Tạp chí Da liễu học Việt Nam

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Bia Bia — Mon, 20 Jan 2025 00:00:00 +0800

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HORI NEVUS

Hien Tran Thi Thu, Phuong Nguyen Ha, Sau Nguyen Huu — Mon, 20 Jan 2025 00:00:00 +0800

Acquired bilateral nevus of Ota-like macules, commonly referred to as “Hori nevus,” is a facial hyperpigmentation condition prevalent among Asian women. This condition is characterized by speckled brown to gray-blue hyperpigmented macules that symmetrically appear on both cheeks, often resembling freckles, lentigines or melasma. Traditional treatments, including depigmentation drugs, cryotherapy, dermabrasion, and peels, have generally showed less effective and are associated with significant side effects. Recent studies, however, indicate that pigment-selective Q-switched lasers, particularly the Q-switched Nd:YAG 1064 nm laser, offer good treatment outcomes. Nonetheless, practitioners must carefully consider potential side effects, such as post-inflammatory hyperpigmentation and exacerbation of melasma, when selecting appropriate treatment methods for patients.

MANAGEMENT OF PSORIASIS DURING PREGNANCY

Huong Vu Xuan, Vinh Nguyen Thi Ha — Mon, 20 Jan 2025 00:00:00 +0800

Psoriasis is considered a chronic inflammatory condition characterized by well-defined red papules and plaques covered with thick, easily shed white scales, primarily appearing in the hairline and pressure areas. The disease is associated with several conditions, including cardiovascular diseases, inflammatory bowel disease, depression, and metabolic syndrome. The physical and mental burden negatively impacts the quality of life of patients

BULLOUS SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE SERIES AND 5-YEAR RETROSPECTIVE REVIEW

Tuan Hoang Quoc, Phuong Hoang Thi, Luong Dang Thi, Tam Hoang Van — Mon, 20 Jan 2025 00:00:00 +0800

Bullous systemic lupus erythematosus (BSLE) is a rare presentation of systemic lupus erythematosus (SLE) that mainly occurs in females (30-40 years old) and less frequently in children and adolescents. BSLE has many clinical and histological feautures that may lead to misdiagnosis and delayed treatment.

We report 14 patients with blistering lesions at admission, who were diagnosed with BSLE over the last 5 years in The National Hospital of Dermatology and Venereology (NHDV), Vietnam. Our cases were reviewed carefully of the clinical presentation, histopathology, immunofluorescence and therapeutic regimens. Because these manifestations may be confused with several other blistering diseases, such as bullous pemphigoid (BP), dermatitis herpetiformis (DH) or epidermolysis bullosa acquisita (EBA). All of our cases presented with the rapid and widespread development of tense vesicles and bullae over erythematous macules or plaques predominantly on the face, neck, upper extremities and trunk with symmetrical distribution. Mucosal involvement is common on oral and genital areas. The lesions usually progress without scarring and milia, but hypo or hyperchromia may be present. These cases shared the histopathology in common with a subepidermal bullae with neutrophil-predominant inflammatory infiltrate below the bullae formation. Both the direct and indirect immunofluorescence findings were made to confirm the diagnosis of BSLE. Some of our cases were well-responded to treatment with dapson, but several ones required systemic corticosteroids and immunosuppressants. We emphasize the relevance of recognizing BSLE - a rare presentation of SLE - which may evolve with marked clinical presentation.

CUTANEOUS METASTASIS OF LUNG CANCER

Hung Nguyen Manh, Giang Quach Thi, Minh Nguyen Thi Ha — Mon, 20 Jan 2025 00:00:00 +0800

Cutaneous metastasis from lung cancer is rare but should be ruled out in patients with suspicious skin lesions and a history of smoking or lung cancer. All types of lung cancer can metastasize to the skin, with varying clinical manifestations. The incidence of cutaneous metastasis in lung cancer patients ranges from 1-12%. In 20-60% of cases, skin lesions appear before or simultaneously with the diagnosis of the primary tumor. Skin lesions are typically nodular, mobile or fixed, hard or soft, solitary or multiple, and painless. Histologically, cutaneous metastases often show moderate to poor differentiation. Treatment for solitary cutaneous metastasis typically includes surgery alone or combined with chemotherapy and/or radiation therapy. If multiple skin lesions or metastases to other organs are present, chemotherapy is the primary treatment option. Cutaneous metastasis from lung cancer is associated with a poor prognosis, with an average survival time of around 5-6 months. In this report, we present a case of a 58-year-old male patient with these manifestations.

CLINICAL CHARACTERISTICS AND SERUM CONCENTRATIONS OF SOME T-HELPER 2-DERIVED CYTOKINES IN PATIENTS WITH GENERALIZED ERYTHEMA MULTIFORME

Huyen Tran Thi, Lan Pham Thi, Phuong Pham Thi Minh, Vinh Nguyen Thi Ha — Mon, 20 Jan 2025 00:00:00 +0800

Objective: To describe the clinical characteristics of patients with erythema multiforme (EM) presenting with generalized skin lesions and to investigate the serum concentrations of certain T-helper 2 (Th2) cytokines in these patients, exploring their correlation with specific clinical features.

Subjects and Methods: This cross-sectional descriptive study included 33 patients diagnosed with EM featuring generalized skin lesions at the National Hospital of Dermatology and Venereology from April 2017 to August 2019. Additionally, 32 healthy controls (HCs) participated as the control group. Clinical examinations, medical history interviews, and serum sample collections were conducted for all subjects. The fluorescence covalent microbead immunosorbent assay technique was used to detect multiple cytokines simultaneously: IL-4, IL-5, and IL-13. The Mann-Whitney U test compared the serum cytokine levels between the two groups, with statistical significance set as p<0.05. Pearson's test was applied to evaluate the correlation between two quantitative variables.

Results: The mean age of EM patients with generalized lesions was 42.2 years; 30.3% were male, and 69.7% were female. Twenty-two patients (66.7%) had an illness duration of less than one week—a history of medication use before illness onset was reported by 60.6% of patients. Only 15.2% of patients had mucosal lesions. In the EM group, serum levels of IL-4 and IL-5 were 1.55±4.35 pg/ml and 7.12±18.91 pg/ml, respectively, which were lower than those in the HCs group (9.15±10.17 pg/ml and 21.38±20.85 pg/ml, respectively), p<0.001. Serum IL-13 levels were identical in both groups (1.48 pg/ml). No correlation was found between serum IL-4 levels and age (r=0.08; p>0.05), nor between serum IL-5 levels and age (r=-0.055; p>0.05).

Conclusion: Th2 cytokine levels in the EM group with generalized skin lesions were lower compared to the HCs group, with no correlation between these cytokine levels and age. Th2 is likely not an important factor in the pathogenesis of generalized EM.

Received: 16 May 2023
Revised: 24 June 2023
Accepted: 22 July 2023

FREQUENCY OF THE SINGLE NUCLEOTIDE POLYMORPHISM RS743572 VARIANT OF CYP17A1 GENE AND ITS ASSOCIATION WITH ACNE SEVERITY IN VIETNAMESE PATIENTS

Vy Le Nguyen Thuy , Tro Chau Van, Tuan Nguyen Huu Ngoc — Mon, 20 Jan 2025 00:00:00 +0800

Objective: To determine the frequency of the rs743572 variant of the CYP17A1 gene and its association with clinical characteristics in patients diagnosed with acne.

Materials and methods: A cross-sectional study was conducted on Vietnamese patients diagnosed with acne from March 2023 to July 2023 at Ho Chi Minh City Hospital of Dermatology and Venereology. The variant was identified using Sanger sequencing.

Results: A total of 95 Vietnamese patients were diagnosed with acne. The majority were aged 12-25 (84.2%), with a median age of 21 years (ranging from 12 to 43 years), and 60.0% were female. The allele frequencies were 43.2% for allele A and 56.8% for allele G. The genotype distribution was 16.8% AA, 52.6% AG, and 30.6% GG. A statistically significant association was found between the presence of the variant and the clinical severity of the disease.

Conclusion: This is the first study to determine the rate of the rs743572 variant in a Vietnamese acne population, initially noting a statistically significant association between the variant and disease severity.

Received: 14 October 2023
Revised: 19 July 2024
Accepted: 30 August 2024

THE ASSOCIATION BETWEEN ANTI-U1-RNP ANTIBODY AND SKIN LESIONS, MUSCLE INVOLVEMENT AND PERIPHERAL VASCULAR INJURY IN PATIENTS WITH SYSTEMIC SCLEROSIS

Huong Vu Xuan, Doanh Le Huu, Phuong Hoang Thi, Hien Do Thi Thu, Luong Vu Huy — Mon, 20 Jan 2025 00:00:00 +0800

Objective: To evaluate the relationship between anti-U1-RNP antibodies and skin, muscle, peripheral vascular, and renal damage in patients with systemic sclerosis.

Subjects and methods: A cross-sectional descriptive study was conducted on 55 patients diagnosed with systemic sclerosis according to the criteria of the American College of Rheumatology (ACR) and the European League Against Rheumatism (2013) at the National hospital of Dermatology and Venereology from September 2021 to September 2022. Patients were tested for anti-U1-RNP antibodies in their blood using the ANA 23 profile test.

Result: The positivity rate for anti-U1-RNP antibodies was 14.5%. Among skin lesions, the most common manifestation was sclerodactyly (87.3%), followed by poikiloderma (47.3%), and less frequently, digital edema (27.3%). The average modified Rodnan skin score in the systemic sclerosis group was 21.2 ± 6.8, with the anti-U1-RNP positive group scoring higher (27.3 ± 6.1) than the negative group (20.2 ± 5.8) (p = 0.002). The incidence of peripheral vascular damage, including the rate of periungual telangiectasia and periungual hemorrhage, was higher in the anti-U1-RNP positive group compared to the negative group (p = 0.018 and p = 0.034, respectively). The rate of elevated muscle enzymes (CK > 190 U/l) in the anti-U1-RNP positive group (75.0%) was also higher than in the negative group (17.4%) (p = 0.002). The incidence of elevated serum creatinine and proteinuria in the systemic sclerosis group with positive anti-U1-RNP antibodies was higher than in the negative group (p = 0.018 and p = 0.029, respectively).

Conclusion: Patients with systemic sclerosis who test positive for anti-U1-RNP antibodies tend to have higher rates of skin lesions, peripheral vascular damage, muscle damage, and renal damage compared to those who test negative.

Received 12 May 2023
Revised 11 July 2023
Accepted 28 August 2023

ASSOCIATION OF ANTI-KU AUTOANTIBODIES AND SOME ORGAN DAMAGE OF AUTOIMMUNE CONNECTIVE TISSUE DISEASES

Mon, 20 Jan 2025 00:00:00 +0800

Objective: To assess the association between anti-Ku antibodies and organ damage in common autoimmune connective tissue diseases.

Materials and Method: This was a descriptive, cross-sectional, retrospective, and prospective study involving 215 patients diagnosed with autoimmune connective tissue diseases, including systemic sclerosis, systemic lupus erythematosus, dermatomyositis, and overlap syndromes of ACTDs, treated at the National Hospital of Dermatology and Venereology from January 2021 to December 2022. Patients were tested for the presence of anti-Ku antibodies using the ANA 23 profile test kit.

Result: Out of the 215 patients in the study, 60 (27.9%) tested positive for anti-Ku antibodies, predominantly at a weak level (1+). Among these, 43.3% had systemic lupus erythematosus, 10% had systemic sclerosis, 18.3% had dermatomyositis, and 28.3% had overlap syndromes of ACTDs. The group with positive anti-Ku antibodies exhibited a higher incidence of butterfly rash and mouth ulcers. The positive anti-Ku antibody group had a significantly higher rate of elevated muscle enzymes (53.3%) compared to the negative group (29.7%) (p = 0.001). Additionally, the incidence of pulmonary arterial hypertension was 39.5%, with the positive anti-Ku antibody group having a higher rate (61.7%) than the negative group (31%) (p < 0.05). High-resolution computed tomography revealed interstitial lung lesions in 37.2% of the patients, with no significant difference between the positive and negative groups.

Conclusion: Anti-Ku antibodies are relatively prevalent in patients with autoimmune connective tissue diseases, particularly in systemic lupus erythematosus and overlap syndromes of ACTDs. Patients with positive anti-Ku antibodies are at a higher risk of developing acute skin lesions in systemic lupus erythematosus, muscle damage with elevated muscle enzymes, and pulmonary arterial hypertension compared to those without these antibodies.

Received 14 August 2023
Revised 13 September 2023
Accepted 03 November 2023

PROLACTIN SERUM LEVELS IN PEMPHIGUS PATIENTS

Thong Thai Van, Em Doan Van Loi, Diep Le Ngoc, Hao Nguyen Trong — Mon, 20 Jan 2025 00:00:00 +0800

Objective: Pemphigus is an autoimmune blistering disease. Prolactin is a hormone that affects the immune system; elevated serum prolactin levels may reduce the destruction of autoimmune B-cell lines, lower the activation threshold of B-cells, and promote autoimmune responses. This study aims to investigate the difference in serum prolactin levels between pemphigus patients and a control group.

Subjects and Methods: A case-control study was conducted on 30 pemphigus patients and 20 controls who visited Ho Chi Minh City Dermatology Hospital between January 20, 2022, and September 30, 2022, for serum prolactin level testing.

Results: Serum prolactin levels were significantly higher in the pemphigus group compared to the control group [12.9 (9.2 – 20.1) ng/ml vs. 6.7 (4.3 - 9.5) ng/ml; p = 0.0001]. The study also found a moderate positive correlation between serum prolactin levels and the extent of skin lesions in the patient group (r = 0.39, p = 0.03).

Conclusion: Serum prolactin levels were significantly higher in pemphigus patients compared to the control group.

Received 20 November 2023
Revised 27 December 2023
Accepted 28 February 2024

THE EFFICACY AND SAFETY OF SECUKINUMAB 150MG REGIMEN IN TREATING PATIENTS WITH PSORIASIS VULGARIS

Mon, 20 Jan 2025 00:00:00 +0800

Objectives: Evaluate the effectiveness and safety of secukinumab 150mg subcutaneous injection regimen in treating patients with moderate to severe psoriasis vulgaris.

Subjects and methods: Prospective clinical trial on 32 patients with moderate to severe psoriasis. Patients were treated with secukinumab 150mg subcutaneous injection regimen for weeks 0, 1, 2, 3, 4, 8, 12, 16. Evaluate treatment response with PASI, DLQI and IGA 2011 and record adverse effects during 16 weeks.

Results: After 16 weeks of treatment, PASI and DLQI gradually decreased during the period. The proportion of PASI 75 responses was highest at week 12 with 90.7%, while the proportion of PASI 90 and PASI 100 responses increased continuously until week 16, with 75% and 25% at week 16 respectively. There is a correlation between patients’ weight and the efficacy of the regimen. 3 cases (9.4%) experienced adverse effects, including fatigue, nasopharyngitis and shingles.

Conclusion: Secukinumab 150mg regimen showed as an effective therapy with minor adverse events in the treatment of patients with moderate to severe psoriasis vulgaris.

Received 11 November 2023
Revised 30 December 2023
Accepted 28 February 2024

IMMUNOHISTOCHEMICAL CHARACTERISTICS OF BASAL CELL CARCINOMA AT NATIONAL HOSPITAL OF DERMATOLOGY AND VENEREOLOGY, VIETNAM

Mon, 20 Jan 2025 00:00:00 +0800

Objective: To investigate the immunohistochemical characteristics of basal cell carcinoma at the National Hospital of Dermatology and Venereology.

Methods: A descriptive, cross-sectional, retrospective, and prospective study was conducted on 312 patients diagnosed with basal cell carcinoma at the National Hospital of Dermatology and Venereology from January 2019 to September 2023. Histopathological and immunohistochemical analysis was performed using four immune markers: BerEP4, Bcl-2, p63, and EMA.

Results: BerEP4 immunostaining was positive in all 312 cases of basal cell carcinoma, representing various histological subtypes. Bcl-2 immunostaining was also positive in all 312 cases of basal cell carcinoma, with notably stronger expression in peripheral tumor cells compared to the central region. P63 immunostaining yielded positive results in 310 cases of basal cell carcinoma, accounting for 99.4% of the cases studied. EMA immunostaining, on the other hand, was negative in 308 cases of basal cell carcinoma, equivalent to 87.2%. The four cases of EMA-positive basal cell carcinoma were all classified as the histopathological subtype of squamous basal cell carcinoma (within the invasive category).

Conclusions: These results suggest that immunohistochemistry with the four immune markers, BerEP4, Bcl-2, p63, and EMA, can be used to support the definitive and differential diagnosis of basal cell carcinoma compared to other cutaneous carcinomas.

Received 15 September 2023
Revised 26 September 2023
Accepted 03 November 2023

SKIN CANCERS IN VIETNAMESE XERODERMA PIGMENTOSUM PATIENTS

Mon, 20 Jan 2025 00:00:00 +0800

Objective: Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder caused by defects in DNA repair, leading to severe photosensitivity and significantly increased risk of skin cancer. This study aimed to investigate the clinical features and characteristics of skin cancers in newly diagnosed XP patients in Vietnam from 2018 to 2022, with the goal of improving diagnosis and management.

Methods: We conducted a descriptive cross-sectional study on 36 newly diagnosed XP patients. Diagnosis was based on medical history and clinical examination. Data on the presence of skin cancers, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), were collected and analyzed.

Results: Among the 36 patients, 8 (22.22%) had one or more skin cancers. Six patients had BCCs, and two had SCCs. The mean age at first BCC appearance was 44 ± 18.72 years. One patient presented with multiple BCCs (3 lesions). All BCC cases were treated surgically with good outcomes. The highest number of SCCs (4 lesions) was observed in a 55-year-old man, who also had 20 actinic keratoses (AKs). All patients with BCC or SCC had concurrent AKs. A 16-year-old male, who developed skin cancer at age 9, died due to a giant tumor on his head, representing the youngest case of skin cancer in this cohort.

Conclusion: Early diagnosis and management of XP, including sun protection and regular monitoring for skin cancers, are essential for improving patient outcomes. The findings from this study contribute to the development of practical guidelines for diagnosing and managing XP in Vietnam.

Received 15 June 2024
Revised 06 July 2024
Accepted 18 October 2024

EVALUATION OF THE MOSAIC 7 TEST FOR THE DIAGNOSIS OF IMMUNOBULLOUS SKIN DISEASE

Mon, 20 Jan 2025 00:00:00 +0800

Objective: To determine the positive rate of the Mosaic 7 test in autoimmune bullous diseases at the National Hospital of Dermatology and Venereology.

Materials and methods: A cross-sectional retrospective study was conducted on 44 medical records and serology of patients with autoimmune bullous diseases at the National Hospital of Dermatology and Venereology from October 2021 to September 2022. Data collected included gender, age, diagnosis, histopathology results, indirect immunofluorescence, direct immunofluorescence, and Mosaic 7 test results.

Result: Of the 44 patients with autoimmune bullous diseases, 22 had pemphigus vulgaris, 5 had pemphigus foliaceus, and 17 had bullous pemphigoid. The Mosaic 7 test results varied among the different types of bullous diseases. In pemphigus vulgaris patients, the Mosaic 7 test showed a high positive rate on the esophageal well (90.9%), Desmoglein 1 well (95.5%), and Desmoglein 3 well (86.4%). In pemphigus foliaceus patients, the test showed a 100% positive rate on the esophageal and Desmoglein 1 wells, but 0% on the Desmoglein 3 well. In bullous pemphigoid patients, the positive rates varied across different wells of the Mosaic 7 test.

Conclusion: The Mosaic 7 test demonstrated high utility in diagnosing autoimmune bullous skin diseases, particularly in identifying Desmoglein 1 and Desmoglein 3 in pemphigus vulgaris. However, further studies with larger sample sizes are warranted to validate and refine the test's accuracy.

Received 10 April 2023
Revised 08 June 2023
Accepted 03 November 2023

Tạp chí Da liễu học Việt Nam

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Bia

HORI NEVUS

MANAGEMENT OF PSORIASIS DURING PREGNANCY

BULLOUS SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE SERIES AND 5-YEAR RETROSPECTIVE REVIEW

CUTANEOUS METASTASIS OF LUNG CANCER

CLINICAL CHARACTERISTICS AND SERUM CONCENTRATIONS OF SOME T-HELPER 2-DERIVED CYTOKINES IN PATIENTS WITH GENERALIZED ERYTHEMA MULTIFORME

FREQUENCY OF THE SINGLE NUCLEOTIDE POLYMORPHISM RS743572 VARIANT OF CYP17A1 GENE AND ITS ASSOCIATION WITH ACNE SEVERITY IN VIETNAMESE PATIENTS

THE ASSOCIATION BETWEEN ANTI-U1-RNP ANTIBODY AND SKIN LESIONS, MUSCLE INVOLVEMENT AND PERIPHERAL VASCULAR INJURY IN PATIENTS WITH SYSTEMIC SCLEROSIS

ASSOCIATION OF ANTI-KU AUTOANTIBODIES AND SOME ORGAN DAMAGE OF AUTOIMMUNE CONNECTIVE TISSUE DISEASES

PROLACTIN SERUM LEVELS IN PEMPHIGUS PATIENTS

THE EFFICACY AND SAFETY OF SECUKINUMAB 150MG REGIMEN IN TREATING PATIENTS WITH PSORIASIS VULGARIS

IMMUNOHISTOCHEMICAL CHARACTERISTICS OF BASAL CELL CARCINOMA AT NATIONAL HOSPITAL OF DERMATOLOGY AND VENEREOLOGY, VIETNAM

SKIN CANCERS IN VIETNAMESE XERODERMA PIGMENTOSUM PATIENTS

EVALUATION OF THE MOSAIC 7 TEST FOR THE DIAGNOSIS OF IMMUNOBULLOUS SKIN DISEASE