikihisa , Etuaful Samuel , Suzuki Keiji , Nishigai Keiko , Asiedu Kingsley , Yamada Nobutaka , Asano Goro
Published: July 2014

We report an unusual case of malignant melanoma clinically diagnosed as Buruli ulcer, that arose in a 13‐year‐old boy and presented as an ulcerated, fungating 2 cm mass on the right buttock. The tumor showed the histology and immunohistology of a malignant melanoma. We present this interesting case of malignant melanoma of soft tissue, arising in an unusual location of the body. The tumor presented with clinical features of Buruli ulcer in an area endemic for this disease as well as other tropical ulcerations. Neoplasms, including melanoma, should be considered in the differential diagnosis of Buruli ulcer in endemic areas.
A Study from Nepal Showing No Correlation between Lichen Planus and Hepatitis B and C Viruses
Authors: Garg Vijay Kumar , Karki B.M.S , Agrawal Sudha , Agarwalla Arun , Gupta Ritu
Published: July 2014

A total number of 86 cases of Lichen planus (LP) were seen over a period of one and a half years. This constituted 0.58% of 14833 new dermatological patients seen. Hepatitis B and C viral (HBV & HCV) serology was carried out in 64 patients and 43 age and sex matched controls. In the examined patients, 35 (54.27%) had the skin lesions only. Oral lesions were present in 15 (23.4%) of the patients in addition to skin lesions, while 14 (21.9%) had only oral involvement. Serology for HBsAg and HCV was negative in all types of LP patients and the controls. In Nepal, HBV and HCV seem to be not important in the pathogenesis of LP.
Pseudoxanthoma Elasticum (PXE)‐like Calcification in Adult Dermatomyositis
Authors: Gushi Akiyo , Kanekura Takuro , Mochitomi Yuji , Kawabata Hisashi , Kanzaki Tamotsu
Published: July 2014

A case of pseudoxanthoma elasticum (PXE)‐like calcification in adult dermatomyositis (DM) is described. The patient was a 38‐year‐old woman with a history of dermatomyositis for 3 months. Yellowish, hard, papulo‐plaque lesions, which looked like those of pseudoxanthoma elasticum, were noted on her left axilla. Calcium deposition was confirmed by X‐ray, histopathological, and electron microscopic examinations. Histopathological and histochemical examinations showed acicular calcium deposition in the middle and deep dermis surrounded by mucin. Electron microscopic examination revealed that the calcium deposition was not on collagen fibers. These morphological features were distinct from those of PXE. We proposed the possibility that degenerated mucin or degenerated elastic fiber might result in subsequent calcium deposition in reticular calcinosis in adult DM. The calcification clinically disappeared without any specific treatment except for prednisolone and cyclophosphamide.
A Case of Tufted Hair Folliculitis
Authors: Isomura Iwao , Morita Akimichi , Tamada Yasuhiko
Published: July 2014

A 35‐year‐old man developed red papules and plaques with alopecia and hair tufts on the parietal and occipital areas of his scalp. Each tuft was comprised of 5 to 25 hairs arising from individual hair follicules. Histopathological findings showed a dense infiltration of plasma cells in the dermis. Based on these findings, he was diagnosed as tufted hair folliculitis. Oral minocycline and topical gentamicin were not effective, but the patient responded well to four weeks of oral refampicin.
A Case of Disseminated and Recurrent Infundibulofolliculitis Responsive to Treatment with Systemic Isotretinoin
Authors: Çalka Ömer , Metin Ahmet , Özen Süleyman
Published: July 2014

We report a 16‐year‐old Turkish patient who developed disseminated and recurrent infundibulofolliculitis (DRIF) and responded well to systemic isotretinoin therapy after three months.
Levofloxacin Alone Efficiently Treated a Cutaneous Mycobacterium fortuitum Infection
Authors: Fujita Nobuhiro , Utani Atsushi , Matsumoto Fumiaki , Matsushima Hironori , Kakuta Mari , Hatamochi Atsushi , Shinkai Hiroshi
Published: July 2014

Cutaneous infections with Mycobacterium (M.) fortuitum are rare, and some cases resist treatment. We report two cases of cutaneous M. fortuitum infection successfully treated with levofloxacin alone.
Induction of Darier's Disease by Repeated Irradiation by Ultraviolet B; Protection by Sunscreen and Topical Ascorbic Acid
Authors: Heo Eun‐Phil , Park Sun‐Hoo , Yoon Tae‐Jin , Kim Tae‐Heung
Published: July 2014

Darier's disease, keratosis follicularis, is frequently aggravated by sun exposure. Although there have been reports of Darier's disease reproduced by repeated exposure to ultraviolet B, little is known about its photo‐protection. We artificially induced Darier's disease in a 47‐year‐old Korean man, and tested the protection afforded by sunscreen and topical ascorbic acid. Complete lesions of Darier's disease arose with repeated exposure of ultraviolet B (2600 mJ/cm2 for 10 days), and sunscreen and topical ascorbic acid protected against its appearance. This result strongly suggests that sunscreen and ascorbic acid would be very helpful in preventing the aggravation of Darier's disease caused by sun exposure.
Clinical Manifestations of Hand Eczema Compared by Etiologic Classification and Irritation Reactivity to SLS
Authors: Kang Yun Chul , Lee Sanghoon , Ahn Sung Ku , Choi Eung Ho
Published: July 2014

Hand eczema is a common skin disease. Because of its variable etiologies and clinical manifestations, it is difficult to determine the etiology from the clinical manifestation. Among the contact allergens, nickel is the most common. Patients with hand eczema and a nickel allergy have a poorer prognosis than patients without a nickel allergy. The reason is still uncertain; suggestions include persistent exposure to nickel or a weak skin barrier. The purpose of our study was to identify the characteristic clinical manifestations by etiology and to compare the skin barrier state between patients with nickel allergies and those without them. Ninety‐three patients were classified into 4 types; irritation contact type, allergic contact type, atopic type and mixed type. After the sodium lauryl sulfate (SLS) test to compare the skin barrier state, visual score and transepidermal water loss (TEWL) were measured and analyzed statistically. From this study, it was not possible to ascertain a statistical difference, however a few characteristic clinical manifestations according to etiology can be stated. There was no difference in the visual scoring system or the TEWL after the SLS irritation test between the nickel‐allergy group and the non‐allergy group. Therefore, we believe that the poor prognosis of hand eczema with nickel allergy may be due to the nickel allergy itself rather than skin barrier state.
Benign Neonatal Hemangiomatosis in a Pre‐term Infant
Authors: Bubnoff Dagmar Von , Bieber Thomas , Steen Kay
Published: July 2014

Benign neonatal hemangiomatosis (BNH) is a condition of multiple neonatal strawberry hemangiomas limited to the skin. Characteristically, a rapid proliferative growth phase is followed by a prolonged involutional phase. Regression of cutaneous lesions usually starts in the fourth month, but variations until complete involution are high for individial lesions. Disseminated neonatal hemangiomatosis (DNH) represents a serious multisystemic disorder with hemangiomas in different organs and the skin. Early evaluation of the patients and treatment of visceral hemangiomas is of crucial importance. While solitary hemangiomas have been reported to occur more commonly in pre‐term infants, prematurity has rarely been described in the literature as being associated with BNH.
Nutritional and Vitamin Status of Non‐Healing Wounds in Patients Attending a Tertiary Hospital in India
Authors: Agrawal Sudha , Pandey Shyam Sundar , Shukla Vijay Kumar , Kaur Paramjeet
Published: July 2014

Non‐healing wounds are a common cause of morbidity worldwide. The wounds are the result of inadequate repair in an optimum period and are due to the presence of predisposing factors. The abnormalities of certain biochemical factors are important in impeding wound healing. One hundred patients with non‐healing wounds of more than six weeks duration were studied for nutritional and vitamin status and their correlation with healing time. The healing time was significantly prolonged in patients with serum protein concentrations below 6 gram/dl, but the healing time was not correlated with the concentrations of vitamin C or vitamin E. Anemia also did not alter the healing time. Adequate protein intake is the most important prerequisite for good wound healing.
The Role of Oxidants and Antioxidants in Generalized Vitiligo
Authors: Yildirim Mehmet , Baysal Vahide , Inaloz H. Serhat , Kesici Demet , Delibas Namik
Published: July 2014

Oxidative stress may be induced by increasing the generation of reactive oxygen species (ROS) and other free radicals. The generation of ROS is known to be associated with a decrease in antioxidant levels. In the present study, the role of oxidative stress was assessed in the pathogenesis of generalized vitiligo. Superoxide dismutase (SOD), glutathione peroxidase (GSH‐Px), and glutathione (GSH) levels in erythrocytes and serum malondialdehyde (MDA) and nitric oxide (NO) levels were investigated in 24 patients with generalized vitiligo and 20 healthy controls. Our results indicated that significantly increased levels of erythrocyte SOD, serum MDA, and NO were associated with a marked reduction of erythrocyte GSH‐Px and GSH activities in patients with generalized vitiligo (p<0.05). Our observations suggest that the presence of an imbalance in the oxidant‐antioxidant system might play a role in the pathogenesis of vitiligo. Our results further support the concept that free radical‐mediated damage may be the initial pathogenic event in melanocyte degeneration in generalized vitiligo.
Onychomycosis and the Diagnostic Significance of Nail Biopsy
Authors: Grover Chander , Reddy Belum Siva Nagi , Chaturvedi Krishnamoorthy Uma
Published: July 2014

Onychomycosis is the most common cause of deformed nails. It is often confused clinically with other nail diseases such as psoriasis. A cross sectional study was carried out in 120 clinically suspected onychomycosis patients to assess the diagnostic utility of nail unit histopathology. The majority of the patients were males (72.5%) in the age group of 20–40 years (55%). Involvement of fingernails alone (37.5%) was found to be more common than toenails (12.5%). Distal and lateral subungual onychomycosis [DLSO] (76.6%) was the predominant morphological type noted. Direct microscopy with 10% potassium hydroxide (KOH) preparation revealed fungal filaments in 82.5% of the cases. Mycological culture on Sabouraud's dextrose agar with and without cycloheximide indicated fungal isolates in 44% of the cases, with Trichophyton mentagrophytes being the most common isolate (38.3%). The combined approach with KOH preparation and culture showed the evidence of fungus in 103 cases (85.8%). Of the rest of the 17 cases in whom both these procedures failed to confirm a diagnosis, nail unit biopsy was carried out in 15 consenting patients. Fungal hyphae (better demonstrable on PAS staining) were evident in 14 cases (93.3%). Other histopathological features observed among these patients were subungual hyperkeratosis, neutrophilic infiltrate, parakeratosis, hemorrhage, and serum crusts. We concluded that histopathological examination of nails is a valuable diagnostic aid in onychomycosis, especially if routine parameters fail to establish a diagnosis.
A Case of Pustulosis Palmaris et Plantaris that Began as Generalized Pustular Eruption
Authors: Yoshida Yoko , Nishimura Youichi , Tanaka Toshihiro
Published: July 2014

A 65‐year‐old woman suddenly developed a widespread sterile pustular outbreak with high pyrexia. Many pustules appeared on her hands, including both the dorsal and the palmer side, and a few pustule appeared on her trunk and arms in the pattern of acute generalized pustular bacterid. Histopathology of the eruption showed subcorneal pustules. The eruption and pyrexia did not resolve with any of several antibiotics and NSAIDs, but resolved with the oral etretinate. Thereafter, pustules and scaly erythema remained on the arch of the foot and thenar of the palm, typical of pustulosis palmaris et plantaris.
Becker's Nevus with Ipsilateral Breast Hypoplasia: Improvement with Spironolactone
Authors: Jung Jae Hoon , Kim You Chan , Park Hyang Joon , Cinn Yong Woo
Published: July 2014

Ipsilateral breast hypoplasia is a rare abnormality in Becker's nevus. The pathogenesis of the breast hypoplasia is not understood, but an increased level of androgenic receptor in the affected area may play a role. We report a case of Becker's nevus with ipsilateral breast hypoplasia. Spironolactone, an anti‐androgenic agent, was tried for treatment of the hypoplasia, and, one month later, breast enlargement was seen in only the hypoplastic breast with Becker's nevus. This finding supports the theory that breast hypoplasia in Becker's nevus is related to an increase in androgenic receptor.
Immunohistochemical Study of Chondrolipoma: Possible Importance of Transforming Growth Factor (TGF) ‐βs, Latent TGF‐ β Binding Protein‐1 (LTBP‐1), and Bone Morphogenetic Protein (BMP) for Chondrogenesis in Lipoma
Authors: Nakano Mineo , Arai Eiichi , Nakajima Yuji , Nakamura Hiroaki , Miyazono Kohei , Hirose Takanori
Published: July 2014

To clarify the pathogenesis of chondrolipoma, we examined the expressions and localizations of TGF‐β1, ‐β2, ‐β3, BMP, and LTBP‐1 in our rare case by immunohistochemical staining, and compared them with the staining patterns seen in normal human tracheal cartilage tissue and osteochondroma (controls). In the present case, there was weak TGF‐β1 expression in both lacuna and spindle cells around the cartilage, intense TGF‐β2 expression in both lacuna and spindle cells, and weak‐to‐moderate TGF‐β3 expression in the spindle cells. In lacuna cells, LTBP‐1 was expressed moderately and BMP intensely. In contrast, the normal cartilage showed weak‐to‐moderate expressions of TGF‐β2, ‐β3, and BMP in the lacuna cells with zero‐to‐weak TGF‐β2 and zero‐to‐moderate TGF‐β3 expressions in the spindle cells, while LTBP‐1 was negative in both lacuna and spindle cells. Osteochondroma cases showed moderate‐to‐intense expressions of TGF‐β2, ‐β3, and BMP in the lacuna cells, while LTBP‐1 was positive in the lacuna cells and negative in the spindle cells. These findings suggest that the pattern of expression of TGF‐βs, LTBP‐1, and BMP may be important in the pathogenesis of chondrolipoma.
Report of a Turkish Child with Sjögren‐Larsson Syndrome Associated with Peripheral Nerve Involvement
Authors: Akdeniz Necmettin , Çalka Ömer , Anlar Ömer , Akbayram Sinan , Çaksen Hüseyin , Metin Ahmet , Çinal Adnan
Published: July 2014

Sjögren‐Larsson syndrome is a rare hereditary neurocutaneous disorder characterized by ichthyosis, spastic di‐ or tetra‐plegia, and mild to moderate mental retardation. In this article, we present a nine‐year‐old girl with the classical features of the syndrome associated with peripheral nerve involvement because of its rare presentation. To the best of our knowledge, only three cases of Sjögren‐Larsson syndrome with peripheral nerve involvement have been previously reported in the literature. We assume that Sjögren‐Larsson syndrome involves extensive disorders of the ectodermal tissues, including the peripheral nerves as well as the skin and the central nervous system.
Relapsing Ulcerative Papules over Bilateral Hands and Scrotum in an Asian Man: An Atypical Manifestation of Primary Cutaneous CD30‐Positive Lymphoma
Authors: Lan Cheng‐Che E. , Yu Hsin‐Su , Cheng Shih‐Tsung , Chen Gwo‐Shing
Published: July 2014

A 33‐year‐old Taiwanese man presented at our clinic with multiple erythematous ulcerated papules over his bilateral hands. CD30‐positive anaplastic large cell lymphoma (CD30+ ALCL) was diagnosed by an incisional biopsy. After a thorough survey for extracutaneous involvement, the diagnosis of primary cutaneous CD30+ ALCL was established. Due to spontaneous regression of some skin lesions, the patient refused therapeutic intervention. Subsequently, an ulcerative nodule arose over the scrotum. It spontaneously regressed 5 weeks later. Although histologically alarming, this particular lymphoma bears favorable prognosis. Thus, recognition of this entity is of great importance, because it may prevent patients from undergoing unnecessary aggressive treatment. To our knowledge, CD30+ ALCL has not been reported to evolve in the pattern similar as observed in our patient. Thus, this Asian man presents a rare presentation of CD30+ ALCL.
Basal Cell Carcinoma on the Right Hallux
Authors: Matsushita Kiyomi , Kawada Akira , Aragane Yoshinori , Tezuka Tadashi
Published: July 2014

Basal cell carcinomas (BCCs) usually develop in sun‐exposed areas. The finger, toe, and nail unit are very rare sites of BCC. We describe a patient with BCC on the right hallux. Clinically, it appeared as a brown‐colored small plaque with an irregular border on the nail fold and dorsum of the right hallux. Histopathological findings were consistent with the superficial type of BCC.
Expression of Basic Fibroblast Growth Factor, Vascular Endothelial Growth Factor, and Thrombospondin‐1 Related to Microvessel Density in Nonaggressive and Aggressive Basal Cell Carcinomas
Authors: Oh Chang‐Keun , Kwon Yoo‐Wook , Kim You‐Sun , Jang Ho‐Sun , Kwon Kyung‐Sool
Published: July 2014

The aggressive forms of basal cell carcinoma (BCC) are biologically different in a number of features from their nonaggressive counterparts. The expression of basic Fibroblast Growth Factor (bFGF), Vascular Endothelial Growth Factor (VEGF), and Thrombospondin‐1 (TSP‐1) was examined in primary culture samples of nonaggressive and aggressive BCCs. We studied the relationship between neoangiogenesis by counting microvessels, tumor aggressiveness, and the expression of three different angiogenic factors. bFGF mRNA was detectable in all BCC samples, but there was no significant difference in the levels of expression between the two types. VEGF mRNA was also detectable in all BCC samples. VEGF expression in the aggressive type was approximately 3.5‐fold higher than in the nonaggressive type. TSP‐1 expression was variable and not related to the type of BCC. The mean value of microvessel density (MVD) was significantly higher for the aggressive type than for the nonaggressive type. There was a significant correlation between VEGF levels and MVD. No significant relationships were found between bFGF, TSP‐1 mRNA expression, and MVD. In conclusion, the results of present study suggest that VEGF expression and angiogenesis might play important roles in the progression to aggressive BCC.
A Cardiac Allograft Recipient with Bowen's Disease on a Finger and Concurrent Perianal Bowenoid Papulosis
Authors: Ibe Miha , Kawase Masaaki , Ishiji Takaoki , Kamide Ryoichi , Niimura Michihito
Published: July 2014

We report a patient who developed Bowen's disease of the finger and bowenoid papulosis of the perianal area after cardiac transplantation. Human papillomavirus (HPV) type 16 only, not any skin‐related or epidermodysplasia verruciformis‐related types, was detected in both lesions by in situ hybridization and polymerase chain reaction. The same virus type was identified in both the tumor of the finger and the perianal area, which suggests contact transmission. HPV 16 has often been associated with malignant changes and may be at least one source of the malignancies that are more common in immunosuppressed patients. The presence of a potentially oncogenic type of the HPV in an immunosuppressed patient highlights the importance of regular follow‐up of such patients.
Inguinal Keratotic Basal Cell Carcinoma Mimicking Giant Solitary Trichoepithelioma
Authors: Şahin Mustafa Turhan , Demir Mehmet Akif , Kaya Yavuz , Can Mine , İnanir Işil , Öztürkcan Serap
Published: July 2014

Keratotic basal cell carcinoma may not only clinically but also histologically share more or less the same features with giant solitary trichoepithelioma. It can be difficult to distinguish these two entities from each other, even for an experienced dermatopathologist. We present an unusual case of inguinal keratotic basal cell carcinoma mimicking giant solitary trichoepithelioma in a 56‐year‐old woman with a finger‐like tumor of 20 years duration. The patient presented with an asymptomatic, skin colored, firm, nonulcerative, nodular lesion. Scanty mitotic activity and apoptotic cells were the histopathologic findings against basal cell carcinoma, whereas absence of papillary mesenchymal bodies, presence of peritumoral lacunae detected only around the solid areas, and accumulation of amyloid‐like hyalinized material were the findings in favor of basal cell carcinoma. This case illustrates that keratotic basal cell carcinoma must be taken into account in the differential diagnosis of inguinally located solitary, polypoid masses, especially giant solitary trichoepithelioma.
Disseminated Cellulitic Cryptococcosis in the Setting of Prednisone Monotherapy for Pemphigus Vulgaris
Authors: Yoo Simon S. , Tran Mark , Anhalt Grant , Barrett Terry , Vonderheid Eric C.
Published: July 2014

Cryptococcal infections are seen mainly in immunocompromised hosts. The cutaneous manifestations of infection can include papules, plaques, nodules, vesicles, ulcers, ecchymosis, and, rarely, cellulitis. Cryptococcal meningitis is a life‐threatening complication of this disease. Pemphigus vulgaris is a rare auto‐immune blistering disease that can also be life‐threatening. Treatment of pemphigus commonly entails both corticosteroids and steroid‐sparing agents. We present a case of disseminated cryptococcal infection in a patient with pemphigus vulgaris treated with high dose corticosteroids as monotherapy. This case provides an opportunity to discuss the difficulty of managing two potentially mortal conditions in which the treatment of pemphigus vulgaris may exacerbate the disseminated cryptococcal infection.
Unilesional Mycosis Fungoides Mimicking Bowen's Disease
Authors: Yoo Simon S. , Viglione Michael , Moresi Margaret , Vonderheid Eric
Published: July 2014

Cutaneous T‐cell lymphoma includes a heterogeneous group of lymphomas that share the unique feature of T lymphocytes which are tropic to the skin. Clinically, the presentation of this disease is protean and can range from a single lesion to generalized erythroderma. Unilesional mycosis fungoides, a rare variant, is presented here. Its morphology mimicked squamous cell carcinoma in situ, and was refractory to conventional therapies. A review of the treatment of this subset is also presented.