A Case of HIV-associated Granuloma Annulare / 대한피부과학회지

Granuloma annulare is a chronic inflammatory skin disease characterized by erythematous or flesh-colored papular eruptions of annular configuration. In a HIV positive patient, granuloma annulare could be confused with other papular diseases because it could be presented as atypical appearances due to the defect of the immune system. Moreover, without specific treatment for granuloma annulare, the lesions could be improved by systemic anti-retroviral therapy.

Duration Required for Negative Conversion of KOH Mount in Toenail Onychomycosis According to the Clinical Factors and Treatment Regimens / 대한의진균학회지

BACKGROUND: Onychomycosis is one of the most common diseases of the nails accounting for up to 50% of all nail problems. There are many literatures on the cure rate and duration for complete cure according to the various factors. However, little information is available regarding duration required for negative conversion of KOH mount. OBJECTIVE: The purpose of this study was to evaluate the duration required for negative conversion of KOH mount in patients with toenail onychomycosis according to the clinical factors and treatment regimens. METHODS: Medical records of 325 patients with onychomycosis between May 2001 and February 2012 were reviewed retrospectively to obtain the following information: age, sex, presence of diabetes mellitus (DM), extent of nail involvement, therapeutic methods, and result of KOH mount at each timepoint. RESULTS: Extent of nail involvement, old age (> or =60) and DM were negatively associated with the duration required for conversion of KOH mount. Extent of nail involvement also negatively affected the rate of conversion of KOH mount at week 48. Positive KOH mount at week 28 was negatively associated with complete cure. CONCLUSIONS: Extent of nail involvement, old age, and DM can prolong the duration required for negative conversion of KOH mount. Also, positive KOH mount at week 28 had negative effect on the cure of onychomycosis.

Vestibular Papillomatosis Mimicking Condyloma Acuminatum / 대한피부과학회지

Vestibular papillomatosis is an uncommon benign condition that can occur on labia minora and is considered as a normal anatomical variant of the vulva, as the female equivalent of pearly penile papules in men. Because vestibular papillomatosis resemble condyloma, it can be misdiagnosed as condyloma acuminatum and can lead to unnecessary treatment. We herein report a case of a 27-year-old women with multiple skin-colored soft papules on labia minora. The lesion was distributed symmetrically on the inner of labia minora and showed a separate base of individual projection. To the best of our knowledge, this is a unique case reported in the Korean dermatological literature.

A Case of Targetoid Hemosiderotic Nevus / 대한피부과학회지

No abstract available.

Toxic Epidermal Necrolysis with Ocular Involvement Following Vaccination for Hemorrhagic Fever with Renal Syndrome

We report a case of toxic epidermal necrolysis with ocular involvement following vaccination for hemorrhagic fever with renal syndrome. A healthy 20-year-old male soldier presented with confluent purpuric and erythematous dusky red macules evolving to flaccid blister and epidermal detachment on the whole body with conjunctival injection. The patient had no antecedent medical or surgical conditions except for two doses of hemorrhagic fever with renal syndrome vaccination. With supportive care, skin lesions were improved. Ophthalmic examinations revealed conjunctival injection with epithelial defects in both eyes. Ocular complications were resolved after amniotic membrane transplantation. Toxic epidermal necrolysis may be considered as a possible complication of hemorrhagic fever with renal syndrome vaccination.

A Case of Pigmented Mammary Paget's Disease

Pigmented mammary Paget's disease is a uncommon clinicopathologic variant of mammary Paget's disease, and this mimics malignant melanoma both clinically and histopathologically. Herein, we report on a rare case of pigmented mammary Paget's disease. An 81-year-old woman presented with 2.5x1 cm sized, red and brown, eczematous plaque on her right areola, and she'd had this lesion for 3 years. Histopathology showed large, atypical cells with large nuclei and abundant pale cytoplasm throughout the epidermis. Dispersed melanocytes were noted in the epidermis and some of the Paget's cells contained melanin within their cytoplasm. Immunohistochemical studies demonstrated that the intraepidermal pagetoid cells were positive for cytokeratin 7; in contrast, they were negative for S-100, Periodic-acid Schiff (PAS), Alcian blue at PH 2.5, HMB-45 and carninoembryonic antigen (CEA). We recommend that pigmented mammary Paget's disease should be included in the differential diagnosis of pigmented lesions on the nipple.

A Case of Plasma Cell Cheilitis Treated with Topical Pimecrolimus / 대한피부과학회지

Plasma cell cheilitis is a rare, idiopathic, benign inflammatory disease of lips, characterized by dense plasma cell infiltrates in the upper dermis. It presents as erythematous patches with erosion usually on the lower lip of elderly people. Although, various therapeutic options, including topical steroids, intralesional injection of glucocorticoids, oral nystatin and topical antibiotics have been tried, none of them is promising. A 68-year-old woman presented with a 4-month history of erosive patches with crusts on her lower lip, which was resistant to topical corticosteroids. A histopathologic examination revealed dense inflammatory cell infiltration mainly consisting of plasma cells in the dermis, consistent with plasma cell cheilitis. She was treated with topical pimecrolimus and after 2 weeks of application, the lesion started to get better. After 7 weeks it had almost disappeared. Herein, we present a case of plasma cell cheilitis treated with topical application of pimecrolimus.

Cure Rate, Duration Required for Complete Cure and Recurrence Rate in Patients with Onychomycosis of Great Toe Nail According to the Extent of Nail Involvement / 대한의진균학회지

BACKGROUND: Despite enormous advances in the treatment of onychomycosis in recent years, many factors such as the extent of nail involvement affect treatment response. OBJECTIVES: The purpose of this study was to evaluate the cure rate, duration required for complete cure and recurrence rate in patients with onychomycosis of great toe nail according to the extent of nail involvement. METHODS: Medical records in patients with onychomycosis on the great toe nail were reviewed retrospectively to obtain the following information: diagnosis, age, sex, presence of systemic diseases, extent of nail involvement, and duration for complete cure. One year after complete cure, patients underwent a follow-up examination of recurrence. RESULTS: The complete cure rate (CCR) as a whole was 78.3%, duration required for complete cure (DC) was 31.7+/-18.4 weeks, recurrence rate (RR) was 36.0%. CCRs were 92.4% in the nail involvement-under-25% group (A), 81.8% in the group involving 25~50% of the nail (B), 72.2% in the group involving 50~75% of the nail (C), 63.9% in the group involving 75~100% of the nail (D) (p<0.05). DCs were 15.8+/-7.8 weeks in group A, 32.9+/-9.8 weeks in group B, 33.5+/-7.5 weeks in group C, and 53.9+/-16.8 weeks in group D (p<0.05). RRs were 12.5% in group A, 44.8% in group B, 52% in group C, and 45.2% in group D (p<0.05). Conclusion: There were statistically significant differences in CCR, DC, and RR depending on the extent of the nail involvement; therefore, it seems important to obtain early treatment.

A Case of Cutaneous Metastatic Adenosquamous Carcinoma of the Pancreas / 대한피부과학회지

Pancreatic adenosquamous carcinoma is a rare variant of ductal adenocarcinoma and accounts for only 1~4% of exocrine pancreatic malignancies. Although pancreatic carcinoma shows an aggressive biologic behavior, cutaneous metastasis from pancreas carcinoma is rare. We report a case of a pancreatic adenosquamous carcinoma which clinically manifested as two firm nodules on the right upper extremity. It was this first clinical manifestation that made it possible to diagnose pancreatic adenosquamous carcinoma.

Morsicatio Labiorum / 대한피부과학회지

Morsicatio is a condition caused by chronic irritation of the tongue (morsicatio linguarum), buccal (morsicatio buccarum) or labial mucosa (morsicatio labiorum). The condition shows a macerated, grey-white lesion of mucosa where bacterial colonies form and is caused by continuous biting, chewing and sucking of the cheeks or lips. We herein report a case of morsicatio labiorum which occurred in a woman. This is a rarely encountered mucocutaneous disorder, and has never before been reported in the Korean dermatological literature.