A 17-year-old female presented to our department with dark purple erythematous spots on her fingers and toes that had appeared in infancy and had been treated as severe chilblains. She had a history of open-angle glaucoma, but had no family history of similar skin symptoms. At presentation in April, dark red spots, crusts, and scars were observed on the dorsal surfaces of the fingers of both hands, as well as on both auricles and knees, accompanied by partial loss of fingernails. Autoantibodies were all negative. The patient's symptoms improved during summer; however, during winter, blisters and ulcers arose on her fingers and toes. Genetic analysis revealed a heterozygous pathogenic mutation in the TREX1 gene. The patient was diagnosed as having Aicardi-Goutières syndrome with glaucoma and severe chilblain-like erythema.
A 72-year-old man presented with multiple skin metastases of esophagogastric junction carcinoma. Six weeks after stating ramucirumab and paclitaxel combination therapy, he developed well-defined, pruritic, erythematous papules on the occipital, parietal, and eyebrow areas. He was diagnosed with multiple pyogenic granulomas (multiple PG) due to the presence of telangiectasias and dilatations of various sizes in the dermis. Ramucirumab-associated multiple PG and idiopathic PG differ in their expression of vascular endothelial growth factor (VEGF) -A and VEGFR-2 and arise via different mechanisms. We hypothesized that ramucirumab, a human anti-VEGFR-2 antibody, inhibits intra-tumor angiogenesis but paradoxically induces angiogenesis.
Moisturizers for medical use are commonly used for the treatment of asteatosis. The moisturizer contains heparinoids, one of the most widely used in the medical field. Heparinoid is a polysulfated mucopolysaccharides (mucopolysaccharide polysulfate, MPS) made from chondroitin sulfate; it has a high water-holding capacity and moisturizing effect. In this paper, we review the action mechanism of MPS as a therapeutic agent for asteatosis, focusing on the pharmacological effects of MPS reported in recent years.