A Case of Stevens-Johnson Syndrome Caused by Acetazolamide / 대한피부과학회지

A 53-year-old man having glaucoma treated with acetazolamide. After 7 days, he developed diffuse erythematous papules on both forearms and hands with multiple erosive lesions on his lips and genitalia. In the diagnosis of Stevens-Johnson syndrome, he was treated with systemic prednisolone with no sequale. Acetazolamide, which is a kind of sulfa drug and carbonic anhydrase inhibitor is commonly prediscribed by ophthalmologists. However severe side effects such as Stevens-Johnson syndrome has been overlooked. Moreover, according to recent research, HLA-B59 was known to be detected in Stevens-Johnson syndrome caused by methazolamide, which is analogous to acetazolamide. For these reasons, we emphasized the possibility of adverse drug reaction due to acetazolamide and the need caution about genetic risk factor through HLA typing.

A Case of Bullous Scabies Mimicking Epidermolysis Bullosa Aquisita / 대한피부과학회지

We report a case of bullous scabies in a 81-year-old male patient. He had severe pruritic, multiple tense bullae on erythematous base with erosions and crusts from which scabies mites were identified. Histopathologic findings(H&E) revealed subepidermal bulla and direct immunofluorescence showed linear deposition of IgG and C3 at the dermoepidermal junction and linear IgG, C3 deposition at the dermal side of the salt split skin test. However, no EBA or BP antigens were detected. Although skin lesions improved after antiscabietic and oral steroid treatments, pruritic bulla developed repeatedly with scabies reinfestation or discontinuation of oral treatment.

A Case of Atypical Progressive Cribriform and Zosteriform Hyperpigmentation / 대한피부과학회지

We report a case of atypical progressive cribriform and zosteriform hyperpigmentation (PCZH) in a 4-year-old boy. Progressive cribriform and zosteriform hyperpigmentation is a distinctive pigmentary disorder first described by Rower et al. in 1978. It is characterized clinically by uniformly tan cribriform macular pigmentation in a zosteriform distribution and histopathologically by increased melanin in the basal cell layer and absence of nevus cells. This case has two distinctive findings; the onset age was below 10 years and the lesions distributed on the whole body along Blaschko's lines. Histopathologic examination showed pigmentary incontinence.

A Case of Multiple Eccrine Spiradenoma associated with Multiple Trichoepithelioma / 대한피부과학회지

Eccrine spiradenoma is a benign adnexal tumor which is differentiated into the direction of eccrine gland. Occasionally, eccrine spiradenoma is associated with other skin tumors, especially cylindroma or trichoepithelioma. A 55-year-old woman with multiple trichoepithelioma on the face presented with paroxysmally painful three papules on the face and the right arm for 5 months. On low magnification, the tumor was a sharply demarcated lobule surrounded by a fibrous capsule in the dermis. On higher magnification, the lobule is composed of basophilic cells arranged in characteristic small rosettes, two cell types of which are large central cells of pale nuclei and small peripheral cells of dark nuclei. We, herein, report an unusual case of multiple eccrine spiradenoma associated with multiple trichoepithelioma.

Shiitake Dermatitis in Korea ; Clinical and Histopathologic Study / 대한피부과학회지

BACKGROUND: Shiitake dermatitis has been reported mostly from Japan and characterized by distinctive pattern of itchy skin eruption after the ingestion of raw shiitake mushrooms. OBJECTIVE: The purpose of this study is to investigate clinical, laboratory and histopathologic profiles about shiitake dermatitis occurring in Korea. METHODS: From 1997 to 2001, we had observed 58 patients with shiitake dermatitis and investigated clinical, laboratory and histopathologic aspects. RESULT: Most patients with shiitake dermatitis presented with a very strong itching sensation, which was accompanied with linearly grouped or disseminated small erythematous papules. 53 patients(91%) had noticed their skin eruption within 3 days after eating shiitake mushrooms. The involved sites were trunk, extremities, neck and face in decreasing order of frequency. Laboratory and histopathologic findings were nonspecific. In 33 patients(57%), the eruption occurred after eating boiled or panbroiled shiitake mushrooms. CONCLUSION: In this study, clinical, laboratory and histopathologic findings of shiitake dermatitis were almost consistent with the previous reports. But, contrary to the previous reports in Japan, many cases with shiitake dermatitis occurred on eating sufficiently boiled or cooked shiitake mushrooms. This may imply another eiologic factor different from thermolabile toxin.

A Case of Papular Xanthoma / 대한피부과학회지

Papular xanthoma is a very rare disorder. It is characterized by an eruption of papular and papulonodular xanthomatous elements located on the head, trunk, and extremities. No systemic involvement can be found and blood lipid levels are normal. Histologically there is an infiltrate composed of foamy histiocytes and Touton giant cells in the dermis and characteristically no initial nonlipidized histiocytic phase can be traced in the early development of the lesion. We present a case of papular xanthoma in a 18-month-old boy with typical clinical, histopathologic findings.

High Energy Electron Beam Therapy for Epithelial Skin Cancers of the Head and Neck / 대한피부과학회지

BACKGROUND: High energy electron beam therapy is an excellent modality for treating epithelial skin cancers with high local tumor control, good cosmesis and low complication. OBJECTIVE: Our purpose was to determine the local control rate, complication rate and cosmesis of electron beam therapy with histopathologically confirmed epithelial skin cancers. METHODS: A total of 23 consecutively treated, biopsy proven epithelial skin cancers of the head and neck treated with electron beam therapy were retrospectively analyzed to determine the rate of local control, radiotherapy reaction and cosmesis. RESULTS: Seventy percent of patients received electron beam therapy after biopsy only and 26% received electron beam therapy following surgical excision with pathologically positive margins or insufficient excision. The overall local tumor control rate was 87%. Patients with basal cell carcinoma had a 89% overall control rate; patients with squamous cell carcinoma had 80%. Excellent or good cosmesis was achieved in 96%. Side effects were mild and self-limiting. CONCLUSION: Electron beam therapy remains an excellent treatment modality for epithelial skin cancer and offers excellent cosmesis.

A Case of Trichilemmal Horn

Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.

Linear Focal Elastosis Associated with Striae Distensae in an Atopic Patient / 대한피부과학회지

We report a case of linear focal elastosis associated with striae distensae. A 20-year-old man presented with asymptomatic, several, striae-like yellow palpable bands extending horizontally in the lumbar region. Histologic examination revealed many fine wavy and fragmented bundles of elastic fibers in the dermis. Striae distensae were also presented in the buttock, axilla. He had been treated with topical steroids for atopic dermatitis since childhood. This patient can be one more case to support the association between linear focal elastosis and striae distensae.

A Case of Steatocystoma Multiplex on the Face in a Family / 대한피부과학회지

We describe a family with a two-generation history of steatocystoma multiplex with an unusual clinical manifestation. A 7-year-old boy had multiple asymptomatic, small, yellowish cysts on the face since birth. His father and 4-year-old brother also presented several similar persistent cysts localized to the face. This family had no other abnormality on physical examination. The cysts discharged oily yellow material when incised. Biopsy of several lesions disclosed that the cysts had typical features of steatocystoma multiplex histologically.

A Case of Solitary Neurofibroma on the Finger with Nail Deformity / 대한피부과학회지

We report an 82-year-old woman with a solitary neurofibroma occurring on the middle finger and nail deformity. Neurofibroma may present as multiple or solitary lesions. Although there is no predilection site of solitary lesion, the occurrence on hands is rare. We report a case of solitary neurofibroma on hand with typical histologic findings but not with pain, numbness and dysfunction.

A Case of Melanonychia Caused by Trichophyton rubrum / 대한피부과학회지

We report a case of fungal melanonychia caused by Trichophyton (T.) rubrum in a 69-year-old female patient. She had brownish to black pigmentation affecting all toe nails that clinically simulated melanonychia. Mycologic examination of toe nails revealed T. rubrum. The causes of melanonychia are numerous, but fungal origin is rare. Although T. rubrum is known to be one of the frequently isolated organisms of fungal melanonychia, there have been no reports of T. rubrum-induced melanonychia yet in Korea.

A Case of Eruptive Steatocystoma Multiplex on the Scalp / 대한피부과학회지

A 46-year-old man had noticed an asymptomatic, small, yellowish, papular eruption on the scalp about one year ago. Since then, the lesions had slowly increased in size and number. There was no family history of similar lesions. An incision made into the cysts discharged oily yellow material. Biopsy of a lesion disclosed that the cysts had typical features of steatocystoma multiplex histologically. This case was a unique eruptive variety of steatocystoma multiplex on the scalp.