Unilateral Psoriasis in a Woman with Ipsilateral Post-Mastectomy Lymphedema

Psoriasis is a multi-factorial disease with various clinical manifestations. We present a case of unilateral psoriasis associated with ipsilateral lymphedema that developed after mastectomy for breast cancer. A 42-year-old Korean woman was referred to our clinic with a 1-month history of multiple erythematous scaly patches on the right arm, back, and breast and was diagnosed with psoriasis by a skin biopsy. Three years previously, she had been diagnosed with breast cancer (T1N2), underwent a right quadrantectomy and axillary lymph node dissection, and completed adjuvant chemotherapy followed by high-dose adjuvant radiotherapy. She had started rehabilitation therapy on the right arm for secondary lymphedema 30 months previously. Because of the long interval between radiation and psoriasis, we speculated that changes in the local milieu caused by the lymphedema might be a causative factor. We hereby report a rare case of unilateral psoriasis following post-mastectomy lymphedema.

Neonatal Erythema Multiforme: A Case Report

Erythema multiforme (EM) is an extremely rare condition in infancy. To the best of our knowledge, there have been only three cases of neonatal EM described in the literature, and no such cases have been reported in Korea. A preterm neonate born at 35 weeks and six days of gestation presented with multiple annular erythematous patches with a targetoid shape over his entire body at 36 days of age (corrected age of 7 days). He had no systemic symptoms except for transient mild fever. No triggering factor except for hepatitis B and BCG vaccination was found. Neutropenia was noted upon laboratory analysis. Skin biopsy specimens showed findings suggestive of erythema multiforme. The skin lesions improved rapidly upon administration of intravenous methylprednisolone; however, neutropenia continued for a much longer period. The significance of neutropenia with respect to the development of EM was not clarified. There has been no recurrence of skin lesions over a one-year follow-up period.

A Case of Polypoid Clear Cell Acanthoma on the Nipple

Clear cell acanthoma (CCA) is a rare benign epidermal tumor. It usually presents as a flat nodule or dome-shaped plaque and is often localized on the legs of the elderly. We observed an unusual case of polypoid CCA on the nipple of a 14-year-old girl. At present, a few cases of CCA on the nipple area have been reported in the literature. However, CCA presented as a polypoid tumor on the nipple area has been reported very rarely. We herein report the very rare case of polypoid CCA on the nipple and suggest that CCA should be included in the clinical differential diagnosis of polypoid lesions on the nipple.

A Study of the Patch Test Results with Preservative Antigens for Patients with Suspected Cosmetic Contact Dermatitis / 대한피부과학회지

BACKGROUND: Preservatives are important contact allergens. However, any reports that have focused on them are relatively scanty in Korea. OBJECTIVE: The aim of this study is to investigate the prevalence of preservative allergy in patients with suspected cosmetic contact dermatitis. METHODS: We retrospectively reviewed the patch test results and medical recordings of the patients who were suspected of having cosmetic contact dermatitis from January 2003 to December 2008 and who visited Seoul National University Hospital. A total of 330 patients (males: 69, females: 261) were enrolled in our study and the medical records included the patients' demographic information, the site of contact dermatitis, the past dermatologic diseases and the duration of the disease. We used 30 cosmetic preservative antigens. RESULTS: The mean age of the patients was 42.5 years and the most common age of the group with contact dermatitis was in the forties. The most prevalent site for contact dermatitis was the face (60.3%). Forty nine patients (14.8%) had a past history of atopic dermatitis. A hundred thirty nine patients (42.1%) showed at least one positive patch test result. Thiomerosal showed the highest patch test rate (10.6%), followed by cocamidopropylbetaine (8.1%), Euxyl K400 (7.8%), Dodecyl gallate (6.9%) and Octyl gallate (6.6%). CONCLUSION: As the positive rate of a patch test with preservative antigens was relatively high, certain preservative antigens contained in the cosmetic series should be included in the patch test for patients with suspected cosmetic contact dermatitis.

Chemical Leukoderma Improved by Low-dose Steroid Pulse Therapy

Chemical leukoderma occurs due to the toxic effect of a specific chemical preceding allergic contact dermatitis. The mechanism is either destruction or inhibition of melanocytes by the offending substance. Clinicohistopathologically, no absolute criteria can differentiate chemical leukoderma from vitiligo. However, chemical leukoderma can be diagnosed clinically by a history of repeated exposure to a known or suspected depigmenting agent at the primary site. There is no agreed treatment guideline for chemical leukoderma. We report a healthy 51-year-old man who had multiple hypopigmented macules and patches on his face, neck, arms and legs after exposure to occupationally related chemicals. The lesions were recalcitrant to topical corticosteroids, but they showed much improvement after 3 cycles of systemic steroid pulse therapy. We suggest this therapy may be a good treatment option for chemical leukoderma.

Facial Verruca Plana That Developed after Semipermanent Tattooing

Tattooing is becoming more popular around the world. As a result, the reported complications of tattoo are increasing. Local inflammation, infection and allergic reactions are the most common adverse effects. We report here on a healthy 39-year-old woman who developed multiple verruca plana lesions after undergoing semipermanent tattooing. The tattooing had been done 1 year earlier by an amateur.

A Case of Onycholysis with Subungual Suppuration Secondary to Paclitaxel / 대한피부과학회지

Paclitaxel is one of the taxoid-antineoplastic agents. These agents are used in the treatment of breast, lung and ovary cancer. Nail changes due to treatment with the taxanes (mainly docetaxel) are reported in 30~40 percent of patients. Paclitaxel is not commonly associated with dermatological reactions, although localized skin reactions and tissue necrosis following extravasation have been reported. Reports of the incidence of nail changes associated with paclitaxel is noted as the pigmentation or discoloration of the nail bed, vary from 2~20%. We report a patient with onycholysis and subungual suppuration during treatment with paclitaxel.

A Case of Solar Urticaria Induced by UVA, UVB and Visible Light / 대한피부과학회지

Solar urticaria is an uncommon photodermatosis characterized by the occurrence of pruritic erythema and wheals after exposure to sunlight or artificial radiation. A 52-year-old woman presented with a month long history of pain, wheal and sometimes mild dyspnea which developed after sunlight exposure. Phototesting for UVA, UVB and visible light were all positive, which has never been reported in Korea. The patient was treated with antihistamine and antimalarial drug.