Clinicopathological Characteristics of Kaposi's Sarcoma and Usefulness of Detection of Human Herpes Virus 8 / 대한피부과학회지

BACKGROUND: Kaposi's sarcoma (KS) is a multicentric proliferative vascular tumor which involves cutaneous and visceral tissues. Recent study has clearly identified human herpes virus 8 (HHV8) in all Kaposi's sarcoma patients, indicating that HHV8 is closely involved in the pathogenesis of Kaposi's sarcoma. OBJECTIVE: The purpose of this study was to document clinical and histopathological features of KS and to emphasize the necessity of detection of HHV8 in the differential diagnosis of KS from other vascular lesions. METHODS: The medical records and histopathological slides of patients with KS diagnosed at Ajou University Hospital from January 1995 to December 2004 were reviewed. We performed immunohistochemical stain and polymerase chain reaction (PCR)-based analysis to detect HHV8 in KS and other vascular lesions. RESULTS: Among 12 patients, classic KS was found in 9 patients, AIDS-associated KS in 1 patient, and iatrogenic immunosuppressive KS in 2 patients. Patients with KS presented with various clinical features, showing purple- colored macules to nodules or tumors. Although lower extremities are most frequently involved sites, involvement of other sites such as arm and neck was noticed. Mucosal and systemic involvement was detected in AIDS- associated case. Immunohistochemical stains for HHV8 were positive in all KS, but they were negative in other vascular lesions. PCRs for HHV8 were positive in 8 of 11 (72.7%) KS, but they were negative in other vascular lesions. Classic KS responded well to surgical and radiation therapies and showed indolent course. Immunosuppressive KS regressed partially after dose reduction of immunosuppressive drug therapy, but the lesions persisted. CONCLUSION: Immunohistochemical stain and/or PCR for HHV8 are useful means to differentiate KS from other vascular tumors.

Congenital Atrophoderma of Pasini and Pierini

Idiopathic atrophoderma of Pasini and Pierini is a form of dermal atrophy of unknown etiology, usually affecting women during their adolescence and young adulthood. A 2-yr-old girl was presented with erythematous atrophic lesion on the right shoulder, which appeared from birth. The histologic findings were consistent with atrophoderma. This patient, to the best of our knowledge, is the first case of atrophoderma with an onset since birth.

opical Photodynamic Therapy of Verruca Using a Light-Emitting Diode Device / 대한피부과학회지

BACKGROUND: Photodynamic therapy (PDT) has been reported to be useful in treating nonmelanoma skin cancers and a variety of benign skin conditions including warts. However, only one case of condyloma acuminata treated with PDT has been reported in Korea. OBJECTIVE: The purpose of this study was to evaluate the complete response rate and side effect of PDT, using light emitting diode (LED) device and 20% 5-aminolevulinic acid (ALA) to treat recalcitrant verruca. METHODS: We treated 8 cases of recalcitrant verruca (3 cases of verruca vulgaris, 3 cases of verruca plana, 2 cases of condyloma acuminata) with PDT, using ALA and a 630+/-50nm LED device. The light intensity was 30-50mW/cm2 and the light dose was 50-120J/cm2. RESULTS: After treatment, two cases of verruca plana showed complete response, and one case of verruca plana, two cases of verruca vulgaris, and two cases of condyloma acuminata showed partial response. However, one case of verruca vulgaris showed no response. There was only burning sensation and/or wheals during treatments. CONCLUSION: Topical PDT may be an alternative therapy in the treatment of verruca, especially of verruca plana.

A Case of Colocalization of Lichen Planus and Vitiligo / 대한피부과학회지

Lichen planus and vitiligo are common skin disorders, which rarely coexist. We report a case of colocalization of lichen planus and vitiligo in a 42-year-old woman. Furthermore, herein, we discuss the possible mechanism of colocalization of lichen planus and vitiligo, including the role of actinic damage in the initiation of lymphocytic infiltrates of lichen planus in vitiliginous skin.

Comparison of Behcet's Disease and Recurrent Aphthous Ulcer According to Characteristics of Gastrointestinal Symptoms

Behcet's disease (BD) is a multisystemic chronic inflammatory disease. It is characterized by recurrent oral and genital ulcers, uveitis, skin lesions and other manifestations, including neurologic, vascular, joint, and gastrointestinal ulcers of variable severity. Recurrent aphthous ulcer (RAU) represents a very common, but poorly understood, mucosal disorder. If a patient of RAU without any other typical symptoms of BD has gastrointestinal symptoms, it is difficult to distinguish this RAU from true BD with gastrointestinal involvement. Because pathognomonic clinical features and tools are absent, the differential diagnosis of these two diseases relies on the characteristic clinical features and the judgement of an experienced physician. Sixty-five out of a total 960 RAU patients and forty-four of 556 BD patients with gastrointestinal symptoms between January 1996 and December 2003 participated in this study. All were evaluated with esophagogastroduodenoscopy and colonoscopy. Clinical, endoscopic and histopathologic findings were analyzed and ELISA tests were conducted to detect serum levels of ASCA and pANCA. No significant difference was found between the two groups. Differential diagnosis between RAU with gastrointestinal symptoms and BD with gastrointestinal involvement requires further prospective, large-scale study.