皮膚科および皮膚科疾患ジャーナル

Lentigines are usually flat, pigmented macules on the skin and mucosa. These lesions are characterized by mostly smaller than 0.5 cm, irregular borders and different shades of brown and black. They can be in the form of circumscribed or widespread lesions, and occur either as isolated lesion or as a part of some congenital syndromes. The speckled lentiginous nevus is also named as Nevus Spilus which is a peculiar acquired lentiginous nevus, which can be divided into two distinct clinicopathological variants as macular and papular. On the other hand, centrofacial lentiginosus is a special form of congenital lentiginosus which is inherited as autosomal dominant, and is usually associated with some neurological and psychiatric findings. We report a 43-year old woman with a giant maculo-papular speckled lentiginous nevus associated with a different and non-syndromal isolated centrofacial lentiginosus. To the best of our knowledge this association has not been reported previously.

Dowling Degos disease is characterised by hyperpigmented macules arranged in a reticulate pattern in the flexures. The rare hypopigmented variant shows characteristic acanthosis with antler like rete ridges but with pigment only at the tips of the rete ridges. We describe here a rare variant with coexistence of characteristic reticulate hyperpigmentation and hypopigmented macules, which has been described as generalised Dowling Degos disease.

Background: Freckles are common superficial pigmented lesions which can become cosmetic problems. Advances in laser technology have resulted in the ability to treat pigmented lesions with greater safety and efficacy. Objective: The study aimed to evaluate the effectiveness of 1,064 nm Q-switched neodymium: yttrium–aluminum– garnet (Nd- YAG) laser in the treatment of freckles. Methods: Fifty patients with freckles referring to the laser centers of Al-Azhar University hospital (Asyut) were enrolled in this open-label, monocentric study. All participants received 3 sessions of 1,064-nm Q switched Nd:YAG laser at 4-weeks intervals. The pigmentation area and severity index (PSI score) was calculated based on 3 parameters: Area, darkness, and density of the pigmented lesions. Results: Fifty patients (4 males and 46 females) completed the study protocol. The age of the patients ranged from 6-43 years, the duration of freckles showed a wide range, (1 month-20 years) with a mean duration of 5.13 ± 4.72 years. There was a statistical significant improvement in mean PSI after treatment of freckles with 1064 Q-Switched Nd-YAG. Excellent improvement (≥75%) were occurred in 17 cases (34%), very good improvement (50-74%) in 14cases (28%), good improvement (≥25-49%) in 16 cases (32%) and poor improvement (<25% lightening) in 3 cases (6%). The correlation between improvement and clinical parameters showed positive significant correlation with duration of disease and number of sessions. The reported side effects among this study were post-inflammatory hyperpigmentation in 2 cases (4%), hypopigmentation in 3 cases (6%) and erythema in 6 cases (12%). Conclusions: 1064 Q-switched Nd- YAG laser is effective modality in the treatment of freckles especially in patients with long duration.

Primary Oral Mucosal Melanoma (POMM) is a very rare entity and it develops from malignant transformation of melanocytes from mucosal epithelium. POMM has a very poor prognosis and aggressive behavior. It represents only 0.5% of all oral malignancies, accounting 0.2 to 8% of all melanomas, with an incidence of 1.2 cases per 10 million per year. POMM is asymptomatic in its early stages and usually not noticed by the patients, resulting in the delay in diagnosis. Immunoreactivity of melanoma cells to antibodies against: S-100 protein; Melan-A (MART-1) and HMB-45 (gp100) can be very useful to distinguish POMM from other malignancies. Others markers may indicate variations in its biologic behavior and prognosis, such as Ki-67; P53 and P16, and maybe useful for prognostic prediction.

Wound healing occurs by regeneration or repair in which the damaged tissue at the wound site is replaced with fibroblastic mediated scar tissue. However, inadequate cell repair due to poor vascularity at the wound site results in non-healing wounds. This study evaluated the effect of human embryonic stem cell (hESC) therapy in six patients with non-healing wounds. The wound was cleaned and washed with normal saline and cotton gauze. The ready to use form of hESCs was sprayed on the wound and final dressing was done with antibiotics, vaseline gauze and cotton pads. The wounds of all the patients healed after receiving hESC therapy. Reduction in the size of wounds and granulation was observed among all the patients. hESC therapy showed improved and faster wound healing in non-healing wounds of different etiologies.