A Study of Skin Color by Melanin Index according to Sex, Age, Site and Skin Phototype in Koreans

BACKGROUND: Skin color is determined by many factors including melanin and nonmelanin pigments like hemoglobin and extraneous chemicals. Various factors such as race, sex, and age have been reported to have an influence on skin color. METHODS: Measurement of malanin index (M-index) was made by reflectance spectropho-tometer at three different sites including forehead, abdomen and forearm in total 800 healthy subjects consisting of 100 males and 100 females of neonates (three days after birth) and children (male:8.08±0.84, female:8.03±0.80, total :8.06±0.82 years of age), ado-lescence (mate:13.89± 0.76, female:13.96±0.79, total:13.93±0.78 years of age), and adults(male:24.26±0.82, female:24.40±0.89, total:24.33±0.86 years of age). We also investigated the change of M-index by each skin phototype of college students determined by Fitzpatrick classification. RESULTS: From the birth to the puberty, sex difference of melanin index was generally not not-ed, but adult females showed lower levels of melanin index in all sites measured. M-index in-creased from birth to adolescence, and decreased after adulthood. Forehead showed highest melanin index compared with other sites. Increase of M-index was noted as skin phototype goes from III to V. CONCLUSIONS: Factors including sex, age, body sites and skin phototype have a significant in-fluence on the changes of skin color in humans.

Rupture of Renal Artery in a Patient with Behçet's Disease

The vascular involvement is seen in 8% to 24% of patients with Behçet's syndrome. Arterial lesions are less frequently observed and the involvement of renal artery is very rare. Indeed, there is only one case report of ruptured renal aneurysm due to Behc et's disease. We report a case of renal artery rupture, which was likely caused by Behçet's disease. Even though we cannot completely rule out the other causes of renal artery rupture with this patient, the rupture was likely due to vascular involvement of Behçet's disease. Dermatologists always should consider the possibility of major vessel involvement when they treat patients with Behçet's disease, even if the incidence is very low and the patient may not complain of any systemic symptoms. INTRODUCTION: Behçet's disease was first defined by Hulusi Behçet's in 1937 as a multisystemic disease with the triad of recurrent aphthous stomatitis, genital ulceration and relapsing iritis. Its etiology remains obscure. It is accepted that the pathologic process of Behçet's disease is an immunologic vasculitis. Among vascilar lesions, the venous system is the major affected site. Arterial lesions, such as aneurysms or occlusions, are rarely reported, but sometimes adversely affects the course of the disease. Aneurysm formation is known to be life-threatening because of the risk of rupture.

A Case of Tubular Apocrine Adenoma

Tubular apocrine adenoma(TAA) is a rare benign neoplasm usually found on the scalp. It has been designated as an apocrine histogenesis on the basis of its ultrastructural characteristics, enzyme, and immunohistochemical phenotype. Histopathologically the neoplasm consists of tubules or cysts, which show signs of apocrine secretion and sometimes needs to be differentiated from papillary eccrine adenoma. We report a typical case of TAA on nostril which shows differentiation toward apocrine in nature.

A Clinical and Histopathologic Study of Syringoma / 대한피부과학회지

BACKGROUND: Syringoma is a relatively common benign appendageal tumor derived from the intraepidermal eccrine ducts. It occurs predominantly in women at puberty or later in life. The lesions usually are multiple and may be present in great numbers. Histopathologically, numerous small ducts are embedded in a fibrous stroma and their walls are lined by two rows of epithelial cells. OBJECTIVE: The aim of this study is to investigate clinical and histopathologic features of syringoma in Koreans. METHODS: Total 32 patients were included in this study. Data complied were sex, age, onset of disease, symptoms, family history, localization, distribution, and some histopathologic findings including acanthosis, basal hyperpigmentation, proliferation of fibrous stroma, vacuolization of cells, keratin-filled cyst, and characteristic tad-pole appearance. RESULTS: 1. It was observed predominantly in females as the sex ratio of 31:1. The mean age at diagnosis was 37.5-years-old. 2. The age of onset was in the 2nd decade in 9 patients, 3rd decade in 10 patients, 4th decade in 7 patients, 5th decade in 5 patients, and 7th decade in 1 patient. 3. Only two patients complained of mild itching. 4. Family history was noted in 14 patients. 5. It occurred most frequently in the upper and lower eyelids(28 cases), and followed by forehead(5 cases), genitalia(3 cases), temple(2 cases), cheek(1 case), and neck(1 case). 6. The distribution was bilateral except two patients. 7. The color of lesion showed skin-colored(23 cases), yellowish(6 cases), and brownish (3 cases). 8. Twelve cases of acanthosis, 11 cases of basal hyperpigmentation, 26 cases of proliferation of fibrous stroma, 13 cases showing vacuolization of inner cell layer of ducts, 8 cases showing keratin-filled cysts and 15 cases showing characteristic tad-pole appearance were observed. CONCLUSION: According to our study, syringoma predominantly occurs in eyelids of women as bilateral asymptomatic skin-colored papules and histopathologic findings frequently shows keratin-filled cysts.

The Effect of Nerve Growth Factor on Proliferation of Cultured Human Melanocytes / 대한피부과학회지

BACKGROUND: Nerve growth factor(NGF) is a neurotrophic polypeptide necessary for the survival and growth of some central neurons, as well as sensory afferent and sympathetic neurons. In addition to its actions on the nervous system, it also has significant biologic effects on cells of the immune-inflammatory compartment. NGF can variably induce melanocyte mitosis, increase melanogenesis, enhance dendricity and prevent apoptotic cell death following the UV injury. OBJECTIVE: The purpose of this study is to evaluate the effects of NGF on proliferation of cultured human melanocytes. METHODS: The effects of NGF on proliferation of cultured human melanocytes were evaluated. To specify the NGF effect on proliferation of human melanocytes, excess of anti-NGF neutralizing polyclonal antibody was added. RESULTS: 1) In 1% of melanocyte growth supplement(MGS) medium, all experimental groups showed no significant increase of cell number. The addition of anti-NGF polyclonal antibody did not influence the proliferation of melanocytes. 2) In 0.2% of MGS medium, all experimental groups showed no significant increase of cell number. The addition of anti-NGF polyclonal antibody did not influence the proliferation of melanocytes. CONCLUSION: These results suggest that, even though NGF has many biological influencse on melanocytes, it does not play a significant role in the proliferation of melanocyts.

Two Cases of Cutaneous Metastasis from Hepatoma Mimicking Pyogenic Granuloma

Metastatic cancers to the skin are rare and usually originate in the lung, breast, large intestine, or ovary. They commonly present with lesions in the area overlying the neoplasm, but the morphology, pattern and distribution may vary. Hepatoma metastasizes to the lungs, adrenal glands, regional lymph nodes, portal vein, gallbladder, pancreas, bone, hepatic vein, kidney, mediastinum, less commonly, the heart, peritoneum, diaphragm, and bone marrow. Cutaneous metastasis from hepatoma occurs very rarely and, if present, it usually presents as solitary or multiple nodules. We report two cases of cutaneous metastases from hepatoma.

A Case of Photoallergic Contact Dermatitis Due to Ketoprofen Plaster / 대한피부과학회지

Ketoprofen, a propionic acid derivative is a non-steroidal anti-inflammatory drug with analgesic activity and it is used in the symptomatic treatment of rheumatoid arthritis and osteoarthritis. When exposed to sunlight, ketoprofen is broken down into various benzophenones. 3-ethyl-benzophenone as the major photoproduct is responsible for the photoallergic reaction to ketoprofen. A 30-year-old male presented with well-demarcated erythematous patches with itching sensation on both his ankle areas. He had applied Ketotop(R) plasters on both his ankle areas for arthralgia, and then the Ketotop(R) plaster-detached areas were exposed to sunlight. Patch test and photopatch test with?as is?showed positive reaction in photopatch test and the ingredients of Ketotop(R) plaster revealed positive reaction to the ketoprofen contained in Ketotop(R) plaster in photopatch test.

The Effect of Nerve Growth Factor on Cell Proliferation and Expression of Its Receptors in Cultured Human Keratinocytes / 대한피부과학회지

BACKGROUND: Nerve growth factor(NGF) is a neurotrophic polypeptide necessary for the survival and growth of some central neurons, as well as sensory afferent and sympathetic neurons. In addition to its actions on the nervous system, it also has a significant biologic effects on cells of the immune-inflammatory compartment. Recent studies suggest that NGF is an important autocrine growth factor and survival factor for keratinocytes which express both high- and low-affinity receptors for NGF. OBJECTIVE: The purpose of this study is to detect NFG receptors on cultured human keratinocytes and to evaluate the effect of NGF on proliferation of cultured human keratinocytes. METHODS: Cultured human keratinocytes were examined for the expression of high affinity receptor TrkA and low affinity receptor p75 by Northern blot, Western blot and immunocytochemistry. The effects of NGF on proliferation of cultured human keratinocytes were also evaluated. To specify the NGF effect on proliferation of human keratinocytes, excess of anti-NGF neutralizing polyclonal antibody was added. RESULTS: 1) NGF significantly stimulated the proliferation of keratinocytes in both 1% of keratinocyte growth supplement(KGS)-added medium(100ng/ml) and 0.2% KGS-added media(50, 100, 500ng/ml), (p<0.05). The cell number was dose-dependently increased in 0.2% KGS-added media. 2) Whenever we added 500 ng/ml of anti-NGF polyclonal antibody to the growth media, the cell number was statistically higher in 100ng/ml NGF-added group of 1% KGS-added medium, but there was not any statistical significance in 0.2% KGS-added media group. 3) Immunocytochemical staining with specific antibodies to TrkA and p75 revealed positive findings for these receptors, but TrkB and TrkC were not detected. 4) We could not detect both the mRNA and protein of TrkA and p75 by Northern and Western blot methods. CONCLUSION: These results suggest that both high affinity- and low affinity receptors for NGF are expressed in cultured human keratinocytes and NGF can induce keratinocyte proliferation.

A Case of Linear and Whorled Nevoid Hypermelanosis / 대한피부과학회지

Linear and whorled nevoid hypermelanosis(LWNH) is a congenital disorder which was first described by Kalter in 1988 and is characterized by asymmetrically distributed linear and whorled hyperpigmentation following Blaschko's lines. It usually appears at birth or during the first weeks of life and is rarely associated with various congenital defects. Its pathogenesis is not well known, but developmental somatic mosaicism appears the most likely cause. It is probably not a rare disease, but not well recognized or is confused with other entities. Herein, we report a typical case of LWNH in 9 month-old boy.

Immunohistochemical Study on the Expression of Chemokines and Chemokine Receptors in Psoriasis / 대한피부과학회지

BACKGROUND: Psoriatic keratinocytes express CXC chemokines like IL-8 and GRO-alpha, and CC chemokines like MCP-1 and RANTES, which have a significant role in the accumulation of inflammatory cells in psoriatic skin and both CXCR1 and CXCR2 receptors are also expressed in psoriatic keratinocytes, which suggests that IL-8 and GRO-alpha could have a role in the characteristic epidermal changes through binding to their receptors in psoriatic keratinocytes. OBJECTIVE: The purpose is to understand the pathogenetic mechanisms of psoriasis by comparing immunoreactivity of various chemokines and chemokine receptors between lesional and non-lesional skin of psoriasis. METHODS:We have performed immunohistochemical studies with mouse anti-human IL-8, mouse anti-human GRO, anti-huamn MCP-1, mouse anti-human RANTES, anti-human CDw 128 IL-8RA/ CXCR1, and anti-human IL-8RB/CXCR2 for lesional and non-lesional skin of ten psoriatic patients. RESULTS: 1.Immunohistochemical reactivity for IL-8 is stronger in lesional epidermis than non-lesional epidermis(p<0.05) and immunohistochemical reactivity for GRO-alpha is stronger in lesional epidermis than non-lesional epidermis(p<0.05). 2.Immunohistochemical reactivity for MCP-1 is stronger in lesional epidermis than non-lesional epidermis(p<0.05), and immunohistochemical reactivity for RANTES is stronger in lesional epidermis than non-lesional epidermis(p<0.05). 3.Immunohistochemical reactivity for CXCR1 is stronger in lesional epidermis than non-lesional epidermis(p<0.05) and immunohistochemical reactivity for CXCR2 is stronger in lesional epidermis than non-lesional epidermis(p<0.05). 4.Immunofluorescent staining reveals positive finding in epidermis of lesional psoriasis, but negative finding in CXCR2. CONCLUSION: These results suggest that psoriatic keratinocytes express CXC chemokines like IL-8 and GRO-alpha, and CC chemokines like MCP-1 and RANTES, which have a significant role in the accumulation of inflammatory cells in psoriatic skin and that both CXCR1 and CXCR2 receptors are also expressed in psoriatic keratinocytes, which suggests that IL-8 and GRO-alpha could have a role in the characteristic epidermal changes through binding to their receptors in psoriatic keratinocytes.

A case of xanthogranuloma in adult / 대한피부과학회지

Juvenile xanthogranuloma(JXG) is a benign disorder in which one, several, or occasionally numerous red to yellow nodules are present. The lesion may be present at birth, but usually arises in early infancy. Adult-onset xanthogranuloma clinically differ from juvenile xanthogranuloma in that the lesion is usually solitary and does not involve internal organs, and generally does not resolve without treatment. We report a case of xanthogranuloma in adult which occurred on the scalp and the trunk of 52-year-old male showing typical clinical and histopathological findings.

Immunohistochemical Study on the Expression of Chemokines and Chemokine Receptors in Psoriasis / 대한피부과학회지

BACKGROUND: Psoriatic keratinocytes express CXC chemokines like IL-8 and GRO-alpha, and CC chemokines like MCP-1 and RANTES, which have a significant role in the accumulation of inflammatory cells in psoriatic skin and both CXCR1 and CXCR2 receptors are also expressed in psoriatic keratinocytes, which suggests that IL-8 and GRO-alpha could have a role in the characteristic epidermal changes through binding to their receptors in psoriatic keratinocytes. OBJECTIVE: The purpose is to understand the pathogenetic mechanisms of psoriasis by comparing immunoreactivity of various chemokines and chemokine receptors between lesional and non-lesional skin of psoriasis. METHODS:We have performed immunohistochemical studies with mouse anti-human IL-8, mouse anti-human GRO, anti-huamn MCP-1, mouse anti-human RANTES, anti-human CDw 128 IL-8RA/ CXCR1, and anti-human IL-8RB/CXCR2 for lesional and non-lesional skin of ten psoriatic patients. RESULTS: 1.Immunohistochemical reactivity for IL-8 is stronger in lesional epidermis than non-lesional epidermis(p<0.05) and immunohistochemical reactivity for GRO-alpha is stronger in lesional epidermis than non-lesional epidermis(p<0.05). 2.Immunohistochemical reactivity for MCP-1 is stronger in lesional epidermis than non-lesional epidermis(p<0.05), and immunohistochemical reactivity for RANTES is stronger in lesional epidermis than non-lesional epidermis(p<0.05). 3.Immunohistochemical reactivity for CXCR1 is stronger in lesional epidermis than non-lesional epidermis(p<0.05) and immunohistochemical reactivity for CXCR2 is stronger in lesional epidermis than non-lesional epidermis(p<0.05). 4.Immunofluorescent staining reveals positive finding in epidermis of lesional psoriasis, but negative finding in CXCR2. CONCLUSION: These results suggest that psoriatic keratinocytes express CXC chemokines like IL-8 and GRO-alpha, and CC chemokines like MCP-1 and RANTES, which have a significant role in the accumulation of inflammatory cells in psoriatic skin and that both CXCR1 and CXCR2 receptors are also expressed in psoriatic keratinocytes, which suggests that IL-8 and GRO-alpha could have a role in the characteristic epidermal changes through binding to their receptors in psoriatic keratinocytes.

A case of xanthogranuloma in adult / 대한피부과학회지

Juvenile xanthogranuloma(JXG) is a benign disorder in which one, several, or occasionally numerous red to yellow nodules are present. The lesion may be present at birth, but usually arises in early infancy. Adult-onset xanthogranuloma clinically differ from juvenile xanthogranuloma in that the lesion is usually solitary and does not involve internal organs, and generally does not resolve without treatment. We report a case of xanthogranuloma in adult which occurred on the scalp and the trunk of 52-year-old male showing typical clinical and histopathological findings.

Two Cases of Nerve Sheath Myxomas

Nerve sheath myxoma(NSM) is a rare cutaneous neoplasm of uncertain histogenesis. NSM can be divided into two groups; NSM1 (a myxoid NSM) and NSM2 (a cellular neurothekeoma). NSMs are characterized histologically by well-defined, lobular or plexiform dermal proliferation of stellate, spindle-shaped cells embedded in abundant myxoid stroma. A variable amount of nerve fascicles are entrapped within and around the tumor. Two variants of NSM share the same features to a certain degree but differ in cellularity and mucin deposition. We report two cases of NSMs with different clinical and histopathologic features.