Two Cases of Unilateral Ashy Dermatosis

Ashy dermatosis is a typically asymptomatic disease of unknown origin that causes symmetrical gray spots to appear on the trunk and extremities. We report 2 cases of ashy dermatosis with unilateral distribution. To our knowledge, only 5 cases of ashy dermatosis with unilateral lesion have been reported so far. Case 1: an 11-year-old woman presented with asymptomatic slate-gray pigmented plaques on the left trunk and left upper arm. The skin biopsy specimen demonstrated a mild lymphohistiocytotic infiltrate in the upper dermis with epidermal and dermal melanosis. Q-Switched ruby laser did not improve such lesions. Case 2: a 21-year-old man was referred to our hospital because of asymptomatic slate-gray pigmented plaques on the left trunk and left upper arm. Histopathological findings were compatible with a mild lymphocytic infiltration with melanin incontinence in the upper dermis. The mechanism that governs unilateral distribution of ashy dermatosis, including in our cases, remains unclear

A Case of Dapsone-induced Mild Methemoglobinemia with Dyspnea and Cyanosis

Dapsone is a dual-function drug with antimicrobial and antiprotozoal effects and anti-inflammatory features (1). In dermatology, it is a first choice for conditions such as leprosy, IgA pemphigus, dermatitis herpetiformis, and linear IgA bullous dermatosis, or an adjunctive treatment for, e.g. bullous pemphigoid (BP) and pemphigus vulgaris (1). However, dapsone is associated with some adverse effects, including methemoglobinemia (1)

A Case of Dapsone-induced Mild Methemoglobinemia with Dyspnea and Cyanosis

Dapsone is a dual-function drug with antimicrobial and antiprotozoal effects and anti-inflammatory features (1). In dermatology, it is a first choice for conditions such as leprosy, IgA pemphigus, dermatitis herpetiformis, and linear IgA bullous dermatosis, or an adjunctive treatment for, e.g. bullous pemphigoid (BP) and pemphigus vulgaris (1). However, dapsone is associated with some adverse effects, including methemoglobinemia (1)

Granular C3 Dermatosis

There has been no previous systematic study of bullous skin diseases with granular basement membrane zone deposition exclusively of C3. In this study we collected 20 such patients, none of whom showed cutaneous vasculitis histopathologically. Oral dapsone and topical steroids were effective. Various serological tests detected no autoantibodies or autoantigens. Direct immunofluorescence for various complement components revealed deposition only of C3 and C5?C9, indicating that no known complement pathways were involved. Studies of in situ hybridization and micro-dissection with quantitative RT-PCR revealed a slight reduction in expression of C3 in patient epidermis. These patients may represent a new disease entity, for which we propose the term “granular C3 dermatosis”. The mechanism for granular C3 deposition in these patients is unknown, but it is possible that the condition is caused by autoantibodies to skin or aberrant C3 expression in epidermal keratinocytes

Ustekinumab successfully treated a patient with severe psoriasis vulgaris with primary failure to infliximab and secondary failure to adalimumab

Biologic drugs have been recently used to treat psoriasis. However, some patients do not respond or lose therapeutic benefit with first-line use of tumor necrosis factor (TNF) antagonists. We report a case of psoriasis vulgaris, that failed to respond to TNF antagonists, infliximab and adalimumab, completely disappeared after treatment with ustekinumab, a therapeutic agent for biologically blocking p40 protein of interleukin (IL) 12 and 23. This report highlights anti-TNF agents only inhibited the TNF-α/inducible nitric oxide synthase (iNOS)-producing dendritic cells (TIP-DCs), but the plasmacytoid-DC-derived psoriatic response was re-initiated. On the other hand, ustekinumab may inhibit both the TIP-DCs and the plasmacytoid-DC-derived inflammatory response

A Case of Tuberculous Cellulitis

We describe a rare case of cutaneous TB where cellulitis-like symptoms are presented