Diffuse Cutaneous Mastocytosis with Generalized Bullae

We report on a 9-month-old female infant with multiple tense bullae and erosions covering the entire body, including the face, scalp, and trunk. The histopathological examination revealed sub-epidermal bullae with a dense dermal cellular infiltrate. The infiltrate was identified as a collection of mast cells using toluidine blue and Giemsa stains. The direct immunofluorscence was negative. A diagnosis of cutaneous diffuse mastocytosis with generalized bullae was made based on these clinical and histopathological findings. In cases with diffuse cutaneous mastocytosis with generalized bullae, systemic involvement is more frequent and more severe compared to other types of cutaneous mastocytosis. Some lethal outcomes have been reported. This is the first reported case of diffuse cutaneous mastocytosis in the Korean literature.

A Mechanism for the Up-regulation of the IL-8 Gene Expression in Keratinocytes by All-trans Retinoic Acid / 대한피부과학회지

BACKGROUND: Retinoic acid (RA) has been reported to induce the up-regulation of inflammatory cytokines such as IL-1, TNF-alpha and IL-8 in dermal fibroblasts and keratinocytes. There is no evidence to support a direct interaction between the RA-mediated transcriptional machinery and IL-8 gene transcription. OBJECTIVE: The aim of this study is to clarify the mechanism of the up-regulation of IL-8 in keratinocytes by RA. METHODS: The IL-1, IL-8, TNF-alpha and MCP-1 mRNA expressions in HaCaT cells stimulated by RA were measured by quantitative RT-PCR. The effects of a NF-kappaB inhibitor and IL-1 receptor antagonist (ra) on the IL-8 mRNA expression were measured by quantitative RT-PCR. Electrophoretic motility shift assay (EMSA) was conducted on the RA-stimulated HaCaT cells that were or were not treated with NF-kappaB inhibitor to measure the NF-kappaB binding activity in each group. The phospho-IkappaB activity in the HaCaT cells after stimulation with RA was also measured by Western blotting. RESULTS: An up-regulation of the IL-8 gene expression by RA was demonstrated in the HaCaT cells. The inhibition assay revealed the involvement of the NF-kappaB binding site of the IL-8 gene in the RA-enhanced promoter activity. EMSA demonstrated that RA enhanced the formation of the DNA-NF-kappaB complex. There was no evidence to support IL-1 as an intermediate stimulus between the RA-mediated transcriptional machinery and IL-8 gene transcription. Western blot analysis revealed increased phospho-IkappaB activity in the HaCaT cells after stimulation with RA. CONCLUSION: Our result suggested that the IL-8 gene expression of HaCaT cells after RA stimulation is caused by the activation of IKK and the dissociation of IkappaB from NF-kappaB and the transcription of NF-kappaB in the nucleus.

A Case of Solitary Fibrous Tumor That Developed on the Scalp / 대한피부과학회지

Solitary fibrous tumor is an uncommon mesenchymal neoplasm that can arise in both pleura and extrapleural locations. This tumor is composed of spindled cells intimately admixed with collagen bundles that are arranged in a 'patternless pattern'. Immunohistochemically, the tumor cells strongly express CD34 and vimentin. This tumor can mimic a variety of benign and malignant mesenchymal tumors. Rare cases of primary cutaneous solitary fibrous tumor have recently been reported and they have been added to an increasing variety of mesenchymal tumors that may primarily arise in the skin. We present here a case of primary cutaneous solitary fibrous tumor and we briefly review the relevant literature.

A Case of Ingrown Toenails Treated by the Super Elastic Wire Insertion Method / 대한피부과학회지

An ingrown toenail, which causes pain especially with secondary infection, and is one of the most common diseases of toenails. It becomes difficult for a patient to walk and this subsequently impairs the quality of life. Surgical procedures, including total or partial excision of the nail bed, phenolization and the carbon dioxide laser matricectomy method, are commonly performed to treat this problem. The disadvantages of these methods include their complexity, the pain, the time required to do the procedure and the need for local anesthesia during the operation. We present here successful therapy for a patient with ingrown nails with using a super elastic wire (SE-wire, Machiwire(R)). To the best of our our knowledge, this is the first case that describes the clinical benefits of the SE-wire for the treatment of ingrown nails in a Korean patient.

A Case of Ingrown Toenails Treated by the Super Elastic Wire Insertion Method / 대한피부과학회지

An ingrown toenail, which causes pain especially with secondary infection, and is one of the most common diseases of toenails. It becomes difficult for a patient to walk and this subsequently impairs the quality of life. Surgical procedures, including total or partial excision of the nail bed, phenolization and the carbon dioxide laser matricectomy method, are commonly performed to treat this problem. The disadvantages of these methods include their complexity, the pain, the time required to do the procedure and the need for local anesthesia during the operation. We present here successful therapy for a patient with ingrown nails with using a super elastic wire (SE-wire, Machiwire(R)). To the best of our our knowledge, this is the first case that describes the clinical benefits of the SE-wire for the treatment of ingrown nails in a Korean patient.

A Case of Nuchal Fibroma / 대한피부과학회지

Nuchal fibromas are rare, benign fibrous proliferations characterized by hypocellular dense collagen in the dermis and the subcutaneous fat layer. Nuchal fibromas usually develop in the posterior neck as a solitary, soft tissue mass. Herein, we report a case of a nuchal fibroma presenting on the posterior neck of a 60-year-old male. An excisional biopsy was done and showed haphazardly-arranged, dense collagen infiltration throughout the dermis and the subcutaneous fat layer. Moreover, fat lobules, adnexas and nerve fibers were entrapped by collagen bundle infiltrations. Dermatologists should include nuchal fibrma in the differential diagnosis of patients with a posterior neck mass.

A Case of Xanthoma Disseminatum Presenting as Pedunculating Nodules and Plaques / 대한피부과학회지

Xanthoma disseminatum is a rare mucocutaneous xanthomatosis classified as a benign form of non-Langerhans cell histiocytosis. We describe an illustrative case with extensive mucocutaneous involvement which was unresponsive to treatment. The patient presented with numerous variable-sized, yellow-brown papules and confluent plaques on the perorbital, perioral, neck, axilla, upper chest, groin, perianal, antecubital fossae and popliteal fossae including the upper respiratory tract. She was treated with oral cyclophosphamide but showed no clinical improvement. She then developed dyspnea, dysphagia and experience defecation difficulties, so was treated with palliative surgery to help relieve the symptoms.

A Case of Melanocytic Nevus Associated with Epidermal Cyst / 대한피부과학회지

Nevus with a cyst is characterized by a melanocytic nevus that is closely associated anatomically with an epidermal cyst. It is important to recognize this common benign condition because the growth of these lesions is sometimes misinterpreted by the patient and clinicians as presenting either a new melanoma or malignant transformation of a preexisting lesion. We report a case of intradermal melanocytic nevus associated with an epidermal cyst which developed in a 68-year-old man.

Detection of childhood leukemia by chest P-A and its early diagnostic value

Leukemia, the most common malignant disease in the pediatric field, is one of the most interesting targets ofmodern medical research. So we reviewed the bone changes in 51 patients of leukemia admitted to the Dept. ofPediatrics Jeonbug National University Hospital for 5 years from Jan. 1st 1977 to Dec. 31st 1981. The results wereas follow. The male patient was more prevalent with sex ratio male to female 2.7:1, and the highest incidence wasnoticed between 2 years and 4 years of age (23.5%) and followed by between 6 years and 8 years of age (21.6%).Acute lymphocytic leukemia occurred in 62.7%(32 cases) and acute myelocytic leukemia in 33.3%(17 cases), chronicmyelocytic leukemia in 2%(1 case), acute monolcytic leukemia in 2%(1 case). The most common symptoms and signs onadmission was fever (56.9%), and followed by lymphadenopathy(52.9%), hepatosplenomegaly (49.0%) in order ofincidence. The most common chief complaint on admission was fever (39.2%), and followed by pallor (37.3%), andgeneralized malaise (25.5%). The patients with hemoglobin value under 4.0m% occupied 21.6% and about two thirdsshowed hemoglobin less than 8.0m%. The leukocyte counts on admission between 5,000 and 1,10,000/mm3 was noticed in6 cases(11.85) and lower than 5,000/mm3 in 8 cases (15.7%). In the chest X-ray the most common osseous change wasmetaphseal band of humerus in 24 cases (47.1%) , and followed by metaphseal cortical scalloping of upper humerusin 39.2%, osteolytic change in 31.4% periosteal reaction in 7.8%, osteosclerosis in 2%. The most common extraosseous change in chest P-A was mediastinal widening with hilar lymphadenopathy in 1.4% and followed by pulmonary infiltration in 29.4%, pleural reaction in 5.9%. The twelve cases in which hematologic changes weremild, showed radiologic abnormalities in 10 cases (83%), and the 39 cases in which hematologic changes were severe, showed radiologic abnormalities in 31 cases(79%). Especially, In hematologic mild group, showed metaphyseal cortical scalloping of proximalhumerus in 5 cases (41 %), and in hematologic severe group, showed metaphyseal cortical scalloping of proximal humerus in 15 cases (40%). 50 metaphyseal contical scalloping of proximal humerus may be the key finding on detection of early childhood leukemia. The osseous changes were noticed in 75% of ALL, and 47% of AM L, and the extraosseous changes were noticed in 60% of ALL, and 47% of AML.