Histopathologic, Immunohistochemical, and Electron Microscopic Findings of Pigmented Skin Lesions Immediately after Q-switched Alexandrite Laser Treatment / 대한피부과학회지

BACKGROUND: There have been only a few electron microscopic studies after laser treatment of pigmented skin lesions. OBJECTIVE: The purpose was to investigate the pathologic, immunohistochemical, and electron microscopic changes following Q-switched alexandrite laser treatment of pigmented skin lesions. METHODS: Three patients with acquired bilateral nevus of Ota-like macules, and 2 patients with cafeau lait macule were irradiated with Q-switched alexandrite laser. Forty biopsies were taken before and immediately after laser treatment. Hematoxylin-eosin, Fontana-Masson, and gp100 staining were performed for the evaluation of the histopathologic and immunohistochemical findings of the specimens. Electron microscopic findings were also evaluated. RESULTS: Histopathologically, suprabasilar separations were observed immediately after laser treatment. Vacuolar alterations of pigment-containing cells were frequently found in the epidermis and/or in the dermis. Fontana-Masson and gp100 staining positivity changed to negative or decreased in the epidermis immediately after laser treatment, while they changed to negative in the dermis. Ultrastructurally, epidermal pigment-containing cells frequently showed severe vacuolar changes in the cytoplasm, pyknotic nuclei, and vacuolated and/or fragmented melanosomes immediately after laser treatment. Dermal melanocytes frequently revealed vacuolated and/or fragmented melanosomes immediately after laser treatment. CONCLUSION: Histopathologic, immunohistochemical, and electron microscopic examination of pigmented skin lesions immediately after Q-switched alexandrite laser treatment demonstrated vacuolated or fragmented melanosomes and vacuolar alteration of pigment-containing cells in the epidermis and/or in the dermis, which suggested selective photothermolysis of melanosomes.

Postoperative Deposition of Calcium on the Surface of a Hydrophilic Acrylic IOL in Diabetic Patients

PURPOSE: Through a study of 3 diabetic patients who experienced decreased visual acuity due to deposit on the surface of hydrophilic acrylic IOLs which were inserted after cataract extraction, the authors attempted to examine pathological and histochemical characteristics of such undesirable deposit on the IOL surface and also evaluate whether a correlation exists between that and diabetes mellitus. METHODS: A 42 year old male patient with bilateral proliferative diabetic retinopathy who has had diabetes for 10 years, a 43 year old male with identical clinical history, and a 46 year old male with bilateral proliferative diabetic retinopathy and clinically significant macular edema who has had diabetes for 13 years were selected for the study. Cataract was extracted by phacoemulsification and after hydrophilic acrylic IOL was inserted into the bag, deposit appeared on IOL surface which caused decreased visual acuity. IOL exchange was conducted thereafter, and by studying the pathological and histochemical characteristics of deposit found on the surface of the retrieved IOL, and by examining the deposit's fine details with electron microscope, the authors attempted to identify the causative material and also evaluate whether diabetes plays a significant role in giving rise to such undesirable deposit. RESULTS: All three IOL that have been retrieved from the patients were covered with multiple deposits which took on a structure with fine circular granules, and all these deposits tested positive when 1% alizarin red staining and von Kossa staining (designed to identify calcium in a given material) were conducted. Electron microscopic study of the deposit also showed needlelike calcium crystals.

A Case of allergic angitis and granulomatosis with manifestation of pleuritis and pericarditis / 천식및알레르기

Allergic angitis and granulomatosis is a kind of rare systemic vasculitis, with various manifestations of disease of lung, heart, skin, musculoskeletal system, nervous system and hepatobiliary tract. There was no report of a case with manifestation of pleuritis and pericarditis, while several cases had been reported in Korea. So we here report a case of allergic angitis and granulomatosis with manifestations of pleuritis and pericarditis. The case also showed clinical manifestations of hypereosinophilia, asthma, rhinitis, pulmonary infilterates with eosinophilia and nephritis. Open lung biopsy showed arteritis with heavy infilteration of activated eosinophil in lung, pleura and pericardium. The involvement of heart might cause critical complication leading death. The patients who are supposed as allergic angitis and granulomatosis should be examined for the involvement of heart.