Ju-Hyun Jo

Pustular psoriasis and the Kobner phenomenon caused by allergic contact dermatitis from zinc pyrithione-containing shampoo.

Zinc pyrithione is a shampoo ingredient that has been shown to be safe and effective for dandruff and scalp psoriasis. It is thought to decrease the cell turnover rate in hyperproliferative dermatoses such as psoriasis, and also has fungistatic and antimicrobial activity, although its exact mode of action is unknown. In psoriasis, external factors, such as trauma, infection and drugs, may provoke aggravated manifestations of psoriatic skin lesions. Rarely, irritant or allergic mechanisms are likely causes of psoriatic flare and Köbnerization. A patient had had stable psoriasis for 25 years and no any other skin disease. Within 20 days, she developed an aggravated scaly erythematous patch on the scalp, where a shampoo had been applied, and simultaneously developed pustular psoriasis on both forearms. Patch testing showed a relevant sensitization to zinc pyrithione, and we observed symptomatic aggravation by provocation testing with zinc pyrithione shampoo. We report a rare case of psoriasis aggravated by the induction of allergic contact dermatitis from zinc pyrithione after using antidandruff shampoo.

A case of severe tongue ulceration and laryngeal inflammation induced by low-dose nicorandil therapy

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Infiltrative Trichilemmal Carcinoma Treated with 5% Imiquimod Cream

Background Trichilemmal carcinoma (TLC) is a rare cutaneous neoplasm that occurs in the sun-exposed skin of the elderly. Although the clinical behavior of TLC appears to be relatively indolent, wide excision or Mohs micrographic surgery is the recommended treatment owing to its locally aggressive growth. Recently, imiquimod has become an important part of the armamentarium in the treatment of nonmelanoma skin cancer. Objective This article serves to remind dermatologists that in addition to Mohs micrographic surgery and surgical excision, imiquimod 5% cream may have a role in the treatment of TLC. Methods In addition to a review of the literature, we present a case of TLC successfully treated with 5% imiquimod cream. Conclusion Its nonsurgical approach and excellent cosmetic result make imiquimod 5% cream another promising therapeutic option for TLC, even though it is histologically infiltrative.

A case of primary erythromelalgia improved by mexiletine

the A ⁄ B rings to the antibody, as those of steroid-glyoxal do. Our results suggest that patients with an immediate hypersensitivity to methylprednisolone, hydrocortisone or prednisolone succinates tolerated oral prednisone, so that intravenous fluorinated glucocorticoids can be reserved for emergencies. As for the steroid-glyoxal affinity to proteins, Wilkinson and Jones found a linear relationship between corticosteroid affinity to arginine, the usage of glucocorticoids and the relative number of corticosteroid contact sensitizations. The authors suggested that the alkaline pH of an altered or wounded skin promotes steroid-glyoxal binding to cutaneous proteins. It is difficult to establish if such a binding occurs also in the blood circulation, where the specific corticosteroidbinding globulin (transcortin) shows no essential arginine residues in the binding sites at neutral blood pH.

A Case of Eccrine Poroma Treated with 5% Imiquimod Cream

To the Editor: Eccrine poroma rarely preceds to the development of porocarcinma and the treatment of choice is conventional surgical excision. However, surgery can be a burden for particular locations and cause cosmetic problems. The new immonomodulator, imiquimod, has been reported to be an effective nonsurgical treatment for nonmelanoma skin cancer, including basal cell carcinoma. This article serves to remind dermatologists that, in addition to surgical excision, imiquimod 5% cream may be an alternative in the treatment of eccrine poroma. In addition to a review of the literature, we present a case of eccrine poroma successfully treated with 5% imiquimod cream. In our case, the response of eccrine poroma occurring in the face to imiquimod was encouraging. The nonsurgical approach and excellent cosmetic results make imiquimod 5% cream an attractive treatment modality for eccrine poroma. A 67-year-old man was referred to our hospital with an asymptomatic, flesh-colored nodule with crusts on his left temple area for accurate diagnosis and treatment (Fig. 1). The lesion had first appeared ten years earlier and then slowly progressed to its present size and shape in the last two years. The adjacent skin was normal, and no regional lymph nodes were palpable. He noted that he did not have any previous treatment history nor a family or past medical history of any cutaneous malignancies. A punch biopsy specimen showed that the tumor was composed of broad columns of uniform basaloid cells extending into the dermis from the undersurface of the epidermis (Fig. 2). These cells were cuboid or ovoid and smaller than the epidermal keratinocytes with which they were in contact. They were periodic acid-Schiff (PAS) positive. He was diagnosed as eccrine poroma. The patient was referred for surgical excision, but he denied any surgical procedure. After he was informed of the diagnosis and treatment options were discussed, treatment with imiquimod was begun three times per week. He was told before treatment that additional surgical intervention, including biopsy, would be necessary if clinical recurrence was suspected. Two weeks after the initiation of treatment, the lesion became The Journal of Dermatology Vol. 32: 691–693, 2005