The acquired immunodeficiency syndrome patients with compromised immunity are prone to hemophagocytic syndrome secondary to opportunistic infections.This paper reports a rare case of hemophagocytic syndrome secondary to human parvovirus B19 infection in an acquired immunodeficiency syndrome patient,and analyzes the clinical characteristics,aiming to improve the diagnosis and treatment of the disease and prevent missed diagnosis and misdiagnosis.
Humans ; Lymphohistiocytosis, Hemophagocytic/drug therapy* ; Erythema Infectiosum/complications* ; Acquired Immunodeficiency Syndrome/complications* ; Parvoviridae Infections/diagnosis* ; Parvovirus B19, Human

The stomach is the most common primary site of an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type, which is characterized by an indolent clinical course. A diagnosis of gastric MALT lymphoma requires an endoscopic biopsy that should be confirmed by an experienced pathologist. Gastric MALT lymphoma shows a variable endoscopic appearance, including erosion, erythema, discoloration, atrophy, ulcer, and subepithelial lesion. The distribution is often multifocal. Therefore, clinical suspicion and multiple biopsies are essential for an accurate diagnosis. Gastric MALT lymphoma is almost invariably associated with a Helicobacter pylori (H. pylori) infection. H. pylori eradication therapy is the mainstay of treatment, which must be delivered to all patients regardless of the H. pylori infection status or stage. For patients who have failed to achieve remission following eradication therapy, radiotherapy or chemotherapy can be considered. Radiotherapy is an effective treatment modality for a localized stage and shows excellent outcomes. In the presence of disseminated or advanced disease, chemotherapy and/or immunotherapy with the anti-CD20 monoclonal antibody, rituximab, can be applied. Treatment should be individualized according to the stage and symptoms, as well as the patients' preference. Given that the clinical course of gastric MALT lymphoma is usually indolent, watchful waiting may be an adequate strategy in selected cases where scheduled follow-up is guaranteed.
Atrophy ; Biopsy ; Diagnosis ; Drug Therapy ; Erythema ; Follow-Up Studies ; Helicobacter pylori ; Humans ; Immunotherapy ; Lymphoma, B-Cell, Marginal Zone ; Radiotherapy ; Rituximab ; Stomach ; Ulcer ; Watchful Waiting

Chemotherapy-induced acral erythema (CIAE) is an uncommon, self-limited local skin reaction that usually occurs after high-dose chemotherapy. There is no specific treatment for this disease and it disappears within three to five weeks. In this case report, we present a 16-year-old female with acute lymphoblastic leukemia who developed severe CIAE. The lesions appeared as a well-defined erythema of the hands, feet, and back with symmetrically well-defined borders 5 days after low-dose MTX treatment. The erythema progressed to bullae formation and desquamation. It resolved spontaneously within 2 weeks. CIAE is very uncommon in children; however we should consider acral erythema as a differential diagnosis when bullous skin reaction occurs in a patient who receives chemotherapy.
Adolescent ; Child ; Diagnosis, Differential ; Drug Therapy ; Erythema ; Female ; Foot ; Hand ; Hand-Foot Syndrome ; Humans ; Methotrexate ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Skin

Rosacea is a common chronic cutaneous disorder that primarily occurs on the convex surfaces of the central face and is often characterized by exacerbations and remissions. A case of a 52-yr-old woman visited our clinic in February 2008 complaining typical features of rosacea including multiple pinhead to rice-sized erythematous papules. We applied various conventional treatments including topical benzoyl peroxide and metronidazole as well as oral metronidazole, isotretinoin, and doxycycline. The lesions were not controlled but were rather aggravated by complications from these treatments. Therefore, we prescribed oral azithromycin, which has anti-inflammatory effects and reduces reactive oxygen species. Ten weeks after the administration of oral azithromycin, 500 mg per day for 2 weeks, the lesions had mostly disappeared and no specific side effects related to the azithromycin were noted. Oral azithromycin dosing 500 mg/day for 2 weeks is effective for treatment of intractable rosacea.
Administration, Oral ; Azithromycin/administration & dosage/pharmacology/*therapeutic use ; Erythema/diagnosis/drug therapy ; Female ; Humans ; Middle Aged ; Reactive Oxygen Species ; Rosacea/diagnosis/*drug therapy ; Skin Diseases/drug therapy

Erythema nodosum is the most common form of septal panniculitis and the most frequent skin manifestation associated with inflammatory bowel disease, affecting up to 15% of Crohn's disease patients. Since the development of erythema nodosum is closely related with a variety of disorders and condition, it can serve as an important early sign of systemic disease. Here, we present the occurrence of erythema nodosum as an early sign of Cronh's disease in a 16-year-old woman.
Adolescent ; Anti-Inflammatory Agents/therapeutic use ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/complications/*diagnosis/drug therapy ; Erythema Nodosum/complications/*diagnosis/pathology ; Female ; Humans ; Mesalamine/therapeutic use ; Prednisolone/therapeutic use ; Skin/pathology

Erythropoietic protoporphyria (EPP) is a rare disorder of heme biosynthesis caused by mutations in the gene encoding the enzyme ferrochelatase. In EPP, deficient ferrochelatase activity leads to the excessive production and biliary excretion of protoporphyrin (PP). The major clinical features of EPP are photosensitivity and hepatobiliary disease that may progress to severe liver disease, that are caused by the toxicity of PP. EPP-related liver disease has been treated medically or surgically including liver transplantation. We described a 20-year-old male with severe liver disease who was diagnosed with EPP based on clinical and laboratory findings. He was treated with cholestyramine resin. Six months after the treatment, he was doing well without any abdominal pain or photosensitivity.
Bilirubin/blood ; Cholestyramine Resin/*therapeutic use ; Edema/complications ; Erythema/complications ; Ferrochelatase/genetics/metabolism ; Humans ; Liver Diseases/complications/*diagnosis/pathology ; Male ; Protoporphyria, Erythropoietic/complications/*diagnosis/drug therapy ; Protoporphyrins/metabolism ; Young Adult

PURPOSE: Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin, and erysipelas of upper extremity following breast cancer treatment has never been reported in the Korean literature. METHODS: 39-year-old female presented to our hospital complaining of fever and painful swelling of her left upper extremity. She had a history of breast cancer and was treated with breast conserving surgery with axillary lymph node dissection, chemotherapy, and radiation. On physical examination, her left upper extremity showed vesicle, bullae, local heatness and erythema with well-defined margin. With these distinctive features of a skin lesion, we gave a diagnosis of erysipelas and started treatment with intravenous antibiotics. RESULTS: Resolution of the signs and symptoms of erysipelas occurred after 7 days of treatment. CONCLUSION: The diagnosis of erysipelas with distinctive feature of skin lesion is essential and we emphasize that the prevention of any trauma are very important in these patients for prophylactic measures.
Adult ; Anti-Bacterial Agents ; Bacterial Infections ; Breast Neoplasms* ; Breast* ; Dermis ; Diagnosis ; Drug Therapy ; Erysipelas* ; Erythema ; Female ; Fever ; Hot Temperature ; Humans ; Lymph Node Excision ; Mastectomy, Segmental ; Physical Examination ; Skin ; Subcutaneous Tissue ; Upper Extremity*

PURPOSE: Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin, and erysipelas of upper extremity following breast cancer treatment has never been reported in the Korean literature. METHODS: 39-year-old female presented to our hospital complaining of fever and painful swelling of her left upper extremity. She had a history of breast cancer and was treated with breast conserving surgery with axillary lymph node dissection, chemotherapy, and radiation. On physical examination, her left upper extremity showed vesicle, bullae, local heatness and erythema with well-defined margin. With these distinctive features of a skin lesion, we gave a diagnosis of erysipelas and started treatment with intravenous antibiotics. RESULTS: Resolution of the signs and symptoms of erysipelas occurred after 7 days of treatment. CONCLUSION: The diagnosis of erysipelas with distinctive feature of skin lesion is essential and we emphasize that the prevention of any trauma are very important in these patients for prophylactic measures.
Adult ; Anti-Bacterial Agents ; Bacterial Infections ; Breast Neoplasms* ; Breast* ; Dermis ; Diagnosis ; Drug Therapy ; Erysipelas* ; Erythema ; Female ; Fever ; Hot Temperature ; Humans ; Lymph Node Excision ; Mastectomy, Segmental ; Physical Examination ; Skin ; Subcutaneous Tissue ; Upper Extremity*

Myelodysplastic syndrome (MDS) is a heterogenous group of stem cell disorders usually characterized by progressive refractory cytopenias, which could progress to acute myeloid leukemia. MDS may be associated with a wide spectrum of skin lesions, including neoplastic cell infiltration, Sweet's syndrome, pyoderma gangrenosum, erythema elevatum diutinum, vasculitis, and panniculitis. However, erythema nodosum is rarely associated with MDS. Unusual rheumatologic manifestations in patients with MDS also have been reported, which range from asymptomatic serological abnormalities to classic connective tissue disorders such as Sjogren's syndrome, relapsing polychondritis, systemic lupus erythematosus, rheumatoid arthritis and mixed connective tissue disease. However, concurrent erythema nodosum and serositis has rarely been reported. We describe a case of MDS with erythema nodosum and immune-mediated pericardial effusion in a 34-year-old woman.
Adult ; Biopsy ; Diagnosis, Differential ; Erythema Nodosum/*complications/diagnosis/drug therapy ; Female ; Follow-Up Studies ; Glucocorticoids/therapeutic use ; Humans ; Myelodysplastic Syndromes/*complications/diagnosis/drug therapy ; Prednisone/therapeutic use ; Serositis/*complications/diagnosis/drug therapy ; Tomography, X-Ray Computed

BACKGROUND: In Korea, breast cancer is the most common cancer in female and its incidence is increasing recently. Moreover, breast cancer is the most common cutaneous metastasis in female. However, dermatologic disorders manifested in patients with breast cancer have not been investigated yet. OBJECTIVES: Our purpose was to study the clinical characteristics of dermatologic disorders in patients with breast cancer. METHODS: A clinical observation and review of medical records were made by analyzing 359 cases of breast cancer who visited Our Lady of Mercy hospital from 1994 to 2003. Among them, 91 cases of the patients with breast cancer showed dermatologic disorders. Their photographs of cutaneous findings and histologic specimens were reviewed by more than 2 dermatologists. RESULTS & CONCLUSIONS: 1. The mean age at the diagnosis of breast cancer was 48.74+/-11.28 years old. 2. The stages of patients with breast cancer were as follows: stage 0 (4 cases), stage 1 (48 cases), stage 2 (196 cases), stage 3 (94 cases), stage 4 (2 cases), and others (15 cases). 3. The treatments of patients with breast cancer were as follows: surgery (358 cases), radiation therapy (115 cases), chemotherapy (256 cases), combination of chemotherapy and radiation therapy (82 cases), and others (9 cases). 4. The numbers of patients developing cutaneous infections among the patients with breast cancer were as follows: bacterial infection (18 cases), fungal infection (18 cases), and viral infection (14 cases). 5. The numbers of patients developing pruritus and eczema among the patients with breast cancer were as follows: contact dermatitis (7 cases), seborrheic dermatitis (3 cases), neurodermatitis (2 cases), and others (9 cases). 6. The numbers of patients developing treatment-associated dermatologic disorders among the patients with breast cancer were as follows: urticaria (11 cases), radiodermatitis (8 cases), drug eruption (6 cases), and lymphedema (1 case). 7. The number of patients developing skin metastasis among the patients with breast cancer was 10 cases. 8. The numbers of patients developing other dermatologic disorders among the patients with breast cancer were as follows: psoriasis (4 cases), erythema multiforme (2 cases), and others (16 cases). 9. The numbers of patients developing postoperative dermatologic complications were as follows: seroma (28 cases), arm swelling and lymphedema (9 cases), wound infection (6 cases), and others (5 cases).
Arm ; Bacterial Infections ; Breast Neoplasms* ; Breast* ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Diagnosis ; Drug Eruptions ; Drug Therapy ; Eczema ; Erythema Multiforme ; Female ; Humans ; Incidence ; Korea ; Lymphedema ; Medical Records ; Neoplasm Metastasis ; Neurodermatitis ; Pruritus ; Psoriasis ; Radiodermatitis ; Seroma ; Skin ; Urticaria ; Wound Infection