ABSTRACT
An atypical teratoid/rhabdoid tumor (AT/RT) is a rare malignancy occurring in the first few years of life. This tumor shows rapid growth, a poor response to treatment, and poor prognosis. Cutaneous metastases presents as hamartomatous lesions mimicking skin tags. Immunohistochemical examination shows varied patterns of expression based on the sites of the body affected. Integrase interactor-1 (INI-1) gene sequencing and loss of expression of INI-1 observed with immunostaining can confirm AT/RT. In our patient, the skin lesion was identified at birth. Histopathological examination of the skin lesion could not establish an accurate diagnosis. Two months later, the patient presented with a brain tumor. Immunohistochemical examination of the brain lesion revealed complete loss of INI-1 expression in tumor cells, and the lesion was diagnosed as AT/RT. After that, we can detect the loss of INI-1 expression in the skin on the back. We report a rare case of AT/RT affecting the brain with cutaneous metastasis diagnosed with immunohistochemical staining.
Subject(s)
Humans , Brain , Brain Neoplasms , Diagnosis , Integrases , Neoplasm Metastasis , Parturition , Prognosis , SkinABSTRACT
Localized cutaneous argyria is a rare condition in which the skin changes into blue-grey spots due to the absorption of silver. The lesions need to be differentiated from other pigmentary disorders and require radiographic and histological examination for more accurate diagnosis. Scanning electron microscopy and energy dispersive x-ray spectroscopy can be a confirmatory tool in the evaluation of silver elements in biopsy tissue. This report shows the localized cutaneous argyria in earlobe of a 21-year-old woman who wears silver earrings for 10 years.
Subject(s)
Female , Humans , Young Adult , Absorption , Argyria , Biopsy , Diagnosis , Ear , Microscopy, Electron, Scanning , Nevus, Blue , Silver , Skin , Spectrometry, X-Ray EmissionABSTRACT
Stewart-Treves syndrome (STS) is a rare cutaneous angiosarcoma that develops in chronic lymphedema. The majority of STS is described in the upper extremity after aggressive locoregional therapy for breast cancer and is rarely reported in lower extremities. A 68-year-old woman presented with a 3-month history of multiple purpuric tumorous plaques and nodules on the right posterior thigh. She had a history of radical hysterectomy with lymph node dissection and postoperative radiotherapy due to uterine cervical cancer 16 years ago. She received right total hip replacement surgery due to hip joint avascular necrosis 14 years ago. She had suffered from chronic leg edema, especially on the right side. Skin biopsy on the right posterior thigh showed irregular vascular channels lined by atypical endothelial cells. Special stains showed positivity for CD31, CD34, factor VIII, and D2~40, which are pan-vascular or lymphatic markers. She showed a pelvic mass and pelvic bone metastasis on radiologic staging work-up. She refused all treatment, including surgery, radiotherapy, and chemotherapy, except for pain control. She died 2 months after diagnosis of this highly malignant tumor. The lymphedema on both lower extremities after uterine cervical cancer treatment was aggravated especially on the right lower extremity after right total hip replacement surgery. Increased weight of the right lower extremity resulted in 4 episodes of recurrent hip dislocation. We contend that these multiple factors (uterine cervical cancer treatment, total hip replacement surgery on the right side, and recurrent hip dislocations) attributed to development of Stewart-Treves syndrome. We herein report a case of Stewart-Treves syndrome of the lower extremity following chronic leg lymphedema after uterine cervical cancer treatment and hip surgery.
Subject(s)
Aged , Female , Humans , Arthroplasty, Replacement, Hip , Biopsy , Breast Neoplasms , Coloring Agents , Diagnosis , Drug Therapy , Edema , Endothelial Cells , Factor VIII , Hemangiosarcoma , Hip , Hip Dislocation , Hip Joint , Hysterectomy , Leg , Lower Extremity , Lymph Node Excision , Lymphedema , Necrosis , Neoplasm Metastasis , Pelvic Bones , Radiotherapy , Skin , Thigh , Upper Extremity , Uterine Cervical NeoplasmsABSTRACT
No abstract available.
Subject(s)
Anal Canal , Paget Disease, Extramammary , Radiotherapy , VulvaABSTRACT
BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is a malignant proliferation of keratinocytes of the epidermis. It may have the potential to metastasize distally in contrast to the cutaneous basal cell carcinoma. OBJECTIVE: We investigated the recent trend of cSCC development from a clinical, histopathological, and prognostic perspective. METHODS: One hundred and sixty cases of cSCC in patients who had visited the Samsung Changwon Hospital over the past 10 years (between 2006 and 2016) were retrospectively studied. We analyzed their age, sex, location, etiologic factor, histopathologic finding, and treatment. RESULTS: The average age of cSCC was 77 years old and the sex ratio was 1:2.27. The most commonly involved location was the head and neck (73.13%). The etiologic factors were unknown (61.88%), actinic keratosis (23.13%), Bowen's disease (10.63%), burn scar (2.5%), chronic eczema (0.63%) and chronic inflammatory disease (0.63%). The average tumor diameter and thickness were 18.1 mm and 3.58 mm, respectively. The degrees of differentiation were well-differentiated (68.75%), moderately differentiated (28.75%) and poorly differentiated (2.5%). The occurrence rate of cSCC metastasis was 6.25% (10 cases/160 cases). The most common primary locations of cSCC metastasis were the lower extremities (5 cases/10 cases) and head and neck (2 cases/10 cases). All 10 cases were metastasis to adjacent lymph nodes. Five cases showed metastasis to distant lymph nodes, the lungs, liver or bone. The average tumor diameter and thickness of cSCC metastasis were 45.3 mm and 9.46 mm, respectively. Histopathologically, the degrees of differentiation were well-differentiated, moderately differentiated and poorly differentiated type (4 cases, 5 cases, and 1 case, respectively). CONCLUSION: The location of the lower extremities (p=0.000) and a size larger than 20 mm (p=0.000) were related to cSCC metastasis. cSCC metastasis was found at an average of 7.5 months after diagnosis. High-risk cSCC patients should be followed closely, particularly during the first 2 years after diagnosis.
Subject(s)
Humans , Bowen's Disease , Burns , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Cicatrix , Diagnosis , Eczema , Epidermis , Epithelial Cells , Head , Keratinocytes , Keratosis, Actinic , Liver , Lower Extremity , Lung , Lymph Nodes , Neck , Neoplasm Metastasis , Retrospective Studies , Sex RatioABSTRACT
Clinical guidelines suggest that suspicious pigmented lesions of the plantar or palmar area require biopsy for early detection of acral melanoma. We present here a case of acral lentiginous melanoma in which various melanocytic atypia was observed at each biopsy site, including focal melanocytic proliferation. We suggest that this atypical melanosis is part of a contiguous phase of invasive tumor growth, which is known as the very early stage of melanoma in situ. In addition, noninvasive dermoscopy has been effective for the early discovery of hidden lesions of acral melanoma.
Subject(s)
Biopsy , Dermoscopy , Melanoma , MelanosisABSTRACT
BACKGROUND: Several differences in basal cell carcinomas (BCCs) were found, according to the ethnic group; for example, pigmented BCCs was more common in Asian or Hispanic patients. However, there are few reports on the subclinical extension of the BCC in Asian patients. OBJECTIVE: The aim of this study was to evaluate the subclinical infiltration of the basal cell carcinoma in Asian patients. METHODS: All patients with BCC who visited the department of dermatology at Korea University Ansan Hospital were treated with Mohs micrographic surgery. In 81 patients, 83 tumors of BCC were completely eradicated by Mohs micrographic surgery (MMS) from April 2001 to August 2008, and were reviewed in this study. Information recorded included the total margin and the number of stages of Mohs micrographic surgery, anatomic location, tumor size, presence of pigmentation, clinical type, and pathological subtype. We divided the clinical types into nodular, ulcerated, and pigmented, and the pathological types into nodular, micronodular, morpheaform, and adenoid. The BCC was of pigmented type if pigmentation covered more than 25% of the tumor, regardless of whether pigmentation was distinct, or if there was apparent pigmentation that covered more than 10% of the tumor. RESULTS: The nose and cheek were the most common sites requiring more than one stage of surgery. In tumors smaller than 1 cm, 91.7% required only one stage of excision, compared with 60.6% in tumors larger than 1 cm. More than two Mohs stages were required in 25% of non-ulcerated BCCs and in 46.2% of ulcerated BCCs. Sixty eight percent of pigmented BCCs required only one stage of Mohs micrographic surgery. In cases of non-pigmented BCCs, only 45% required one Mohs stage. More than one Mohs stage was required in 19.2% of non-aggressive BCCs and in 42.9% of aggressive BCCs. CONCLUSION: Subclinical infiltration differed between the two groups according to the size of the BCC (1 cm threshold) and most of the BCCs were located in the head and neck area. Considering this result, indication for MMS can be extended for BCCs larger than 1 cm in Asian patients. Ulcerated BCCs required more Mohs stages than non-ulcerated BCCs. Pigmented BCCs might show lesser subclinical infiltration than non-pigmented BCCs. Aggressive pathological subtypes showed more subclinical infiltration than the non-aggressive types; however, after evaluation of the border that was excised with MMS, mixed histologic types were found to be more frequent than generally accepted. Therefore, we consider that, when planning surgery, dermatologists should not place too much confidence in the pathologic subtypes identified by biopsy.
Subject(s)
Humans , Adenoids , Asian People , Biopsy , Carcinoma, Basal Cell , Cheek , Dermatology , Head , Hispanic or Latino , Hypogonadism , Korea , Mitochondrial Diseases , Mohs Surgery , Neck , Nose , Ophthalmoplegia , Pigmentation , UlcerABSTRACT
Zinc deficiency is characterized by acrodermatitis enteropathica like eruption such as periorificial dermatitis, diarrhea and mental irritability. This syndrome occurs due to decreased supplementation, increased consumption or decreased bowel absorption of zinc. We report here on a case of acquired zinc deficiency in a patient who was receiving total parenteral nutrition due to ischemic colitis. She showed denuded patches on the perinasal, perioral and perineal area and tense bullae on both hands. She was suffering from diarrhea and mental irritability. Her blood zinc level was 4.9microng/dl. Subsequent intravenous zinc supplementation cleared up her clinical manifestations.
Subject(s)
Humans , Absorption , Acrodermatitis , Blister , Colitis, Ischemic , Dermatitis , Diarrhea , Hand , Parenteral Nutrition, Total , Stress, Psychological , Transcutaneous Electric Nerve Stimulation , ZincABSTRACT
The acral regions of the limbs of Asians are predisposed to develop malignant melanoma, but giant-sized acral melanoma has not been previously reported in the Asian population. Giant-sized melanoma implies aggressive tumor invasion and so it is more difficult to achieve a therapeutic cure. A 56-year-old woman presented with a giant acral melanoma of the left thumb with concomitant bone destruction and axillary lymph node metastasis. The initial lesion was a subungual black macule on the left thumb that had grown into a giant 7.0*4.0*3.5 cm-sized melanoma over a 3 year period. The left thumb was amputated and the axillary lymph nodes were completely dissected. During the ensuing 3 months, she underwent adjuvant treatment with interferon-alpha-2a. The interesting feature of this case is that the large melanoma mass of this patient, which was accompanied with adjacent bone destruction and lymph node metastasis, had developed rapidly from a small black macule in the nail matrix, and this black macule was suspected to be a subungual melanoma.
Subject(s)
Female , Humans , Middle Aged , Asian People , Extremities , Lymph Nodes , Melanoma , Nails , Neoplasm Metastasis , ThumbABSTRACT
Becker nevus syndrome is a phenotype characterized by the presence of a Becker nevus in association with unilateral hypoplasia of the breast or other cutaneous, muscular or skeletal defects. We report an interesting case of Becker's nevus syndrome associated with fibrous dysplasia of the sphenoid bone, tooth abnormalities and facial asymmetry.
Subject(s)
Breast , Nevus , Phenotype , Skin Neoplasms , Sphenoid Bone , Tooth , Tooth AbnormalitiesABSTRACT
Milker's nodule is a harmless skin lesion that's caused by the paravaccinia virus (also called pseudocowpox virus), which is a member of the genus Parapoxviridae. It occurs worldwide, but it is prevalent only in individuals who are in close contact with cattle. We report here on a woman who presented with a dusky purpuric center surrounded by a white or gray ring and an outer red halo on the back of the right hand. Histologically, intracytoplasmic inclusion bodies were evident in the upper epidermis, and these revealed cylindrical virus particles on electron microscopy. Parapoxvirus was identified by polymerase chain reaction with using pan-parapoxvirus primer 1 (PPP-1) and PPP-4.
Subject(s)
Animals , Cattle , Female , Humans , Epidermis , Hand , Inclusion Bodies , Microscopy, Electron , Parapoxvirus , Polymerase Chain Reaction , Pseudocowpox Virus , Skin , VirionABSTRACT
White fibrous papulosis of the neck is a rare disorder, characterized by asymptomatic white papules that appear around neck in elderly people. The histopathologic findings showed thickened collagen bundles in the papillary to mid dermis. We report a case of white fibrous papulosis of the neck in a 53-year-old man.
Subject(s)
Aged , Humans , Middle Aged , Collagen , Dermis , NeckABSTRACT
A 35-year-old woman with advanced lung cancer, treated with intravenous docetaxel and paclitaxel, developed subungual abscesses and secondary onycholysis involving all the finger nails. Bacterial culture demonstrated the growth of Pseudomonas aeruginosa. We report a case of onycholysis and subungual abscesses in a patient treated with docetaxel and paclitaxel.
Subject(s)
Adult , Female , Humans , Abscess , Fingers , Lung Neoplasms , Onycholysis , Paclitaxel , Pseudomonas aeruginosaABSTRACT
Sebaceous hyperplasia is not a rare disorder and commonly develops on the face over the age of forty. The typical clinical manifestation is 2~3 mm sized, single or multiple, soft, protuberant, yellowish nodules with central umbilication. Histological examination reveals a group of mature sebaceous lobules and central sebaceous ducts. We describe an unusual case of a 28-year old female patient with grouped premature sebaceous hyperplasia. The lesions presented clinically as grouped, yellowish, umbilicated papules on the left cheek, and had developed at 10 years of age.
Subject(s)
Adult , Female , Humans , Cheek , HyperplasiaABSTRACT
Argyria is a rare skin discoloration caused by silver deposition. We report a case of generalized argyria caused by ingestion of silver solution in a 63-year-old man. He had diffuse slate gray discoloration of sun-exposed skin, prominent face, neck and V of the chest. The histopathologic findings showed brown black granules deposited in the basement membrane zone of eccrine glands, pilosebaceous units, arteriolar wall and dermal elastic fibers.
Subject(s)
Humans , Middle Aged , Argyria , Basement Membrane , Eating , Eccrine Glands , Elastic Tissue , Neck , Silver , Skin , ThoraxABSTRACT
Kaposi's sarcoma is a neoplastic, vascular tumor involving the skin or internal organs. We report a case of a 72-year-old male who presented with multiple, grouped, purpuric papules, hemorrhagic bullae and nodules showing zosteriform distribution on the sole of his right foot. In our case, as in some of the cases from the literature, the patient was initially misdiagnosed clinically as having herpes zoster. Histopathologic findings revealed a diffuse infiltrate of small blood vessels and slit-like spaces extending through most of the dermis. Many of the spindle-shaped cells expressed factor VIII-related antigen, and human herpes virus 8 (HHV-8) DNA was detected by polymerase chain reaction (PCR) in paraffin-embedded tissue.
Subject(s)
Aged , Humans , Male , Blood Vessels , Dermis , DNA , Foot , Herpes Zoster , Polymerase Chain Reaction , Sarcoma, Kaposi , Skin , von Willebrand FactorABSTRACT
Kaposi's sarcoma is a neoplastic, vascular tumor involving the skin or internal organs. We report a case of a 72-year-old male who presented with multiple, grouped, purpuric papules, hemorrhagic bullae and nodules showing zosteriform distribution on the sole of his right foot. In our case, as in some of the cases from the literature, the patient was initially misdiagnosed clinically as having herpes zoster. Histopathologic findings revealed a diffuse infiltrate of small blood vessels and slit-like spaces extending through most of the dermis. Many of the spindle-shaped cells expressed factor VIII-related antigen, and human herpes virus 8 (HHV-8) DNA was detected by polymerase chain reaction (PCR) in paraffin-embedded tissue.
Subject(s)
Aged , Humans , Male , Blood Vessels , Dermis , DNA , Foot , Herpes Zoster , Polymerase Chain Reaction , Sarcoma, Kaposi , Skin , von Willebrand FactorABSTRACT
A 59-year old man presented with a 0.5 x 0.3 cm-sized area of, pink-colored, dome-shaped papules on the paranasal area. There was no previous history of trauma to the area. Histopathologic diagnosis was consistent with eccrine poroma. We reported a case of eccrine poroma arising on the paranasal area, an unusual location for this condition.
Subject(s)
Humans , Middle Aged , Diagnosis , PoromaABSTRACT
Estrogen and progesterone are widely used in oral contraceptives and hormone replacement therapies and are rarely known to cause a photosensitive reaction. We report a case of photosensitivity induced by the hormonal replacement agents containing estrogen and progesterone. A 36-year-old woman reported a 3-year history of erythematous papules and diffuse erythema on sun-exposed areas. She had taken the hormonal agents for 5 years, following a total abdominal hysterectomy and bilateral salpingo-oophorectomy for cervical cancer. A phototest showed a marked decrease in the minimal erythema dose (MED) of UVA (3J/cm2) and UVB (30mJ/cm2). After the cessation of the hormonal agents, the skin lesions subsided with the disappearance of photosensitivity, and the MED was raised to 5J/cm2(UVA) and 90mJ/cm2 (UVB).