A Case of Churg-Strauss Syndrome / 대한피부과학회지

Churg-Strauss syndrome is a clinicopathologic disorder of severe asthma, fever , and eosinophilia together with systemic vasculitis involving various organ systems. Characteristic cutaneous lesions include erythematous maculopapules resembling erythema multiforme, hemorrhagic lesions, and cutaneous and subcutaneous nodules. Histologically, extravascular granuloma and leukocytoclastic vasculitis are the most common findings. We report a case of 40-year-old woman who presented with generalized multiple hemorrhagic bullae that had developed 1 month ago. Previously, She had allergic rhinitis and asthma. Laboratory studies revealed peripheral blood eosinophilia, and positive p-ANCA. Skin biopsy revealed eosinophilic infiltrates and leukocytoclastic vasculitis.

Two Cases of Tufted Angioma Improved with Intralesional Injection of Steroid / 대한피부과학회지

Tufted angioma is a rare, acquired vascular tumor, most commonly presenting in the first year of life, which was first described by Wilson Jones in 1979. Spontaneous resolution of this tumor are known to be very rare and local recurrence often occurs unless the tumor is excised completely. We present two cases of tufted angioma developed in two 1-year-old girls. Skin biopsy in a case showed compatible findings with tufted angioma and the other was diagnosed at an other hospital. The lesions were treated with intralesional injections of triamcinolone acetonide and showed marked improvement. During follow up period, the lesions kept improving.

Staphylococcal Scalded Skin Syndrome, Review of 20 Cases / 대한피부과학회지

BACKGROUND: Staphylococcal scalded skin syndrome is a relatively uncommon but well described syndrome defined by clinical, microbiological and histological criteria. The spectrum of the disease in children includes not only a severe and acute exfoliative form(generalized form) but also a scarlatiniform eruption(abortive form) and bullous impetigo(localized form). OBJECTIVE: We performed the study to review the clinical, microbiological and histological features of staphylococcal scalded skin syndrome in Korean children. METHODS: We reviewed retrospectively medical records, clinical photographs, microbiologic results and histopathologic findings of 20 cases of staphylococcal scalded skin syndrome diagnosed at Hanyang University Kuri Hospital from February 1998 to November 2001. RESULTS: 1. Of the 20 patients, 13 were generalized type and 7 were abortive type and male to female sex ratio was 1:1.5. The mean age of onset was 3.2 years. 2. The ordinary cultures from the suspected sites of primary infection revealed methicillin-sensitive Staphylococcus aureus in 7 of the 18 patients, and methicillin-resistant Staphylococcus aureus in 6 of the 18 patients. The colonized sites were conjunctiva(23%), throat(23%), skin(23%), nasal cavity(23%) and ear(8%) in 13 cases. 3. Perioral crusting and fissuring was observed in all cases and the erythema was accentuated in the flexural areas. 4. Histopathologic findings of 11 cases showed intraepidermal cleavage, with splitting occuring beneath and within the stratum granulosum. In 6 of 8 generalized forms, several acantholytic epithelial cells were observed. 5. The coexisting diseases were variable, including atopic dermatitis(5 cases), polycystic kidney disease(1 case) and varicella(1 case). 6. All the patients were treated with first generation cephalosporin and vancomycin therapy without significant sequelae. CONCLUSION: There are no significant relation between clinical types of SSSS and causative organisms. Methicillin-resistant Staphylococcus aureus may induce generalized form and abortive form of staphylococcal scalded skin syndrome but should be confirmed by production of exfoliation in the new-born mouse assay.

A Case of Poroma with Features of Hidroacanthoma Simplex, Eccrine Poroma, and Dermal Duct Tumor / 대한피부과학회지

Hidroacanthoma simplex, eccrine poroma, and dermal duct tumor have all been reported as distinct neoplasms of eccrine sweat duct origin. However, these tumors have recently come to be viewed as variants of benign poroid neoplasia owing to their similar histopathologic and cytologic features. Some cases of two or three subtypes of poroid neoplasm coexisting in a single lesion have been reported in foreign countries. We report herein a 61-year-old female who visited our outpatient department due to an erythematous pedunculated mass on the left thigh. Histopathologic findings showed both poroid and cuticular cells, intercellular or intracytoplasmic ducts, and monomorphism of the nuclei of poroid and cuticular cells in all three neoplasms. This is the first case of a poroma composed of three histologically distinct lesions in a single lesion in Korea.

A Case of Necrobiosis Lipoidica Diabeticorum with Koebner Phenomenon / 대한피부과학회지

The isomorphic response of Koebner is a well-known phenomenon commonly associated with psoriasis, but it has been also described in conjuction with a host of other disorders. However it has seldom been associated with necrobiosis lipoidica diabeticorum, a rare skin manifestation of diabetes mellicuts. In this report, we describe a 59-year-old woman who developed necrobiosis lipoidica diabeticorum on the left shin where a mosquito had bitten her 2 months ago. Four months ago, she was diagnosed as necrobiosis lipoidica diabeticorum on the right forearm and shin by biopsy and the lesions were improved with corticosteroids intralesional injection. The lesions were asymptomatic and had grown slowly. Histopathological findings showed a large palisading granulomas composed of histiocytes, epithelioid cells and areas of necrobiosis of collagen with multinucleated giant cells. Van Gieson stain showed decreased and fragmented elastic fibers and there were no deposits of mucin in the necrobiotic areas. The lesions were improved with triamcinolone acetonide intralesional injection and there was no recurrence during 4 months.

A Case of Keratosis Follicularis Squamosa (Dohi) / 대한피부과학회지

Keratosis follicularis squamosa (Dohi) is a rare aquired keratinizing disorder, which is particularly common among Asians, including Japanese and Chinese. We report a case of keratosis follicularis squamosa (Dohi) in a 54-year-old woman, who had multiple dark brownish atrophic plaques with collarette scales on the buttock and thigh symmetrically. The biopsy specimen showed a dilated hair follicle with keratotic plugging and epidermal hyperkeratosis associated with slight parakeratosis. Gram positive cocci were demonstrated in the dilated hair follicle and horny layer. After 4 weeks of treatment with minocycline, the lesion showed a marked improvement.

Epidermolysis Bullosa Acquisita: A Complete Remissions versus Patients with Long-term Persistent Activities / 대한피부과학회지

BACKGROUND: In epidermolysis bullosa acquisita, it has been recognized that there exists heterogeneity in the clinical and serologic/immunopathologic features. OBJECTIVE: We examined patients with epidermolysis bullosa acquisita to see if there were any associated clinical and serological features which may predict disease activity or prognosis in the disease. METHODS: Clinical and some serologic features were compared. between 2 groups of patients with epidermolysis bullosa acquisita; one with complete remission of the symptoms and signs of the disease for more than 2 years and the other group with persistent disease activities of longer than 5 years.

Livedo Reticularis Associated with Atrial Myxoma

We describe the case of a 45-year-old woman who had self-regressing livedo reticularis on the lower extremities. Examination of a biopsy specimen from the mottled area revealed myxomatous emboli in the deep dermal arterioles. Echocardiography showed a myxoma in the left atrium. After the tumor was surgically excised, the patient had no further evidence of the disorders during the 3-year period of follow-up. Livedo reticularis caused by an peripheral arterial embolism, which in turn was caused by the tumor fragments in our patient with left atrial myxoma, is considered to be unusual.