High Dose UVA-1 Phototherapy for Morphea / 대한피부과학회지

Morphea is a rare, sclerotic connective tissue disorder and is thought to be caused by a decreased collagenase activity. Numerous treatment modalities have been tried, such as infiltration with glucocorticosteroid, D-penicillamine, antimalarial agents and cyclosporine. However, all have shown only limited success. We report a case of a 21 year- old female with localized scleroderma, who showed a marked improvement after localized therapy with high dose UVA-1.

A Case of Granulocyte Colony-stimulating Factor InducedVasculitis with Atypical Myeloid Cells / 대한피부과학회지

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor (HGF) with many applications in cancer therapy. Many cutaneous adverse reactions associated with G-CSF have been reported in recent years, including injection site reactions, pyoderma gangrenosum, Sweet's syndrome, cutaneous leukocytoclastic vasculitis, and widespread folliculitis. We report a case of vasculitis with atypical myeloid cell induced by G-CSF on the lower extremities

A Case of Lichen Planus Limited to the Soles / 대한피부과학회지

Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. As palmoplantar lichen planus do not usually have the classically clinical features of lichen planus, a biopsy is very useful. Histopathologic findings are identical to classic lichen planus. According to literature, similar lichen planus may be found elsewhere on the body in palmoplantar lichen planus. We report a case of lichen planus limited to the soles in a 50 year-old female, who presents with erythematous hyperkeratotic crusted pruritic plaques on both soles.

A Case of Macular Amyloidosis due to Nylon Towel / 대한피부과학회지

Amyloidosis is a disorder of protein metabolism characterized by the extracellular deposition of abnormal protein fibrils. We report a case of macular amyloidosis due to nylon towel on his back. A 61-year-old male presented with asymptomatic hyperpigmented macules on the scapulae for 6 years. He had a habit of scrubbing his back for many years with a rough nylon towel while taking a bath. The histologic examination revealed liquefaction degeneration and homogenous eosinophilic deposition in the papillary dermis. In Congo red, amyloid material stained positively and in anti-keratin antibody staining. He had neither clinical nor laboratory evidence of systemic amyloidosis. A diagnosis of friction amyloidosis was made on histological and immunohistopathological findings.

A Case of Kikuchi's Disease (Histiocytic Necrotizing Lymphadenopathy) Showing Typical Histopathologic Findings in Cutaneous Lesion / 대한피부과학회지

Kikuchi's disease(Histiocytic necrotizing lymphadenitis) is an idiopathic, self-limiting disease typically affecting cervical lymph nodes in young adults. Cutaneous involvement has been reported in 16-40%. We report a case of Kikuchi's disease in 10-year-old female that showed asymptomatic erythematous papules on the face accompanied by cervical lymphadenopathy. The histopathologic examination of the skin revealed diffuse dermal lymphohistiocytic infiltrate, a large amount of nuclear dust with absence of neutrophils, which is characteristic of Kikuchi's disease. In general, histopathologic findings of skin biopsy show a mirror image of that of lymph nodes involved in Kikuchi's disease. Therefore, it is important to recognize cutaneous manifestations of this entity, because we can avoid invasive lymph node biopsy. if skin lesions involved show typical histopathologic findings of Kikuchi's disease.

A Case of Vancomycin-Induced Linear IgA Bullous Dermatosis / 대한피부과학회지

Linear IgA bullous dermatosis(LAD) is a subepidermal blistering disease characterized by linear IgA deposits in the basement membrane zone when visualized on direct immunofluorescence microscopy. Intravenous vancomycin has been the drug most implicated, and this disease has been termed vancomycin-induced LAD. Vancomycin-induced LAD tends to spontaneously resolve upon discontinuation of the offending drug. A 70-year-old male patient developed septic knee. Bacterial cultures from this lesion grew methicillin- resistant Staphylococcus aureus. He was treated with vancomycin. Eight days after vancomycin injection, painful bullae appeared on the trunk, feet, and genitalia. A skin biopsy showed a subepidermal blister with an infiltrate composed of neutrophils and eosinophils. Direct immunofluorescence of perilesional skin showed linear IgA deposition at dermo-epidermal junction. The vancomycin was stopped; teicoplanin was substituted. He was treated with dapsone. The use of vancomycin is increasing in Korea and therefore it is important for dermatologist to be aware of the association with LAD.

A Case of Metastatic Leiomyosarcoma on the Scalp / 대한피부과학회지

Leiomyosarcoma are malignant mesenchymal tumors usually found in the uterus, retroperitoneaum, gastrointestinal tract, or deep soft tissue. They do however, rarely occur as primary skin tumors. Metastases from a leimyosarcoma to skin are unusual. We report a case of metastatic leiomyosarcoma on the scalp. A 47-year -old female had hysterectomy following diagnosis of leiomyosarcoma 17 months ago. She presented with an 8 months history of a solitary nontender nodule on the scalp. The histological examination revealed a well demarcated, quite high cellular tumor nodule in the deep dermis . A tumor was usually composed of spindle cells with abundant eosinophilic cytoplasm and elongated, blunt ended nuclei. Some other cells showed pleomorphic nuclei and mitotic figures. Immunohistopathological staining of smooth muscle actin was positive. A diagnosis of metastatic leiomyosarcoma was made on histological and immunohistopathological findings.

A Case of Verrucous Hyperplasia with Lymphedema of the Leg Amputation Stump / 대한피부과학회지

Verrucous hyperplasia shows multiple warty like lesion on the amputation stump, but the pathologic findings of viral verrucae has not been discovered. A verrucous plaque on the amputation stump of the right leg was found in 31-year-old man. He had suffered from a traumatic amputation of right leg since 8 years ago. A leg prosthesis had been worn since that time. Histopathologic findings shows hyperkeratosis, acanthosis, papillomatosis, superficial dermal edema and dilated thick-walled venules oriented vertical to the skin surface. Verrucous hyperplasia was diagnosed with lymphedema on the basis of clinical and histological findings.