A Case of Multinucleate Cell Angiohistiocytoma / 대한피부과학회지

Multinucleate cell angiohistiocytoma is a rare benign fibrohistiocytic vascular condition with distinctive histologic features. It tends to occur more frequently in middle-aged women, to favor the extremities, and to appear as grouped reddish-brown papules. We describe a case of solitary multinucleate cell angiohistiocytoma that appeared as a papule on the upper lip of a 24-year-old man.

Angiokeratoma Circumscriptum with Transepidermal Elimination / 대한피부과학회지

Transepidermal elimination is a mechanism whereby foreign or altered constituents can be removed from the dermis. The phenomenon of transepidermal elimination may occur as a primary process characterizing disorders such as elastosis perforans serpiginosa, reactive perforating collagenosis and chondrodermatitis nodularis chronica helicis; as well as a secondary process characterizing disorders such as granuloma annulare, necrobiosis lipoidica diabeticorum, calcinosis cutis, pseudoxanthoma elasticum, spitz nevi, pimented nevi, porokeratosis plantaris discreta and metastatic tumors. A 17-year-old man presented with a 2X2 cm sized well-circumscribed slightly erythematous plaque with some black colored papules on the left dorsum of his hand. The histopathology of the lesion indicated angiokeratoma circumscriptum with transepidermal elimination.

A Case of Verruciform Xanthoma Associated with Epidermal Atypia / 대한피부과학회지

Verruciform xanthoma is a rare benign lesion characterized by verrucous epidermal hyperplasia with aggregates of foam cells in dermal papillae. The pathogenesis is still unknown. Although most verruciform xanthoma tend to occur as isolated lesions, several have been associated with other conditions including squamous cell carcinoma and epidermal atypia. We describe a case of verruciform xanthoma associated with epidermal atypia.

Malignant Melanoma on Congenital Melanocytic Nevus

Congenital melanocytic nevi are considered to be precursors of malignant melanoma. Although the risk of malignant melanoma with medium and small congenital melanocytic nevi is uncertain, it is important to notice the possibility of malignant transformation in those lesions. We describe a 62-year-old woman who had had a brown soft verrucous tumor on her right lower back since birth. She first noticed a black nodule in the center of the tumor 5 years before which had ulcerated 3 months prior to presentation without healing. A biopsy specimen revealed malignant melanoma arising from a congenital melanocytic nevus.

Two Cases of Microvenular Hemanogioma / 대한피부과학회지

Microvenular hemangioma (MH) is a recently described, uncommon, acquired vascular, tumor presenting clinically as a small reddish nodule in young and middle, aged individuals of either gender. Histologically, thin and irregularly branching small venules with inconspicouous lumia and without cellular atypia are found widely throughout the dermis. The presence of histologic features of the collagen dissection and vascular tufts makes it necessary to differentiate MH with Kaposi's sarcoma and angioblastoma. As we are aware, the description of these two cases which showed the characteristic clinical and histologic features of MH, is the first report of MH in Korea.

Histopaghologic Finding and Modulation of Expression of The Cell Surface Molecules in The Primary Syphilitic Sedions of a Rabbit Infected with Treponema pallidum / 대한피부과학회지

BACKGROUND: When T. pallidum invades through skin and mucous membrane, there may be some changes in the expression of cell surface molecules and cell adhesion molecules on the keratinocytes and vascular endothelial cells. OBJECTIVES: The purpose of this study was to investigate histologic changes and changes in the expression of cell surface molecules and cell adhesion molecules on the keratinocytes and vascular endothelial cells according to the time course of primary syphilic lesion. METHODS: We obtained primary syphilitic lesions by inoculation of T. pallidum into the back skin of the rabbit. Biopsies of the syphilitic lesions were performed according to the stages. and H&E and immunohistochemical stains for cell surface molecules were done. RESULTS: 1. Out of the 39 injected sites(103 T. pallidum were inoculated into the back skin of the rabbit), 24(61.5%) primary syphilitic lesion could be found. The duration for the developement of papules, ulcers, and softenings is an average 15 days, 27 days, and 47 days respectively. 2. H & E findings :Acanthosis, spongiosis, and exocytosis in the epidermis were observed in the papule of the primary syphilitic lesion. Infiltration of inflammatory cells, including many lymphocytes, a few histiocytes and plasma cells was also observed. Some cases showed endothelial cell swelling of vessels. Compared to papules, the number of lymphocytes in the ulcer reduced but the number of histiocytes increased. Softened lesion showed infiltrating cells, consisted of lymphocytes and histiocytes, and fibrosis. 3. Immunohistochemical findings :Keratinocytes of the lower epidermis, upper portion of hair follicles, vessel, and infiltrating inflammatory cells in papules and ulcers showed expression of the MHC class II molecule. Most of the infiltrating cells in all cases of papules showed CD5 expression. Keratinocytes, inflammatory cells, and vascular endothelial cells showed positive reaction to ICAM-1 stain in papules and ulcers. VCAM-1 showed the positive reaction to the vascular endothelial cells in the papules and ulcers. In softened lesions, the intensity of the positive reaction to MHC class II, ICAM-1 and VCAM-1 was weakened. CONCLUSION: The skin of the rabbit which was invaded by T. pallidum increased the expression of the cell surface molecules and cell adhesion molecules of MHC class I, MHC class II, ICAM-1, and VCAM-1. We believe that these expressions of cell surface molecules and cell adhesion molecules by T. pallidum, inflammatory cells, activated keratinocytes, and vascular endothelial cells play important roles in the host defence mechanism and the T. pallidum infection.

A Case of Targetoid Hemosiderotic Hemangioma / 대한피부과학회지

We describe a 23-year-old man showing typically clinical and histological features of targetoid hemosiderotic hemangioma. About 35 cases of this newly-described entity have been reported since the first description by Santa Cruz and Aronherg in 1988. It is important to distinguish these tumors from patch stage Kaposi's sarcoma, retiform hemangioendothelioma and progressive lymphangioma.

Clinical Observation of Cutaneous Malignant Tumors and Premalignant Lesions over 15 Years (1982-1996) / 대한피부과학회지

No abstract available.

Differences in Expression of HLA Antigens among Subtypes of Vitiligo / 대한피부과학회지

BACKGROUND: Vitiligo is an acquired disorder with destruction of melanocytes and is clinically characterized by depigmented patches of skin. The pathogenesis of vitiligo is still unclear, but melanocyte self destruction, neurohumoral factors, autoimmunity and inherent cellular defects have all been proposed as possible etiological factors. OBJECTIVE: The purpose of this study was to find out the differences in expression of HLA antigens among subtypes of vitiligo according to classification, onset and family history and then to disclose the pathogenesis of vitiligo in view of genetic and autoimmunological aspects. METHODS: We investigated HLA-A, B, C, DR in subgroups of 87 vitiligo patients according to type, onset, and family history. Results : 1. There were no HLA antigens with significantly increased frequency in vitiligo patients compared to the control group. 2. There was a significant increase in frequency of HLA-DRl2 in patients of non-segmental vitiligo with a family history ; an increase in frequency of HLA Cw2 in patients without a family history ; and a significant increase in frequency of HLA-DRl2 in all patients of non-segmental vitiligo compared to the control group.(p(c)<0.05). 3. The frequency of HLA-B63 was significantly increased in all patients of segmental vitiligo compared to the control group(p(c)<0.05), but there were no HLA antigens with significantly increased frequency in patients of subgroups of segmental vitiligo divided by the presence or absence of a family history of vitiligo. 4. The frequency of HLA-B54 was significantly increased in all vitiligo patients with a family history(p(c)0.05) but there were no HLA antigens with significantly increased frequency in all vitiligo patients without a family history. 5. There were no HLA antigens with significantly increased frequency in vitiligo patients subgrouped by age of onset (less or over 16 years) of disease. Conclusion : From the above results, we can assume that non-segmental vitiligo may have autoimmune mechanisms in the pathogenesis, as there was a significant increase in HLA-DRl2 in patients with non-segmental vitiligo.

The Relationship between Coping Mechanisms and Psychological Symptoms in Vitiligo Patients / 대한피부과학회지

BACKGROUND: Vitiligo is an acquired disorder which causes body disfiguring and may provoke emotional stress, functional impairment, and psychiatric symptoms. OBJECTIVE: (1) To assess whether the psychiatric symptoms are more frequent in vitiligo patients than control patients. (2) To investigate whether the vitiligo patients with more severe psychiatric symptoms use more negative and passive coping mechanisms than patients with less severe psychiatric symptoms. To carry out this study we evaluated psychiatric symptoms, problems in daily activities, and the relation-ship between coping mechanisms and psychiatric symptoms. METHODS: A clinical study was done on 150 vitiligo patients. Other dermatology patients were used as a control group. Both groups had visited the dermatology clinic of the Severance hospital. Questionaires regarding age, sex, severity of disease, duration of disease, SCL-90(symptom check list 90), the coping list of Weisman, and items for adaptability of daily activity were recorded. Results : Male vitiligo patients showed more psychological symptoms than female patients. Vitiligo patients had many more difficulties in daily activities than the control patients. The patients who had more severe psychiatric symptoms used more negative and passive coping mechanisms than less severe patients. Conclusion : Vitiligo provoked psychiatric symptoms and difficulties in daily activities. Psychiatrically more severe patients used negative and passive coping mechanisms. Comprehensive dermatologic and psychiatric treatment may be required in the treatment of vitiligo.

Two Cases of Cutaneous Larva Migrans

Cutaneous larva migrans(CLM) is a ubiquitous self-limiting skin eruption which has intensely pruritic, serpiginous, raised, sharply demarcated, red lesions. It is most frequently caused by larvae of dog and cat hookworms. We report two typical cases of cutaneous larva migrans that appeared as pruritic exanthems in two people after they had travelled in Southeast Asia. It is suggested one should consider cutaneous larva migrans in the differential diagnoses of erythematous pruritic lesions.

A case of loiasis

The prevalence of Loa loa infections in non-endemic areas such as Korea is very low, even though it is quite common in the endemic regions of West and Central Africa. We describe a patient who presented with temporary localized edema (classical Calabar swellings) after travelling to Cameroon and in whom the diagnosis of loiasis was made by ELISA. This is the second reported case of loiasis in Korea. As international travel is becoming more frequent, Loa loa infection should be considered in the differential diagnosis for patients with eosinophilia and Calabar swellings in Korea.

Spindle Cell Lipoma of the Palm / 대한피부과학회지

A 33-year-old woman developed a pea-sized, painless, pedunculated nodule on the right palm. Microscopically, it consists of an intricate mixture of lipocytes and uniform spindle cells that was closely associated with a varying number of short bundles of collagen fibers. The lesion had been excised and showed no evidence of recurrence.

Frey' s Syndrome in a Child without Definite Causes / 대한피부과학회지

Freys syndrome is characterized by attacks of facial erythema and gustatory sweating occurring in the cutaneous distribution of the auriculotemporal nerve. After sugery, trauma, abscess, or other diseases of the parotid gland, the postganglionic sympathetic and parasympathetic nerve fibers are disrupted. Some misdirected auriculotemporal nerve fibrils join with the distal sympathetic nerves innervating the sweat glands and subcutaneous vessels. We report a case of Freys sindrome in a 6-year old boy without any definite injury to the parotid gland. After considering our case and review of literature of Freys syndrome in children, we conclude that there may be a congenital defect in the auriculotemporal nerve innervation responsible for cases occuring in children.

The Effect of Small Doses of Oral Corticosteroids in Vitiligo Patients / 대한피부과학회지

BACKGROUND: One of the most, probable pathogenesis of vitiliga is autoimmune. Systemic cor tico st,eroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. OBJECTIVE: We have assessed the clinical effect of a oral small oral dose of corticosteroid to minimize side effects in vitiligo patients. METHODS: Thirty four patients(9;male, 25;female) with vitiligo were evaluated in this study. The patients took 7.5mg-20mg prednisolone initially for 2 months and then the dosage was tapered to half of the initial dosiat the 3rd month and half of dose of 3rd month for the last 4th month. We compared the effcct of treatment of vitiligo before and aft.er the study by photographs. and side efferts were issessed at. 1, 2, 3 and 4 month. RESULTS: The arrest of the progression of vitiligo was noticed in 79% of patients and repigmentation was noticed in 59% of patients which is statistically significant. The effect, of treatment according to extent, duiation, type, and site of vitiligo were not statistically significant. The side effects of treatment were minimal and did not affect the course of treatment. CONCLUSION: Small doses of iral corticosteroids are effective without any significant side effects in preventing progression and loiiduce repigmentation of active spreading vitiligo and generalized type of vitiligo that is difficult to treat with topical corticosteroids.

Two Cases of Pigmentary Demarcation Lines Associated with Pregnancy / 대한피부과학회지

Pigmentary demarcation lines are borders of abrupt transition between more deeply pigmented skin and that of lighter pigmentation. We describe two patients with pigmentary demarcation lines associated with pregnancy symrnetrially involving the buttocks and flexor as jects of legs. Hormonal changes in pregnancy and compression by the enlarged uterus of Sl and S2 peripheral nerves may be responsible for these changes.

Skin Rash in A Patient with Infectious Mononucleosis after the Intake of Ampicillin / 대한피부과학회지

During the course of infectious mononucleosis, intake of ampicillin and its analogues such as amoxicillin may cause hypersensitivity skin rashes. We report herein a case of ampicillin induced skin rash in a 41-year-old female patient with infectious mononucleosis. Infectious mononucleosis was confirrned by datetion of IgM antibody against Epstein-Barr(EB) viral capsid antigen(VCA) in her serum. During the icuteillness, she taked ampicillin for 3 days, and 1 week after the intake of ampicillin, a genertliz:d erythernatous and purpuric maculopapualr eruption developed. Physicians should be careful not to use ampicillin and its analogue if batients are suspected to be infected with EB virus as ampicillin induces severe skin rashes in patients with infectious mononucleosis.

Leukemic Macrocheilitis Associated with Chronic Lymphocytic Leukemia / 대한피부과학회지

Specific cutaneous infiltrates in chronic lymphocytic leukemia(CLL) presenting as tumor and large nodule on face, scalp and upper trunk and involvement of oral mucsa is extremly rare. In 7% of cases, leukemic infiltrates of the skin precede the diagnosis of Leuke. We report herein leukemic macrocheilia which occured 3 years before a diagnosis of CLL.