Role of the Neutrophil-to-Lymphocyte Ratio as a Predictor of Prognosis in Cellulitis / 대한피부과학회지

Background@#Cellulitis is an inflammatory disease of the skin and subcutaneous tissue caused by bacterial infection and is one of the most common reasons for admission to the Department of Dermatology. There are many biomarkers to help diagnose inflammatory diseases, and the neutrophil-to-lymphocyte ratio (NLR) has recently been raised as an option. @*Objective@#This study aimed to evaluate the efficacy of pretreatment NLR for predicting the severity and prognosis of cellulitis. @*Methods@#We reviewed the medical records of 102 patients diagnosed with cellulitis over the past 5 years. White blood cell count, erythrocyte sedimentation rate, C-reactive protein (CRP) level, procalcitonin level, and NLR were measured on the first day of admission. The associations of CRP, procalcitonin, and NLR ratio with body temperature and number of hospitalization days were assessed. @*Results@#The CRP level and NLR were positively correlated with body temperature. In addition, positive correlations were found between the number of hospitalization days and biomarkers (p＜0.05), with the NLR showing the highest coefficients. @*Conclusion@#In patients with cellulitis, the NLR is a helpful parameter for evaluating the severity and prognosis of the disease. However, further studies are required to confirm this.

A Case of Pigmented Eccrine Poroma on Scalp Clinically Mimicking Seborrheic Keratosis / 대한피부과학회지

No abstract available.

Basal Cell Carcinoma Arising in an Agminate Nevus Sebaceous / 대한피부과학회지

No abstract available.

Pseudoaneurysm as a Post-Biopsy Complication

No abstract available.

A Case of Extramammary Paget's Disease of the Axilla / 대한피부과학회지

No abstract available.

A Case of Subcorneal Pustular Dermatosis / 대한피부과학회지

No abstract available.

Maxillary Sinus Carcinoma Initially Mistaken for Morpheaform Basal Cell Carcinoma / 대한피부과학회지

Squamous cell carcinoma (SCC) of the maxillary sinus is the most common malignant neoplasm of the paranasal cavity. The most frequent initial symptoms are swelling of the cheek, nasal obstruction, epistaxis, and nasal discharge. Herein, we report the case of a 62-year-old Korean male who initially presented with a whitish irregular depressed plaque with an indurated border in his left cheek. After a several-week delay in diagnosis, he was eventually diagnosed with maxillary sinus carcinoma.

A Case of Spindle Cell Lipoma of the Scalp / 대한피부과학회지

No abstract available.

The Antimicrobial Activity of (-)-Epigallocatehin-3-Gallate and Green Tea Extracts against Pseudomonas aeruginosa and Escherichia coli Isolated from Skin Wounds

BACKGROUND: Skin infections with Gram-negative bacteria are sometimes challenging to treat, because these bacteria show multidrug resistance against commonly used antibiotics and patients with Gram-negative bacterial infection overall have deteriorated in conditions in many cases. Studies have shown that epigallocatechin gallate (EGCG) and green tea extracts (GTE) inhibit the growth of several Gram-positive bacteria species. OBJECTIVE: The purpose of this study was to investigate the minimum inhibitory concentrations (MICs) of EGCG and GTE in Pseudomonas aeruginosa and Escherichia coli, and assess the use of these chemicals as an alternative or adjunct topical antimicrobial agent against P. aeruginosa and E. coli with multidrug resistance. METHODS: The MICs of EGCG, GTE, and other tested antibiotics were measured and compared to determine the antibacterial efficacy and the differences in pattern of resistance. RESULTS: The P. aeruginosa and E. coli strains used in this study showed multidrug resistance. EGCG inhibited the growth of P. aeruginosa at a MIC level of 200~400 microg/ml. The MIC of GTE was a 1 : 16 dilution for P. aeruginosa. EGCG showed antimicrobial activity against E. coli at a MIC of 400 microg/ml. In the case of GTE, the MIC was a dilution between 1:8 and 1:4 for E. coli. CONCLUSION: EGCG and GTE showed potential as alternative or adjunct topical antimicrobial agents for infections that are resistant to traditional antibiotic therapy.

Etanercept-induced Leukocytoclastic Vasculitis / 대한피부과학회지

Leukocytoclastic vasculitis is a small vessel inflammatory disease mediated mostly by deposition of immune complexes. Etanercept (Enbrel(R)) is widely used not only for rheumatic disorders such as ankylosing spondylitis but also for dermatological diseases including psoriasis. Adverse drug reactions including pruritus, angioedema, and skin cancer have been reported. A 35-year-old female presented with palpable purpuric patches that developed on both lower legs 10 months after etanercept administration. A skin biopsy showed characteristic features of leukocytoclastic vasculitis, including perivascular infiltration of neutrophils and lymphocytes with leukocytoclasia and fibrinoid necrosis of the vessel wall. The patient was treated with oral and topical steroids, and the response was excellent and rapid. The patient was administered etanercept to control underlying ankylosing spondylitis. The skin lesions disappeared gradually after 4 weeks, and no other lesions were seen. The number of patients using etanercept has been increasing thus, the possibility of leukocytoclastic vasculitis in patients using etanercept should be considered.

Annular Erythema Associated with Anti-Ro/La Antibody Occurring in Plantar Area / 대한피부과학회지

Recurrent annular erythema associated with anti-Ro/La antibody is a diagnostic term for annular erythemas that usually occurs in the face and the upper extremities of patients with positive anti-Ro/La antibodies. They have been reported in patients with Sjogren's syndrome, lupus erythematosus, or Sjogren's syndrome/systemic lupus erythematosus syndrome. Recently, there have been cases without any underlying autoimmune diseases. We, hereby, report an annular erythema, associated with anti-Ro/La antibody occurring in both soles, which is an unusual location for this disease.

Kaposi's Sarcoma in a Patient with Iatrogenic Cushing's Syndrome / 대한피부과학회지

Kaposi's sarcoma (KS) is a multifocal proliferative vascular tumor involving cutaneous and extra-cutaneous tissues. KS has been reported in patients treated with immunosuppressive agents for autoimmune diseases. However, KS has rarely been reported in patients with iatrogenic Cushing's syndrome. A 77-year-old woman was evaluated with multiple asymptomatic violaceous nodules and plaques on both lower legs. She had been diagnosed with iatrogenic Cushing's syndrome and had been treated with low-dose corticosteroid replacement therapy for >10 years. A histopathologic study showed extensive vascular proliferation in the dermis with spindle-shaped cells. Immunohistochemical staining for CD31, CD34, human herpesvirus (HHV)-8, and D2-40 was positive. We hereby report a case of KS in a patient with iatrogenic Cushing's syndrome.

Pedunculated Sclerotic Fibroma Resembling Soft Fibroma / 대한피부과학회지

Sclerotic fibroma is a rare skin neoplasm that can occur seen sporadically or in association with Cowden's disease. Clinically, it presents as asymptomatic flesh-colored or pinkish slow-growing papules or nodules with a wide anatomical distribution. We report a rare case of pedunculated type of sclerotic fibroma resembling soft fibroma, which has not been reported in Korea.

Vitamin K1 Dermatitis / 대한피부과학회지

Vitamin K1 dermatitis is a cutaneous adverse reaction to vitamin K1, and this malady presents as an erythematous eczematoid patch or pseudoscleroderma. At first, liver disease was thought to be related to vitamin K1 dermatitis. However, it is no longer considered as being related to liver disease due to the increasing case reports of patients with vitamin K1 dermatitis and who are without liver disease. Type IV hypersensitivity reaction was suspected to be the cause of this reaction. This disease can be easily ignored because of its low incidence. We hereby report on a case of vitamin K1 dermatitis that was confirmed by a skin test.

Birt-Hogg-Dube Syndrome, a Rare Case in Korea Confirmed by Genetic Analysis

Simple benign tumors can present as part of a syndrome with substantial mortality. Fibrofolliculomas are benign skin tumors most often associated with the Birt-Hogg-Dube syndrome (BHDS). The most life-threatening complication of this syndrome is renal cancer and other major features include multiple lung cysts and spontaneous pneumothorax. We present the case of a 54 year-old man with multiple flesh-colored papules on his face confirmed histologically as fibrofolliculomas. He had a history of recurrent pneumothorax and chest computed tomography showed multiple lung cysts. To confirm the diagnosis of BHDS, we conducted gene analysis that revealed a single nucleotide duplication in the folliculin (FLCN) gene (Exon 11, C.1285dupC). BHDS confirmed by the FLCN gene mutation is rarely reported in Korea. Appropriate investigation is recommended whenever a patient with benign skin tumors is encountered.

Annular Lupus Vulgaris Mimicking Tinea Cruris

Cutaneous tuberculosis is an infrequent form of extrapulmonary tuberculosis. It is often clinically and histopathologically confused with various cutaneous disorders. A 36-year-old man attended our clinic with slowly progressive, asymptomatic, annular skin lesions on both the thighs and buttocks for 10 years. He consulted with many physicians and was improperly treated with an oral antifungal agent for several months under the diagnosis of tinea cruris, but no resolution of his condition was observed. A diagnosis of lupus vulgaris was made based on the histopathologic examination and the polymerase chain reaction assay. Anti-tuberculosis therapy was administered and the lesions started to regress.

A Case of Kikuchi's Disease Presenting with Unique Facial Involvement

Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare, self-limited lymphadenopathy, typically in young women, that usually remits spontaneously and does not recur. KD is clinically characterized by cervical lymphadenopathy and a high fever. Extranodal involvement (skin, arthritis, meningitis) rarely occurs. When KD is involved in a skin lesion, it presents with various shapes, but rarely manifests with symmetrically distributed, erythematous, firm nodules only on the face. In this report, we describe a patient with KD and unique skin manifestations.

A Case of Fixed Drug Eruption Induced by Tegafur-Uracil(TEGASIL) / 대한피부과학회지

A mixture of tegafur and uracil (TEGASIL) is a common antineoplastic agent. Tegafur is a fluoropyrimidine structurally similar to 5-fluorouracil (5-FU); uracil slows the degradation of 5-FU by dihydropyrimidine dehydrogenase, which results in higher 5-FU concentrations in tumors. Mucocutaneous side effects induced by this agent are rare and include photosensitivity of lichenoid and eczematous types, acral erythema, hyperpigmentation and palmoplantar keratoderma. However, there have been no reports of fixed drug eruption associated with TEGASIL. We report here on a case of fixed drug eruption due to oral TEGASIL.

A Case of Axillar Syringomas

Syringoma is common benign neoplasm that is mostly seen around the eyes. However these tumors can occur in atypical locations such as the axilla. Although the axilla is possible site for syringoma, no previous case of syringoma limited to the axilla has been reported in Korea. We report here on a case of syringoma that appeared as grouped yellow-brownish papules limited to the axillae of a 24-year-old woman.

A Case of Cutaneous Inflammatory Myofibroblastic Tumor

Pseudo-inflammatory tumors are also known as plasma cell granuloma, inflammatory pseudo-tumor and inflammatory myofibroblastic tumor, and these tumors are a group of highly variable proliferations of myofibroblastic cells that are associated with a prominent inflammatory infiltrate. This tumor is known to most commonly occur in the lungs, bladder and gastrointestinal system with only a few cases having been reported in the skin. A previously healthy 26-year-old man presented with a 6-year history of an intermittently pruritic lesion on his back. On the histologic examination, there were spindle cells in fascicles and a mixed inflammatory cellular infiltrate of plasma cells and lymphocytes. A diagnosis of inflammatory fibroblastic tumor was made and the nodule was surgically removed. We report here on an additional case of this rare cutaneous entity, and it is probably the first such report from Korea.