A Case of T-cell Lymphoblastic Lymphoma Involving the Skin / 대한피부과학회지

Lymphoblastic lymphoma(LBL) is non-Hodgkin's lymphoma with a high tendency of rapid progression to acute leukemia, but cutaneous infiltration is rare. Cutaneous lesions in LBL were largely red papules and nodules. We herein report a case of 24-year-old woman with T-cell LBL(TLBL) involving the skin. The lesions revealed 1~3 cm-sized, multiple confluent scaly patches on her face and back, and subsided about 4 weeks later during the period of follow-up and combination chemotherapy. Histologically there were perivascular, periadnexal and perineural infiltrates of medium-sized lymphoid cells in mid to deep dermis. The neoplastic cells had scant cytoplasm, very fine chromatin, and inconspicuous nucleoli and expressed CD5, CD45, CD45RO and TdT.

A Case of Sebaceous Epithelioma / 대한피부과학회지

A 42-year-old woman was treated with total abdominal hysterectomy and bilateral salpingo- oophorectomy due to endometrial carcinoma 3 years ago, and has taken regular check-ups ever since. A 1.0cm-sized, yellow-orange colored, pedunculated mass had ben developed on her scalp about 1 year before. Excision showed an exophytic pedunculated, well-circumscribed nodule composed of predominant undifferentiated basaloid cells, some vacuolated sebocytes and numerous sebaceous duct like structures. There was no relapse during the follow-up of about 6 months. The development of sebaceous epithelioma in this case would be associated with Muir-Torre syndrome.

A Case of Eccrine Poroma on the Calf / 대한피부과학회지

A 66-year-old woman presented with a 1.5 by 1.2 cm sized, crusted erythematous nodule on the lateral aspect of her left calf. She had a small nodule on the left calf that had been removed by electrocauterization before her visit, but which had recurred. There was no previous history of trauma to the area. Histopathologic diagnosis was consistent with eccrine poroma. The tumor was excised, and no recurrence was noted when she examined 8 months later. We report a case of eccrine poroma arising on the left calf where is unusual location.

A Case of Churg-Strauss Syndrome Showing Hemorragic Bullae / 대한피부과학회지

A 61-year old woman was presented with various sized, tense and hemorrhagic bullae on the extremities with edema for 10 days. She had a history of bronchial asthma and had a tingling sensation on both legs. Laboratory findings showed leukocytosis, hypereosinopilia and p-ANCA(+). Chest radiograph showed patchy infiltrations in the left upper lobe. Water's view showed bilateral maxillary antral mucosal thickening. Electromyography showed polyneuropathy on both lower legs. Histopathologically, there were conspicuous infiltration of eosinophils within bulla and around vessels in the dermis and radially distributed histiocytes in the degenerated collagen. Treatment with prednisolone 30 mg per day showed a dramatic improvement in symptoms.

A Case of Giant Cell Tumor of Tendon Sheath on the Right 3rd Toe / 대한피부과학회지

A 40-year old woman presented with a skin colored, multinodular, hard mass of 1.5x1.0cm and 1.0X1.0cm on the right 3rd toe for 20 years. Histopathologically, the tumor consisted of lobules of varied cellularity surrounded by dense collagen. Some areas were cellular and consisted of histiocyte-like cells, osteoclast-like giant cells, foam cells. Other areas were less cellular and consisted of spindle cells within hyalinized stroma, compatible with giant cell tumor of tendon sheath.

A Case of Darier-like Actinic Keratosis / 대한피부과학회지

A 82-year old man was presented with a 0.7 by 0.5 cm sized, atrophic, mild erythematous macule on the left temple for 4 months. There was no history of verruca on the lesion or taking arsenic. Histopathologically, there were suprabasal acantholysis, lacunaes, vesicles with a few corps ronds and grains in the suprabasal layer and granular layer. Atypical cells and dyskeratotic cells were, in groups, seen in the entire epidermis and its appendages. But, glandular structures were not found. We report a rare case of actinic keratosis showing Darier-like features.

Primary Systemic Ki-1(CD30)-positive Large Cell Lymphoma / 대한피부과학회지

We report a case of Ki-1(CD30) positive large cell lymphoma which developed on the skin of the right inguinal area in an 8-year-old boy. The lesion was a 3.0x5.0cm sized ulcerative tumor with elevated margin, rapidly growing during 2 week period and was associated with enlargement of the left inguinal lymph nodes. Histopathologic feature showed anaplastic large cells with abundant cytoplasm and multinucleated giant cells with wreath-like nuclei in the dermis and subcutis. Immunohistochemically, tumor cells were CD30 positive. He was treated with chemotherapy through BFM-NHL protocol, with good response.

A Case of Nodular Fasciitis / 대한피부과학회지

Nodular fasciitis is an uncommon nonneoplastic swelling consisting of reactive fibroblastic proliferation occurring in the subcutaneous tissue of the extremities. It is characterized by benign clinical course and aggressive histologic features mimicking soft tissue sarcoma, Herein we report a 33-year-old man with a solitary, tender, 1.2 X 1.5cm sized hard nodule on the right forearm which clinically and histologically shows a typical nodular fasciitis.

Seroprevalence Study of Hepatitis C in Leprosy Patients / 나학회지

Hepatitis C is transmitted via parenteral routes and has commonly chronic course with progression to liver cirrhosis and hepatocellular carcinoma. The seroprevalence of HCV in Korea is about 1%, but in leprosy patients it is not well-known. So, the study was performed on anti-HCV seroprevalence and its epidemiologic survey in leprosy patients. The leprosy patients were 619 subjects(M:343, F:276) who were hospitalized in Catholic Skin Clinic from 1997 to 2001. Serum anti-HCV was checked by MEIA(Microparticle Enzyme Immunoassay) method, as well as HBsAg, HBsAb and alanine aminotransferase(ALT) value. In addition, age, sex, residency, duration of leprosy, and the frequency of liver problems were reviewed by medical records. The results were as follows; 1. The mean age of subjects was 68.3+/-9.2 years with ranging from 28 to 94 years. 2. The anti-HCV seropositivity among 619 leprosy patients was 39.3% and it showed increasing trend with aging(p0.05). 3. The residency of anti-HCV positive subjects were Gyeongbuk(40.7%), Gyeongnam(35.4%), Daegu(19.4%), and other areas(28.9%) in order. 4. The seropositivities of HBsAg and HBsAb were 4.5% and 11.8% respectively. Only 6(2.5%) patients were positive on both HBsAg and anti-HCV. 5. In 563 leprosy patients excluding unknown type(56 subjects), the anti-HCV seropositivities in leprosy type were 41.2%(163/396) in lepromatous leprosy(LL), 35.0%(14/40) in borderline leprosy(BB), 31.5%(40/127) in tuberculoid leprosy(TT) respectively with insignificant correlation(p>0.05). The HBsAg seropositivities were 4.8% in LL, 5.0% in BB, 3.1% in TT respectively, with insignificant correlation(p>0.05). 6. There were significant relationships between the seroprevalence of anti-HCV and the duration of leprosy in the well-recorded 433 leprosy patients (p or =40U/L) group was significantly higher than in normal group(<40U/L)(58.3% vs 37.2%, p<0.05). Of the 6 anti-HCV and HBsAg positive patients, ALT value was elevated in one patient. Comparatively, the anti-HCV positives were likely to have a higher incidence of liver problems. In conclusion, the seropositivity of anti-HCV in leprosy patients(39.3%) was high. There were significant relationship of the seropositivity of anti-HCV with age, duration of leprosy, residency, ALT value, and the frequency of liver problems, but not associated with sex, HBV markers and types of leprosy. Therefore check-up of routine biochemical screen of anti-HCV and the evaluation for the possible transmission routes (such as transfusion, drug abuse, sexual/household contact, shared needles, folk remedies, acupunctures, tattoos, etc.) are needed to set-up the precautionary measures in leprosy patients.

Two Cases of Irritant Dermatitis due to Clematis apiifolia A.P.DC / 대한피부과학회지

The clematis apiifolia A.P. DC. is a plant which belongs to Clematis Linne, Ranunculaceae. It contains anemonol, clematiscampher, clematin, labenzyme, saponin, of which anemonol is a probable irritant reacting component. We report two cases of irritant dermatitis due to Clematis apiifolia A.P.DC. plant. These patients developed painful, inflamed erythematous patches with flaccid bullae and erosions on the application sites of the crushed plant for self-treatment of arthralgia.

A Case of Bowen's Disease Partially Responded to Photodynamic Therapy

Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.

A Case of Incontinentia Pigmenti Associated with Right Cerebral Hemiatrophy / 대한피부과학회지

Incontinentia pigmenti is an uncommon genodermatosis presented by characteristic cutaneous stages and frequent association with one or more ectodermal or mesodermal anomalies. A new-born girl, 2 days old, had had crops of erythematous papules and vesicles on the trunk and extremities. At 2 years of age, she had the whorled hyperpigmentation. There were no anomalous features in teeth, eyes and hair, but she had a neurologic disorder. Left hemiplegia, related to upper motor neuron weakness, showed brisk left DTR, spastic Achilles tendon with walking disorders, decreased grasping power of left hand and weakness of left upper extremity. Brain MRI revealed marked loss of volume in the white matter of the right lateral ventricle in T1 weighted images. We report herein an explicit case of incontinentia pigmenti associated with right cerebral hemiatrophy.

Unilateral Progressive Pigmented Purpura / 대한피부과학회지

Progressive pigmented purpura(Schamberg type) is of uncertain etiology. The lesion is characterized by a symmetrical rash of petechial and brown pigmented macules limited to the legs. Unilateral occurrence is considered a rarity. We report a 37-year-old woman presented with a 20-year history of unilateral distribution of purpuric and pigmented lesions scattered on the right shin and calf. Histopathologic feature showed band-like infilterate of superficial perivascular lymphohistiocytes with extravasation of erythrocytes and hemosiderin deposition in the upper dermis.

A Case of Atypical Fibroxanthoma / 대한피부과학회지

Atypical fibroxanthoma(AFX) is a pleomorphic spindle cell neoplasm of the dermis, which is a clinically benign reactive lesion despite apparently malignant histologic features. We describe a 38-year-old woman with AFX developed on the right popliteal area. The lesion was superficially located and composed of densely cellular, pleomorphic spindle cells and several bizarre multinucleated giant cells. It is uncommon that AFX developes on the lower leg in the middle age.

A Case of Nevus Comedonicus / 대한피부과학회지

We describe a 16-year-old female with Nevus comedonicus(NC) that has been developed since birth. The lesions had a unilateral, linear or zosteriform distribution on the left lower leg and posterior thigh, and were well closely arranged, slightly depressed papules that had dark firm plugs resembling comedones in their centers. In the meantime, recurrent infections with fistula, abscess and residual scars had been complicated. Histopathologic features showed deep invagination of epidermis and dilated follicular orifices filled with keratin plugs in the centers of papules.

A Case of Neuroma Cutis Simulating Isolated Plantar Collagenoma / 대한피부과학회지

The true neuromas represent a specific entity in the range of benign nerve sheath tumor. The lesions exist in the skin and mucous membrane. Of these, palisaded encapsulated neuroma(PEN) is a solitary tumor measuring less than 0.5 cm and usually locates on the face. A 5-year-old boy presented with an isolated 3.0X3.0X0.7cm sized, soft collagenoma-like mass on the plantar area of left foot. It had developed for about 4 years. The histologic features demonstrated PEN-like encapsulated bulbous expansions in the dermis. This clinical manifestation of neuroma is considered a rarity.