A Case of Thermal Keratosis along with Erythema Ab Igne / 대한피부과학회지

We report a case of thermal keratosis with erythema ab igne which occurred on the dorsal side of a patient's left hand due to chronic exposure to infrared rays. A 62-year-old male presented with reticular hyperpigmentation on the dorsal side of his left hand and left knee along with multiple hyperkeratotic nodules on the dorsal side of his left hand without any symptoms. He had a hobby of playing internet games with a heater on his left side. A skin biopsy of the hyperkeratotic lesion showed hyperkeratosis and acanthosis in the epidermis. The dermis revealed many elastic fibers and superficial perivascular monocytic infiltration. The patient was diagnosed with thermal keratosis and erythema ab igne due to his history of chronic infrared exposure, distinctive clinical characteristics and the biopsy results. The application of topical steroid with the recommendation to cease exposure to heaters resulted in the almost disappearance of the papules and a little restoration of the skin color.

A Case of Signet-ring Cell Gastric Carcinoma of which the First Symptom was Skin Lesions / 대한피부과학회지

Cutaneous metastases of internal malignancies are rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% in patients of all malignancies. Furthermore, cutaneous metastasis from adenocarcinoma of the stomach has been found to be exceedingly rare. A 39-year-old woman presented with multiple, asymptomatic, erythematous nodules on her scalp and back. A biopsy taken from the nodule showed a signet ring cell type of adenocarcinoma. A gastroendoscopic examination and biopsy was done and showed the same histologic findings. The diagnosis of cutaneous metastasis of signet-ring cell gastric carcinoma was made. It is clinically worth reporting that the first symptom was skin lesions of the scalp and back.

The Change of the Frontal Hair Line According to the Treatment for Androgenetic Alopecia / 대한피부과학회지

BACKGROUND: Androgenetic alopecia (AGA) occurs as a result of progressive miniaturization of scalp hair in genetically predisposed individuals. Several effective treatments for AGA are well known. However, there is a paucity of literature about the influence of such treatments on the frontal hair line (FHL). OBJECTIVE: To assess the effectiveness of oral finasteride and/or topical minoxidil on the FHL. METHODS: An assessment of 100 male patients with AGA of grades II to IV was made, based on the Norwood- Hamilton scale after six months of treatment. The patients were divided into three groups. Group 1 received 1 mg of oral finasteride daily. Group 2 exclusively used 5% minoxidil solution 1 ml twice daily. Group 3 received 1 mg of finasteride daily in combination with a topical application of 5% minoxidil solution. We measured the length from the mid-pupillary line to three points of the FHL with calipers; midpoint of the forehead, and right and left temporal recession, respectively. RESULTS: An improvement of the FHL was observed in all of three groups. There was a tendency for patients taking only finasteride to show an overall improvement in the frontal hair line, while patients applying only minoxidil solution showed an improvement in both temporal recession lines. Comparing the three groups at three points of the FHL respectively, at both temporal recession of the FHL, Group 3 showed the best result, followed by Group 2, and finally Group 1. The center of the FHL Group 3 showed the best result, followed by Group 1, and finally Group 2. CONCLUSION: We found that the combination therapy of finasteride and minoxidil had a synergic effect on FHL in the treatment of androgenetic alopecia. In the assessment of treatment efficacy to the FHL of patients with AGA, the method of using calipers in this study was worthwhile.

A Case of Verrucous Hyperplasia with Lymphedema of Leg Amputation Stump / 대한피부과학회지

Verrucous hyperplasia appears as multiple, warty, coalescent papules arising on the distal portion of amputation stump skin, yet it displays no histological evidence of viral warts. It occurs when the chronic pressure of a poor prosthetic fit disrupts vascular and lymphatic channels, subsequently causing chronic tissue edema. We report a case of 30 year old male, with 15 year history of wearing below-the-knee prosthesis, who presented with a verrucous papule that arose at his amputation site. Histopathological findings showed hyperkeratosis, acanthosis, superficial dermal edema and dilated thick vessles oriented vertical to the skin surface. Verrucous hyperplasia with lymphedema was diagnosed on the basis of clinical and histological findings.

A Case of Allergic Dermatitis Due to Orthopedic Implant / 대한피부과학회지

The most common form of allergic dermatitis due to orthopedic implant is persistent eczematous reaction. We present an allergic dermatitis occurring in the right upper arm of 77-year-old man who presented an erythematous edematous patch & plaque on the right upper arm after humerus osteosynthesis with orthopedic implant. The lesion disappeared after the removal of the orthopedic implant.

A Case of Localized Skin Infection Due to Scedosporium Apiospermum / 대한피부과학회지

Scedosporium(S). apiospermum is the asexual stage of Pseudallescheria boydii. This ubiquitous fungus causes not only mycetoma but also infection of a variety of body sites including the skin. Localized skin infection without grain production due to this organism is much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection which occured in a 75-year old female. She had multiple suppurative nodules with pustules on a dark red plaque at the dorsum of the right forearm. Cultural isolation for definitive diagnosis showed typical S. apiospermum. The patient was treated successfully with oral terbinafine 250mg daily for 1 week and oral itraconazole 200mg daily for 3 weeks.

A Clinicopathologic Study of Bowen's Disease / 대한피부과학회지

BACKGROUND: Bowen's disease is a form of intraepidermal (in situ) squamous cell carcinoma in histopathology, the representative premalignancy of the cutaneous squamous cell carcinoma and is usually persistent and progressive, with a small potential for invasive malignancy by 3-5%. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of Bowen's disease. METHODS: A total of 45 patients with Bowen's disease were enrolled in this study. The hospital charts and histopathological slides were reviewed at Chungnam university hospital from 1983 to 2002. RESULTS: The male and female ratio was 1: 1.14. The mean age at diagnosis was 63 years. Twenty-two cases (58%) of solitary bowen's disease were located in non sun exposed area. Trunck, extremities, genital area followed in decreased order. Sixteen cases (42%) of solitary bowen's diseases occurred on the sun-exposed area. Face, dorsum of hand followed in decreased order. Thirty-three cases(73%) of single lesions and seven cases(27%) of multiple lesion. Analysis of clinical character of the Bowen's disease was performed and results were as follows: the most common type were patch(20 cases; 44%) and plaque (18 cases; 40%). And nodule, ulcer and papule type in decreased order. Analysis of histopathological character of the Bowen's disease was performed and results were as follows: the most common type were psoriasiform(15 cases; 41%) and irregular (12 cases; 32%). And verrucous, atrophic and combined type in decreased order. CONCLUSION: In Bowen's disease among Koreans, there were many distinctive clinical and histopathological features compared to those of non-Korean cases. In Korean cases, Bowen's diseases were located on sun exposed area only 42%, pigmented lesions were 20% and sex ratio 1: 1.14(male: female).