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Background@#Prurigo nodularis (PN) is a severely pruritic chronic skin disease, and its management is challenging.Although some studies have described the natural course and demographics of PN, there are few studies on the quality of life (QOL) or psychological problems in patients with PN. @*Objective@#This study aimed to evaluate the QOL and psychological problems of PN patients and identify the factors which effect on the QOL and psychological problems of these patients. @*Methods@#We performed a cross-sectional study of 41 patients with PN who visited the Department of Dermatology at Konyang University Hospital between November 2022 and March 2023. Age, sex, clinical features, itch Numeric Rating Scale (NRS), Dermatology Life Quality Index (DLQI), Beck Depression Inventory (BDI), Insomnia Severity Index (ISI), and Beck Anxiety Inventory (BAI) were evaluated through the questionnaire. @*Results@#PN patients had mean DLQI, BDI, ISI, and BAI scores of 13.9, 15.0, 8.9, and 13.0, respectively. There were no significant differences in the DLQI, BDI, ISI, or BAI scores with respect to sex, smoking, alcohol, drug history, disease duration, or treatment duration. Patients with systemic diseases or other dermatologic diseases were more likely to have higher DLQI scores than those without any associated disease (p=0.043 and p=0.015). Moreover, patients with higher itch NRS scores had higher DLQI and ISI scores (p=0.002 and p=0.030). @*Conclusion@#We found that PN had a large impact on QOL and mental health. Therefore, we recommend that dermatologists pay close attention to the psychological aspects when treating and educating patients with PN.
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Clear cell acanthoma is a rare benign tumor, which usually presents as a solitary erythematous to brown colored papule or nodule, with a predilection for the lower leg of t hemiddle-aged and older individuals. An 11-year-old male presented with a 1-month history of bilateral brownish colored and exudative plaques on the both areolae.Histopathologic examination showed psoriasiform proliferation of pale keratinocytes and neutrophil exocytosis. Therefore, the patient was diagnosed with clear cell acanthoma. Typically, clear cell acanthoma occurs as a unilateral lesion on the leg in an adult. However, our case shows a bilateral lesion as well as the uncommon age and site.To our knowledge, this case of bilateral clear cell acanthoma has been rarely reported in Korea. Herein, we report a case of clear cell acanthoma that occurred on both areolae in a child.
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no abstract available.
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Pleomorphic dermal sarcoma (PDS), formerly known as malignant fibrous histiocytoma (MFH), is a rare mesenchymal tissue tumor. A 40-year-old male presented with a 2-month history of a well-defined, solitary, round, palpable protruding mass with central ulceration, 1.5 cm in diameter. Punch biopsy showed tumor cells of variable size and hyperchromatic nuclei with frequent bizarre atypical cells and atypical mitoses arranged in a storiform-pleomorphic pattern in the entire dermis. After complete resection, PDS was diagnosed because the lesion had invaded the deep subcutaneous fat. Because MFH has been renamed according to the World Health Organization new classification system, we reclassified the 10 cases that have been reported as MFH in Korea. Nine cases were renamed undifferentiated pleomorphic sarcoma, with only one being renamed mucofibrosarcoma. Herein, we report a rare case of PDS treated with surgical excision with a review of the literature.
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Median raphe cysts (MRCs) are rare benign lesions that occur as a result of congenital defects during the embryological development of the male genitalia in the fetal period. It can develop anywhere along the midline, from the meatus to the anus. Pigmented MRCs are rare subtypes that contain melanin pigments or melanocytes in the epithelium, and there are only eight such cases reported worldwide. We report herein a case of pigmented MRC in the perineum of a 3-year-old boy. The clinical features include a linear tubular structure and foreign body granuloma at the tip of the linear cystic lesion and rare histological findings of pigmented cuboidal epithelium and squamous epithelium. Immunohistochemical staining revealed strong positivity for c-kit in the pigmented cuboidal epithelium. In this report, we discuss a rare case of pigmented MRC with a mixed type of squamous epithelium and pigmented cuboidal epithelium and review the associated literature.
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Background@#Rosacea is a common chronic inflammatory skin disease, which primarily affects the central face. In 2002, the National Rosacea Society (NRS) committee developed the first diagnostic criteria for rosacea, based on its subtypes. The revised classification in 2017 prompted a proposal to transit from a subtyping to a phenotyping approach, reflecting current insights into rosacea pathogenesis, pathophysiology, and management. @*Objective@#This study aimed to elucidate the clinical features of rosacea and compare two diagnostic criteria in rosacea patients. @*Methods@#We performed a clinical study on 100 patients with rosacea diagnosed according to the 2002 NRS criteria. The age, sex, clinical features, subtypes, severity, and predisposing factors were evaluated using the questionnaire. In addition, we compared the 2002 and 2017 criteria, and evaluated patients if they met the revised criteria. @*Results@#According to the 2002 NRS classification, the erythematotelangiectatic type (88.0%) was the most frequent, followed by the papulopustular (43.0%), ocular (13.0%), and phymatous (6.0%) types. There were 44 overlapping cases, including 38 cases with 2 subtypes mixed and 6 cases with three subtypes. Six patients were diagnosed with rosacea using the 2002 NRS criteria but they did not satisfy the revised 2017 criteria. @*Conclusion@#We found that the diagnostic features of the 2002 criteria are too ambiguous for the diagnosis of rosacea. Therefore, we recommend that dermatologists recognize the necessity of a transition from a subtyping to a phenotyping approach, according to the 2017 criteria for the diagnosis of rosacea.
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The introduction of immune checkpoint inhibitors, including anti-programmed cell death receptor-1 antibodies (anti-PD-1 Ab), such as nivolumab and pembrolizumab, represents a major breakthrough in cancer therapy. The PD-1 pathway inhibits T cell activation, maintaining a normal and balanced immune response. Anti-PD-1 Ab induces T cell activity by inhibiting the suppressive effect of PD-1 signaling on T cells. Excessive stimulation of T cells represents a potential mechanism for multiple skin lesions. To the best of our knowledge, reports on cutaneous adverse effects during treatment with anti-PD-1 Ab are limited in the dermatological literature of Korea. Herein, we report two rare cases of nivolumab-induced lichenoid drug eruption and pembrolizumab-induced psoriasis.
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Background@#Cobalt is an important contact allergen and is contained mainly in metal products. Recent studies have reported an association between leather exposure and cobalt allergic contact dermatitis. However, there is no study on this subject in Korea. @*Objective@#The aim of this study is to examine cobalt content and release from leather sofas, shoes, watch straps, and gloves sold in Korea, and to investigate leather exposure in cobalt allergic contact dermatitis. @*Methods@#We collected 38 leather samples of leather sofa, 15 leather shoes, 8 leather watch straps, and 10 leather gloves sold in Korea. The cobalt spot test and inductively coupled plasma optical emission spectrometry were used to confirm cobalt content and release from leather samples. @*Results@#All 71 leather samples were negative for cobalt in the spot test. No cobalt was found in the 35 leathers tested by inductively coupled plasma optical emission spectrometry. @*Conclusion@#Unlike previous studies, cobalt was not identified in leather in this study. Therefore, the possibility of cobalt allergic contact dermatitis caused by leather is relatively low in Korea. However, further studies with larger numbers of leather samples are needed to obtain more accurate results.
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Poroid hidradenoma (PH) is a rare benign tumor that shows differentiation of the eccrine sweat gland. It occurs mainly in adults, presenting as a 0.5 to 2 cm-sized intradermal nodule, mostly on the head, extremities, trunk and neck. We report two rare cases of PH, one on the face and the other on the heel. The first patient was a 50-year-old male who had a solitary, skin-colored nodule on his right temple for 6 months.The second patient was a 67-year-old female who presented with a solitary, bean-sized, tender nodule on her left heel for 1 year. The common histological examination finding was a well-circumscribed tumor composed of solid portions and large cystic spaces in the center. The tumor cells consisted of small, monomorphic poroid cells and large cuticular cells in both cases. To our knowledge, only few cases of PH have been reported. Herein, we report two rare cases of PHs with literature review
ABSTRACT
Background@#Rosacea is a common chronic inflammatory skin disease, which primarily affects the central face. In 2002, the National Rosacea Society (NRS) committee developed the first diagnostic criteria for rosacea, based on its subtypes. The revised classification in 2017 prompted a proposal to transit from a subtyping to a phenotyping approach, reflecting current insights into rosacea pathogenesis, pathophysiology, and management. @*Objective@#This study aimed to elucidate the clinical features of rosacea and compare two diagnostic criteria in rosacea patients. @*Methods@#We performed a clinical study on 100 patients with rosacea diagnosed according to the 2002 NRS criteria. The age, sex, clinical features, subtypes, severity, and predisposing factors were evaluated using the questionnaire. In addition, we compared the 2002 and 2017 criteria, and evaluated patients if they met the revised criteria. @*Results@#According to the 2002 NRS classification, the erythematotelangiectatic type (88.0%) was the most frequent, followed by the papulopustular (43.0%), ocular (13.0%), and phymatous (6.0%) types. There were 44 overlapping cases, including 38 cases with 2 subtypes mixed and 6 cases with three subtypes. Six patients were diagnosed with rosacea using the 2002 NRS criteria but they did not satisfy the revised 2017 criteria. @*Conclusion@#We found that the diagnostic features of the 2002 criteria are too ambiguous for the diagnosis of rosacea. Therefore, we recommend that dermatologists recognize the necessity of a transition from a subtyping to a phenotyping approach, according to the 2017 criteria for the diagnosis of rosacea.
ABSTRACT
The introduction of immune checkpoint inhibitors, including anti-programmed cell death receptor-1 antibodies (anti-PD-1 Ab), such as nivolumab and pembrolizumab, represents a major breakthrough in cancer therapy. The PD-1 pathway inhibits T cell activation, maintaining a normal and balanced immune response. Anti-PD-1 Ab induces T cell activity by inhibiting the suppressive effect of PD-1 signaling on T cells. Excessive stimulation of T cells represents a potential mechanism for multiple skin lesions. To the best of our knowledge, reports on cutaneous adverse effects during treatment with anti-PD-1 Ab are limited in the dermatological literature of Korea. Herein, we report two rare cases of nivolumab-induced lichenoid drug eruption and pembrolizumab-induced psoriasis.
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Background@#Cobalt is an important contact allergen and is contained mainly in metal products. Recent studies have reported an association between leather exposure and cobalt allergic contact dermatitis. However, there is no study on this subject in Korea. @*Objective@#The aim of this study is to examine cobalt content and release from leather sofas, shoes, watch straps, and gloves sold in Korea, and to investigate leather exposure in cobalt allergic contact dermatitis. @*Methods@#We collected 38 leather samples of leather sofa, 15 leather shoes, 8 leather watch straps, and 10 leather gloves sold in Korea. The cobalt spot test and inductively coupled plasma optical emission spectrometry were used to confirm cobalt content and release from leather samples. @*Results@#All 71 leather samples were negative for cobalt in the spot test. No cobalt was found in the 35 leathers tested by inductively coupled plasma optical emission spectrometry. @*Conclusion@#Unlike previous studies, cobalt was not identified in leather in this study. Therefore, the possibility of cobalt allergic contact dermatitis caused by leather is relatively low in Korea. However, further studies with larger numbers of leather samples are needed to obtain more accurate results.
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Kikuchi’s disease, also referred to as histiocytic necrotizing lymphadenopathy, is a benign self-limiting lymphadenitis accompanied by mild fever and night sweats. This disorder usually affects young women and presents with non-specific cutaneous findings. A 15-year-old female adolescent presented with erythematous papules and plaques on both cheeks accompanied by fever, night sweats, and right cervical lymphadenopathy. Histopathological evaluation of a skin biopsy specimen showed mild perivascular and periadnexal infiltration in the dermis.Fine-needle aspiration biopsy of lymph nodes revealed coagulative necrosis with lymphocytic, histiocytic, and karyorrhectic debris. We present a rare case of Kikuchi’s disease that was diagnosed based on histopathological evaluation of skin and lymph node specimens.
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Clear cell hidradenoma (CCH) is a rare benign tumor that shows differentiation toward the structure of a sweat gland. Recently, hidradenoma has been re-classified into apocrine and eccrine variants and CCH has been classified as apocrine differentiation. A 34-year-old man without any underlying diseases presented with an erythematous, papilliform, 1-cm exophytic nodule on the left neck that had been present for 3 years. Skin biopsy specimens were obtained by excision biopsy of his left neck. Histopathologic findings showed a well-circumscribed tumor composed of solid portions with polyhedral cells and clear cells, a tubular space with columnar cells, and decapitation secretion. Additionally, round, basophilic, poroid cells, tubular structures containing hyalinized material, and intercellular bridges were observed in the epidermis. Herein, we present a rare case of CCH with apocrine and eccrine differentiation.
ABSTRACT
Poroid hidradenoma (PH) is a rare benign tumor that shows differentiation of the eccrine sweat gland. It occurs mainly in adults, presenting as a 0.5 to 2 cm-sized intradermal nodule, mostly on the head, extremities, trunk and neck. We report two rare cases of PH, one on the face and the other on the heel. The first patient was a 50-year-old male who had a solitary, skin-colored nodule on his right temple for 6 months.The second patient was a 67-year-old female who presented with a solitary, bean-sized, tender nodule on her left heel for 1 year. The common histological examination finding was a well-circumscribed tumor composed of solid portions and large cystic spaces in the center. The tumor cells consisted of small, monomorphic poroid cells and large cuticular cells in both cases. To our knowledge, only few cases of PH have been reported. Herein, we report two rare cases of PHs with literature review
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Syringocystadenocarcinoma papilliferum (SCACP) is a rare malignant adnexal neoplasm, which is considered as a malignant counterpart of syringocystadenoma papilliferum (SCAP). Clinically, SCACP appears as a nodule, inflammatory plaque, or tumor. The lesion is usually covered with crusts, which are formed by secretion of the apocrine epithelial cells. Histologically, SCACP resembles SCAP, with cystic papillomatous invaginations connected to the skin surface by funnel-shaped structures lined by infundibular epithelium. The stroma of the tumor consists of a dense inflammatory infiltrate of plasma cells and lymphocytes. SCACP differs from SCAP in terms of the architectural and cytological features of the tumor cells, and is characterized by higher nuclear cytoplasmic ratio, nuclear irregularity, coarse chromatin, and increased mitotic activity. However, the immunohistochemical findings of SCACP vary. Since only 49 cases of SCACP have been reported in the English literature, the clinical and histologic characteristics of SCACP have not been fully established. Further studies on the diagnostic criteria for SCACP are warranted. Here, we report a rare case of SCACP and present a review of other relevant literature.
Subject(s)
Chromatin , Cytoplasm , Epithelial Cells , Epithelium , Lymphocytes , Plasma Cells , Skin , Sweat Gland NeoplasmsABSTRACT
BACKGROUND: Acne is a common inflammatory skin disease that involves the seborrheic area, developing not only in adolescence but also in adulthood. Abnormal epidermal barrier function in acne is reported and suspected as a risk factor that leads to sensitive skin through a few experimental studies. Impaired skin barrier function against environmental factors and irritants may play a role in increasing sensitivity of the skin in patients with acne. OBJECTIVE: This study aimed to investigate the clinical characteristics of patients with acne and analyze the association between acne and sensitive skin. METHODS: Acne severity and history of treatments were recorded and subjective symptoms of sensitive skin with aggravating factors were analyzed through a questionnaire. Acne severity was determined using the Investigator's Global Assessment scale of acne severity and Global Acne Grading System. The score and severity of sensitive skin were determined using the Baumann skin-type test. RESULTS: Of 100 patients with acne, 76% were actually confirmed to have sensitive skin. However, there was no significant association between acne severity and severity of sensitive skin (p=0.805). The most common aggravating factor of sensitive skin was washing the face (60%), followed by cosmetics use (56%) and hot weather (55%). The most common symptom of sensitive skin was itching (55%), which was proven as the only factor associated with severity of sensitive skin (p=0.016). CONCLUSION: Cosmetics use on the face is a noticeable important aggravating factor of sensitive skin, which can provoke itching, which is proven as the only symptom significantly related with severity of sensitive skin. Therefore, in the treatment of acne with sensitive skin, proper use of moisturizers and careful washing are required, and it is important to avoid hot weather and excessive sun exposure and carefully choose cosmetics.
Subject(s)
Adolescent , Humans , Acne Vulgaris , Clinical Study , Irritants , Pruritus , Risk Factors , Skin Diseases , Skin , Solar System , WeatherABSTRACT
Nivolumab is anti-programmed death 1 (PD1) receptor antibody, which can be used in the treatment of metastatic squamous cell cancer. By blocking the PD1 receptors on T cells, it enhances T-cell response against cancer cells. A 69-year-old man, who works as a farmer, presented with erythematous lichenified plaques on sun-exposed areas, such as the face, the chest, and both the forearms. Before the hospital visit, he was receiving lung cancer treatment with paclitaxel and cisplatin, but there was no improvement. Subsequently, the regimen was changed into nivolumab, and PET-CT showed decreased in cancer size. However, skin rashes developed simultaneously. It is consistent with the results of a previous study in which cutaneous side effects developed in 42% of responders compared to 7% of non-responders. Herein, we report a case of nivolumab-induced cutaneous toxicity on sun-exposed areas based on the clinical findings, including the distribution of rashes, which were improved after decreasing the nivolumab dose with literature review.
Subject(s)
Aged , Humans , Cisplatin , Exanthema , Farmers , Forearm , Lung Neoplasms , Neoplasms, Squamous Cell , Paclitaxel , Programmed Cell Death 1 Receptor , T-Lymphocytes , ThoraxABSTRACT
Basal cell carcinoma (BCC) is the most common malignant skin tumor that usually develops in the head and neck region. It has a wide range of histological variants and constitutes approximately 65% of epithelial tumors. Cutaneous plasma cell infiltration can occur in individuals with various disorders, including amyloidosis, plasma cell neoplasm, and infectious diseases such as syphilis and deep fungal infections. A 53-year-old woman presented with scaly erythematous plaque on the left cheek. Skin biopsy showed smooth-bordered collections of basaloid proliferation with epidermal connection, and fibrotic stromas were noted in the dermis. Notably, mixed inflammatory cells were noted in the upper dermis, and they were mainly plasma cells. There was no evidence of other organ involvement and infection. She was diagnosed with BCC with plasma cell infiltration and was treated with topical and oral steroid, and excision was performed. In our literature review, plasma cell infiltration is related to tumor ulceration and more likely to be seen in patients with high-risk BCCs. Herein, we report a peculiar case of BCC with plasma cell infiltration.