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Byline: Hiraku. Kokubu, Takeshi. Kato, Sino. Fujimoto, Toshihiro. Tanaka, Noriki. Fujimoto Context: Few reports focused on the sex differences in alopecia areata (AA) treated with steroid pulse therapy. Aims: This [...]

This article discusses a case of cryoglobulinemic vasculitis complicating Sjögren's syndrome with IgA accumulation. The patient, a 90-year-old Japanese female, presented with bilateral lower limb purpura and joint pain. Laboratory investigations showed elevated levels of various markers, including immunoglobulin G (IgG), immunoglobulin A (IgA), and rheumatoid factor (RF). The patient was diagnosed with primary Sjögren's syndrome complicated by cryoglobulinemic vasculitis. Treatment with prednisolone and azathioprine improved the symptoms. The article highlights the importance of careful examination to identify underlying conditions such as Sjögren's syndrome or cryoglobulinemia in cases clinically diagnosed as IgA vasculitis. [Extracted from the article]

The association between immunoregulatory cytokines, such as interleukin (IL)‐10 or IL‐35, and dipeptidyl peptidase‐4 inhibitor (DPP4i)‐related bullous pemphigoid (BP) has not been evaluated. Serum IL‐10 and IL‐35 levels were measured in 39 patients with BP (24 males and 15 females; 6 DPP4i‐related and 33 DPP4i‐unrelated BP patients) and 10 healthy controls. The number of CD26+ cells in the dermis around bulla on sections was counted immunohistochemically for 12 patients (six patients with DPP4i‐related BP and six randomly sampled patients with DPP4i‐unrelated BP). Patients with DPP4i‐related BP had lower levels of serum eosinophils (DPP4i‐related vs. DPP4i‐unrelated BP: 476.1 ± 234.0 vs. 911.3 ± 948.8/μL; p = 0.537) and a higher rate of infiltrating CD26+ cells (32.9 ± 7.1% vs. 15.7 ± 4.4%; p = 0.01). There were no significant differences in serum IL‐10 (6.77 ± 0.24 vs. 6.84 ± 0.20 pg/mL), serum IL‐35 (2.63 ± 0.17 vs. 2.63 ± 0.21 pg/mL), serum anti‐BP180NC16a antibodies (67.31 ± 37.4 vs. 76.18 ± 54.59 U/mL) and Bullous Pemphigoid Disease Area Index before treatment in this study. Serum IL‐10 and IL‐35 levels do not increase in patients with BP and may not be a candidate for a therapeutic target for BP. An increase in CD26+ cells might be associated with DPP4i‐related BP. [ABSTRACT FROM AUTHOR]

In this study, dermoscopy was applied to determine the site of skin biopsy in cases of palmoplantar pustulosis (PPP) with invisible tiny pustules or vesicles. Fifty‐two clinically diagnosed PPP patients (11 men and 41 women) were observed by a dermoscope and underwent skin biopsy. Nineteen patients had visible pustules, whereas 33 had no visible pustules. Pustules were detected by a dermoscope on palmoplantar lesions in 17 of the 33 PPP patients. In contrast, 16 patients showed no presence of pustules or vesicles observed by a dermoscope. In this group, biopsy specimens were taken from scaly lesions. Out of the 16 patients, 10 histologically showed pustules in the epidermis. We finally detected pustules for 46 patients among 52 who were clinically diagnosed with PPP. As a result, we detected pustules in PPP for 19 patients on "inspection", and 36 patients on "inspection and dermoscopy", and 46 patients on "inspection, dermoscopy, and biopsy". Dermoscopy is significantly useful comparing the detection rate (inspection, 0.41; inspection and dermoscopy, 0.78; p = 0.0003; using χ2‐test). In addition, we also should learn from the results that the detection rate goes down to 0.78 without a biopsy. Thus, dermoscopy is certainly a useful tool for invisible pustules and also undetectable pustules to detect pustules in PPP. Moreover, we objectively showed that "inspection, dermoscopy, and biopsy" are the best way to make a PPP diagnosis. [ABSTRACT FROM AUTHOR]

We present a very rare case of primary Sjögren's syndrome with refractory myositis. She had only anti‐Ro60 antibody of anti‐SS‐A, which is extremely rare in patients with Sjögren's syndrome and polymyositis/dermatomyositis. We suggest a possibility that not only anti‐SS‐A/Ro52 but also anti‐SS‐A/Ro60 may contribute to the resistance in the same way. [ABSTRACT FROM AUTHOR]