A Case of Extraskeletal Chondroma of the Foot / 대한피부과학회지

Among various soft tissue tumors, extraskeletal chondroma is a rare benign cartilaginous tumor most frequently found in the hands, adjacent to periarticular tissue. We recently experienced a case of extraskeletal chondroma in a 47-year-old woman. The skin lesion showed a slowly-growing, solitary nodule on the dorsal aspect of her foot, causing pain and tenderness. An excisional biopsy was undertaken, revealing a well-encapsulated subcutaneous nodule which was mainly composed of mature hyaline cartilage.

A Case of Sarcoidosis Showing Various Cutaneous Manifestations / 대한피부과학회지

Sarcoidosis is a chronic idiopathic disorder characterized by the accumulation of noncaseating granulomas. We report a case of sarcoidosis with various cutaneous manifestations in a 42-year old female. On cutaneous examination, there were multiple papules on the posterior neck and anterior chest, subcutaneous nodules along an old scar of the right scapular area, violaceous nodule with satellite lesions and subcutaneous nodule on the right knee. Histopathology revealed noncaseating granulomas in all 5 specimens. She was treated with oral prednisolone leading to an excellent clinical response within 3 months of treatment, and remains well without recurrence for follow-up period of 20 months. .

Study of Dermatofibromas Using Immunohistochemical Staining / 대한피부과학회지

BACKGROUND: Dermatofibromas are common benign tumors which occur in the skin. They have been divided into "fibrous" lesions, composed entirely or almost entirely of fibroblasts and collagen, and "cellular" lesions composed to a significant degree of phagocytic cells with the appearance of histiocytes. A cellular variant characterized by increased cellularity, storiform arrangement, larger size, and location in the deep dermis, often with extension into the superficial subcutaneous tissue may be difficult to differentiate from dermatofibrosarcoma protuberans. There is an incessant controversy over the histogenesis of dermatofibromas, although many authors consider that these tumors derive from primitive mesenchymal cells. The recent development in immunohistochemical staining technology and ultrastructural study revealed various cellular proliferation in the lesion, including fibroblast, histiocyte and myofibroblast. OBJECTIVE: Our purpose was to study by immunohistochemistry the differences between fibrous and cellular dermatofibromas and to find the relationship between the myofibroblast and the histogenesis of dermatofibroma. METHODS: We will select 36 cases of dermatofibromas which include 27 fibrous and 9 cellular types. We have studied the immunophenotype of 36 dermatofibromas using antibodies against vimentin, smooth muscle actin, desmin, CD34, factor XIIIa, CD68 and MMP 11. RESULTS: All dermatofibromas were positive for vimentin, smooth muscle actin, and factor XIIIa, but negative for desmin and CD34. All cellular type were positive for CD68, but 24/27 of the fibrous type were positive for CD68. MMP 11 was positive in 6/9 of the cellular type and 25/27 of the fibrous type. The degree of staining for vimentin, factor XIIIa, CD68, and MMP 11 was not different in both types. But the degree of staining for smooth muscle actin in the fibrous type was higher than in the cellular type. CONCLUSION: The differences in the degree of staining for smooth muscle actin and the positivity for CD68 suggest the possibility of a different differentiation of dermatofibroma between cellular and fibrous types. The prominent vimentin and smooth muscle actin immunoreactivity and desmin non-reactivity may suggest that the myofibroblast may play a role, in part, for developing dermatofibromas. Further investigations with ultrastructural study using electron microscopy and double/triple immunohistochemical staining would be necessary.

A Case of Transformation of Mycosis Fungoides to Large Cell Lymphoma / 대한피부과학회지

Cutaneous T cell lymphoma (mycosis fungoides/Sezary syndrome) is a clonal malignacy of helper (CD4+) T lymphocytes usually first detected in the skin. In 8-55% of mycosis fungoides, the malignant T cell clone undergoes, cytologic transformation characterized by pleomorphic, large cells with prominent nucleoli, resulting in the morphologic appearance of a large cell lymphoma. The prognosis of large cell transformation of mycosis fungoides is poor; so detection of cytologic transformation is important to decide further treatment. We report a case of 22-year-old mycosis fungoides patient who developed large cell transformation during photochemotherapy (PUVA).

A Case of Impetigo Herpetiformis Occurring In Puerperium / 대한피부과학회지

Impetigo herpetiformis is a rare, severe dermatologic disorder occurring predominantly in the third trimester of pregnancy. Rarely, it may present during the puerperium, and this suggests that impetigo herpetiformis should be included in the differential diagnosis of puerperal fever, particularly in those cases associated with dermatoses. We report a 32-year-old woman who developed impetigo hermpetiformis during puerperium. She was a primigravida and did not have a previous history of psoriasis. Three days after parturition she developed a severely pruritic pustular rash composed of erythematous patches first presented in both axilla. The patient showed rapid improvement with oral prednisolone 40 mg/day for 5 days, and the lesions healed in 10 days. Follow-up for 12 months revealed no recurrence.

A Case of Pachyonychia Congenita / 대한피부과학회지

Pachyonychia congenita is an uncommon genodermatosis of abnormal keratinization characterized by dystrophic nails and hyperkeratosis of the palms, soles, oral mucosa, and hair follicles. Mutations in keratin 6, 16, and 17 have been identified in a number of families. The 4 major features of the syndrome are onychogryphosis, palmoplantar keratoderma, follicular hyperkeratosis, and oral leukokeratosis. Treatment is only palliative, however, with attempts directed at improving symptoms that cause significant disability. We report a case of pachyonychia congenita in a 5-day-newborn with characteristic changes of nail, palms, soles, and oral mucosa.

Two Cases of Plasma Cell Cheilitis Treated with Intralesional Injection of Corticosteroids

Plasma cell cheilitis is a rare inflammatory disorder which shows a dense, band-like infiltrate of plasma cells in the upper dermis. Although the histological picture is shared with other diseases of the lips, plasma cell cheilitis is not associated with any known dermatoses. Some authors have shown the effectiveness of topical or intralesional corticosteroids; however, there have been many reports describing poor therapeutic response to topical steroids. We de-scribe two patients with plasma cell chielitis whose clinical condition responded rapidly to the intralesional injection of corticosteroids.

Primary Cutaneous CD30 (Ki-1) Positive Lymphoproliferative Disorder: Report of a Borderline Case / 대한피부과학회지

Primary cutaneous CD30 positive large cell lymphoma is a cutaneous T-cell lymphoma with a favorable prognosis, which is characterized by solitary or localized skin lesions with a tendency of spontaneous regression and frequent relapses. On the basis of the morphologic and immunophenotypic similarities between the large atypical cells in lymphomatoid papulosis and the neoplastic cells in primary cutaneous CD30 positive large cell lymphoma as well as their favorable prognosis, these two diseases are now regarded to be in a spectrum of primary cutaneous CD30 positive lymphoproliferative disorder. We present a borderline case of primary cutaneous CD30 positive lymphoproliferative disorder which recurred on the anatomic site different to the primary lesions despite multiple-agent chemotherapy.

A Case of Cutaneous Metastasis of Cholangiocarcinoma / 대한피부과학회지

Cholangiocarcinoma is the second most common hepatobiliary malignancy. Histopathologically, it usually appears as a differentiated tubular adenocarcinoma. It shows a strong tendency toward early regional spread. Cutaneous metastases of cholangiocarcinoma are rare although distant hematogenous metastases may be observed during the late stages. We report a case of cutaneous metastasis of cholangiocarcinoma, presenting as a solitary asymptomatic firm nodule on right upper lip.

Two Cases of Malignant Fibrous Histiocytoma / 대한피부과학회지

Malignant fibrous histiocytoma(MFH) was first introduced referring to a group of soft tissue tumors characterized by a storiform or cartwheel-like growth pattern. MFH is an aggressive soft-tissue sarcoma that most commonly occurs in the skeletal muscle of the extremities or retroperitoneum of adults. We report 2 cases of MFH occurring in 59-year-old man and 57-year-old woman. In the first case, the tumor occurred in right upper arm and has been removed totally. It was consisted of storiform, pleomorphic and myxoid area. In the second case, a painful nodule developed in right shin where the tumor had been excised 1 year ago. A biopsy revealed plump spindle cells appearing in a storiform-pleomorphic pattern.