A Case of Atypical Dyschromatosis of Unilateral Dermatomal Distribution / 대한피부과학회지

We report a 19-year-old patient with numerous mottled hyperpigmented and hypopigmented macules over his left upper and lower extremities and left side of trunk. which are unilateral and dermatomal distribution. He has had these macules for 5 years. The family history does not revealed similar pigmentary changes. The pigmented macules resemble those of dyschromatosis universalis herediteria or dyschromatosis symmetrica hereditaria. In addition, the histopathologic features were also simlar to those reported in dyschromatosis, but clinically our case had unilateral dermatomal distribution which was different from typical dyschromatosis. Therefore, We think our case as atypjcal dyschromatosis

A Case of Extramammary Paget's Disease of the Axilla / 대한피부과학회지

Extramammary Paget's disease is able to affect genital, perianal, axillary, periauricular regions and eyelids. Extramammary Paget's disease has been almost always reported on the genital and perinanal area. Extramammary Paget's disease of the axilla has not been reported until now in Korean literature. We report a case of extramammary Paget's disease of the axilla in a 53-year-old female.

A Case of Pigmented Clear Cell Acanthoma

No abstract available.

Correlation between Androgenetic Alopecia and Lipid Parameters for Risk Factors of Coronary Artery Disease / 대한피부과학회지

BACKGROUND: The association of androgenetic alopecia and coronary artery disease has not been well documented although many studies have tried to reveal this association. This relationship is still a controversial issue. OBJECTIVES: The aim of this study is to investigate the association between the androgenetic alopecia and lipid parameters for risk factors of coronary artery disease. METHODS: The subjects of this study were 102 patients with androgenetic alopecia who had visited the Department of Dermatology, Pil-dong Hospital, College of medicine, Chung-Ang University during 2 years (from January 2000 to December 2001). The subjects of control group were 40 male individuals who had no androgenetic alopecia, no risk factor of coronary artery disease and no coronary artery disease. RESULTS: 1. There were significant differences in the serum total lipid, phospholipid, triglyceride between the patients and the control group. But there were no significant differences in serum LDL-cholesterol, HDL-cholesterol, and total cholesterol between the two groups. 2. There were significant differences in the serum total lipid, phospholipid, triglyceride between frontal baldness patients and the control group (p<0.05). But there were no significant differences in the serum LDL-cholesterol, HDL-cholesterol, and total cholesterol between the two groups. 3. There were significant differences in the serum total lipid, phospholipid, triglyceride, LDL-cholesterol, and total cholesterol between vertex baldness patients and the control group (p<0.05). But there were no significant differences in serum HDL-cholesterol between two groups. 4. There were no significant differences in the serum total lipid, phospholipid, triglyceride, LDL-cholesterol, HDL-cholesterol and total cholesterol between androgenetic alopecia patients who were increased serum testosterone and the control group. CONCLUSION: These data suggest that androgenetic alopecia involving the vertex scalp is associated with significantly increased total cholesterol and LDL-cholesterol for risk factors of coronary artery disease. We recommend that dermatologists should investigate the lipid parameters, especially total cholesterol and LDL-cholesterol in vertex baldness patients.

Expression of Sodium-dependent Vitamin C Transporter in Rat Dermal Fibroblasts / 대한피부과학회지

BACKGROUND: Vitamin C is one of the most typical types of water-soluble antioxidants that exerts a variety of biochemical actions on a living body. It acts on the skin by promoting wound healing, preventing skin aging, and inhibiting skin cancer. It also works not only as an antioxidant, protecting the skin from UV radiation but also as an anti-inflammatory agent. It reinforces immunity as well. Recent studies proved the whitening effect of vitamin C, and it can be instilled into the skin by way of iontophoresis. When vitamin C is transported in vivo it is either by simple diffusion or by a transporter. Only a small amount is transported by simple diffusion and the transporter is responsible for most of the vitamin C transport. This study was designed to evaluate the presence of sodium dependent vitamin C transporter (SVCT) and to identify which factor controls its expression. METHODS: Expressions of SVCT 1 and 2 mRNA in the rats' dermal fibroblast were measured by RT-PCR at 3, 6, 12, 24, and 48 hours. RESULTS: The results were used to compare the expression levels of SVCT-1 and SVCT-2 when treated with TGF-beta, estradiol, and retinoic acid. Estradiol showed the highest level of expression of SVCT-1 and SVCT-2. The next highest was TGF-beta, followed by retinoic acid. CONCLUSION: SVCT-1 and SVCT-2 were found to be expressed in the rats' dermal fibroblasts, and exposure to estradiol, TGF-beta and retinoic acid resulted in a higher degree of their expression.

A Case of Majocchi's Granuloma Caused by Trichophyton rubrum / 대한의진균학회지

Dermatophytes usually do not invade beyond the epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state may allow penetration of the fungi into reticular dermis. We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 39-year-old male presented with 3.5x5 cm sized, erythematous, ulcerated lesion on the left heel for about 1 month. Histologic findings of the skin lesion showed granulomatous change and numerous hyphae in the dermis. Trichophyton rubrum was isolated on the fungus culture. The patient was treated with terbinafine (250 mg/day) for 10 weeks, resulting in the clearing of the skin lesion.

A Case of Majocchi's Granuloma Caused by Trichophyton rubrum / 대한의진균학회지

Dermatophytes usually do not invade beyond the epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state may allow penetration of the fungi into reticular dermis. We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 39-year-old male presented with 3.5x5 cm sized, erythematous, ulcerated lesion on the left heel for about 1 month. Histologic findings of the skin lesion showed granulomatous change and numerous hyphae in the dermis. Trichophyton rubrum was isolated on the fungus culture. The patient was treated with terbinafine (250 mg/day) for 10 weeks, resulting in the clearing of the skin lesion.

Two Cases of Agminated Lentigines / 대한피부과학회지

Agminated lentigines is characterized by numerous lentigines confined to a body segment, with a sharp demarcation at the midline. We report two cases of agminated lentigines, which were of asymmetric distribution on one side of the body, in a 16-year-old girl and a 27-year-old woman. The Lesions of the first patient were zosteriform, they involved the left side of the chest, axilla and shoulder. Lesions of the second case were involved on the left side of the abdomen and flank. Histologic examination showed hyperpigmentation of the basal layer, elongation of rete ridges, and an increased number of melanocytes.

A Case of Edematous Striae Distensae by Corticosteroid and Generalized Edema in Nephrotic Syndrome / 대한피부과학회지

Striae distensae are characterized by linear, smooth bands of atrophic-appearing skin. In histologic findings, the epidermis is thin and flattened. There is a decrease in the thickness of the dermis. Separation of collagen fibers and small, fragmented elastic fibers are seen in the dermis. Striae distensae develop as a result of disruption of the connective tissue framework. Main mechanism of edematous striae distensae is disintegration of collagen, followed by the pressure induced by generalized edema as the secondary mechanism. The patient is a 17-year-old boy who had generalized pitting edema and abdominal distension due to nephrotic syndrome. On the abdomen, he has presented with edematous striae and ulceration with exudate for 1 week. Edematous striae distensae are uncommon but can develop from the combined effects of glucocorticoid and generalized edema. We report a case of edematous striae distensae in nephrotic syndrome.

A Case of Pyoderma Gangrenosum Associated with Ulcerative Colitis / 대한피부과학회지

We present a case of pyoderma gangrenosum associated with ulcerative colitis. The patients, a 21-year-old women has suffered from skin defect on the left chest and pubic area since 7 days ago. During treatment for pyoderma gangrenosum she developed new gastrointestinal symptoms such as nausea, vomiting, and diarrhea. On colonoscopic examination and biopsy she was diagnosed ulcerative colitis. Prednisolone was given orally in the dose of 60mg/day and mesalamine was given orally in the dose of 1000mg/day for ulcerative colitis. Clinical improvement was observed after 15 days.

A Case of Sebaceous Epithelioma Arising from Nevus Sebaceus / 대한피부과학회지

Nevus sebaceus is a congenital cutaneous hamartoma which has a potential to develop both benign and malignant neoplasms in late life. One of the benign neoplasms is sebaceous epithelioma that is developed secondarily in lesions of nevus sebaceus. We have experienced a case of sebaceous epithelioma associated with nevus sebaceus in a 54-year-old male. Two nodular tumors developed on the verrucous surfaced yellowish plaque on the scalp. Histopathologic examination revealed mature sebaceous glands in the upper dermis and ectopic apocrine glands in the lower dermis on the verrucous surfaced yellowish plaque, and undifferentiated basaloid cells which were arranged in a palisading pattern at the periphery and groups of mature sebaceous cells on the two nodular tumors. We report a case of sebaceous epithelioma arising from nevus sebaceus.

Two Cases of Scrofuloderma / 대한피부과학회지

Scrofuloderma results from a direct extension of an underlying tuberculosis focus such as the lymph node, bone or joint to the underlying skin, and is often associated with pulmonary tuberculosis. One 72-year-old man presented with erythematous swollen patch with scales on the left hand and erythematous swollen patch on the left elbow. He had tuberculous osteomyelitis of left elbow. And another patient who is a 59-year-old man presented with hemorrhagic, purulent ulcers with crust and exudate on the left and right chest. Each size of ulcers are 6.0x5.0cm and 5.0x5.0cm. He had reactive pulmonary tuberculosis and tuberculous spondylitis. Biopsy specimens from the skin showed lymphocytes, epitheloid cells, and Langerhan's giant cells with caseation necrosis. Acid-fast bacilli were identified on AFB staining. We report two unusual cases of scrofuloderma associated with tuberculous osteomyelitis and pulmonary tuberculosis respectively.

A Case Considering of Majocchi's Granuloma Caused by Trichophyton mentagrophytes / 대한의진균학회지

Majocchi's granuloma is well recognized, uncommon infection of dermal and subcutaneous tissue by dermatophytes. The organism usually associated with Majocchi's granuloma is Trichophyton (T.) rubrum. However, other dermatophytes including T. mentagrophytes, T. violaceum, M. audouinii, M. gypseum, M. ferrugineum, and M. canis may be the causative agent. Dermatophytes usually do not invade beyond epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state, such as diabetes mellitus, malignancy, and long term steroid use may allow penetration of fungi together with keratin and necrotic materials into the dermis. A 19-year-old woman presented with erythematous patch on the left lower extremity for 2 years. She had a history of breeding pet dog infected with fungus 3 years ago and treated with antifungal agent for 6 months in local clinic under the impression of tinea corporis. The examination revealed erythematous discrete papulopustular patch with brownish to violaceous scaly margin. KOH examination showed negative result, but histopathologic finding of pustular skin lesion showed chronic granulomatous inflammation with fungal element. The fungal culture grew T. mentagrophytes. The patient was started on itraconazole 200mg daily for 4 weeks and successfully treated. Herein we report a case considering of Majocchi's granuloma by T. mentagrophytes.

A Clinical Study of Skin Diseases in Elderly Patients(IV) / 대한피부과학회지

BACKGROUND: With the advance of socioeconomy and medical science, the population of the aged has been significantly increased. Therefore it needs to be studied the fundamental epidemiologic survey of dermatologic disease in the elderly. OBJECTIVES: The purpose of this study is to evaluate the prevalence of common dermatoses in the elderly and to compare these to previous studies. METHOD: 1,916 out-patients over 65 years old who had visited the Department of Dermatology, University Hospital and Yongsan Hospital, College of Medicine, Chung Ang University from January, 1996 to December, 2001 were analyzed retrospectively. RESULTS: 1. The incidence of aged group over 65 years old to total number of out-patients(24,723) was 7.7%(1,916 cases). 2. The ratio of male to female was 1.06 : 1(986:930). 3. The frequent skin diseases were herpes zoster(12.0%), benign tumor(9.0%), pruritus(8.9%), onychomycosis/tinea pedis(7.7%), contact dermatitis(7.2%), seborrheic dermatitis(5.4%). 4. Eczema was the most common disease group which revealed 18.5%. The second most frequent group was viral infection(15.3%), followed by fungal infection(12.7%), tumor(12.0%), urticaria, drug eruption and erythema(9.4%), pruritus(8.9%), papulosquamous disease(2.8%) and bacterial infection(2.6%). 5. The most common disease in each disease group were as follows : contact dermatitis in eczema, herpes zoster in viral infection, onychomycosis and tinea pedis in fungal infection, urticaria in urticaria, drug eruption and erythema group, generalized pruritus in pruritus group, psoriasis in papulosquamous disease and folliculitis in bacterial infection, respectively. 6. Among 235 cases of skin tumor, 175 cases(74.5%) were benign and the remaining 60 cases(25.5%) were premalignant or malignant. The frequency of benign tumor was in order of seborrheic keratosis, epidermal cyst, skin tag and lipoma, respectively. In malignancy, there were basal cell carcinoma, squamous cell carcinoma and cutaneous metastatic carcinoma. CONCLUSION: Compared to previous studies, tumor and pruritus showed a increasing tendency but eczema a decreasing tendency.