Four Cases of Cutaneous Complications after Artificial Hair Implantation / 대한피부과학회지

The implantation of synthetic fibers into the human scalp to simulate natural hair has been shown to cause severe complications and be a possible danger to human health. The complications are frequent and include pain, pruritus, hemorrhage, infection, facial swelling, loss of natural hair, scarring and possible malignant degeneration of the surrounding scalp. We report herein four typical cases of severe cutaneous complications after artificial hair implantation.

A Case of Atypical Cutaneous Fibrous Histiocytoma

Atypical cutaneous fibrous histiocytoma (ACFH) is not well known and only a small number of cases have been reported. Characteristically, ACFH is found on the trunk and limbs of middle-aged women. Although considerable cellular atypia may be present, it occurs focally, the remainder of the tumor representing more classical cutaneous fibrous histiocytoma. A 37-year-old woman presented with a solitary brownish firm nodule on her right forearm. No other abnormalities were found in her personal or family history. Clinically, the tumor simulated a benign fibrous histiocytoma. Histologic examination revealed a poorly delineated intradermal tumor with the usual appearance of benign cutaneous fibrous histiocytoma, but a variable pro-portion of cells in the tumor were scattered atypical cells or bizarre multinucleated giant cells. We report upon a rare case of ACFH.

A Case of Hobnail Hemangioma

Hobnail hemangioma(HH) is a benign acquired vascular tumor of endothelial origin which should be differentiated from other malignant vascular neoplasm such as Kaposi's sarcoma or angiosarcoma. We report a case of hobnail hemangioma in a 21-year-old woman who had a dusky-red patch on her left shin. Histologically, ectatic vascular channels with a single layer of plumped endothelial cells were seen and the vascular channels seemed to dissect the collagen bundles. She underwent treatment with surgical excision with primary closure.

A Case of Halo Congenital Nevus Undergoing Spontaneous Regression / 대한피부과학회지

Halo congenital nevus is a condition in which halo formation is associated with congenital nevocellular nevus. Both humoral and cell-mediated immunity have been implicated to be involved in halo formation. We described a 8-year-old boy with halo congenital nevus characterized by the unique histologic location of inflammatory cells. He has no personal and familial history of vitiligo, dysplastic nevus, melanoma or autoimmune disease. Histologically, the present case of halo congenital nevus undergoing spontaneous regression showed a marked inflammatory infiltrate with remnants of original nevus cell nests in the upper dermis, whereas no inflammatory infiltrate was present in the deep dermis. Most of inflammatory cells were T-cells.

A Case of Acral Lentiginous Melanoma / 대한피부과학회지

Acral lentiginous melanoma has a poor prognosis, because it has relatively short radial growth phase than lentigo maligna melanoma does. A 50 year-old female was presented with a 4X5cm-sized irregularly pigmented patch developed on the left palm. Initial punch biopsy examinations revealed atypical melanocytes only in the epidermis. But, after complete excision, melanoma cells were also observed in the upper dermis. We report an unusual case of acral lentiginous melanoma which showed vertical growth phase after twenty years of radial growth phase.

A Case of Angiolymphoid Hyperplasia with Eosinophilia / 대한피부과학회지

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign tumor, characterized by marked proliferation of endothelial cells. ALHE shows histopathologic feature of extensive infiltrate of lymphocytes, histiocytes and numerous eosinophils, and occurs on the head and neck of young adults. We report a case of ALHE in a 49-year-old woman. Histopathologic examination revealed lymphoid follicles with germinal centers and proliferation of irregular capillaries with plump endothelial cells, sometimes atypical in appearance, protruding into the lumen of the blood vessels.

A Case of Juvenile Xanthogranuloma Localized in Papillary Dermis / 대한피부과학회지

Juvenile xanthogranuloma is characterized histologically by a dense, sheetlike, well-demarcated, histiocytic infiltration within the papillary and reticular dermis, with occasional extension into subcutaneous tissue, fascia, and peripheral muscle. We report a case of juvenile xanthogranuloma developed in a 5-month-old male infant which showed typical histopathologic features of juvenile xanthogranuloma, involving the papillary dermis only without deep dermal or subcutaneous change.

A Case of Cutaneous Metastasis from Carcinoma of the Urinary Bladder / 대한피부과학회지

Metastases to the skin from internal malignancy are very rare and have been reported to occur in 0.9% to 8% of patients with cancer. Particularly there are few cutaneous metastatic carcinomas from the urinary bladder and their incidence is 1% to 2% of the cutaneous metastasis. A 76-year-old man developed cutaneous metastasis six months later after the diagnosis of carcinoma of the bladder had been made. He was presented with asymptomatic erythematous indurated plaques on the left thigh and the inguinal area. This lesion was diagnosed histologically as poorly differentiated transitional cell carcinoma. We report a case of cutaneous metastasis from carcinoma of the urinary bladder showing the unusual clinical feature of an erythematous indurated plaque.

A Case of Antiphospholipid Syndrome in A Patient with Leg Ulcer and Previous History of Deep Vein Thrombosis / 대한피부과학회지

The antiphospholipid syndrome is a multiple-system disorder characterized by persistently elevated antiphospholipid antibodies and/or arterial or venous thrombosis, thrombocytopenia, or recurrent spontaneous abortion. Various cutaneous manifestations have been associated with this disease and may be the first sign of the underlying problem. We report a case of antiphospholipid syndrome with cutaneous ulcer on the left calf of a 21-year-old woman, who has been treated with deep vein thrombosis.

Tick bite by Haemaphysalis longicornis Neumann: Laboratory Observation of the Causative Tick / 대한피부과학회지

We report a case of a tick bite by Haemaphysalis longicornis Neumann. The tick was found on the left knee of a 75-year-old male and captured alive. We observed its process of laying eggs and becoming larvae after human blood sucking. Our data include the size and weight of the female tick (8.2 X 6.2mm, 138mg) after blood sucking, preoviposition period(4 day), oviposition period(21 day), number of eggs(1486) and size of unfed larva(0.40-0.44 x 0.58-0.60 mm). It had a 2n number of 22 chromosomes which showed chromosomal pattern of bisexual clones but its life cycle, especially oviposition to hatching period, showed that of pathenogenetic clones. This is the first Korean report of a tick bite by Haemaphysalis longicornis Neumann and the laboratory observation of the causative tick laying eggs and becoming larvae.

A Clinical and Histopathological Study of Experimental Canine Scabies

BACKGROUND: Canine scabies is caused by an infestation of Sarcoptes scabiei var. canis (S. canis) in dogs and they can be transmitted to humans. Recently pet raising has been increasing in Korea and various parasitic infestations contracted from them have also been increasing including canine scabies. OBJECTIVE: The purpose of this study was to examine the clinical and histopathological features of experimental canine scabies. METHODS: Two dogs experimentally infested were observed for a year. They were examined physically and the numbers of S. cans were counted from scraping samples of the ear, leg and abdomen every 3 to 7 days and skin biopsies were taken. One was given systemic corticosteroids(Dogl) and the other was observed in its natural course(Dog2). RESULTS: Dogl-Clinically severely pruritic, markedly thick hyperkeratotic scales, crust and generalized erythema on the whole body developed with huge numbers(up to 754.9/100mg from scales of the abdomen) of mites, and histopathologically showed features similar to human crusted scabies. Dog2-Clinically showed milder features than Dogl including the number of S. canis(up to 242.6/100mg from scales of the ear), but histopathologically showed similar features with Dogl. Dog2 also showed a prompt response to one topical application of 20% benzyl benzoate solution. CONCLUSIONS: 1) The number of S. canis increased markedly in both normal and corticosteroidtreated dogs, although it was more significantly increased in the corticosteroid-treated one. 2) Histopathology showed features similar to classical scabies in the early stage but features of human crusted scabies in the full-blown stage. 3) Morphologically Sarcoptes canis differs from Sarcoptes scabiei var. hominis.

A Case of Subdermal Basal Cell Carcinoma / 대한피부과학회지

Basal cell carcinomas usually arise from the epidermis and show some epidermal connections. It is very unusual that basal celi carcinomas occur as subderrnal mass without epidermal connections. A 51 year-old female h;d an asymptomatic skin colored indurated plaque with linear old scar on the left side of nose fcr about 20 years. She had had a tumor that supposed to be a epidermal cyst, on the same site and the lesion was excised about 20 years ago. We performed the punch biopsy on her first visit which revealed hypertrophic scar. She was treated with intralesional injection of triamcinolone acetonide to reduce the size of hypertrophic scar. However, the lesion had not been reduced. She underwent the surgery to remove the scar at plastic surgery and the excisional biopsy showed a subdermal basal cell carcinoma. We recommend that the newly developed skin tumor in the pre-excised region should be required excisional biopsy instead of punch and close observation

A Clinical Observation on Leukemia Cutis / 대한피부과학회지

BACKGROUND: Leukemia cutis is readily recognized and documented by biopsy, in contrast. to leukemic involvement in more occult sites. Nine cases of leukemia cutis have been reported in the Korean literatures. However no collective clinical studies have been reported in Korea. OBJECTIVE: We evaluated the differences in patient age and sex, the clinical appearences and distributions of the skin lesions, interval between diagnosis of systemic leukemia and skin involvement, clinical course, and prognosis according to the type of leukemias. METHODS: We carried out a retvospective study of 22 cases of leukemia cutis. Clinical information was obtained from the records of of 22 patients diagnosed at St. Mary's Hospital from 1988 to 1995. All the included cases were well evaluated for their clinical and histopathologic findings. RESULTS: 1. Among 22 patients with leukemia cutis, male patients outnumbered female by 2 to 1 and the mean age was 25.8 years. 2. The clinical appearance of leukemia cutis includes papules, macules, nodules, plaques in all types of leukemia. Ulcerative lesions and vesicles were seen infrequently in leukemia cutis. Leukemia cutis often involved saultiple location of the skin, with no specific predilection of the site. There were no differences in distribution of lesions depending on the types of systemic leukemia. 3. In 68% of the patients with leukemia cutis, the skin lesions developed after the systemic leukemia was diagnosed, and 14% of patients had concomitant, involvement. 18% of patients had skin lesions preceding the diagnosis of systemic leukemia, howevere cytochemical and cytomorphologic studies of bone marrow and peripheral blood smear were not employed at the time of the skin biopsy. 4. Fourteen of 22 patients(64%) did not achieve a complete remission following the diagnosis of leukemia cutis and two of 14 patients without having complete remission could achieve complete remissions with proper anticancer therapy after the diagnosis of leukemia cutis. Total eight patients(36%) achieved a complete remission, then they had a relapse of leukemia in the skin, without having had any skin involvement at the time of the diagnosis of leukemia. 5. Seventeen of 22 patients(77% ) who were being followed up in our series died after leukemia cutis was diagnosed. The mean intervals between diagnosis of leukemia cutis and death was 3.8 months and they died mostly within 1 year. CONCLUSION: The presence of leukemic infiltration in the skin may help the clinician suspect the early diagnosis and relapse of systemic leukemia. It appears that leukemia cutis is associated with a grave prognosis.

A Case of Cutaneous Protothecosis

Protothecosis is a rare cutaneous soft tissue infection caused by the genus prototheca, most commonly Prototheca wickerhatmii. An 80-year-old woman has had a painful or tender, non-healing, eczematous plaque on the extensor surface of the left forearm for 4 years. A biopsy specimen revealed the characteristic thick-walled morulalike sporangia in the dermis. P. wickerha mili was isolated in the culture and the biochemical studies. Electron microscopic examination showed the thick-walled spores containing dark dense bodies and amyloplasts. Oral itraconazole therapy for 4 weeks resulted-in a marked improvement of the skin lesion.