Subcutaneous Panniculitis-like T cell Lymphoma with Hemophagocytic Syndrome / 대한피부과학회지

Subcutaneous pnniculitis-like T cell lymphoma (SPTCL) is a rare subtype of cutaneous T cell lymphoma which clinically and histopathologically mimics benign panniculitis. It presents as tender erythematous, subcutaneous nodules or plaques on the extremities and trunk, and displays systemic symptoms such as weight loss, fever, chills, fatigue or myaligia. The association of hemophagocytic syndrome (HPS) portends a poor prognosis. We report a case of SPTCL that occurred in a 20-month-old girl. She presented with multiple erythematous subcutaneous nodules on the face, right thigh, buttocks and trunk, plus fever and vomiting. Histopathological examination of the subcutaneous nodules revealed a dense infiltration of atypical T-lymphoid cells in the subcutaneous fat layer, with rimming of fat cells, numerous karyorrhetic bodies and histiocytes, phagocytosed apoptotic cells and Bean bag cells In spite of combination chemotherapy, she died of disseminated intravascular coagulation due to HPS.

A Case of Extramammary Paget's Disease / 대한피부과학회지

Extramammary Paget's disease (EMPD) is a disorder that frequently affects the anogenital region in the elderly. Clinically, it presents a well circumscribed, reddish brown plaque. Histopathologically, the lesion is characterized by large pale "Paget's cells" usually restricted to the epidermis. In general, approximately 20% of affected individuals may develop either a subjacent eccrine or apocrine carcinoma or an internal malignancy, mainly rectal, vaginal, or bladder carcinoma. A high recurrence rate has been reported after excision. We present a case of extramammary Paget's disease with intradermal tumor, which entirely consists of Paget cells and was connected to intraepidermal Pagetoid proliferation by several columns.

The Clinical Effect of Topical Diphenylcyclopropenone (DPCP) Therapy in the Treatment of Atopic Dermatitis in Children and Adolescents / 대한피부과학회지

BACKGROUND: Atopic dermatitis is the most common chronic skin disease in childhood. Severe atopic dermatitis may require use of topical or systemic corticosteroids. These treatments are prone to several adverse side effects. This paper highlights the impressive effect of diphenylcycloprope none(DPCP) sensitization in some cases of childhood and adolescent atopic dermatitis. OBJECTIVE: The purpose of this study was to examine the effect of DPCP in treating severe atopic dermatitis of children and adolescents. METHODS: Twenty eight patients, who had moderate to severe atopic dermatitis, were recruited in the treatment of DPCP weekly for 10 weeks and followed up for another 4 weeks. Severity of atopic dermatitis was measured using SCORAD index. RESULTS: Sixteen of 28 patients had finished the treatment courses. After 10 weeks of therapy with DPCP, the patient's symptoms were improved and the mean SCORAD index was significantly reduced from 48.9+/-17.8 to 18.0+/-9.1 (p<0.01). During the follow-up period, patients could be managed by topical steroid and oral antihistamine and flare-up was not observed. CONCLUSION: According to our study, DPCP can be an effective, safe and well-tolerated therapy for moderate to severe atopic dermatitis in children and adolescents. We suggest that DPCP may be effective in the treatment of moderate to severe atopic dermatitis of children and adolescents without serious complications.

A Case of Zosteriform Cutaneous Metastasis from Transitional Cell Carcinoma of the Urinary Bladder / 대한피부과학회지

The usual sites of the bladder cancer metastases are lymph nodes, liver, lungs and bone. The incidence of metastases to the skin from bladder cancer has been reported to be between 0.2 and 2%. Cutaneous metastases from transitional cell carcinoma (TCC) of the bladder occur infrequently. Metastatic skin cancers vary in type, in rare instances, zosteriform metastases may occur. A 77-year-old man with transitional cell carcinoma of the bladder presented with multiple grouped erythematous papuloplaques and nodules which had developed on the right abdomen, flank and back in zosteriform distribution. Histopathologic examination revealed dermal pleomorphic cellular infiltration and tumor cells in lymphatic vessels. It represents a case of zosteriform cutaneous metastasis from transitional cell carcinoma of the urinary bladder.

A Case of Intradermal Fasciitis of the Scalp / 대한피부과학회지

Nodular fasciitis represents reactive fibroblastic or myofibroblastic proliferative lesions which may be misdiagnosed as sarcomas due to the rich cellularity, mitotic activity and variant morphologic pattern. It arises in the subcutaneous tissue, skeletal muscles, and fascia. Uncommon clinical and pathological variants of nodular fasciitis, such as intradermal, intravascular, cranial, ossifying, parosteal and proliferative fasciitis, have been described. We present a 23-year-old man with a one year history of a 2x1.5cm sized hard tender nodule on the scalp which is partially depressed at the margin. Histological examination revealed clusters of spindle cells in a myxoid background, chronic inflammatory cells and extravasated red cells in the dermis. Immunohistochemically, the spindle cells showed positivity of vimentin or smooth muscle actin, and negativity of desmin or S-100 protein. The staining results support its myofibroblastic origin. There is no involved bony lesion on the brain computed tomography (CT). Therefore we report a rare case of intradermal fasciitis arising on the scalp.

Two Cases of Myrmecia Occuring on the Dorsum of Finger / 대한피부과학회지

Myrmecia, a type of palmoplantar warts, are induced by human papilloma virus type 1(HPV1). They occur not only on the palms and soles, but also on the lateral aspects and tips of fingers and toes. Histologically, it is characterized by abundant eosinophilic inclusion bodies associated with HPV1 E4 gene products. We report two cases of myrmecia developing on the dorsum of finger.

A Case of Xanthoma Disseminatum / 대한피부과학회지

Xanthoma disseminatum is a rare benign, normolipemic form of histiocytoxanthomatosis, affecting the skin and mucous membranes, frequently associated with diabetes insipidus. It occurs mainly in young to middle-aged adults. The cutaneous manifestations consist of hundreds of yellowish papules which symmetrically involve the trunk, face, and proximal extremities including flexures and folds. The histopathologic finding is a mixture of foamy cells, histiocytes, and inflammatory cells. We report a 6-year-old male who had disseminated asymptomatic yellowish papules and plaques on whole body including flexures since infancy. Histological examination showed infiltrating foamy cells with lymphocytes and histiocytes in upper dermis. He had normal lipid profiles and symptoms of polyuria or polydipsia were absent.