Cockarde (Target-Like Lesion) Seborrheic Keratosis: An Unusual Clinical Pattern

No abstract available.

Cutaneous Cholesterol Embolism / 대한피부과학회지

A cholesterol embolism is a systemic disease resulting from the occlusion of arteries by cholesterol crystals released from atheromatous plaques. It has been associated with inflammation, sheering forces from blood flow due to hypertension, aneurysm formation, infection, mechanical manipulation during surgery or vascular procedures, and anticoagulation. We report a case of a cutaneous cholesterol embolism in a 66-year old man who had purpuric skin lesions on both feet associated with diabetes mellitus, hypertension, and anticoagulation for a cerebral infarction.

A Herpes Simplex Virus Infection Secondary to Acupuncture and Cupping

Acupuncture and cupping have a public reputation as being safe even though these practices can lead to complications such as trauma or infection. We report here on a case of herpes simplex virus (HSV) infection secondary to acupuncture and cupping in a 56-year-old woman. The patient, who had a history of acupuncture and cupping on her left forearm for treating her myalgia, developed painful papules. Histologically, the biopsy specimen showed characteristic ballooning degeneration and inclusion bodies in the epidermis and mid-dermis. These clinical and histological findings were consistent with the diagnosis of HSV infection.

Aberrant Breast Tissue Associated with Acanthosis Nigricans / 대한피부과학회지

Aberrant breast tissue is a subset of accessory breast tissue, and it exhibits similar consistency to that of the adjacent normal breast tissue, but it lacks an associated nipple complex. It is a developmental anomaly defined as the persistence of breast tissue along the embryonic mammary line. Aberrant breast tissue is most commonly located in the axilla, though it may be present anywhere along the embryonic mammary line. We report here on an 11-year-old girl with aberrant breast tissue and acanthosis nigricans. She had tender masses that became noticeable with the onset of menarche and mottled hyperpigmentation on both axillae. The histopathologic finding of the lesion revealed the typical features of aberrant breast tissue with acanthosis nigricans.

A Clinical Study of Dermatologic Diseases in Elderly Patients / 대한피부과학회지

BACKGROUND: According to developments in socioeconomic status and medical science, the population of aged individuals has significantly increased. Therefore, this group needs a fundamental epidemiologic survey of dermatologic diseases. OBJECTIVE: The purpose of this study was to evaluate the prevalence of dermatologic diseases in the elderly and to compare with those of previous studies. METHODS: 729 out-patients over 65 years of age who had visited the Department of Dermatology, Yonsei University Wonju Christian Hospital from January, 2004 to December, 2010 were analyzed retrospectively. RESULTS: The elderly group over 65 years of age accounted for 9.7% of all new patients (729/7,532 cases). The ratio of males to females was 1 to 0.99 (366 cases : 363 cases). Patients between 65 and 69 years of age were the majority (36.2%). They visited the hospital most frequently in the summer (31.8%), especially August (11.0%). The most common disease was herpes zoster (10.5%), followed by fungal infection (10.3%), and allergic contact dermatitis (8.4%). Fungal infection was the most frequent disease in patients between 65 and 69 years old and herpes zoster was the most frequent disease between 70 and 79 years old. Scabies was the most frequent disease in patients over 80 years old. Pruritis was found in 9.7% and xerosis in 7.0%. Eczema was the most common disease group (in 22.0%) and the second mmost common was viral infection (12.3%). CONCLUSION: This study provides useful data on the prevalence and characteristics of dermatologic diseases in elderly Korean patients.

Diagnosing Metastatic Merkel Cell Carcinoma Using Positron Emission Tomography-Computed Tomography (PET-CT) / 대한피부과학회지

Merkel cell carcinoma is a rare and lethal skin cancer that mostly occurs in aged persons who are over 60 years old as a dome-shaped purple nodule on the sun-exposed areas of the head, neck and extremities. The mortality rate is high because this tumor has a propensity for local recurrence, regional lymph node metastasis and distant metastasis. Therefore, rapid and precise diagnosis and staging are critical to improve the prognosis. We reported here on a 68-year old man with Merkel cell carcinoma on his right cheek and he had regional cervical lymph node metastasis, as was detected by PET-CT scanning.

Nevus of Nanta on a Patient with Metastatic Renal Cell Carcinoma / 대한피부과학회지

A 52-year-old man presented with a brown to black nodule on his left cheek. Histological examination revealed nests of nevus cells throughout the upper and mid-dermis. An eosinophilic oval-shaped bony structure was found within the nevus. We report here on a case of nevus of Nanta combined with metastatic renal cell carcinoma.

A Case of Schwannoma of the Upper Lip / 대한피부과학회지

Schwannoma, also known as a neurilemmoma, is a benign neurogenic tumor that arises from Schwann cells of the nerve sheath. Usually, it occurs as a slowly-growing, well-circumscribed solitary nodule on the head and neck, trunk, or extremities. However, it is rare on the oral mucosa, especially on the lip. Histologically, the lesion is characterized by an encapsulated nodule that consists of Antoni A cellular tissues with verocay bodies, and Antoni B loose myxoid tissues. Herein, we report a case of a schwannoma of the upper lip, which is a rare location

A Case of Relapsing Polychondritis Associated with Scleritis / 대한피부과학회지

Relapsing polychondritis is a rare rheumatologic disorder most commonly presenting as recurring episodes of inflammation in cartilaginous tissues. Auricular chondritis with red ears resembling cellulitisis the most common clinical manifestation. Other manifestations include arthritis, nasal chondritis, and ocular, pulmonary, and cardiovascular disease. Here we report the case of a 54-year-old female patient with relapsing polychondritis and associated scleritis. On histologic examination, the auricle, including cartilaginous tissues, showed loss of the normal basophilia of cartilage and perichondrial infiltration of inflammatory cells. The patient was treated with systemic steroids. Symptoms in both auricles were reduced, scleritis developed, and ocular symptoms were waning.

The Effect of Intraoperative Autotransfusion using a Continuous Autotransfusion System (CATS(R)) on for Homologous Transfusion in Children / 대한마취과학회지

BACKGROUND: Until recently, it was not easy to conduct intraoperative autotransfusion in children due to technical limitations, however, due to advanced technology this is now possible. This study was conducted to determine if the intraoperative use of the continuous autotransfusion system (CATS(R)) can reduce homologous transfusion during pediatric orthopaedic surgery. METHODS: Fifty-five children scheduled for elective orthopaedic surgery were reviewed and divided into two groups according to the availability of the CATS(R). The control group (n = 29) had surgery without the cell saver, whereas the CATS(R) group (n = 26) had surgery with the cell saver. The amounts of perioperative homologous transfusion were then compared between the two groups. RESULTS: The amount of homologous blood transfusion required during the operation was significantly less in the CATS(R) group 5 +/- 10 (ml/kg) than in the control group 15 +/- 13 (ml/kg) (P < 0.01). There was no difference in the amount of homologous blood transfusion required after operation between the groups. CONCLUSIONS: CATS(R) can reduce the need for intraoperative homologous transfusion during pediatric orthopaedic surgery.

A Case of Hunter Syndrome / 대한피부과학회지

We report a case of Hunter syndrome in a 4 year old boy, who presented with firm skin colored papules and nodules that coalesce to form a reticular pattern (pebbling of the skin) with extensive Mongolian spots. The lesions are arranged bilaterally and symmetrically over the scapulae, upper arm and lateral aspects of the thighs. He also has low intelligence, coarse face, saddle nose and claw hand contracture of both hands. The result of qualitative analysis of urine was positive for dermatan sulfate and heparan sulfate. And enzyme activity of iduronate-2-sulfatase is decreased in plasma and leukocyte. A skin biopsy specimen section stained with hematoxylin-eosin showed widely separated collagen bundles in the dermis associated with mucin deposition.

A Case of Pigmented Fungiform Papillae of the Tongue / 대한피부과학회지

Pigmented fungiform papillae of the tongue are characterized clinically by pigmentation confined to these papillae and histopathologically by melanophages in the lamina propriae. We report a case of pigmented fungiform papillae of the tongue in a 24-year-old Korean woman who has a dark brown-colored pigmented lesion on the anterolateral fungiform papillae.

A Case of Secondary Cutaneous Plasmacytoma, IgDlambda Type on Scalp / 대한피부과학회지

Cutaneous plasmacytoma (CP) is a localized collection of monoclonal plasma cells in the skin. The disease is divided into primary cutaneous plasmacytoma and secondary cutaneous plasmacytoma groups. Secondary cutaneous plasmacytoma, which is so rare as to occur in only 2% of myeloma cases, usually represents terminal expression of the primary diseases and is associated with increased tumor burden. CP can occur at any site of the skin, but we could find only 1 case in English literature related to scalp metastasis alone. Also serum and urine electrophoresis, tissue immunohistochemistry for IgD are not usually conducted in the laboratory. IgDlambda subtype seems to be another value to report. We report a case of secondary cutaneous plasmacytoma, IgDlambda type which developed on the scalp alone of a 41-year-old woman, with a review of related literatures.

A Case of Angiolymphoid Hyperplasia with Eosinophilia / 대한피부과학회지

Angiolymphoid hyperplasia with eosinophilia (ALHE) usually presents as pink to red-brown, dermal papules or nodules on the head and neck, especially around the ears and on the scalp. ALHE also occurs in the mouth, trunk, and extremities, penis and vulva. It can be painful or itchy and is known to be partly (20%) associated with peripheral blood eosinophilia. Histopathological findings show proliferation of blood vessels with plump endothelial cells and perivascular infiltration of numerous lymphocytes and eosinophils. We reported a 30-year-old female patient who had mild pruritic erythematous papules on the scalp that histopathologically showed features of ALHE. She was successfully treated with an intralesional injection of triamcinolone acetonide.

A New Method for Investigation of the Hair Shaft: Hard X-Ray Microscopy with a 90-nm Spatial Resolution

Various methods have been used to investigate the hair shaft. In the ultrastructural hair field, scanning and transmission electron microscopies are widely used investigative methods, but they have some technical limitations. Recently, X-ray microscopes with sub-micron spatial resolution have emerged as useful instruments because they offer a unique opportunity to observe the interior of an undamaged sample in greater detail. In this report, we examined damaged hair shaft tips using hard X-ray microscopy with a 90 nm spatial resolution. The results of this study suggest that hard X-ray microscopy is an alternative investigative method for hair morphology studies.

Pyogenic Granuloma Showing Incidental Focal Acantholytic Dyskeratosis / 대한피부과학회지

Incidental focal acantholytic dyskeratosis (IFAD) has been described for various cutaneous lesions. A 58-year-old man presented with a purple colored, 5 mm crusted papule on the back. An excisional biopsy was performed and histopathological examination showed angiomatous tissue occurring in a discrete mass. It was enclosed by a collarette of acanthotic epidermis. The angiomatous tissue comprised a variably dilated network of blood-filled capillaries, which was surrounded by myxoid stroma. Hyperkeratosis, acantholysis, dyskeratosis and intraepidermal clefts were also focally present. Correlation of the clinical features and the histopathology results established a diagnosis of pyogenic granuloma showing IFAD.

Epidemiology of Complex Regional Pain Syndrome: A Retrospective Chart Review of 150 Korean Patients

Complex regional pain syndrome (CRPS) is a chronically painful and disabling disorder. However, no data are available even on the epidemiology of CRPS in Korea. This study was undertaken to retrospectively assess the epidemiologic characteristics of CRPS in 150 consecutive patients at a tertiary chronic pain center from March 2002 to February 2006. Information was obtained regarding patients' demographics, nature of injury, and treatment modalities. Seventy-one percent of patients had CRPS type I. The mean 11-point verbal numerical rating scale score at initial examinations and at the time of study were 8.0 and 5.7, respectively. Thirty-two percent of patients showed no change or increase in pain intensity during follow-up at our pain center. The mean duration of CRPS symptoms prior to our pain center evaluation and prior to the time of study were 27 months and 50 months, respectively. These patients had seen on average 5 different physicians before being referred to our center. This study shows that the majority of CRPS patients were referred to our center after more than 2 yr of symptoms. The clinical implication of such delayed transfer and strategies to avoid this problem are discussed.

A Case of Cutaneous Lymphadenoma / 대한피부과학회지

Cutaneous lymphadenoma (CL) is a rare, benign, epithelial neoplasm with a prominent lymphocyte infiltration of unknown histogenesis. Both pilosebaceous and eccrine origins have been suggested, and the current view is that CL is a variant of trichoblastoma with adamantinoid features. We report a case of cutaneous lymphadenoma which developed on the left postauricular area of a 46-year-old woman, plus a review of the related literature.

A Case of Adult-onset Lichen Striatus / 대한피부과학회지

Lichen striatus and linear lichen planus are rare disorders that can be confused because they share similar clinical and histopathologic findings. We report a case of lichen striatus on the left wrist and fingers in a 54-year-old woman, who was initially diagnosed with linear lichen planus. She had overlapping clinico-histopathologic features of both lichen striatus and linear lichen planus. To discriminate between the two disorders, careful histological and clinical evaluations are needed, especially when a lichen striatus-like eruption occurs in adults.

Intratumoral Fat in Neurofibroma and Coexistence of Eccrine Hidrocystoma

We report a case of intratumoral fat in neurofibroma and coexistance of eccrine hidrocystoma on the occipital area of the scalp for one year duration. There are several diseases showing fatty change histopathologically. Among them, few cases of neurofibroma showing fatty change had been reported. The mechanism of fatty change is unclear, but several hypotheses are proposed. Here we report a case of neurofibroma showing fatty change and coexistence of eccrine hidrocystoma, and discuss the pathomechanism of fatty change and its relationship with disease.