A Case of Neurotized Nevus with Sclerotic Fibroma-like Change / 대한피부과학회지

We report a case of neurotized nevus with a sclerotic fibroma-like change in a 60-year-old female patient, who presented with a brown colored pedunculated nodule on the upper quadrant of the abdomen. The skin biopsy revealed a well-circumscribed, non-encapsulated nodule in the reticular dermis, which consisted of hypocellular hyalinized collagen bundles separated by clefts mixed with nevus cells. Nevus cells are small with a spindle appearance and contain Meissner corpuscle-like structures called nevic corpuscles. We suggest that a sclerotic fibroma-like change is an evolutionary end-point of a pre-existing lesion. This is supported further by the fact that neuroid change in the intradermal nevus represents the end stage of maturation of melanocytes of the nevi.

A Case of Clear Cell Basal Cell Carcinoma / 대한피부과학회지

Basal cell carcinoma (BCC) is noted for its many histologic variants because of its pluripotential origin from epithelial germ cells. Clear cell BCC has been recognized as a distinct variant and has a clear cell component made up of cells which are either vacuolated or display a finely granular eosinophilic cytoplasm. We report a case of clear cell BCC in a 62-year-old man who had a well-demarcated, skin-colored nodule on the left nasal ala. It was treated by surgical excision with a Burow's graft and no recurrence has been observed.

A Comparison of ALA-IPL Photodynamic Therapy and Acne Mode IPL Phototherapy in the Treatment of Acne Vulgaris / 대한피부과학회지

BACKGROUND: Acne vulgaris is one of the most prevalent and emotionally debilitating dermatologic diseases. Emerging problems with conventional acne treatments, such as the resistance of Propionibacterium acnes to antibiotics and the safety of oral isotretinoin, create a demand for other treatment modalities for acne. An evolving understanding of the Propionibacterium acnes-produced porphyrins and the development of a number of light sources have led to the application of photodynamic therapy for the treatment of acne. OBJECTIVE: To study the effect of light therapy on the treatment of Acne Vulgaris using acne mode intense pulsed light (IPL), and photodynamic therapy with a combination of topical 5-Aminolevulinic acid (ALA, 20%) and acne mode IPL. A comparison of the two treatment modalities would then be made to examine the effect on inflammatory acne lesions and sebum excretion. METHODS: Thirteen patients with varying degrees of acne were included in the study after a 4 week washout period. ALA (20%) was applied to half of the face on each patient. After one hour, the whole face was exposed to intense pulsed light (DECA(R), Italia) using an acne mode (400~1,200 nm) starting at a fluence of 11 J/cm(2). The procedure was carried out three times with 2 week intervals, and the patients were evaluated on post-op 2nd, 4th, and 6th weeks. Histologic changes were observed before and after treatment. RESULTS: After the first and second treatment, there was a statistically significant reduction in inflammatory acne lesion counts and the amount of sebum production from baseline, in both the ALA-PDT group and the IPL group (p<0.05). However, no statistically significant reduction was shown after the third treatment in both groups. There was a slightly higher reduction in the count of inflammatory lesions and the amount of sebum production in the ALA-PDT site compared to the IPL site, but it was not statistically significant. On histologic examination, dermal inflammatory cell infiltrations around the perivascular and periappendageal area were significantly reduced and sebaceous glands became smaller after the 3rd treatment. The adverse effects were negligible. CONCLUSION: ALA-PDT using acne mode IPL, and light therapy using acne mode IPL alone were effective in the reduction of inflamed lesions and sebum secretion in patients with mild to moderate acne vulgaris. Furthermore, no significant adverse effects were observed with both treatments. However, no remarkable contrast of therapeutic effect was statistically observed between the two therapies either.

A Case of Reticulate Pigmented Anomaly of the Flexures (Dowling-Degos Disease) / 대한피부과학회지

Dowling-Degos disease is a rare autosomal dominant genodermatosis with a genetically determined disturbance of epidermal proliferation. The clinical symptoms of Dowling-Degos disease are characterized by the acquired reticulate pigmented anomaly of the flexures. We report a case of Dowling-Degos disease in a 27-year-old female, who presented with numerous small, hyperpigmented macules in reticular pattern, localized to the axillae, inframammary and inguinal areas, popliteal fossa, neck, and face.