ABSTRACT
No abstract available.
Subject(s)
B-Lymphocytes , Lymphoma, B-Cell , Waldenstrom MacroglobulinemiaABSTRACT
BACKGROUND: Cholinergic urticaria is a type of physical urticaria characterized by heat-associated wheals. Several reports are available about cholinergic urticaria; however, the clinical manifestations and pathogenesis are incompletely understood. OBJECTIVE: The purpose of this study was to investigate the clinical characteristics of cholinergic urticaria in Korea. METHODS: We performed a retrospective study of 92 patients with cholinergic urticaria who were contacted by phone and whose diagnoses were confirmed by the exercise provocation test among those who had visited The Catholic University of Korea, Catholic Medical Center from January 2001 to November 2010. RESULTS: All 92 patients were male, and their average age was 27.8 years (range, 17~51 years). Most of the patients had onset of the disease in their 20s and 30s. Non-follicular wheals were located on the trunk and upper extremities of many patients, and the symptoms were aggravated by exercise. Eight patients showed general urticaria symptoms and 15 had accompanying atopic disease. Forty-three patients complained of seasonal aggravation. Most patients were treated with first and second-generation antihistamines. CONCLUSION: Dermatologists should consider these characteristics in patients with cholinergic urticaria. Further investigation and follow-up studies are necessary to better understand the epidemiological and clinical findings of cholinergic urticaria.
Subject(s)
Humans , Male , Diagnosis , Epidemiology , Histamine Antagonists , Korea , Phenotype , Retrospective Studies , Seasons , Upper Extremity , UrticariaABSTRACT
A fixed drug eruption (FDE) is a cutaneous reaction caused by various drugs. Mesna is used to decrease urotoxic side effect of cyclophosphamide and there have been no previously reported cases in Korea for any adverse reactions to this drug. Herein, we report a case of a FDE caused by mesna. A 34-year-old woman presented with asymptomatic, brownish macules and patches on the face and back for the past 4 months. She had been treated for SLE with monthly pulses of intravenous cyclophosphamide and mesna for 6 months. She had experienced similar episodes after injection of mesna. The skin biopsy specimen taken from her showed vacuolar degeneration of the basal cell layer and perivascular lymphohistiocyte infiltration in the papillary dermis. We performed prick test, scratch patch test, and intradermal test with mesna and confirmed that a FDE was caused by this drug.
Subject(s)
Adult , Female , Humans , Biopsy , Cyclophosphamide , Dermis , Drug Eruptions , Intradermal Tests , Korea , Mesna , Patch Tests , SkinABSTRACT
Trichilemmal cyst is a common, benign, cutaneous tumor, which originates from the external root sheath. It usually occurs on the scalp of middle-aged women. It is rarely found on the face, neck, trunk and extremities. A 33-year-old male presented with a tender, skin-colored, hyperkeratotic, subcutaneous nodule on the right sole for 6 months, without any history of trauma. We clinically diagnosed this skin lesion as a callus. The histopathologic examination showed a well demarcated cystic mass that is lined by a stratified squamous epithelium, without granular layers, and is filled with eosinophilic, amorphous, and homogeneous keratins. The patient was diagnosed with a trichilemmal cyst. Herein, we report a case of trichilemmal cyst of unusual predilection site.
Subject(s)
Adult , Female , Humans , Male , Bony Callus , Eosinophils , Epithelium , Extremities , Keratins , Neck , Scalp , SkinABSTRACT
Actinic keratosis (AK) is a common, sun-induced, pre-malignant lesion with a strong likelihood of progressing to a malignancy. The reported risk of AK progressing to squamous cell carcinoma (SCC) varies from less than 1% to 20%. Clinically, induration, pain, large size, marked hyperkeratosis, ulceration, bleeding, rapid growth, and recurrence or persistence may be markers of AK progression into SCC. The risk of SCC metastasizing ranges between 0.5% and 3%. However, SCC of the lip arising from actinic cheilitis is more prone to metastasis than cutaneous SCC, with rates of the former varying between 3% and 20%. Here we report a typical case of SCC from actinic cheilitis with metastasis to the lymph nodes during a 4-year follow-up period. To exclude SCC, we emphasize the need for regular follow-up and prompt evaluation, including careful pathologic examination for actinic cheilitis.
Subject(s)
Actins , Carcinoma, Squamous Cell , Cheilitis , Follow-Up Studies , Hemorrhage , Keratosis, Actinic , Lip , Lymph Nodes , Neoplasm Metastasis , Recurrence , UlcerABSTRACT
BACKGROUND: Apoptosis protease activating factor-1 (Apaf-1), caspase-9, Bcl-2, p53, and survivin are important factors in the pathway of apoptosis, but their clinicopathologic significance remains unclear in human cutaneous melanoma. We investigated the expression of these proteins and their clinical value in human cutaneous melanocytic lesions. METHODS: We performed an immunohistochemical analysis to examine the expression and distribution of Apaf-1, caspase-9, Bcl-2, p53, and survivin in 36 cases of malignant melanoma (22 cases of primary melanoma and 14 cases of metastatic melanoma) and 41 cases of melanocytic nevus. RESULTS: The expression of p53 was significantly higher in malignant melanoma than in melanocytic nevus (p<0.01), however the expressions of Apaf-1 and caspase-9 were significantly lower in malignant melanoma compared with melanocytic nevus (p<0.01 and p=0.027, respectively). Also, there was a significant difference for Bcl-2 staining between primary melanomas and metastatic lesions (p=0.004). Nuclear staining for survivin were absent in nevus, but were positive in 14 of 36 melanomas (p<0.01). CONCLUSIONS: The altered expression of Apaf-1, caspase-9, p53, and survivin are considered to be related to malignant progression in human cutaneous melanocytic lesions. Loss of Bcl-2 can be considered as a prognostic marker of malignant melanomas.
Subject(s)
Humans , Apoptosis , Caspase 9 , Melanoma , Nevus , Nevus, Pigmented , ProteinsABSTRACT
Glomus tumor is composed of a benign neoplasm arising from the glomus body, which participates in thermal regulation. It usually presents as a circumscribed or solitary tumor characterized by paroxysmal pain. They are generally located in the distal extremities, and are most frequently present in the palms, soles, or nail beds. The author herein reports a case in which a glomus tumor was discovered in the nose. A glomus tumorin the nose is rare. In this case, a 66-year-old woman had a solitary, tender, bluish subcutaneous nodule with superficial telangiectasia on her nose for 20 years.
Subject(s)
Aged , Female , Humans , Extremities , Glomus Tumor , Nails , Nose , TelangiectasisABSTRACT
Seborrheic keratoses are the most common benign epidermal tumor of the skin and a frequent focus of patient concern because of their variable appearance. Seborrheic keratoses may arise on any non-mucosal surface, including the face, scalp, and trunk. However, it rarely occurs on the ear, especially on the scapha. We report a case of a 42 year-old female patient presenting with 1 cm, brownish pedunculated nodule of seborrheic keratosis on the scapha.
Subject(s)
Female , Humans , Ear , Ear Auricle , Keratosis, Seborrheic , Scalp , SkinABSTRACT
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
BACKGROUND: There is currently an increasing demand in the field of dermatology for surgical therapy for treating skin cancers, including premalignant and malignant lesions. The rhombic (often referred to as rhomboid) flap is a transposition flap that is an excellent option for reconstructing small to medium-sized defects after skin surgery. Objective: We analyzed our clinical results of using the rhombic flap for reconstruction after skin cancers, and especially in regard to the aspects of cosmesis, complete surgical excisions, recurrence and the scope of dermatosurgical care. METHODS: From July 2004 to May 2008, forty one patients who were diagnosed with non-melanoma skin cancer or benign tumor on the face, trunk and extremities were treated with a rhombic flap or its modified form for the reconstruction of primary cutaneous defects following the excision of tumor. The cases were divided into groups according to the cosmetic units and the clinical outcomes were reviewed, and cosmetic results were scored as excellent, good, fair or poor. RESULTS: Forty-two rhombic transposition flaps were done in 41 patients. Among these patients, 16 were men and 25 were woman. There were 23 cases of malignant tumor and 19 cases of premalignant and benign tumors. Thirty two cases were located on the face (12 on the cheek, 7 on the nose, 5 on the forehead and periorbital area, 2 on the mouth and 1 on the ear) and 10 cases were located on the other sites (4 on the trunk, 2 on the buttock, 2 on the finger, 1 on the arm and 1 on the leg). There was tumor recurrence in one case. The cosmetic results of reconstructions were satisfactory, and 29 cases out of the 42 (69%) cases showed good to excellent results after 6 months. CONCLUSION: Rhombic transposition flap can be a simple and good choice for reconstructing cutaneous defects on the face, trunk and extremities after skin tumor surgery. It could also be applied to the defect with limited skin laxity without tension or distortion, and it especially showed excellent and good cosmetic results in most of the cases.
Subject(s)
Female , Humans , Male , Arm , Buttocks , Cheek , Cosmetics , Dermatologic Surgical Procedures , Dermatology , Extremities , Fingers , Forehead , Mouth , Nose , Recurrence , Skin , Skin NeoplasmsABSTRACT
BACKGROUND: There is currently an increasing demand in the field of dermatology for surgical therapy for treating skin cancers, including premalignant and malignant lesions. The rhombic (often referred to as rhomboid) flap is a transposition flap that is an excellent option for reconstructing small to medium-sized defects after skin surgery. Objective: We analyzed our clinical results of using the rhombic flap for reconstruction after skin cancers, and especially in regard to the aspects of cosmesis, complete surgical excisions, recurrence and the scope of dermatosurgical care. METHODS: From July 2004 to May 2008, forty one patients who were diagnosed with non-melanoma skin cancer or benign tumor on the face, trunk and extremities were treated with a rhombic flap or its modified form for the reconstruction of primary cutaneous defects following the excision of tumor. The cases were divided into groups according to the cosmetic units and the clinical outcomes were reviewed, and cosmetic results were scored as excellent, good, fair or poor. RESULTS: Forty-two rhombic transposition flaps were done in 41 patients. Among these patients, 16 were men and 25 were woman. There were 23 cases of malignant tumor and 19 cases of premalignant and benign tumors. Thirty two cases were located on the face (12 on the cheek, 7 on the nose, 5 on the forehead and periorbital area, 2 on the mouth and 1 on the ear) and 10 cases were located on the other sites (4 on the trunk, 2 on the buttock, 2 on the finger, 1 on the arm and 1 on the leg). There was tumor recurrence in one case. The cosmetic results of reconstructions were satisfactory, and 29 cases out of the 42 (69%) cases showed good to excellent results after 6 months. CONCLUSION: Rhombic transposition flap can be a simple and good choice for reconstructing cutaneous defects on the face, trunk and extremities after skin tumor surgery. It could also be applied to the defect with limited skin laxity without tension or distortion, and it especially showed excellent and good cosmetic results in most of the cases.
Subject(s)
Female , Humans , Male , Arm , Buttocks , Cheek , Cosmetics , Dermatologic Surgical Procedures , Dermatology , Extremities , Fingers , Forehead , Mouth , Nose , Recurrence , Skin , Skin NeoplasmsABSTRACT
PURPOSE: Actinic keratosis (AK) is an incipient form of cutaneous squamous cell carcinoma (SCC). We determined if the pattern of expression of keratin-14 (K14) is a factor for tumor progression in AK and SCC. MATERIALS AND METHODS: Eighteen sections from the tissues of 16 patients were stained with anti-K14 antibody and p16(INK4a). Among the 16 patients, 4 were diagnosed with both SCC and AK at the same site, but AK developed first and SCC developed subsequently. Thus, SCC may have evolved from AK. The other 12 patients were only diagnosed with AK. RESULTS: In all of the AK and SCC tissues, basement membranes showed positive staining for K14. However, strong reactivities were shown in the spinous and granular layers and focuses of dermal invasion in the SCC tissues developed from AK. Two and 3 of the 12 AK cases had moderately positive reactions for K14 in the spinous and granular layers, respectively. Also, all SCC tissues except one had moderate-to-strong reactions in the basal, spinous, and granular layers for p16(INK4a). Two of the 12 AK cases had weak-to-moderate positive reactions in the basal, spinous, and horny layers for p16(INK4a). CONCLUSION: The results of our study advance our understanding of the pathogenesis of SCC developing from AK. The results also indicate a differential role in the control of K14 in normal epithelia, AK, and SCC. K14 expression in the spinous and granular layers may be a prognostic factor for tumor progression of AK.