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ABSTRACT: OBJECTIVE: To determine the association between Kawasaki disease (KD) and atopic diathesis (atopic dermatitis [AD], allergic rhinitis, and asthma) in children younger than 5 years of age. STUDY DESIGN: In this nationwide study, we aimed to analyze the association and temporal relationship between KD and atopic diathesis. Data were obtained from the National Health Insurance Research Database of Taiwan from 1997 to 2010. In total, 200 patients with KD younger than 5 years of age and 800 age- and sex-matched control subjects were enrolled. RESULTS: In the whole study population, an increased risk of any concomitant atopic diseases was observed in patients with KD (OR 1.61, 95% CI 1.15-2.26). The risk of AD was increased in male patients between 1 and 5 years of age (OR 3.02, 95% CI 1.22-7.50). More than 60% of the patients developed atopic diseases after the diagnosis of KD. CONCLUSION: There appears to be an association between KD and risk of AD. Most of the atopic diseases occurred after the episode of KD.
The Journal of pediatrics 05/2013; · 4.02 Impact Factor
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Yi-Ju Chen,
Chih-Chiang Chen,
Ming-Wei Lin,
Tzeng-Ji Chen,
Cheng-Yuan Li,
Chian-Yaw Hwang,
Szu-Ying Chu,
Ding-Dar Lee,
Yun-Ting Chang,
Wen-Jen Wang, Han-Nan Liu
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ABSTRACT: Introduction. An association between psoriasis and sexual dysfunction (SD) has been explored. However, the risk of SD after the diagnosis of psoriasis relative to the age-matched general population remains unknown. Aim. To clarify the risk of developing SD in male patients with psoriasis. Methods. From 2000 to 2001, we identified 12,300 male patients with newly diagnosed psoriasis and 61,500 matching controls from National Health Insurance Database in Taiwan. Main Outcome Measures. The two cohorts were followed up until 2008, and we observed the occurrence of SD by registry of SD diagnosis in the database. Stratified Cox proportional hazard regressions were used to calculate the 7-year SD risk for these two groups. Results. Of the 73,800 sampled patients, 1,812 patients (2.46%) experienced SD during the 7-year follow-up period, including 373 (3.03% of patients with psoriasis) in the study group and 1,439 (2.34% of patients without psoriasis) in the comparison group. The hazard ratio (HR) for SD for patients with psoriasis was 1.27 times (95% confidence interval [CI], 1.11-1.46; P = 0.001) as high as that for patients without psoriasis after adjusting for age, monthly income, number of health-care visits, systemic treatment, and other comorbidities. Stratified analysis showed that the risk of SD was higher in patients older than 60 years old (HR: 1.42, 95% CI: 1.12-1.81) and patients with psoriatic arthritis (HR: 1.78, 95% CI: 1.08-2.91). However, the risk of SD was not significantly elevated in patients receiving systemic treatment, including retinoid, methotrexate, and cyclosporine. Conclusions. Male patients with psoriasis are at increased risk of developing SD. Physicians should pay attention to the impact of psoriasis on psychosocial and sexual health, especially in old-aged patients. Chen Y-J, Chen C-C, Lin M-W, Chen T-J, Li C-Y, Hwang C-Y, Chu S-Y, Lee D-D, Chang Y-T, Wang W-J, and Liu H-N. Increased risk of sexual dysfunction in male patients with psoriasis: A nationwide population-based follow-up study. J Sex Med **;**:**-**.
Journal of Sexual Medicine 05/2012; · 3.55 Impact Factor
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ABSTRACT: Steamed piper betle leaves (PBL) were once used by many Taiwanese women to treat pigment disorders on the face. Most women claimed a quick, favourable response at first, only to be overcome with facial leukomelanosis later.
C57BL/6 mice were randomly assigned to different groups to study if PBL could cause the following effects: contact dermatitis, leukomelanosis, or hair bleaching. Intracellular melanin content was measured by tyrosinase assays.
Most steamed PBL-treated mice developed contact dermatitis and postinflammatory hyperpigmentation (PIH) on their shaved backs. About half developed bleached hair to varying extents. The steamed PBL did not only bleach the hairs, but also, unexpectedly, stimulated melanocyte replication, indicated by the fact that the number of functional melanocytes in the tail epidermis increased significantly after treatment (P = 0.007). Using tyrosinase assays PBL extract at the undiluted concentration showed limited inhibition of melanogenesis, probably via melanocytotoxicity.
The leukomelanosis observed in patients might be the consequence of PIH combined with a mixed reaction (hyper- and hypopigmentation), probably due to the different volatile chemicals that surface after steaming the PBL. This conflicting mixed reaction suggests that counteractive ingredients might exist in PBL. PBL, if purified, might be a promising source of a novel bleaching agent.
Australasian Journal of Dermatology 08/2011; 52(3):172-8. · 1.00 Impact Factor
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Wei-Hsuan Li,
Yi-Ju Chen,
Wei-Cheng Tseng,
Ming-Wei Lin,
Tzeng-Ji Chen,
Szu-Ying Chu,
Chian-Yaw Hwang,
Chih-Chiang Chen,
Ding-Dar Lee,
Yun-Ting Chang,
Wen-Jen Wang, Han-Nan Liu
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ABSTRACT: Renal transplantation has been regarded as the treatment of choice for end-stage renal disease. Renal transplantation increases the risk of cancers due to long-term immunosuppression. The types of post-transplantation malignancies may vary among different geographic regions and ethnic populations. To date, large population-based studies of post-transplantation malignancies in Asian renal transplant recipients (RTRs) have rarely been reported.
To investigate the patterns of post-transplantation malignancies in Chinese RTRs, we performed a nationwide population-based cohort study between 1997 and 2008 based on data from the National Health Insurance Database in Taiwan. Patterns of cancer incidence in RTRs were compared with those of the general population using standardized incidence ratios (SIRs).
Among the 4716 RTRs (2475 males and 2241 females; mean age 44.1 ± 12.4 years) and 22 556 person-years of observation, 320 post-transplant cancers were diagnosed. The SIR of all cancers was 3.75 (95% confidence interval 3.36-4.18). Women had a higher risk than men for the development of malignancies (SIR 5.04 for women and SIR 2.88 for men). Renal, bladder and liver cancers were the most common cancers, with SIRs of 44.29, 42.89 and 5.07, respectively. When stratified by age, RTRs of young age at transplant (<20 years) had the highest risk of post-transplantation malignancies.
This study demonstrates different patterns of malignancies after renal transplantation in Chinese RTRs, with higher incidences of kidney and bladder cancers. Physicians should be more vigilant in examining RTRs for post-transplantation malignancies especially in younger patients.
Nephrology Dialysis Transplantation 06/2011; 27(2):833-9. · 3.40 Impact Factor
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Szu-Ying Chu,
Yi-Ju Chen,
Wei-Cheng Tseng,
Ming-Wei Lin,
Tzeng-Ji Chen,
Chian-Yaw Hwang,
Chih-Chiang Chen,
Ding-Dar Lee,
Yun-Ting Chang,
Wen-Jen Wang, Han-Nan Liu
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ABSTRACT: Alopecia areata (AA) is considered an autoimmune disease with undetermined pathogenesis. Age at onset predicts distinct outcomes. A nationwide study of the relationship of AA with associated diseases stratified by onset age has rarely been reported.
We sought to clarify the role of atopic and autoimmune diseases in AA, thereby better understanding its pathogenesis.
A total of 4334 patients with AA were identified from the National Health Insurance Database in Taiwan from 1996 to 2008. A national representative cohort of 784,158 persons served as control subjects.
Among patients with AA, there were significant associations with vitiligo, lupus erythematosus, psoriasis, atopic dermatitis, autoimmune thyroid disease, and allergic rhinitis. Different ages at onset resulted in disparate comorbidities. Increased risk of atopic dermatitis (odds ratio [OR] 3.82, 95% confidence interval 2.67-5.45) and lupus erythematosus (OR 9.76, 95% confidence interval 3.05-31.21) were found in childhood AA younger than 10 years. Additional diseases including psoriasis (OR 2.43) and rheumatoid arthritis (OR 2.57) appeared at onset age 11 to 20 years. Most atopic and autoimmune diseases were observed at onset ages of 21 to 60 years. With onset age older than 60 years, thyroid disease (OR 2.52) was highly related to AA. Moreover, patients with AA had higher risk for more coexisting diseases than control subjects.
We could not differentiate hypothyroidism from hyperthyroidism.
AA is related to various atopic and autoimmune diseases. Different associated diseases in each onset age group of AA can allow clinician to efficiently investigate specific comorbidities.
Journal of the American Academy of Dermatology 05/2011; 65(5):949-56. · 3.99 Impact Factor
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ABSTRACT: It has long been a debate that whether atopy is a risk factor or protective factor for cancer. However, no large-scale study of different cancers in patients with atopic diseases has been conducted among Asians. Here, we conducted a nationwide study to evaluate the cancer risk in patients with allergic rhinitis (AR), asthma and atopic dermatitis (AD). Drawing on Taiwan's National Health Insurance Research Database, 225,315 patients with AR, 107,601 patients with asthma and 34,263 patients with AD without prior cancers were identified in the period from 1996 to 2008. The standard incidence ratio (SIR) of each cancer was calculated. Although the overall cancer risks in patients with atopic symptoms were not increased, the risks were slightly elevated in female patients with AR or asthma (SIR: 1.13 and 1.08, AR and asthma, respectively) and slightly decreased in males patients with AR. Those aged 20-39 years-old possessed the highest risk. A higher risk of developing brain cancer was found in patients with atopic diseases, and patient with AR or asthma also had an elevated risk of developing cancer of kidney and urinary bladder. In contrast, the risk of nonmelanoma skin cancer was lower in patients with AR and asthma. Compared to patients with only one atopic disease, those with more than one atopic disease had lower cancer risks. Our data suggests that the association between atopy and cancer is site-specific.
International Journal of Cancer 03/2011; 130(5):1160-7. · 5.44 Impact Factor
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ABSTRACT: Digital mucous cysts is a common benign skin disease usually present as solitary or a few soft, translucent to slightly bluish nodules. Here, we report the case of a 90-year-old male patient with numerous translucent nodules on his right fifth finger. Although he had one of them drained, they recurred afterward. Skin biopsy was done on the ventral side of the fifth distal phalange, and clear viscous fluid was noted during the procedure. The surrounding bulging nodules became flattened after milking. By hematoxylin and eosin stain, the section showed a cystic lesion in the dermis. The cyst wall was devoid of a true lining, consisting of eosinophlic, compact, slightly hyalinized collagen. In the cystic space, there was only a small amount of mucin. He was therefore diagnosed with multiple digital mucous cysts. We treated him with intralesional steroid injection and compressive dressing. Two weeks later, however, the skin lesions recurred despite the treatments.
Journal of the Chinese Medical Association 02/2011; 74(2):102-3. · 0.79 Impact Factor
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ABSTRACT: To study the prevalence of atopic dermatitis, allergic rhinitis, and asthma in Taiwan, we analysed the claims data of a nationally representative cohort of 997,729 enrolees from the National Health Insurance register from 2000 to 2007. Overall, 66,446 patients were diagnosed with atopic dermatitis, and 49.8% of them had concomitant allergic rhinitis and/or asthma. The overall 8-year prevalences of atopic dermatitis, allergic rhinitis, and asthma were 6.7%, 26.3% and 11.9%, respectively. Children and adolescents had significantly higher prevalences of these atopic diseases. The prevalence of atopic dermatitis in females was lower than that in males before the age of 8 years, but became higher after that. Patients with atopic dermatitis were more likely to have allergic rhinitis and asthma. Those having both atopic dermatitis and allergic rhinitis possessed an even higher risk for asthma (odds ratio 9.04). The numbers of visits for atopic dermatitis were highest in late spring to mid-summer. These data suggest that atopic diseases are common in Taiwan.
Acta Dermato-Venereologica 11/2010; 90(6):589-94.
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ABSTRACT: It has been described that Caucasian patients with cutaneous malignant melanoma (CMM) are at an increased risk of developing second primary cancer. However, no large-scale study of second primary cancer in CMM patients has been conducted among Asians, who have distinctly different skin types.
We sought to access the risk of second primary cancer among CMM patients based on data from a nationwide database in Taiwan.
Utilizing the catastrophic illness database of Taiwan's National Health Insurance Research Database, we identified 2665 CMM patients without prior cancers in the period from 1997 to 2008. The standard incidence ratio (SIR) of each cancer was calculated.
The mean age ± standard deviation at diagnosis of CMM was 62.2 ± 17.4 years. The mean annual incidence was 0.9 cases per 100,000 people. The overall cancer risk was elevated (SIR: 2.54), with younger patients having a higher risk. The risk remained elevated during the first five years after the CMM diagnosis. CMM patients had a higher risk of developing cancers of eye (SIR: 275.68), connective tissue (SIR: 43.45), brain (SIR: 21.03), and non-melanoma skin cancer (SIR: 17.71).
CMM patients have a 2.54-fold risk of second primary cancer, with younger patients at increased risk. The risk remains elevated during the first five years after the diagnosis of CMM. The sites with highest risk of second primary cancer are eye, connective tissue, brain, and non-melanoma skin cancer.
Journal of dermatological science 10/2010; 60(3):167-72. · 3.71 Impact Factor
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ABSTRACT: The development of skin hyperpigmentation in patients with end-stage renal disease (ESRD) on hemodialysis (HD) have been well documented. However, the cosmetic concern was neither valued seriously nor treated effectively in the past. We report a female case who suffered from facial hyperpigmentation (FH). She was treated by large-spot sized, 1064-nm Q-switched Nd:YAG laser (QSNYL). A significant improvement was found after three treatment sessions at a fluence of 3.9 J/cm(2) with 8-day intervals, but spotted leucoderma developed at the fourth visit. Neither residual FH nor spotted leucoderma subsequently improved following two additional sessions of 1064-nm QSNYL at a lower fluence with topical hydroquinone and HeNe laser, and it persisted at the 1-year follow-up. This clinically specific round-shaped leucoderma suggested laser-induced damage to melanocytes due to unsuitable application. The 1064-nm QSNYL with a large spot size and an appropriate parameter may become an effective therapeutic modality if properly utilized.
Journal of Cosmetic and Laser Therapy 11/2009; 12(1):47-50. · 0.98 Impact Factor
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Jaw-Shyang Jih,
Yi-Ju Chen,
Ming-Wei Lin,
Yu-Chun Chen,
Tzeng-Ji Chen,
Yu-Lin Huang,
Chih-Chiang Chen,
Ding-Dar Lee,
Yun-Ting Chang,
Wen-Jen Wang, Han-Nan Liu
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ABSTRACT: To analyse the epidemiological characteristics and related costs of herpes zoster in Taiwan, a nationally representative cohort of 1,000,000 individuals from the National Health Insurance register was followed up from 2000 to 2006 and their claims data analysed. Overall, 34,280 patients were diagnosed with zoster (incidence 4.89/1000 person-years) and 2944 patients (8.6%) developed post-herpetic neuralgia 3 months after the start of the zoster rash (incidence 0.42/1000 person-years). People with older age, diabetes, and immunocompromising conditions were at higher risk of developing zoster and post-herpetic neuralgia. The overall hospitalization rate for zoster was 16.1 cases per 100,000 person-years. The cost for each home care case and per hospitalized case were approximately 53.30 euro and 1224.70 euro, respectively. Further research into the cost-effectiveness of zoster vaccine is needed.
Acta Dermato-Venereologica 11/2009; 89(6):612-6.
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ABSTRACT: A 50-year-old man presented with an asymptomatic, 1.5 x 1.5 cm, dark-brown noduloplaque with a rubbery consistency (Fig. 1) on the lateral aspect of the left lower leg of uncertain duration. His general condition was healthy, and he did not recall any trauma or insect bite at this site. No similar skin lesions were found elsewhere and no lymphadenopathy was observed. The lesion revealed a nonencapsulated, but well-circumscribed, deep dermal nodule with several lymphoid aggregates and germinal center-like structures within the tumor and also at the periphery, when examined microscopically at scanning power (Fig. 2a). The epidermis showed no remarkable changes, except for basal hyperpigmentation. At higher power, a mixed inflammatory infiltrate composed of histiocytes, foamy histiocytes (Fig. 2b), lymphocytes, and abundant plasma cells (Fig. 2c) with Russell bodies was revealed. The stroma contained mainly hyalinized and sclerotic collagen fibers (Fig. 2d). Prominent venules were noted, especially in the sclerotic areas, and some were surrounded by dense collagen fibers. No vasculitis or emperipolesis was found. No foreign materials were observed by polarization microscopy, and no organisms could be identified by periodic acid-Schiff (PAS), Grocott methenamine silver (GMS), Giemsa, Gram, acid-fast, or fite stains. The results of testing for infection by Epstein-Barr virus (EBV) (latent membrane protein 1, LMP-1) were negative. No spindle cells were found in the lesion. Immunohistochemical studies demonstrated mature plasma cells stained with CD138, and polyclonality was confirmed by the expression of both kappa and lambda light chains. The germinal center-like lymphoid aggregates were found to be B cells, which reacted positively with CD20. Scarce S100-positive cells and even rarer CD1a-positive cells were detected. Test results for smooth muscle actin (SMA) and anaplastic lymphoma kinase (ALK) were negative. Abundant CD68+ macrophages were observed within the lesion (Fig. 3a), and about 50-75% of the inflammatory cells were found to express cyclooxygenase-2 (COX-2) (Fig. 3b). The patient's condition was diagnosed as cutaneous plasma cell granuloma (CPCG). One year after excision, no evidence of recurrence was observed.
International journal of dermatology 05/2009; 48(4):409-11. · 1.18 Impact Factor
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Yun-Ting Chang,
Tzeng-Ji Chen,
Pei-Chi Liu,
Yu-Chun Chen,
Yi-Ju Chen,
Yu-Lin Huang,
Jaw-Shyang Jih,
Chih-Chiang Chen,
Ding-Dar Lee,
Wen-Jen Wang,
Ming-Wei Lin, Han-Nan Liu
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ABSTRACT: The aim of this study was to determine the prevalence, treatment modalities and comorbidity of psoriasis in Taiwan. A nationally representative cohort of 1,000,000 individuals from the National Health Insurance database was followed up for the years 2000 to 2006. Their claims data was used for an epidemiological study. The mean one-year prevalence of psoriasis was 0.23% for men and 0.16% for women, respectively. The prevalence of psoriasis increased more rapidly in male patients aged 30 years and over and reached its peak in patients aged 70 years and over, regardless of sex. Overall, 98.4% of patients received treatment with topical corticosteroids, while 13.1% used Chinese herbal medicines and 13.6% received systemic treatment. Patients with psoriasis had a higher comorbidity of diabetes, hyperlipidaemia, and hypertension. In conclusion, in contrast to Caucasians, the prevalence of psoriasis in Taiwanese people is high er in men than in women and the prevalence increases significantly in patients over 70 years of age.
Acta Dermato Venereologica 02/2009; 89(3):262-6. · 3.18 Impact Factor
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ABSTRACT: The aim of this study was to assess the clinical features of uveitis with biopsy-proven sarcoidosis in Chinese patients.
This was a retrospective study of uveitis patients with biopsy-proven sarcoidosis who consecutively visited the uveitis clinic of Taipei Veterans General Hospital from 1986 to 2005. Medical records were reviewed to obtain demographic data, initial symptoms, biopsy sites, pulmonary conditions detected by chest X-ray and manifestations of uveitis. From 2002 onwards, patients also received chest computed tomography (CT).
A total of 60 uveitis patients with biopsy-proven sarcoidosis were identified. Forty-four patients (73%) were found in the last 4 years. Female predominance with a male-to-female ratio of 1:6.5 was found. The most common initial symptom was uveitis in 41 patients (68%). The most common positive biopsy sites were mediastinal lymph nodes, lung, conjunctiva and skin. Twenty (90.9%) of 22 patients with chest X-ray stage 0 showed >or= stage 1 on CT. The mean age at uveitis onset was 47.7+/-14.7 years (range, 21-76 years), with no gender difference (p=0.913). A peak incidence was found in the 6th decade of life. There was bilateral eye involvement in 54 patients (90%). Frequency of the manifestations of uveitis showed isolated anterior uveitis in 2 patients (3.3%), isolated posterior uveitis in 8 patients (13.3%), intermediate and posterior uveitis (i.e. anterior uveitis sparing) in 16 patients (26.7%), and panuveitis in 34 patients (56.7%).
A marked increase was noted since 2002. One of the causes is the performance of chest CT. Chest CT is useful to discover mediastinal lymphadenopathy and other lesions suggestive of sarcoidosis, as well as to help guide tissue confirmation in patients with peculiar uveitis features indicative of sarcoidosis. Female predominance and peak incidence of uveitis onset in the 6th decade of life were found. The posterior segment was the most common localization of uveitis in biopsy-proven sarcoidosis in Chinese.
Journal of the Chinese Medical Association 11/2007; 70(11):492-6. · 0.79 Impact Factor
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ABSTRACT: Apocrine fibroadenoma (AFA), considered a counterpart of fibroadenoma of breast, is a rare cutaneous apocrine neoplasm occurring almost exclusively in women. We describe a 75-year-old man who presented with a red dome-shaped papule near the nasal bridge. The tumor was composed of numerous tubular, cystic, and partially branching lumina and struts of epithelial cells oriented perpendicular to the skin surface, with which it connected through infundibula. The epithelial strands were embedded in fibrocollagenous stroma. These histopathological features are consistent with AFA. The cytokeratin profiles of our case were similar to those of apocrine or eccrine neoplasms. Progesterone and estrogen receptors (PR/ER) were not expressed. The stroma cells were stained strongly positive for vimentin, but nonreactive for alpha-smooth muscle actin, S-100 protein, or glial fibrillary acidic protein. To the best of our knowledge, this is the first report of facial AFA in man. Different from a more common anogenital AFA, this neoplasm might represent a second type of AFA with unique histopathologic and immunopathological features.
American Journal of Dermatopathology 07/2007; 29(3):274-8. · 1.20 Impact Factor
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Yun-Ting Chang,
Chih-Yi Hsu,
Chan-Te Chou,
Ming-Wei Lin,
Yu-Ming Shiao,
Chang-Youh Tsai,
Chia-Wen Yu,
Jen-Jen Shiue,
Yu-Fen Lee,
Cheng-Hung Huang,
Chih-Chiang Chen,
Ding-Dar Lee,
Wen-Jen Wang, Han-Nan Liu,
Shih-Feng Tsai
Journal of Dermatological Science 06/2007; 46(2):153-6. · 3.72 Impact Factor
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ABSTRACT: Pemphigus is an acquired autoimmune intraepidermal blistering disease that is divided into 2 major subtypes: pemphigus vulgaris (PV) and pemphigus foliaceus (PF). Patients with pemphigus have circulating anti-desmoglein (Dsg)1 and/or anti-Dsg3 IgG autoantibodies. Recently, a novel commercial enzyme-linked immunosorbent assay (ELISA) against Dsg1 and Dsg3 has been established and found to be extremely sensitive and specific. To date, the usefulness of Dsg1 and Dsg3 ELISA in the diagnosis of pemphigus in the Taiwanese population has never been reported.
Serum samples were obtained from 143 patients, including 20 patients with PV, 9 patients with PF, 72 patients with bullous pemphigoid, 1 patient with dermatitis herpetiformis and 41 patients with non-autoimmune blistering diseases. They were tested for anti-Dsg1 and anti-Dsg3 reactivity by ELISA.
Seventeen of 20 PV sera (85%) exceeded the cut-off value of Dsg3 ELISA, and 9 of 9 PF sera (100%) exceeded the cut-off value of Dsg1 ELISA, while only 1 (0.88%) and 3 (2.6%) of 114 non-pemphigus sera exceeded the cut-off values of Dsg3 and Dsg1 ELISAs, respectively. Thus, the sensitivity and specificity of Dsg3 ELISA were 85% and 99.1%, while the sensitivity and specificity of Dsg1 ELISA were 100% and 97.4%, respectively. The correlation between ELISA scores and disease activity along the time course was examined in 6 PV patients and 1 PF patient, and the result was equivocal.
Dsg1 and Dsg3 ELISAs provide a simple, highly sensitive and specific method that can serve as a useful adjunct tool for the initial diagnosis of pemphigus.
Journal of the Chinese Medical Association 03/2007; 70(2):65-70. · 0.79 Impact Factor
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Yun-Ting Chang,
Chan-Te Chou,
Yu-Ming Shiao,
Ming-Wei Lin,
Chia-Wen Yu,
Chih-Chiang Chen,
Cheng-Hung Huang,
Ding-Dar Lee, Han-Nan Liu,
Wen-Jen Wang,
Shih-Feng Tsai
Journal of Investigative Dermatology 11/2006; 126(10):2335-8. · 6.31 Impact Factor
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ABSTRACT: Eccrine poroma (EP) are relatively common benign eccrine neoplasms. Other poroid neoplasms (PNs), namely hidroacanthoma simplex (HS), dermal duct tumor (DDT), and poroid hidradenoma (PH), are seldom reported.
Among 18 653 biopsy specimens received from January 1988 to October 2003, we found 25 PNs (0.134%). We conducted retrospective analysis and obtained clinical and histopathological information.
There were 16 EP, 3 HS, 4 PH, and 2 PH coexisting with either HS or EP. No DDT was found. More than half of PNs presented as red-color neoplasms, but none were diagnosed correctly on clinical grounds alone. The most common preoperative diagnoses were pyogenic granuloma or soft fibromas. Most EPs were located on hair-bearing regions of the limbs (37.5%) and trunk (25%), instead of soles (18.8%) and palms (6.3%). Three HS showed no cuticular cell, but had monomorphic poroid cells. Most EPs (10/16) were composed of both poroid and cuticular cells. All PH were composed of cuticular and poroid cells. Horn cysts were found in three cases (12%). Most PNs (16/25) contained clear cells.
PNs are sudoriferous tumors that may vary considerably in clinical expression. EP, about 64% (16/25) of PNs in our series, was the most common. PH incidence is probably underestimated in the literature. We found six PHs in 25 PNs. Histopathologically, it is not justified to exclude PN diagnosis by noticing horn cysts. It was uncommon for two or three subtypes of PN to occur in a single lesion.
International Journal of Dermatology 07/2006; 45(6):722-7. · 1.14 Impact Factor
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ABSTRACT: Poroid hidradenoma (PH), a less common subtype of poroid neoplasm (PN) than eccrine poroma (EP), has not been immunohistochemically studied before. Six cases of PH (four solitary PH and two PH coexisted with other types of PN) were included in the study. Fifteen cases of EP were also included for comparison. Hematoxylin and eosin, Masson-Zimmerman silver stain, and a variety of immunohistochemical stains were used. Microscopically, PH is not connected to the epidermis. All six PH contained small poroid cells and larger, paler cuticular cells. Some PH showed separate or clusters of sebocytes (2/6), horn cysts (1/6), juxtaposed lymphoid follicles in the stroma (1/6) and foci of keratohyaline granules (2/6), none of which was seen in the 15 EP. Immunohistochemically, the keratin distribution of PH was very similar to that of EP. PH has a very small number of Langerhans cells (significantly lower than the overlying epidermis, P=0.045), and a sparse deposition of melanin. We conclude that except the location, the histopathological and immunochemical differences between PH and EP were small. Sebaceous differentiation in two PH lesions suggested the possibility of an apocrine origin. The deeper parts of eccrine apparatus other than basaloid cells may have been more actively involved in the histogenesis of PH.
Archives for Dermatological Research 02/2006; 297(7):319-23. · 2.28 Impact Factor
