A Case of Myopericytoma on the Lower Leg

Myopericytoma (MP) is a benign tumor composed of cells that show apparent differentiation towards putative perivascular myoid cells called myopericytes. It arises most commonly in the dermis or subcutaneous tissue of the extremities in adults. The most common presentation is a well-circumscribed, slow-growing painless firm mass. A 45-year-old woman presented with a 2-year history of a painless, slowly growing 0.9x0.7 cm sized firm mass in the subcutaneous tissue of the posterior side of the right lower leg. We presumed this lesion to be an epidermal cyst, pilomatricoma or calcinosis cutis and performed an excisional biopsy. The histologic examination showed that it was composed of spindle-shaped myoid-appearing cells in a concentric arrangement, intimately associated with thin-walled vascular channels. Lesional spindle cells were diffusely positive for smooth muscle actin and were negative for CD34, desmin and S100 protein. From these findings, we diagnosed this lesion as a myopericytoma.

A Case of Dowling-Degos Disease on the Vulva

Dowling-Degos disease (DDD) is an autosomal dominant genodermatosis and this disease is a genetically determined disturbance of epidermal proliferation. It is characterized by acquired, slowly progressive pigmented lesions that primarily involve the great skin folds and flexural areas such as the axilla, neck, limb flexures, the inframammary area and the inguinal folds. The vulva is an unusual location for DDD. A 41-year-old woman presented with a 10-year history of multiple, small, reticulated and brownish macules distributed symmetrically on the bilateral external genital regions. We found no other similarly pigmented skin lesions on her body, including the flexural areas. There was no known family history of similar eruptions or pigmentary changes. The histologic examination showed irregular rete ridge elongation with a filiform or antler-like pattern and basilar hyperpigmentation on the tips. Fontana-Masson staining showed increased pigmentation of the rete ridges and the S100 protein staining did not reveal an increased number of melanocytes in the epidermis. From these findings, we diagnosed this lesion as DDD.

A Case of Herpetiform Appearance of Digital Mucous Cysts

A digital mucous cyst (DMC) is clinically characterized by a round to oval, translucent, smooth nodule localized to the dorsal aspect of the distal digits near the distal interphalangeal joint. It usually presents as a solitary lesion, and multiple lesions are uncommon. An 88-year-old man presented with herpetiform translucent papules on the right thumb. We first diagnosed the lesion as molluscum contagiosum or herpetic whitlow. Histopathology showed a cystic space containing mucinous material and numerous fibroblasts surrounded by mucinous stroma in the upper dermis. The lining of the cyst wall was not apparent and mucinous material was stained with Alcian blue, indicating a diagnosis of DMC.

The Effect of 650 nm Red Light Phototherapy on Acne Vulgaris / 대한피부과학회지

BACKGROUND: With the emergence of problems with conventional acne vulgaris treatments, the demand for safe and effective treatment has been increasing. Recently, many studies have shown that phototherapy can be an alternative treatment for acne. OBJECTIVE: This study was designed to investigate the efficacy and safety of red light phototherapy for mild to moderate acne vulgaris. METHODS: Thirty-nine patients with mild to moderate facial acne vulgaris were recruited. The patients were instructed to use an ordinary light emitting diode (LED)-attached device on left facial acne and a red light-emitting device on right facial acne for 16 minutes, twice a day, for 6 weeks. Acne was assessed at baseline and at weeks 2, 4, and 6. RESULTS: A significant reduction of Burton scale and lesion count was observed on the red light emitting side, compared with the LED-emitting side. Improvement of satisfaction of patients and efficacy assessment on the red light emitting side were 82.05% and 84.62%, respectively, compared with 41.03% and 38.46%, respectively, on the LED emitting side. One patient complained of cheilitis, but it was temporary. CONCLUSION: This study shows that 650 nm red light therapy can be an effective and safe treatment for mild to moderate acne vulgaris.

Childhood Lichen Planus with Palmoplantar Involvement

Lichen planus (LP) commonly involves the flexor aspects of the wrists, legs, and oral and genital mucous membranes. But it rarely occurs on the palms and/or soles. It mainly affects people in the age range 30~60 years. Childhood LP is reported to constitute only 1~4% of total cases of LP. In the literature, a few cases of LP on the palms and soles of pediatric patients have been reported. Here we report an interesting case of childhood LP with palmoplantar involvement. The patient was a 7-year-old boy who for 6 months had variously sized and shaped, pruritic, violaceous, polygonal papules and plaques on the whole body. The skin biopsy specimens taken from four sites of the patient (dorsum of the hand and foot, sole and chest) showed typical features of LP on histopathology. A diagnosis of generalized LP with palmoplantar involvement was made.

An Unusual Clinical Presentation of Kimura's Disease Occurring on the Buttock of a Five-year-old Boy

Kimura's disease is a rare inflammatory disorder of unknown etiology primarily seen in young Asian males. It is characterized by painless subcutaneous masses, blood and tissue eosinophilia, and markedly elevated serum immunoglobulin E (IgE) levels. Clinically, the subcutaneous nodules occur predominantly in the head and neck. However, we report the case of a five-year-old boy presenting with an asymptomatic solitary brown pigmented nodule on the left buttock diagnosed with Kimura's disease. Here we describe the diagnosis and treatment of this unusual case.

The Relationship among Pain, Depression, and Anxiety in Patients with Herpes Zoster / 대한피부과학회지

BACKGROUND: Acute and persistent pain are the most significant clinical manifestations of herpes zoster. It has been suggested that the demographic and clinical characteristics of patients with herpes zoster at the time of presentation predict the duration and severity of pain on long-term follow-up. However, the association between pain in herpes zoster and emotional factors such as depression and anxiety has been less well investigated. OBJECTIVE: The purpose of this study was to correlate the characteristics of pain with clinical, demographic, and emotional factors in herpes zoster patients. METHODS: Ninety-seven patients with herpes zoster and 105 healthy controls were recruited from the department of dermatology at a university-affiliated hospital. Depression and anxiety levels were assessed using the Beck Depression Inventory and Beck Anxiety Inventory. We compared severity of initial pain and duration of pain by age, depression, and anxiety. RESULTS: The levels of depression and anxiety were higher in herpes zoster patients compared to controls (p <0.05). There were no significant differences by age, depression, or anxiety. The duration of pain increased with increasing age, depression, and anxiety (p <0.05). Stratified analyses showed that the association between pain duration and increasing depression and anxiety was significant in the young age group (p <0.05), but not significant in the old age group. CONCLUSION: This study suggests that age, depression, and anxiety are the main correlates of pain duration in patients with herpes zoster. Therefore, depression and anxiety should not be ignored in the management of herpes zoster patients.

A Case of Pigmented Bowen`s Disease

Pigmented Bowen`s disease is characterized by increased melanin pigment in the epidermis or papillary dermis, in addition to the typical findings of Bowen`s disease. This disorder has been infrequently reported and it represents less than 2% of all cases of Bowen`s disease. Thus far, there has been only 1 case of pigmented Bowen`s disease on the umbilicus in the medical literature, and no such case has been reported in Korea. Pigmented Bowen`s disease develops on sun-exposed areas of the face and neck, as well as sun-unexposed areas like the trunk, extremities, perianal area and umbilcus. A 36-year-old man presented with a 9-month history of solitary dark brown slithery or wavy plaque with a verrucous surface on the umbilicus, and the lesion measured 1 x 2 cm in size. The histopathologic findings showed hyperkeratosis, parakeratosis and atypical keratinocytes disorderly arranged throughout the epidermis. Increased melanin pigment was noted in the basal layer of the epidermis. From these findings, we diagnosed this lesion as pigmented Bowen`s disease.

A Case of Hereditary Hemorrhagic Telangiectasia

Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is an autosomal dominant disorder of the fibrovascular tissue. It is characterized by the classic triad of mucocutaneous telangiectasias, recurrent hemorrhages, and familial occurrence. The cutaneous manifestation appear clinically as punctuate, linear, or splinter-like telangiectasias of the upper body, oral, and nasal mucous membranes, and nail beds. A 73-year-old woman presented with purpuric, punctuate, and tiny macules on the finger tips of both hands and the tongue. The skin lesions were discovered about 50 years previously. She had a family history of cutaneous telangiectasia. Also, she had episodes of recurrent epistaxis, gastrointestinal bleeding, and anemia. The gastroendoscopy revealed gastric angiodysplasia of the fundus and body of the stomach. The histopathologic study showed dilated capillaries lined by flat endothelial cells in the papillary dermis. From these findings, we diagnosed this case as hereditary hemorrhagic telangiectasia, which has rarely been reported in the dermatologic literature.

A Case of Kaposi Sarcoma Treated with Pentoxifylline / 대한피부과학회지

Kaposi sarcoma is a lympho-angioproliferative disease of the skin and viscera. Because the natural history of Kaposi sarcoma is variable, the assessment of therapy may be difficult and optimal therapy has yet to be determined. Pentoxifylline has been used to treat various dermatologic diseases, but its effectiveness in Kaposi sarcoma has not been reported. We now report a case of Kaposi sarcoma in a 76-year-old man who improved after treatment with oral pentoxifylline.

A Case of Kaposi Sarcoma Treated with Pentoxifylline / 대한피부과학회지

Kaposi sarcoma is a lympho-angioproliferative disease of the skin and viscera. Because the natural history of Kaposi sarcoma is variable, the assessment of therapy may be difficult and optimal therapy has yet to be determined. Pentoxifylline has been used to treat various dermatologic diseases, but its effectiveness in Kaposi sarcoma has not been reported. We now report a case of Kaposi sarcoma in a 76-year-old man who improved after treatment with oral pentoxifylline.

Change of the Growth Rate of the Great Toenail in Patients with Onychomycosis According to Systemic Antifungal Medication / 대한의진균학회지

BACKGROUND: Onychomycosis is one of the most common diseases of nails, accounting for 50% of all nail problems and a recent rise in the prevalence of onychomycosis has been noted. It has been known that the growth rate of nails is influenced by age, sex, seasonal factor, individual health and familial tendency. Several drugs, also, have been known to influence the growth rate of nails. OBJECTIVE: We want to know the influence of antifungal drug, itraconazole and terbinafine that used widespread recently, to the growth rate of nail. METHODS: This study was performed the 41 patients with distal subungal onychomycosis affecting only one sided great toenail and affected area more than 50%. The growth rate of the affected and the unaffected toenails in the same patients according to the medication of itraconazole or terbinafine was measured. Also, the growth rate of nails in 36 people with normal toenail was measured. RESULTS: No growth rate differences were seen in comparing the great toenails affected to onychomycosis in itraconazole and terbinafine group (p> 0.05). Also no growth rate differences were seen in great toenails not affected to onychomycosis in itraconazole and terbinafine group and no growth rate differences with the toenails of normal control (p> 0.05). CONCLUSION: There was no difference of itraconazole or terbinafine to the growth rate of nail. Even though there was no statistical significance, the possibility of the drug effect as normal nail growth became faster with the antifungal medication can not be excluded. So study with comparison of nail growth rate before and after antifungal medication will be needed in the future.

A Case of Atopic Dermatitis Accompanied with Blindness in Ocular Complications / 대한피부과학회지

Long-standing atopic dermatitis patients frequently predispose to ocular complications such as blepharitis, keratoconjunctivitis, uveitis, cataract, and retinal detachment. Among these, cataract and retinal detachment are the most serious complications that may cause visual disturbance. Glaucoma has not been reported as the complication of atopic dermatitis, but it is believed that long-term use of topical corticosteroid on face may cause glaucoma. A 26-year-old man presented with generalized severe atopic dermatitis and gradual loss of vision in both eyes. Because of eczema involving the skin of the face including the eyelids, he had been applying various topical corticosteroids since he was 4 years old. Eight years ago, cataracts developed on both eyes and extracapsular cataract extraction and intraocular lens implantation were done. Ophthalmologic examination revealed that his intraocular pressures were 46mmHg right and 38mmHg left, suggesting glaucoma. Three months following presentation, the patient became totally blind in both eyes.

Two Cases of Tufted Angioma Improved with Intralesional Injection of Steroid / 대한피부과학회지

Tufted angioma is a rare, acquired vascular tumor, most commonly presenting in the first year of life, which was first described by Wilson Jones in 1979. Spontaneous resolution of this tumor are known to be very rare and local recurrence often occurs unless the tumor is excised completely. We present two cases of tufted angioma developed in two 1-year-old girls. Skin biopsy in a case showed compatible findings with tufted angioma and the other was diagnosed at an other hospital. The lesions were treated with intralesional injections of triamcinolone acetonide and showed marked improvement. During follow up period, the lesions kept improving.

A Case of Churg-Strauss Syndrome / 대한피부과학회지

Churg-Strauss syndrome is a clinicopathologic disorder of severe asthma, fever , and eosinophilia together with systemic vasculitis involving various organ systems. Characteristic cutaneous lesions include erythematous maculopapules resembling erythema multiforme, hemorrhagic lesions, and cutaneous and subcutaneous nodules. Histologically, extravascular granuloma and leukocytoclastic vasculitis are the most common findings. We report a case of 40-year-old woman who presented with generalized multiple hemorrhagic bullae that had developed 1 month ago. Previously, She had allergic rhinitis and asthma. Laboratory studies revealed peripheral blood eosinophilia, and positive p-ANCA. Skin biopsy revealed eosinophilic infiltrates and leukocytoclastic vasculitis.