Localized Sweet's Syndrome in an Irradiated Field

Sweet's syndrome is a reactive dermatosis characterized clinically by fever, leukocytosis, and multiple, erythematous, painful plaques. Histopathologic examination reveals a band-like dense dermal inflammatory infiltrate composed mainly of neutrophils with papillary dermal edema, and no features of vasculitis. We report a case of a 56-year-old female diagnosed with cervical cancer, who underwent surgery and concurrent chemoradiation therapy. Approximately 3 years after completing treatment, she presented with erythematous plaques, principally within the radiation field; the skin biopsy showed features consistent with Sweet's syndrome.

A Case of Acantholytic Squamous Cell Carcinoma

Acantholytic squamous cell carcinoma is a well-defined variant of squamous cell cancer in which significant portions of the neoplastic proliferation show a pseudoglandular or tubular microscopic pattern. It usually presents as a nodule with various colors, and it is accompanied by scaling, crusting, and ulceration on the sun-exposed areas of older aged individuals. Histologically, the tumor consists of a nodular, epidermal-derived proliferation that forms island-like structures. At least focally or sometimes extensively, the tumor cells shows a loss of cohesion within the central gland-like or tubular spaces. This tumor resembles the structure of eccrine neoplasms, but it is negative for dPAS, CEA and mucicarmine and it is only positive for EMA and cytokeratins. Herein we report a case of acantholytic squamous cell carcinoma that occurred on the face of an 82-year-old woman.

Generalized Lichen Nitidus Successfully Treated with Narrow-band UVB Phototherapy: Two Cases Report

Lichen nitidus (LN) is an uncommon chronic inflammatory skin disease composed of numerous, tiny, shiny, flesh-colored papules that are predominantly observed on the chest, abdomen, glans penis and upper extremities. The distribution of LN is most often localized, but in some cases it can become generalized. Because LN tends to be asymptomatic and presents spontaneous resolution within several years, it usually does not require treatment except in symptomatic, persistent and generalized cases. We describe a 28-yr-old man and a 7-yr-old boy with generalized LN where both cases improved with narrow-band ultraviolet B (NB-UVB) phototherapy plus topical steroid ointment. Both patients noted improvement within the first three treatments and showed almost complete resolution after 18 and 20 treatments, respectively. NB-UVB phototherapy may be an effective alternative therapy for the treatment of generalized LN, even for those patients in their childhood.

Papular Elastorrhexis

Papular elastorrhexis (PE) is a rare connective tissue disease, histopathologically characterized as decreased and fragmented elastic fibers in the reticular dermis, with or without change to the collagen bundles. It presents as small, white, nonfollicular papules predominantly scattered over the chest, shoulders, or back, and is most often seen in females of the second decade. Although all reported cases of PE have been asymptomatic, a 21-year-old woman presented with a one-year history of multiple, small skin-colored papules on the back which were associated with an intermittent itching sensation. Histopathologic examination revealed fragmented elastic fibers with focal homogenization of collagen in the reticular dermis. Therefore, we report a rare case of papular elastorrhexis with "pruritus".

Beta-catenin, Frizzled-2, BMP-4, Osteopontin, Osteocalcin, and Osteonectin Expression in Calcifying Basal Cell Carcinoma / 대한피부과학회지

BACKGROUND: Although basal cell carcinoma (BCC) is the most common human skin tumor, with calcification reportedly taking place in about 20% of all BCC cases, the pathogenesis of calcification in BCC has not yet been studied. OBJECTIVE: The purpose of this study was to evaluate factors related to the pathogenesis of calcification in BCC. METHODS: We performed immunohistochemical staining for beta-catenin, frizzled-2, BMP-4, osteopontin, osteocalcin, and osteonectin using frozen skin tissue from 15 cases of BCC with calcification and 11 cases of BCC without calcification. RESULTS: The expression of beta-catenin showed positive in 14 of the 15 cases in BCC with calcification, but negative in all 11 cases of BCC without calcification. The expression of frizzled-2 was observed in 14 of the 15 cases in BCC with calcification, and in 10 of the 11 cases in BCC without calcification. The difference did not reach statistical significance (p=0.236). The expression of BMP-4 was observed in all 26 samples of BCC, but the intensity of expression did not reach statistical significance between the two groups (p=0.293). Furthermore, osteopontin and osteocalcin showed no statistical significance between two the groups (p=0.567, p=0.401). The expression of osteonectin was observed in all of the BCC cases, and was stronger in BCC with calcification than in BCC without calcification (p=0.042). CONCLUSION: We suggest that the calcification in BCC might be related to the increase of beta-catenin expression and that osteonectin might also influence the process of calcification in BCC.

A Case of Hidradenoma Papilliferum with Transepidermal Elimination / 대한피부과학회지

Transepidermal elimination is a process by which the skin eradicates undesirable or irritative dermal substances through intact epidermis or follicular epithelium by passive or active means. Although transepidermal elimination is being described in an increasing number and range of pathological processes, transepidermal elimination of hidradenoma papilliferum remains unrecorded to date in the Korean literature. We report a new case of hidradenoma papilliferum with transepidermal elimination. A 32-year-old woman presented with a bean-sized, protruding flesh red-colored nodule on the left labia major. The histologic finding of the lesion indicated a tubular and cystic structure microscopically expelled through the transepidermal canal.