A Case of Majocchi Granuloma Caused by Microsporum canis Presented as Tinea Incognito / 대한피부과학회지

No abstract available.

Eruptive Clear Cell Syringoma without Diabetes Mellitus / 대한피부과학회지

No abstract available.

Clinical Study of Efficacy of Super Elastic Wire for Ingrown Nails of Great Toe / 대한피부과학회지

BACKGROUND: Ingrown toenail is one of the most common nail complaints. It occurs mostly on the great toes, where is an excessive lateral nail growth into the nail fold, leading to painful irritation, inflammation, and growth of the granulation tissue. Many treatments have been described, but these classic treatment modalities may lead to severe damage of the nail fold or frequent relapses. OBJECTIVE: We attempted to evaluate the therapeutic efficacy of super elastic wire (SE-wire, Machiwire(R)), a non-invasive treatment for ingrown toenails. METHODS: Fifteen patients with ingrown toenail were treated with super elastic wire. Objective assessment was evaluated by use of the width index (width of the nail tip/width of the nail root) and height index (height of the nail tip/width of the nail root). Subjective assessment was evaluated by use of a visual analogue scale declared by patients. In addition, wound complications and recurrence were described. RESULTS: The width index and height index were improved (width index: 75.0%-->90.0%, height index: 76.5%-->27.7%). Pain was relieved in 100% of the cases. For subjective assessment, all of the patients were satisfied (more than "satisfactory": 100%). There were two relapsed cases during 5 to 12 month period (mean time: 9 months). CONCLUSION: We recommend super elastic wire method as an alternative treatment for ingrown toenail, because it is simple, easy to perform, noninvasive, effective, and well-tolerated.

Cutaneous Extramedullary Hematopoiesis in Idiopathic Myelofibrosis / 대한피부과학회지

Extramedullary hematopoiesis is commonly seen in the liver, spleen and lymph nodes, but cutaneous extramedullary hematopoiesis (CEH) is very rare. CEH affects mainly children with intrauterine viral or hematologic disorders and rare manifestation of chronic myeloproliferative processes in adults. Idiopathic myelofibrosis (IM) is a chronic myeloproliferative disorder and some cases of IM have extramedullary hematopoiesis. IM is characterized by the proliferation of the endothelial cells and fibroblasts in the bone marrow, resulting in disruption of bone marrow, with subsequent migration and proliferation of the hematopoietic stem cells in other organs. We report a very rare case of cutaneous extramedullary hematopoiesis in a 74-year-old male with IM.

Acral Angioosteoma Cutis

Acral angioosteoma cutis is a rare disease first described in 2006 that is characterized by vascular proliferation with ossification at the acral area, and which bears clinical similarity to pyogenic granuloma. However, there is no lobular pattern in the capillary proliferation that is a typical histopathological feature in pyogenic granuloma. Metaplastic cutaneous ossification is associated with multiple skin diseases and inflammatory conditions such as scars, nevi, basal cell carcinomas, pilomatricomas, chondroid syringomas, and venous stasis. It is rarely associated with vascular proliferation diseases like hemangiomas and pyogenic granulomas. We report a case of capillary proliferation with ectopic bone formation in a 43-year-old female who presented with an ulcerative, dome-shaped subungual nodule on the left fourth toe, which appeared to be a pyogenic granuloma. Because the biopsy findings showed no lobular capillary proliferation, we determined that this case was consistent with acral angioosteoma cutis.

Atrophying Pityriasis Versicolor: Is This a New Variant of Pityriasis Versicolor?

An atypical clinical form of pityriasis versicolor has been infrequently reported, in which cutaneous atrophy is associated with individual pityriasis versicolor lesions. The pathogenesis of this atrophy remains unclear, but is believed to be a delayed-type hypersensitivity reaction to antigens derived from the Malassezia species. A 60-year-old man presented with multiple, slightly scaly, and depressed maculopatches or plaques on the trunk and extremities. Our microscopic examination of the skin scrapings on a KOH preparation revealed numerous short hyphae and spores. The patient was treated daily with 200 mg of itraconazole in combination with topical antifungals, achieving clinical improvement and mycological recovery, which was confirmed upon follow-up 1 month later. This is the first case report of atrophying pityriasis versicolor in Korea. It needs to be differentiated from other atrophying disorders of the skin.

The Efficacy and Safety of Long-term Oral Cyclosporine Treatment for Patients with Atopic Dermatitis

BACKGROUND: Steroids are used in conventional treatment of atopic dermatitis (AD) and they are very effective for improving the symptoms, but they also have several complications. Many studies have reported that short-term use of cyclosporine (CsA) is effective for severe AD as a substitute for steroid. However, there are very few studies on the long-term use of CsA for AD in the Korean population. OBJECTIVE: The purpose of this study was to investigate whether long-term CsA therapy is effective and safe for treating AD. METHODS: We performed a retrospective study of the patients with AD and who were treated with CsA at Kyung Hee Medical Center between January 2001 and February 2008. Among 147 patients, 61 received CsA treatment for more than 6 months. To evaluate the efficacy of CsA treatment, the objective SCORAD was checked for all 61 patients at every visit. Extensive laboratory tests were performed every two months to assess the safety of treatment. RESULTS: The mean duration of CsA treatment was 13.5+/-8.4 months and the mean initial dose of CsA was 2.7+/-0.9 mg/kg/day. The mean objective SCORAD values significantly decreased from 34.1+/-11.2 at baseline to 11.4+/-10.7 after 6-month of CsA treatment (p<0.05). A significant decline of the SCORAD score was observed starting from 1-month of CsA treatment. The mean duration of remission was 4.5+/-2.9 months. A total of 13 adverse events in 10 patients were recorded during the study period. One patient dropped out due to renal dysfunction. Elevation of peripheral blood pressure was noted in 8 patients. Three patients complained of gastrointestinal troubles, and one patient had hypertrichosis, but the problems of these 4 patients were mild and easily treated. CONCLUSION: We suggest that long-term, low-dose CsA treatment is safe and effective for patients who suffer from AD.

Coexistence of Amelanotic Melanoma and Liposarcoma

An amelanotic malignant melanoma is characterized by little or no pigment. It is frequently misdiagnosed because it is a rare entity in general, and because of its unusual clinical features. Liposarcoma is one of the most common adult soft tissue sarcomas. We encountered a case of amelanotic melanoma with a concurrent liposarcoma. A 68-year-old man presented with a single, 1.5x1.5 cm round erythematous, eroded nodule on the left heel. A biopsy specimen showed atypical, pleomorphic tumor cells with little melanin pigment. The tumor cells were positive for S-100, HMB-45 and negative for cytokeratins. These findings were consistent with amelanotic melanoma. On positron emission tomography/computed tomography (PET/CT), a hypermetabolic lesion was found in the left buttock. This lesion was excised and diagnosed as a well-differentiated liposarcoma. An association between sarcomas and other primary malignancies has been reported. However, an association between melanoma and liposarcoma is rare.

Development of Korean Academy of Medical Sciences Guideline on the Skin and Related System: Impairment Evaluation of Disfigurement in Skin and Appearance

The purpose of this study is to develop new standards for the disability evaluation with reference to existing laws and other study reports regarding disabilities for the rational evaluation of the diverse kinds of disfigurement in appearance and skin. Three plastic surgery specialists and 3 dermatology specialists developed a new standard for the disability evaluation which is appropriate for circumstances in Korea. Disability rate does not take into account the social occupation, gender or age of the patient, but instead, evaluate the Activity of Daily Living and the social adaptability of the appearance and skin disfigurement regardless of the balance between different disabilities. We tried to include most cutaneous disorders and categorized them into 3 types; congenital (Type 1), acquired (Type 2) as well as any permanent skin impairment sequelae of disease, trauma or treatment process (Type 3). For type 3 disorders, we tried to rate the score according to the size of involved skin lesion. The disability rate is determined by dividing the disability class into 8 steps based on the seriousness of each type of disability.

A Case of Elephantiasis Nostras Verrucosa

Elephantiasis nostras verrucosa (ENV) is a rare clinical condition associated with chronic non-filarial lymphedema caused by bacterial or non-infectious lymphatic obstruction. A variety of etiologies, including infection, tumor obstruction, trauma, radiation, chronic venous stasis, congestive heart failure, and obesity, can lead to chronic lymphatic obstruction and edema. Mossy papules, plaques, and cobblestone-like nodules are clinically impressive features of ENV, but biopsy reveals only moderately abnormal findings such as pseudoepitheliomatous hyperplasia, dilated lymphatic spaces, fibrous tissue hyperplasia, and chronic inflammation. We present a case of ENV in a 67-year-old man with a 10-year history of multiple nodules and verrucous plaques on both feet. Microbiology ruled out a filarial infection. Nodule biopsy revealed pseudoepitheliomatous hyperplasia, marked dermal fibrosis, and a chronic inflammatory infiltrate. No evidence of carcinoma was identified. Both venous stasis and recurrent cellulitis could contribute to the dermal fibrotic changes of the lesions. However, before the recurrent cellulitis, he did not have any nodular lesions on his feet despite a 10-year history of venous disease. Therefore, this case suggests that venous stasis alone cannot produce the fibrotic nodular lesions of ENV

A Case of CD30 (+)/ALK (-) Primary Systemic AnaplasticLarge Cell Lymphoma with Atypical Clinical Features / 대한피부과학회지

Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's lymphoma, and this tumor is predominantly composed of large lymphoid cells that have a strong expression of CD30. Two major groups of ALCL have been described. The first is a spectrum of CD30+ lymphoproliferative disorders, including primary cutaneous ALCL and lymphomatoid papulosis. The second is systemic nodal ALCL, which can be subdivided into two groups: anaplastic lymphoma kinase (ALK)-positive and ALK-negative. The relative frequency of ALCL in Korea is about 19% of all cutaneous lymphomas. Solitary or multiple large nodular tumoral lesions confined to one body compartment are the most common presentation. We report here on a case of CD30 (+)/ALK (-) primary systemic ALCL in a 77 year-old-male, and the skin lesion manifested as multiple papules, plaques and tumors on the trunk, buttocks and upper and lower extremities.

A Case of Annular Polycyclic Type of Subacute Cutaneous Lupus Erythematosus with Protein Losing Enteropathy / 대한피부과학회지

We present a case of annular polycylic type of subacute lupus erythematosus which fulfilled the criteria of systemic lupus erythematosus and was associated with protein losing enteropathy. A 37-year-old male had erythematous annular rashes with several painful, scattered ulcers and a generalized edematous appearance. Abnormal laboratory findings were hypoalbuminemia, low complement, positive Anti-Ro, La, and ANA in a speckled pattern. Tc-99m human serum albumin scintigraphy revealed extravasation within the small bowel. The histopathologic findings showed vacuolar degeneration, upper dermal edema and cleft with perivascular lymphocytic infiltration. Direct IF revealed granular deposition of IgG along the dermo-epidermal junction. The patient was treated with intravenous steroids and oral hydroxychloroquine.

Patch Testing in Nummular Eczema: Comparison of Patch Test Resultsbetween Nummular Eczema and Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Nummular eczema, which is also known as discoid eczema, is defined by its clinical appearance as coin-shaped, circular, or oval lesions with a definite border. The etiology of nummular eczema is obscure, and many causative factors have been proposed, but there are only a few studies of the relevance of contact allergy in nummular eczema in Korea. OBJECTIVE: The purpose of this study was to investigate the role of allergic contact dermatitis in nummular eczema patients compared with atopic dermatitis. METHODS: A total of 86 patients were enrolled in this study. Patients combined with atopic dermatitis and nummular eczema were classed as atopic dermatitis. The group with atopic dermatitis was 32 patients. The group with nummular eczema was 54 patients. We performed patch tests on both groups, and evaluated their clinical features and the results of the patch testing. RESULTS: The patients comprised of 49 males and 37 females. The mean age of group with atopic dermatitis was 21.3 years, and the mean age of group with nummular eczema was 44.2 years. The distribution by age was most prevalent at 10~19 years for the group with atopic dermatitis group and 40~49 years for the group with nummular eczema. The predominant sites of the lesions were the arms (21.0%), trunk (21.0%), legs (16.3%), widespread on the body (15.1%), hands (13.9%), feet (7.0%), face and neck (5.8%). Sixty seven (77.9%) out of 86 patients showed a positive reaction to one or more allergens. The highest sensitization rates were found with: nickel sulphate (45.3%), cobalt chloride (29.1%), potassium dichromate (20.9%), thimerosal (17.4%), neomycin sulphate (15.1%), thiuram mix (14.0%), formaldehyde (14.0%), colophony (12.8%), 4-phenylenediamine mix (11.6%), fragrance mix (10.5%). Comparing the atopic dermatitis and nummular eczema groups, there was no significant difference in the positivity for patch test allergens and frequent antigens. Comparing with clinical manifestation between the group with positive reaction and the group with negative reaction to the patch test in nummular eczema and atopic dermatitis, in the group with positive reaction of patch test, the severity of disease increased. CONCLUSION: This study shows that contact sensitivity is relatively common both with nummular eczema and atopic dermatitis. But, when there is no difference in the positive rate of antigens in patch test, both groups show high positive rate of metal antigens. Also nummular eczema patients with consistent and recurrent symptoms, the possibility of allergic contact dermatitis should be taken into consideration and a patch test must be performed.

A Case of Kaposi's Sarcoma Associated with Castleman's Disease / 대한피부과학회지

Castleman's disease, also known as angiofollicular lymphoid hyperplasia or giant lymph-node hyperplasia, is an unusual form of a lymphoproliferative disorder, and is divided clinically into a solitary and a multicentric form. The multicentric form of Castleman's disease is almost always of the plasma cell type. This can coexist with Kaposi's sarcoma in some cases. Kaposi's sarcoma is a multicentric, proliferative, vascular tumor involving cutaneous and visceral tissue. Iatrogenically-developed, immunosuppression-associated Kaposi's sarcoma is usually the result of immunosuppressive therapy. A 61-year-old man diagnosed as the plasma cell type of Castleman's disease, who had been treated with prednisolone for 2 years, was referred to the department of dermatology with numerous skin lesions consisting of confluent, violaceous-colored papules and plaques on his palm and soles. Histologic examination of the cutaneous lesions showed consistency with Kaposi's sarcoma. We report a rare case of Kaposi's sarcoma associated with multicentric Castleman's disease.

Four Cases of Cutaneous Larva Migrans after Travel in the Philippines / 대한피부과학회지

Cutaneous larva migrans (CLM) is a rare serpiginous creeping eruption caused by accidental penetration and migration in the skin with a larval form of nematodes. It is caused by hookworm larvae, which are present in the feces of infected dogs and cats. Most cases of CLM in Korea have been shown to involve travelers returning from tropical areas or hot climates. We experienced four patients who had pruritic serpiginous linear eruptions on their skin after traveling to the endemic areas (Boracay island in Philippine). After treatment with albendazole, the skin lesions resolved with post-inflammatory hyperpigmentation. We report herein these four cases, together with a literature review of CLM cases in Korea.

A Clinical Study of Dermatoses of Korean Vietnam Veterans Exposed to Agent Orange / 대한피부과학회지

BACKGROUND: Scientific and epidemiologic studies have shown that several dermatoses of Vietnam veterans were caused by Agent Orange. Most of the previous studies on Vietnam veterans have been about the relationship between systemic diseases including limited dermatoses and Agent Orange, but there have been no clinical studies of dermatoses of Korean Vietnam veterans exposed to Agent Orange. OBJECTIVE: We conducted this study to find out the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange. METHODS: A total of 19, 262 Korean Vietnam veterans who received their first dermatological examination at Seoul Veterans Hospital between January 1997 and December 2003 were included in this study, which consisted of a skin examination and 15-item questionnaire. RESULTS: 1. The distribution of dermatoses groups were as follows: pruritus, psychocutaneous disorders, and neurocutaneous dermatoses (36.1%), dermatomycosis and deep mycosis (20.5%), eczema (11.6%), diseases of the skin appendages (3.6%), epidermal and adnexal nevi and tumors (2.1%), drug eruption, erythema, and urticaria (1.8%), and papulosquamous diseases (1.5%). 2. Pruritus (31.6%) was the most frequent dermatosis in all age groups. 3. The frequency of dermatoses related to exposure to Agent Orange were as follows: seborrheic dermatitis (4.8%), chronic urticaria (1.7%), psoriasis vulgaris (1.2%), xerotic eczema (0.5%), photosensitive dermatitis (0.2%), chloracne (0.1%), soft tissue sarcoma (0.1%), and malignant tumors (0.01%). 4. With regard to regional groups of dispatch in Vietnam, QuiNhon (20.1%) was the most frequent area of dispatch. There was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between Dian, where larger amounts of Agent Orange were sprayed, and the other regional groups. 5. For duration of dispatch in Vietnam, there was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between two groups of duration. CONCLUSION: This study showed the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange, and may be helpful as the fundamental epidemiologic data of dermatoses of Korean Vietnam veterans for dermatologists to examine.

Herpes Zoster of the Penis / 대한비뇨기과학회지

Although herpes zoster can affect any dermatome, outbreaks most often occur in the thoracic and facial regions. Recently, herpes zoster involving the penis was reported. Here, an unusual case of herpes zoster involving the penis, with underlying prostate cancer, is reported.

Two Cases of Solitary Adult Myofibroma

No abstract available.

A Case of Kerion Celsi Caused by Trichophyton mentagrophytes / 대한의진균학회지

Kerion celsi is a highly inflammatory, supprative fungal infection of the scalp caused mainly by zoophilic dermatophytes transmitted from animals to man. We report a case of kerion celsi caused by Trichophyton (T.) mentagrophytes in 9 year-old male, who showed 10 x 9 cm and 2 x 1 cm sized, markedly inflammatory, boggy masses on the scalp and erythematous scaly patch on the philtrum. Cultures from a scalp lesion of the patient on Sabouraud glucose agar showed T. mentagrophytes. Treatment was done systemically with steroid and antifungal agents.

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

Metastasis to the skin from the urinary bladder carcinoma are very rare and their incidence is 1% to 2% of the cutaneous metastasis. A 78-year-old man developed cutaneous metastasis 2 years later after the diagnosis of carcinoma of the bladder had been made. He visited our department with skin colored, soft, tender, subcutaneous nodule on the lower abdomen which had been detected 5 days ago. Histologic examination of the skin lesion showed atypical cells having hyperchromatic and pleomorphic nuclei. Herein we report a case of cutaneous metastasis from carcinoma of the urinary bladder in a 78-year-old man.