ABSTRACT
BACKGROUND: Beau's lines are transverse furrows of the nail plates that can be caused by various conditions. Because the clinical manifestations of Beau's lines tend to depend on its causes, the clinical manifestations may provide diagnostic clues of causative or underlying diseases. OBJECTIVE: This study is conducted to provide a better understanding of Beau's lines and to give dermatologists diagnostic clues from assessment of its morphological patterns. METHODS: In order to investigate the clinical characteristics and patterns of Beau's lines according to its clinical manifestations, a retrospective study was being performed. A total of 150 patients with Beau's lines who visited the nails clinic of our hospital from January 1, 2006, to September 30, 2010, were included. RESULTS: The group of patients with Beau's lines consisted of 78 males (52%) and 72 females (48%). The onset age ranged from 1 to 82 years old. The most frequently involved fingernail was the right thumb nail. In this study, causes of Beau's lines were grouped into eight categories: idiopathic, traumatic, nail/skin disease, systemic illness, bone marrow transplantation, chemotherapy, nail infection, and others. Idiopathic cause was observed the most frequently. The pattern of Beau's lines was symbolized in each patient and was depicted in a row according to order of frequency. The pattern of N2B2L1D1M2 (Numerous/Multiple/Incomplete/Deep/Broad) was observed overall as the most frequently. The most common pattern in the nail/skin diseases category was N2B1L1D1M2 (Numerous/Single/Incomplete/Deep/Broad). In the traumatic group, N1B2L1D1M2 (Confined/Multiple/Incomplete/Deep/Broad) was the most frequently observed pattern. CONCLUSION: This study explored the clinical manifestations of Beau's lines. In some categories of causes, the morphological patterns showed a tendency to converge. Thus, the morphological patterns can provide certain diagnostic information.
Subject(s)
Female , Humans , Male , Age of Onset , Bone Marrow Transplantation , Nails , Retrospective Studies , ThumbABSTRACT
Sarcoidosis is a systemic inflammatory disease of an unknown origin and it is characterized by the presence of noncaseating epitheloid cell granulomas in multiple organs. Herein we report on a case of cutaneous and pulmonary sarcoidosis that was associated with interferon alpha treatment for hepatitis C. A 39-year-old man, a former intravenous drug user, presented with several erythematous papules on both antecubital areas. The histopathologic finding of a skin biopsy showed noncaseating granuloma. The mediastinal and axillary lymph nodes were enlarged on chest X-ray and computed tomography. To the best of our knowledge, this is the first report of cutaneous and pulmonary sarcoidosis that was associated with interferon treatment in the Korean dermatologic literature.
Subject(s)
Adult , Humans , Biopsy , Cicatrix , Drainage , Drug Users , Granuloma , Hepatitis C , Interferon-alpha , Interferons , Lymph Nodes , Sarcoidosis , Sarcoidosis, Pulmonary , Skin , ThoraxABSTRACT
We evaluated the recent trend in the incidence of premalignant and malignant skin lesions between 1991 and 2006. Among 571,057 newly registered dermatology out-patients from our 8 affiliated university hospitals, 2,598 were diagnosed with a premalignant (899, 0.16%) or malignant skin lesions (1,699, 0.30%). Of 899 premalignant cases, 71.2% were actinic keratosis (AK), and 24.6% were Bowen's disease. Of 1,699 malignant cases, 46.2% were basal cell carcinoma, followed by squamous cell carcinoma (19.1%) and melanoma (7.1%). This 16-yr survey was divided equally into two time periods to compare the incidence of premalignant and malignant skin lesions at different time settings. Between 1991 and 1998, the incidence of cutaneous premalignancy was 0.10% which doubled during 1999-2006. For cutaneous malignancy, the incidence was 0.25% during 1991-1998 and 0.34% in 1999-2006. Incidence of AK among the new outpatients was 0.07% in 1991-1998 which staggered up to 0.15% in 1999-2006. These findings show an increase of both premalignant and malignant skin lesions, AK in particular in the dermatology outpatient-based incidence.
ABSTRACT
Retroncyhia shows ingrowth of the nail toward the proximal nail folds. Initial events start from minor trauma of the digital pulp that disturbs longitudinal nail growth. This disturbed growth of the nail changes the growth direction to the proximal nail folds, leading to persistent paronychia, formation of granulation tissue, and other nail changes. Simple avulsion is curative and can improve most symptoms. There are few reports about retronychia in the English literature, and we report 3 cases of retronychia here.
Subject(s)
Granulation Tissue , Nails , ParonychiaABSTRACT
Lymphomatoid papulosis (LyP) is a benign, self-healing, papular eruption that can wax and wane over time. Transformation to T-cell lymphoma has been well documented in 10% to 20% of adults with LyP. However, this transformation rarely occurs in patients younger than 20 years of age. Here, we present the first known pediatric patient in Korea, a 12-year-old boy who developed a subcutaneous nodule on the scrotum 13 months after papulonecrotic lesions of LyP were identified on both lower extremities and face. Histological and immunohistochemical examination of the subcutaneous nodule revealed anaplastic large cell lymphoma (ALCL). A T-cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in the two specimens, indicating that a common T-cell clone had proliferated over time in both the LyP and ALCL lesions.
Subject(s)
Adult , Child , Humans , Clone Cells , Genes, T-Cell Receptor , Korea , Lower Extremity , Lymphoma, Large-Cell, Anaplastic , Lymphoma, T-Cell , Lymphomatoid Papulosis , Scrotum , T-LymphocytesABSTRACT
Behcet's disease (BD) is a multisystemic inflammatory disease that affects various organs and it causes mucocutaneous lesions. BD is only rarely associated with leukemia or other hematologic disorders. Many cases of BD associated with myelodysplastic syndrome (MDS) have recently been reported and these cases are mainly in East Asia and the Mediterranean. We herein report on a case of a 34-year-old man who developed Behcet's disease 8 years after the onset of MDS. He had two, firm, subcutaneous nodules on both shin and recurrent oral ulcer for 2 months. He also had a retinal vasculitis. Skin biopsy from the left shin showed the septal panniculitis, which was consistent with erythema nodosum. He had multiple ileal ulcers observed on the colonoscopy exam, so he was diagnosed with intestinal Behcet's disease. Yet the chromosomal analysis revealed nonspecific abnormality and not trisomy 8. This is the first reported case of intestinal Behcet's disease associated with MDS in the Korean dermatologic literature.
Subject(s)
Adult , Humans , Biopsy , Chromosomes, Human, Pair 8 , Colonoscopy , Erythema Nodosum , Asia, Eastern , Leukemia , Myelodysplastic Syndromes , Oral Ulcer , Panniculitis , Retinal Vasculitis , Skin , Trisomy , UlcerABSTRACT
BACKGROUND: Ionotropic glutamate receptors of the N-methyl-D-aspartate receptor (NMDAR) type are expressed on keratinocytes and play a role in the proliferation, differentiation, and cornification of keratinocytes. However, the expression profile of NMDAR and its role in cutaneous malignancy is unclear. OBJECTIVE: We analyzed the expression of NMDAR-1 in cutaneous squamous cell carcinoma (SCC) and investigated the relationship between NMDAR-1 expression and clinicopathological parameters. METHODS: Thirty-two patients with biopsy-proven cutaneous SCC were enrolled in this study. Each patient was analyzed for tumor diameter, location, local recurrence, and metastasis by conducting a chart review. The SCC specimens were histologically divided into differentiated and undifferentiated groups based on Broders' system. NMDAR-1 expression was examined by performing immunohistochemistry, and the relative staining intensity in the SCCs was graded into 5 levels. According to the staining intensity of NMDAR-1, the specimens were categorized into two groups: the higher group and the lower group. RESULTS: Fifteen (88%) of 17 tumors in the higher group were differentiated SCC, whereas 14 (93%) of 15 tumors in the lower group were undifferentiated SCC. In addition, NMDAR-1 expression was inversely correlated with metastasis (p=0.049). Local recurrence was associated with a lower staining intensity, but the results were not statistically significant. CONCLUSION: Our results demonstrate that NMDAR-1 expression in cutaneous SCC is significantly correlated with its differentiation and metastasis. Therefore, it may be a prognostic indicator for cutaneous SCC.
Subject(s)
Humans , Carcinoma, Squamous Cell , Immunohistochemistry , Keratinocytes , N-Methylaspartate , Neoplasm Metastasis , Receptors, Ionotropic Glutamate , RecurrenceABSTRACT
We report here on a 63-year-old woman who had several small, yellowish papules on the scalp for the previous 2 years. There was no family history of similar lesions. Yellowish, creamy material was expressed from a papule during punch biopsy. Histologic examination from the lesion revealed the typical features of steatocystoma multiplex. We report here on this rare variant of steatocystoma multiplex that was limited to the scalp.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Scalp , Steatocystoma MultiplexABSTRACT
BACKGROUND: Spitz nevus and malignant melanoma have common features clinically and histologically, and in some cases it is impossible to distinguish between the two. Heat shock proteins (HSPs) serve to protect cells, and are activated by cell injury. Some HSPs are shown to be elevated in many types of cancers. Previous studies have reported the expression of heat shock protein in association with melanoma; however, a similar relationship with Spitz nevi has never been investigated. OBJECTIVE: This study was designed to measure the expression pattern of HSP 105 in both Spitz nevi and melanomas. METHODS: The specimens of 4 of Spitz nevi and 10 of malignant melanomas were analyzed for heat shock protein 105 expression through immunohistochemical staining. RESULTS: Immunohistochemical examination of HSP 105 showed strong expression in malignant melanoma specimens. On the other hand, weak expression was observed in Spitz nevus specimens. The degree of expression of HSP 105 showed a statistically significant difference (p<0.05). CONCLUSION: These findings provide the possibility of using HSP 105 as a effective marker for differentiating between Spitz nevi and malignant melanomas. In support of this, HSP 105 is considered to be a tumor-associated antigen of malignant melanoma.
Subject(s)
Hand , Heat-Shock Proteins , Melanoma , Nevus , Nevus, Epithelioid and Spindle CellABSTRACT
Sebaceous hyperplasia usually presents as solitary or multiple, small, yellowish papules on the face, particularly on the forehead. It occurs most commonly in middle-aged individuals and rarely in early adult life. It has also been reported in the vulva, penis, and areola. Histological examination reveals a single greatly enlarged sebaceous gland composed of numerous lobules grouped around a centrally located, wide sebaceous duct. We report a case of a 26-year-old man with sebaceous hyperplasia in the ventral surface of the distal penile shaft, an unusual site.
Subject(s)
Adult , Humans , Male , Forehead , Hyperplasia , Penis , Sebaceous Glands , VulvaABSTRACT
BACKGROUND: Washboard nail most commonly involves the thumbnail or great toenail. As its name implies, it resembles a washboard with a series of evenly spaced ridges across the nail. A central depression can be seen as well. This can develop as the result of repeated habitual trauma to the proximal nail fold by the other fingers or by biting the nailplate. Thus, it is also called habit tic deformity or traumatic nail dystrophy. Although it is known to be not uncommon, there have been no studies on this with a sufficient number of cases and long term follow up. OBJECTIVE: This study was conducted to provide a better understanding of washboard nail and to estimate the outcome of it. METHODS: We reviewed all the medical records and clinical photographs of 21 patients who had been diagnosed with washboard nail at our department between July 2000 and July 2009. RESULTS: The male to female ratio was 1:1.3. The patients' ages varied from 6 to 68 years, with an average of 25.4 years. The mean duration at the first visit was 4.4 years. The most common involved site was both thumbnails. Predisposing factors were found in 42.9% of the patients, which included nail picking or onychophagia. The treatment options were primarily intralesional triamcinolone injection and topical steroid. If the patient had the habitual tic, we educated them to restrain it. The follow up periods varied from 1 to 32 months with a mean of 7.9 months. Among the 14 patients with adequate follow up, 50% of these patients showed clinical improvement. CONCLUSION: This study demonstrated the clinical features of washboard nail. Physicians should closely observe the nail changes and long-term follow up is needed to determine the therapeutic response of patients with washboard nail.
Subject(s)
Female , Humans , Male , Bites and Stings , Congenital Abnormalities , Depression , Fingers , Follow-Up Studies , Medical Records , Nail Biting , Nails , Tics , TriamcinoloneABSTRACT
White superficial onychomycosis (WSO) is defined as fungal infection of the nail plate from dorsal surface of the nail plate. In English literatures, prevalence of WSO in the general population is about 1% to 2%, and the most common causative organism of WSO in adults is Trichophyton mentagrophytes except AIDS patients. On the other hand, the prevalence in children is 0.3%. A 6-year-old boy presented with whitish patches on his ten toe nails which had developed 4 years previously. He had cerebral palsy with spastic tetraplegia and epilepsy, and had admitted eight times for systemic infections, such as pneumonia and pharyngitis. Trichophyton rubrum was revealed as a causative organism by slide culture and PCR test. The nails showed improvement after two months of topical treatment with amorolfine nail lacquer. Herein we report a case of childhood multiple WSO caused by Trichophyton rubrum.
Subject(s)
Adult , Child , Humans , Cerebral Palsy , Epilepsy , White People , Hand , Lacquer , Morpholines , Nails , Onychomycosis , Pharyngitis , Pneumonia , Polymerase Chain Reaction , Prevalence , Quadriplegia , Toes , TrichophytonABSTRACT
We present a case of Norwegian scabies in a 79-year-old male with chronic obstructive pulmonary disease, which resulted in a ward outbreak of classical scabies. A total of 23 people including nurses, nursing students, physicians, other patients in the same ward and their families were diagnosed with the infestation. Skin scales from the patient revealed numerous scabies mites (21.3/mg) at various stages from egg to adult. The patient had previously suffered from neurodermatitis and xerotic eczema for 5 years. Long-term systemic steroid therapy was considered as a possible cause of Norwegian scabies in this patient. Control of the infestation was achieved by implementing an immediate surveillance system, strict isolation and administration of scabicidal medication.
Subject(s)
Adult , Aged , Humans , Male , Eczema , Mites , Neurodermatitis , Ovum , Pulmonary Disease, Chronic Obstructive , Scabies , Skin , Students, Nursing , Weights and MeasuresABSTRACT
Acrosyringeal lichen planus is a rare variant of lichen planus, and is characterized by dermal lymphocytic infiltration juxtaposition to the acrosyringium, plus liquefaction degeneration of the acrosyringeal basal cell layer. We report a case of acrosyringeal lichen planus in a 37-year-old man who had multiple erythematous hyperkeratotic papules on his hands and feet.