A Case of Keratoacanthoma on the Lower Lip / 대한피부과학회지

Keratoacanthoma is a rapidly growing cutaneous tumor with a histopathologic pattern often suggestive of a squamous cell carcinoma (SCC). It may be viewed as an aborted malignancy which only rarely progresses into an aggressive SCC. It is most likely arising from hair follicle that has the tendency of spontaneous resolution. The diagnosis of keratoacanthoma is based on clinical, histopathologic features and biologic behavior. A 75-year-old woman presented with a 1-month history of a rapidly enlarging exophytic tumor on the lower lip. A biopsy was performed leading to a diagnosis of keratoacanthoma. We report a case of keratoacanthoma on the lower lip, because the mucosal area is an unexpected location.

A Case of Hypertrophic Lupus Erythematosus / 대한피부과학회지

Hypertrophic lupus erythematosus is a clinical variant of chronic cutaneous lupus erythematosus (CCLE). It is critical to differentiate hypertrophic lupus erythematosus from CCLE because of treatment and prognosis. We report a case of hypertrophic lupus erythematosus with CCLE occured on arms. Combination therapy with acitretin and intralesional corticosteroid injection resulted in control of previously refractory skin lesion.

A Case of Granuloma Annulare Occurring on Herpes Zoster / 대한피부과학회지

Granuloma annulare is a benign, granulomatous disease that presents clinically as papules and plaques, often in an annular configuration. It has been reported following tuberculin skin tests, insect bites, sun exposure, trauma, and various viral diseases. Several types of cutaneous lesions have previously been described at the site of herpes zoster scars. These include granuloma annulare, lymphoma, pseudolymphoma, granulomatous diseases, and lichen planus. We report a case of granuloma annulare at a herpes zoster scar site.

A Case of Secondary Syphilis Showing a Histological Pattern of Interstitial Granuloma Annulare / 대한피부과학회지

No abstract available.

Skin Diseases among Veterans Exposed to Herbicides Used in Vietnam

BACKGROUND: The herbicides used in Vietnam were later found to be extremely contaminated with 2,3,7, 8-tetrachlorodibenzo-rho-dioxin (TCDD). The carcinogenecity of the product was for all cancers combined. The risk of soft tissue sarcoma, lung cancer, and lymphoma, chloracne, peripheral neuropathy and other diseases were found to be increased. Although many veterans exposed to herbicides had chronic skin diseases with variable clinical features, there were few researches about herbicides-related skin diseases. The purpose of this study was to investigate the characteristics of herbicides-related skin diseases and to provide epidemiologic information. METHODS: This study has been reviewed in the clinical findings of 127 veterans with skin diseases exposed to herbicides who visited Kosin University Gospel Hospital during the 5 years from January of 1997 to December of 2001. RESULTS: The age distribution was in the range of 47~68 years. The mean age was 54.6 years old. All patients were male. In the duration, 34 patients (26.8%) developed skin diseases for 6~10 years, 21 patients (16.5%) for 16~20 years, and 21 patients (16.5%), 25 years. In the incidence, seborrheic dermatitis was the most frequently observed in 45 patients (35.4%) followed by eczematous dermatitis in 41 patients (32.3%), xerotic eczema in 23 (18.1%) and pruritic dermatoses in 21 (16.5 %). In the incidence ratio of skin diseases with systemic diseases, chronic urticaria was the most highly observed with 100% (1/1) followed by fungal infection in 70% (7/10), other diseases in 66.6% (6/9), seborrheic dermatitis in 64.4% (29/45), eczematous dermatitis in 56.1% (23/41), and xerotic eczema in 52.2% (12/23). Sixty eight patients had skin diseases with systemic disease. Hypertension and diabetes were most frequently observed with 24 and 23 patients, respectively. The order of incidence was as follows: liver disease, gastroduodenal ulcer, peripheral neuropathy, chronic gastroenteritis, and hyperlipidemia. Mycosis fungoides was found in 4 cases and monoclonal T cell gamma receptor gene rear-rangement was detected in 2 cases (50%). CONCLUSION: Skin diseases among veterans exposed to herbicides used in Vietnam was chronic and showed variable clinical features. It was difficult to confirm the relationship between skin diseases and herbicides, but further researches are required to seek guidelines for the evaluation of skin diseases.

A Case of Glucagonoma Syndrome Diagnosed as Necrolytic Migratory Erythema / 대한피부과학회지

Necrolytic migratory erythema (NME) is a typical cutaneous manifestation of glucagonoma syndrome. The entire syndrome consists of NME, glucose intolerance, weight loss, anemia, glossitis, diarrhea, and increased glucagon levels. We herein report a patient with glucagonoma syndrome who was diagnosed as having NME. A 48-year-old male presented with a 2-month history of painful erythematous, desquamative, erosive papules and plaques on both lower extremities. Histological examination revealed an intraepidermal cleft, the presence of vacuolated, pale epidermal cells, and necrosis in the upper epidermis. His glucagon level was 2650 pg/ml, with the upper limit of a normal range being 250 pg/ml. The patient was treated with octreotide, and showed an improvement of the skin eruption with normalization of the glucagon level within 4 weeks.

Clinicopathologic Findings of Metastatic Skin Cancer / 대한피부과학회지

BACKGROUND: The incidence of metastatic skin cancer has been reported to be relatively low. Because the diagnosis is not so difficult, cutaneous metastasis could be an important clue to discover the hidden internal malignancy, if found before recognizing primary cancer, or play a significant role to determine therapeutical plans and prognosis if found after diagnosis of primary cancer. MATERIAL AMD METHODS: This study was made upon the 68 cases of metastatic skin cancer, which had been confirmed histopathologically in the department of dermatology, Kosin University Gospel hospital from January, 1986 to August, 2003. Age and sex distributions, sites of primary cancer, time of detection, localization of the lesions, morphologic and histopathologic findings were examined by the review of medical records, clinical photographs, and pathologic slides. RESULTS: 1. The mean age at the time of diagnosis was 56.6 years and most patients were distributed over 5 decades. The male to female ratio was 1: 1.3. 2. Metastasis from breast carcinoma consisted of 19 cases, this was the most common primary cancer, followed by lung cancer, melanoma, and stomach cancer. In men, lung cancer and stomach cancer were the most common primary neoplasm, while breast cancer was the most frequent in women. 3. 50 of the cases were detected after diagnosis of primary cancer and during therapy. The other 18 cases were detected before the internal malignancy was recognized. 4. The localization of metastatic skin cancer was widespread over the whole body. The majority of cutaneous metastasis was predisposed to the surface near primary cancer, but distant metastases such as alopecia neoplastica on the scalp were also observed. 5. The most common morphologic features were single or multiple nodules, while inflammatory and indurated plaques were also found. 6. Histopathologic examination revealed that adenocarcinoma was the most common pathologic type, followed by squamous cell carcinoma and melanoma. The histopathologic features of cutaneous metastasis generally mimicked that of primary tumors. CONCLUSION: Generally, metastatic skin cancer is detected after the diagnosis of primary cancer showing subsequent treatment failure and poor prognosis. In some cases, however, cutaneous metastasis can be the earliest sign to recognize internal malignancy. Especially in the cases of metastatic skin cancer originating from the kidney, liver and thyroid gland, cutaneous features are the most significant evidences to presume the site of origin without any other findings. Therefore, it is important to recognize the clinical and histopathologic findings of metastatic skin cancer for the most successful diagnostic, therapeutic and prognostic determination.

A Case of Rosai-Dorfman Disease Limited to the Lip

No abstract available.

A Case of Generalized Nodular Scabies / 대한피부과학회지

Nodular scabies is a clinical variant of classic scabies with uncertain cause. The cutaneous manifestations consist of firm, erythematous nodules focally affecting genitalia, groin and axillae, and no case of generalized involvement has been reported in the literature. On histopathologic examination, mites and excretas were known to be seldom found in the stratum corneum, but if serial sections are studied, they can be seen in as much as 20% of the cases. The dermis shows dense superficial and deep perivascular mixed cell infiltration composed of lymphocytes, histiocytes, plasma cells, eosinophils, and atypical mononuclear cells, which should be distinguished from many types of lymphomas. We herein report a case of nodular scabies that clinically affected whole body and histopathologically revealed mite and eggshells in the stratum corneum and perivascular mixed cell infiltration throughout the dermis.

A Case of Macular Amyloidosis due to Nylon Towel / 대한피부과학회지

Amyloidosis is a disorder of protein metabolism characterized by the extracellular deposition of abnormal protein fibrils. We report a case of macular amyloidosis due to nylon towel on his back. A 61-year-old male presented with asymptomatic hyperpigmented macules on the scapulae for 6 years. He had a habit of scrubbing his back for many years with a rough nylon towel while taking a bath. The histologic examination revealed liquefaction degeneration and homogenous eosinophilic deposition in the papillary dermis. In Congo red, amyloid material stained positively and in anti-keratin antibody staining. He had neither clinical nor laboratory evidence of systemic amyloidosis. A diagnosis of friction amyloidosis was made on histological and immunohistopathological findings.

A Case of Kikuchi's Disease (Histiocytic Necrotizing Lymphadenopathy) Showing Typical Histopathologic Findings in Cutaneous Lesion / 대한피부과학회지

Kikuchi's disease(Histiocytic necrotizing lymphadenitis) is an idiopathic, self-limiting disease typically affecting cervical lymph nodes in young adults. Cutaneous involvement has been reported in 16-40%. We report a case of Kikuchi's disease in 10-year-old female that showed asymptomatic erythematous papules on the face accompanied by cervical lymphadenopathy. The histopathologic examination of the skin revealed diffuse dermal lymphohistiocytic infiltrate, a large amount of nuclear dust with absence of neutrophils, which is characteristic of Kikuchi's disease. In general, histopathologic findings of skin biopsy show a mirror image of that of lymph nodes involved in Kikuchi's disease. Therefore, it is important to recognize cutaneous manifestations of this entity, because we can avoid invasive lymph node biopsy. if skin lesions involved show typical histopathologic findings of Kikuchi's disease.