A Case of Poikiloderma Vasculare Atrophicans

Poikiloderma vasculare atrophicans (PVA) is a rare variant of mycosis fungoides, and is characterized by generalized hyperkeratotic scaly papules in net-like, retiform, or zebra-like patterns. A 59-year-old Korean woman presented with asymptomatic, erythematous-to-violaceous, reticulated confluent papules on the trunk and extremities. Skin lesions were initially limited to both thighs 25 years ago, and then spread slowly over her body. Histopathological examination showed band-like inflammatory infiltrations and epidermotropism consisting of mostly CD8+ lymphocytes. Based on the clinical manifestations and histological findings, the diagnosis of PVA was made. We herein report on a case of PVA, which featured a long-benign course without progression into the tumor stage over a period of 30 years.

A Case of Subacute Cutaneous Lupus Erythematosus That Simultaneously Presented with Papulosquamous and Annular Lesions / 대한피부과학회지

Subacute cutaneous lupus erythematosus (SCLE) includes the papulosquamous and annular-polycyclic variants that present with psoriasiform lesions and annular/polycyclic erythema, respectively. Most patients predominantly have either one or the other subtype, but it is rare that patients have a combination of both lesions. A 13-year-old boy had both erythematous, well-defined, annular-shaped patches and erythematous, ill-defined, hyperkeratotic scaly patches that were scattered on the entire body. Although his clinical manifestations seemed typical for SCLE, his laboratory findings were all negative for LE-specific autoantibodies, including ANA, anti-Ro/SS-A antibody, anti-La/SS-B antibody, anti-dsDNA antibody, etc. The characteristic histopathological features for lupus erythematosus and the granular deposition of IgG and C3 along the dermo-epidermal junction, as detected by direct immunofluorescence testing of lesional skin biopsy specimens, could lead us to the diagnosis of SCLE. We herein report on a case of SCLE that simultaneously presented with both papulosquamous and annular-shaped lesions.

A Clinical Study of Urticarial Dermatitis / 대한피부과학회지

BACKGROUND: Urticarial dermatitis is not a commonly used term but may be a useful term representing clinical and histological features as a subset of the dermal hypersensitivity reaction pattern. However, there have been no previous clinical studies on urticarial dermatitis in Korea. OBJECTIVE: The purpose of this study was to investigate the clinical characteristics, courses, and responses to various treatments in patients with urticarial dermatitis. METHODS: From January 2007 to February 2009, a total of 24 Korean patients who were diagnosed with urticarial dermatitis by clinical and histological criteria were involved in this study. Retrospective analysis using their medical records and the routine blood tests including IgE was performed. RESULTS: Men (n=19) were involved more predominantly than women (n=5). The mean age of the patients was 49.4 years and the mean duration of the disease was 21.1 months. The skin lesion involved the trunk most commonly and spread throughout the entire body, particulary to the proximal part of the extremities. An abnormally elevated IgE level (mean 819.7 mg/dl) and eosinophil count (mean 7.3%) were observed in 12 patients and 9 patients, respectively. Combination therapy of an oral antihistamine agent and topical steroids was mostly not effective. The skin lesions and symptoms were improved transiently by low-dose corticosteroid therapy, dapsone, and narrow-band UVB (NBUVB) phototherapy, but relapsed or aggravated shortly after cessation of treatment or reduction of drug dosage. CONCLUSION: Urticarial dermatitis is mostly chronic with a waxing and waning disease course. The administration of dapsone or NBUVB phototherapy are additional therapeutic options to oral corticosteroids in the treatment of urticarial dermatitis.

A Clinical Study of Patients with Hand Eczema / 대한피부과학회지

BACKGROUND: Hand eczema is a common dermatosis, yet it is has diverse etiologic factors and clinical manifestations, and it is usually recalcitrant to treatment. There are only infrequent population-based clinical and epidemiological studies on hand eczemain the medical literature. OBJECTIVE: The purpose of this study was to investigate the clinical manifestations and influences of occupation, concomitant allergic diseases, various aggravating factors and seasonal changes for patients with hand eczema. In addition, we tried to categorize the patients with hand eczema by the morphological characteristics. METHODS: A total of 189 patients who showed clinical manifestations of hand eczema were included in this study. We retrospectively reviewed the clinical characteristics of all the patients and we performed patch tests with the Korean standard series for 24 patients. RESULTS: The mean duration of the disease was 37.3 months. Housewives were the largest group (32.8%) by occupation, followed by students (23.8%). Bilateral involvement on both hands (83.1%) was significantly more common than unilateral involvement (16.9%). All the patients were categorized into 4 morphological types: the recurrent vesicular type, the hyperkeratotic type, the dry type, and others, and these occurred in 50.3%, 24.3%, 23.8%, and 1.6% of the patients, respectively. The most common aggravating factor was wet work at 24.3 percent. Of the 24 patients for whom the patch test was performed, 20 patients showed a positive reaction to more than one allergen and nickel sulfate was the most common allergen in these patients. CONCLUSION: This study demonstrated the various clinical characteristics of Korean patients with hand eczema. It is especially remarkable that they had a long clinical course and a higher positive rate on standard patch tests.

A Case of Zosteriform Cutaneous Leiomyomatosis Widely Distributed on the Neck and Chest / 대한피부과학회지

Cutaneous leiomyoma is a benign tumor of smooth-muscle fibers. There are five types of cutaneous leiomyoma; multiple piloleiomyomas; solitary piloleiomyoma; solitary genital leiomyoma; solitary angioleiomyoma; and leiomyoma with additional mesenchymal elements. A 50-year-old woman had a 13-year history of variable sized painful eryhtematous papules and nodules on the left upper chest, shoulder, arm and back. These lesions were distributed in a zosteriform pattern and corresponded with the left fourth cervical and the left second thoracic dermatome. The histopathologic findings revealed typical piloleiomyoma. One case of zosteriform cutaneous leiomyoma has been reported in the Korean literature. However, the lesions of the case corresponded with two close dermatomes and developed widely. Such a case has never been reported in the Korean literature case.