A Case of Familial Cutaneous Collagenoma

Familial cutaneous collagenoma is a rare hereditary disease that is inherited in an autosomal dominant pattern. It is characterized by early onset of multiple, skin-colored, sometimes hypopigmented cutaneous nodules, which initially show a symmetrical arrangement on the trunk, and later on the neck and upper limbs. We report on a case of a 45-year-old female who presented with multiple oval to round hypopigmented papules measuring 5~15 mm on her trunk. Histopathologically, the lesions showed an increased amount of collagen fibers and decreased, fragmented elastic fibers in the dermis. The skin lesions were diagnosed as familial cutaneous collagenoma and no treatment was administered. To the best of our knowledge, our case is the first reported case of familial cutaneous collagenoma (FCC) in the Korean literature.

Clinical Observation of Tattooed Prisoners / 대한피부과학회지

BACKGROUND: Little is known about the characteristics of tattoos on prisoners. OBJECTIVE: Our purpose was to investigate the clinical characteristics of tattooed prisoners and compare them with other previously reported data. METHODS: Between November 2006 and August 2010, we selected 98 tattooed men in a correctional institution in Seoul and investigated their personal and clinical information, including the average age of their first tattoo, sites of tattoos, contents of tattoos, motivations for getting tattooed, removal of tattoos, and occurrences of medical complications, etc. RESULTS: The most common educational level was the high school graduated group (39.8%). Most tattooed prisoners had a religion (83.7%). Thirty-three of the men (33.7%) had self-injuries. The average age of their first tattoo was 18.5 years, and the average number of tattoos was 2.7. Fifty-three of the tattooed prisoners (54.1%) were first-time offenders. There was a correlation between the number of tattoos and the rate of recidivism. Left arm was the most common site of tattoos (23.6%). Most of the tattoos were performed by others, especially friends (56.1%). Half of the prisoners received their tattoos in society. The most common tattoo material was Chinese ink (41.8%), and the most common motivation for getting tattoos was curiosity (48.0%). Among the various contents of the tattoos, letters were the most frequent (28.1%). Complications were observed in 16 cases (16.3%); hypertrophic scar, keloid, local skin infections, and allergic reactions such as itching. Most of the tattooed prisoners had regrets (80.6%) and requested tattoo removal. Embarrassment was the most common motivation for tattoo removal (35.4%). Removal of tattoos was attempted in 37 cases (37.8%). CONCLUSION: Most of the study results are compatible with those of previous studies. However, education level, religion, and contents of tattoos were slightly different. Further, we obtained new information regarding motivation for tattoo removal, correlation between the number of tattoos and number of crimes, and the attitudes toward their tattoos. We hope the obtained results will be helpful for understanding people with tattoos tattoo in a correctional institution.

Spinal Cord Injury Markedly Altered Protein Expression Patterns in the Affected Rat Urinary Bladder during Healing Stages

The influence of spinal cord injury (SCI) on protein expression in the rat urinary bladder was assessed by proteomic analysis at different time intervals post-injury. After contusion SCI between T9 and T10, bladder tissues were processed by 2-DE and MALDI-TOF/MS at 6 hr to 28 days after SCI to identify proteins involved in the healing process of SCI-induced neurogenic bladder. Approximately 1,000 spots from the bladder of SCI and sham groups were visualized and identified. At one day after SCI, the expression levels of three protein were increased, and seven spots were down-regulated, including heat shock protein 27 (Hsp27) and heat shock protein 20 (Hsp20). Fifteen spots such as S100-A11 were differentially expressed seven days post-injury, and seven proteins including transgelin had altered expression patterns 28 days after injury. Of the proteins with altered expression levels, transgelin, S100-A11, Hsp27 and Hsp20 were continuously and variably expressed throughout the entire post-SCI recovery of the bladder. The identified proteins at each time point belong to eight functional categories. The altered expression patterns identified by 2-DE of transgelin and S100-A11 were verified by Western blot. Transgelin and protein S100-A11 may be candidates for protein biomarkers in the bladder healing process after SCI.

Evaluation of the Quality of Life in the Patients with Chronic Urticaria / 대한피부과학회지

BACKGROUND: Chronic urticaria (CU) is one of the most common skin disorders. This disease commonly induces emotional, social and psychological problems due to the erythematous lesion and intense pruritus. But there has been inadequate objective evaluation of the quality of life (QOL) of the patients with CU in Korea. OBJECTIVE: The purpose of this study was to investigate the QOL of the Korean patients with CU by means of a new disease-specific tool and to assess the association between the QOL and the severity of disease. METHODS: A total of 118 patients with CU were interviewed using the CU QOL questionnaire (CU-Q2oL). Their symptoms were evaluated with the urticaria severity score. We analyzed the relationship between the severity score and the CU-Q2oL score with Pearson's correlation test. RESULTS: The average score of the CU-Q2oL was 50.08+/-18.68. It was high when the patients had high severity scores (p<0.01). The severity score was increased in the patients with old age and when they were married. Comorbid systemic and skin diseases, a long duration of urticaria and systemic symptoms accompanying urticaria were also related to a high severity score. CONCLUSION: This study showed that CU has a significant impact on the QOL of Korean patients with CU in proportion to the disease severity. Clinicians need to consider the QOL and the CU severity of their patients to achieve the ideal goals of treatment.

A Case of Accessory Tragus on the Nasal Vestibule

We present a case of accessory tragus (AT) which developed at an unusual site, the nasal vestibule, of a 1-day-old girl. To our knowledge, this is the first report of an accessory tragus that appears on the nasal vestibule.

A Case of Trichilemmoma on the Right Shoulder / 대한피부과학회지

Trichilemmoma is a benign, solitary, small tumor that might often be misdiagnosed as a basal cell carcinoma or verruca. It is usually seen on the face, and especially on the nose and cheeks. A 79-year-old Korean man presented with a 2.0x2.0 cm-sized nodular mass on his right shoulder and the lesion was histopathologically diagnosed as a trichilemmoma. The atypical clinical appearance and localization of his neoplasm did not help us diagnose the lesion, and the histological findings were the only clues for making the diagnosis of trichilemmoma.

A Case of Milia Occurring on Superficial Basal Cell Carcinoma of the Face / 대한피부과학회지

We report here on a 71-year-old female who had well-demarcated erythematous patches, along with some pearly papules, on the right cheek. Histopathological examination of the lesions revealed a basaloid cell mass, which appeared to be a superficial basal cell carcinoma, and a small keratin-filled cyst that appeared to be a milium. A part of the milium was surrounded by the basaloid cells of tumor islands and milia later developed on the lesion of basal cell carcinoma. We suggest that basal cell carcinoma may be one of the causes of secondary milia.

Efficacy of EMLA(R) for Pain Relief during PhotodynamicTherapy in the Treatment of Common Warts / 대한피부과학회지

BACKGROUND: Photodynamic therapy (PDT) in the treatment of warts is known to be a relatively effective and safe cure. However, the pain, which occurs during being exposed to a light source and after its exposure, is being reported to be the most frequent and serious limitation in this therapy. OBJECTIVE: The purpose of this study is to examine whether the level of pain can be lowered, by comparing EMLA(R), which is a topical anesthesia, with placebo, during topical ALA-PDT, and to try to compare the range and characteristics in pain. METHODS: Twenty two patients with common warts were treated with ALA-PDT twice in the interval of 4 weeks, and were divided into two groups by the random distribution table. The distribution was made so that the patients, who used EMLA(R) as the topical anesthesia given at the first visit, could use a placebo at the second visit, and so that the patients who used placebo at the first visit, could use EMLA(R) at the second visit. Thus, a randomized, double-blind, placebo-controlled crossover study was carried out. The pain was evaluated during the treatment, right after the treatment, and one day after the treatment by using Visual Analogue Scale (VAS). Also four different ranges of the pain and its six characteristics were evaluated. RESULTS: Of the 22 patients with common warts who underwent this study. 1 patient, was completely cured after the first visit, and did not participate further in the study. The data of the patients with complete recovery wasn't included in the final statistical analysis. As a result of the evaluation of pain, the mean VAS score that was measured during the treatment, right after the treatment, and one day after the treatment was measured to be a little lower in the case of applying EMLA(R) versus placebo, but a statistically significant difference was not observed. Regarding the degree of pain, regardless of applying EMLA(R), most patients felt painful locally on the surface, and the majority complained of burning and shooting pain. CONCLUSION: Dermatologists tend to routinely apply EMLA(R), prior to a procedure in order to decrease pain. However, as a result of this research, the routine use of EMLA(R) given at PDT is thought to be unreasonable.

Acquired Reactive Perforating Collagenosis in a Chronic HCV Hepatitis Patient Who was Treated with Interferon Alpha / 대한피부과학회지

Reactive Perforating Collagenosis (RPC) is a kind of perforating dermatosis, which shows transepidermal elimination of altered collagens. Acquired form is developed in an adult without family history, is favorably developed in scratched region due to pruritic sense. Acquired RPC has been reported to be associated with various systemic disorders, such as diabetes mellitus, liver disease, chronic renal failure, lymphoma, AIDS, hypothyroidism, hyperparathyroidism, and neurodermatitis, accompanied by itching & scratching. We report a case of acquired RPC in a patient with HCV hepatitis who was treated with interferon alpha. Skin lesions showed multiple erythematous centrally umbilicated, crusted papules of variable sizes on the extensor surfaces of both shins.

A Case of Cutaneous Smooth Muscle Tumor of Uncertain Malignant Potential / 대한피부과학회지

Smooth muscle tumors have been classified into leiomyoma and leiomyosarcoma. But the criteria for malignancy are not well defined. Traditionally, mitoses are the most important differentiating feature between leiomyoma and leiomyosarcoma. However mitotic activity was regarded as an acceptable finding in about 20% of cutaneous leiomyoma. The widely used designation "smooth muscle tumor of uncertain malignant potential" is a reflection of the limitation of available criteria to precisely diagnose tumors with borderline atypical features. We present herein a case of a cutaneous smooth muscle tumor of uncertain malignant potential, which is mitotically active, on the abdomen of a 45-year-old man.

A Case of a Solitary Type of Congenital Self-healing Reticulohistiocytosis / 대한피부과학회지

Congenital self-healing reticulohistiocytosis (CSHRH) typically presents at birth or in the first few weeks of life as a widespread eruption of cutaneous red-brown papulonodules that resolve spontaneously without involvement of other organs. While multiple lesions are common, a solitary lesion is rare. We describe a solitary type of CSHRH in a full-term, male neonate. He had an erythematous papule with a yellowish crust on the left heel without any systemic symptoms. Four weeks later, the skin lesion had disappeared spontaneously.