ABSTRACT
BACKGROUND: Pilomatricoma is a benign, appendageal tumor differentiating towards the normal hair follicles and is characterized by basaloid, transitional, and shadow cells. It is most frequently seen in children; however, a bimodal onset distribution is observed in the first and sixth decades. OBJECTIVE: The purpose of this study was to analyze the clinical and histopathological features of pilomatricomas in patients over 50 years of age, and to compare these features with those occurring in patients under 20 years of age. METHODS: We retrospectively reviewed the medical records and histopathological findings of 73 patients under 20 years and above 50 years of age. The morphological stages of the tumors were analyzed through histopathological findings. RESULTS: The age of patients in the over 50-year age group ranged from 50 to 82 years, with a mean age of 60 years. The male-to-female ratio was 1.1:1. The duration of lesions was from 1 month to several years, with half of the patients having the tumors for over 12 months. The predilection sites were the head (51%), followed by the upper extremities (21%), neck (15%), trunk (6%), and lower extremities (6%). In 73% of the patients over 50 years of age, pilomatricoma was less likely the suspected diagnosis compared with that in the under 20-year age group. Epidermal cysts were most likely suspected in patients over 50 years of age. Histopathologically, half of the tumors were located in the subcutis, which was not significantly different when compared with pilomatricomas in the under 20-year age group. The most common evolutional stage of tumors was early regressive (52%), followed by late regressive (27%), fully developed (15%), and early stage (6%). Capsulation (9%), inflammatory cell infiltration (60%), multinucleated giant cells (36%), calcification (33%), and ossification (12%) were observed. With the exception of capsulation, there were no significant differences in these histopathological features in pilomatricomas in patients over 50 years of age compared with those in patients under 20 years of age. CONCLUSION: Pilomatrichomas in patients over 50 years of age show no pain, are located in the head and neck, are present for a long duration, and have various clinical presentations when compared with those in patients under 20 years of age. However, they are not rare tumors in adults. Accordingly, pilomatricomas should be included in the clinical differential diagnosis of a solitary, deep skin tumors presenting in adults, especially when they occur on the head.
Subject(s)
Adult , Child , Humans , Diagnosis , Diagnosis, Differential , Epidermal Cyst , Giant Cells , Hair Follicle , Head , Lower Extremity , Medical Records , Neck , Pilomatrixoma , Retrospective Studies , Skin , Upper ExtremityABSTRACT
Annular elastolytic giant cell granuloma is a rare form of granulomatous dermatosis, characterized clinically by annular plaques with slightly elevated margins, and histopathologically by the phagocytosis of elastic fibers by multinucleated giant cells. It typically occurs in sun-exposed areas of the skin in middle-aged women. However, some cases involving unexposed areas have been described. A 57-year-old man had erythematous plaques on both palms accompanied by a sensation of heat for 2 weeks. Histopathological examination revealed granulomatous infiltration with multinucleated giant cells and elastophagocytosis, which is consistent with annular elastolytic giant cell granuloma. Herein we report an interesting case of annular elastolytic giant cell granuloma that occurred on non-sun-exposed skin, palms.
Subject(s)
Female , Humans , Middle Aged , Elastic Tissue , Giant Cells , Granuloma, Giant Cell , Hot Temperature , Phagocytosis , Sensation , Skin , Skin DiseasesABSTRACT
Grover disease (GD), also referred to as transient or persistent acantholytic dermatosis, is an acquired pruritic papular or papulovesicular eruption characterized histopathologically by focal acantholysis and dyskeratosis. Because GD resembles several generalized papular diseases, the diagnosis of GD is a clinical challenge, particularly when dermatologists meet patients without papular eruptions. We experienced two elderly men showing eczematoid plaques with severe pruritus on their backs. Histopathological examinations revealed a focal acantholysis, spongiosis, and dyskeratosis, a pattern consistent with GD. We report two cases of GD with clinical features of nonspecific eczematous dermatosis.
Subject(s)
Aged , Humans , Male , Acantholysis , Diagnosis , Pruritus , Skin DiseasesABSTRACT
Grover disease (GD), also referred to as transient or persistent acantholytic dermatosis, is an acquired pruritic papular or papulovesicular eruption characterized histopathologically by focal acantholysis and dyskeratosis. Because GD resembles several generalized papular diseases, the diagnosis of GD is a clinical challenge, particularly when dermatologists meet patients without papular eruptions. We experienced two elderly men showing eczematoid plaques with severe pruritus on their backs. Histopathological examinations revealed a focal acantholysis, spongiosis, and dyskeratosis, a pattern consistent with GD. We report two cases of GD with clinical features of nonspecific eczematous dermatosis.
Subject(s)
Aged , Humans , Male , Acantholysis , Diagnosis , Pruritus , Skin DiseasesABSTRACT
No abstract available.
Subject(s)
Blue Toe Syndrome , Disseminated Intravascular CoagulationABSTRACT
BACKGROUND: Ulnar nerve palsy leads to thumb-web depression, hypothenar flattening, and inter-digital depression in patients with leprosy. To camouflage these deformities, patients used to inject paraffin or silicone oil into the areas of muscle atrophy associated with thumb-web depression and hypothenar flattening. After several years and decades, paraffinomas eventually resulted in extensive inflammatory fibrosis and recalcitrant recurrent ulcers at the injection sites. OBJECTIVE: The aim of this study is to compare the results of different surgical treatments for paraffinomas in patients with leprosy, and to find out the most effective treatment method that has a low recurrence rate. METHODS: Between January 2000 and December 2012, 47 patients with paraffinomas who had visited the Korean Hansen Welfare Association Hospital were enrolled to participate in the study. The number of paraffinomas was 56, and the mean age of the patients was 73 years. A retrospective evaluation of the cosmetic results and recurrence rate was performed. RESULTS: Of the 56 surgically treated paraffinomas, 30 lesions were treated using primary closure, 20 lesions were treated with skin graft, and 6 lesions were treated with skin flap. The cosmetic outcomes, which were assessed using a four-point grading scale, were excellent in 10.7% (6/56), good in 25% (14/56), fair in 38% (21/56), and poor in 28% (15/56) of the patients. There were no significant differences among the three surgical procedures with respect to the cosmetic results. The recurrence rate was 33% (10/31) in the primary closure group, 50% (10/20) in the skin graft group, and 17% (1/6) in the skin flap group. There were no significant differences in the recurrence rate among the three surgical procedures. CONCLUSION: The extensive and aggressive curettage of lesions is very important to reduce recurrence rate. When the older age of the patients is considered in conjunction with the simplicity of the operation and the total operation time, primary closure is considered the treatment of choice both cosmetically and practically.
Subject(s)
Humans , Congenital Abnormalities , Curettage , Depression , Fibrosis , Leprosy , Muscular Atrophy , Paraffin , Recurrence , Retrospective Studies , Silicone Oils , Skin , Transplants , Ulcer , Ulnar NeuropathiesABSTRACT
No abstract available.
ABSTRACT
Terbinafine is a highly effective oral antifungal agent that is used to treat dermatophyte infections of the skin and nails. Although generally well tolerated, common side effects of terbinafine include nausea, vomiting, abdominal pain, urticarial or erythematous eruptions, and pruritus. Taste disturbance is a rare side effect of terbinafine, occurring in 0.6%approximately2.8% patients taking the drug orally. Here, we report the case of a 67-year-old man who complained of taste disturbance and loss of appetite 1 month after starting terbinafine treatment for onychomycosis. Low body mass index and advanced age are considered predisposing factors for the development of terbinafine-induced taste disturbance. As the proportion of elderly population is increasing, the frequency in use of the prescription of drugs such as terbinafine for the elderly is also increasing. Therefore, clinicians should be aware of this unfamiliar and uncommon adverse effect associated with the antifungal agent, terbinafine and should perform careful follow-up of elderly patients with low BMI taking this medication, as they may become depressed or alter their food intake in response to a decrease or loss of taste sensation.
Subject(s)
Aged , Humans , Abdominal Pain , Appetite , Arthrodermataceae , Body Mass Index , Causality , Eating , Follow-Up Studies , Nausea , Onychomycosis , Prescriptions , Pruritus , Sensation , Skin , VomitingABSTRACT
In Korea, physician assistants (PAs) have emerged owing to the shortage of medical residents, especially in the surgical departments of tertiary hospitals. In addition, the Korean Ministry of Health and Welfare has been planning to reduce the number of medical residents. Hence, training hospitals decided to hire PAs to replace medical residents. PAs can perform a large part of residents' time-consuming job. However, PAs are not a common type of workforce in the field of dermatology. The aim of this study is to compare the roles of dermatology specialist, resident, PAs, and registered nurse (RN), and discuss the limitations and futures of PAs in the field of dermatology. Moreover, in Korea, the legal definition and status of PAs are absent or, if present, inconsistent. Between PAs and other positions such as residents, registered nurses, and nurse specialists, lies an unsettled conflict. Therefore, if PAs are employed, a more precise complement is needed.
Subject(s)
Humans , Complement System Proteins , Dermatology , Korea , Physician Assistants , Specialization , Tertiary Care CentersABSTRACT
In Korea, physician assistants (PAs) have emerged owing to the shortage of medical residents, especially in the surgical departments of tertiary hospitals. In addition, the Korean Ministry of Health and Welfare has been planning to reduce the number of medical residents. Hence, training hospitals decided to hire PAs to replace medical residents. PAs can perform a large part of residents' time-consuming job. However, PAs are not a common type of workforce in the field of dermatology. The aim of this study is to compare the roles of dermatology specialist, resident, PAs, and registered nurse (RN), and discuss the limitations and futures of PAs in the field of dermatology. Moreover, in Korea, the legal definition and status of PAs are absent or, if present, inconsistent. Between PAs and other positions such as residents, registered nurses, and nurse specialists, lies an unsettled conflict. Therefore, if PAs are employed, a more precise complement is needed.