A Case of Pigmented Follicular Cyst

We report a pigmented follicular cyst (PFC) in a 40-year-old male manifestated clinically as pigmented nevus. Histopathologic findings revealed an infundibular cyst in the mid dermis containing a small amount of keratinous material. The cystic wall consisted of four or five layers of squamous epithelium with a granular layer with abundant keratohyaline granules and the cyst wall contained one hair follicle. It must be differentiated from other pigmented lesions of over-lying skin such as eruptive vellus hair cyst, apocrine hydrocystoma and melanocytic nevus coexistance of an epidermoid cyst. Surgical excision and histopathological examination are necessary for an accurate diagnosis in pigmented lesions.

Measurement and Comparison of Hydration and Lipid Levels between Patients with Acne vulgaris and Patients with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Skin surtice lipids increase and decrease in tints with acne vulgaris and in patients with atopic dermatis, respectively. Notably, hydratior. in decreased in patients with atopic dermatitis. Clinically it is common for the two diseases to occur together. OBJECTIVE: We would like to find out the rate, clinical cteristics, and hydration and lipid levels when acne vulgaris and atopic dermatitis concur. METHODS: We classific the clinical levels and measured the hydration and lipid levels of the face and forearm area of patients with acne vulgaris, patients phatopic dermatitis, and patients with both diseases, who visited the Youngdong Severance Hospital. RESULTS: 1) 13.8% (14/102) of patients with acne vulgaris had at, epidermatitis. 31.1% (14/45) of patients with atopic dermatitis had acne vulgaris. 2) Patients with acne vulgaris had increased lipid levels and normal hydration levels. 3) Patients with atopie dermatitis had decreased lipid and iylration levels. 4) Patients withoth cnevulgaris and atopic dermatitis a no severe grade of acne vulgaris, and showed decreased hydration but normal lipid levels. CONCLUSION: In patients with both arne vulgaris and atoic dermatitis, clinically acne vulgaris was not severe and hydation levels were lower than normal controls.

Evaluation of Treatment Effect of Primary Hyperhidrosis using Skin Surface Hydrometer / 대한피부과학회지

BACKGROUND: Primary hyperhidrosis is the disease of production of exessive sweat which is mainly localized in palm, sole, and axilla, treatment of the disease is usually accomplished with topical 20% aluminum chloride solution, an iontophoretic device, and surgery(sympathectomy) being reserved for recalcitrant cases. OBJECTIVE: We have compared the therapeutic effects with each treatments for hyperhidrosis using a skin surface hydrometer. METHODS: Thirty six patients(11 ; male, 25 ; femlale) with primary hyperhidrosis were evaluated in this study. Nineteen patients used topical 20% aluminum chloride solution, 10 patients used iontophoretic device, and 7 patients in recalcitrant cases. had sympathectomy. We have measured the conductance on the stratum corneum of the palm and sole suing skin surface hydrometer before and after treatment every weeks for a month. the control group were composed of healthy 10 males and 2 females. RESULTS: 1) In the patients of primary hyperhidroisis the conductances of palm, sloe and axilla were higher than that of control group(P<0.01). 2. There was a marked reduction of conductance after the treatment for one week by topical 20% aluminum chloride solution, an lontophoretic device, and sympathectomy(P<0.01). 3. After 2-4 week of treatment by the change obsetved after treatment for one week. 4. By iontophoretic device, there was a slight increasement of conductance of the palm after 2-3weeks of treatment. 5. We obseved a sustained decrease in the conductance by sympathectomy into 4 week. CONCLUSION: Topical 20% aluminum chloride solution, iontophoretic device, and sympathectomy were effective for treatment of hyperhirosis. Among hem sympathectomy showed the best effect. We observed that the skin surface hydrometer is useful to evaluate of the efficacy of the treatment.

A Case of Disfiguring Xanthelasma Palpebrarum

We report a case of xanthelasma palpebrarum (XP) with bilateral extensive and disfiguring involvement of all four eyelids. The patient was a 28-year-old woman and noticed this condition eight years ago. Physical examination showed yellowish flat topped bilateral extensive plaques around the eyes. Laboratory result was remarkable for a decrease of a serum high density lipoprotein cholesterol (HDL-C). Other laboratory findings were within normal limits. Histopathologic findings showed diffuse infiltrations of foamy cells, histiocytes and foreign body giant cells in the dermis. Electronmicroscopic examination showed that the dermal infiltrate was composed of lipid laden histoncytes showing multiple villi which indicated an activated state of histioncyte. Bilateral and extensive XP is very rare. Only two cases have been reported in the literatures as far as we know.

Conjugal Syphilis

BACKGROUND: The infection rate of syphilis in married couples has been reported by a few investigators during the 1940s. However, studies on recent trends of that particular aspect of syphilis in married couples have not yet been done. OBJECTIVE: We therefore studied the infectivity of T. pallidum and recent trends of conjugal syphilis by observing the spouses of patients with untreated syphilis. METHODS: Couples married for more than 1 year who visited Yonsei Medical Center from 1983 to 1990 for syphilis were entered into this study. We observed the infection rate among spouses of 224 index patients (defined as, between husband and wife, the one who was the first to be diagnosed to have syphilis) who were not treated for syphilis. Syphilis was diagnosed on the basis of physical examination, history of extramarital sexual contacts, and the results of VDRL, TPHA, FTA-ABS, and 19S(IgM)-FTA tests. RESULTS: Fifty-six wives(48%) of 117 male index patients and 50 husbands (47%) of 107 female index patients had been infected at the time of examination. Among the 224 couples, 106(47%) were both infected and in 118(53%), only either husbands(27%) or wives(26%) were infected. Two spouses(50%) of the 4 first incident patients with primary syphilis, 9(53%) of 17 with secondary syphilis and 23(72%) of 32 with early latent syphilis were infected at the time of examination. CONCLUSION: From our results showing the low infection rates among married couples, even in early syphilis when the infectivity is high, it can be deduced that T. pallidum has only a low infectivity.

Mohs micrographic surgical removal of basal cell carcinoma and reconstruction with masalis myocutaneous sliding flap / 대한피부과학회지

A technique for the chemical fixation of cutaneous tumors followed by serial excision using microscopic control has been developed since the mid 1930s. Mohs micrographic surgery is the most reliable and cost effective treatment modslity, offering maximal preservaticn of normal tissue and therefore the lowest functional and cosmetic morbidity in the cancer treatments. We report a case of basal cell carcinoma treated with Mohs micrographic surgery and reconstructed with nasalis myocutaneous sliding flap. The pstient was a 56-year-old woman, who had a been sized basal cell carcinoma on her nasal tip for the previous 3 years. The lesion was removed under complete microscopical control using fresh tissue technique. The defect healed with atrophic scar formation ore and half months later. To remove scar tissue and to gsin proper cosmetic results, reconstruction with nasalis myocutaneous sliding flap was performed successfully.

A Case of Atypical Sessile Dermatofibroma

We report a case of a morphologic variant of dermatofibroma. A coin sized, brownish, shinny, somewhat fibrotic pedunculated tumor in a 39-year-old male was diagnosed as a sclerosing hemangioma, a type of dermatofibroma histopathologically. Its dome shape morphology was unusual in comparison with the typical morphology of dermatofibroma that we know.