The sign of Leser-Trélat (LT) is defined as the sudden eruption of multiple seborrhoeic keratoses (SKs), or increase in the number and size of existing SKs, associated with an underlying malignancy. A 75-year-old man was admitted to our hospital with dyspnoea and multiple verrucous papules that had been developing gradually over the previous 30 years. During the 3 months before presentation, the number of SKs on his chest and back had increased rapidly. A diagnosis of nasopharyngeal carcinoma was made based on results of computed tomography, endoscopy and biopsy examinations. The patient is receiving radiotherapy at present. To our knowledge, this is the first case of the Leser-Trélat sign associated with nasopharyngeal carcinoma.
Atopic dermatitis (AD) is a chronic skin inflammatory disease characterized by uncontrolled Th2 cells response to environmental allergens. Long-term topical application of corticosteroids for treating AD may induce severe side effects. Sulfuretin is a major flavonoid found in Rhus verniciflua and carries antioxidant and anti-inflammatory properties. Its therapeutic effect on AD has not been characterized. We first studied the cytotoxic and regulatory effects of sulfuretin on differentiated Th2 cells. Next, we evaluated therapeutic effect of sulfuretin on AD-like damages caused by 2,4-dinitrochlorobenzene (DNCB) in a mouse model. Serum IgE level, overall symptomatic score, and cytokine accumulation at the lesions were measured. Lastly, we investigated the regulatory mechanism of sulfuretin on GATA3 pathway in primary mouse CD4 cells. Study on in vitro differentiated Th2 cells showed sulfuretin inhibited IL4 production in dose-dependent manner without any cytotoxicity. In vivo study showed 10 μM sulfuretin alleviated the AD symptoms including skin lesion severity, scratching incidence, IgE serum level, and proinflammatory cytokine accumulation at local skin lesion site. Mechanistic study suggested sulfuretin attenuated Th2 cytokine production by suppressing GATA3 expression. Our results demonstrate that sulfuretin could be used as therapeutic application for treating AD.
An unusual form of secondary syphilis was reported, characterized by multiple papules involving the intertriginous areas. The skin biopsy was performed but was nondiagnostic. Later on, serologic tests confirmed the diagnosis. This patient is presented to emphasize the importance of considering syphilis in any patient with an at-risk sexual history and popular verrucous lesions of the skin folds.
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