Clinicopathological study of 30 Cases of Cutaneous Mastocytosis / 대한피부과학회지

BACKGROUND: Mastocytosis is characterized by accumulation of mast cells in various organs, most frequently, in skin. Cutaneous mastocytosis is a relatively rare disease in outpatient clinics and the clinicopathological study has not been done yet in Korea. OBJECTIVE: The aim of this study is to analyze the clinicopathological features of cutaneous mastocytosis. In addition, we examined CD117 expression in the skin biopsy specimens immuno histochemically. METHODS: Thirty cases of cutaneous mastocytosis were collected from 1990 to 1999 in Asan Medical Center. Clinical records, photographs, and biopsy slides were reviewed. In each biopsy specimen, CD117 was stained by immunoperoxidase method. RESULTS: Among 30 cases, 29 cases were childhood type urticaria pigmentosa(76.7%) or masto cytoma(20.0%) and only 1 case occurred after 16 years of age. The incidence showed a peak under 1 year old (70.0%) and males affected 2.3 times as much as females. The trunk and distal extremities are the most common site of urticaria pigmentosa and mastocytoma, respectively. CD117 was strongly positive in all cases of urticaria pigmentosa (both child and adult type) and mastocytoma. CONCLUSION: Urticaria pigmentosa of infantile onset was the most common, followed by infantile mastocytoma. Systemic reactive manifestations are rare in cutaneous mastocytosis. The strong expression of CD117 was seen regardless of the type of cutaneous mastocytosis.

A Case of Guttate Psoriasis in the Recipients of Allogeneic Bone Marrow Transplantation / 대한피부과학회지

In many studies, it has been demonstrated that donor-derived cells would eventually replace the hematopoietic and immune system of the recipient after allogeneic bone marrow transplantation (BMT). And there are several case reports describing resolution or development of autoimmune diseases after BMT. Psoriasis is considered to be an autoimmune disease of abnormal keratinocyte proliferation induced by T lymphocytes. Herein we describe a 17-year-old woman presenting with guttate psoriasis, who suffered from acute lymphocytic leukemia and underwent allogeneic BMT 6 months ago. This is the first case of guttate psoriasis possibly associated with BMT in the Korean literature.

A Case of Nodular Fasciitis Showing Keloid-like Histological Features / 대한피부과학회지

Nodular fasciitis is a reactive myofibroblastic proliferative lesion and is frequently misdiagnosed as a sarcoma. Histopathologically, nodular fasciitis can be grouped into three subtypes based on their relation with the fascia: subcutaneous, fascial, intramuscular. The subcutaneous type is the most common type. Its histological appearance is quite variable, with lesions ranging from highly cellular "pseudosarcomatous" to myxoid proliferations, to hyalinized tumefactions with keloid-like strands of collagen. Herein we report a case of subcutaneous nodular fasciitis showing keloid-like, hylainized, and thickened collagenous change.

A Case of Lymphomatoid Papulosis / 대한피부과학회지

Primary cutaneous CD30+ lymphoproliferative disorders include primary cutaneous CD30+ (anaplastic) large T cell lymphoma, lymphomatoid papulosis, and borderline cases. These represent a clinical and histologic continuum rather than a separate entity. We report a 39-year-old woman with the clinical features of lymphomatoid papulosis. Histology favored primary CD30+ anaplastic large cell lymphoma. Although she was treated with aggressive combination chemotherapy, the lesions recurred shortly after discontinuation of chemotherapy. She is now regularly followed up without any treatment.

Two Cases of Secondary Syphilis Accompanied by Acquired Immunodeficiency Syndrome / 대한피부과학회지

Syphilis and human immunodeficiency virus(HIV) disease may coexist, and syphilis is often the presenting infection of patients with concurrent HIV infection, because syphilis may accelerate development of immunodeficiency in HIV-infected persons, and conversely HIV infection causes reactivation of dormant syphilis. Cutaneous secondary syphilis in HIV-infected patients is often associated with unusual and severe clinical features. We report a 44-year-old man in that syphilis reactivated by HIV infection, and a 23-year-old man in that syphilis was a presenting sign of HIV infection.

A Case of Epidermolytic Palmoplantar Keratoderma / 대한피부과학회지

Palmoplantar keratodermas are divided into autosomal dominant and autosomal recessive groups by the mode of transmission. The autosomal dominantly transmitted group is further divided into epidermolytic and nonepidermolytic types according to the histological findings. Hereditary epidermolytic palmoplantar keratoderma manifests clinically as a localized thickening of the palms and soles. Herein we report a 29-year-old woman showing the typical clinical and histologic features of epidermolytic palmoplantar keratoderma without family history. This case could be spontaneous mutations that will later breed a true autosomal dominant trait.

A Comparative Study between Adolescent Acne and Post-adolescent Acne

BACKGROUND: The prevalence of patients over the age of 25 years with acne has significantly increased over the past 10 years. Several etiologic factors such as genetic factor, hyperandrogenism, stress, and cosmetics have been studied. OBJECTIVES: The purpose of this study is to evaluate the differences between adolescent acne and post-adolescent acne, based on the clinical features, asoociated diseased and aggravating factors of 327 acne patients. METHODS: 327 consective patients, first visited to our hospital with clinical facial acne between March 2000 and February 2001, were enrolled. 220 adolescent patients(AP) were under the age of 25 and post-adolescent patients(PP) were over age of 25. RESULTS: 1. In the face, cheeks and forehead in adolescents, chin and cheeks in post-adolescents were predilection sites. The predominant type was a comedonal type in adolescents and a papulopustular type in post-adolescents(P<0.05). Severity of inflammatory type was not different between two groups. Familial factors were important in both groups, but more frequently found in post-adolescents with persistent acne(P<0.05). 2. Rosacea, chloasma, and hyperandrogenic features such as hirsutism and androgenetic alopecia were more frequently observed in post-adolescents. Seborrheic and atopic dermatitis were more frequent in adolescents. Four patients had all the features of chloasma, acne, rosacea, seborrheic dermatitis and hirsutism. 3. Aggravation by weason especially summer, sweating, stress, and cosmetics was more frequent in adolescents. In PP, acne was more frequently aggravated by sunlight, foods and menstrual period. CONCLUSION: Post-adolescent acne was mainly a papulopustular type predominantly located on the chin and cheeks with mild to moderated severity, and family history and hyperandrogenism were strong etiologic factors in persistent acne. Aggravating factors were not significantly different between two group, which suggested cosmetics and stress might not be important in post adolescent acne.

A Case of Granuloma Faciale Showing Unusual Histopathological findings

Granuloma faciale is an uncommon localized form of small-vessel vasculitis characterized by single or multiple lesions on the face in middle-aged whites, especially males. Histopathological examination demonstrates a dense polymorphous cellular infiltrate consisting of neutrophils, eosinophils, lymphocytes and histiocytes in the upper two thirds of the dermis. A characteristic subepidermal Grenz zone separates the infiltrate from the epidermis. We report a case of granuloma faciale, showing interesting evidence of palisaded granuloma-like pattern in the serial biopsy specimen at 3-year interval.

A Case of Benign Symmetric Lipomatosis

Benign symmetric lipomatosis is characterized by diffuse symmetric deposits of nonencapsulated fat, generally affecting the cervical and upper dorsal regions. There is a history of alcohol abuse in nearly all the cases. It is rarely reported in non-drinkers. Herein we report a 63-year-old man presenting with one year's history of multiple ill-defined symmetric soft mass on posterior neck, upper trunk and upper extremities without the history of alcohol abuse. We ad-ministered corticosteroid orally due to osteoarthritis of the knee for a long time.

A Case of Well-differentiated Sebaceous Carcinoma / 대한피부과학회지

There is not always a sharp distinction among the sebaceous neoplasms including sebaceous adenoma, sebaceoma, and sebaceous carcinoma. Sebaceous carcinoma is a malignant tumor derived from the adnxal epithelium of sebaceous glands. It may exhibit a variety of histological growth patterns and diverse clinical presentations. Herein we report a 65-year-old man presenting with a 0.5cm skin-colored papule on the left cheek, which shows the histopathological features of well-differentiated sebaceous carcinoma.

Second Primary Cancers in Patients with Cutaneous Malignant Melanoma / 대한피부과학회지

Survival from malignant melanoma has improved, and as a consequence, the possibility of raised risk of second primary cancers needs to be taken into account in clinical management. We report two cases of second primary cancers in patients with cutaneous malignant melanoma. One is a 61-year-old man suffered from head and neck squamous cell carcinoma with acral lentiginous melanoma, the other is a 65-year-old woman who suffered from malignant lymphoma with superficial spreading melanoma.

A Case of Ki-1 Positive Large Cell Lymphoma Transformed from Mycosis Fungoides: long-term follow-up and treatment / 대한피부과학회지

A 67-year-old man presented with several nodules on the extremities followed by mycosis fungoides of 5 years' duration. On biopsy of the newly formed nodule, Ki-1 positive large cell lymphoma was diagnosed. He was treated with methotrexate, topical and intralesional steroids and PUVA for as long as 7 years. We herein report the follow-up course and efficacy of the therapeutic modalities.

A Case of Desmoplastic Trichilemmoma / 대한피부과학회지

The case of an unusual desmoplastic variant of trichilemmoma arising in the face of a 72-year-old man is reported. Desmoplastic trichilemmoma is characterized by the presence of a densely sclerotic stroma, surrounded by lobules of epithelial cells with features of outer root sheath differentiation, including glycogen-rich, clear cytoplasms and peripheral palisading. In the central part of the tumor, irregular cords and nests of epithelial cells entrapped in the desmoplastic stroma are found. The pathological appearance can mimic trichilemmal carcinoma, morpheic basal cell carcinoma, and squamous cell carcinoma. Recognition of this benign neoplasm as such will prevent misdiagnosis and unnecessary aggressive treatment.

A Case of Semicircular Lipoatrophy / 대한피부과학회지

A 39-year-old woman presented with one-month-history of symmetrical linear depressions on the anterolateral aspects of both upper thighs. The patient was aware of her leaning against the table to apply make-up. Histological examination showed atrophy of the upper part of the subcutaneous fat. We herein report the clinical course and etiologic features of semicircular lipoatrophy.