Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of respiratory tract infections in pediatric and adult populations worldwide. M. pneumoniae is also associated with extrapulmonary complications, such as mucocutaneous eruptions. In dermatologic disorders, M. pneumoniae infection is known to be associated with erythema multiforme and Stevens-Johnson syndrome in children and young adults. Recently, several cases with M. pneumoniae-associated mucositis, which lacks typical target lesions, have been reported. The term Mycoplasma-induced rash and mucositis was suggested as a revised version of the term, Mycoplasma pneumoniae-associated mucocutaneous disease, which previously included erythema multiforme and Stevens-Johnsons syndrome. This revision helps to distinguish Mycoplasma-induced rash and mucositis, which has a distinct morphology, mild disease course, and potentially important clinical implications regarding treatment. Herein, we report a patient with Mycoplasma-induced rash and mucositis.
Adult ; Child ; Erythema Multiforme ; Exanthema* ; Humans ; Mucositis* ; Mycoplasma pneumoniae ; Mycoplasma* ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Tract Infections ; Stevens-Johnson Syndrome ; Young Adult

BACKGROUND: Sublingual immunotherapy (SLIT) with house dust mites (HDM) preparation has recently been proven to be beneficial for treating allergic rhinitis and asthma. However, there has been no report regarding the efficacy and safety of SLIT in Korean patients with atopic dermatitis (AD). OBJECTIVE: We intended to investigate the efficacy and safety of SLIT in Korean patients with AD. METHODS: A total of 34 patients with AD and immunoglobulin E (IgE)-proven HDM sensitization (Class ≥3) were recruited. Eczema area and severity index (EASI) score, total serum IgE level, specific IgE assays to Dermatophagoides pteronyssinus, D. farinae, and adverse effects were recorded during follow-up. "Responder" was defined as a patient with ≥30% improvement in EASI score after SLIT. RESULTS: Twenty-three patients continued SLIT for 12 months or more, whereas 3 patients (8.8%) dropped out because of exacerbation of dermatitis, and 8 patients (23.5%) were lost to follow-up. The average duration of SLIT treatment was 22.4 months (range, 12~32 months). EASI scores reduced significantly after 6 months of treatment (p<0.05) compared with those at baseline. A total of 18 patients were determined to be responders to SLIT after 6 months. Total and specific IgE serum levels did not significantly reduce after SLIT. No patients experienced serious adverse events, with the exception of two patients who developed transient lip and tongue swelling. CONCLUSION: Our study demonstrated that SLIT with HDM extracts is effective and tolerable in Korean patients with AD. Further controlled long-term trials are required to reinforce the current results.
Asthma ; Dermatitis ; Dermatitis, Atopic* ; Dermatophagoides pteronyssinus ; Eczema ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Immunoglobulins ; Lip ; Lost to Follow-Up ; Pyroglyphidae ; Rhinitis, Allergic ; Sublingual Immunotherapy* ; Tongue

No abstract available.
Dermatitis*

Tuberous sclerosis complex (TSC) is a neurocutaneous disorder with variable manifestations. The diagnosis is based on clinical criteria, and is divided into definite, probable, and possible TSC. If patients present with mild symptoms, clinicians may hesitate to perform further evaluations because of the high economic burden. A 16-year-old male presented with multiple skin-colored papules on the lower back and buttock. The histopathologic findings were compatible with connective tissue nevi (CTN). No other findings were observed with the exception of one hypomelanotic macule on the left shin. As the patient's parents wished to confirm the diagnosis, genetic testing was performed, and a TSC1 gene mutation was detected. With this genetic result, further evaluations were performed without hesitation. Genetic testing is a sensitive and specific modality for the diagnosis of TSC. We report a case of TSC presenting with CTN only, in which genetic testing was very useful to confirm the diagnosis and to determine the appropriateness of further high-cost studies.
Adolescent ; Buttocks ; Connective Tissue* ; Diagnosis ; Genetic Testing* ; Humans ; Male ; Neurocutaneous Syndromes ; Nevus* ; Parents ; Tuberous Sclerosis*

Notalgia paresthetica (NP) is a chronic localized itch, affecting mainly the inter-scapular area particularly between the T2-T6 dermatomes. Occasionally it has a more widespread distribution and involves the shoulders, back, and upper chest. There are no specific cutaneous signs, apart from those attributed to scratching and rubbing. Various etiologies have been reported, but the cause of NP is not established. The current hypothesis regarding its etiology postulates that a neuropathic itch develops due to nerve entrapment of the posterior rami of spinal nerve arising at T2-T6. Another recent documented case showed an increase in the number of intradermal nerves by neural immunochistochemistry staining of S-100 protein, protein gene product 9.5 (PGP 9.5). Herein, we experienced an uncommon case of NP of the back and tried to clarify pathogenesis by using quantitative sensory testing, such as neurometer and Von-Frey filaments. Also, we performed neural immunochemistry to confirm an increase in nerve fibers at the site of the lesion.
Immunochemistry ; Nerve Compression Syndromes ; Nerve Fibers ; Pregabalin* ; S100 Proteins ; Shoulder ; Spinal Nerves ; Thorax

No abstract available.
Myelodysplastic Syndromes* ; Neutrophils* ; Skin Diseases*

No abstract available.
Acitretin* ; Eczema* ; Hand*

Neutrophilic infiltrates of skin in the setting of lupus patients with bullous systemic lupus erythematosus (SLE) and leukocytoclastic vasculitis are well documented. However, most dermatology studies do not consider cutaneous involvement by SLE in the histologic differential diagnosis of neutrophilic inflammatory dermatosis in non-bullous or non-vasculitic lesions. Nevertheless, an increasing number of studies have reported cell-rich or Sweet's-like neutrophilic reactions as well as patients with skin lesions characterized by paucicellular neutrophilic dermal infiltrates. A 56-year-old female patient with history of lupus nephritis presented with multiple erythematous to brownish papulo-patches and plaques on both legs for 1 month. She had no signs or systemic symptoms of Sweet's syndrome. Histopathologic finding showed perivascular and interstitial neutrophilic infiltration with leukocytoclasia in the upper dermis, but not as dense as commonly observed in Sweet's syndrome with absence of papillary dermal edema. Herein, we present a rare case of non-bullous neutrophilic dermatosis associated with SLE. It is important to consider SLE-associated neutrophilic dermatosis in the differential diagnosis of neutrophilic tissue reactions and to be aware of the broad histologic spectrum that may be encountered in SLE-associated neutrophilic dermatosis, ranging from subtle paucicellular lesions to florid Sweet's-like lesions.
Dermatology ; Dermis ; Diagnosis, Differential ; Edema ; Female ; Humans ; Leg ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Middle Aged ; Neutrophils* ; Skin ; Skin Diseases* ; Sweet Syndrome ; Vasculitis

No abstract available.
Dermoscopy* ; Foreign Bodies*

No abstract available.
Breast Neoplasms* ; Breast*