The Effect of In Vivo Grown Corneal Epithelium Transplantation on Persistent Epithelial Defects with Limbal Stem Cell Deficiency

We report our experience with corneal epithelium, grown in vivo, transplantation in three patients with persistent epithelial defect (PED). The three patients had ocular surface disease unresponsive to standard treatments and were therefore chosen for transplantation. They underwent transplantation of epithelial sheets, grown in vivo, to the most affected eye. In vivo cultivation was carried out in the cornea of a living related donor. After epithelialization was completed, the epithelium grown on an amniotic membrane was harvested gently; it was then transplanted into the patient's eye after debridement of fibrovascular tissue. The cultivated epithelium was completely epithelialized by 2 weeks; it was well-differentiated with well-formed hemidesmosome. On immunohistochemical staining, p63, connexin 43, and Integrin beta4 were expressed in the cells on the epithelial sheet. The PED was covered completely and maintained for 4 weeks in all cases. However, corneal erosion recurred after 5 weeks in two cases. This novel technique demonstrates the corneal epithelial cells can be expanded in vivo successfully on denuded amniotic membrane of a healthy cornea and harvested safely. A corneal epithelial sheet, grown in vivo, can be transplanted to treat eye with a severe ocular surface disease, such as total limbal deficiency.

A Case of Scalp Metastasis Manifested as the Presenting Sign of Thyroid Carcinoma / 대한피부과학회지

Cutaneous metastasis from the papillary thyroid carcinoma is rare. An otherwise asymptomatic 57-year-old man presented with a 3 year history of a steadily-enlarging scalp nodule. The histopathologic features showed a complicated pattern of follicular architecture formed by papilliform fibrovascular stroma. The tumor cells stained positive for thyroglobulin. A subsequent thyroid sonogram revealed multiple nodules in both lobes and resection of the thyroid gland identified papillary thyroid carcinoma. The solitary scalp nodule was presenting sign of an occult thyroid carcinoma. We report a case of cutaneous metastasis from the papillary thyroid carcinoma.

A Case of Alopecia Neoplastica from Breast Cancer / 대한피부과학회지

We report a case of alopecia neoplastica in a 54-year-old woman, who presented with a 2 month history of a solitary 2X2 cm sized, erythematous hairless plaque on the vertex. Histological findings showed an extensive infiltration of tumor cells in the dermis, resulting in loss of the pilosebaceous structure. Tumor cells infiltrated in sheets or cords of cells, sometimes demonstrating glandular structures, and tumor cells formed small groups or single rows between thickened collagen bundles; the characteristic features of alopecia neoplastica.

A case of Verrucous Carcinoma Arising on the Glans Penis with Insertion of Penile Prosthesis / 대한피부과학회지

Verrucous carcinoma is a variant of well-differentiated squarmous cell carcinoma. Although this tumor is well-documented in the oral cavity, its occurrence on the glans penis is rare. It is a relatively nonaggressive tumor which seldom metastasizes to the resional lymph node or distantly. With proper treatment, the prognosis is excellent. We have experienced a case of verrucous carcinoma arising on the glans penis with the previous insertion of paraffin and penile prosthesis for the augumentation of penis, which was treated with total phallectomy. We report this case with a review of literature.

A Case of Sebaceous Epithelioma Arising from Nevus Sebaceus / 대한피부과학회지

Nevus sebaceus is a congenital cutaneous hamartoma which has a potential to develop both benign and malignant neoplasms in late life. One of the benign neoplasms is sebaceous epithelioma that is developed secondarily in lesions of nevus sebaceus. We have experienced a case of sebaceous epithelioma associated with nevus sebaceus in a 54-year-old male. Two nodular tumors developed on the verrucous surfaced yellowish plaque on the scalp. Histopathologic examination revealed mature sebaceous glands in the upper dermis and ectopic apocrine glands in the lower dermis on the verrucous surfaced yellowish plaque, and undifferentiated basaloid cells which were arranged in a palisading pattern at the periphery and groups of mature sebaceous cells on the two nodular tumors. We report a case of sebaceous epithelioma arising from nevus sebaceus.

Two Cases of Scrofuloderma / 대한피부과학회지

Scrofuloderma results from a direct extension of an underlying tuberculosis focus such as the lymph node, bone or joint to the underlying skin, and is often associated with pulmonary tuberculosis. One 72-year-old man presented with erythematous swollen patch with scales on the left hand and erythematous swollen patch on the left elbow. He had tuberculous osteomyelitis of left elbow. And another patient who is a 59-year-old man presented with hemorrhagic, purulent ulcers with crust and exudate on the left and right chest. Each size of ulcers are 6.0x5.0cm and 5.0x5.0cm. He had reactive pulmonary tuberculosis and tuberculous spondylitis. Biopsy specimens from the skin showed lymphocytes, epitheloid cells, and Langerhan's giant cells with caseation necrosis. Acid-fast bacilli were identified on AFB staining. We report two unusual cases of scrofuloderma associated with tuberculous osteomyelitis and pulmonary tuberculosis respectively.

Carotid Intima Media Thickness (IMT) in Relation to Subclinical Atherosclerosis in Turner Syndrome / 대한산부인과학회잡지

OBJECTIVE: This study was undertaken to determine whether women with Turner syndrome have greater subclinical atherosclerosis and evaluate the relationship to risk factors for atherosclerosis. METHODS: 18 Women with Turner syndrome and 18 women as control group were measured the intima media thickness (IMT) of common carotid artery by B-mode ultrasound. We compared the IMT between cases and controls, and analyzed risk factors which affect the IMT. RESULTS: There are no differences between the groups in age and body mass index (BMI). The height was shorter (147.8+/-7.9 vs 160.3+/-5.9, p<0.001) and the waist-hip ratio (WHR) was significantly increased in Turner syndrome (0.86+/-0.04 vs 0.78+/-0.04, p<0.001). Fasting blood sugar (FBS) (90.1+/-9.9 vs 79.4+/-4.4 mg/dl, p<0.001), fasting insulin (9.5+/-3.0 vs 4.7+/-1.0 IU/ml, p=0.009), total cholesterol (187.1+/-21.3 vs 154.8+/-21.8 mg/dl, p=0.014), and LDL (111.3+/-10.0 vs 82.8+/-16.4 mg/dl, p=0.009) were significantly higher in Turner syndrome. Compare to control, the IMT was significantly increased in Turner syndrome (0.61+/-0.09 vs 0.49+/-0.02 mm, p=0.002). In the analysis of correlation between the IMT and clinical & biochemical characteristics, Turner syndrome status, WHR, FBS and fasting insulin were significantly affecting factors (Coefficients of correlation: 0.720, p<0.001; 0.671, P<0.001; 0.445, p=0.020; 0.904, p<0.001). CONCLUSION: These results suggested that women with Turner syndrome might have an increased risk of subclinical atherosclerosis and insulin resistance was most important risk factor.

A Case of Clear Cell Acanthoma / 대한피부과학회지

We report a case of clear cell acanthoma occurred in a 61 year old man. He developed a brownish bean sized nodule on the left chest 3 years ago. The skin lesion has slowly increased in size without any subjective symptoms. Histopathologic examination revealed proliferation of clear cells within a sharply demarcated area of the epidermis. The presence of numerous neutrophils throughout the epidermis were also noted.

Adenocarcinoma arising in Sacrococcygeal Teratoma: A case report

Authors experienced a rare adenocarcinoma arising in presacral sacrococcygeal teratoma in a adult and herein reported. The patient was a 52 year old female admitted because of lower abdominal pain for 5 to 6 months. Past and familial history were unremarkable. On rectal examination a mass was palpated 3 cm above the anal verge. The large bowel was displaced by an extrinsic mass but there was no evidence of intrinsic tumor lesion on barium enema, CT was done and showed a large presacral tumor attached to the sacrum. Clinical impression was sacrococcygeal teratoma. Resected tumor mass was a relatively well circumscribed cystic mass, measuring 11 x 11 cm and the cystic content was previously evacuated. Inner surface showed ragged appearance, and focal nodular solid area was noted. On microscopic examination, the tumor revealed the derivatives of three germ layers and main components were tissues of respiratory tract. Sections from the solid area showed a well differentiated adenocarcinoma and with stromal, capsular and perineural invasion. Borderline malignant epithelial lesions are also noted suggesting the pathogenesis and progression of this tumor. There was no recurrence for one year after surgery in the follow up.

A Case of Acral Lentiginous Melanoma / 대한피부과학회지

We report herein a case of acral lentiginous melanoma in a 65-year-old female. An about 2x3cm sized erythematous to brownish mass with central ulceration was located on the left heel accompanied by enlargement of the left inguinal lymph nodes. Histopathologic findings showed lentiginous proliferation of atypical melanocytes with pseudoepithliomatous hyperplasia and invasion of tumor cells from the epidermis into the dermis. Focal pigmented melanocytes were also noted. Complete surgical excision and chemotherapy with DTIC were done. Marked edematous swelling on the left lower leg was developed after 8 months and 1 month later she was expired.