Clinical, Pathologic and Immunohistochemical Study of Extramammary Paget's Diseases / 대한피부과학회지

BACKGROUND: Extramammary Paget's disease (EMPD) is an uncommon but distinctive tumor. Definitive diagnosis requires biopsy of the lesion and immunohistochemical staining. Immunohistochemical study using anti-cytokeratin monoclonal antibodies may be helpful for differentiating EMPD from other similar skin lesions and primary EMPD from pagetoid spread of underlying regional internal malignancy (secondary EMPD). OBJECTIVE: The purpose of this study was to identify clinical findings, histopathologic features and immunohistochemical characteristics of EMPD. METHODS: The twelve cases diagnosed as EMPD at our institution over ten years were included. Clinical records and pathology slides of the patients were reviewed retrospectively. Immunohistochemical stains for CK7, CK20, CEA, EMA, PSA, GCDFP15 and mucin stains such as PAS, d-PAS, alcian blue (pH 2.5) were done using paraffin blocks. RESULTS: 1. In most cases, EMPD developed on the scrotum of senile male patients. 2. In the pathologic findings, Paget cells were observed from the epidermis only in 2 cases, from the epidermis and intradermal skin appendages in 7 cases and from the dermis in 3 cases. 3. In all cases except for the single case associated with a transitional cell carcinoma of the urinary bladder, there were histochemical findings of alcian blue-, PAS- and immunohistochemical findings of CK7+, CK20-, CEA+, EMA+. 4. In the single case associated with transitional cell carcinoma of the urinary bladder, there were histochemical findings of alcian blue-, PAS- and immunohistochemical findings of CK7+, CK20+, CEA-, EMA-. CONCLUSION: The combination of CK7 and CK20 demonstrates these to be useful markers in distinguising primary EMPD from a pagetoid spread of extracutaneous malignancies. Namely, immunophenotypes other than CK7+/CK20- in Paget cells suggest underlying regional internal malignancy.

A Case of Cutaneous Sarcoidosis Treated with Thalidomide / 대한피부과학회지

A patient with cutaneous sarcoidosis was treated with thalidomide for steroid unresponsive sarcoidal granulomas of the skin. The duration of the therapy was 16 weeks, during which time, the skin lesions showed clinically and histologically improvement. The initial dosage was 50mg a day, which was increased to 100mg a day after 5 weeks. No side effect was noted. The good response of sarcoidal granulomas of the skin to thalidomide observed in this patient demonstrates the usefulness of this drug as a possible long-term monotherapeutic or steroid-sparing agent in the treatment of cutaneous sarcoidosis.

A Case of Verrucous Carcinoma on the Wrist Joint / 대한피부과학회지

Verrucous carcinoma is a low-grade squamous cell carcinoma first described in 1948 by Ackerman. It is a slowly growing, fungating and verrucous tumor that may penetrate deep into the tissue. There are many causative agents such as HPV infection, chronic irritation, radiation, and etc. We report a case of verrucous carcinoma developed at the wrist joint, a relatively unusual site.

A Case of Eccrine Poroma with Transepidermal Elimination / 대한피부과학회지

Transepidermal elimination (TE) is a spontaneously developed phenomenon in certain skin disorders in which altered connective tissue or foreign material is expelled via epidermis to the exterior. TE may occur either as a primary process such as elastosis perforans serpiginosa and reactive perforating collagenosis, or a secondary phenomenon, such as perforating granuloma annulare and pseudoxanthoma elasticum. We experienced a case of eccrine poroma on the scalp with keratinized tumor cells expelled through transpeidermal cannal microscopically.

A Case of Bart's Syndrome

Bart's syndrome was initially described as a genodermatosis characterized by congenital localized absence of the skin with blistering and nail deformities 1-3. However, it is considered as any type of epidermolysis bullosa(EB) with localized congenital absence of the skin on the extremities. A 33-day-old fbmale baby was presented with congenital absence of the skin over the left shin and dorsa of both feet which were covered with the thin, translucent, and brown-red glistening membranes. Blistering of the right calf and left great toe nail deformity were also noted. She was diagnosed as a recessive dystrophic EB by the histopathological, ultra- structural and immunomapping studies.

Treatment for Pseudocyst of the Auricle with Intralesional Injection of Minocycline: A Report of One Case / 대한피부과학회지

Pseudocyst of the auricle is a disease of degenerative cartilage associated with asymptomatic swelling of the external ear caused by an intracartilaginous accumulation of serous fluid. Histological examination shows an intracartilaginous cavity without an epithelial lining. This disease is characterized by frequent relapses despite various therapeutic approaches. In this report we describe one patient with pseudocyst of the auricle who was successfully treated with intralesional injection of 1 mg/mL of minocycline hydrochloride.

Two Cases of Herpetic Syringitis / 대한피부과학회지

The histology of herpes virus infection of the skin is characterized as an intraepidermal vesicle formed as the result of acantholysis and ballooning degeneration of kerationocytes. Dermal changes is limited to polymorphous inflammatory cells infiltrate, leukocytoclastic vasculitis, and herpetic folliculitis. Involvement of eccrine epithelium is very rare finding. We report two cases of herpes zoster with prominent viral infection of the eccrine sweat glands.

A Case of Rowell's Syndrome / 대한피부과학회지

Rowell's syndrome is described as erythema multiforme(EM)-like lesions in the presence of lupus erythematosus(LE) associated with immunoserological characteristics of speckled antinuclear antibodies and positive tests for anti-Ro/La antibodies and rheumatoid factor. We report a case of Rowell's syndrome in a 28-year-old woman with systemic lupus erythematosus for 13 years, who presented with targetoid eruptions on the right arm and with positive immunoserologic findings as above.