Three Cases of Malignant Melanoma

Malignant Melanoma is rare, occupied less than about 0.5% of malignant skin cancer, in Korea. We have experienced three cases for recent 2 years. Case 1 was a 65-year-old woman suffered from 2.0 × 3.0cm sized fungating mass with central ulceration on the left heel for 1 year duration. Left inguinal lymph node was enlarged. She expired 9 months later in spite of treatment with surgical excision, lymph node dissection, and chemotherapy with DTIC. Case 2 was a 37-year-old woman showed 1.0 × 1.5cm sized lobulated, black papules on the right preauricular area for 8 years duration. Satellite lesions developed 1 year ago. There were recurrences on the excisional sites after treatment with wide surgical excision. Case 3 was a 45-year-old woman had 0.5 × 2.Ocm sized, black pigmented patch with satellite lesions on the left sole for 2 years duration. Surgical excision and follow-up for 1 year after treatment showed no recurrence yet.

A Case of X - linked Ichthyosis / 대한피부과학회지

We report a case of X-linked ichthyosis in a 19 year-old male patient who has been covered with brown to black colored thick scales on the lateral aspect of chest, upper abdomen and inner aspect of both extremities since one month at, birth. Histopathologic findings showed hyperkeratosis and papillomatosis with normal granular cell layers in the epidermis. On electron microscopy, multilayered keratins with increased melanosomes in the stratum corneum were noted. In his family, his cousin is also affected by the same disease.

A Case of Generalized Essential Telangiectasia / 대한피부과학회지

Generalized essential telangiectasia is defined as condition in which the veins and cspillaries of the skin undergo primary dilation independently of preceding or coexisting skin lesions of other types. We report herein a case of generalized essential telangiectasia in a 27-year-old female, who has been suffered from generalized erythematous to reddish linear, mottled, or net like telangiectatic macules except face, hands and feet. There were no abnormal laboratory findings and no evidence of systemic disease. Histopathologic examinations showed only dilated telangiectatic vessels in the upper dermis.

A Cases of Nevus Sebaceus of Jandassohn Associated with Tubular Apocrine Adenoma / 대한피부과학회지

The nevus sebaceus of Jadsssohn is an organoid nevus generally noted on the scalp or the face as a single lesion. A 26-year-old man has suffered from a pea sized, pedunculated cherry red colored papule on the back ground of yellowish colored verrucous plaque on the vertex. Clinically, pedunculated papule was similar to granuloma pyogenicum, but histopathologic examination showed the features of tubular apocrine adenoma with focal areas of syringocystadenoma papilliferum, suggesting that might be a variant or could be associated with syringocystadenoma papilliferum.

Acquired Reactive Perforating Collagenosis of Diabetes Mellitus and Chronic Renal Failure

We report, herein, a case of reactive perforating collagenosis in a 52-year-old man with diabetes mellitus and chronic renal failure on hemodialysis. He had multiple, pinhead to pea sized, round or oval shaped, central umbilicated papules on the face, trunk, and extremities for 3 months duration. The papules developed after scratching due to pruritus. Histopathologic examination showed a cup-shaped depression of the epidermis filled with parakeratotic material, necrobiotic collagen and inflammatory cells. At the base of the depression, the epidermis showed interruption through which basophilic bundles of collagen ex-tend in a vertical direction from the dermis. The skin lesions improved after treatment with oral antihistaminics:

Three Cases of Allergic Contact Dermatitis due to Hair Growth Stimulator / 대한피부과학회지

To take advantage of hypertrichosis, one of the side effcct of minoxidil, is used as a application to male pattern baldness and alopecia areata. Recently 101 Hair Regrowth Liniment which is a new hair growth stimulator from China is used in male pattern baldness, but its components, actions and side effects are exactly unknown. We experienced three cases of allergic contact dermatits one case due to minoxidil and others due to 101 Hair Regrowth Liniment which were confirmed by patch test.

Two Cases of Tattoo Reaction / 대한피부과학회지

Tattooing has been performed the for cosmetic purpose by many beautician in the beauty parlors without having been any medicalknowledge. This has resulted in various serious complications. One patient is a 56-year-old female, who had been developed pruritic erythernstous indurated plaques on the tattooing sites about 3 months after getting tattoo. Skin biopsy findings revealed granulomatous inflamrnation and patch test showed positive reaction to potsssiurn dichromate. The other patient is a 55-year-old female, who had been developed erythematous papules on the both lips of tattooing sites about 1 year after getting tattoo. Skin biopsy findings revealed lichenoid resction. Patch test showed positive reactions to reornycin eulfate and nickel sulfate. Patch test of as is revealed positive reactions to red color.

A Case of Leser - Trelat Sign Associated with Small Cell Carcinoma of the Lung / 대한피부과학회지

Leser-Trelat sign is characterized by the sudden appearance and rapid increase in number and size of seborrheic keratoses associated with an internal malignancy. A 78-year-old woman showed multiple pea to bean sized dark brownish papules and plsques on the trunk. Skin lesions had appeared suddenly since 5 months ago and then rapidly increased in number and size. The histopathologic exsmination of the skin lesions revealed seborrheic keratoses. The chest roentgenogram revealed the mass shadow on the right hilar region and transbronchial lung biopsy revealed small cell carcinoma.

Lichenoid Drug Eruption due to Ethambutol

A 73-year-old female patient, who had been treated with antituberculous drugs for 4 months, was referred to our department because of generalized macules and papules present for 15 days. Clinical examination revealed polygonal, flat papules of erythematous to violaceous hue on the entire skin. Histopathologic findings were similar to those of lichen planus. In a provocation test with ethambutol, the skin lesions were aggravated and the new lesions developed. We considered this case to be a lichenoid drug eruption due to ethambutol. The skin lesions gradually cleared after ethambutol was eliminated from the patient's tuberculosis therapy.

Etretinate Therapy of Epidermal Nevi

Two cases of epidermal nevi treated with systemic etretinate are presented. Case 1, a 21-year-old female, had been suffered from brownish verrucous papules and plaques on the left inguinal area, thigh, lower leg and dorsum of the foot since her first month of life; and case 2, a 4-year-old boy, had been suffered from brownish verrucous papular plaques on the left chest, axilla and back since birth. In both cases, there was no family history of similar disease. On histopathological examination, case 1 showed the findings of epidermolytic. hyperkeratosis but case 2 did not, with the exception of clumping of keratohyaline granules. In the treatment with systemic etretinate, we observed marked clinical improvement in case 1, but not in case 2. Any particular side effects of etretinate were not observed during treatment. We consider that etretinate therapy is useful in treating epidermal nevus with epidermolytic hyperkeratosis histopathologically.

Adverse Reaction to Methotrexate and Etretinate in a Patient with Psoriasis

A 49-year-old Caucasian male patient suffered from fever general weakness and diffuse hair loss on the scalp for 3 days. Skin lesions showed erythematous scaly patches with pustules and erosions on the lower extremities and perianal region, and multiple ulcerations on the labial mucoas. A complete blood cell count revealed thrombocytopenia and leukopenia, which gradually worsened day after day (platelet: 29, 000/mm², WBC: 1,000/mm³). Candida albicans was isolated from the lesions of the oral cavity and lower extremities. Twelve days prior to the visit, he had taken etretinate Tegison®) P.O.25mg/day, prednisolone P.O. 50mg1dy and methotrexate P.O. 15mg/day for 5 days for the treatment of psoriasis. We presume that these adverse reactions may be synergistic adverse reactions, probably due to methotrexate and etretinate in consideration of the patient's history.

A Study of Topical Corticosteroid Effect on the Rat Skin Mast Cell / 대한피부과학회지

The effect of long-term topical application of corticosteroids on rat cutaneous mast cells was examined under the light microscopy. Two potent corticosteroids, 0.05% clobetasol-17-propionate and 0.25% desoxymethasone, produced a remarkable decresse greater than 50% of pretreatment mast cell number by two weeks. Wheress a less potent corticosteroid, 0.1% hydrocotisone-17-valerate, produced a remarkable decrease greater than 50% of pretreatment mast cell number by four weeks. All corticosteroids produced a remarkable decrease greater than 80% of pretreatment mast cell number by six weeks. These results suggest that long-term topical application of corticosteroids may have the deleterious effects on cutsneous mast cells.

A Case of Paraffinoma / 대한피부과학회지

We experienced a 57-year-old male patient who have had multiple coin sized, erythematous, psinful, indurated ulcerations with purulent discharge on the right calf area since 10 years before. Previously he received injections of paraffin in the lesion site for correcting the thinning of right calf due to complication of pyoderma. Histopathologic examination showed "Swiss cheese" appearance of parsffinoma. Good result was obtained after treatment with surgical excision and split thickness skin graft.

A Case of Acral Lentiginous Melanoma / 대한피부과학회지

We report herein a case of acral lentiginous melanoma in a 65-year-old female. An about 2x3cm sized erythematous to brownish mass with central ulceration was located on the left heel accompanied by enlargement of the left inguinal lymph nodes. Histopathologic findings showed lentiginous proliferation of atypical melanocytes with pseudoepithliomatous hyperplasia and invasion of tumor cells from the epidermis into the dermis. Focal pigmented melanocytes were also noted. Complete surgical excision and chemotherapy with DTIC were done. Marked edematous swelling on the left lower leg was developed after 8 months and 1 month later she was expired.

Allergen Prick Test Reactivity in the Patients with Uriticaria and Atopic Dermatitis / 대한피부과학회지

This study was undertaken to investigate the skin sensitivity to 54 different allergens in 248 patients of 81 acute urticaria, 141 chronic urticaria and 26 atopic dermatitis, who visited in Department of Dermatology, College of Medicine, Chung Ang University Hospital from February 1986 to January 1987. The results were as follows . 1. The sex ratio of male to female of 248 patients with allergic state was 1.1: 1 (130: 118) and third and fourth decades occupied 56.5%. In regard to the duration of chronic urticaria, less than 1 year were 31.2% and between 1 to 3 years were 28.3%. 2. In acute urticaria, the prick test positive reactivity to allergens were in descending order to mite, household insect mixture, Trichophyton mixture, house dust, mold mixture C and silk, whereas in chronic urticaria ', mite, household insect mixture, house dust, cockroaeh mixture, Trichophyton mixture and silk and in atopic dermatitis ; mite, house dust, Trichophyton mixture, household insect mixture, mold mixture A and C. 3. The positive reactivities of allergens in patients with atopic dermatitis, chronic urticaria and acute urticaria were 69.2%, 52.5% and 35.8%, respectively. 4. The positive reactivity to compound allergens were higher than to single and the most frequent combinations were 2 to 5 allergens (85.4%). 5. Out of 54 allergens used in this study, 49 allergens were reactive and the most frequent group of allergens were house dusts (41.5%) and commonly involved allergens were mite (27.8%), household insect mixture (15.7%), house dust (13.7%), Trichophyton mixture (11.7%) and cockroach mixture(7.7%). 6. Common other allergic diseases combined with atopic dermatitis were rhinitis and bronchial asthma, occuring in 23.1%.

Development of Herpes Zoster during Treatment of Bullous Pemphigoid with Immunosuppressive Drug / 대한피부과학회지

A 47 year-old woman with generalized fresh tense or ruptured bullae was diagnosed as bullaus pemphigoid by histopathological and direct immunofluorescent test. We treated her with prednisolone and bethamethasone for 3 weeks. And soon after, herpes zoster developed along the right T9 dermatome. It is not precise whether true association or only incidental concomitance, but, there may be present some relatioship.

A case of Multiple cutaneous Horns on the Corona of Glans Penis and Scrotum / 대한피부과학회지

A 39-year-old male patient had multiple dark brownish colored conical protruding masses on the corona of glans penis and scrotum for 1 year and coincidently tinea cruris. The lesion of corona of glans penis was a 1.5*1.5cm sized mass and scrotal lesions were 0.3*0.3 to 0.5*0.5cm sized multiple masses. Histopathologic findings revealed characteristic findings of verruca vulgaris. Skin lesions were excised.

Mycosis Fungoides Treated with PUVA / 대한피부과학회지

We report a case of mycosis fungoides in a 37 year-old male patient who had relatively well defined, irregular, erythematous plaques covered with acales on the buttock, lower extremities, anterior chest and back. Histopathological findings showed epidermotropism and Pautrier microabscesses in the epidermis and infiltration of atypical lymphocytes in the upper dermis. Electron microscopic findings showed mycosis cells with convoluted nuclei and prominent nucleolei He had been received PUVA therapy combined with topical and systemic corticosteroid for 4 months. Skin lesions were improved markedly after treatment with total 262 joules/crn2 and then maintained with 14 joules/cm2 in every week.

A Patient with Xeroderma Pigmentosum Developing Malignant Melanoma and Basal Cell Epithelioma / 대한피부과학회지

Xeroderma pigmentosurn is a photosensitive hereditary disorder and especially rare in Korea. A 30-year old male patient had been suffered from walnut sized tumor and several ulcerated papules on the face, and scattered brownish macules on the sun-exposed area. Clinical features and histopathologic findings were consistent with malignant malanoma and basal cell epithelioma developing in a xeroderma pigmentosum respectively. Malignant melanoma was surgically excised.

A Case of Acrosclerosis Transformed from Guttate Morphea / 대한피부과학회지

Clinically, the transformation of morphea to scleroderma is rare. We report a case suggested acroselerosis transformed from guttate morphea. Patient was 30-year old woman who had generalized bean-sized depigmented macules except face since early childhood. About one year ago, Raynauds phenomenon, edema and sclerotic change of the both hands and feet were developed. On the laboratory findings, there were positive reaction for rheumatoid factor and antinauclear antibody test and increase of erythrocyte sedimentation rate. Histopathologically, there were even increased collagen fibers, atherosclerotic change of the vessels and atrophic sweat glands.