A Case of Mucoepidermoid Carcinoma on the Upper Lip of Young Man / 대한피부과학회지

Mucoepidermoid carcinoma of the lip is an extremely rare disease. It originates from the sweat glands and consists of both proliferating squamous and mucin-producing cells. It is imperative to diagnose and treat the condition early, because of it's highly aggressive and unpredictable nature. A 25-year-old man presented with 1-year history of a tender, bean-sized ulcer covered with hemorrhagic crust on the upper lip. The histopathological findings showed multiple nests composed of epidermoid, clear cells and spaces filled with eosinophilic material throughout the dermis. We diagnosed this upper lip lesion as a mucoepidermoid carcinoma, and removed it totally.

Combination Therapy with Pulsed Dye Laser and Intralesional Bleomycin for the Treatment of Recalcitrant Warts / 대한피부과학회지

BACKGROUND: Some warts prove resistant to multiple therapies, particularly on an immunosuppressed patient. A previous study revealed that combination therapy with pulsed dye laser and intralesional bleomycin was effective on recalcitrant warts. OBJECTIVE: The aim of this study was to confirm whether the combination therapy with pulsed dye laser and intralesional bleomycin was effective for the treatment of recalcitrant warts. METHOD: Fifteen patients, all with recalcitrant warts, were recruited. Two patients were on long-term immunosuppressant drugs. Twenty warts were treated in total. The warts were anaesthetized with local anesthetic cream (EMLA(R) 5% cream) then treated with a pulsed dye laser (5mm spot, fluence 9.5-10J/cm2). Immediately following this, bleomycin (1mg/ml) was injected into the base of the warts. At 3-4 weeks after the last treatment, the warts were evaluated to assess clearance rate, total treatment numbers and side effects. RESULT: 1. Complete clearance was achieved for 17 out of 20 warts (85%). 2. Partial clearance was achieved for 3 out of 20 warts (15%). 3. Recalcitrant warts were cleared with an average of 1.95 treatments. 4. Recalcitrant warts on the immunosuppressed patients were cleared with an average of 2.0 treatments. 5. No significant side effects were observed. CONCLUSION: Combination therapy with the pulsed dye laser and intralesional bleomycin appears to be a safe, rapid, well tolerated and successful treatment for recalcitrant warts. It also appears to be effective for recalcitrant warts on immunosuppressed patients.

Two Cases of Sweet's Syndrome with Atypical Clinical Features / 대한피부과학회지

Sweet's syndrome, also referred to as acute febrile neutrophilic dermatosis, is characterized by tender, erythematous vesiculopapules and plaques, a high fever and general weakness. Histologically, a dense infiltration is composed predominantly of neutrophils, with edema in the upper dermis. We report two cases of sweet's syndrome with atypical clinical features: one presented with a carcinoma en cuirasse-like clinical feature, and the other presented with a cellulitis-like clinical feature.

A Case of Chondroid Syringoma with Folliculosebaceous-Apocrine Differentiation / 대한피부과학회지

Chondroid syringoma is a sweat gland tumor which is composed of a mixture of epithelial cells and mesenchymal tissue. It is referred to as a mixed tumors. Mixed tumor with follicular, sebaceous and apocrine differentiation are considered to be an expression of the common embryologic origin of elements of the folliculosebaceous-apocrine unit. A 74 year-old man presented with an asymptomatic, firm, pigmented nodule on the right cheek. Histologically, it showed numerous aggregates of cuboid epithelial cells with tubuloalveolar structures and keratinous cysts within a chondroid stroma. This was consistent with a chondroid syringoma. We herein describe an unusual chondroid syringoma with folliculosebaceous-apocrine differentiation.

The Effects of Coenzyme Q10, Kinetin, and Thioctic acid on Ultraviolet B Irradiated Cultured Human Skin Fibroblasts / 대한피부과학회지

BACKGROUND: Coenzyme Q10 is an endogenous lipid soluble antioxidant that scavenges reactive oxygen species (ROS) directly, inhibits biomolecule oxidation, and affects antioxidant defense in vivo. Kinetin (N6-furfuryladenine) belongs to the family of N6-substituted adenine derivatives known as cytokinins. Kinetin also exerts anti-aging effects. Commercial products of coenzyme Q10 and kinetin are developed and are selling as a rejuvenating drug. However, the action mechanisms of kinetin are not fully known, though it has been suggested to act both as an inhibitor of reactive oxygen species (ROS) formation and as a scavenger of ROS. Thioctic acid (alpha-Lipoic acid), which becomes a powerful antioxidant in its reduced form, has been suggested as a dietary supplement to treat diseases associated with excessive oxidant stress. Exposure of the skin to ultraviolet (UV) radiation, particulary UVB (290-320nm), causes adverse biological effects, including alterations in cutaneous immune cells, photoaging and photocarcinogenesis. Several studies have shown that coenzyme Q10, kinetin, and thioctic acid afforded the protection effects against UVB-induced inflammatory responses and photoaging. Objective and Method: In this study, we investigated the effects of coenzyme Q10, kinetin and thioctic acid on UVB irradiated human skin fibroblasts using a viability test, thiobarbituric acid assay and Northern blot analysis. RESULT: Cell survival curves after UVB irradiation showed a dose dependent decremental pattern by trypan blue exclusion assay. Only 30% of dermal fibroblasts survived at 150mJ/cm2 UVB irradiation. The damage was associated with cell membrane lipid peroxidation, as shown by accumulation malondialdehyde (MDA). By pre-cultivation with coenzyme Q10, kinetin and thioctic acid, a significant protection effect was noted as an increase in the absolute number of surviving cells and marked decrease in the levels of MDA. CONCLUSION: Coenzyme Q10, kinetin, and thioctic acid, which have been newly accepted as having UV protection properties, are effective membrane peroxidation inhibitors and inhibitors of reactive oxygen species (ROS) formation and scavenger of ROS.

Three Cases of Perforating Disorder / 대한피부과학회지

The perforating disorders comprise a group of unrelated pathologic abnormalities sharing the common characteristic of transepidermal elimination. This phenomenon is characterized by the elimination or extrusion of altered dermal substances and, in some cases, by such material behaving as foreign material. Traditionally, four diseases have been included in this group: Kyrle's disease, perforating folliculitis, reactive perforating collagenosis, elastosis perforans serpiginosum. We describe three cases of perforating disorder which showed different clinical and histopathological figures.

A Clinical Study on Herpes Zoster During the Last 10-Year-Period (1994-2003) / 대한피부과학회지

BACKGROUND: Herpes zoster is a common dermatologic disease characterized by unilateral pain and vesicular eruptions. The incidence of herpes zoster seems to be increasing recently. OBJECTIVE: The aim of this study was to elucidate the epidemiology and the clinical characteristics of herpes zoster. METHOD: During the 10-Year-Period from Jan. 1994 to Dec. 2003, 1089 patients with herpes zoster were evaluated in regard to annual incidence, age, sex, and monthly, seasonal, and dermatomic distributions. Patients with herpes zoster were further assessed concerning associated diseases and complications. RESULT: 1. The annual incidence averaged over the 10 years was 2.98% (1089 cases of total 36, 531 outpatients) which is increasing recently. 2. Herpes zoster was seen most frequently in the 7th decade of life, and the ratio of male to female was 1: 1.43. 3. There was no marked monthly or seasonal variation in the incidence of herpes zoster. 4. The most common dermatomic distribution was thoracic dermatome (49.6%), followed by trigeminal (19.5%), cervical (14.9%), lumbar (7.9%), sacral (5.3%) and multiple dermatomic involvement (2.8%). 5. Associated diseases of herpes zoster were observed in 398 patients (36.5%), which included hypertension (12.6%), diabetus mellitus(7.9%), gastric ulcer (2.8%), chronic renal failure (1.7%), asthma(1.7%), angina pectoris (1.6%), malignancy (0.6%) and so on. 6. The most common complication of herpes zoster was postherpetic neuralgia (7.4%), followed by eye complication (3.2%), secondary bacterial infection (1.8%), scar formation (0.8%), neurogenic bladder (0.4%), and Ramsay-Hunt syndrome (0.2%). CONCLUSION: Most of the results described in this study are similar to those previously reported, except for a higher incidence in female. The recent annual incidence of herpes zoster shows a tendency to increase.

A Case of Anticonvulsant Hypersensitivity Syndrome Induced by Carbamazepine / 대한피부과학회지

Anticonvulsant hypersensitivity syndrome is a life threatening immunologic reaction of anticonvulsants therapy such as phenytoin, phenobarbital, or carbamazepine, characterized by multiple abnormalities such as fever, rash, lymphadenopathy, acute hepatocellular injury, leukocytosis, and eosinophilia. We report a case of anticonvulsant hypersensitivity syndrome thought to be caused by the use of carbamazepine in a 65-year-old male. He developed erythematous skin eruption four weeks after beginning therapy with carbamazepine. The clinical, laboratory and histologic findings of this patient were compatible with anticonvulsant hypersensitivity syndrome.

A Case of Childhood Granulomatous Periorificial Dermatitis / 대한피부과학회지

Childhood granulomatous periorificial dermatitis (CGPD) is a benign, facial eruption primarily of prepubertal children. It is a distinctive granulomatous process of unknown etiology and is characterized by monomorphic, yellow-brown papules limited to the perioral, perinasal, and periocular regions. The condition is self-limiting and is not associated with systemic manifestations. It can usually be distinguished from sarcoidosis on clinical and histological grounds. We report a case of childhood granulomatous periorificial dermatitis in a 9 year-old boy who had suffered from pruritic erythematous papules around mouth and eyelids. (Korean J Dermatol 2004;42(10): 1333~1336)

A Case of Targetoid Hemosiderotic Hemangioma / 대한피부과학회지

Targetoid hemosiderotic hemangioma is a benign vascular tumor characterized by a small solitary lesion consisting of a brown to violaceous papule, surrounded by a thin, pale area and a peripheral ecchymotic ring. We report a case of targetoid hemosiderotic hemangioma on left lower abdomen of a 33-year-old female. She had a 5 mm x 5 mm sized slightly raised violaceous papule surrounded by an ecchymotic halo on left lower abdomen. We took a biopsy of the lesion and identified it as targetoid hemosiderotic hemangioma. This case showed characteristic clinical and histologic findings of targetoid hemosiderotic hemangioma.

A Case of Childhood Dermatomyositis with Scalp Dermatitis / 대한피부과학회지

Dermatomyositis is a multiple disease characterized by inflammatory myopathy with specific cutaneous findings including heliotroph erythema, Gottron's papules, lupus erythematosus-like skin lesions, and cutaneous calcinosis. We report a case of childhood dermatitis that developed in a 9-year-old girl. Skin lesion showed malar erythema, Gottron's papule, cutaneous calcinosis, poikiloderma, and scalp dermatitis. These were compatible with dermatomyositis. and other clinical, laboratory, and histopathologic findings supported the diagnosis of dermatomyositis. She was treated with methotrexate, oral corticosteroid, and hydroxychloroquine.