Folliculotropic Mycosis Fungoides in 20 Korean Cases: Clinical and Histopathologic Features and Response to Ultraviolet A-1 and/or Photodynamic Therapy

BACKGROUND: Folliculotropic mycosis fungoides (FMF) is a variant of mycosis fungoides (MF) that is characterized clinically by variable types of skin eruptions, including plaques, acneiform lesions, and alopecic patches. Histopathologically, FMF is characterized by folliculotropic infiltrates. OBJECTIVE: This study was conducted to scrutinize the clinical and histopathologic features of FMF in Koreans and the responses to phototherapy. METHODS: Twenty Koreans diagnosed with MF who had histopathologic evidence of folliculotropism were enrolled. RESULTS: Eighteen patients had head-and-neck-region infiltration, while five had solitary lesion. In all patients, the atypical lymphocytic infiltrate had a perifollicular distribution. Twelve patients were treated with ultraviolet A (UVA)-1. Eleven of these 12 patients with early-stage FMF experienced >80% improvement (8: complete remission; 3: partial remission). Four patients, including 2 who relapsed after UVA-1, were treated with photodynamic therapy (PDT), reaching complete remission after PDT. CONCLUSION: As FMF has variable clinical presentations, skin biopsy is required to confirm the diagnosis. And both UVA-1 and methyl aminolevulinate-PDT are clinically effective in treatment of early-stage FMF.

Erratum: Folliculotropic Mycosis Fungoides in 20 Korean Cases: Clinical and Histopathologic Features and Response to Ultraviolet A-1 and/or Photodynamic Therapy

In the originally published version of this article, complete anonymity was not achieved.

Usefulness of Dermoscopy in the Differential Diagnosis of Ruptured and Unruptured Epidermal Cysts

BACKGROUND: An epidermal cyst is a common keratin-filled epithelial-lined cyst. The treatment of choice for epidermal cysts is surgical excision. If the cyst becomes ruptured, incision and drainage with oral antibiotic therapy or intralesional steroid injection are required. OBJECTIVE: To analyze the dermoscopic features that can differentiate between ruptured and unruptured epidermal cysts. METHODS: The clinical and dermoscopic features of the pathologically confirmed epidermal cysts of two subgroups of 38 patients, 20 with unruptured cysts and 18 with ruptured cysts, were reviewed. RESULTS: With regard to the dermoscopic features, an ivory- white background color and punctum were commonly found in both groups (p>0.05). The unruptured-cyst group showed higher frequencies of pore sign (p0.05), no vascular structure, and arborizing telangiectasia (p0.05) and peripheral linear branched vessels (with an erythematous rim) (p<0.05). CONCLUSION: Dermoscopy is helpful in differentiating between ruptured and unruptured epidermal cysts.

Usefulness of Dermoscopy in the Differential Diagnosis of Ruptured and Unruptured Epidermal Cysts

BACKGROUND: An epidermal cyst is a common keratin-filled epithelial-lined cyst. The treatment of choice for epidermal cysts is surgical excision. If the cyst becomes ruptured, incision and drainage with oral antibiotic therapy or intralesional steroid injection are required. OBJECTIVE: To analyze the dermoscopic features that can differentiate between ruptured and unruptured epidermal cysts. METHODS: The clinical and dermoscopic features of the pathologically confirmed epidermal cysts of two subgroups of 38 patients, 20 with unruptured cysts and 18 with ruptured cysts, were reviewed. RESULTS: With regard to the dermoscopic features, an ivory- white background color and punctum were commonly found in both groups (p>0.05). The unruptured-cyst group showed higher frequencies of pore sign (p0.05), no vascular structure, and arborizing telangiectasia (p0.05) and peripheral linear branched vessels (with an erythematous rim) (p<0.05). CONCLUSION: Dermoscopy is helpful in differentiating between ruptured and unruptured epidermal cysts.

Pityriasis Lichenoides-like Mycosis Fungoides: Clinical and Histologic Features and Response to Phototherapy

BACKGROUND: Pityriasis lichenoides (PL)-like skin lesions rarely appear as a specific manifestation of mycosis fungoides (MF). OBJECTIVE: We investigated the clinicopathological features, immunophenotypes, and treatments of PL-like MF. METHODS: This study included 15 patients with PL-like lesions selected from a population of 316 patients diagnosed with MF at one institution. RESULTS: The patients were between 4 and 59 years of age. Four patients were older than 20 years of age. All of the patients had early-stage MF. In all patients, the atypical lymphocytic infiltrate had a perivascular distribution with epidermotropism. The CD4/CD8 ratio was <1 in 12 patients. Thirteen patients were treated with either narrowband ultraviolet B (NBUVB) or psoralen+ultraviolet A (PUVA), and all of them had complete responses. CONCLUSION: PL-like MF appears to have a favorable prognosis and occurrence of this variant in adults is uncommon. MF should be suspected in the case of a PL-like skin eruption. Therefore, biopsy is required to confirm the diagnosis of PL-like MF, and NBUVB is a clinically effective treatment.

Cutaneous Epithelioid Hemangioendothelioma That Enlarged in Size during Pregnancy: Dermoscopic Features / 대한피부과학회지

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that has been reported in systemic organs and in the skin as a biologically "borderline" neoplasm with intermediate malignant potentials. Skin involvement in EHE is rare, but when present, it occurs most commonly in the upper and lower extremities, presenting as a solitary, slightly painful, soft tissue mass. Skin involvement is often associated with underlying soft tissues or bone tumors. Histopathological study reveals cords and nests of epithelioid endothelial cells in a myxoid or hyalinized background and small intracytoplasmic vacuoles containing red blood cells. There have been no reported cases yet describing the dermoscopic features of EHE. Herein, we describe a young woman who developed cutaneous EHE that enlarged during pregnancy, we provided the dermoscopic findings and a review of the relevant literature.

Clinical Features and Histological Findings of 17 Patients with Chronic Actinic Dermatitis / 고신대학교의과대학학술지

OBJECTIVES: This study was designed to evaluate the clinical, histological and immunohistochemical findings and treatment of chronic actinic dermatitis in Korean patients. METHODS: Seventeen Korean patients with chronic actinic dermatitis were enrolled for this study. The clinical and histological findings and the results of phototest were reviewed with medical records, clinical photographs and pathologic slides. We also reviewed the effectiveness of the treatments in all patients with chronic actinic dermatitis. RESULTS: In all patients with chronic actinic dermatitis, pruritus was severe, and the patients present in the early stages with erythemas on the face, neck and the back of the hands. As the eruption progresses, it became lichenified and scaly plaques and papules developed. The face, upper extremity and neck were most commonly affected. The most common abnormal results of the phototests were decreased MED-UVB alone. In 8 patients with actinic reticuloid, histopathologic findings showed irregular acanthosis, parakeratosis, spongiosis, atypical hyperchromatic cells with cerebriform nuclei, epidermotropism, Pautrier-like microabscess, deep perivascular lymphocytic infiltrates, vertically-streaked collagen in the papillary dermis, stellate and multinucleated fibroblasts. Treatment includes topical tacrolimus and corticosteroid, oral corticosteroid, azathioprine and cyclosporine. CONCLUSIONS: Our study showed classic clinical and histological findings. The most common abnormal results of the phototests were decreased MED-UVB alone. Topical steroid, tacrolimus and systemic cyclosporine, azathioprine are effective in treating chronic actinic dermatitis.

Ultraviolet A1 Phototherapy of Mycosis Fungoides

No abstract available.

Ultraviolet A1 Phototherapy of Mycosis Fungoides

No abstract available.

Comment on "Pseudopautrier's Abscess"

No abstract available.

Histologic and Dermoscopic Findings of Clear Cell Acanthosis in Seborrheic Keratosis / 대한피부과학회지

Clear cell acanthosis is a reaction pattern of the epidermis that can be observed as the chief histopathologic finding in clear cell acanthoma and as a focal change in other epidermal lesions, such as verruca vulgaris and seborrheic keratosis. Dermoscopy is a useful noninvasive tool that permits the visualization of key vascular structures that are usually not visible to the naked eye. A 63-year-old Korean man was presented with 2 year of a well-circumscribed, dome-shaped nodule on the nipple. Our patient represents patterns of both a clear cell acanthoma and a seborrheic keratosis on dermoscopic and histopathologic finding, but, notably, on dermoscopy vascular structures were more irregular linear distribution than classic clear cell acanthoma and different from dotted vessels shown in psoriasis. In this report, we describe a case of clear cell acanthosis in seborrheic keratosis for whom dermoscopy was used as a valuable diagnostic tool.

The Diagnostic Significance of Infiltration Pattern and Perilesional Lymphoid Cell Infiltrate in Dermatofibroma

No abstract available.

Lymphomatoid Papulosis with Pseudocarcinomatous Hyperplasia / 대한피부과학회지

Lymphomatoid papulosis (LyP) is a chronic lymphoproliferative disorder characterized by the appearance of crops of papules, nodules, and sometimes large plaques at different stages of development. Pseudocarcinomatous hyperplasia (PCH) presents with extreme proliferation of the epidermis with downgrowth into the dermis, which histologically mimics the features of squamous cell carcinoma. However, squamous cells usually are well differentiated, and atypicalities, such as individual cell keratinization, nuclear hyperplasia, and hyperchromasia, are minimal or absent. PCH has rarely been reported in LyP. Here, we showed that PCH associated with LyP may closely resemble squamous cell carcinoma, thereby giving rise to wrong diagnosis and treatment.

Large Superficial Basal Cell Carcinoma Arising in the Scalp

Superficial basal cell carcinoma (sBCC), a rare sub-type of basal cell carcinoma, can frequently occur in younger patients. This cancer type preferentially develops on the trunk. However, other subtypes of BCC can occur in the head and neck, probably secondary to sunlight exposure. Especially, sBCC on the scalp has been rarely-reported, accounting for 0.7~0.8% of all sBCC cases. We report a case of 71-year-old female with a large sBCC of the scalp, an unusual site of sBCC.

Pseudoxanthoma Elasticum Presenting as Localized Skin Lesion without Systemic Involvement / 대한피부과학회지

Pseudoxanthoma elasticum (PXE) is a heritable disorder of elastic tissue and it has many systemic manifestations. PXE is a systemic disorder that most markedly affects the elastic tissues in the skin, retina and blood vessels. Defects in the ABCC6 gene lead to calcification of elastic tissue. We herein report on two cases of pseudoxanthoma elasticum that presented with focal involvement on the skin of the neck without marked wrinkling.

Comments to "Pr imary Cutaneous CD30+ Anaplastic Large Cell Lymphoma That Developed after Lymphomatoid Papulosis" / 대한피부과학회지

No abstract available.

Comments to "Primary Cutaneous CD30+ Anaplastic Large Cell Lymphoma That Developed after Lymphomatoid Papulosis" / 대한피부과학회지

No abstract available.

Narrowband Ultraviolet B Phototherapy of Early Stage Mycosis Fungoides in Korean Patients

BACKGROUND: Narrowband UVB (NBUVB) is currently used to treat early mycosis fungoides (MF). There are a number of reports on the efficacy and safety of NBUVB in Caucasians, but little data is available for Asians. OBJECTIVE: This study was designed to evaluate the effectiveness and safety of NBUVB for early stage MF in Korean patients. METHODS: We enrolled 14 patients (12 men, 2 women; age range, 10~64 years) with clinically and histologically proven MF. Three patients were stage IA, and the others were stage IB. The patients received NBUVB phototherapy three times a week. The starting dose was 70% of the minimal erythema dose and was increased in 20 percent increments if the previous treatment did not cause erythema. Clinical response, total number of treatments, total cumulative dose, duration of remission and side effects were investigated. RESULTS: Eleven of 14 patients (78.6%) achieved complete remission within a mean of 15.36+/-5.71 weeks (range, 5~27 weeks), 31.0+/-7.4 treatments (range, 16~39 treatments) and a mean cumulative UVB dose of 31.31+/-12.16 J/cm2 (range, 11.4~46.8 J/cm2). Three of the 14 patients (21.4%) achieved a partial remission. After discontinuation of treatment, 6 of 11 patients (54.5%) with complete remission relapsed after a mean of 8.5+/-4.09 months. No serious adverse effects were observed except for hyperpigmentation (7/14, 50%). CONCLUSION: Our data suggest that NBUVB therapy is safe and effective for the treatment of early stage MF in Korean patients.

A Case of Botryomycosis at the Excoriation Site in a Patient with Chronic Eczema / 대한피부과학회지

Botryomycosis is a chronic, granulomatous and suppurative infection. The skin is the most frequently affected organ. The most common species is Staphylococcus aureus, followed by Pseudomonas aeruginosa. Clinically, the skin lesions most commonly affect the hands and feet and they can appear as nodules, ulcers, sinuses, fistulae and verrucous plaques. Histopathologic examination reveals grains with surrounding eosinophilic material and inflammatory cells. We report here on a case of botryomycosis at the excoriation site in a 90-year-old female patient with chronic eczema.

A Case of Recalcitrant Hidradenitis Suppurativa Treated with Secondary Healing and a Split Thickness Skin Graft after Exteriorization / 대한피부과학회지

Hidradenitis Suppurativa (HS) is a chronic relapsing disease that involves the apocrine gland-bearing skin. It results in sinus tract formation, fibrosis and scarring. Many different treatments for HS have been reported, including topical and systemic antibiotics, intralesional steroids, systemic retinoids, hormonal therapies and immnunosuppressive agents, but they all have limited beneficial effects. Surgical treatments, including wide exteriorization with secondary intention, a skin graft and a flap can be effective treatments for recalcitrant HS. We present here the case of a 26-year-old man with recurred inguinal and axillary HS, and this was treated with secondary healing and a split thickness skin graft after exteriorization. Based on our experience, it is suggested that secondary healing and a split thickness skin graft after exteriorization are effective for recalcitrant HS with multiple interconnected tracts and abscesses.