Search

Background/Objectives: Plaque psoriasis is a debilitating condition that significantly affects patient well-being. Limited data are available regarding the effect of psoriasis and treatment on health-related quality of life (HRQoL) and work ability among Taiwanese patients.To document and compare HRQoL, treatment satisfaction, and work disability among Taiwanese patients with current and past moderate-to-severe plaque psoriasis. Methods: This was a multicenter, non-interventional, cross-sectional study of adult patients with moderate-to-severe plaque psoriasis. During a single clinic visit, each patient was assessed for body surface area (BSA) involvement, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), Euro Quality of Life-5 Dimensions (EQ-5D), 10-level satisfaction scale for psoriasis treatment, and Working Productivity and Activity Impairment (WPAI). Multivariate regression was used to identify factors associated with HRQoL and work disability. Results: A total of 305 patients were included within the analysis. The mean PASI score was 11.83, and the mean BSA involvement was 20.90%. The mean EQ-5D score was 65.68 and the mean DLQI score was 12.55. Fewer than half of patients (45.68%) indicated they were satisfied with the standard therapy they were currently receiving. Among employed patients, the mean reduction in on-the-job effectiveness was 32.09% and the mean reduction in overall productivity was 33.48%. The regression analysis indicated that patients with more severe psoriasis defined by PASI scores show a greater impact in quality of life and impairment in work disability; and that patients who were satisfied with current standard treatment had a better quality of life. Conclusion: The effect of psoriasis on HRQoL among patients with psoriasis in Taiwan is substantial, with fewer than half of patients reporting satisfaction with therapeutic options. Keywords: DLQI, EQ-5D, Health-related quality of life, Psoriasis, WPAI

Background/objectives Lymphocytic hidradenitis is a non-specific histopathological feature observed in many dermatoses such as lupus erythematosus, morphea or scleroderma. When it occurs it is usually accompanied by the other distinctive histological features of those conditions. Isolated lymphocytic hidradenitis is uncommon and its clinical features and associated underlying medical conditions are still undetermined. Methods We performed a retrospective review of patients who clinically presented with annular erythema between 2000 and 2016. Altogether, 30 patients with a histopathological presentation of isolated lymphocytic hidradenitis were identified. Their following characteristics were recorded: clinical features, number and localisation of lesions, serology and other associated medical conditions. Results Isolated lymphocytic hidradenitis was found most frequently in middle-aged women. Most patients (n = 28, 93%) presented with many annular erythematous patches and plaques with mild pruritus; 22 (73%) had the SS-A antibody and 17 (57%) met the diagnostic criteria of Sjogren syndrome. Among these patients, 11 had primary and six had secondary Sjogren syndrome associated with systemic lupus erythematosus. Altogether 15 (50%) patients tested positive for a high titre of the antinuclear autoantibody. Other underlying diseases identified during the follow-up period include cryoglobulinaemia, angioimmunoblastic T-cell lymphoma, autoimmune hepatitis, hepatitis C infection and toxic thyroid goitre. Conclusions Lymphocytic hidradenitis is a microscopic finding associated with annular erythemas of Sjogren syndrome. Systemic survey for sicca symptoms and work up for autoimmune diseases, including antinuclear antibodies, SS-A, SS-B antibodies, cryoglobulin, lymphoma, viral and autoimmune hepatitis should be performed to facilitate the correct diagnosis.

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor with intermediate malignant potential. It predominantly affects children and young adults and is most often located in the extremities. The atypical pattern of AFH may create significant diagnostic difficulty. We present a case of AFH diagnosed via molecular confirmation by fluorescence in situ hybridization (FISH) and also review cases of AFH with atypical histologic presentations in Taiwan. We present this case to remind clinicians that identification of gene fusions by molecular testing is a valuable diagnostic tool for AFHs, especially in cases with atypical histopathological presentations. Keywords: Angiomatoid fibrous histiocytoma (AFH), Fluorescence in situ hybridization (FISH), Molecular testing

Coffee is a popular beverage all over the world, but spent coffee grounds (SCGs) constituting almost 75% of original beans are usually considered waste and disposed off. The present study analyzed the functionalities of SCG with a view of its reuse in the cosmetic industry. The SCG extraction was carried out by the hydrothermal method. The resultant extracts were tested for its antioxidant capacity, tyrosinase inhibition, and moisturizing ability. LC–MS/MS results showed two major components in SCG extracts, namely, trigonelline and caffeine. Also, the SCG contained total flavonoid contents of 29 ± 4.5 mg quercetin equivalents (QE)/g SCG and total phenolic contents of 9.44 ± 0.90 mg gallic acid equivalents (GAE)/g SCG. Regarding functionality analysis, SCG extracts exhibited reduction capacity of 8.18 ± 0.39 mg vitamin C equivalent (VCE)/g SCG, DPPH free-radical scavenging activity (IC50) of 3.11 mg SCG/mL, ABTS free-radical scavenging activity (IC50) of 13.61 mg SCG/mL, and tyrosinase inhibition capacity (IC50) of 2.23 mg SCG/mL. Moreover, the volatilization rate of the extract solution (37 mg SCG/mL) reduced by 15.9%. These results demonstrate the utility of recycling of SCG and illustrate its potential application in the development of skin care products.

Taiwan has been experiencing a resurgence of measles since the beginning of 2009. We retrospectively reviewed the clinical presentations of eight confirmed measles cases during a nosocomial outbreak, in order to identify diagnostic clues. The exan-them was polymorphous and non-specific in terms of its morphology, distribution, sequence of appearance, and symptoms. The presence of cough and coryza as well as abnormal results of routine laboratory studies were also non-specific and unhelpful for the differential diagnosis of measles from other infectious diseases, adverse drug reactions, or autoimmune diseases. In our experience, the combination of exudative conjunctivitis with febrile exanthem is the most distinguishing feature of measles. Serologic studies can confirm the diagnosis within a few hours. Further measles outbreaks are possible in the near future as a result of increased international travel, immigration of foreign workers, and overseas marriages. Dermatologists must be proficient in the diagnosis of measles in order to prevent the potential morbidity and mortality associated with future outbreaks.

Background Although an umbilical nodule is common in neonates and young infants, an umbilical nodule of poor therapeutic response will increase the likelihood of other uncommon etiology. Clear cell acanthoma (CCA) has never been described as an oozing umbilical nodule on infants. Methods To present a case of CCA which occurred on an 8-month-old female infant presenting with one weeping nodule on the umbilicus since early neonate. The lesion underwent skin biopsy and subsequent hematoxylin-eosin and periodic acid-Schiff staining. Result Three courses of liquid nitrogen cryosurgery were performed after the diagnosis of CCA was confirmed. The lesion resolved rapidly. Conclusion This report presents the first and youngest case of umbilical CCA in the English literature. This case supports the inflammatory dermatosic nature of CCA.

Cutaneous verrucous carcinoma is a rare variant of low-grade squamous cell carcinoma. It usually involves distal extremities and is often misdiagnosed as giant warts. Multiple cutaneous verrucous carcinomas are rare in the English-language literature. We describe a 41-year-old man with multiple verrucous plaques on both feet and ankles, as well as the left thigh. Immunohistochemical study with proliferating cell nuclear antigen revealed positive staining of the basal and suprabasal layers. The patient's condition was successfully treated with systemic acitretin.

BACKGROUND Tumescent local anesthesia is widely used in dermatologic surgery. Minimizing pain associated with injections is crucial to successful surgical procedures. OBJECTIVE This study investigates the pain associated with warm and room temperatures in neutralized or nonneutralized tumescent anesthetic solutions injection. METHODS Thirty-six patients with axilla osmidrosis who underwent local anesthesia for surgery were randomly assigned to three groups. Group A received warm neutral (40°C) and room-temperature neutral (22°C) tumescent injections to each axillary region. Group B received warm neutral (pH 7.35) and warm nonneutral (pH 4.78) tumescent injections on each side of axilla. Group C received warm nonneutral and room-temperature nonneutral tumescent injections on each side of axilla. Pain associated with infiltration of anesthesia was rated on a visual analog scale (VAS). RESULTS A statistically significant decrease (p < .001) in pain sensation was reported on the warm, neutral injection side (mean rating, 32.7 mm) compared with the room-temperature, neutral injection side (mean rating, 53.3 mm). Patient-reported pain intensity was significantly lower on the side that received warm, neutral tumescent anesthesia (mean rating, 26.8 mm) than on the side receiving warm, nonneutral tumescent anesthesia (mean rating, 44.9 mm; p < .001). The difference in VAS scores between warm neutral (mean rating, 23.9 mm) and room-temperature nonneutral (mean rating, 61.2 mm) was statistically significant (p < .001). CONCLUSION The warm, neutral tumescent anesthetic preparation effectively suppressed patient pain during dermatologic surgical procedures.

Elastosis perforans serpiginosa (EPS) is an unusual perforating disorder characterized by extrusion of altered elastic fibers through the epidermis. Clinically, it presents as keratotic papules with a tendency for serpiginous or annular distribution that most commonly involves the sides of the neck and the back. However, involvement of the penis has rarely been reported. We present a case of EPS involving the neck, axilla, and glans penis in a 42-year-old man who had received long-term d -penicillamine treatment for Wilson disease. Skin biopsy revealed perforating channels containing numerous altered elastic fibers, with a characteristic “bramble brush” or “lumpy-bumpy” appearance as demonstrated by an elastin stain. The latter is thought to be pathognomonic for penicillamine-induced degenerative elastosis. These degenerative changes occurring in glans penis have rarely been described in the literature. Prompt recognition of the rare presentation could lead to early discontinuation of the offending drug, to prevent further sequelae.