ABSTRACT
Background@#Pityriasis rotunda (PR) is a rare dermatosis characterized by the presence of multiple, strikingly circular or oval-shaped, sharply demarcated, and scaly hyperpigmented patches. Its etiology remains poorly understood. To date, there have been no comprehensive analyses of PR in Koreans. @*Objective@#To investigate the clinical, pathological, and dermoscopic features of PR. @*Methods@#Sixteen patients with PR were evaluated. @*Results@#A female preponderance was observed (male:female ratio 1:7), and the mean age of the patients was 33.2±16.1 years (range, 15∼68 years), with the peak incidence observed in patients in their 20s. Notably, all the lesions developed on the trunk. The most common clinical diagnosis is PR. Histologically, PR appears similar to ichthyosis vulgaris. Hyperkeratosis was mainly ortho-keratotic, with plugs observed within hair follicles, elongated rete ridges, diminished stratum granulosum, enhanced pigmentation of the basal layer, pigmentary incontinence, and sparse superficial perivascular lymphoid cell inflammatory infiltrate. Periodic acid-Schiff staining was negative for fungi. Hyperpigmented patches with occasional scales were separated from each other by paler striae on dermoscopy. @*Conclusion@#PR commonly presents as multiple round lesions of variable sizes on the trunk of patients in their 20s. They showed characteristic findings, including hyperkeratosis with relative focal hypogranulosis, histopathologically, and some lesions showed dark and light brown polygonal patches with paler striae arranged dermoscopically, in a mosaic pattern. This was a retrospective single-center study with a small sample size; however, we believe that this paper will contribute to the clarification and understanding of PR.
ABSTRACT
Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months.His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy.
ABSTRACT
Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months.His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy.
ABSTRACT
Background@#Clear cell acanthoma is a rare benign epidermal tumor that is considered a nonspecific reactive dermatosis. To date, no reports have described systematic analyses of clear cell acanthoma in Koreans. @*Objective@#We investigated the clinical, histopathological, and dermoscopic features of clear cell acanthoma. @*Methods@#In this study, we evaluated 14 lesions of clear cell acanthoma. @*Results@#We observed female predominance (male:female ratio 1:1.3), and the mean patient age was 55.8±18.0 years (range 15∼76 years), with the peak incidence observed in patients in their 60s. Notably, 57.1% of lesions developed on the lower extremities. The lesion was most commonly misdiagnosed as seborrheic keratosis. Histopathological examination revealed a well-demarcated area of keratinocytes with pale-staining cytoplasm and psoriasiform epidermal hyperplasia and mild spongiosis, exocytosis of neutrophils, and thinned suprapapillary plates. Dermoscopic examination showed a clear cell acanthoma with characteristic vascular findings, including pinpoint red dots, globular red dots, and glomeruloid structures with linear or reticular patterns. @*Conclusion@#Clear cell acanthoma commonly presents as a small solitary lesion measuring <1 cm in diameter that occurs on the lower extremities in women in their 60s. Histopathological characteristics of this lesion include Periodic acid Schiff-positive with pale cytoplasm, and dotted, globular, and glomeruloid vessels with a linear or reticular pattern on dermoscopy. This was a single-center, small-sized retrospective study; however, in our view, the results of this study would contribute to the literature by providing a better understanding of clear cell acanthoma in Koreans.
ABSTRACT
Nontuberculous mycobacteria are ubiquitous environmental organisms that are rare pathogens in immunocompetent individuals. However, cutaneous nontuberculous mycobacteria infections have been increasingly associated with invasive procedures, including surgery, liposuction, filler injection, intramuscular injection, mesotherapy, piercing, acupuncture, and cupping therapy. Herein, we report the first case of cutaneous nontuberculous mycobacteria infection caused by the East-Asian traditional treatment ‘Gua Sha’, also known as scraping, coining or spooning in English. A 35-year-old healthy female presented with widespread, painful skin nodules and pustules on her upper and lower extremities that had developed after Gua Sha treatment for body contouring. Histopathologic examination of the lesions revealed granulomatous inflammation in the dermis and the culture isolates were identified as Mycobacterium massiliense with molecular identification. The patient was successfully treated with intermittent incision and drainage of persistent nodules and oral clarithromycin based on antimicrobial susceptibility testing. We recommend implementation of a standard safety protocol for Gua Sha practitioners to minimize the risk of infection transmission.
ABSTRACT
Basal cell carcinoma (BCC) is the most common type of skin cancer. It typically develops on sun-exposed and hair-containing areas of the body, such as the head and neck regions. The occurrence on the palms and soles is very rare. A 66-year-old Korean woman presented with a red elliptical ulcerative nodule on her left palm. Biopsy revealed basaloid cell mass and nests in the dermis with basal cells containing dark and elongated nuclei. She was diagnosed with basal cell carcinoma, and wide excision with full-thickness skin graft was performed. To the best of our knowledge, no case of basal cell carcinoma on the palm without basal cell nevus syndrome has been reported in Korean literature. Herein, we report this case owing to its rare occurrence on such location.
ABSTRACT
BACKGROUND: Cutaneous carcinosarcoma is a rare biphasic tumor comprising malignant epithelial and heterologous mesenchymal elements. Data on the clinical and histopathologic characteristics of this tumor in Asian populations are not available. The purpose of this study was to investigate the clinicopathologic and immunohistochemical features of cutaneous carcinosarcoma in the Korean population. METHODS: We retrospectively reviewed the records of 11 patients with cutaneous carcinosarcoma who were diagnosed from 2006 to 2016. RESULTS: The mean patient age at diagnosis was 71.5 years (range, 43–96 years) and there was a men predilection. The most common site of cutaneous carcinosarcoma was the head and neck (8/11, 72.7%). Histopathologically, most tumors showed a characteristic morphology consisting of two types of tumor cells, varied differentiated epithelial cells (such as basal or squamous cells) and spindle cells with transition zones between the two components. These two cell types also demonstrated variable immunohistochemical characteristics. CONCLUSION: Although the number of cases in this study was limited, our results provide valuable insight into the clinical and histopathologic characteristics of cutaneous carcinosarcoma in the Korean population.
Subject(s)
Humans , Male , Asian People , Carcinosarcoma , Diagnosis , Epithelial Cells , Head , Neck , Pathology , Retrospective StudiesABSTRACT
No abstract available.
Subject(s)
Humans , Keratoderma, Palmoplantar , Pityriasis Rubra Pilaris , Pityriasis , SiblingsABSTRACT
Cactus spines can easily puncture the skin with only minor pressure. Removal of the offending cactus spine is the treatment of choice; however, it is very difficult, even with tweezers. A 17-year-old Korean girl presented for evaluation of multiple purple-colored macules and papules on the left cheek and left thumb. Two months earlier, she had pricked her finger and face on cactus spines while volunteering in Haiti. An ultrasound identified wedge-shaped echogenic materials suspected as cactus spines. We recommended surgical removal of the spines, but she vehemently refused. We then advised her to take amoxicillin/clavulanic acid and undergo regular follow-up. During the follow-up period, the spines dislodged spontaneously for easy removal and the patient removed them with tweezers. The lesions actually improved over the next several months. Here, we report this rare and interesting case for educational purposes because such a case has never been previously reported in Korea.
Subject(s)
Adolescent , Female , Humans , Cactaceae , Cheek , Fingers , Follow-Up Studies , Haiti , Korea , Punctures , Skin , Spine , Thumb , Ultrasonography , Wounds and InjuriesABSTRACT
BACKGROUND: Juvenile xanthogranuloma is a benign, self-limited disorder that usually occurs in infants and young children. Xanthogranuloma is rare in adults, and therefore studies reporting adult xanthogranuloma are limited. OBJECTIVE: We investigated the clinical, histopathological, and immunohistochemical characteristics of adult xanthogranuloma. METHODS: In this study, we evaluated 20 lesions in 19 patients with adult xanthogranuloma. RESULTS: A male predominance was observed (male : female ratio 1.4 : 1), and the mean age of patients was 35.1±16.3 years (range 15∼66 years), with the peak incidence observed in patients in their 20s. Notably, 65.0% of the lesions developed on the head and neck. The nodular form was more common than the papular form of this condition. Histopathological examination revealed dense monomorphic histiocytic infiltration without lipidization and scattered eosinophils without multinuclear giant cells in 5 lesions (25.0%), foamy histiocytic infiltration with variations of completely developed Touton giant cells in 10 lesions (50.0%), and fibrohistiocytic proliferation in 3 lesions (15.0%). On immunohistochemical examination, histiocytes including giant cells showed positive test results with Factor XIIIa (90.9%), vimentin (100%), and CD68 (100%) and negative test results with CD1a, smooth muscle actin, and S-100 protein stains. Tumor excision was the treatment for choice. CONCLUSION: Adult xanthogranuloma most commonly manifested as the nodular form of the disease on the head and neck of men in their late 20s. Histopathologically, the classic Touton cell-rich stage was most commonly observed, followed by the stage of early predominantly mononuclear infiltration. This was a single-center, small-sized retrospective study; however, we expect the results of this study to contribute to a better understanding of adult xanthogranuloma.
Subject(s)
Adult , Child , Female , Humans , Infant , Male , Actins , Coloring Agents , Eosinophils , Factor XIIIa , Giant Cells , Head , Histiocytes , Incidence , Muscle, Smooth , Neck , Retrospective Studies , S100 Proteins , Vimentin , Xanthogranuloma, JuvenileABSTRACT
Amputation of the lower extremities followed by the use of an artificial leg is very common. However, malignancy arising in an amputation stump is an extremely rare event. In this report, we describe a case of squamous cell carcinoma arising in the amputation stump of a 56-year-old Korean man. To the best of our knowledge, similar cases have not been previously reported in Korea.
Subject(s)
Humans , Middle Aged , Amputation Stumps , Amputation, Surgical , Artificial Limbs , Carcinoma, Squamous Cell , Epithelial Cells , Korea , Lower ExtremityABSTRACT
No abstract available.
Subject(s)
Humans , Alopecia Areata , Alopecia , Hair , Prostheses and ImplantsABSTRACT
BACKGROUND: Topical tacrolimus is an effective anti-inflammatory therapy for acute and chronic states of atopic dermatitis (AD) in both adults and children. Topical tacrolimus has particular use at sensitive areas such as the face, anogenitals, and skin folds of neck and extremities. However, many AD patients also experience aggravated symptoms on trunk. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of topical tacrolimus for AD patients with truncal lesions. METHODS: AD patients with truncal lesions who were aged ≥2 years were recruited from 20 centres in Korea. They received treatment with topical tacrolimus ointment twice daily during 4 weeks. The primary end point was change of the local eczema area and severity index (EASI) of the trunk from baseline to day 28. The secondary end points were changes in the patient global assessment (PGA) score and itch visual analogue scale (VAS) score of the trunk between baseline and day 28. RESULTS: Two hundred and ninety-one patients were recruited, and 176 patients completed the full 4-week treatment course. By the end of the treatment, the mean local EASI of the trunk (2.2±4.71) was significantly decreased from that at baseline (4.71±4.03, p < 0.001). PGA (1.71±1.15) and itch VAS score of the trunk (2.61±2.19) on day 28 were also profoundly decreased compared with the baseline (2.96±1.07 and 5.15±2.47, respectively). No serious adverse events were observed during the study period. CONCLUSION: Topical tacrolimus is an effective and safe therapy for truncal lesions in AD patients.
Subject(s)
Adult , Child , Humans , Administration, Topical , Dermatitis, Atopic , Eczema , Extremities , Korea , Neck , Skin , TacrolimusABSTRACT
It is well recognized that the deposition of mucin occurs in areas of eruption in patients with lupus erythematosus. However, nodular cutaneous mucinosis is regarded as a rare distinctive cutaneous mucinosis in which the mucin deposition occurs in areas other than the sites of eruption in patients with systemic lupus erythematosus and manifests as a clinically specific lesion. Although several cases have been described in the literature, there have been only two reported cases in Korean literature. Thus, we report an interesting case of nodular cutaneous mucinosis that occurred in a young man. A 16-year-old man visited our clinic presenting with multiple soft subcutaneous nodules on his back for 6 months. He denied any other symptoms. Histological examination showed diffuse mucin deposition throughout the superficial and mid-reticular dermis. The abnormal laboratory values were as follows: a positive antinuclear antibody, increased anti-dsDNA, and reduced WBC count and C3 levels. He was diagnosed with nodular cutaneous mucinosis with systemic lupus erythematosus and treated with oral hydroxychloroquine and methylprednisolone. Our report is of interest owing to the rarity of developing nodular cutaneous mucinosis as an initial presentation of systemic lupus erythematosus.