Syphilitic alopecia (SA) is a rare skin manifestation in secondary syphilis and sometimes indistinguishable from other alopecia. SA is of 2 types, symptomatic and essential, and 3 clinical types, moth-eaten or patchy ...Syphilitic alopecia (SA) is a rare skin manifestation in secondary syphilis and sometimes indistinguishable from other alopecia. SA is of 2 types, symptomatic and essential, and 3 clinical types, moth-eaten or patchy pattern, diffuse pattern and a combination of both. SA in our case indicated symptomatic SA with moth-eaten hairloss. A 46-year-old Japanese homosexual man experienced hairloss followed by the pruritic skin rash. Physical examination of the scalp showed diffusely spread papulosquamous erythema and incomplete hairloss around the lesions. The scalp lesions appeared as “moth-eaten alopecia”. Serological examination for syphilis and HIV were positive. Thus, SA complicated with HIV infection was diagnosed. He was treated with a single perioral dose of ampicillin for 4 weeks, then his condition improved rapidly and hair regrowth occurred. HIV-infected persons show a high incidence of syphilis. Therefore, HIV test should be considered for patients with alopecia.展开更多
Spitz nevus (SN) is predominantly distributed throughout the lower extremities, while an acral location is rare. Since SN occasionally resembles the clinicopathological presentation of malignant melanoma (MM), it pres...Spitz nevus (SN) is predominantly distributed throughout the lower extremities, while an acral location is rare. Since SN occasionally resembles the clinicopathological presentation of malignant melanoma (MM), it presents a diagnostic challenge, especially on glabrous skin. Past reports suggest that several genetic aberrations are associated with specific clinicopathological subtypes of melanocytic tumors. Immunohistochemistry can provide a clue to the presence or absence of a molecular aberration typical of Spitz tumors. We describe a case of a plantar SN with genetic analysis, including anaplastic lymphoma kinase (ALK), ROS proto-oncogene 1 (ROS1), BRAF (V600E) protein, and BRCA1-associated protein-1 (BAP1). However, we were not able to detect a characteristic gene aberration. To the best of our knowledge, no genetic aberrations in plantar SN cases have been reported. A comprehensive understanding of tumor genomics is expected to play an essential role in the classification of melanocytic tumors. Further genetic research on plantar SN is required to establish new criteria for distinguishing between SN and MM.展开更多
We report a 64-year-old female patient with an insulin allergy. She was treated with a combination of oral antihistamines, topical hydrocortisone cream, and moisturizing agents, which resulted in the improvement of ec...We report a 64-year-old female patient with an insulin allergy. She was treated with a combination of oral antihistamines, topical hydrocortisone cream, and moisturizing agents, which resulted in the improvement of eczema and intense pruritus. To evaluate insulin allergy, intradermal skin tests were performed with several insulin agents for clinical use and 0.9% NaCl. Skin testing with semisynthetic human insulin resulted in local, immediate skin reactions such as itchy erythema and wheals. Furthermore, we analyzed our case and 25 Japanese cases of insulin allergy previously reported in the literature as far as we know. Interestingly, the number of male patients was approximately two times higher than that of female, and the insulin-specific IgE antibody test was positive in 21 patients. We should keep the possibility of human insulin allergy in mind and prepare for it when initiating human insulin therapy.展开更多
文摘Syphilitic alopecia (SA) is a rare skin manifestation in secondary syphilis and sometimes indistinguishable from other alopecia. SA is of 2 types, symptomatic and essential, and 3 clinical types, moth-eaten or patchy pattern, diffuse pattern and a combination of both. SA in our case indicated symptomatic SA with moth-eaten hairloss. A 46-year-old Japanese homosexual man experienced hairloss followed by the pruritic skin rash. Physical examination of the scalp showed diffusely spread papulosquamous erythema and incomplete hairloss around the lesions. The scalp lesions appeared as “moth-eaten alopecia”. Serological examination for syphilis and HIV were positive. Thus, SA complicated with HIV infection was diagnosed. He was treated with a single perioral dose of ampicillin for 4 weeks, then his condition improved rapidly and hair regrowth occurred. HIV-infected persons show a high incidence of syphilis. Therefore, HIV test should be considered for patients with alopecia.
文摘Spitz nevus (SN) is predominantly distributed throughout the lower extremities, while an acral location is rare. Since SN occasionally resembles the clinicopathological presentation of malignant melanoma (MM), it presents a diagnostic challenge, especially on glabrous skin. Past reports suggest that several genetic aberrations are associated with specific clinicopathological subtypes of melanocytic tumors. Immunohistochemistry can provide a clue to the presence or absence of a molecular aberration typical of Spitz tumors. We describe a case of a plantar SN with genetic analysis, including anaplastic lymphoma kinase (ALK), ROS proto-oncogene 1 (ROS1), BRAF (V600E) protein, and BRCA1-associated protein-1 (BAP1). However, we were not able to detect a characteristic gene aberration. To the best of our knowledge, no genetic aberrations in plantar SN cases have been reported. A comprehensive understanding of tumor genomics is expected to play an essential role in the classification of melanocytic tumors. Further genetic research on plantar SN is required to establish new criteria for distinguishing between SN and MM.
文摘We report a 64-year-old female patient with an insulin allergy. She was treated with a combination of oral antihistamines, topical hydrocortisone cream, and moisturizing agents, which resulted in the improvement of eczema and intense pruritus. To evaluate insulin allergy, intradermal skin tests were performed with several insulin agents for clinical use and 0.9% NaCl. Skin testing with semisynthetic human insulin resulted in local, immediate skin reactions such as itchy erythema and wheals. Furthermore, we analyzed our case and 25 Japanese cases of insulin allergy previously reported in the literature as far as we know. Interestingly, the number of male patients was approximately two times higher than that of female, and the insulin-specific IgE antibody test was positive in 21 patients. We should keep the possibility of human insulin allergy in mind and prepare for it when initiating human insulin therapy.
