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Zosteriform cutaneous metastases from a carcinoma mammae Widiasri, Kharisma Yuliasis; Sayekti, Ayu Wikan; Febiyanto, Novian; Wahyuanggradewi, Elliana; Giantoro, Jeffrey; Pudjiati, Satiti Retno; Rinonce, Hanggoro Tri; Siswati, Agnes Sri
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Cutaneous metastases were reported in 18.6-26.5% of breast cancer patients. Zosteriform cutaneous metastasis is an unusual and rare morphological variant. Clinicians, especially dermatovenereologists, should consider dermatomal cutaneous metastases in oncology patients aside from herpes zoster, which is common in this population. Case Illustration: A 62-year-old woman presented with clustered papules and vesicles with an erythematous base, sometimes painful, on the right side of the chest in T5-T7 dermatomal distribution of 1-month duration. She had undergone a radical mastectomy for breast carcinoma and had been receiving chemoradiotherapy, which was completed in March 2018. A diagnosis of zosteriform cutaneous metastases was established after discovering malignant cells in the representative lesion via biopsy, similar to those sampled from the previous cancerous right mammary tissue. Discussion: Zosteriform cutaneous metastasis is a rare occurrence, with a variety of clinical backgrounds, morphological, and histological features that can influence the clinical course of the disease. The mechanism for the occurrence of zosteriform cutaneous metastasis remains uncertain; several studies reported possible causes: Koebner-like reactions at the site of previous herpes zoster infections, perineural lymphatic spread, spread through blood vessels associated with the dorsal ganglion, unintentional implantation during surgery, direct invasion of the underlying structure (primary cancer), and spread from the lymphatic system. This case suits the diagnosis of zosteriform cutaneous metastases based on lesion morphology, location, distribution, and histopathological features matching those of the primary tumor. Conclusion: Metastatic disease should be considered in the differential diagnosis of zosteriform rash in oncology patients.
The effectiveness of ceramide moisturizing cream in pruritic papular eruption treatment of HIV/AIDS patients Sayekti, Ayu Wikan; Putri, Ann Kautsarina; Pudjiati, Satiti Retno; Winarni, Dwi Retno Adi
Bali Dermatology Venereology and Aesthetic Journal BDVAJ - Volume 7, Issue 1 (January 2024)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/balidervenaesthj.v7i1.96

Abstract

Background: Pruritic papular eruption (PPE) is one of the most common skin manifestations in HIV/AIDS patients. Pruritic papular eruptions are due to immune dysregulation, causing dominance of interleukin-4, which causes a decrease in ceramide synthesis (CER) and impaired skin barrier function. This study aimed to investigate the effectiveness of CER over non-CER moisturizing cream in HIV/AIDS patients with PPE. Methods: Double-blind experimental design. The research subjects are PPE patients at Dr. Sardjito General Hospital. CER and non-CER moisturizing cream are applied for three weeks, respectively. Analysis of the trans-epidermal water loss (TEWL), skin hydration, and itching were analyzed using an unpaired T-test or the Mann-Whitney test with a significance of p<0.05. Results: Ceramide synthesis moisturizing cream decreased the TEWL value by 3.56 ± 2.38 g/m2/hour; increased the value of skin hydration by 16.39±7.19 a.u.; decreased skin lesions by 0.79 ± 4.95; reduced itching by 1.54 ± 0.78 and without causing side effects. Non-CER moisturizing cream decreased the TEWL value by 1.57 ± 2.00 g/m2/hour; increased the value of skin hydration by 12.03 ± 6.88 a.u.; decreased skin lesions by 1.42 ± 3.00; reduced itching by 1.17 ± 0.70 and also without causing side effects. Conclusion: Ceramide cream is more effective than non-CER moisturizing cream in reducing TEWL and increasing skin hydration. Ceramide and non-CER moisturizing creams have the same effectiveness in reducing the number of lesions and reducing itching. Ceramide and non-CER moisturizing creams do not cause side effects.