ABSTRACT
The major problem of the treatment of the sacral ulcer is that the area is under too much pressure. Thus, in a case of skin graft after the removal of a lesion, if the padding is not enough, the ulcer will recur. The gluteus maximus muscle has an abundant volume of subcutaneous fat and muscle, and provides the pressure site with enough padding. Therefore, the gluteus maximus musculocutaneous flap has been most commonly used for the treatment of the sacral pressure ulcer. We herein report a case of malignant fibrous histiocytoma in the sacral area treated with the gluteus maximus musculocutaneous flap.
Subject(s)
Histiocytoma, Malignant Fibrous , Myocutaneous Flap , Pressure Ulcer , Skin , Subcutaneous Fat , Transplants , UlcerABSTRACT
DPCP(diphencyclopropenone) has been used for the treatment of alopecia areata or verruca. Common side effects due to topical treatment with DPCP are pruritus, blistering, cervical lymphadenopathy and urticaria. Rarely, vitiligo can be induced by topical treatment with DPCP as a complication on the pigmentary system. Herein we report a case of vitiligo induced by DPCP in a patient with malignant melanoma. She was diagnosed with malignant melanoma in her 4th toe, Rt., a year ago. As part of adjuvant therapy, DPCP was topically applied to the inguinal area every week. After 4 months, vitiligo appeared on the area of DPCP application.
Subject(s)
Humans , Alopecia Areata , Blister , Lymphatic Diseases , Melanoma , Pruritus , Toes , Urticaria , Vitiligo , WartsABSTRACT
BACKGROUND: Photodynamic therapy(PDT) is a kind of non-invasive photochemotherapy, which is designed to kill the target cells through photodynamic reaction. It has been reported that PDT is very effective in superficial lesions, including extramammary Paget's disease. Yet, there has been no clinical trial for the treatment of extramammary Paget's disease using PDT in Korea. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of PDT in treating extramammary Paget's disease METHOD: Seven patients with anogenital extramammary Paget's disease were treated repeatedly with local PDT using topical ALA 20% and intralesional injection of hematoporphyrin derivative (HpD), and systemic PDT using HpD. Fluences of 125-200J/cm2 and intensities of 50-100mW/cm2 were used. RESULT: The clinical outcomes were disappointing. All the patients experienced only partial responses despite repeated treatments. But side effects were minimal. CONCLUSION: PDT is not effective enough for the treatment of extramammary Paget's disease to be used as a primary therapy. It would be better to use as an adjuvant to other treatment methods. Photodynamic sensitization, also known as photodynamic diagnosis, might help us define a more reliable border of the extent involved and the surgical margin to be excised.
Subject(s)
Humans , Diagnosis , Hematoporphyrin Derivative , Injections, Intralesional , Korea , Paget Disease, Extramammary , PhotochemotherapyABSTRACT
BACKGROUND: Photodynamic therapy(PDT) is a kind of non-invasive photochemotherapy, which is designed to kill the target cells through photodynamic reaction. It has been reported that PDT is very effective in superficial lesions, including extramammary Paget's disease. Yet, there has been no clinical trial for the treatment of extramammary Paget's disease using PDT in Korea. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of PDT in treating extramammary Paget's disease METHOD: Seven patients with anogenital extramammary Paget's disease were treated repeatedly with local PDT using topical ALA 20% and intralesional injection of hematoporphyrin derivative (HpD), and systemic PDT using HpD. Fluences of 125-200J/cm2 and intensities of 50-100mW/cm2 were used. RESULT: The clinical outcomes were disappointing. All the patients experienced only partial responses despite repeated treatments. But side effects were minimal. CONCLUSION: PDT is not effective enough for the treatment of extramammary Paget's disease to be used as a primary therapy. It would be better to use as an adjuvant to other treatment methods. Photodynamic sensitization, also known as photodynamic diagnosis, might help us define a more reliable border of the extent involved and the surgical margin to be excised.
Subject(s)
Humans , Diagnosis , Hematoporphyrin Derivative , Injections, Intralesional , Korea , Paget Disease, Extramammary , PhotochemotherapyABSTRACT
Acral lentiginous melanoma has a poor prognosis, because it has relatively short radial growth phase than lentigo maligna melanoma does. A 50 year-old female was presented with a 4X5cm-sized irregularly pigmented patch developed on the left palm. Initial punch biopsy examinations revealed atypical melanocytes only in the epidermis. But, after complete excision, melanoma cells were also observed in the upper dermis. We report an unusual case of acral lentiginous melanoma which showed vertical growth phase after twenty years of radial growth phase.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Dermis , Epidermis , Hutchinson's Melanotic Freckle , Melanocytes , Melanoma , PrognosisABSTRACT
Lichen nitidus is a rare, usually asymptomatic chronic inflammatory dermatosis composed of numerous, tiny, discrete, flesh colored, shiny papules. Since the disease is asymptomatic and self-limiting, the specific treatment is not required in most cases. But when the lesion is generalized, symptomatic, persistent, interfering with outlook, the treatment is required. Diphenylcyclopropene (DPCP), a potent contact sensitizing agent has been used for refractory wart and alopecia areata based on its ability to induce delayed hypersensitivity reaction or nonspecific cell-mediated immunity. We report two cases of lichen nitidus improved after topical DPCP application.
Subject(s)
Alopecia Areata , Hypersensitivity, Delayed , Immunity, Cellular , Immunotherapy , Lichen Nitidus , Lichens , Skin Diseases , WartsABSTRACT
Early diagnosis and treatment are essential for a successful treatment of malignant tumor. The malignant melanoma is notoriously acknowledged as threatening and known to readily metastasize during the early stages. The solid tumors including malignant melanoma frequently metastasize to regional lymph nodes via lymphatic vessels. During the latest clinical amelioration, it has been clearly conspicuous that early discovery of metastatic pathological alteration in sentinel lymph nodes could prevent prophylactic regional lymph node dissection. Additionally, an application of an appropriate treatment is conceivable by accurately recognizing the stages of the illness. For malignant melanoma clinically without palpable lymph nodes, through the application of lymphoscintigraphy and vital dye staining, we report two cases of malignant melanoma, microscopically metastasized in the sentinel lymph node and review the previous literatures.
Subject(s)
Early Diagnosis , Lymph Node Excision , Lymph Nodes , Lymphatic Vessels , Lymphoscintigraphy , MelanomaABSTRACT
Giant cell tumor of tendon sheath is a benign histiocytic proliferation of the articular and peritendinous synovial tissue and manifests as a painless, firm, smooth, subcutaneous mass which occurs predominantly on the hand where it is typically located adjacent to the interphalangeal joints of the hands, especially the terminal interphalangeal joints. Histologically, it is characterized by the presence of multinucleated giant cells. We herein report a case of giant cell tumor of tendon sheath located on the fingertip with the involvement of overlying skin, which shows rare location and unusual clinical manifestation.
Subject(s)
Giant Cell Tumors , Giant Cells , Hand , Joints , Skin , TendonsABSTRACT
Extramammary Paget's disease is a rare malignancy occuring mainly in apocrine gland- bearing areas such as vulva, scrotum, perianal area, and axilla. Histopathologically, the Paget's cells are usually confined within the epidermis and may be associated with underlying adenocarcinoma. Although surgical excision is the treatment of choice, the clinical demarcation of the lesion is still a frequent problem in the treatment of extramammary Paget's disease. We tried photodynamic diagnosis to determine the surgical margin of extramammary Paget's disease and with surgical excision guided by photodynamic diagnosis successfully treated two cases.
Subject(s)
Adenocarcinoma , Axilla , Diagnosis , Epidermis , Paget Disease, Extramammary , Scrotum , VulvaABSTRACT
A 38-year-old man presented with a black pigmented patch overlying his upper lip, a part of the gingiva and the hard palate. An intradermal tumor mass was palpated at the central portion of the pigmented patch of the upper lip. Diphenylcyclopropenone (DPCP) is a potent contact sensitizer that could stimulate non-specific immunity. We report a case of desmoplastic malignant melanoma (DMM) in which an atypical lentiginous pigmentation disappeared with topical DPCP immunotherapy and the dermal tumor mass was removed by a surgical wedge-shaped excision. Though an atypical lentiginous pigmentation of DMM sometimes undergoes extensive spontaneous regression, in our case it could be attributed to the therapeutic effect of topical DPCP immunotherapy rather than a spontaneous regression.
Subject(s)
Adult , Humans , Gingiva , Immunity, Innate , Immunotherapy , Lip , Melanoma , Palate, Hard , PigmentationABSTRACT
BACKGROUND: Recently, as rabbits have become a popular pet in Korea, there has been an increase in reports of dermatophytosis in humans as a result of frequent contact with rabbits. OBJECTIVE: The purpose is to investigate the clinical and mycological features of dermatophytosis in humans transmitted from rabbits. METHODS: Seventeen cases of dermatophytosis, developed after contact with rabbits, were clinically evaluated from November, 1999 to May, 2000. Mycologic studies were carried out from the lesions of rabbits and humans. RESULTS: Dermatophytes were cultured from 15 of 17 (88.2%) specimens from the lesions of humans. Trichophyton (T.) mentagrophytes, granulosum-asteoroid form, was isolated in 12 specimens (70.6%) and Microsporum (M.) canis was isolated in 3 specimens (17.6%). Human infection showed a high incidence in young children under age 10 (52.9%), with female predominance (2 times), and high familial incidence, and mainly being tinea faciale and tinea corporis. Tinea capitis also was observed in four cases, and M. canis was isolated from two of them. CONCLUSION: Rabbits can be an infectious source of human ring-worm due to T. mentagrophytes and M. canis. These zoophilic dermatophytes can be frequently transmitted to humans and induce inflammatory lesions. Therefore, epidemiologic studies of the prevalence of dermatophytes in healthy or infected rabbits, and sanitary measure are necessary.
Subject(s)
Child , Female , Humans , Rabbits , Arthrodermataceae , Incidence , Korea , Microsporum , Prevalence , Tinea Capitis , Tinea , TrichophytonABSTRACT
Lipoid proteinosis is a rare autosomal recessively inherited disorder that is characterized by the deposition of hyaline-like material in the skin, oral cavity, and other organs. Microscopically, there is extensive deposition of amorphous eosinophilic material surrounding capillaries, sweat glands and in papillary dermis. Although the pathogenesis of this disease is not well understood, it is believed that it may result from the defect of collagen metabolism leading to abnormal accumulation of noncollagenous glycoprotein. We report a case of lipoid proteinosis in a 20-year-old female that demonstrates the characteristic clinical, histopathological, and ultramicroscopic features of this disease.
Subject(s)
Female , Humans , Young Adult , Capillaries , Collagen , Dermis , Eosinophils , Glycoproteins , Metabolism , Mouth , Skin , Sweat GlandsABSTRACT
Hirsutoid papillomas of vulvae present as smooth or filiform papules located on the inner surfaces of the labia minora. This disease is usually considered as anatomical variants of the vestibular mucosa. Differentiation from condyloma acuminata is important to avoid unnecessary treatment. Herein we report a case of hirsutoid papillomas of vulvae in a 21-year-old female who complained of pruritic papules on the vulva of one year's duration. Papules were located on the inner surfaces of the left labia minora and vestible of the vulva. Clinically, they were quite similar to condyloma acuminata. Histologically, however, the epithelium was devoid of features of human papillomavirus(HPV) infections such as koilocytosis, double nucleation, and dyskeratosis.
Subject(s)
Female , Humans , Young Adult , Epithelium , Mucous Membrane , Papilloma , VulvaABSTRACT
We report a case of Trichilemmal carcinoma in a 75-year-old man who was presented with an exophytic nodule on the lower lip. The tumor was composed of glycogen-rich cytoplasmic cells with PAS-positive, diastase-labile and had a characteristic trichilemmal keratinization. The trichilemmal carcinoma is well known to have originated from the outer root sheath of the hair follicle in the hair bearing area. It is interesting that our case had developed on the lip, an exceptional site for a follicular tumor : the hair follicle could not be seen. It might have been developed from an ectopic follicle or at the follicle of vermillion border and grew up into the lip.
Subject(s)
Aged , Humans , Cytoplasm , Hair , Hair Follicle , LipABSTRACT
BACKGROUND: Photodynamic therapy(PDT) is a type of photochemotherapy that is designed to kill targeted tumor cells. OBJECTIVE: The Clinical effects of PDT were analysed for response rates, post-treatment healing and adverse effects on several cutaneous carcinoma in situ. METHOD: PDT with topical 5-aminolevulinic acid-based irradiation of corresponding 630+5nm light was performed in 6 carcinoma in situ patients who had actinic keratosis, Bowen' disease or cutaneous squamous cell carcinoma. RESULT: In all patients the clinical results were exellent with respect to initial complete responses and cosmetic outcome. CONCLUSION: PDT might be chosen as a first line treament for cutaneous carcimoma in situ.
Subject(s)
Humans , Carcinoma in Situ , Carcinoma, Squamous Cell , Keratosis, Actinic , Photochemotherapy , SkinABSTRACT
Shiitake (Lentinus edodes) is a kind of mushroom which is cooked and eaten as a food in Chinese, Japanese and Korean meals. It is nowadays the second most commonly produced edible mushroom in the world. In 1985, a case characterized by itchy skin eruptions after the ingestion of raw shiitake mushrooms was reported and was termed as toxicodermia. Here we report five cases of shiitake dermatitis which developed after ingestion of raw or cooked shiitake mushrooms. All patients complained of severe itching and showed linear grouped erythematous papules after scratching(Kobner phenomenon). To our knowledge, this is the first report of shiitake dermatitis in the Korean literature.
Subject(s)
Humans , Agaricales , Asian People , Dermatitis , Eating , Meals , Pruritus , Shiitake Mushrooms , SkinABSTRACT
Neonatal lupus erytematosus is a distinct subset of lupus erythematosus. It is characterized by cutaneous findings exhibiting the morphology of subacute cutaneous lupus erythematosus, congenital heart block, and anti-Ro/SSA and/or anti-La/SSB autoantibodies which result from the transplacental passage of maternal autoantibodies. We report a case of a 12-week-old female infant who presented with characteristic clinical and histopathological features of cutaneous neonatal lupus erythematosus but without evidence of congenital heart block. Initial serological studies reveled the presence of anti-La/SSB anti-bodies and antinuclear antibodies. 5 months later, follow-up serology was negative in accordance with a clinical remission.
Subject(s)
Female , Humans , Infant , Antibodies, Antinuclear , Autoantibodies , Follow-Up Studies , Heart Block , Lupus Erythematosus, CutaneousABSTRACT
Keloid is a hyperproliferative disorder of dermal connective tissues, that sometimes causes perplexy and cannot be managed with medical therapy alone, such as intralesional corticosteroids or interferon injections. In those cases, the best results can be obtained when medical therapy is combined with surgical therapy. Four cases of keloid that had been successfully treated with surgical keloidectomy and postoperative adjunctive therapy are herein reported.
Subject(s)
Adrenal Cortex Hormones , Connective Tissue , Interferons , KeloidABSTRACT
Autoimmune polyglandular syndrome (APGS) is characterized by the association of two or more endocrine disorders that are mediated by autoimmune mechanism. We report herein a case of alopecia universalis associated with APGS manifesting autoimmune Addison's disease, insulin-dependent diabetes mellitus, Hashimoto's thyroiditis, primary gonadal failure, which met the criteria of APGS type II. Alopecia is less commonly associated PGA type II.