Expressions of Cytokeratin and Ki-67 in the Development of the Pilomatricoma / 대한피부과학회지

BACKGROUND: Pilomatricoma (PM) is benign follicular tumor composed of the basophilic cells, transitional cells, shadow cells, squamoid cells and keratin filaments/amorphous debris. At present, PM is assumed to differentiate toward hair-forming cells of hair follicles but definite direction is not clear. OBJECTIVES: This study was made in order to investigate the pathways of cell differentiation associated with sudden keratinization in PM. METHODS: In the present study, 19 cases of human PM was histopathologically examined and classified into 4 groups according to the chronological stages. RESULTS: In the chronological stages according to Kaddu's classification, there were 2 cases of early lesion, 6 cases of fully developed lesion, 7 cases of early regressive lesion and 4 cases of late regressive lesion. The basophilic cells changed into the shadow cells or amorphous debris through the transitional cells moving toward the exterior of the PM, as well as toward the interior. As keratinization occurs, some inner basophilic cells which had been located in marginal areas of keratinization lost their tight cell-cell bonding. These cells showed edematous/vesicular and squamoid changes. High molecular weight cytokeratin was expressed in a linear pattern in some early and fully developed lesions. There were fewer layers of basophilic cells between the stroma and squamoid cells/amorphous debris than between the stroma and shadow cells. Ki-67 was expressed strongly both basal and overlying basophilic cells. Apoptotic bodies were detected in most transitional cell layers and some amorphous debris zones. CONCLUSIONS: The present study suggests dual pathways of cell differentiation in PMs. In the sudden keratinization pathway, the basophilic cells, transtional cells, shadow cells, and squamoid cells are suddenly keratinized, and the basophilic cells become early the transitional cells or squamoid cells. Cytoplasmic expressions of Ki-67 and cytokeratin in the basophilic cells show that the basophilic cells differentiate toward the innermost layer of the outer root sheath cells.

A Case of Multicentric Reticulohistiocytosis / 대한피부과학회지

Multicentric reticulohistiocytosis(MR) is a rare systemic disease of unknown etiology, characterized by destructive polyarthritis and mucocutaneous eruptions in various locations. In most cases rapidly progressive destructive polyarthritis is the presenting symptom, followed by typical skin eruptions. Skin lesions are characterized clinically by erythematous to brownish nodular lesions on the face, periungual areas and the trunk. The biopsy demonstrating the characteristic granulomatous infiltration of multinucleated giant cells and histiocytes with a ground-glass appearance is diagnostic. We report a case of multicentric reticulohistiocytosis in a 57-year-old female patient, who had skin lesions with polyarthritis and cardiac problem. To our knowledge, this is the first case report in Korea.

A Case of Flexural Darier' s Disease / 대한피부과학회지

Dariers disease is a domirantly inherited skin disease that is characterized by keratotic papules predominantly on the sebornieic areas, palmar pits, and a nail dystrophy. The diagnosis is difficult in the small group with flexural involvement because the features of flexural Dariers disease overlap clinically and histolopica.lly with those of Hailey-Hailey disease. The diagnosis of Dariers disease may be confirmed if the patient has the pathognomonic nail dystrophy. We presents a case of flexured. Dariers disease in a 65 year old woman. She has suffered from skin lesions which have some resemblance to those of Hailey-Hailey disease. We could diagnose her skin lesions as Dariers disease because she had the eharacteristic nail dystrophy.

A Case of Unilateral Nevoid Telangiectasia Associated With Acanthosis Nigricans / 대한피부과학회지

We report a case of unilateral nevoid telangiectasia associated with acanthosis nigricans in a 20-year old male patient. Unilateral nevoid telangiectasia may be congenital or acquired. The unilateral and dermatomal distribution suggests that distribution of target vessels is fixed and that they are sensitive to estrogen. Estrogens are mainly produced by the ovaries, but they are also produced by peripheral cirornatization of androgen. Because a major site of this conversion is adipose tissue, estrogen can increase in an obese person. Obesity also reverses the metabolism of estrogen and increases the serum insulin level. Therefore it seems that obesity in our patient induces the development of unilateral nevoid telangiectasia and acanthosis nigricans.

Benign Neonatal Hemagiomatosis with Unusually Persistent Lesions and Conjunctival Hemangioma

Most neonatal cutaneous hemangiomatosis are complicated by visceral involvement and. are associated with a high mortality rate in the first month of life. Some neonates with multiple cutaneous hemangiomas, however, may follow a benign course of spontaneous resolution without visceral involvement. Such cases are called benign neonatal hemangiomatosis (BNH). BNH is characterized by a lack of mucosal or symptomatic visceral involvement. rapid spontaneous regression of cutaneous hemangimas, and an excellent prognosis. We report herein a case of BNH which is atypical compared to previously reported BNFI cases. Our patient had a more prolonged course than those of usual cases with BNH and showed a conjunctival involvement.