OBJECTIVE: To explore the changes of collagen fibrosis in the vulva skin of SD rats with lichen simplex chronicus (LSC) after focused ultrasound therapy and explore the mechanism by which focused ultrasound reduces the recurrence of vulvar LSC. METHODS: Fifty female SD rat models of vulvar LSC were established and randomly divided into the treatment group and the control group (=25) for treatment with focused ultrasound and sham treatment, respectively. Before and after the treatment, vulvar skin tissues were sampled to observe the pathological changes with HE staining and assess the density of collagen fibers using Masson staining. The ultrastructure of the collagen fibers in the superficial dermis was observed using transmission electron microscopy. The expressions of notch1 and c-fos in the vulvar tissue were detected by immunohistochemistry and Western blotting. RESULTS: After 4 weeks of focused ultrasound therapy, 16% (4/25) of the rats in the treatment group showed lesion progression to LSIL, 4% (1/25) still had LSC, and 80% (20/25) showed normal vulvar skin. In the control group, progression to LSIL occurred in 19 (76%) rats, 3 (12%) rats still showed LSC, and only 3 (12%) had normal vulvar skin. The difference in the cure rate differed significantly between the two groups ( < 0.05). The density of collagen fibers in the superficial dermis and the expressions of notch1 and c-fos in the vulvar skin were significantly lower in the treatment group than in the control group ( < 0.05). CONCLUSIONS Focused ultrasound therapy can inhibit superficial collagen fibrosis of the dermis by lowering the expressions of notch1 and c-fos in the vulvar skin to reduce the recurrence of vulvar LSC in rats.
Animals ; Female ; Neurodermatitis ; Rats ; Rats, Sprague-Dawley ; Recurrence ; Vulvar Diseases

Introduction: Methotrexate is being given by dermatologists in only extreme cases of skin disorders such as in severe Psoriasis Vulgaris. Strict precautionary measures are done to avoid its well-known adverse effects. An early but less common sign of its toxicity are painful erosions on plaques. Methotrexate is an effective but potentially toxic treatment for different severe dermatologic disorders such as in severe Psoriasis Vulgaris. Meticulous and complete history-taking, physical examination and laboratory work-up to come up with a correct diagnosis as well as, knowledge of indications for treatment, proper dosing, folate supplementa-tion, monitoring, proper referral and early detection of its toxicity are important in order to avoid cutaneous and systemic adverse effects including death. Case Report A case of a 57-year old male with a 2-day history of painful erosions on plaques on both upper and lower extremities after eleven days of taking Methotrexate 2.5mg/tablet one tablet three times a day without folate supplementation. He was then being treated by a general physician as a case of Psoriasis Vulgaris. He was subsequently admitted under the Internal Medicine service due to epigastric pain, nausea, anorexia, generalized body weakness and passage of black tarry stools. He was referred to the Department of Dermatology for the painful erosions on plaques. He expired two days after admission due to Acute Respiratory Failure. Post-mortem Skin punch biopsy was done and revealed chronic eczematous dermatitis consistent with Lichen Simplex Chronicus with superimposed drug induced hypersensitivity reaction.
Neurodermatitis

No abstract available.
Darier Disease* ; Lichens* ; Neurodermatitis*

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neurodermatitis ; physiopathology ; therapy ; Spinal Cord ; physiopathology ; Young Adult

Darier's disease is an autosomal dominant acantholytic skin disorder. The disease is characterized by symmetric distribution of hyperkeratotic papules in seborrheic regions of the skin and nail changes with potential for exacerbation by ultraviolet light, heat, occlusion, or stress. It presents as generalized (hypertrophic or vesiculobullous type) or localized (linear or zosteriform type) condition. A 53-year-old male patient presented with hyperkeratotic verrucous papules on the back that had an onset in childhood. Clinically, his condition resembled lichen simplex chronicus. The lesions were exacerbated by sun exposure or sweating. A 3-mm punch biopsy specimen revealed prominent acantholysis with hyperkeratosis and parakeratosis. Numerous corps grains and corps ronds were present near the granular layer. We report a case of localized Darier's disease mimicking lichen simplex chronicus on the back. The skin lesion improved following treatment with a topical corticosteroid. Localized Darier's disease should be considered as one of the differential diagnoses of lichen simplex chronicus on the back.
Acantholysis ; Biopsy ; Edible Grain ; Darier Disease* ; Diagnosis, Differential ; Hot Temperature ; Humans ; Male ; Middle Aged ; Neurodermatitis* ; Parakeratosis ; Skin ; Solar System ; Sweat ; Sweating ; Ultraviolet Rays

BACKGROUND: Telemedicine can be useful in dermatology on Ulleung island which is 217 km away from Pohang and without dermatologists. OBJECTIVE: The purpose of this study is to measure the effectiveness of telemedicine in treating skin diseases on Ulleung island. METHODS: 33 patients on Ulleung island were examined by a fullmotion real-time video by one dermatologist in a Dongsan hospital of Keimyung University once a week. From June 2011 to June 2012, there have been 53 treatments of telemedicine in 33 patients. RESULTS: 14 diseases were found in 33 patients. The most common disease group was infectious skin disease and eczema in 9 patients. In addition, there were other skin diseases such as acne vulgaris, allergic contact dermatitis, prurigo nodularis, lichen simplex chronicus, malignant melanoma, seborrheic dermatitis, polymorphous light eruption and so on. CONCLUSION: Dermatology favors telemedicine because we had investigated its value and possibilities by clinical experience of telemedicine between Ulleung island and Dongsan medical center in Daegu.
Acne Vulgaris ; Dermatitis, Allergic Contact ; Dermatitis, Seborrheic ; Dermatology ; Eczema ; Humans ; Light ; Melanoma ; Methylmethacrylates ; Neurodermatitis ; Polystyrenes ; Prurigo ; Skin ; Skin Diseases ; Skin Diseases, Infectious ; Telemedicine

Autoerythrocyte sensitization syndrome (AES) was first described by Gardner and Diamond in 1955, when four women with painful bruising were depicted. Patients with AES typically present with the development of recurrent, spontaneous, painful ecchymosis, frequently preceded by a prodrome of pain or itching of the skin. The patients are sensitive to their own red blood cells injected intradermally, and underlying coagulopathies are thought to be absent. We introduce a 70-year-old woman presenting with recurrent episodes of painful bruising on the trunk and extremities.
Aged ; Diamond ; Ecchymosis ; Erythrocytes ; Extremities ; Female ; Humans ; Neurodermatitis ; Pruritus ; Skin

Acupuncture, Ear ; methods ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Neurodermatitis ; therapy

BACKGROUND: Several studies have been performed to evaluate the efficacy of dietary n-3 fatty acid for patients with renal dysfunction. While about 40% to 80% of patients with end-stage renal disease (ESRD) complain about pruritus and xerosis, there are few reports on the effects of topical n-3 fatty acid on these symptoms. OBJECTIVE: In order to investigate the possible beneficial effects of topical n-3 fatty acid, oils extracted from chia (Salvia hispanica) seed were formulated into topical products, the effects of which were measured. METHODS: Five healthy volunteers having xerotic pruritus symptoms and 5 patients with pruritus caused by either ESRD or diabetes were involved in this study. A topical formulation containing 4% chia seed oils were applied for an 8-week duration. Subjective itching symptoms were assessed on a 6-point scale, as were other skin functions, namely transepidermal water loss and skin capacitance. RESULTS: After the 8 weeks of application, significant improvements in skin hydration, lichen simplex chronicus, and prurigo nodularis were observed in all patients. A similar improvement was also observed among healthy volunteers with xerotic pruritus. Improvement of epidermal permeability barrier function and skin hydration, represented by trans-epidermal water loss and skin capacitance, respectively, were also observed. No adverse effects were observed in all the tested patients and volunteers. CONCLUSION: Chia seed oil can be used as an adjuvant moisturizing agent for pruritic skin, including that of ESRD patients.
alpha-Linolenic Acid ; Fatty Acids, Omega-3 ; Humans ; Kidney Failure, Chronic ; Methylmethacrylates ; Neurodermatitis ; Oils ; Permeability ; Polystyrenes ; Prurigo ; Pruritus ; Seeds ; Skin ; Water Loss, Insensible

Reactive Perforating Collagenosis (RPC) is a kind of perforating dermatosis, which shows transepidermal elimination of altered collagens. Acquired form is developed in an adult without family history, is favorably developed in scratched region due to pruritic sense. Acquired RPC has been reported to be associated with various systemic disorders, such as diabetes mellitus, liver disease, chronic renal failure, lymphoma, AIDS, hypothyroidism, hyperparathyroidism, and neurodermatitis, accompanied by itching & scratching. We report a case of acquired RPC in a patient with HCV hepatitis who was treated with interferon alpha. Skin lesions showed multiple erythematous centrally umbilicated, crusted papules of variable sizes on the extensor surfaces of both shins.
Adult ; Collagen ; Diabetes Mellitus ; Hepatitis ; Humans ; Hyperparathyroidism ; Hypothyroidism ; Interferon-alpha ; Interferons ; Kidney Failure, Chronic ; Liver Diseases ; Lymphoma ; Neurodermatitis ; Pruritus ; Skin ; Skin Diseases