Patch Testing in Patients with Lichen Simplex Chronicus / 대한피부과학회지

BACKGROUND: Lichen simplex chronicus (LSC) may develop under various chronic pruritic conditions, such as allergic contact dermatitis (ACD). However, there have been only a few studies on the relationship between ACD and the development of LSC. OBJECTIVE: To investigate the clinical features and frequency of contact sensitization in patients with LSC. METHOD: In a retrospective study, 71 patients with LSC, who had shown resistance to conventional treatment and had been examined with patch tests in the Korean standard series, were evaluated for their clinical features and results of the patch testing. RESULTS: 1. The patients comprised of 32 males and 39 females. The mean age was 51.8 (19-80) years, and the highest incidence was shown in the 50-60 year age range. The predominant sites of the dermatitis were the trunk (25.4%), arms (16.7%), widespread on the body (14.7%), the scalp (9.8%) and the neck (9.8%). 2. Sixty five (91.5%) out of 71 patients showed a positive reaction to one or more allergens. The highest sensitization rates were found with: nickel sulfate (38%), balsam of Peru (25.6%), 4-phenylenediamine base (23.9%), fragrance mix (22.5%), mercury ammonium chloride (18.3%), cobalt chloride (18.3%) and potassium dichromate (15.5%). CONCLUSION: This study shows that contact sensitization may possibly play an etiologic role in the development of LSC, and there are some dominant allergens, including nickel, 4-phenylenediamine, balsam of Peru and fragrance mix. Therefore, when LSC is resistant to conventional treatment, it is important to carry out patch testing, and to bear in mind the possibility of ACD contributing to the development of LSC.

A Case of Lichen Sclerosus et Atrophicus on the Scalp / 대한피부과학회지

No abstract available.

Efficacy of Interferon-alpha2b in Treatment of Warts / 대한피부과학회지

BACKGOUND: Interferon-alpha2b has already proven to be effective in the clinical treatment of virus-originated diseases such as hairy cell leukemia, condyloma acuminatum, and AIDS-related Kaposi's sarcoma. The use of recombinant interferon-alpha2b may allow various types of wart to be treated relatively atraumatically and with less incidence of recurrence. OBJECTIVE: We tried to compare the effectiveness and safety of intralesional injections of recombinant interferon-alpha2b with natural interferon-alpha2b in the treatment of patients with various types of wart. METHOD: Patients with more than two warts were treated by injecting the different warts with 0.5 to 1.0X105 IU/1mm3 of recombinant and natural interferon-alpha2b, twice per week for 4 to 20 weeks. The response to treatment was followed up at 36 weeks. RESULTS: At the end of treatment, clearing of the treated warts had occurred in 83.3% of the recombinant interferon-alpha2b group and 91.6% of the natural interferon-alpha2b group. A more rapid cure rate was observed in the natural interferon-alpha2b group than in the recombinant interferon-alpha2b group. The rest showed partial improvement. With evaluation for relapse up to 16 weeks after treatment, warts were found to relapse in 11.1% of both the recombinant and natural interferon groups. CONCLUSION: Intralesional natural interferon-alpha2b has a better therapeutic effect than recombinant interferon-alpha2b, and may be considered as a therapeutic modality of recalcitrant verruca or when it can be anticipated that destructive techniques or blistering agents will not be tolerated.

A Case of Alopecia Mucinosa Occurring in the Nasal Canal of a Child / 대한피부과학회지

We report a case of alopecia mucinosa in a 9-year-old girl. She presented with several papules on an erythematous patch on the right side of the ala nasi, a hairless nodular lesion on the same side of the nasal canal. Histopathologic findings obtained from the nasal canal revealed typical features of alopecia mucinosa, such as reticular degeneration, cystic space formation and mucin deposition in the pilosebaceous follicle. The case displayed no evidence or clinical features of any malignant changes, and we suspect the case to be an acute form of alopecia mucinosa.

A Case of Bednar Tumor / 대한피부과학회지

A Bednar tumor is a rare pigmented subtype of dermatofibrosarcoma protuberans (DFSP). The clinical and histopathological findings of Bednar tumors are identical to DFSP, except for the presence of melanin-containing cells within the lesion. We present a case of a Bednar tumor on the left anterior chest of a 58-years-old woman. It was presented as an asymptomatic, firm, hyperpigmented 1.8x2.7cm sized nodule with surrounding erythematous patch which had been present for over 35 years. The tumor was treated by wide local excision of the lesion. There has been no evidence of recurrence during a 1 year follow-up period.

A Case of Basal Cell Carcinoma Arising in Linear Porokeratosis

Porokeratosis are characterized by distinct clinical findings of a keratotic ridge that corresponds to the cornoid lamella on histology and has well defined potential for malignancy. We report a case of basal cell carcinoma(BCC) arising in linear porokeratosis in a 77-yearold man.

A Case of Infarcted Supernumerary Digit / 대한피부과학회지

The hand is complex embryological organ and the supernumerary digit is one of the most common congenital anomalies of the upper limbs. We report a premature female with congenital grotesque mass on her left hand that was found roentgenographically and histopathologically to be composed of infarcted cartilage structure. The patient had also congenital heart disease. We treated it with total excision.

A Case of Congenital Constricting Band of the Trunk / 대한피부과학회지

Congenital constricting band of the trunk is a rare malformation with a wide spectrum of associated congenital anomalies. A 3-year-old boy with a congenital constricting band around the waist and anterior thigh and clubfoot deformity is reported. Laboratory test and chest and abdominal X-ray examination were within normal limits and unremarkable. Histopathologic examination revealed compact fibrocollagenous bundles in deep dermis. The compact fibrocollagenous bundles are parallel to the skin surface and have thin wavy nuclei. We think these bundles caused annular constriction on the trunk. We follow up the patient regularly without specific treatment because the constricting band caused no functional impairment and hypertrophic scar had developed at the biopsy site.

A Case of Cutaneous Protothecosis / 대한피부과학회지

Protothecosis is an unusual cutaneous soft tissue infection caused by the Prototheca, which is a genus of the unicelluar, achloric algae. We report a case of cutaneous protothecosis in a 66-year-old female, who showed erythematous, purulent patches and plaques with ulcerations on the right forearm for 2 months. Biopsy specimen revealed the characteristic thick-walled morulalike sporangia in the dermis. Prototheca wickerhamii was isolated in the culture and the biochemical study. Electron microscopic examination showed the thick-walled spores containing dark dense bodies and amyloplasts. After two months of oral itraconazole 200mg/day, skin lesions were improved.

A Simple Detection Method of the Resistance to the Treatment of Onychomycosis: A Case Report of Aspergillus sydowii Onychomycosis

A 35-year-old housewife was diagnosed with onychomycosis and treated by oral terbinafine, 250mg/day, for 4 months. Clinically all infected nails improved gradually. However, her left great toe-nail was not improved thereafter. At that time the proximal end of the onychomycotic lesion was marked with surgical blade, and terbinafine therapy was continued for four weeks. However, the onychomycotic nail was not improved, and the scratch mark passed by the proximal end of the infected nail. Therefore, we detected the resistance to the therapy and switched the medication to itraconazole 100 mg/day and then another scratch mark was done at the proximal end of the onychomycotic lesion. After another 2 weeks the infected nail went along with the scratch mark distally, and showed clinical improvement. After 8 weeks therapy of itraconazole, she was cured clinically and mycologically. The fungal culture was identified as Aspergillus sydowii.

Clinical and Statistical Survey of Skin Changes in Korean Neonates / 대한피부과학회지

A total of 748 newborns delivered at the Fatima Hospital, Taegu, Korea, over period of 8 months were examined for the presence of skin lesions within 48 hours of birth. The frequencies of the type of birthmarks were: salmon patch, 61.8%; portwine stain, 0.7%; mongolian spot, 99.1%; cafe-au-lait spot, 0.5%; congenital nevomelanocytic nevus, 0.5%; milia, 44.5%; sebaceous hyperplasia, 76.9%; nevus sebaceus, 0.9%; erythema toxicum neonatorum, 29.3%; genital hyperpigmentation, 49.7%. Erythema toxicum neonatorum was less common in premature infants and more frequent on the second day of life than first one. Genital hyperpigmentation was observed predominantly in the male neonate. There was positive relationship between genital hyperpigmentation and birthweight.

Clinical Study of Halo Nevi / 대한피부과학회지

BACKGROUND: There have been few clinical studies of halo nevi. OBJECTIVE: The purpose of this study was aimed at evaluating the clinical and histopathologic features of halo nevi and correlation between halo nevi and vitiligo. METHODS: The medical records of 40 patients with halo nevi and biopsy specimens of 30 patients with halo nevi were reviewed. RESULTS AND CONCLUSION: 1.The ratio of male to female patients was 1:1.5. 2.The mean age of the onset was 20.1 years (male : 11.5, female : 25.9). 3.Multiple halo nevi were present in 32.5%(male : 25%, female : 37.5%). 4.The areas in which the lesions developed were head and neck(39.1%), back(32.8%), anterior chest(12.5%), abdomen(10.9%), groin(3.1%), and lower extremity(1.6%) in descending order. 5.The mean duration of each color in central nevus was as follows: black(2.7 years), pink(3.5 years), gray(4.9 years) 6.The most common pathology of the central nevus was intradermal(80%). 7.The halo nevi associated with vitiligo were 21 cases(52.5%) out of 40 patients. Among them, the cases with non-segmental vitiligo were 13(61.9%), the cases with segmental vitiligo were 8(38.1%). 8.Out of the 21 cases with halo nevi associated with vitiligo, the cases with halo nevi prior to vitiligo were 4(19.1%), concurrent onset 12(57.1%) and the cases with halo nevi after vitiligo were 5(23.8%).

The Ivory Colored Hypopigmentation After Autologous Suction Blister Grafts in Vitiligo Lesion May be Caused by the Pretreated Deep Freeze

BACKGROUND: Ivory colored hypopigmentation has been frequently observed in morphea and lichen sclerosus et atrophicus, and also seen after phenol peels, dermabrasion, cryosurgery and post-laser resurfacing. OBJECTIVE: This study was undertaken to investigate the cause of hypopigmentation following autologous suction blister graft (ASBG) in vitiligo patients. METHODS: The ivory lesion and contralateral normal skin were collected by punch biopsies. And the tissues were stained with hematoxylin-eosin, Fontana-Masson, Masson's trichrome, Verhoeff-van Gieson, and S-100 protein to compare the differences between two specimens. RESULTS: H-E and Masson's Trichrome stains showed that compacted hyalinized sclerotic collagens and collapsed, small sized capillaries in the upper dermis were definite in the hypopigmented lesion, whereas norma1 control sites were unremarkable. Elastic fibers were markedly decreased or fragmented in upper dermis of the hypopigmented lesion. Fontanna-Masson stain identified that the lesional epidermis was more hyperpigmented rather than hypopigmented. S-100 stain showed no differences between hypopigmented and contro1 sites. CONCLUSION: The results suggest that the ivory colored hypopigmentation is not caused by the failure of procedure, but by scar formation due to deep freeze; therefore, this kind of complication may be prevented by carefully performing the cryotherapy.

An Epidermoid Cyst with Seborrheic Verruca-like Cyst wall Showing Incidental Acantholysis

A 37-year-old female was presented with an epidermal cyst on her lower back. Histopathologic examination was consistent with an epidermoid cyst with seborrheic verrucalike cyst wall and acantholytic change was also found in the cyst wall. Human papillomavirus(HPV)-specific DNA sequences in paraffin-embedded tissue section were not detected by polymerase chain reaction using HPV consensus primers.