Comparative Study of Syphilid and Syphilid-Like Eruptions on the Palms

No abstract available.

Usefulness of Ultrasonography in the Diagnosis of Sparganosis: A Case Report / 대한피부과학회지

Sparganosis is a kind of parasitic skin disease caused by sparganum, the plerocercoid larvae of the taper worm of the genus Spirometra. Sparganosis usually manifests as migrating or fixed subcutaneous nodules; therefore, it should be differentiated from lipoma, cysts, and cutaneous malignancies. Although the final diagnosis of sparganosis in humans depends on the identification of the worm in an infected tissue, suspicion for the presence of the parasite and careful history taking are important before making the diagnosis. However, it might be difficult for a clinician to suspect the existence of sparganosis because the incidence of this disease is extremely low. Therefore, an effective method for differentiating sparganosis from other skin disorders is needed. We suggest that ultrasonography could be an answer to this problem, on the basis of our experience of a case of cutaneous sparganosis in a 65-year-old woman showing very characteristic ultrasonographic findings.

Dermoscopic Approach to a Small Round to Oval Hairless Patch on the Scalp

BACKGROUND: Various kinds of alopecia can show small round or oval hairless patch. Dermoscopy could be a simple, useful tool for making a correct diagnosis. OBJECTIVE: The aim of this study is to investigate clinical usefulness of dermoscopy for diseases with small round or oval hairless patch on the scalp. METHODS: Dermoscopic examination was performed for 148 patients with small round or oval hairless patch using DermLite(R) II pro. The type and its patient number of alopecia investigated in the study were as below: alopecia areata (n=81), trichotillomania (n=24), tinea captis (n=13), traction alopecia (n=12), lichen planopilaris (n=8), discoid lupus erythematosus (n=7), congenital triangular alopecia (n=2) and pseudopelade of Brocq (n=1). The significance of dermoscopic findings for each disease were evaluated. RESULTS: Characteristic dermoscopic findings of alopecia areata were tapering hairs and yellow dots. Those of trichotillomania and traction alopecia were broken hairs. Dermoscopic findings of tinea capitis included bent hairs, perifollicular white macules and greasy scales. Discoid lupus erythematosus and lichen planopilaris were characterized by dermoscopic findings of lack of follicular ostia. Furthermore, keratin plugs were frequently seen in discoid lupus erythematosus whereas perifollicular hyperkeratosis and erythema were frequently seen in lichen planopilaris. CONCLUSION: Dermoscopic examination for small round or oval hairless patch showed characteristic findings for each disease. Based on these results, we propose dermoscopic algorithm for small round or oval hairless patch on the scalp.

A Case of Disseminate and Recurrent Infundibulo-Folliculitis / 대한피부과학회지

Disseminated and recurrent infundibulo-folliculitis is an infrequent entity of unknown etiology that was first described in 1968, by Hitch and Lund. Most patient reports have been on young black male adults. It is rarely reported in Asian, and there has been only 1 case reported in the Korean medical literature in the year 1984. The syndrome has been characterized as tiny uniform, skin-colored papules similar to 'goose-bumps' of skin. These papules predominantly involve the trunk and proximal extremities, and are usually accompanied by mild pruritus. In this report, we presented a 33-year-old man with a 10-year history of generalized skin-colored, follicular papules on the chest and back with intermittent pruritus. The clinical initial differential diagnosis included keratosis pilaris, lichen spinulosus, lichen nitidus, folliculitis, and disseminated and recurrent infundibulo-folliculitis. A histopathologic examination showed predominant mononuclear cell infiltration around the infundibular portion of hair follicles, follicular spongiosis and lack of hyperkeratosis. Herein, we reported a rare case of disseminated and recurrent infundibulo-folliculitis with typical clinical and histopathological findings in a 33-year-old Korean man.

A Case of Palmoplantar Psoriasis Improved by 308-nm Excimer Laser / 대한피부과학회지

Various modalities have been used for the treatment of psoriasis, including phototherapy. The choice of psoriasis treatment is based on the characteristics of the lesions, locations and amount of involved body surface area. Narrowband ultraviolet (UV) B therapy is a widely used and highly efficient method for psoriasis. But, large areas of unaffected skin may be irradiated along with the psoriatic lesions during phototherapy. The 308-nm excimer laser is a further development of narrowband UVB and was reported to be an effective and safe treatment for localized psoriasis. We experienced an excellent effect without significant adverse reactions of 308-nm excimer laser in a 9-year-old patient with palmoplantar psoriasis who was recalcitrant to oral cyclosporine and topical calcipotriol/betamethasone treatment.

Syphilid with a Histological Pattern of Non-caseating Epithelioid Granuloma / 대한피부과학회지

No abstract available.

A Case of Eosinophilic Ulcer of the Oral Mucosa with Nodular Change / 대한피부과학회지

No abstract available.

A Pilot Study of 1% Pimecrolimus Cream for the Treatment of Childhood Segmental Vitiligo

BACKGROUND: There is as yet no effective and safe treatment for vitiligo. One percent pimecrolimus cream, a topical calcineurin inhibitor, has been tried for the treatment of vitiligo, with its therapeutic efficacy having mostly been reported in non-segmental vitiligo. However, questions about the therapeutic efficacy of 1% pimecrolimus cream have remained unanswered regarding segmental vitiligo. OBJECTIVE: The aim of this study was to study the therapeutic efficacy and safety of 1% pimecrolimus cream for segmental childhood vitiligo. METHODS: Nine childhood patients with segmental vitiligo were treated with 1% pimecrolimus cream twice daily for three months, after which good responders were scheduled to continue with the 1% pimecrolimus cream monotherapy. The efficacy and safety of this treatment were determined by the levels of repigmentation, initial response time and the presence of adverse events including burning, dryness, stinging and itching. RESULTS: Four of nine patients achieved mild to moderate responses after three months of treatment and thus continued with treatment. Among these four patients, three achieved an excellent response and one patient achieved a moderate response, with a mean treatment duration of 7.3 months. Transient local burning sensation was the most common adverse event. In comparison with the patients with poor response, those patients with good response showed a shorter disease duration (8.5+/-10.5 mo vs. 13.4+/-10.1 mo), more frequent facial involvement (4/4 patients vs. 3/5 patients) and earlier initial response after treatment (1.0+/-0.0 mo vs. 2.0+/-1.0 mo). CONCLUSION: This study suggests that 1% pimecrolimus cream is an effective and well-tolerated treatment for segmental childhood vitiligo.

Extensive Psoriasis Induced by Pegylated Interferon Alfa-2a and Ribavirin in the Treatment of Chronic Hepatitis C

A 56-year-old man with chronic hepatitis C was treated with pegylated interferon alfa-2a in combination with ribavirin. However, psoriatic lesions appeared and worsened dramatically during therapy. Because of the extensive skin eruptions, he stopped therapy for chronic hepatitis C and subsequently started narrow-band ultraviolet B phototherapy and topical calcipotriol/betamethasone dipropionate ointment. After this, the psoriasis improved in a slow but comprehensive manner. Our case suggests that physicians should keep in mind the possibility of psoriasis as a side effect of interferon treatment for chronic hepatitis C.

Livedo Racemosa Associated with Epstein-Barr Virus-induced Post-transplant Lymphoproliferative Disorder / 대한피부과학회지

Livedo racemosa (LR) is characterized by a striking violaceous netlike patterning of the skin similar to the livedo reticularis, from which it differs by its localization (more generalized), and shape (irregular, broken circular segments). LR is probably caused by patchy impairment of cutaneous arteriolar circulation, resulting in venous dilatation and stasis of blood. LR is always associated with a pathological condition, including hematologic/hypercoagulable disease, vasculitis, connective tissue diseases, neoplasm, lymphoma, infection, cerebrovascular disease, adverse response to a drug, and etc. Hence, clinical, pathological and laboratory examinations are important for excluding these underlying diseases. To date, there have been few reports of LR secondary to posttransplant lymphoproliferative disease (PTLD) in dermatologic literatures. Herein, we report a case of LR associated with Epstein-Barr virus-induced PTLD of cervical lymph node in a 19-year-old female, who had generalized reticular erythematous to violaceous patch on the entire body after allogenic peripheral blood stem cell transplantation.

Two Cases of Eosinophilic Pustular Folliculitis Improved with Topical Tacrolimus / 대한피부과학회지

No abstract available.

Morbihan Disease: A Rare Variant of Rosacea / 대한피부과학회지

Morbihan disease, also known as 'rosacea lymphedema' or 'solid persistent facial edema' was first reported by Degos, in 1957, for describing persistent lymphedema on the upper half of the face in association with rosacea. Although the pathogenesis of Morbihan disease is not established well, two hypotheses were proposed; firstly, the hypothesis of lymphatic obstruction by destruction of vessel supporting connective tissue (e.g. elastin), and secondly, the hypothesis of mast cell-induced fibrosis. Herein, we report a 71-year-old man who had 9-months history of persistent bilateral edema of the eyelids. The histopathologic exam from edematous eyelid revealed marked dermal edema, dilated vascular structure with perivascular mixed cellular inflammatory infiltration. Moreover, focal granulomatous infiltration adjacent to a vascular structure and numerous mast cells were also identified. This case is the first reported case of Morbihan disease in Korean dermatological literature. Furthermore, the histopathologic findings of this case support both of the two hypotheses for development of Morbihan disease.

Clinical Study of Itch in Korean Patients with Chronic Idiopathic Urticaria / 대한피부과학회지

BACKGROUND: Although itch is a cardinal symptom of urticaria, its clinical characteristics are not well elucidated in Korean urticaria patients. OBJECTIVE: To characterize the clinical patterns and sensory, affective and therapeutic dimensions of itch in Korean patients with chronic idiopathic urticaria (CIU). METHODS: A face-to-face structured questionnaire based on the McGill pain questionnaire was given to 83 patients with CIU. RESULTS: All of the 83 patients recruited in the study have fully filled-out the questionnaire. In 71.1 percent of the total CIU patients, itch appeared on a daily basis. Patients experienced exacerbation of itch during winter (41.0%) and at night (37.3%). The buttock (50.6%) and front of the thigh (50.6%) were major sites of involvement with itchiness. Patients perceived itch as burning (62.7%), stinging (44.6%) and crawling sensations (42.2%), rather than stabbing (25.3%), tickling (24.1%) and pinching (10.8%). The main associated symptom was heating sensation (60.2%). The majority of the patients answered that itch was annoying (84.3%), worrisome (80.7%) and bothersome (78.3%). Korean CIU patients answered that stress (36.1%) and hot climate (33.7%) aggravated the itch, and medications (55.4%) alleviated it. Among antihistamines, systemic corticosteroids and topical corticosteroids, antihistamines were the most effective treatment for management of itch in patients with CIU. CONCLUSION: This study highlights the detailed description and characteristics of itch in Korean CIU patients. Moreover, we tried to emphasize the clinical differences of itch in CIU patients in comparison with that in atopic dermatitis patients.

Zosteriform Atrophoderma of Pasini and Pierini / 대한피부과학회지

Atrophoderma of Pasini and Pierini is characterized by sharply demarcated, slightly depressed blue-brown plaques, arising within the areas of the normal skin. The lesions are usually symmetrically distributed on the trunk, particularly on the back, and to a lesser extent on the extremities. A 14-year-old boy developed well-demarcated depressed plaques in a zosteriform distribution, along the left side of his shoulder, back, and arm, without any symptoms. A biopsy taken from the border between the depressed plaque and the normal-looking skin on the back showed evident dermal atrophy with decreased dermal thickness and thickening of collagen bundles in the depressed plaque, compared to the normal-looking skin, which were consistent with atrophoderma of Pasini and Pierini. Herein, we report an unusual case of zosteriform atrophoderma of Pasini and Pierini.

Two Cases of Irritation Fibromas on Lower Lip / 대한피부과학회지

Irritation fibroma, also known as traumatic fibroma or focal fibrous hyperplasia, is the most common soft tissue exophytic lesion occurring in the oral cavity. It is a reactive lesion, caused mostly by chronic trauma to the oral mucous membranes. There is no gender or racial predilection, and the most common sites for irritation fibromas are the buccal and labial mucosa and the lateral surface of the tongue. Typical lesion presents as smooth, dome-shaped or pedunculated nodule with color of surrounding mucosa. Histopathologically, irritation fibromas are characterized by their dome shape with a keratinized stratified squamous epithelium, dense bundles of collagen fibers, spindle- or fibroblast-like cells, relatively few blood vessels and inflammatory cells in the submucosa. Although dermatologist should have interest in irritation fibromas due to their higher prevalence, there have been few reports in dermatologic literatures. Herein, we report two cases of multiple irritation fibromas on the lower lip, following lip biting.

Two Cases of Irritation Fibromas on Lower Lip / 대한피부과학회지

Irritation fibroma, also known as traumatic fibroma or focal fibrous hyperplasia, is the most common soft tissue exophytic lesion occurring in the oral cavity. It is a reactive lesion, caused mostly by chronic trauma to the oral mucous membranes. There is no gender or racial predilection, and the most common sites for irritation fibromas are the buccal and labial mucosa and the lateral surface of the tongue. Typical lesion presents as smooth, dome-shaped or pedunculated nodule with color of surrounding mucosa. Histopathologically, irritation fibromas are characterized by their dome shape with a keratinized stratified squamous epithelium, dense bundles of collagen fibers, spindle- or fibroblast-like cells, relatively few blood vessels and inflammatory cells in the submucosa. Although dermatologist should have interest in irritation fibromas due to their higher prevalence, there have been few reports in dermatologic literatures. Herein, we report two cases of multiple irritation fibromas on the lower lip, following lip biting.

Five Cases of Onychatrophy Following Bleomycin Intralesional Injections for Periungual Warts / 대한피부과학회지

Onychatrophy is the processes in which the nail has initially formed satisfactorily and then shows total or partial regression. The causes of onychatrophy with pterygium include lichen planus, acrosclerosis, Stevens-Johnson syndrome, and cicatrical pemphigoid, and those without pterygium include severe paronychia, Stevens-Johnson syndrome, epidermolysis bullosa, and drugs. Bleomycin is an antitumor, antibacterial, and antiviral agent used in many dermatologic diseases such as warts, vascular anomalies, hemangioma, and cutaneous malignancies. Cutaneous adverse effects of bleomycin strongly depend on the route of administration and dosage. Bleomycin intralesional injection for periungual warts could result in permanent Raynaud phenomenon, nail dystrophy, and nail loss. We report five cases of onychatrophy following bleomycin intralesional injections for periungual warts. We remind that if bleomycin intralesional injection near the nail matrix is inevitable in recalcitrant periungual warts, the performer must manipulate precisely to avoid adverse effects.

Lichen Striatus-Induced Pterygium Unguis / 대한피부과학회지

Pterygium unguis occurs as a result of the scarring process between the proximal nail-fold and matrix and lichen planus is a typical example, although it has also been reported to occur in patients with sarcoidosis or leprosy. Lichen striatus is a childhood linear inflammatory dermatitis of unknown etiology. Many nail changes such as nail-bed hyperkeratosis, nail pitting, longitudinal ridging, onycholysis, and longitudinal fissures have been described in patients with lichen striatus, but pterygium unguis is very rare. It has been suggested that the onset and resolution of onychodystrophy correlates well with the course of skin eruption, but pterygium unguis results in permanent nail changes regardless of skin eruption. A 3-year-old boy presented with a linear papular eruption on the right hand and pterygium on the index finger. He was diagnosed with lichen striatus by histopathological findings, and the papular eruption was resolved with topical tacrolimus ointment, but the pterygium did not improve.

A Clinical Study of 66 Patients with Steroid-Induced Rosacea / 대한피부과학회지

BACKGROUND: Topical corticosteroids are not uncommonly abused in patients with facial dermatoses. Although it is well known that uncontrolled use of topical corticosteroids cause steroid-induced rosacea, its clinical manifestation is not studied yet in Korean patients. OBJECTIVE: The purpose of this epidemiological study was to investigate a usage history of topical corticosteroid and clinical manifestation of steroid-induced rosacea. METHODS: Among the 424 rosacea patients who visited the dermatologic clinics of Pusan National University Hospital between January 2006 and May 2011, a face-to-face structured questionnaire was given to 66 rosacea patients with a history of topical corticosteroid use on the face for more than 1 month before onset of rosacea symptoms. Investigated factors include sex, age, history about use of topical corticosteroids and clinical manifestations. RESULTS: Of the 66 patients, 41 were female and 25 were male with the mean age of 52.1+/-14.6 (range 16~76) year. Celestone-G(R) (n=14) was the most commonly used product in the 34 patients who remembered the brand name of topical corticosteroids, which they had used. Forty-three patients used topical corticosteroids for treatment of facial skin lesions without diagnosis. Eighteen patients purchased topical corticosteroids without doctor's prescription. The mean duration and frequency of topical corticosteroid use was 3.8 years and 1.3 times per day, respectively. Constant erythema (n=31) was the most common symptom and it started to occur 2 months after use of topical corticosteroid. CONCLUSION: High-potency topical corticosteroids are frequently used for patients with facial dermatoses without correct diagnosis and without doctor's prescription. Besides, abuse of topical corticosteroids cause rosacea symptoms, such as constant erythema. To prevent the occurrence of steroid-induced rosacea, there should be a great social concern for abuse and misuse of topical corticosteroid in patients with facial dermatosis.

Three Cases of Linear Cutaneous Lupus Erythematosus / 대한피부과학회지

Linear lesions of discoid lupus erythemaosus (DLE), subacute cutaneous lupus erythematosus or tumid lupus erythematosus, following the lines of Blaschko, are called linear cutaneous lupus erythematosus (LCLE). Lesions of LCLE appear as linear unilateral erythematous plaques predominantly on the face. Neck, trunk or the extremities may also be affected. Histological findings show hyperkeratosis with follicular plugging, epidermal atrophy, hydropic degeneration and dense perivascular infiltration of the inflammatory cells, including lymphocytes and histiocytes. To our knowledge, four cases of linear lupus erythematosus have been reported in Korean literature. We report three patients diagnosed with LCLE.