Ota's nevus is a mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly occurs unilaterally in areas innervated by the first and second division of the trigeminal nerve. We report a case of Ota's nevus treated by combination therapy with cryosurgery and a Q-switched Alexandrite laser. A 48-year-old female had had a type III Ota's nevus from birth. Cryosurgery was tried at first using hard chalk dry ice on the lesion of the forehead and cheek. After that, The Q-switched Alexandrite laser was used three times at twelve week intervals at the site of the eyelid. Good therapeutic effects were gained and our patient was very satisfied. There were no complications or scarring. A Biopsy of the area treated revealed a similar histological pattern with significantly less melanin indicating melanin removal. Combination therapy with cryosurgery and an Alexandrite laser on the Ota's nevus may be cheaper, more effective and a safer method. It may also reduce the limitation of the two methods when used individually.
Biopsy ; Calcium Carbonate ; Cheek ; Cicatrix ; Cryosurgery* ; Dry Ice ; Eyelids ; Female ; Forehead ; Humans ; Lasers, Solid-State ; Melanins ; Middle Aged ; Nevus of Ota* ; Parturition ; Pigmentation ; Trigeminal Nerve

Vesiculobullous eruptions are a rare cutaneous manifestation of systemic lupus erythematosus (SLE). They are related to intense inflammation within the cutaneous lesions and subsequent blister formation. We report a case of vesiculobullous eruption of SLE in a 23-year-old male. The bullous eruptions were present ori the lip, forehead, both feet and hands. He met ARA(American Rheumatism Association) is criteria for a diagnosis of SLE and the eruptions developed during a systemic attack of the disease. Routine histology of the lesion showed subepidermal blisters with intact epidermis and dense neutrophilic infiltration in the upper dermis. Direct immunofluorescence of lesional skin showed a linear-granular pattern of immune deposits at the dermoepidermal junction. Electronmicroscopy of the lesional skin showing subepidermal bullae are located beneath the lamina densa. Combination therapy of prednisolone and hydrochloroquine showed complete clearing of the lesions within several weeks. We observed a good response without evidence of recurrence.
Blister ; Dermis ; Diagnosis ; Epidermis ; Fluorescent Antibody Technique, Direct ; Foot ; Forehead ; Hand ; Humans ; Inflammation ; Lip ; Lupus Erythematosus, Systemic* ; Male ; Neutrophils ; Prednisolone ; Recurrence ; Rheumatic Diseases ; Skin ; Young Adult

BACKGROUND: Elastic fibers are a major fibrillar component of the extracellular matrix of several organs, and their presence provides elastic properties to these tissues. Recent molecular biological studies also have revealed that accumulation of elastotic material in the skin reflects enhanced synthesis of not only elastin but also a fibrillin, an integral component of the elastic fibers, and steady-state levels of the elastin mRNA increased in photodamaged skin. Futhermore, a variety of cytokines, growth factors, and hormones have been shown to modulate elastin gene expression including transforming growth factor- beta, tumor necrosis factor-a, insulin-like growth factor-I, glucoreorticoids, cyclic AMP, and vitamin D3. Recently, interleukin-1 beta (IL-1 beta) and IL-10 has been shown to up-regulatory function in elastin gene expression. OBJECTIVE: The purpose of this study was to examine the effect of IL-1 beta and IL-10 on elastin gene expression in cultured human fibroblasts. METHODS: Fibroblasts cultures were produced with DMEM medium. Cells were treated with IL-1 p (1U/ml, 10U/ml) and IL-10(0.1ng/ml, 1ng/ml, 10ng/ml) nuclear proteins were extracted. Effect of IL-1 beta and IL-10 on elastin gene expression were measured by Northern blot analysis, chloram- phenicol acetyltransferase(CAT) assay, and laser confocal microscopy. RESULTS: In Northern blot analysis, IL-1 beta and IL-10 showed an up-regulatory effect on elastin mRNA steady-state levels compared with controls incubated without IL-1 p and IL-10. In CAT assay, the percentage of acetylation were increased in cultured fibroblasts. The promoter activities were increased 1.5 and 2.2-fold in IL-1 beta (1U/ml, 10U/ml) and 2.2-fold in IL-10(lng/ml, 10ng/ml) treated fibroblasts compared to control groups. In laser confocal microscopy, the results indicated significant increase in the elastin epitopes associated with the cells in cultured with IL-1 beta and IL-10. CONCLUSION: These results show that IL-1 p and IL-10 increase elastin gene expression on transcriptional and protein levels of cultured fibroblasts. It suggests that they may effect on elastin synthesis by a stage up-regulater in human skin.
Acetylation ; Animals ; Blotting, Northern ; Cats ; Cholecalciferol ; Cyclic AMP ; Cytokines ; Elastic Tissue ; Elastin* ; Epitopes ; Extracellular Matrix ; Fibroblasts ; Gene Expression ; Humans* ; Intercellular Signaling Peptides and Proteins ; Interleukin-1 ; Interleukin-10* ; Interleukin-1beta* ; Microscopy, Confocal ; Necrosis ; Nuclear Proteins ; RNA, Messenger ; Skin

No abstract available.
Aspergillosis* ; Child* ; Humans ; Leukemia

A 38-year-old woman showed pruritic reddish patches, plaques and an indurated mass of 6 year's duration on the face, trunk, back, upper and lower extremities. Histopathological and immunohistochemical findings suggested the diagnosis of mycosis fungoides (tumor stage). She was treated with chemotherapy(CVP regimen) with a mild resolution. Then 6 months later, a skin lesion on the forehead developed in to a tumorous lesion and the truncal lesions got worse. So we tried combination therapy with Retinoid(etretinate 0.5mg/kg/day) and PUVA (Total dose of 228 joules/cm(2)) for 7 months. After 7 months, marked improvement of the skin lesions was noticed. The combination of Retinoid and PUVA was considered a good therapeutic trial for mycosis fungoides of the early advanced stage.
Adult ; Diagnosis ; Female ; Forehead ; Humans ; Lower Extremity ; Mycosis Fungoides* ; Skin