The Clinical and Histopathological Study of Ota's Nevus / 대한피부과학회지

BACKGROUND: Ota's nevus, characterized by the presence of melanocytes in the dermis, has been familiar among dermatologists, but the etiology, the pathophysiology, the clinical and histological classification are not entirely clear. To understand and elucidate them, more clinical studies and researches are necessary. OBJECT: The aim of this study was to document the clinical and histopathological features of Ota's nevus. METHODS: We examined 299 patients with Ota's nevus who visited the dermatology clinic in Korea from February 1993 to August 2003. Among them, 188 patients were biopsied. All the specimens were stained with hematoxylin and eosin. We examined the age & sex distribution, age of onset, seasonal variation, associated skin diseases, aggravating factors and color. We clinically classified Ota's nevus into 4 types according to Tanino's classification and histologically into 5 types based on the pattern of pigmentation. RESULTS: 1. The ratio of male and female was 1: 3. 2. The peak age of onset was at birth (28.4%) and puberty (24.8%). 3. Seasonal variation was observed with distinct aggravation in the summer (60%). 4. The associated diseases were 9 cases of persistent mongolian spot, 6 cases of nevus flameus, 4 cases of blue nevus, 3 cases of vitiligo, 3 cases of nevus of Ito, 2 cases of atopic dermatitis, 2 cases of psoriasis, 2 cases of cafe au late macules and 2 cases of contact dermatitis. 5. The aggravating factors were sunlight (35.8%), emotional stress (21.0%), menstruation (12.6%), cold exposure (9.5%), pregnancy (9.5%), fatigue (9.5%) and chemical agents (2.1%). 6. The color of lesions were blue black (36.8%), brown (34.8%), dark brown (16.1%) and slate (11.0%). 7. All cases were classified according to Tanino's METHODS: type Ia (23.1%), type Ib (20.1%), type II (26.7%), type III (9.4%), type IV (20.7%). 8. The histological subtypes of Ota's nevus were classified as: the superficial type (35.6%); the middermis type (5.9%), the superficial-middermis type (18.6%); the mid-lower dermis type (2.7%); the diffuse type was composed of the superficial dominant type (19.7%), the middermis dominant type (4.8%), the dispersed (true diffuse) type (12.2%) and the deep dominant type (0.5%). 9. In the relation between histological types and the color of the lesion: the superficial type had 31 cases of brown color, 15 cases of blue black color, 11 cases of dark brown color and 9 cases of slate color; the middermis type had 6 cases of blue black color and 2 cases of dark brown color, query number of cases of slate color; the superficial-middermis type had 12 cases of blue black color, 10 cases of dark brown color, 7 cases of brown color and 6 cases of slate color: the mid-lower dermis type had 3 cases of blue black color; for the diffuse type, the superficial dominant type had 13 cases of brown color, query number of cases of blue black color and 7 cases of dark brown color; the mid-dermis dominant type had 4 cases of brown color, query number of cases of dark brown color, the dispersed type had 14 cases of blue black color and 5 cases of brown color; the deep dominant type had 1 case of blue black color. CONCLUSION: The histological reclassification of Ota's nevus may be very useful in making a therapeutic prognosis of the disease.

Two Cases of Folliculosebaseous Cystic Hamatroma / 대한피부과학회지

Folliculosebaceous cystic hamartoma is a rare, benign condition. The histological criteria of folliculosebaceous cystic hamartoma have been well established by Kimura et al. We report two cases of folliculosebaceous cystic hamartoma which showed typical histological findings. As far as we know, it has not yet been reported in Korean dermatological literature. The first case is a 23-year-old man who had a pedunculated nodule on the scalp. The second one is a 46-year-old man who had a bean sized pedunculated nodule on the left cheek.

A Study of the Therapeutic Effect of Nevus of Ota by the Q - switched Nd : YAG Laser / 대한피부과학회지

BACKGROUND: The nevus of Ota is a benign dermal melanocytic lesion that was previously proved difficult to treat. Recently, the Q-switched ruby laser and Q-switched Nd: YAG laser have been reported to by, successful in the treatment of benign pigmented lesions and tattos. OBJECTIVE: Our study evaluates the treatment of 60 patients with nevus of Ota with Q-switched Nd: YAG lase (l064nm). METHOD: Sixty patients with nevus of Ota were treated by the Q-switched Nd: YAG laser with pulse width 10nsec, and energy fluences ranging from 5.8 to 12J/cm and the laser repetition rate was 5 or 10Hz. The response to treatment was assessed by four independent investigators with photographs. RESULTS: 1. Total therapeutic effects of Q-switched Nd: YAG laser showed excellent result in 23.3%, good in 45%, fair in 18,3%, and poor in 13.3%. 2. Therapeutic effects by distribution proposed by Tanino showed excellent or good results in 84.6% at type Ia, 78.6% at, type Ib, 66.7% at type II, 60% at type III and 45.5% at type N. 3. Therapeutic effects by the number of treatments showed excellent or good results in 22.2% of patients after one treatment, 72.7% after two treatments, 93.3% after three treatments and 100% after four treatment. 4. Therapeutic effects by energy showed excellent or good results in 9.2% at energy range of 10 to 12J/arl and 66.6%, at energy range of 5.8-9.5J/cm. 5. Complications included transient hyperpigmentation (6.7% ), secondary bacterial infection (1.7 %), hypopigmentation (1.7%) and atrophic scar (1.7%). However these subsided spontaneously in a year. 6. The recurrence rate was 2.4%. CONCLUSION: The Q-switched Nd: YAG laser is a very effective mode of treatment for nevus of Ota which has provent unresponsive to other therapeutic modalities.

Verruca Vulgaris Developed on the Skin Tag

Skin tags are very common skin tumors in middle age. In spite of their frequent occurrence, there was no reported cases of verruca vulgaris developing on the soft fibroma. We report a case of verruca vulgaris developing on the bag-like skin tag. We think that the incidence of HPV infection on the large skin tags may be higher than on normal skin due to their protrusion and repetitive irritation.

Treatment of angiofibroma with carbon dioxide laser and copper vapor laser / 대한피부과학회지

Angiofibroma is a disfiguring facial deformity that constitutes pait of the multiple system involvement in tuberous sclerosis. We describe eight affected patients who have been treated with:arbon dioxide laserabration and subsequent copper vapor later treatment for residual angiomatous component, which resulted in conspicious cosmetic improvement without scarring or recurrence. This report documents that the treatment with carbon dioxide later and subsequent copper vapor laser is an efficient and safe remedy for treating multiple facial angioibromas.

Histologic changes of nevus flammeus following copper vapor laser treatment / 대한피부과학회지

Nevus flammeus is a benign but cosmetically devascating congenital inalformation involving mature capillaries. The copper vapor laser is a therapeutic device which had been newly applied to this. Yellow copper vapor light is absorbed by the intraluminal oxyhemoglobulin mo ecules, leading to the destruction of blood vessels. This study was undertaken to evaluate the histobigic findings in a patient with nevus flammeus according to the sequential time after copper vapor laser therapy. The results were as followed, One hour after treatment, nonspecific damages to the epidermis and upper part of the dermis were observed. The specific damage to the vessels which showed thrombi formations and partial disruption of the vessel walls was prominent. One cay after treatment, degeneration of the epidermis and sepaiation of the dermoepidermal junction were apparent. Three days after treatment, extravasations of a small amount of erythrocytes and inflanimatory cell infiltrations were present, especially around the vessels. Seven days after treatment, the capillaries showed a deposition of fiorinoid material around themselves. Partial disappearance of the vessel walls was seen. There was hisi ologic evidence of the replacement of abnormal ectatic vessels by normal appearing vessels with small uminal diameters, surrounded by endothelial cells.

A case of nevus comedonicus-treated by carbon dioxide laser / 대한피부과학회지

At twenty two year old female with nevus comedonicus and an increased tendency to form keloids is described. Although example of successful treatment of nevus comedonicus are readily found in the literature none propose reasonable therapeutic models for keloid formers. As our patient clearly demonstrated this tendency. We initated a t,rial with the carbon dioxide laser due to it's ability to cause less thermal damage. Subsequent to completion of this t,rial, the lesion has imprcived with the acceptable cosmetic results and less comedogenic activity.

Lymphangiectasia (acquired lymphangioma) of the vulva: treatment using carbon dioxide laser vaporization / 대한피부과학회지

No abstract available.

Pigmented and Morphea Like Basal Cell Epothelioma / 대한피부과학회지

A black pigmented ulcerative, 1cm x 3cm nodule was developed in a 43 year old woman since 5 years ago. Clinically, it resembled the malignant melanoma and histopathological study revealed the combination of pigmented and morphea like basal cell epithelioma. Wide and deep excision down to oral mucosa with frozen section of free margin and primary closure had performed to bring the excellent cosmetic outlook, Both the pigmented basal cell epithelioma and morphea like basal cell epithelioma are reported rarely, however, to the best of our review of the English literature, this is the first of reported case of combinated type of pigmented and morphea like basal cell epitheliorna. We are now on close observation of the patient for recurrence and metastasis of the tumor.

A Case Report of Amelanotic melanoma / 대한피부과학회지

A case of amelanotic melanoma developed on a 19 years old boy was reported. Since the identification of amelanotic melanoma, there were few reports about the tumor but none in Korea. In this case, the histologic findings showed ulceration of the epidermis and irregular junctional activity, and in the dermis, there showed alveolar formation and nevus cell nest like cell masses. And in the deep dermis, the loss of dermal stroma with numerous bizzare giant cells and variable sized, hyperchromatic, plemorphic, mitotic figures were also seen, Strikingly, there were no melanin pigments in H-E stain as well as in Masson-Fontana stain, which was thought to be a amelanotic melanoma. The patient was treated with B.C.G caccination by intralesional and hypodermic injection, on the lesion and on both, the lesion was markedly improved with only scarformation on previously ulcerated lesion. The patient shall be followed up continuously.

Clinical Study On Topical Vitamin A Acid Derivetive (VAAD) in Acne Vulgaris / 대한피부과학회지

Although many regimens for the acne therapy were proposed and vere used upto date, there is, no ideal choice of treatment. Since a certain relationship between the vitamin A and some dermatoses accompanied, with dyskeratoses had been proposed by Harris in 1932. many studies have been reported for the acne treatment with vitamin A topical or oral administration. (Straumfjord 1943, Lynch & Cook 1947, Anderson & Stokoe 1968). In 1969, Kligman observed the peeling effect of vitamin A acid (VAA), a metabolite of vitamin A, on the human skin and he experienced very good effect of VAA topical application on acne patients. Tbereafter, many authors studied about the VAA and reported the excellent effect on acne (McGills et al. 197l, Mills R Plewig 1972, Juhlin 1975). Moxeover, in 1976, Kim & Lee observed similar results with the authors mentioned above in its cure rate and side effects. In contrast to their high cure rate in those studies, however, its untoward side effects were freqvently elicited with severe intensity. So, author studied the effectiveness and side effects of VAAD which was changed in its chemical structure to diminish the side effects of VAA. Thirty-seven patients (M:F=4:33) were studied, and the results obtained were as follows. 1. The total number of lesions decreased significantly from third week and decreased by half in 4th. week. 2. The number of closed comedones decreased significantly from second week but the number of open comedones temporarily increased in 1st. week and decreased thereafter. 3. pustules and papul s continually decreased but new pustule formation developed in 3 patients and also disappeared in 4 weeks of treatment. 4. Allergic contact dermatitis was developed in 1 patient among 37 patients in 4th. week. 5. There were some undesirable side effects of scaling, pruritus, buming sensation in about 80% respectively, but its intensity was mild or moderate, and fissure, edema and exudation which appeared in VAA treatment were not observed. only a few patients complained tightness, erythema and pain. In comparison with VAA, the duration of treatment with VAAD was delayed about 1-2 weeks and the effectiveness in acne therapy with VAAD was almost equal to VAA therapy, and the side effects were markedly diminished.