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ABSTRACT Background/Objectives: Steamed piper betle leaves (PBL) were once used by many Taiwanese women to treat pigment disorders on the face. Most women claimed a quick, favourable response at first, only to be overcome with facial leukomelanosis later. Methods: C57BL/6 mice were randomly assigned to different groups to study if PBL could cause the following effects: contact dermatitis, leukomelanosis, or hair bleaching. Intracellular melanin content was measured by tyrosinase assays. Results: Most steamed PBL-treated mice developed contact dermatitis and postinflammatory hyperpigmentation (PIH) on their shaved backs. About half developed bleached hair to varying extents. The steamed PBL did not only bleach the hairs, but also, unexpectedly, stimulated melanocyte replication, indicated by the fact that the number of functional melanocytes in the tail epidermis increased significantly after treatment ( P = 0.007). Using tyrosinase assays PBL extract at the undiluted concentration showed limited inhibition of melanogenesis, probably via melanocytotoxicity. Conclusions: The leukomelanosis observed in patients might be the consequence of PIH combined with a mixed reaction (hyper- and hypopigmenta tion), probably due to the different volatile chemicals that surface after steaming the PBL. This conflicting mixed reaction suggests that counteractive ingredients might exist in PBL. PBL, if purified, might be a promising source of a novel bleaching agent. [ABSTRACT FROM AUTHOR]

The article explores the relative risk of cancer in Taiwanese patients with rheumatoid arthritis (RA). The study includes data of 23,644 patients with RA using the National Health Insurance database of Taiwan from 1996 to 2007. The results showed that among the patients with RA, 935 cancers were observed. It also showed that the patients with RA have an increased risk of cancer, especially hematologic cancers.

Background Eccrine poroma (EP) are relatively common benign eccrine neoplasms. Other poroid neoplasms (PNs), namely hidroacanthoma simplex (HS), dermal duct tumor (DDT), and poroid hidradenoma (PH), are seldom reported. Methods Among 18 653 biopsy specimens received from January 1988 to October 2003, we found 25 PNs (0.134%). We conducted retrospective analysis and obtained clinical and histopathological information. Results There were 16 EP, 3 HS, 4 PH, and 2 PH coexisting with either HS or EP. No DDT was found. More than half of PNs presented as red-color neoplasms, but none were diagnosed correctly on clinical grounds alone. The most common preoperative diagnoses were pyogenic granuloma or soft fibromas. Most EPs were located on hair-bearing regions of the limbs (37.5%) and trunk (25%), instead of soles (18.8%) and palms (6.3%). Three HS showed no cuticular cell, but had monomorphic poroid cells. Most EPs (10/16) were composed of both poroid and cuticular cells. All PH were composed of cuticular and poroid cells. Horn cysts were found in three cases (12%). Most PNs (16/25) contained clear cells. Conclusions PNs are sudoriferous tumors that may vary considerably in clinical expression. EP, about 64% (16/25) of PNs in our series, was the most common. PH incidence is probably underestimated in the literature. We found six PHs in 25 PNs. Histopathologically, it is not justified to exclude PN diagnosis by noticing horn cysts. It was uncommon for two or three subtypes of PN to occur in a single lesion. [ABSTRACT FROM AUTHOR]