Reconstruction of Defect on the Nasal Dorsum with Modified Bilateral Rhombic Flap / 대한피부과학회지

The skin over the nose is less mobile for primary closure of defects. In addition to skin graft and secondary intention healing, there are various local flap techniques and their modifications for the reconstruction of nasal defects. Imprecise engineering of wound repair methods and contracture can lead to twisting of the nose and distortion of surrounding anatomic structures such as the nasal ala and paranasal sulcus. The skin defects on the nasal dorsum were reconstructed with a modified bilateral rombic flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that the modified bilateral rhombic flap can reconstruct defects on the center area of the nasal dorsum effectively and in a single stage.

A Case of Kimura's Disease: Approach by Immunohistochemical Study and Analysis of Clonality / 대한피부과학회지

Kimura's disease is a chronic, inflammatory disorder of unknown origin. It is characterized by clinically recurrent painless swelling on head and neck region, histopathologically multiple lymphoid follicles, increased serum IgE levels, and eosinophilia of tissue and peripheral blood. It has been known that Kimura's disease is the reactive immunological disease. Recently, however, it was suggested the clonal T cell proliferation might contribute to the pathogenesis in the Kimura's disease. But, it is still uncertain that Kimura's disease is of reactive nature or neoplastic origin. A 71-year-old woman visited our clinic with painless violaceous swelling on her right cheek. Skin biopsy was performed and, taken together, Kimura's disease was diagnosed. Tissue section was examined with immunohistochemical stains with markers of lymphocytes, plasma cell, and periendothelial cell, and polymerase chain reaction for the TCR gene rearrangement was performed. We present a case of Kimura's disease investigated by the immunohistochemical study and TCR gene rearrangement test and suggest this case is in the limited favor of the reactive nature of Kimura's disease.

Reconstruction of Nasal Alar Defect with Transposition of the Island Pedicle Flap / 대한피부과학회지

Transposition of the island pedicle flap is a versatile method of mobilizing tissue from a relatively distant reservoir and moving it across intervening tissue. Advantages are the similar color and texture to those of the affected area, the minimal donor scar, the increased viability with local blood supply, and the potential to camouflage scars into natural skin lines or cosmetic units. In a 73-year-old woman, the lesion of a basal cell carcinoma on her left nasal ala was removed by Mohs micrographic surgery and the resultant defect was reconstructed by transposition of the island pedicle flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that transposition of the island pedicle flap is another alternative for the reconstruction of nasal alar defects.

Two Cases of Multiple Cutaneous Squamous Cell Carcinomas / 대한피부과학회지

The causes of the cutaneous squamous cell carcinomas(SCCs) are diverse, and when the multiple SCCs are found at the same time, not only the treatment of the lesions but also the consideration of the causes are important. Then, when actinic keratoses coexist with SCCs on the sun-exposed area at the same time, the most probable cause of the SCC is the ultraviolet light-induced skin damage. But when the multiple SCCs are developed on the sun-protected area, one must consider the patient's history of exposure to arsenic. We report two patients having multiple SCCs of the skin. One is considered to be associated with the previous arsenic exposure and the other with chronic sun damage and the resultant actinic keratoses.

The Changes of the Barrier Function of Axillary Skin and the Quality of Life in the Patients of Axillary Hyperhidrosis after the Injection of Botulinum Toxin A / 대한피부과학회지

BACKGROUND: Axillary hyperhidrosis is a distressing problem in the making of a person's social life. The characteristics of the axillary skin in the patients of the axillary hyperhidrosis and the exact reasons of the reduced barrier function of the axillary skin are still not known. OBJECTIVE: To confirm the changes in the barrier function of axillary skin and the changes in the quality of life, before and after, the injection of botulinum toxin type A for patients of primary axillary hyperhidrosis. METHODS: The subjects of this study, were composed of nineteen patients of primary axillary hyperhidrosis. The values of hydration (Corneometer), transepidermal water loss (TEWL) and acidity (pH) on the skin of the axilla and forearm were measured, each time before and at 1 week, 2 weeks, 3 weeks, 4 weeks, and 3 months after the injection of botulinum toxin A. The changes in the quality of life were also measured, through the Modified Dermatology Life Quality Index (MDLQI), before and at 4weeks after the injection of botulinum toxin A. RESULTS: Compared with the skin of the forearm, the values of the Corneometer, TEWL, and pH were significantly higher in the axillary skin. Also the values of the Corneometer, TEWL, and pH decreased after the injection of botulinum toxin A, reaching the lowest levels, in all parameters, at 3 weeks. The quality of life improved significantly, with the MDLQI decreasing from 18.63 to 4.53. CONCLUSION: It can be suggested that the reduced barrier function in the axillary skin is associated with the increased activity of the eccrine gland of the axilla, so it is, at least, partially recovered by the inhibition of sweating through the botulinum toxin A injection. Furthermore, the quality of life for patients of axillary hyperhidrosis can be significantly improved by the injection of botulinum toxin A.

A Case of Sclerosing Panniculitis treated with Stanozolol / 대한피부과학회지

Sclerosing panniculitis refers to indurated erythema with hyperpigmented scleroderma-like hardening on the medial lower third of the legs. It has been called indurated cellulitis, chronic cellulitis, hypodermitis sclerodermiformis or lipodermatosclerosis. It has been suggested that sclerosing panniculitis is associated with venous insufficiency. The treatment of sclerosing panniculitis is very difficult. Stanozolol is valuable in treating intractable sclerosing panniculitis, giving relief of pain, reducing induration, inflammation, tenderness and pigmentation by its fibrinolytic activity. We report a case of sclerosing panniculitis, clinically improved by stanozolol.

A Case of Acneiform Skin Eruption Associated with ZD1839(Iressa(R)) / 대한피부과학회지

Epidermal growth factor (EGF) has an important role in the regulation of the proliferation and differentiation of epidermal keratinocytes, as well as in the survival, angiogenesis and metastasis of various cancer cells. There have been some reports of acneiform skin lesions that occurred in the cancer patients treated with ZD1839(Iressa(R)), an inhibitor of EGF tyrosine kinase. We report a case of acneiform eruption related to the anticancer drug, ZD1839(Iressa(R)).

A Case of Cutaneous Focal Mucinosis / 대한피부과학회지

Cutaneous focal mucinosis is a rare condition characterized with asymptomatic, single, dermal mucin deposition anywhere on the body surface except on the joint surfaces of the hands, wrists and feet. Histopathologically, homogenous mucinous material is deposited in the dermis to replace dermal composition mucin. We herein report a case of cutaneous focal mucinosis with the review of the literature.

A Case of Allergic Contact Dermatitis Caused by Topical Hydrocortisone Cream / 대한피부과학회지

Topical steroid is one of the main armaments for dermatologists, but it can cause many unwanted side effects. Allergic contact dermatitis, even if it is rare, is one of them and would fall the physician in to confusion. So it is important to consider this problem in the case of dermatitis with no or poor response to appropriate topical steroid therapy. We herein report a case of allergic contact dermatitis caused by topical hydrocortisone cream.

Allergic Contact Dermatitis Caused by a Hearing Aid / 대한피부과학회지

There are many underlying diseases which cause chronic otitis externa, including contact dermatitis, seborrheic dermatitis, dermatophytosis and so on. Allergic contact dermatitis caused by a hearing aid is a rare condition, but it is important because the patient would have difficulties in hearing without use the of a hearing aid. We herein report a case of allergic contact dermatitis caused by a hearing aid, which has been diagnosed by patch tests, along with the review of the literature.

A Case of Submuscular Lipoma on the Forehead / 대한피부과학회지

Lipomas are the most common mesenchymal neoplasms and are characterized by a lobular growth of mature adipocytes with a sharply demarcated border delineated by a thin fibrous capsule. Lipomas usually appear in the adipose tissue but occasionally develop in other mesenchymal tissues and can be classified as either subcutaneous or subfascial tumors. Subfascial lipomas are one of the most uncommon sites for soft-tissue tumors and can be intramuscular, intermuscular, or submuscular. Accordingly subfascial lipomas of the forehead can be differentiated into submuscular and subgaleal lipomas depending on the exact anatomic localization below the frontalis muscle or underneath the galea aponeurotica. The patient, a 33-year-old man, visited our clinic with a complaint of asymptomatic 2x2cm-sized dome-shaped tumor on his forehead. The tumor was surgically excised. During the operation the tumor was found to be located below the frontalis muscle and was revealed histopathologically as lipoma.

A Case of Intravascular Papillary Endothelial Hyperplasia Developing on the Sole / 대한피부과학회지

Intravascular papillary endothelial hyperplasia(IPEH) is a relatively rare disease which is characterized by the development of endothelial-lined papillary projections. It is now believed to be a reactive process that result from organization of a thrombus. We report a case of intravascular papillary endothelial hyperplasia developed on the plantar surface of right 4th toe.

A Case of Vaginal Adenosis / 대한피부과학회지

The mucosa of vagina in normal women is lined with thick nonkeratinizing squamous epithelium. The vaginal adenosis is defined as the abnormal presence of glandular epithelium or columnar epithelium with secretary product in the vagina. The incidence of vaginal adenosis was highly increased when diethylstilbestrol(DES) was in wide use by the mid 1940s. A 44-year-old woman without the previous intrauterine DES-exposure visited our clinic with pain on external genital area and erosive red erythematous patch on the vagina. Histopathologically, the multiple glands consisted of the columnar epithelium existed in the lamina propria of vaginal mucosa. And the lining cells resembled those cells of the fallopian tube and endometrium, namely mucinous columnar cells. We report a case of vaginal adenosis in a 44-year-old woman.

A Case of Lichen Myxedematosus in a Patient with HIV Infection / 대한피부과학회지

Lichen myxedematosus(LM), also known as papular mucinosis, is a rare, idiopathic disorder caused by the focal dermal deposition of mucin and occurs both as an isolated entity and manifestations of various systemic disorders. Cutaneous disease is common in patients infected with human immunodeficiency virus(HIV) and cutaneous mucinosis has been reported with increased frequency in HIV patients. A male patient with HIV infection was consulted to our clinic for evaluation of asymptomatic diffusely-scattered papules on his upper extremities and trunk. Histopathological finding was the deposition of mucin in the dermis and lichen myxedematosus type 2 was diagnosed. We present of a case of lichen myxedematosus in a HIV-infected male patient.

A Case of Klippel-Trenaunay Syndrome with Bilateral Nevus Flammeus in a Neonate / 대한피부과학회지

Klippel-Trenaunay syndrome is characterized as a triad of skin capillary malformations, varicose veins and venous malformations, and soft tissue hypertrophy of the affected extremity. Venous malformations are the main cutaneous manifestation of this syndrome, present at birth and are usually unilateral. The patient, a 3-day-old male neonate, was consulted to our clinic with the skin lesions of dark red to violaceous patches on both lower extremites and swelling on the right lower extremity. Histopathologically, a specimen from the dark violaceous skin of the right swollen extremity showed dilatation of capillaries of both dermis and subcutaneous fat. We present a case of Klippel-Trenaunay syndrome with the bilateral nevus flammeus of both lower extremities in a 3-day-old male neonate.

Two Cases of Recurrent Dermatofibrosarcoma Protuberans Treated by Mohs Micrographic Surgery / 대한피부과학회지

Dermatofibrosarcoma protuberans(DFSP) is an uncommon recurrent soft-tumor of skin and is locally highly invasive and aggressive, although it rarely metastasizes. When possible, of the many treatment modalities, the surgical excision is indicated primarily. There are three surgical modalities, which are excision with undefined or conservative surgical margins, excision with wide surgical margins and Mohs micrographic surgery(MMS). And the classical standard surgery was the local wide excision with at least 3cm margin around the primary tumor and through the deep fascia. However recent studies has showed that MMS decreased the recurrent rate of the tumor, conserving the normal uninvolved tissue, and MMS is accepted as the first choice treatment modality of DFSP. Some studies reported that the margin of 2.5cm is necessary to clear the tumor in MMS. We present two cases of recurrent DFSP treated by Mohs micrographic surgery, one through 4-staged resection, the other, 3-staged resection of the tumor.

A Case of Diffuse Plane Xanthoma Associated with Monoclonal Gammopathy of Unknown Significance and Normolipoproteinemia / 대한피부과학회지

Diffuse plane xanthoma is a group of plane xanthomas that appear as yellow-brown flat patches or slightly elevated plaques with a wide-spread distribution. Cutaneous xanthomas may occur either hyperlipoproteinemic or normolipoproteinemic states. Diffuse plane xanthoma with normolipoproteinemia is often associated with multiple myeloma, other reticulo-endothelial malignancies and monoclonal gammopathy of unknown significance(MGUS). We report a case of diffuse plane xanthoma associated with monoclonal gammopathy of unknown significance(MGUS) and normolipoproteinemia.