Diffuse Normolipemic Plane Xanthoma with Multiple Myeloma / 대한피부과학회지

Diffuse plane xanthoma (DPX) is a rare variant of plane xanthoma and DPX appears as yellow flat patches or slightly elevated plaques on the eyelids, neck, upper trunk and flexural areas. Lynch and Winkelmann divided it into two groups according to the presence of hyperlipidemia. Diffuse normolipemic plane xanthoma is often associated with reticuloendothelial proliferative disease such as multiple myeloma and monoclonal gammopathy with unknown significance (MGUS). We report here on a case of diffuse normolipemic plane xanthoma associated with multiple myeloma in a 59 year-old man.

Localized Bullous Pemphigoid on Both Upper Extremities in a Hemiplegic Patient / 대한피부과학회지

Bullous pemphigoid is a chronic autoimmune blistering disease characterized clinically by tense bullae that develop on normal or erythematous skin. Bullous pemphigoid is associated with autoantibodies to two hemidesmosomal proteins, BPAG1 (230 kD) and BPAG2 (180 kD). The localized form of BP is an unusual variant that occurs in 5~30% of the patients. A 58-year-old man who had been suffering from right hemiplegia since 2006, presented with multiple tense bullae localized on both arms and hands. Direct immunofluorescence test showed linear deposition of IgG and C3 along the basement membrane zone. The antibodies against the recombinant NC16a-domain of BP180 were positive by ELISA and immunoblotting using epidermal extract of normal human foreskin demonstrated that the patient's serum reacted with only BP180 antigen. Here, we report a case of localized bullous pemphigoid on both upper extremities in a hemiplegic patient predominantly on the opposite side to the hemiplegia.

Castleman's Disease with Cutaneous Involvement Manifestating as Multiple Violaceous Plaques on Entire Body

Castleman's disease (CD) is an uncommon B-cell lymphoproliferative disorder characterized by lymph node hyperplasia with vascular proliferation. Cutaneous involvement in CD is rare. A 65-year-old man presented with a 7-year history of gradually developing multiple reddish to violaceous indurated plaques on the scalp, trunk, and legs. On physical examination, there were palpable enlarged cervical, axillary, and inguinal lymph nodes. Laboratory examination revealed anemia, thrombocytosis, hyperproteinemia, hypoalbuminemia, and polyclonal hypergammaglobulinemia. An inguinal lymph node biopsy and a skin biopsy were performed and the patient was diagnosed with the plasma cell type of CD. Chemotherapy was started and the lesions have responded to treatment.

Lymphomatoid Papulosis Developed after Remission of Hodgkin's Lymphoma / 대한피부과학회지

Lymphomatoid papulosis is a lymphoproliferative disorder which is characterized by chronic recurrent self-healing papules or nodules with histologic features suggestive of a malignant lymphoma. An association of lymphomatoid papulosis with other lymphomas including mycosis fungoides, Hodgkin's disease and anaplastic large cell lymphoma is present in approximately 10 to 20% of cases. We herein report a case of lymphomatoid papulosis developed after remission of Hodgkin's disease.

Zosteriform Cutaneous Metastasis from a Gastric Adenocarcinoma / 대한피부과학회지

Skin metastases from internal malignancies are rare and have been reported in 0.7~9% of malignancies, most commonly from carcinomas of the breast, lung, colon, kidney, stomach, and melanoma. The common clinical manifestations of cutaneous metastases are nodular, inflammatory and sclerodermoid metastatic lesions. Other manifestations of skin metastasis include neoplastic alopecia, acute dermatitis like, en cuirasse, carcinoma erysipelatoides, carcinoma telangictatoides, and zosteriform. Zosteriform cutaneous metastases are very rare and may demonstrate vesicobullous, papular, and nodular lesions. In the previous reports, zosteriform metastasis was associated with melanoma, lymphoma, breast cancer, squamous cell carcinoma, colorectal carcinoma, respiratory carcinoma, and urinary tumors. We report the first case of a zosteriform cutaneous metastasis from a gastric adenocarcinoma in the Korean literature.

A Comparison of Red and Blue Light Emitting Diode Lights in Photodynamic Therapy for the Treatment of Acne Vulgaris / 대한피부과학회지

BACKGROUND: Acne vulgaris is a very common inflammatory disease, particularly in adolescents and young adults. Problems such as the inconvenience of long term treatment, the resistance of Propionibacterium acnes to antibiotics and the side effects of isotretinoin have led to investigate photodynamic therapy for the treatment of acne vulgaris. OBJECTIVE: We wanted to evaluate of the efficacy and safety of topical methyl aminolevulinate-photodynamic therapy (MAL-PDT) using red and blue light emitting diode (LED) lights on acne vulgaris. METHODS: Thirty two patients with inflammatory facial acne were treated with topical MAL-PDT with red LED light on the right side and blue LED light on the left side at 2-week intervals for three sessions. MAL was applied to the acne lesions on the entire face with a 45-minutes incubation time. Evaluation was performed by counting the acne lesions at baseline, 2, 4, 6, 8 and 12 weeks after the beginning of the treatment. RESULTS: After 12 weeks of PDT, we found a statistically significant reduction of the inflammatory and non-inflammatory acne lesions from baseline using both red and blue LED lights. Yet there was no significant difference in effectiveness between the two treatments on the inflammatory and non-inflammatory acne lesions. Some of the patients experienced transient erythema, stinging, pain and hyperpigmentation with both treatments. CONCLUSION: Photodynamic therapy with red and blue LED lights appeared to be an effective and safe therapeutic modality for the inflammatory and non-inflammatory acne lesions of mild to moderate acne vulgaris, although there was no significant difference in the efficacy between the two kinds of lights.