A Case of Basal Cell Carcinoma Presenting as a Cyst Occurred in the Dermis / 대한피부과학회지

Basal cell carcinoma (BCC) is a tumor arising from pluripotential cells found within the basal cell layer of the epidermis or various pilosebaceous units and usually shows some epidermal connection. Occasionally BCC shows no epidermal connection and is located deep in the subepidermal tissues. In these cases, BCC originates from the lower parts of the pilosebaceous apparatus or from other epithelial structures such as epidermoid cysts. A 74-year-old man visited our department complaining of a cystic mass above his right lip angle which had been present for 1 year. He had a warty nodule on the same site and the lesion had been excised about 15 years ago. We performed surgical removal following the diagnosis of an epidermal cyst. But histopathologic examination revealed a ermal mass of various shapes and sizes composed of basophilic tumor cells without epidermal connection, central cystic degeneration and peritumoral lacunnae. Thus we diagnosed this case as BCC presenting as a cyst without epidermal connection.

A Case of Generalized Pustular Psoriasis Associated with Systemic Lupus Erythematosus / 대한피부과학회지

Generalized pustular psoriasis (GPP) is an acute, systemic form of psoriasis, characterized by fever, chills, rigors, and generalized pustule formation on the skin. The concomitant occurrence of lupus erythematosus and psoriasis has been reported sporadically. But the coexistence of GPP and systemic lupus erythematosus have rarely occurred. We herein report a case of GPP in a 19-year-old female, who has been managed with SLE since the age of 14 years.

Microorganisms Isolated from Acne and Their Antibiotic Susceptibility / 대한피부과학회지

BACKGROUND: The representative organism isolated from acne lesion is Propionibacterium acnes (P. acnes), but other organisms, such as Staphylococcus epidermidis (S. epidermidis), have also been isolated. These organisms play an important role in the inflammatory process, therefore, we usually treat the inflammatory acne with antibiotics. However, long term use of antibiotics may result in development of resistant strains and treatment failure. In these cases, antibiotic susceptibility test may be helpful. OBJECTIVE: The purpose of this study was to investigate microorganisms isolated from acne and their antibiotic susceptibility METHOD: We examined the species of bacteria aerobically and anaerobically isolated from 41 patients (38 acne patients and 3 acneiform eruption patients) and determined the antimicrobial susceptibilities of P. acnes and S. epidermidis. For P. acnes, we measured the minimal inhibitory concentration(MIC) of tetracycline by using E test. RESULT: Among the bacteria isolated, P. acnes (18 patients) was the most common, followed by S. epidermidis (14 patients). The MICs of tetracycline ranged from 0.016 to 0.380 microgram/ml, and 94.1% were inhibited by < or = 0.094 microgram/ml of tetracycline. The tetracycline MICs of P. acnes isolates were significantly lower when isolates came from patients whose acne duration was less than 2 years. The isolation rate of P. acnes was significantly higher in pustule lesions compared to non-pustule lesions. In antibiotic susceptibility test for S. epidermidis, the resistance rate of ofloxacin, erythromycin, clindamycin and tetracycline was 14.3%, 35.7%, 21.4% and 50.0% respectively. CONCLUSION: We confirmed that representative organisms isolated from acne lesions were P. acnes and S. epidermidis, and that the ranges of tetracycline MICs for P. acnes were low, thus suggesting that the appearance of resistant strains of P. acnes is not yet common. On the other hand, the resistance rate of S. epidermidis was relatively high. Therefore when we use antibiotics for acne patients, we should keep in mind that the appearance of resistant strain is possible and antibiotic susceptibility should be checked.

A Clinical Study of 265 Patients with Vitiligo in the Gwangju Chonnam Province / 대한피부과학회지

BACKGOUND: Vitiligo is a depigmentary disorder characterized by discrete, pale white macules. Its prevalence is approximately 1-2% of the general population. The pathogenesis of vitiligo is unknown, but genetic, biochemical and immunological hypothesis are proposed. OBJECTIVE: The aim of this study was to evaluate the clinical features of vitiligo and to compare the results with previous studies. METHOD: We evaluated the clinical features of 265 Korean vitiligo patients who lived in the Gwangju Chonnam Province (118 males and 147 females). RESULTS AND CONCLUSION: The mean age of the first visit and onset was 31.6+/-22 years (male: 29.0, female: 33.8) and 27.8+/-21 years (male: 24.8, female: 30.3) respectively. The most common interval between onset and visiting was within 6 months. The order of frequency in clinical types of vitiligo was vulgaris type (42.4%), focal type (31.4%), segmental type (14%) and acrofacial type (6.4%). The most common site of initial involvement was the face (37.4%) and the most common site of involvement was the face (27.6%). Precipitating factors, such as genetic tendency (7.6%), and trauma (3.8%), were found in 17.8% of patients. The prevalence of poliosis was 6.7% of vitiligo patients, and the eyebrow (50%) was the most common site of poliosis. Family history was found in 10.6% of patients, and associated diseases were found in 25.4% of patients. In conclusion, although this study is not helpful in evaluating the treatment response and the prognosis of vitiligo, this study is useful in providing some basic epidemiological data on vitiligo patients.