Back issues No.1 - 2004  
  Original Study
  Evaluation of Allergen-Specific IgE Antibodies by MAST in Atopic Dermatitis
Yuh-Ru Huang, Hamm-Ming Sheu
Dermatol Sinica 22 : 1-14, 2004

Background: Increased serum total IgE and specific IgE antibody to ingested or inhaled antigens are one of the main immunological abnormalities in atopic dermatitis(AD). Dietary factors and a variety of inhalants have been implicated in exacerbation of AD. Purpose: The purpose of the present work is to elucidate the prevalence of inhalant, food, fungal and plant allergens in patients with AD in southern Taiwan. Methods: We collected serum samples from 507 patients with AD who were treated at Nat ..................More
  Efficacy and Safety of Tacrolimus Ointment for Patients of Atopic Dermatitis in Taiwan
Yu-Hsin Wu, Hsi-Ching Wang, Tien-Yi Tzung, Ding-Dar Lee, Jui-Lung Shen
Dermatol Sinica 22 : 15-22, 2004

Tacrolimus ointment is a topical non-steroid immunomodulator formulated for patients of atopic dermatitis. In this multi-center, open-labeled, single-drug, 4-week clinical trial, 78 patients of moderate to severe atopic dermatitis in Taiwan were enrolled. During this study, we used 0.03% or 0.1% tacrolimus ointment to assess its efficacy and safety. Significant improvement in physician’s global evaluation of clinical response, eczema area and severity index, percent body surface affected and t ..................More
  Right-left Study Comparing of Tazarotene-petrolatum with Calcipotriol in Chronic Plaque Psoriasis
Jen-Chin Wu, Tien-Yi Tzung, Nei-Jen Hsu, Ya-Hui Chen, Luo-Ping Ger
Dermatol Sinica 22 : 23-34, 2004

In the treatment of plaque psoriasis, tazarotene was known to be effective, but its efficacy in a Taiwanese population has not been reported. Our purpose was to compare the efficacy, side effects and the duration of therapeutic effects of a once-daily tazarotene 0.1% gel plus petrolatum with the standard twice daily calcipotriol 0.005% ointment in the treatment of patients with plaque psoriasis. A total of 23 Taiwanese patients(21 male and 2 female) with 50 pairs of psoriatic lesions were recrui ..................More
  Case Report
  Human Papillomavirus-Associated Bowen’s Diseases of the Neck
Tsung-Hua Tsai , Yu-Hung Wu , Pei-Lun Sun , Hsin-Yi Su , Chin-Yuan Tzen, Hsiu-Chin Chen
Dermatol Sinica 22 : 29-40, 2004

Human papillomavirus(HPV) is known to be involved in the pathogenesis of anogenital cancer. However, it has also been demonstrated in some patients with extragenital Bowen’s disease, mainly on the hands, and it usually involves a mucosal type of HPV. We report a 73-year-old woman who had multiple Bowen’s disease lesions on the nape of her neck. HPV-16 DNA was detected in the lesions by means of PCR and DNA sequence analysis. No anogenital lesions related to HPV infection were present. Period ..................More
  Cat Scratch Disease-A Case Confirmed by Nested Polymerase Chain Reaction
Chi-Fu Kao , Pei-Lun Sun , Yu-Hung Wu , Hsin-Yi Su , Man-Ning Wang
Dermatol Sinica 22 : 35-40, 2004

Cat scratch disease(CSD) is the most common cause of localized chronic lymphadenopathy in children and adolescents in the US, but it is rarely reported in Taiwan. It is transmitted by Bartonella henselae. The diagnosis of CSD is usually made by clinical symptoms and compatible pathological findings. Recently, a serum antibody for B. henselae has been used to confirm the diagnosis; it is present in 88 to 100% patients. We report a 19-year-old female who bred cats and developed a painful inguinal ..................More
  Pemphigus Vulgaris Heralded by Acute Paronychia:A Case Report and Review of the Literature
Hua-en Lee, Wen-Rou Wong, Mei-ching Lee , Hong-Shang Hong
Dermatol Sinica 22 : 41-45, 2004

Acute paronychia, presenting as abscess formation involving the paronychium of the nails, is thought to be an uncommon feature of pemphigus vulgaris(PV). We report a patient with PV who developed acute paronychia of multiple fingernails and toenails, that precede to the exacerbation of other mucocutaneous lesions. A biopsy specimen of the paronychium of the finger revealed suprabasal acantholysis with pustule formation. Direct immunofluorescence study of the same lesion showed intercellular depo ..................More
  Sporotrichosis-like Dermatosis Caused by Mycobacterium avium complex—A Case Report
Guan-Yu Chen, Jing-Jou Yan, Heng-Leong Chan, Hamm-Ming Sheu
Dermatol Sinica 22 : 46-52, 2004

We report a case of cutaneous atypical mycobacteriosis in a 30-year-old female due to Mycobacterium avium complex. The skin lesions were three enlarging subcutaneous tender nodules with ulceration over right thigh and knee in a sporotrichoid pattern. Histopathological examination revealed irregular epidermal hyperplasia with a dense mixed cell infiltrate composed of neutrophils, lymphocytes, plasma cells, eosinophils and multi-nucleated giant cells. The Gomori methenamine silver stain fails to d ..................More
  Cutaneous Mucormycosis—A Case Report
Fu-Sen Hsieh, Mark Ming-Long Hsu, J Yu-Yun Lee , Wen-Chieh Chen
Dermatol Sinica 22 : 53-58, 2004

Cutaneous mucormycosis is an uncommon fungal infection, occurring mainly in immunosuppressed and diabetic patients, leading to mortality if adequate treatment is delayed. It could also happen in normal healthy person after localized trauma. Here we report a case of cutaneous mucormycosis manifesting as a painful erythematous papule, rapidly progressing to necrotic ulcer with eschar formation. Treatment was initiated with extensive surgical debridement, intravenous amphotericin B, and oral itraco ..................More
  Psoriasis with Systemic Lupus Erythematosus and Subacute Cutaneous Lupus Erythematosus—Report of a Case
Hsin-Chieh Tang, Jia-Tsun Yen Chih-Yi Lin
Dermatol Sinica 22 : 59-63, 2004

Photosensitive disorders should be considered in patients with psoriasis who have photosensitivity. We reported a rare case of psoriasis combined with systemic lupus erythematosus and subacute cutaneous lupus erythematosus. A 27-year-old female presented with several annular plaques on the upper back for one month. Other dermatologic findings revealed erythematous plaques with mild scaling on the scalp. The patient also already has had psoriasis for 8 years. According to the American College of ..................More
  Cutaneous Chloroma(Granulocytic Sarcoma)—A Case Report and Review of the Literature
Hsin-Yi Lin , Hsu-Jung Hsieh , Tzei-Yi Lin
Dermatol Sinica 22 : 64-68, 2004

Chloroma is a rare green tumor that occurs in extramedullary sites. It is composed of myeloid series cells and may present in patients with acute or chronic leukemia and myelodyslastic syndromes, and in aleukemic patient as well. Chloroma is usually misdiagnosed as malignant lymphoma. Histopathology and immunohistochemistry help provide an accurate diagnosis. We present a case of a 51-year-old woman who noted a progressive enlargement of a green plaque over the left nasal ala. Skin biopsy showed ..................More
  Uterine Leiomyosarcoma Metastatic to the Scalp—A Case Report and Review of the Literature
Chun-Hua Wang , Gwo-Shing Chen , Hui-Hua Hsia* , Sheau-Fang Yang
Dermatol Sinica 22 : 69-73, 2004

Leiomyosarcoma is an uncommon neoplasm. It occurs more frequently in the uterus, retroperitoneal space, stomach and large vessels. Metastatic leiomyosarcomas to the skin, in general, are extremely rare. Herein, we describe a patient with leiomyosarcomas of uterus who developed multiple cutaneous metastatic leiomyosarcomas on the scalp over the duration of one year. The diagnosis was confirmed by histopathological and immunohistochemical studies, which showed the tumor positively stained for desm ..................More
  Mixed Merkel Cell and Squamous Cell Carcinoma on the Skin—A Case Report
Chih-Chiang Chen, Han-Nan Liu
Dermatol Sinica 22 : 74-78, 2004

Merkel cell carcinoma is a rare primary neuroendocrine skin tumor that usually arises in the head and neck of elderly patients. Local recurrence and metastasis are common and the mortality rate has been reported to be as high as 30%. There is a high incidence(25-34%) of coexistence with second neoplasm, including other skin tumors and hematological malignancies in patients with Merkel cell carcinoma. However, mixed Merkel cell and squamous cell carcinoma in the same lesion is very rare. Herein w ..................More
  Malignant Peripheral Nerve Sheath Tumor of the Skin in Various Presentation
Hui-Wen Cheng , Chia-Yi Yang , Kai-Yam Ng , Fen-Yi Sung , Ting-An Chang
Dermatol Sinica 22 : 79-87, 2004

Malignant peripheral nerve sheath tumor(MPNST) was a spindle cell sarcoma, which could arise from nerve tissue, neurofibroma or showing nerve sheath differentiation. Cutaneous MPNST was especially rare compared with the tumors of deep soft tissue. Microscopically, all tumor cells revealed irregular contours, high cellularity and pleomorphism, located mainly in the dermis. These tumor cells were all with wavy or comma-shaped nuclei arranged in storiform or fascicular pattern. Hyperchromatism and ..................More
  Necrotizing Sialometaplasia Affecting the Upper Lip: A Sheep in Wolf’s Clothing
Ta-Tung Lee , Ming-Yu Lee , Ho-Hsing Chang , J Yu-Yun Lee
Dermatol Sinica 22 : 88-92, 2004

Necrotizing sialometaplasia(NS) is a self-limited inflammatory disease mainly involving minor salivary glands. The clinical and histological resemblance to malignancy, such as squamous cell carcinoma and mucoepidermoid carcinoma, makes this entity important. Lips are rarely involved. A 39-year-old man presented with a deep-seated nodule with central ulceration of the upper lip for a three-month duration. The tumor was biopsied followed by excision after an initial report of low-grade mucoepiderm ..................More
  Vitiligo Universalis Associated with Evans Syndrome and Antiphospholipid Syndrome—A Case Report and Review of the Literature
Chih-Hsiung Yang, Chia-Yu Chu, Sung-Jan Lin
Dermatol Sinica 22 : 93-99, 2004

The pathogenesis of vitiligo has been proposed as a destruction of melanocytes by autoimmune processes. Evans syndrome is the combination of autoimmune hemolytic anemia and immune-mediated thrombocytopenia. The antiphospholipid syndrome is characterized by arterial/venous thrombosis, recurrent pregnancy loss, or thrombocytopenia in the presence of antiphospholipid antibodies. We present a case of vitiligo universalis associated with Evans syndrome and antiphospholipid syndrome, the association o ..................More
  Resident Forum
  One Indurated Tumor on the Right Thigh in a 50-year-old Patient
Hsin-Chieh Tang , Tun-Yuan Liu , Chia-Chun Kao
Dermatol Sinica 22 : 100-101, 2004

CASE REPORT One 50-year-old female complained of one painless skin lesion over the right thigh for 6 months. Dermatologic examination showed one ill-defined, indurated, erythematous to violaceous subcutaneous nodule on the medial side of the right thigh for 6 months(Fig. 1). She denied any systemic disease. Nobody had the similar skin lesions in her family. Other physical examination did not show any abnormal findings such as lymphoadenopathy or hepatosplenomegaly. Pathologic examination reve ..................More
  A digital painful nodule in a 52 years old lady
Feng-Sheng Kuo, Tsen-Fang Tsai, Yu-Fu Chen, Chih-Ming Hung
Dermatol Sinica 22 : 102-103, 2004

Case Report A 52 year-old lady visited our out patient clinic due to localized pain of her right index without previous traumatic history. A 0.8x0.8 cm fresh colored elastic tender nodule was noted on her pulp of her right index (Fig.1). The pain was not radiating in character and was not associated with sensory abnormality. The flexion and extension of her index were not impaired. We excised the nodule under local anesthesia. The histopathology of the excised nodule was shown in figure. 2. The ..................More
  Recalcitrant Scalp Pruritus in a 3-year-old Girl
Fu-Sen Hsieh, Mark Ming-Long Hsu
Dermatol Sinica 22 : 104-105, 2004

Case Report A 3 year-old healthy girl complained of scalp itching and irritation for several weeks. The treatment at dermatologic clinics showed little or no effect. Careful examination at our department revealed many yellow-brown semi-transparent papules(arrow) firmly adherent to scalp(Fig. 1) and some excoriated crust-like lesions on the posterior neck skin. Further inspection revealed several transparent nits(arrowhead) on some hair shafts(Fig. 1). The papular lesions were scraped and exami ..................More
  A Circumscribed Erythematous Plaque on the Scrotum
Feng-Sheng Kuo , Tsen-Fang Tsai , Yu-Fu Chen , Chih-Ming Hung
Dermatol Sinica 22 : 106-107, 2004)

Case Report A 40-year-old male found an asymptomatic annular erythema on the scrotum. It enlarged gradually in half a year. Topical steroid and antifungal agents were given in vain, and he was referred to our hospital. No lesions were found elsewhere. The patient denied local contact of any chemicals. The lesion was excised in total and no recurrence was found. ..................More
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