Hee Jin Song

A Case of Cicatricial Alopecia Associated with Erlotinib

Erlotinib is a small-molecule tyrosine kinase inhibitor (TKI) of the epidermal growth factor receptor (EGFR). Erlotinib has been used primarily to treat non-small cell lung cancer. In addition to its role in tumor cells, EGFR is also an important regulator of growth and differentiation in the skin and hair. Therefore, EGFR-TKIs have been associated with a number of cutaneous side effects including follicular acneiform eruptions, cutaneous xerosis, chronic paronychia, desquamation, seborrheic dermatitis, and hair texture changes. Herein, we report a rare case of a 61-year-old woman who was treated with erlotinib and experienced cicatricial alopecia.

Photodistributed telangiectasia induced by amlodipine.

Calcium channel blockers are widely used antihypertensive drugs, which are uncommonly associated with cutaneous reactions, such as pruritus, urticaria, or alopecia. Photosensitivity presenting with telangiectasia has rarely been described. We present here a case of photodistributed telangiectasia induced clinically by amlodipine and histologically by enlarged capillaries in the upper dermis without signs of vasculitis.

Red scrotum syndrome: successful treatment with oral doxycycline.

References 1 Taïeb A, Picardo M. VETF Members, the definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force. Pigment Cell Res 2007; 20: 27–35. 2 Dawid M, Veensalu M, Grassberger M, et al. Efficacy and safety of pimecrolimus cream 1% in adult patients with vitiligo: results of a randomized, double-blind, vehiclecontrolled study. J Dtsch Dermatol Ges 2006; 4: 942–946. 3 Radmanesh M, Saedi K. The efficacy of combined PUVA and low-dose azathioprine for early and enhanced repigmentation in vitiligo patients. J Dermatolog Treat 2006; 17: 151–153. 4 Patel DC, Evans AV, Hawk JLM. Topical pseudocatalase mousse and narrowband UVB phototherapy is not effective for vitiligo: an open, single-centre study. Clin Exp Dermatol 2002; 27: 641. 5 Schallreuter KU, Moore J, Behrens-Williams S, et al. Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase. Int J Dermatol 2002; 41: 482–487.

A Case of Neutrophilic Dermatosis of the Dorsal Hands with Concomitant Involvement of the Lips

Neutrophilic dermatosis of the dorsal hands (NDDH) is a localized, pustular variant of acute febrile neutrophilic dermatosis (Sweet syndrome). The lesions of NDDH clinically resemble those of Sweet syndrome (SS), but they differ from classic SS according to their locations (NDDH is predominantly restricted to the dorsal hands) and the smaller number of accompanying systemic symptoms. The histology of the NDDH lesion shows a dense dermal neutrophilic infiltration. The lesions rapidly resolve after systemic corticosteroid and/or dapsone therapy. We herein report on a case of neutrophilic dermatosis of the dorsal hands in a 34-year-old woman. The patient also had skin changes with erythematous plaque on the right lips.

Acral angioosteoma cutis.

Acral angioosteoma cutis is a benign lesion of unknown pathogenesis and is a newly described, distinct entity from other cutaneous lesions. It is clinically characterized by an exophytic lesion resembling pyogenic granuloma on the acral skin, combined with histologic findings of multiple tiny spicules composed of woven bone between well-formed capillaries proliferating in the superficial dermis. Here, we present a case of acral angioosteoma cutis on the left third toe of a 58-year-old woman, which was successfully treated by excision.

A case of pincer nail treated using a shape-memory alloy.

A pincer nail deformity can be described as an increase in the transverse curvature along the longitudinal axis of the nail. The curvature increases from the proximal to the distal aspect, leading to a pinching of the involved digits. Treatment of pincer nails using a shape-memory alloy (K-D, S&C Biotech, Seoul, South Korea) is a simple treatment that makes it possible to retain the normal shape of the nails without removing them, allowing the patient to conduct his or her daily activities after treatment.

Bone marrow-derived mesenchymal stem cells prevent alopecia areata development through the inhibition of NKG2D expression: a pilot study.

Hair follicle (HF) is an immuneprivileged site. When the HF immune privilege is collapsed, CD4 and CD8 T cells, and some natural killer (NK) cells, accumulate around the autoantigens of the hair bulb and contribute to the development of alopecia areata (AA).[1] Th1 cytokines and chemokines, such as interferon (IFN)G, CXCL9 and CXCL10, are predominantly detected in AA lesions and might induce the collapse of the hair follicle immune privilege.[2,3] Recent studies have shown that a NK cell receptor, NKG2Dmediated signalling, has been strongly associated with the pathogenesis of AA.[4] The antibodymediated blockade of IFNG prevented AA development in grafted mice and blocked the accumulation of CD8+NKG2D+ T cells in the skin.[5] According to recent conceptions of pathology, the restoration or prevention of the collapse of HF immune privilege eventually leads to a more effective management of AA. Mesenchymal stem cells (MSCs) show immunomodulatory and antiinflammatory effects on immune cells and are proposed as an approach to immunomodulation therapy, such as chronic inflammation or autoimmune disorders.[6] The effects of MSCs on AA have not yet been studied.

Repeated ultraviolet irradiation induces the expression of Toll-like receptor 4, IL-6, and IL-10 in neonatal human melanocytes

Human melanocytes express Toll‐like receptor 4 (TLR4), which regulates ultraviolet (UV)‐induced cutaneous immunosuppression in Langerhans cells. Lipopolysaccharide (LPS) stimulation increases melanocyte pigmentation and TLR4 expression, while inducing local innate inflammatory responses.