Lymphomatoid Papulosis Developing in an Mycosis Fungoides Lesion after Narrow Band UVB Phototherapy and Topical Corticosteroid Application / 대한피부과학회지

Patients with lymphomatoid papulosis have other lymphomas in 10~20% of cases, most commonly mycosis fungoides, Hodgkin's disease, and anaplastic large cell lymphoma. In a series involving at least 40 patients with lymphomatoid papulosis, the association of lymphomatoid papulosis with mycosis fungoides ranged from approximately 7% to 18%. It is most important to distinguish lymphomatoid papulosis from CD30-positive large cell transformation of mycosis fungoides. Both conditions can be distinguished on clinical grounds, and clinical course is often the only distinguishing feature. We report a case of lymphomatoid papulosis developing in an mycosis fungoides lesion in a patient who received 3 rounds of narrow band UVB phototherapy and topical corticosteroid application.

Metallic Discoloration on the Right Shin Caused by Titanium Alloy Prostheses in a Patient with Right Total Knee Replacement

The differential diagnosis of bluish-gray pigmentation of the skin includes dermal melanocytosis, malignant melanoma and metallic discoloration. Of these disorders, metallic discoloration, which develops from deposits of fine metallic particles on the skin, is an uncommon dermatologic disease. We report a case of metallic discoloration of the right shin caused by titanium alloy prostheses in a patient with right total knee replacement. The patient had bluish-gray pigmentation on her right shin as well as pain while walking. Histopathologic findings of the skin lesion showed abundant black particles in the perivascular area of the lower dermis. Polarizing microscopy revealed refractile foreign materials in the dermis. An energy dispersive X-ray spectrophotometer unit attached to a transmission electron microscope detected titanium and aluminium peaks in the specimen.

Metallic Discoloration on the Right Shin Caused by Titanium Alloy Prostheses in a Patient with Right Total Knee Replacement

The differential diagnosis of bluish-gray pigmentation of the skin includes dermal melanocytosis, malignant melanoma and metallic discoloration. Of these disorders, metallic discoloration, which develops from deposits of fine metallic particles on the skin, is an uncommon dermatologic disease. We report a case of metallic discoloration of the right shin caused by titanium alloy prostheses in a patient with right total knee replacement. The patient had bluish-gray pigmentation on her right shin as well as pain while walking. Histopathologic findings of the skin lesion showed abundant black particles in the perivascular area of the lower dermis. Polarizing microscopy revealed refractile foreign materials in the dermis. An energy dispersive X-ray spectrophotometer unit attached to a transmission electron microscope detected titanium and aluminium peaks in the specimen.

Two Siblings with Cerebrotendinous Xanthomatosis / 대한피부과학회지

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive lipid storage disease caused by sterol 27-hydroxylase (CYP27) deficiency. We report two CTX siblings that were presented with typical manifestations such as achilles tendon xanthomas, mental retardation, progressive gait ataxia, and upper motor signs. Their parents and other three sisters were healthy. Serum cholesterol level was within normal limits for both siblings. The older brother has been treated conservatively with muscle relaxant and dopamine agonist because the disease was so progressive, but the younger sister has been treated with 250 mg/day chenodeoxycholic acid (CDCA) and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor (simvastatin 40 mg/day) to prevent the progressive neurologic dysfunction.

Onychomycosis Caused by Scopulariopsis brevicaulis: Report of Two Cases

Onychomycosis is usually caused by dermatophytes, but some nondermatophytic molds and yeasts are also associated with invasion of nails. Scopulariopsis brevicaulis is a nondermatophytic mold found in soil as a saprophyte. We report two cases of onychomycosis caused by S. brevicaulis in a 48-year-old male and a 79-year-old female. The two patients presented with a typical distal and lateral subungual onychomycosis. Direct microscopic examination of the potassium hydroxide preparation revealed fungal elements. From toenail lesions of the patients, brown colonies with powdery surface, which are a characteristic of S. brevicaulis, were cultured on two Sabouraud's dextrose agar plates. Three cultures taken from nail plates within a 2-week interval yielded similar findings. Numerous branched conidiophores with chains of rough walled, lemon-shaped conidia were observed in slide culture by light microscopy and scanning electron microscopy. The nucleotide sequences of the internal transcribed spacer for the two clinical isolates were identical to that of S. brevicaulis strain WM 04.498. To date, a total of 13 cases of S. brevicaulis onychomycosis including the two present cases have been reported in Korea. Mean age of the patients was 46.1 years, with a higher prevalence in males (69.2%). Toenail involvement was observed in all cases including a case involving both fingernail and toenail. The most frequent clinical presentation was distal and lateral subungual onychomycosis in 12 cases, while one case was proximal subungual onychomycosis.

A Case of Localized Axillary Syringomas / 대한피부과학회지

No abstract available.

Isolation Rates and Carrier State of Dermatophytes, Nondermatophyte Molds, Malassezia Species, and Candida Species in Indoor Dogs and Cats in Daegu / 대한의진균학회지

BACKGROUND: Fungal agents are commonly transmitted from dogs and cats to humans. OBJECTIVE: To identify the mycoflora of and association of skin diseases in dogs and cats fed as pets indoors. METHODS: A total of 435 animals (355 dogs and 80 cats) with or without skin lesions were included in the study; these animals lived indoors and had been examined in a veterinary hospital between August 2010 and May 2011. Their hair and scales were obtained using Mackenzie's brush technique, and a mycologic study was performed. RESULTS: Of the 435 animals examined, 3.2% had dermatophytes (DM), including 1.5% of the dogs with dermatoses (D-dogs), 0.6% of the dogs with normal skin (N-dogs), 43.8% of the cats with dermatoses (D-cats), and 6.3% of the cats with normal skin (N-cats). All the DMs isolated were identified as Microsporum canis. Nondermatophyte molds were isolated from 24.1% of the animals examined, including 19.3% of the D-dogs, 29.7% of the N-dogs, 18.8% of the D-cats, and 26.6% of the N-cats. Of the 435 samples examined, 49.5% yielded Malassezia pachydermatis (Mz. pachydermatis), including those from 58.4% of the D-dogs, 53.8% of the N-dogs, 31.3% of the D-cats, and 17.2% of the N-cats. The prevalence of Mz. pachydermatis infection in dogs aged 6 years and more was higher than that in the other dogs. CONCLUSION: In this study, the prevalence of DM in dogs and cats was lower than that reported in previous studies. DMs were found in a significantly higher percentage of D-cats (43.8%) than D-dogs (1.5%) (p < .001) and of N-cats (6.3%) than N-dogs (0.6%) (p=0.022). The prevalence of nondermatophyte molds did not significantly differ between dogs and cats with dermatoses or normal skin.

Isolation Rates of Dermatophytes and Fungi from Dogs and Cats in an Animal Shelter in Daegu / 대한의진균학회지

BACKGROUND: Dogs and cats are most friendly animals and contact frequently as pets with humans. It is for human possible to be transmitted from infected or contaminated animals. OBJECTIVE: This study was performed to identify fungi including dermatophytes and non-dermatophytic molds (NDM), Malassezia spp., and Candida spp. from the dogs and cats in an animal shelter. METHODS: We visit an animal shelter in Daegu at July 2011, examined 82 animals including 75 dogs with healthy skin, 4 skin diseased dogs, and 3 cats with healthy skin. Specimens were collected from skin lesions or normal skin by Mackenzie's brush technique and inoculated directly on Sabouraud dextrose agar and Leeming and Notman agar. They were identified by the morphological characteristics and rRNA sequencing. RESULTS: Of the 82 samples examined, 14 (17.1%) yielded positive dermatophyte cultures and, in particular, 0% of the 4 diseased dog samples, 14.7% of the healthy dog samples, and 100% of the healthy cat samples. All isolated dermatophytes from the dogs and cats were identified as M. gypseum. Outdoor dogs (23.8%) showed higher prevalence of M. gypseum than indoor dogs (2.7%). Isolation rate of M. gypseum from soil showed different rate as distance from animal cage, including near (40%), 5 m (20%) and 100 m (0%). CONCLUSION: Interesting result of this study showing the higher isolation rate of M. gypseum in outdoor dogs than indoor dogs suggests the transmission of M. gypseum from soils to animals, and also, possible transmission to human through animals.

Neurilemoma Localized in the Palmaris Longus Tendon with no Connection to the Major Nerve Trunk

PURPOSE: Neurilemoma is benign tumor of the nerve sheath which arises from Schwann cells. It is usually formed along the path of a peripheral nerve but is rarely separate from normal nerve fascicles. We experienced a patient with an isolated neurilemoma localized in the palmaris longus tendon with no connection to the major nerve trunk, which was in an unusual location and has never been reported. We report our case with the review of the literature. METHODS: A 23-year-old female visited our clinic with mild pain on the mass at the flexor area of the right wrist which had been present for about one year. The physical examination revealed a 1 x 1 cm sized subcutaneous mass at the flexor area of the right wrist. Sonography and computed tomography showed an ovoid, superficial solid mass on the palmaris longus tendon. Upon surgical excision, a 1 x 0.5 cm sized mass attached to the palmaris longus tendon was found. The tumor had no connection with the median nerve and was detached easily from the palmaris longus tendon. RESULTS: Histological examination demonstrated the mass to be a neurilemoma, which consists of spindle shaped cells with oval elongated nuclei arranged fascicles. No sensory dysfunction or evidence of recurrence was found during the 12 months of postoperative follow-up. CONCLUSION: We experienced a rare case of neurilemoma attached to the palmaris longus tendon with no connection to the major nerve trunk. We wish to emphasize its unusual location through our case and hope to expand our spectrum in exploring the upper extremity mass.