Cutaneous Adverse Effects Associated with Iressa(R)(Gefitinib) Medication / 대한피부과학회지

We report cutaneous adverse effects developed in three patients and are probably related to Iressa(R)(Gefitinib, ZD1839) medication. Iressa(R) is a new anti-cancer agent which acts by inhibiting epidermal growth factor (EGF) receptor signal transduction. The three patients had all taken Iressa(R) for treatment of non-small cell lung cancer and came to our clinic with cutaneous adverse effects. All three patients had acneiform eruptions, and one of the patients also had periungal granulation lesions. Histopathologically, periadnexal inflammatory cellular infiltrations were seen in the acneiform lesions of the three patients and granulation-like tissue proliferations in periungal granulation lesions of the one patient.

A Case of Subungual Melanoma in Situ Presenting Longitudinal Melanonychia / 대한피부과학회지

A 43-year-old woman presented with two brown longitudinal streaks, which had been present in her left thumb for 5 years. A 3mm punch biopsy from the nail matrix showed that atypical melanocytes were scattered solitarily in suprabasal and basal layers. Five years after the first visit, she presented with changes of the longitudinal streaks. Two bands were altered into one 0.6cm-sized black pigmented band. There was dystrophy in the distal part of the thumb nail and extension of pigmentation to the skin adjacent to the nail plate, involving the nail fold. Axillary lymph-nodes were not palpable. A longitudinal incisional biopsy revealed increased large atypical melanocytes in suprabasal and basal layers of the epidermis. These findings strongly supported the diagnosis of subungual melanoma. Our case is interesting in that subungual melanoma presented longitudinal melanonychia.

Two Cases of Cutaneous Cytomegalovirus Infection in Immunocompromised Patients

Cytomegalovirus (CMV) is a major cause of morbidity and mortality in immunocompromised patients. CMV can cause pneumonia, retinitis, gastrointestinal ulcers, and widely disseminated disease, but cutaneous CMV is rare. We report two cases of cutaneous CMV infection presenting as perianal ulcers. A 54 year-old male who had liver transplantation and a 72-year-old male, who was treated with chemotherapy for angioimmunoblastic T-cell lymphoma, presented with perianal ulcers and had systemic symptoms of CMV infection with CMV antigenemia. They had multiple ulcerations with erythematous bases on the perianal area, and histopathologic examinations showed large atypical cytomegalic cells in the dermis, and immunohistochemical stains, with the anti-CMV antibody showed positive reactions.

Cutaneous Leiomyoma of the Nipple in a Male

Cutaneous leiomyoma is a benign tnmor originating from smooth muscle fibers which are derived from arrector pili muscle, media of blood vessels and dartoic muscle of scrotum, vulvar, or nipple. It is classified into 3 types according to the site of origin, namely pilar leiomyoma, angioleiomyoma and genital leiomyoma. Leiomyoma of the nipple is the less kquent type of cutaneous leiomyoma. We report a case of cutaneous leiomyoma on the nipple in a 53-year-old man.

A Case of Common Blue Nevus with Satellite Lesions / 대한피부과학회지

We experienced a patient who presented with a common blue nevus with satellite lesions. A 56-year-old woman was presented with a 0.7x0.9cm sized dome-shaped blue-black papule and five dotted and linear blue-black macular satellite lesions on the right arm. The clinical manifestation was suggestive of peripherally disseminating malignant melanoma. Histopathological examination of the main lesion as well as the satellites showed the appearance of common blue nevus without malignant change.

Korean Acne Grading System / 대한피부과학회지

BACKGROUND: A good acne grading system should reflect epidemiological and clinical features of a particular patient group. Current Korean acne grading systems are mostly based on the skin colors, epidemiology, and clinical features of Western countries, which make them less than being ideal for Korean acne patients. OBJECTIVE: We tried to devise an acne grading system based on clinical and epidemiological characteristics of Korean acne patients. This system is intended for use in primary care setting as well as in research purposes. METHODS: In the formulation of a new acne grading system, a panel of 5 dermatologists from 5 referral centers took into account the degree of complexity of the system, criteria for severity as well as skin colors through the review of clinical photographs of 250 acne patients. The new grading system then underwent inter-rater and intra-rater discrepancy assessment and simulation with 149 patient photos to find out an optimal epidemiological representation. RESULTS: We developed 6-scale grading system with both standard pictures and ranges of number of lesions as criteria. Intra-rater and inter-rater reproducibility turned out to be moderate to strong, suggesting clear instruction and easy performance. Simulation with 4 different models yielded best parameter ranges for the optimal criteria. CONCLUSIONS: With the feedback from the large-scale field applications, this new acne grading system will serve as a multipurpose acne grading system for Korean patients.

Two Cases of POEMS Syndrome Presenting As Glomeruloid Hemangioma / 대한피부과학회지

Glomeruloid hemangioma is a histologically distinctive cutaneous hemangioma that has recently been associated with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome. We report two cases of glomeruloid hemangioma associated with POEMS syndrome. Histopathology of two cases showed multiple dilated vascular spaces composed of a conglomerate of capillaries, resulting in structures resembling renal glomeruli. Periodic acid-Schiff positive and diastase-resistant eosinophilic globules were found within the cytoplasm of vacuolated endothelial cells.

Two Cases of Warty Dyskeratoma / 대한피부과학회지

We report two cases of warty dyskeratoma which is uncommon skin lesion. A 50-year-old male presented with an asymptomatic dermal nodule on periauricular area. Histopathologic findings showed the dermal cystic structures lined by epithelial wall of papillomatosis and suprabasal cleft formation with numerous villi and acantholytic cells. The second case was a 48-year-old male with an asymptomatic papule on cheek. Histopathologic finding showed the cup-shaped keratin-filled invagination lined by papillomatotic wall and filled with numerous acantholytic, dyskeratotic cells. Both findings were the characteristic features of warty dyskeratoma.

A Case of Tuberculosis Verrucosa Cutis / 대한피부과학회지

We report a case of tuberculosis verrucosa cutis in a 39-year-old male patient, who presented verrucous plaque on the dorsum of right third finger. Seven months ago, he had a cut with paper and skin lesion developed. Histopathologic features revealed parakeratosis, irregular acanthosis in the epidermis and inflammatory cellular infiltrates and tuberculoid granulomas in the dermis. AFB- positive bacilli were demonstrated. He has been treated with isoniazid, rifampicin, ethambutol, and pyrazinamide for 4 months till now and the skin lesion has been markedly improved.

A Case of Generalized Pustular Psoriasis Improved with Isotretinoin / 대한피부과학회지

Generalized pustular psoriasis is a lethal variant of psoriasis characterized by the appearance of sterile pustules on psoriatic skin. Etretinate and acitretin are effective in pustular forms of psoriasis, including generalized pustular psoriasis. A major concern with the use of systemic retinoid is their high teratogenic potential. Since etretinate and acitretin are remetabolized into long-lived compounds, isotretinoin may be used to treat women of childbearing years with generalized pustular psoriasis. We report a case of generalized pustular psoriasis in a 28-year-old woman whose condition was improved with isotretinoin. Clinical improvement was noted with the administration of isotretinoin at the dose of 30mg/day.

A Case of Dermatomyofibroma in a 2-year-old Boy

Dermatomyofibroma is a rare benign dermal tumor, mainly found in young women. Clinically it can be confused with keloid or dermatofibrosarcoma protuberans. Typical histopathologic features of dermatomyofibroma are sufficiently distinctive to alert histopathologists to consider dermatomyofibroma in the diagnostic process. We report a case of dermatomyofibroma, presenting as reddish plaques and nodules on the buttock of a 2-year-old boy. Histopathologic examination showed fascicles of uniform spindle cells in the reticular dermis, predominantly oriented parallel to the epidermal surface. Immunohistochemical study and electron microscopy confirmed its myofibroblastic nature.

A Case of Zosteriform Pilar Leiomyoma

Cutaneous pilar leiomyomas are benign, often painful, smooth muscle tumors that usually present as red-brown nodules. They are usually multiple and commonly found on the extensor aspects of the arm, trunk, and face. Multiple lesions may be grouped or widespread. They are rarely distributed in a linear fashion or seem to follow a dermatome. We report a 54-year-old woman with multiple pilar cutaneous leiomyomas distributed in a zosteriform pattern on her right trunk.

Two Cases of Plexiform Schwannoma / 대한피부과학회지

We present two cases of plexiform schwannoma, a benign peripheral nerve sheath tumor, characterized by a plexiform growth pattern. Plexiform schwannoma must be distinguished from plexiform neurofibroma because of the propensity of the latter for malignant degeneration. Although plexiform schwannoma usually arises sporadically, it can be rarely associated with neurofibromatosis type 2. We report two cases of plexiform schwannoma. One was single sporadic lesion on the abdomen of a 28-year-old woman. The other showed multiple plexiform schwannomas associated with bilateral acoustic neuromas.

A Case of Cutaneous Sinus Tract of Dental Origin

The most common cause of chronic draining sinus tract on the face and neck is the extension of chronic dental infection. The presence of an intermittently draining granulomatous lesion on the face or neck should alert clinicians to the necessity of routine dental examination including radiographic studies. Early correct diagnosis and appropriate dental treatment can pre-vent unnecessary and ineffective antibiotic therapy or surgical treatment. We report a case of a 22-year-old woman with a cutaneous sinus tract on submental region, associated with a periapical abscess of the left mandibular lateral incisor.