ABSTRACT
Herpetic whitlow is a painful cutaneous infection that occurs on the fingers and toes, and it is caused by herpes simplex virus (HSV)-1 or -2. It is correlated with the immunocompromised state of patients or with occupations that are in frequent contact with the secretions or mucous membranes infected by HSV. We present here a 29-year-old woman who was referred to our department with recurrent vesicles and ulcerative lesion of the right 3rd finger. She was immunocompetent and did not have any occupational hazard of herpetic whitlow. We made the diagnosis of herpetic whitlow by the clinical features and the histopathologic examinations. In addition, we used polymerase chain reaction assay to detect the type of HSV and we confirmed she suffered with herpetic whitlow that was caused by HSV-2.
Subject(s)
Adult , Female , Humans , Fingers , Herpesvirus 2, Human , Methylmethacrylates , Mucous Membrane , Occupations , Polymerase Chain Reaction , Polystyrenes , Simplexvirus , Toes , UlcerABSTRACT
Reactive perforating collagenosis (RPC) is one of a range of essential perforating disorders. Two types have been recognized: the childhood or inherited form, and the adult or acquired form. Acquired RPC is usually associated with systemic diseases, especially diabetes mellitus, and/or renal failure. We present a case of a 47-year-old female with umbilicated skin lesions triggered by an insect bite. Histology from the lesion revealed transepidermal elimination of collagen.
Subject(s)
Adult , Female , Humans , Middle Aged , Collagen , Diabetes Mellitus , Insect Bites and Stings , Insecta , Pruritus , Renal Insufficiency , SkinABSTRACT
Malignant neoplasms arising in burn scars are well known. In previous literature, 25 cases of burn scar sarcomas were reported. However, dermatofibrosarcoma protuberans is very rare and only two cases have been reported. A 43-year-old Korean man presented with multiple erythematous clustered plaques and nodules and a skin-colored subcutaneous mass on the chest after a severe burn injury at the age of 8 years. A biopsy specimen revealed dermatofibrosarcoma protuberans. The tumor was excised widely to include the surrounding burn scar. Herein, we report this third case of dermatofibrosarcoma protuberans arising from a burn scar.
Subject(s)
Adult , Humans , Biopsy , Burns , Cicatrix , Dermatofibrosarcoma , Sarcoma , ThoraxABSTRACT
Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign vascular tumor characterized by the development of endothelial-lined papillary projections in the vascular lumen. Most authors believe that IPEH represents an unusual pattern of organizing thrombus, implying that a thrombus is the initial cause. A 13-year-old boy came to hospital because of a purpuric patch and violaceous plaque on his right forearm. Clinically, the lesions were thought to be a hemangioma or other vascular malformation. Therefore, we treated him with intense pulsed light (IPL) four times. After treatment, the initial skin lesions were erythematous and edematous and a new bluish mass and multiple scattered subcutaneous nodules appeared near the original skin lesions. Histologic examination of the new bluish mass showed an organic thrombus and endothelial-lined capillary projections in the dilated vascular lumen, compatible with IPEH. Here, we report an interesting case of IPEH after IPL treatment in a 13 year-old boy.
Subject(s)
Adolescent , Humans , Capillaries , Forearm , Hemangioma , Hyperplasia , Light , Porphyrins , Skin , Thrombosis , Vascular MalformationsABSTRACT
A 28-year-old woman presented with multiple, asymptomatic, erythematous to bluish papules located on the chest. Histopathologically, three round, well defined cystic structures were seen on the upper and lower dermis. The first cyst was milia, the second was apocrine hidrocystoma and the other, largest cyst was an eruptive vellus hair cyst (EVHC). A diagnosis of multiple pilosebaceous cysts combined with apocrine hidrocystoma was made. Since the milia and EVHC originate from the pilosebaceous unit, and the apocrine duct opens to the pilosebaceous orifice, we suggest that they can occur simultaneously in the same unit.
Subject(s)
Adult , Female , Humans , Biopsy , Dermis , Hair , Hidrocystoma , ThoraxABSTRACT
Dermatofibrosarcoma usually occur on the trunk or the proximal extremities and only rarely on the head and neck. Due to its slow growth and asymptomatic initial lesions, the time to first treatment is more than 10 years. A 23-year-old man presented who had developed a asymptomatic erythematous papule, plaque and skin-colored subcutaneous nodule on the forehead. Four months earlier the erythematous papule had appeared, gradually enlarged and spread. One month prior to presenting the skin-colored subcutaneous nodule appeared. Histologic examination showed spindle shaped cells with storiform pattern and the cells were positive for CD34 stain. We report a case of dermatofibrosarcoma protuberans on the forehead with rapid growth.
Subject(s)
Humans , Young Adult , Dermatofibrosarcoma , Extremities , Forehead , Head , NeckABSTRACT
BACKGROUND: Telangiectasia macularis eruptiva perstans (TMEP) is a rare form of cutaneous mastocytosis, and this is characterized by multiple brownish-red confluent macules and telangiectasia. Although several cases of TMEP have been reported in the Korean literature, no clinicopathological studies have yet been reported. OBJECTIVE: This study was undertaken to document the clinical features of TMEP, to examine the histopathological features of TMEP and to quantify the number of perivascular mast cell by using the 'mast cells per vessel unit method (MPV). METHODS: The medical records of 16 patients with TMEP and who were seen at our institution from 1999 through 2006 were retrieved. We retrospectively reviewed the medical records, clinical photographs and histopathology slides of these patients. Furthermore, we quantified the number of perivascular mast cells, using the MPV method, on the slides of the TMEP patients, and then we compared this to the number of perivascular mast cells in normal skin (n=10) and urticaria pigmentosa skin (UP, n=10) as controls. RESULTS: The ratio of male to female was 13:3 and the mean age of onset was 36.31+/-12.34 years. The most commonly involved sites were both the trunk and upper extremities (62.5%). 5 patients (31.3%) showed constitutional symptoms. A microscopic examination demonstrated scant perivascular infiltrate with mast cells. The average number of mast cells less than 55micrometer of vessel diameter in the TMEP, normal skin and UP was 3.32, 1.17 and 5.89, respectively and the average number of mast cells that were more than 55micrometer in the TMEP, normal skin and UP was 7.00, 2.08 and 21.00, respectively and these values showed statistical differences (p<.0001). The MPV that was of less than 55micrometer of vessel diameter in the patients with associated cutaneous or systemic symptoms was greater that that of the patients without associated symptoms and these values showed statistical differences (p<.005). CONCLUSION: This study suggested that TMEP can be associated various constitutional and cutaneous symptoms. The MPV method can be an effective method for differentiating the histopathologic findings of TMEP from those of normal skin or UP.
Subject(s)
Female , Humans , Male , Age of Onset , Glycosaminoglycans , Mast Cells , Mastocytosis, Cutaneous , Medical Records , Retrospective Studies , Skin , Telangiectasis , Upper Extremity , Urticaria PigmentosaABSTRACT
BACKGROUND: Telangiectasia macularis eruptiva perstans (TMEP) is a rare form of cutaneous mastocytosis, and this is characterized by multiple brownish-red confluent macules and telangiectasia. Although several cases of TMEP have been reported in the Korean literature, no clinicopathological studies have yet been reported. OBJECTIVE: This study was undertaken to document the clinical features of TMEP, to examine the histopathological features of TMEP and to quantify the number of perivascular mast cell by using the 'mast cells per vessel unit method (MPV). METHODS: The medical records of 16 patients with TMEP and who were seen at our institution from 1999 through 2006 were retrieved. We retrospectively reviewed the medical records, clinical photographs and histopathology slides of these patients. Furthermore, we quantified the number of perivascular mast cells, using the MPV method, on the slides of the TMEP patients, and then we compared this to the number of perivascular mast cells in normal skin (n=10) and urticaria pigmentosa skin (UP, n=10) as controls. RESULTS: The ratio of male to female was 13:3 and the mean age of onset was 36.31+/-12.34 years. The most commonly involved sites were both the trunk and upper extremities (62.5%). 5 patients (31.3%) showed constitutional symptoms. A microscopic examination demonstrated scant perivascular infiltrate with mast cells. The average number of mast cells less than 55micrometer of vessel diameter in the TMEP, normal skin and UP was 3.32, 1.17 and 5.89, respectively and the average number of mast cells that were more than 55micrometer in the TMEP, normal skin and UP was 7.00, 2.08 and 21.00, respectively and these values showed statistical differences (p<.0001). The MPV that was of less than 55micrometer of vessel diameter in the patients with associated cutaneous or systemic symptoms was greater that that of the patients without associated symptoms and these values showed statistical differences (p<.005). CONCLUSION: This study suggested that TMEP can be associated various constitutional and cutaneous symptoms. The MPV method can be an effective method for differentiating the histopathologic findings of TMEP from those of normal skin or UP.
Subject(s)
Female , Humans , Male , Age of Onset , Glycosaminoglycans , Mast Cells , Mastocytosis, Cutaneous , Medical Records , Retrospective Studies , Skin , Telangiectasis , Upper Extremity , Urticaria PigmentosaABSTRACT
A 32-year-old woman had multiple bluish macules and patches on her right back. They had gradually increased in number and size since they had first appeared at age 27 years. About 35 blue or blue-grey macules and patches measuring 1~40 mm in diameter were scattered on her back. Histologic examination showed hyperkeratosis and basal hypermelanosis in the epidermis and scattered spindle-shaped cells containing melanin granules in upper and middle dermis. Most of the dermal melanocytes were arranged parallel to the epidermis. We report a case of blue nevus on the back which presented as multiple scattered bluish macules and patches.
Subject(s)
Adult , Female , Humans , Dermis , Epidermis , Hyperpigmentation , Melanins , Melanocytes , Nevus, BlueABSTRACT
Accumulation of calcium in the skin is usually classified as a group of disorders referred to as calcinosis cutis. Based on pathophysiologic mechanisms, it has been classified as metastatic, dystrophic, idiopathinic and iatrogenic calcinosis cutis. Local tissue injury due to repetitive trauma by an acupuncture needle can cause dystrophic calcinosis cutis. A 61-year-old woman developed hyperpigmented pea sized subcutaneous nodules on the right side of her lower abdomen. She had received several sessions of acupuncture treatments on the right abdomen in a herb medicine clinic. A biopsy specimen showed amorphous basophilic deposits in the dermis and serum levels of calcium, phosphate were within the normal range. We report a case of dystrophic calcinosis cutis following acupuncture treatments by a herb medicine doctor.
Subject(s)
Female , Humans , Middle Aged , Abdomen , Acupuncture , Basophils , Biopsy , Calcinosis , Calcium , Dermis , Needles , Pisum sativum , Reference Values , SkinABSTRACT
Restrictive dermopathy is a lethal, autosomal recessive disorder characterized by tautness of skin, multiple joint contractures, and respiratory insufficiency resulting in fetal akinesia and death during the neonatal period. Histologic findings show a flat dermoepidermal junction, overall thinned dermis with hypoplastic appendages, a dense fibrotic reticular dermis with collagen parallel to the epidermis, and a thick layer of subcutaneous adipose tissue. It is a rare disorder that has not yet been reported in the Korean literature. Herein, we present a case of restrictive dermopathy in a neonate.
Subject(s)
Humans , Infant, Newborn , Collagen , Contracture , Dermis , Epidermis , Joints , Respiratory Insufficiency , Skin , Subcutaneous FatABSTRACT
Pseudoxanthoma elasticum is a rare, heritable disorder of elastic fibers characterized by yellowish, coalescing papules on the loose and wrinkled flexural skin. An 18-year-old man presented cutis laxa-like marked wrinkling on the axillae, trunk and thighs for about 10 years. There was no similar skin lesion on his family members and no other systemic involvement was found. Histopathological examination of the abdomen revealed fragmentation and calcification of elastic fibers in the middle and lower dermis. Von Kossa staining showed calcium deposition along the altered elastic fibers. Herein, we report a rare case of autosomal recessive pseudoxanthoma elasticum presenting generalized cutaneous laxity.
Subject(s)
Adolescent , Humans , Abdomen , Axilla , Calcium , Dermis , Elastic Tissue , Pseudoxanthoma Elasticum , Skin , ThighABSTRACT
Generalized granuloma annulare (GGA) is characterized by disseminated necrotic dermal papules but the pathogenesis has not been fully elucidated. A 5-month and a 3-month male infant had diffusely scattered, erythematous papules on their trunks, and upper and lower extremities. Histopathological examination revealed an infiltration of histiocytes around and between altered collagen fibers in upper and mid dermis. The collagen fibers were separated by mucin, which was positively stained with alcian blue at pH 2.5. After they were treated with topical and/or systemic corticosteroid, the lesions disappeared. To the best of our knowledge, these two cases are non-perforating GGA in the youngest patients yet reported in English literature.
Subject(s)
Humans , Infant , Male , Alcian Blue , Collagen , Dermis , Granuloma Annulare , Granuloma , Histiocytes , Hydrogen-Ion Concentration , Lower Extremity , MucinsABSTRACT
Antiphospholipid syndrome is defined as the presence of lupus anticoagulant antibodies or anticardiolipin antibodies with vascular thrombosis or specific pregnancy complications. Antiphospholipid syndrome can be associated with autoimmune, malignant or infectious diseases. Cutaneous manifestations of antiphospholipid syndrome are variable and can be a first clue to the syndrome or other associated diseases. We report a case of systemic lupus erythematosus and secondary antiphospholipid syndrome presenting as livedo reticularis on both legs of a patient. We recommend that patients with livedo reticularis should be examined for systemic lupus erythematosus or antiphospholipid syndrome.
Subject(s)
Humans , Antibodies , Antibodies, Anticardiolipin , Antiphospholipid Syndrome , Communicable Diseases , Leg , Livedo Reticularis , Lupus Coagulation Inhibitor , Lupus Erythematosus, Systemic , Pregnancy Complications , ThrombosisABSTRACT
A 17-year-old woman was stung by a jellyfish on her right lower leg in waters off the Korean coastline. The lesions presented as erythematous, painful patches and cleared-up within 2 weeks. However, 2 weeks later, erythematous band-like patches and crusts developed at the previous contact site and similar lesions occurred on non-contact areas. Histologic examination revealed hyperkeratosis, focal spongiosis in the epidermis and perivascular lymphohistiocytic infiltrate, with numerous eosinophils in the upper dermis. We report a case of jellyfish dermatitis which showed immediate toxic reaction and delayed cutaneous reaction following a jellyfish sting from a species present in Korea.
Subject(s)
Adolescent , Female , Humans , Bites and Stings , Dermatitis , Dermis , Eosinophils , Epidermis , Korea , LegABSTRACT
Clinical analysis was performed on 83 ankle fractures admitted and treated at the Orthopedic Service of the 17th Army Hospital during the period from April 1966 to April 1969. 1) Fourty five cases in the right ankle and the remainder in the left. 2) Closed reduction followed by adequate external immobilization was applied in 49 cases and the other 34 cases treated by open reduction included 20 cases in which initial manual reduction was failed. 3) Results of treatment in 33 cases could be evaluated as satisfying, in which reduction followed by short leg or patella setting below knee cast was adopted. 4) Average healing period was 2 to 3 months and in 5 cases it required more than 5 months. 5) Comminuted compression fracture and those with extensive soft tissue damage posed most difficult problems with ultimate poor functional restoration. In 8 such cases it was obligatory to apply a surgical fusion from the start of treatment.