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A 76-year-old man was admitted to our hospital with Guillain-Barré syndrome (GBS), presenting with facial palsy, dysarthria, and dysphagia as Grade 3 immune-related adverse events (irAEs) due to pembrolizumab administration for Stage IV lung adenocarcinoma. Although prednisolone (1 mg/kg) was started for GBS due to the irAE, dark erythema and skin eruptions appeared on the patient’s torso. Then erosion was observed on 18% of the body surface area and skin biopsy was performed. Finally, the patient was diagnosed with Stevens-Johnson syndrome/toxic epidermal necrosis overlap. Intravenous immunoglobulin therapy was started, and the skin symptoms improved, with the erosion becoming epithelial. He died of aspiration pneumonia related to GBS, although his neurological symptoms had improved after steroid and intravenous immunoglobulin therapy. This is the first reported case of pembrolizumab-induced GBS and Stevens–Johnson syndrome/toxic epidermal necrosis overlap. It is necessary to be careful that the possibility of other severe irAEs may occur simultaneously.

Abstract is missing (Quiz)

Granuloma faciale (GF) is an uncommon inflammatory dermatosis that is characterized by one or several asymptomatic brown red nodules or plaques usually occurring on the face. GF is known to be extremely resistant to treatment. Various treatments have been attempted, including topical or intralesional or systemic corticosteroids, dapsone, antimalarials, colchicine, topical tacrolimus, and topical psoralen; however, none of these have been found to be reliably efficacious. We tried numerous combinations and rotations of therapeutic modalities for GF over a long time. We described a case of GF in which the eruptions were carefully observed over the course of 14 years before finally resolving. Our experience suggests that continuous and careful follow-up, and trials of combinations and rotations of therapeutic modalities are essential for treating GF.

The article present a case study of an 80‑year‑old Japanese man with hard nodules on the second to fourth fingers of the right hand. Topics include physical examination revealed hard skin coloured to reddish nodules on the right hand and the left side of the forehead; mentions a skin biopsy specimen from the digit showed dermal nodular proliferation of atypical chondrocyte‑like cells; and also mentions the lung tumor specimen showed a biphasic pattern consisting of atypical squamoid cells.

The article discusses a science study on cyanobacterium species 6803 and 7942 conducted to examine whether alternative electron flow (AEF) can replace the photosynthetic electron flux in cyanobacteria. Topics include techniques used, use of open oxygen-electrode system to monitor oxygen-exchange, and quenching of chlorophyll fluorescence. The results show that AEF functioned in 6803 and replaced the photosynthetic electron flux.

Linear IgA/IgG bullous dermatosis (LAGBD) is an autoimmune blistering disease characterized by the local accumulation of IgA- and IgG-class anti-basement membrane autoantibodies. It typically presents as a generalized pruritic vesiculobullous eruption. No cases of localized LAGBD have yet been reported. We report a case of a 78-year-old man with LAGBD localized to the perianal area. The patient complained of suffering from persistent ulcers around the anus for more than 3 years. Physical examination revealed several blisters and ulcers up to 2-cm in diameter around the anus. No lesions were found elsewhere on the body. Histological analysis of a skin biopsy revealed subepidermal blistering, while direct immunofluorescence showed the linear deposition of IgA and IgG antibodies at the dermoepidermal junction. Indirect immunofluorescence of normal human skin whose layers had been separated using 1M NaCl showed the binding of both IgA and IgG to the epidermal side. Immunoblotting demonstrated the presence of circulating IgA and IgG autoantibodies that bound to a 120-kDa protein. This is the first case of localized LAGBD whose skin lesions were restricted to the perianal region. [ABSTRACT FROM AUTHOR]

The article describes cases of older patients with methotrexate-associated lymphoproliferative disorders (MTX-LPD). Topics cited include the cutaneous manifestations of MTX-LPD, association of MTX with Epstein-Barr virus (EBV) positive diffuse large B-cell lymphoma, spontaneous regression of lymphoma after MTX discontinuation, and expression of EBV in tumor cells.

A case study describing the exacerbation of pemphigus foliaceus after electron-beam radiation for extramammary Paget's disease is presented. Topics discussed include the clinical history of the patient, how the diagnosis of pemphigus foliaceus was made, and the necessity of precautions against the exacerbation of pemphigus after irradiation. The need to be aware of the occurrence of pemphigus after irradiation even in cases with no history of blistering diseases is noted.

The article describes a case study concerning a 31-year-old male patient with Kindler syndrome (KS) accompanied by severe intestinal involvement. Topics discussed include multiple blisters and erosions presented by the patient at birth, mutations in the FERMT1 gene that cause KS, and cutaneous features. Also mentioned are intestinal involvement such as colitis and diarrhea in childhood, occurrence of severe late-onset ileal strictures, and genotype correlation.

The article describes a case study concerning a 63-year-old man diagnosed with myelodysplastic syndrome (MDS) and acquired trisomy 8. Topics discussed include the development of oral aphthae, intestinal and genital ulceration and high fever, the symptoms' similarity to those of Behçet's disease (BD), and gene expression patterns. Also mentioned are screening for underlying hematological disorders and better training of dermatologists to examine patients with BD-like mucocutaneous lesions.