A Case of Primary Cutaneous Diffuse Large B-cell Lymphoma / 대한피부과학회지

Primary cutaneous diffuse large B-cell lymphomas are characterized by a non-epidermotropic monotonous infiltrate of large follicular center cells with various proportions of centroblasts, large centrocytes, multilobated cells or immunoblasts without extracutaneous manifestations. We report a case of a 61-year-old man, who presented with several, annular plaques on the trunk. The clinicopathologic features and immunohistochemical profiles were diagnostic of primary cutaneous diffuse large B-cell lymphoma.

Eosinophilic Pustular Folliculitis: a Clinico-Pathologic Study in Korea / 대한피부과학회지

BACKGROUND: Eosinophilic pustular folliculitis (EPF) is a rare chronic disease of unknown cause with pruritic papulopustular lesions and a prominent eosinophilic infiltrate. OBJECTIVE: The purpose of this study was aimed at evaluating the clinical and histopathological features of EPF. METHODS: The hospital charts and histopathologic slides of 8 patients with EPF diagnosed at Asan Medical Center from 1989 to 1998 were reviewed. We also reviewed the previously published reports of 10 patients with EPF in Korea. RESULTS: Nine male and nine female patients were enrolled in this study. The mean age at diagnosis of EPF was 26 years in men and 27 years in women. All the patients complained of mild to severe pruritus. EPF was presented with follicular papules or pustules, except 2 patients, who presented with erythematous plaques free of papules or pustules. All the patients showed the typical histopathological findings of EPF. Laboratory investigation showed hypereosinophilia in 73% of patients (11/15). The levels of blood eosinophils tended to decrease as cutaneous lesions resolved. EPF was improved with dapsone in 12 patients and the rest were treated with topical or systemic steroid or antihistamines. CONCLUSION: EPF may be more common in Korea than can be suspected. Because EPF showed characteristic histopathological findings and EPF responds well to dapsone, the knowledge with this disease may be important to diagnose and treat it.

Mixed Tumor of the Skin: Clinicopathological Study of Seven Cases

BACKGROUND: Mixed tumor of the skin or chondroid syringoma is a benign neoplasm characterized by histological features of a mixture of epithelial and mesenchymal components. It is a rare and benign appendageal tumor, found mostly on the head and neck, and present as an asymptomatic, firm, subcutaneous nodule. There have only been a few reported cases in Korea. OBJECTIVES: This study was aimed to characterize the clinical and histopathlological features of mixed tumor of the skin. METHODS: We reviewed the clinical data and histologic slides of seven patients who have been diagnosed with mixed tumor of the skin by histopathological examination. RESULTS: There were six male patients and only one female. Age of onset of mixed tumor of the skin varied from 26 to 65 years. A11 patients had the lesion on the head: perioral area (3 cases), nose (2 cases), cheek (1 case), and temple area (1 case). Each tumor was a solitary, asymptomatic, and firm, about 0.5-1.5 cm sized, subcutaneous nodule. Histopathologically, all 7 cases presented apocrine differentiation. Two cases showed follicular differentiation, and 2 cases showed sebaceous differentiation. Every tumor showed myxoid stroma except two with typical chondroid matrix. Adipose metaplasia of the matrix was present in 2 cases. In 3 cases, the so-called hyaline cells were rich in the stroma. CONCLUSION: Mixed tumor of the skin was most commonly seen as an asymptomatic, firm subcutaneous nodule on the head. Tumors showing apocrine differentiation were more common than that of eccrine differentiation, All 7 cases presented apocrine differentiation. Follicular and sebaceous differentiation might occur in apocrine type of mixed tumors of the skin. The stroma of mixed tumor of the skin might be myxoid, chondroid, or adipose.

Purpura Fulminans

Purpura fulminans may be seen in three different clinical settings: (1) in the neonatal period from protein C and S deficiencies, (2) during severe bacterial infections such as “sepsis-associated” purpura fulminans, and (3) during the convalescence of an otherwise benign “preparatory” infectious disease most commonly involving the skin. We report a case of a 20-month-old male child with purpura fulminans as a presenting sign of disseminated intravascular coagulopathy (DIC). He had suffered from fever of unknown origin for a month. Although purpura fulminans is not a common disorder to dermatologists, the awareness of this disorder may be the clue to diagnose and treat underlying diseases.