ABSTRACT
Background@#Verruca vulgaris is a common cutaneous viral infectious disease caused by human papilloma virus (HPV). The main treatment modalities are cryotherapy, immunotherapy, laser therapy, intralesional injection of bleomycin, and salicylic acid therapy. However, there is no definitive tool for predicting clinical improvement or treatment response. @*Objective@#This study was designed to evaluate clinical treatment response according to the hardness of verruca vulgaris skin lesions. We developed a new prediction tool called the “hardening sign” that divides the course of treatment into four categories based on inspection and palpation. @*Methods@#We conducted a retrospective medical chart review of patients who visited Hanyang University Guri Hospital between January 2016 and January 2017 and were clinically diagnosed with verruca vulgaris. We divided the patients into four groups according to the grade of rigidity of their lesions. @*Results@#Forty-seven patients (24 male and 23 female) were identified. The mean age at diagnosis was 17.2±8.5 years, and the mean duration of treatment was 28.8±27.7 weeks. The mean number of hospital visits was 16.5±12.4. Eleven patients underwent only cryotherapy, while 36 patients underwent combined cryotherapy and immunotherapy. We observed significantly shorter durations of treatment for patients with higher grades of hardening. There was no correlation between the hardening grade and the number of treatments required for patients to be completely cured. @*Conclusion@#This study suggests that the therapeutic response of verruca vulgaris warts to cryotherapy can be easily predicted by careful consideration of the “hardening sign”.
ABSTRACT
Viral warts are benign proliferations of the epithelium caused by human papilloma virus (HPV) infection. Diverse therapeutic options are available for viral warts, depending on extension and severity of the disease. We report a case of a 19-year-old man who presented with multiple viral warts on hands and feet for 5 years. He was treated at other clinics before visiting our hospital, but there was no improvement. We treated the lesions with a combination therapy of systemic acitretin and diphenylcyclopropenone (DPCP) immunotherapy for 6 months. A significant improvement was observed during the 12th week of therapy. Herein, we report a case of recalcitrant viral warts showing complete regression when a combination therapy of oral acitretin and immunotherapy was administered.
ABSTRACT
Solitary fibrous tumors (SFT) are uncommon mesenchymal tumors. SFT have several synonyms including localized fibrous tumor, benign mesothelioma, localized fibrous mesothelioma, and submesothelial fibroma. SFT usually occur in the pleura or other serosal surfaces, but SFT can also develop in extrapleural areas including the nasal cavity, orbit, retroperitoneum, and pelvis. Cutaneous SFT is extremely rare, and more likely to occur in the head and neck region. Histologically, this tumor can mimic a variety of benign and malignant tumors such as dermatofibroma, dermatofibrosarcoma protuberans, spindle cell lipoma or other mesenchymal tumors. Most cases of SFT show non-aggressive clinical courses, with low recurrence rates. Herein, we describe a case of primary cutaneous SFT which presented with huge mass on the back.
Subject(s)
Dermatofibrosarcoma , Head , Histiocytoma, Benign Fibrous , Lipoma , Mesothelioma , Nasal Cavity , Neck , Orbit , Pelvis , Pleura , Recurrence , Skin , Solitary Fibrous Tumor, Pleural , Solitary Fibrous TumorsABSTRACT
While lymphangioma circumscriptum may present anywhere on the body, the vulva is a rare site. However, vulvar involvement can occur in some clinical settings, and Crohn’s disease is one of the underlying etiologies of acquired lymphangioma circumscriptum. A 31-year-old woman presented with an 8-year history of widespread verruciform plaques on her vulva. She complained of a mild itching sensation at the lesion site. She was diagnosed with Crohn’s disease 11 years prior but had not been treated. She had no history of trauma or surgery in the perineal area and no familial history of cancer or hereditary disorders. The histopathologic findings were consistent with lymphangioma. Based on the clinicopathologic findings, the patient was diagnosed with lymphangioma circumscriptum on the vulva. Herein, we report a rare case of acquired lymphangioma circumscriptum of the vulva mimicking condyloma acuminatum in a patient with Crohn’s disease.
ABSTRACT
While lymphangioma circumscriptum may present anywhere on the body, the vulva is a rare site. However, vulvar involvement can occur in some clinical settings, and Crohn’s disease is one of the underlying etiologies of acquired lymphangioma circumscriptum. A 31-year-old woman presented with an 8-year history of widespread verruciform plaques on her vulva. She complained of a mild itching sensation at the lesion site. She was diagnosed with Crohn’s disease 11 years prior but had not been treated. She had no history of trauma or surgery in the perineal area and no familial history of cancer or hereditary disorders. The histopathologic findings were consistent with lymphangioma. Based on the clinicopathologic findings, the patient was diagnosed with lymphangioma circumscriptum on the vulva. Herein, we report a rare case of acquired lymphangioma circumscriptum of the vulva mimicking condyloma acuminatum in a patient with Crohn’s disease.
ABSTRACT
Peripheral T cell lymphoma, unspecified (PTCL-U) comprises a heterogenous group of mature T-cell lymphomas that do not match with any defined T-cell entities in the current classification system. A 68-year-old man presented with extensive erythematous to brownish ulcerative tumors with yellowish discharge on the neck, trunk, and both upper extremities that had persisted for the past 7 months. Histological findings showed medium- to large-sized pleomorphic lymphocytes with cellular atypia infiltrating the deep dermis and subcutis. Immunohistochemical analysis of specimens from this patient revealed positive staining for CD2, CD45, and granzyme B and mildly positive staining for CD3, CD4, CD30, and CD79a. Based on these clinico-pathological findings, the patient was finally diagnosed with PTCL-U. We report herein a rare case of PTCL-U presenting as multiple ulcerative tumors.
Subject(s)
Aged , Humans , Classification , Dermis , Granzymes , Lymphocytes , Lymphoma, T-Cell , Lymphoma, T-Cell, Peripheral , Neck , T-Lymphocytes , Ulcer , Upper ExtremityABSTRACT
Fixed drug eruptions (FDEs) are characterized by the presence of site-specific recurrence of a solitary or multiple, well-circumscribed, erythematous macules or patches that recur with each exposure to a particular medication. Several drugs including non-steroidal anti-inflammatory drugs, non-opioid analgesics, sedatives, anticonvulsants, sulfonamides, and tetracycline have been associated with an increased risk of inducing FDE. A 45-year-old woman with known history of levofloxacin use presented with erythematous patches on her face and left forearm. Although a patch test to levofloxacin showed a negative reaction, intradermal tests to assess hypersensitivity to levofloxacin were positive, and she was diagnosed with levofloxacin-induced FDE. Her antibiotic was switched to moxifloxacin, which she tolerated well. Moxifloxacin did not show cross-reactivity. Because of the widespread use of fluoroquinolones, it is important to consider these as possible etiological agents in cases of FDE. We describe a case of FDE diagnosed using positive intradermal tests to detect sensitivity to levofloxacin.
Subject(s)
Female , Humans , Middle Aged , Analgesics , Anticonvulsants , Drug Eruptions , Fluoroquinolones , Forearm , Hypersensitivity , Hypnotics and Sedatives , Intradermal Tests , Levofloxacin , Patch Tests , Recurrence , Sulfonamides , TetracyclineABSTRACT
Tufted angioma is a rare benign vascular neoplasm that usually occurs in children. It appears as an erythematous, purplish, indurated papule or plaque on the trunk or neck. Although it can have variable clinical manifestations, the annular or serpiginous configuration of lesions resembling tinea infections has rarely been reported. A 47-year-old woman presented with an erythematous plaque enlarging by peripheral extension to form polycyclic or serpiginous figures on her left chin and buccal cheek for 7 months without any subjective symptoms. Tinea faciale was considered as the initial clinical diagnosis, but repeated KOH tests were all negative; therefore, skin biopsy was performed. Histopathology revealed discrete circumscribed foci of capillaries scattered throughout the dermis showing a cannon ball appearance, compatible with tufted angioma. Clinical features showed considerable improvement after 2 sessions of intense pulsed light and pulsed-dye laser (5 repetitions) without any complications. Herein, we report a rare case of polycyclic variant of tufted angioma, which developed in a woman in her 5th decade.
Subject(s)
Child , Female , Humans , Middle Aged , Biopsy , Capillaries , Cheek , Chin , Dermis , Diagnosis , Diagnosis, Differential , Hemangioma , Neck , Skin , Tinea , Vascular NeoplasmsABSTRACT
Granuloma annulare is a relatively common benign dermatosis of unknown etiology. It is typically characterized by skin-colored to violaceous annular or arcuate lesions. The localized form of the disease usually resolves spontaneously, but treatment may be required in cases of intractable symptoms such as pruritus, or for cosmetic purposes. Herein, we report the case of a 65-year-old man diagnosed with a localized form of granuloma annulare that was refractory to various treatments but showed clinical improvement with a combined regimen of excimer laser and topical tacrolimus.
Subject(s)
Aged , Humans , Granuloma Annulare , Granuloma , Lasers, Excimer , Pruritus , Skin Diseases , TacrolimusABSTRACT
Nevus sebaceous is a common congenital cutaneous hamartoma occurring mainly on the face and scalp. It is well known that secondary neoplasms can be easily observed in the primary lesion. However, a case of trichoblastoma and compound nevus concurrently arising from nevus sebaceous has not been previously reported. A 26-year-old woman presented with a well-demarcated atrophic skin-colored plaque on her scalp from birth. On the plaque, a black dome-shaped round nodule and a brownish nodule with irregular margins were found one week previously without subjective symptoms. Histopathological examination of the central plaque lesion revealed epidermal hyperplasia and hyperplasia of the sebaceous glands and eccrine glands. In addition, ectopic, dilated apocrine glands were revealed in the lower dermis, and the hair follicles remained small and primordial, consistent with nevus sebaceous. A section of the black nodule showed palisading basaloid cells surrounded by abundant fibrous stroma. Nests of nevus cells were found at the dermo-epidermal junction and dermis in the brownish nodule. Based on these findings, the black nodule and brownish nodule were diagnosed as trichoblastoma and compound nevus, respectively. Herein, we report an interesting case of trichoblastoma and compound nevus concurrently arising from nevus sebaceous, which is, to our knowledge, the first such report in the dermatologic literature.