Four Cases of Primary Cutis Verticis Gyrata / 대한피부과학회지

No abstract available.

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 Warty Dyskeratoma of the Scalp / 대한피부과학회지

We report a case of warty dyskeratoma in a 59-year-old man. For 10 years, he had had an asymptomatic solitary 0.5x0.5 cm sized, erythematous, hard papule with a yellowish, central keratotic plug on the vertex. Histological findings showed a large cup-shaped, keratin-filled invagination of acanthotic epidermis, and a suprabasal cleft formation with corps ronds, grains and numerous villi at the lower portion of the invagination, the characteristic features of warty dyskeratoma.

A Clinical Study of Dermatoses of Korean Vietnam Veterans Exposed to Agent Orange / 대한피부과학회지

BACKGROUND: Scientific and epidemiologic studies have shown that several dermatoses of Vietnam veterans were caused by Agent Orange. Most of the previous studies on Vietnam veterans have been about the relationship between systemic diseases including limited dermatoses and Agent Orange, but there have been no clinical studies of dermatoses of Korean Vietnam veterans exposed to Agent Orange. OBJECTIVE: We conducted this study to find out the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange. METHODS: A total of 19, 262 Korean Vietnam veterans who received their first dermatological examination at Seoul Veterans Hospital between January 1997 and December 2003 were included in this study, which consisted of a skin examination and 15-item questionnaire. RESULTS: 1. The distribution of dermatoses groups were as follows: pruritus, psychocutaneous disorders, and neurocutaneous dermatoses (36.1%), dermatomycosis and deep mycosis (20.5%), eczema (11.6%), diseases of the skin appendages (3.6%), epidermal and adnexal nevi and tumors (2.1%), drug eruption, erythema, and urticaria (1.8%), and papulosquamous diseases (1.5%). 2. Pruritus (31.6%) was the most frequent dermatosis in all age groups. 3. The frequency of dermatoses related to exposure to Agent Orange were as follows: seborrheic dermatitis (4.8%), chronic urticaria (1.7%), psoriasis vulgaris (1.2%), xerotic eczema (0.5%), photosensitive dermatitis (0.2%), chloracne (0.1%), soft tissue sarcoma (0.1%), and malignant tumors (0.01%). 4. With regard to regional groups of dispatch in Vietnam, QuiNhon (20.1%) was the most frequent area of dispatch. There was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between Dian, where larger amounts of Agent Orange were sprayed, and the other regional groups. 5. For duration of dispatch in Vietnam, there was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between two groups of duration. CONCLUSION: This study showed the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange, and may be helpful as the fundamental epidemiologic data of dermatoses of Korean Vietnam veterans for dermatologists to examine.

A Case of Chondroid Syringoma with Follicular Differentiation / 대한피부과학회지

Chondroid syringoma, also known as `mixed tumor of the skin', is a kind of acquired hamartoma of folliculosebaceous-apocrine lineage. Histologically, it is characterized by the biphasic pattern, with epithelial structures enveloped by abundant stroma. We report a case of chondroid syringoma, as an asymptomatic nodule, on the upper lip of a 55-year-old male. Histologically, the tumor had both epithelial components with follicular differentiation and myxochondroid stroma.

A Case of Cutaneous Leiomyosarcoma / 대한피부과학회지

Cutaneous leiomyosarcoma is a rare soft-tissue tumor of smooth muscle derivation that accounts for 2%-3% of all soft tissue sarcomas. Cutaneous leiomyosarcomas can be subdivided into dermal and subcutaneous leiomyosarcomas. Because of the different prognosis, it is important to distinguish between dermal and subcutaneous forms. Immunohistochemical stains, such as vimentin, smooth muscle actin (SMA), desmin, CD68, CD34, and S-100, may aid in the recognition of smooth muscle derivation and in the differentiation from other malignant spindle cell tumors. We report a case of cutaneous leiomyosarcoma on the extensor surface of the left thigh in a 61-year-old man.

Immunohistochemical Expression of the alpha- and gamma-Catenin in the Fetal Skin Development / 대한피부과학회지

BACKGROUND: Catenins are the associated protein with E-cadherin in the formation of adhesion complexes in normal and tumor cells related with epithelial differentiation and development of organ formation as well as in the tumor spread. The present study was aimed to find the distribution of alpha- and gamma-catenins in fetal skin development. OBJECTIVE: The purpose of this study was to observe the distribution of above two adhesion related proteins in the fetal skin during development, and to find its relationship by expression and their distribution pattern. METHODS: Skin was obtained from the scalp, chest, and sole of 21 human fetuses, ranging from 13 to 37 weeks of gestational age. Immunohistochemical staining was performed by the avidin biotin peroxidase complex method on paraffin embedded tissue using the anti-human monoclonal antibody against the human alpha- and gamma-catenins. RESULTS: alpha- and gamma-catenins were expressed strongly in basal cells of the epidermis and germ cells of skin adnexa, such as hair and eccrine glands at 13th week, followed by decreased basal cell expression. Increase in the suprabasal epithelium and differentiated adnexal epithelium, such as outer root sheath cells and eccrine ducts and glands at 18th week, and adult pattern in 23th week of gestation. Both showed similar distribution pattern in skin though gamma-catenin appeared two or three weeks later. alpha- and gamma-catenins are expressed not only in the epithelium of the skin, but also in the mesenchymal cells such as endothelial cells and fibroblasts. Though both catenins are more strongly expressed in the membrane portion, cytoplasmic expression is also noted. CONCLUSION: Both alpha- and gamma-catenin showed basically the same expression distribution pattern in the fetal skin developmental stage, suggesting that both adhesion molecules are highly related to each other in function and development of epidermis and adnexae of the skin in fetal stage.

A Clinical Study of Skin Problems of The Amputee / 대한피부과학회지

BACKGROUND: There has been no clinical study of skin problems of the amputee in Korea and at Veterans Hospital, we have experienced so many skin problems of amputees. OBJECTIVE: We tried to observe skin problems of amputees and to relate them with sweating, poor hygiene, poor fit of socket, mechanical trauma, and duration of wearing prosthesis. METHODS: 125 extremity amputees who visited the Seoul Veterans Hospital during the period of 5 years from Jan. 1994 to Dec. 1998 were analyzed clinically. RESULTS: The study results are summarized as follows: 1. Among the 125 extremity amputees, the number of male patients was 124(99.2%) and that of female patients was 1(0.8%). The age distribution showed a peak incidence in the 7th decade(30.4%), followed by the 5th decade(28.8%), 6th decade(24.8%), and the mean age was 56.4 years. 2. The most common type of amputation was below the knee amputation(74 cases), the second was above the knee amputation(37 cases). 3. The duration of wearing prosthesis was above 20 years in 88 patients(70.4%), 16-20 years in 15(12%), 11-15 years in 11(8.8%), and 1-5 years in 6(4.8%). 4. The skin problems of the amputees were superficial fungal infection, chronic ulcer, intertriginous dermatitis, callus, corn, verrucous hyperplasia, verruca which were 63 cases(50.4%), 26 cases(20.80%), 17 cases(13.6%), 6 cases(4.8%), 5 cases(4%), 5 cases(4%), 3 cases(2.4%) respectively. 5. The predisposing factors of the dermatoses were mechanical trauma(84 cases) which acted as a cause of the chronic ulcer, intertriginous dermatitis, corn and callus, sweating(80 cases) and poor hygiene(11 cases) as those of superficial fungal infection, and poor fitting(6 cases) as that of verrucous hyperplasia. CONCLUSION: Superficial fungal infection and chronic ulcer were the main skin problems of the amputee. The longer the duration of wearing prosthesis, the more skin problems developed. The mechanical trauma and sweating were the major predisposing factors of stump dermatoses, especially of chronic ulcer and superficial fungal infection. Amputation is only the beginning of a long period of rehabilitation, and the treatment of the patient and the affected skin goes on for the rest of the patient's life. This clinical study suggests that the dermatologist must be concerned of the care of amputee's skin problems.

A Case of Trichoblastoma / 대한피부과학회지

Trichoblastoma is a benign cutaneous neoplasm that consists of follicular germinative cells. We report a case of trichoblastoma in a 58-year-old man. The tumor was presented as a solitary symmetrical shaped pedunculated 5.0x4.0x2.0cm sized multilobular tumor on right lower leg for 2 years. Histopathologic examination showed well circumscribed dermal tumor composed of multilobular tumor islands of palisaded basaloid epithelial cells. The tumoral lobules were concentrically surrounded by hyalinized collagen bundles with fibroblasts. The overall architecture was reminiscent of hair bulbs. Cytokeratin 14 stain showed positive reaction, but cytokeratin 10 stain showed negative reaction. The tumor was completely excised with clear margin. No sign of recurrence has been noted until 9 months later.

A Case of Adult-onset Urticaria Pigmentosa / 대한피부과학회지

Mastocytosis is a heterogenous group of disorders characterized by abnormal growth and accumulation of mast cells in one or more organ systems. Urticaria pigmentosa represents the most common form of cutaneous mastocytosis in children and adults. We report a case of adult-onset urticaria pigmentosa in a 53-year-old man. The patient had pruritic multiple scattered well-demarcated brownish macules and papules on whole body for 4 years. Histopathologic examination showed diffuse and perivascular infiltration of lymphocytes and cuboidal mast cells in the upper dermis. Any sign or symptom of systemic involvement was not detected.

A Case of Epithelioid Angiosarcoma of the Scalp / 대한피부과학회지

Angiosarcoma is a rare malignant tumor of endothelial cell origin. Histopathologically, varied differentiation may be observed even within the same tumor. Epithelioid angiosarcoma is one subset of poorly differentiated angiosarcoma which is a rare variant. We report a case of epithelioid angiosarcoma of the scalp in a 59-year-old man. The patient had a painful solitary, 2x3 cm sized, dome-shaped, firm, erythematous to purplish nodule with crust on the vertex of the scalp. Histopathologically, the tumor was chiefly composed of solid sheets of atypical epithelioid cells with prominent eosinophilic cytoplasm, a large vesicular nuclei, and occasional intracytoplasmic vacuoles. Well to moderately differentiated areas with irregular vascular channel-like structures lined by atypical hyperchromatic endothelial cells were also seen in the peripheral areas of the tumor. Immunohistochemically, the tumor cells were positive with CD31 which is sensitive marker of endothelial cell.

Immunohistochemical Expression of Placental Form of Glutathione S-transferase (GST-pi) in Fetal Skin / 대한피부과학회지

BACKGROUND: Glutathione S-transferases(GST) are a family of multi-functional enzymes involved in cellular detoxification and excretion of a variety of exogenous and endogenous toxic or carcinogenic compounds. The GST family has been divided into three classes, alpha, mu, and pi, based on substrate specificity and sequence homology. GST-pi is an acidic type and predominant in skin, small intestine, breast, lung and prostate. The overexpression of GST-pi associated with skin tumor and tumor-like lesion suggests that GST-pi is a major detoxifying enzyme in skin tumors. OBJECTIVE: The purpose of this study was to observe the expression and the distribution pattern of GST-pi in the human fetal skin. METHODS: Skin was obtained from the scalp, chest, and sole of 49 human fetuses, ranging from 8th to 40th weeks of gestational age. Immunohistochemical staining was performed using avidin biotin peroxidase complex method on paraffin embedded tissue using antirabbit polyclonal antibody against the human GST-pi. RESULTS: GST-pi was expressed in intermediated layer of epidermis at 8th week, and gradually increased in strength of expression stronger in suprabasal layer. In hair unit, GST-pi was expressed in sebaceous gland, bulge, hair matrix cell and outer root sheath cell from 15th week. In eccrine gland, also GST-pi was expressed in central differentiated cells of intradermal eccrine duct from 18th week, and in terminal duct and acini from 26th week of fetal age. CONCLUSION: GST-pi was expressed from the 8th week of gestation suggesting that GST-pi plays an important role in detoxification for the protection of the skin in fetal stage from the various toxic agent.

A Case of Desmoplastic Trichilemmoma / 대한피부과학회지

Desmoplastic trichilemmoma is a rare variant of trichilemmoma characterized by typical features of trichilemmoma with abundant desmoplastic stroma. We report herein a 54-year-old man presented with 2-year history of a solitary bean sized verrucous nodule on the occipital scalp. Histologically, the tumor showed a well-defined lobular growth extending from the epidermis into the dermis with abundant central desmoplastic stroma. Epithelial lobules at the margins of the neoplasm showed the typical features of trichilemmoma composed of glycogen-rich clear cells and peripheral palisading columnar cells. In contrast, at the center the cells assume a more random pattern of cords and strands traversed by the hyaline stroma, mimicking invasive carcinoma. It was diagnosed desmoplastic trichilemmoma by the distinctive histologic appearance and totally excised.

A Case of Chronic Actinic Dermatitis / 대한피부과학회지

Chronic actinic dermatitis was recently proposed as a syndrome including photosensitive eczema, photosensitivity dermatitis, actinic reticuloid, and persistent light reactivity. It is defined on the basis of 3 criteria, including clinically persistent eczematous eruption on sun-exposed skin, histologically consistent with chronic eczema, and photobiologically decreased MED to UVB. We report herein a 61-year-old man presented with 2-year history of erythematous to brownish lichenified papules and plaques on sun-exposed areas and shown decreased minimal erythema doses to both UVB and UVA. Biopsy specimen showed consistent with chronic eczema. He was treated with topical therapies of topical steroids and intralesional injection of triamcinolone, and oral anti-histamine, with avoidance of exposure to sun.

A Case of Alopecia Neoplastica Metastasis from Breast Carcinoma / 대한피부과학회지

Breast cancer is a common cancer in women and the most common primary tumor metastatic to the skin. Cutaneous metastasis from breast cancer occurs predominently through lymphatic dissemination. Alopecia neoplastica is rare and probably caused by the hematogenous spread of the internal carcinoma. It has diagnostic importance because it may be the first sign of an undiscovered internal malignancy. We report a case of a 40-year-old female who showed alopecia neoplastia secondary to an invasive intraductal carcinoma of the breast.

Occupational Dermatoses in Metalworking Fluid Exposed Workers . ( II ) Allergic Contact Dermatitis / 대한피부과학회지

BACKGROUND: Skin contact with metalworking fluid(MWF) remains a frequent cause of occupational dermatitis. However, no precise data is available about sensitization in metalworkers exposed to MWF in Korea. OBJECTIVES: The purpose of this study was to evaluate the prevalence of contact sensitivity among metalwokers who handle MWFs and to investigate the suitability of a screening test with MWFs being actually used in metalworkers. METHODS: An epidemiological study was performed using a'questionnaire in 771 workers in 9 derpartments of a motor company. 278 out of 771 workers had actual contact with MWF. Patch tests were performed in 73 metalworkers who had suspected dermatits in relation to exposure of MWF, which was selected via interviews and dermatologic examinations. Patch tests were included with a routine series of common components of MWF(materials obtained from Chemotechnique, Sweden), a solvent series and several dilutions of various crude MWFs(8 species) RESULTS: Contact sensitization was established in 14 metalworkers(5% of 278). Sensitising substances were biocide(6 cases), corrosion inhibitors(2 cases), emulsifiers(2 cases), biostatic substances(1 cses) and others(4 cases). Therefore 10 out of 14 metalworkers had true occupational allergic contact dermatitis. 10 out of 73 screening patch tests showed positive reactions to MWF elements, and 9 people who were positive to MWF elements showed positive reactions to crude MWF, but 1 person did not. CONCLUSION: The prevalence of occupational allergic contact dermatitis(3.5% of 278) was low. The screening patch test by crude MWFs actually used in metalworkers may give false negatives. Therefore for the purpose of diagnosis of allergic contact dermatitis, we need a process of patch tests with MWF elements.

A Case of Type IIa Hyperlipoproteinemia with Xanthoma Planum , Xanthoma Tendinosum and Xanthoma Tuberosum / 대한피부과학회지

We report a case of a 59 year-old female with hyperlipoproteinernia who had xanthoma tuberosum, xanthoma tendinosurn and xanthoma planum. Yellowish nodules appeared on the right elbow 26 years ago and the lesions gradually increased in size and spread to the elbow, hand, knee, foot and achilles tendon. Except for the skin lesion, she was normal on physical examination. The laboratory findings showed that the serum cholesterol, beta lipoprotein and total lipid were increased. The beta band was rnarkedly elevated on electrophoresis, which suggested type IIa hyperlipoproteinemia. Histopathological findings shc wed many aggregates of foam cells and foreign body giant cells were seen in the dermis.

A Study of Occupational Dermatoses in metal Workers / 대한피부과학회지

No abstract available.

A Case of Darier' s Disease Treated by the Combined Treatment with Oral Etretinate and Topical Tretinoin Cream / 대한피부과학회지

We report a case of Dariers disease which showed a more effective result using a combined treatment with oral etretinate and topical tretinoin cream than treatment with oral etretinate alone in a 17-year old male patient. Oral etretinate 40mg was given daily and topical therapy with tretinoin cream was applied to lesions of neck and face. Two weeks later, lesions of neck and face showed good improvement compared with the not applied lesions. Topical therapy was then extended to other lesions. Six weeks after treatment, there was a marked improvement. Three months after treatment, most of lesions were nearly gon.

A Case of Hidradenoma Papilliferum of the Nipple / 대한피부과학회지

We report a case of hidradenoma papilliferum of the left nipple in a 23-year-old female patient. Hidradenoma papilliferum occurs only in women, usually on the labia majora or in the perineal or perineal region and represents an adenoma with apocrine dif ferentiation. Histologic examination of the lesion revealed findings consistent with hidradenoma papilliferurn. She had been performed surgical excision