Thai Journal of Dermatology

Chronic Actinic Dermatitis in Thailand: A Study of Clinicophotobiological Characteristics and Treatment Outcomes Over 13 years

2024-12-06T11:15:16+07:00

Background: There have been reported chronic actinic dermatitis (CAD) cases in younger patients of darker skin types, particularly in South Asian. There remains a relative paucity of information of CAD patients in Southeast Asia generally and Thailand specifically.

Objective: Address clinicophotobiological characteristics of CAD patients and outcomes of treatments in Thailand.

Materials and Methods: Medical records of Thai patients who diagnosed CAD and confirmed by phototesting were reviewed retrospectively from a 13-year period at a single center. Clinicophotobiological features, and outcomes of treatments were evaluated.

Results: Of 90 patients, a preponderance of patients were male with a median age at diagnosis of 55.73 ± 12.01 years; 63.3% of the patients had Fitzpatrick skin type IV. All patients presented with eczema on photodistributed areas, only 11 of those patients (12.2%) presented with eczema on both sun-exposed and sun-covered areas. Most patients demonstrated photosensitivities to both UVB and UVA (67.8%). Only 3.5% of patients had a photoallergy to a fragrance mix and balsam of peru. Fifty percent of patients had allergic contact dermatitis with fragrance mix (14.4%), balsam of peru (6.7%), nickel (6.7%), p-phenylenediamine (5.6%), and cobalt (5.6%). Less than 50% of the patients required systemic immunosuppressive treatment. Most patients had a partial response within a median time of 4 months after treatment.

Conclusion: Thai patients with CAD who have higher skin types are predominately observed in males with an earlier age at onset. Most patients exhibit both UVA and UVB photosensitivities. The coexistence of CAD and allergic contact dermatitis is common.

Unilateral Segmental Type 2 Hereditary Leiomyomatosis and Renal Cell Cancer

2024-10-15T08:59:04+07:00

Our case report describes a patient who exhibited clinical unilateral segmental involvement of painful, firm papules and nodules on the right side of the face, upper chest, back, and forearm. Leiomyomatosis was preferred and confirmed by skin biopsy based on clinical presentation and uterine leiomyoma history. Our patient meets the criteria diagnosis of hereditary leiomyomatosis and renal cell carcinoma (HLRCC), known as Reed syndrome, with multiple cutaneous leiomyomas confirmed by biopsy and early-onset symptomatic uterine fibroids. Imaging revealed benign renal cysts, a finding with increased incidence in HLRCC patients. Genetic testing revealed a heterozygous FH:c.574C>T variant in exon 5, establishing the diagnosis of HLRCC. Due to the risk of renal malignancies in HLRCC patients, ongoing surveillance and early genetic screening are essential to improve patient outcomes and prevent serious complications.

Ulcerative Sweet’s Syndrome and Aseptic Abscess in Association with Acute Myeloid Leukemia

2024-09-17T10:57:06+07:00

Sweet's syndrome (SS) is an uncommon prototype of neutrophilic dermatosis. While the precise pathogenesis remains unclear, it is linked to inflammatory cascade, disease triggers, and an association with many hematologic and visceral malignancy. Ulcerative SS is an uncommon presentation and is often associated with malignancy. Moreover, SS is also related to aseptic neutrophilic abscess in intra-abdominal viscera.

Prurigo Pigmentosa with Positive Direct Immunoflurescence: A Rare Case Report in Thailand

2024-10-28T08:03:01+07:00

Prurigo pigmentosa is a rare inflammatory dermatosis characterized by recurrent symmetrical erythematous papules that coalesce into reticulate hyperpigmentation. The lesions occur symmetrically on the back, trunk, and neck, which had profound pruritus. It is commonly reported in young women, especially in East Asia. Clinical and histopathological assessments are used to make the diagnosis that vary from early to late lesions. Most patients do not show positive direct immunofluorescence, except for only one case report. We report a 24-year-old Thai woman with an ill-defined erythematous plaque on her back and chest wall with pruritus for 3 weeks which direct immunofluorescence showed positive immunoglobulin M at superficial blood vessels and complement 3 with focal granular pattern at dermo-epidermal junction.

Extradigital Glomus Tumor: A Case Report of Pain on Back Over 10 Years

2024-12-17T05:58:05+07:00

Glomus tumors are benign neoplasms of the glomus body, commonly found in the subungual area of digits. Occasionally, these tumors occur outside the digital region, making diagnosis more challenging. We report a case of 62-year-old woman who experienced pain on her back for 10 years. A careful examination revealed a small erythematous papule on the interscapular area. Dermoscopic findings showed homogenous, unstructured purplish area. A punch excision was performed, and histological and immunohistochemistry analysis of the tissue was consistent with a glomus tumor. The patient reported no pain following the procedure. This case report highlights the clinical, dermoscopic, and histological features of extradigital glomus tumors. It also emphasizes the importance of including these tumors in the differential diagnosis of painful nodules and demonstrates the effectiveness of complete surgical excision in achieving excellent outcomes.