The Study on The Nature of Fibrous Materials Extracted from Follicular Skin Lesions / 대한피부과학회지

BACKGROUND: Comedo extractor is in general used for the management or diagnosis of the follicular cutaneous disorders such as acne and folliculitis. During observing such extracted materials, we happened to discover the extraordinary thread-like fibrous materials. OBJECTIVE: We tried to clarify the nature of these fibrous materials. METHODS: The extracted materials from 20 patients with follicular cutanous disorders including 10 acne vulgaris and 10 pityrosporum folliculitis and 10 normal persons were investigated by pKOH, Masson trichrome for collagen fiber, Gomori's reticulum for reticulum fiber, acid orcein for elastic fiber, periodic acid-Schiff for fungal element and alcian blue for mucin. And we performed above mentioned special stainings in two biopsy specimens. RESULTS: Most of the extracted fibrous materials were reticulum fibers(95%) and some of them were elastic fibers(35%). And we observed the reticulum fibers and elastic fibers taken off from the pilosebaceous follicle on the histopathologic study. CONCLUSION: The fibrous materials extracted from follicular lesions were reticulum fibers or elastic fibers. And the observed presence of elastic fibers and reticulum fibers might result from tissue necrosis produced by leukocytes during the inflammatory phase of pilosebaceous follicles.

A Histopathologic Study of Pilosebaceous Changes in Psoriatic Lesion of the Scalp / 대한피부과학회지

BACKGROUND: Although there have been many studies on psoriasis, only a few studies have been conducted on pilosebaceous changes and even those results are controversial. While a few studies have been conducted on the morphological changes of the pilosebaceous unit in scalp psoriasis, comparative studies on the morphometric changes of pilosebaceous structures with a normal control group have not been conducted. OBJECTIVE: The purpose of this study is to elucidate the morphological change of the pilosebaecous unit in scalp psoriasis. METHODS: We conducted a comparative study an the morphometric changes of the pilosebaceous structure in 10 cases of scalp psoriasis with a normal control group. Results : The results of this study are summarized as follows : 1. Total hair counts, telogen hair counts, telogen hair counts, and the sizes of hairs and follicles in the lesional scalp showed no statistically significant increase than in the normal control. 2. The intrafollicular hyperkeratosis in infundibulum and sebaceous atrophy were more proininet in the lesional area than in the normal control area. These findings were also significantly prominent in the uninvolved normal-appearing area than in the normal control area. 3. Perifollicular inflammation, squamous metaplasia of the sebaceous gland and telangiectasia in the lesional and uninvolved areas were prominent, and these findings were not found in the normal control areas. Conclusion : The sebaceous atrophy and squamous metaplasia are very important findings of morphologic changes in psoriasis, and this paradoxical change may be an important clue to clarify the pathogenesis of psoriasis.

A Clinicopathological Study of the Pedunculated Lipofibromas: A comparison with Nevus Lipomatosus Cutaneous Superficialis / 대한피부과학회지

No abstract available.

A Clinicopathological Study of the Multiple Trichoepitheliomas / 대한피부과학회지

BACKGROUND: The diagnostic dilemma in differentiation between multiple and solitary trichoepitheliomas from basal cell carcinoma(BCC) is well documented. Some authors reported that up to 35% of trichoepitheliomas were misdiagnosed initially as BCC, especially the keratinizing variant. OBJECTIVE: The purpose of this study was to review the clinicopathological characteristics of the multiple trichoepitheliomas and to suggest specific findings and useful special staining methods for differentiating from BCC. METHODS: We reviewed 14 cases of multiple trichoepitheliomas from a clinicopathological aspect. We performed H&E, periodic acid Schiff, Giemsa, Fite, and alcian blue staining using the formalin-fixed paraffin-embedded samples of multiple trichoepitheliomas. RESULTS: The average age at onset was 24.7 and 78.6% of the cases showed autosomal dominant inheritance patterns. The sites of frequent involvement were the nasolabial folds and nose, and the average size of the lesions was 4.3 x 4.3 mm. The most important histopathological finding in differentiation was papillary mesenchymal tissue, and this was well observed with the Giemsa stain. Several other findings were also useful in differentiation, such as stellate structures in cystic walls, parakeratosis and eosinophilic necrotic bodies in the cystic walls, primitive hair follicles, epidermal connections, and mast cell infiltration. CONCLUSION: Several staining methods, such as the Giemsa, periodic acid Schiff, Fite, and alcian blue stains, were useful in differentiating the trichoepitheliomas from BCCs.

A Case of pseudoglucagonoma Syndrome Treated with Medium-chain Triglyceride / 대한피부과학회지

Necrolytic migratory erythema is a rare, distinctive, necrotizing cutaneous eruption usually associated with glucagonoma, an alpha-cell tumor of the pancreas. Other clinical features include ane- mia, diabetes mellitus and weight loss. However, it also occurrs without the pancreatic glucagonoma. So this rare condition is called pseudoglucagonoma syndrome, and has been described in association with chronic hepatic diseases, malabsorption with villous atrophy, chronic pancreatitis, celiac sprue, hypoproteinemia and odontogenic infection. We report a case of pseudoglucagonoma syndrome induced by malnutrition without glucagonoma. A 28-year-old Korean female was referred to our department complaining of multiple erythematous, desquamative, crusted and erosive patches on the extremities, and diffuse scalp alopecia for 5 years. She also had perianal erosion, angular cheilitis without glossitis, amenorrhea, axillary and pubic hair loss, and weight loss. Six years previously she had had Whipples operation for a pancreatic solid and papillary neoplasm. The laboratory data showed hypoalbuminemia, essential fatty acid deficiency, diabetes mellitus and slightly high levels of zinc and glucagon. A skin biopsy showed irregular acanthosis, epidermal edema and pallor, dyskeratosis, areas of superficial epidermal necrosis and vascular dilatation of the papillary dermis. The patient improved dramatically after intravenous hyperalimentation and oral intake of mediurn chain triglyceride. For 2.5 years she has taken medium-chain triglycerides without any other treatment, and no side effects on recurrence has been observed.

A Clinical Study of the Osteo-arthropathy in Palmoplantar Pustulosis / 대한피부과학회지

BACKGROUND: Palmoplantar pustulosis(PPP) is often associated with osteo-arthropathy, especially sternocostoclavicular hyperostosis(SCCH). The relation between PPP and SCCH or other types of seronegative arthropathy remains unclear. OBJECTIVE: The purpose of this study was to investigate the distribution and the frequency of osteo-arthropathy in patients with PPP. METHODS: Twenty fiv patients with PPP were included in this study, and checked for clinical symptoms and signs, labiratory findings, and radiologic findings including plain X-ray, 99mTc-MDP bone scan, and computed tomography. RESULTS: The incidenc of osteo-arthropathy in PPP was 64%. The prevalent age at onset of osteo arthropathy was the forth decade in males, and the sixth decade in females. The frequent, sites of osteo arthralgia were sternocostoclavicular areas, spines, shoulders, knees, and sacroiliac joints, and the frequent sites of increased radioisotope uptake were similar to t,he distribution of sites of osteoarthropathy. 99mTc-MDP bone scan was more sensitive in detecting osteo-arthropathy than plain X ray and commputed tomography. In laboratory findings, we observed an increase in the erythrocyte sedimentation rate, leukocyte counts, alkaine phosphatase, and the positivity of C-reactive pr otein. CONCLUSIONS: The frequent involvement of the anterior chest, wall, knees, spines, and sacroiliac joints was noted in patients with PPP. 99mTc MDP bone scan may be the most helpful in making a diagnosis of osteo-arthropathy accompanied with PPP.

A Case of Pedunculated Pigmented Eccrine Poroma Combined with Congenital Melanocytic Nevus on the Scalp / 대한피부과학회지

It has been generally assum d that eccrine poroma arises from acrosyringium, the epidermal sweat duct unit. Eccrine poroma mainly involves the non hairy surfaces of the skin, but it has also been found on hair-bearing areas. One of the characteristics of this structure is absence of melanocytes and melanin granules arnong its cells. However a complete absence of melanocytes and melanin granules in eccrine poroma is not invariable and a few reports of such an occurrence have been presented. The authors report herein a case of unusual and rare eccrine poroma. The eccrine poroma had melanin pigment and melanocytes, was pedunculated and occurred on the parietal scalp which was the unusual site of involvement. The eccrine poroma was also combined with a pedunculated congenital melanocytic nevus on the supraauricular scalp.

The Incidence and Culture of Erythrasma in Korea / 대한피부과학회지

BACKGROUND: The authors did not find any study about erythrasma in Korea, where as there are several studies about the incidence and bacteriology of erythrasma in some areas. Failure to differentially diagnose the clinical entities of tinea pedis versus erythrasma can lead to mistreatment and disability because of the clinical similarities. OBJECTIVE: This study was carried out to investigate the incidence of erythrasma according to the seasons and sites, to determine the useful culture media, and to evaluate the antibiotic sensitivities and the treatment responses. METHODS: The incidence of erythrasma was investigated among the unselected dermatologic patients. The axillae, groins and toewebs were examined under Wood's light. The scale showing characteristic coral-red fborescence was Gram-stained and Corynebacterium minutissimnm was cultured using Loeffler slant media, Brucella blood agar plates and usual blood agar plates. RESULTS: Clinical erythrasma was found in 26.7% of the 240 patients examined. The incidences of erythrasma in summer and fall were higher than winter In the bacteriologic study Gram positive cocco-bacilli were found in all erythrasma patients and Corynebacterium minutissimum was cultured and identified in 24 0%. Most of cultured causative organisms were sensitive to usual antibiotics in the clinical uses. The average interval from the oral administration of erythrasma to the loss of coral-red fluorescence was 4.1 weeks, and the patients in severe erythrasma group were needed more time(2.2 weeks) for clinical improvement than the patients in mild one. CONCLUSION: Erythrasma is common in the dermatologic patients and it is important to differentially cliagnose the clinical entities of tinea pedis versus erythrasma.

A Clinical Study of 30 Cases of Pityriasis Rubra Pilaris / 대한피부과학회지

BACKGROUND: Pityriasis rubra pilaris (PRP) is a rare disease characterized by widespread follicular acuminate papules. Traditionally, two forms have been described : hereditary (juvenile) and acquired (generally aduIrt). A.substantial contribution, however, suggests that further subdivision is appropriate. OBJECTIVE: The purpose of this study was to investigate clinicopathologic features of PRP and to compare the results of clinical classification with Griffiths' classification. METHODS: The retrospective clinicopathologic study carried out in 30 cases of PRP over the last 30 years. RESULTS: 1. The incidence of type lV was 38.5%. For both type I and III it was 30.8%. The onset ages of the type I, III, and lV were 36.1, 6.0, and 96 years respectively. 2. The most common site of initial involvement was the palms, and the most common involvement site during the diease course was the dorsa of palms and feet. The incidence involved in the whole body was 46.6%. 3. The incidences of insidious and acute onset were 60% and 40% respectively. No case had the family history of PRP. 4. In the histopathologic study, diffuse hyperkeratosis, acanthosis, and mild dermal infiltrations were found in all cases. Follicular pluggings were observed in 93.3% of cases CONCLUSION: We investigated the clinical classifications and clinicopathologic features of PRP. We think that more studies such as prognosis and treatment of PRP should be achieved in the near future.

A Study of Serum Lipids and Lipoproteins in Patients with Psoriasis / 대한피부과학회지

BACKGROUND: Previous studies have demonstrated that patients with psoriasis may have an increased risk of contacting a variety of noncutaneous diseases, including arterial and venous occlusive diseases. Changes in plasma lipid and lipoprotein composition in patients with psoriasis may be the reason for the increased risk of atherosclerosis in these patients. OBJECTIVE: This study was carried out to investigate the differences of serurn lipid, lipoprotein and apolipoprotein levels between the psoriasis patients and control groups and to suggest which are related with atherogenic risk in the psoriasis. METHODS: Serum lipid, lipoprotein and apolipoprotein levels were measured in 100 patient with psoriasis and in 30 healthy people. RESULTS: In the serum lipids study total cholesterol, TG, LDL-C and VLDL-C levels were lower and HDL-C level was higher in the psoriasis group than in the control group. Statistical significant differences were noticed in total cholesterol levels between the female psoriasis patients and the female control groups. In the serum lipoproteins study apolipoprotein B and lipoprotein (a) levels were higher and apolipoprotein A I level was lower in the psoriasis group than in the control group, and statistical significant differences of apolipoprotein B and lipoprotein (a) levels were noticed in the atherogenic risk group and severe psoriasis group compared with the control group. CONCLUSION: These findings suggest that the atherogenic risk in psoriasis is related with the high level of apolipoproteins especially apolipoprotein B, and is not related with serum lipid.