The Clinical Effect of 5% Imiquimod Cream in the Treatment of Verruca Plana / 대한피부과학회지

BACKGROUND: Despite numerous therapeutic options, the treatment of verruca plana remains unsatisfactory for both patients and physicians. Imiquimod, a novel topical immune response modifier, has been successfully used for the treatment of external anogenital warts. OBJECTIVE: The purpose of this study was to investigate the efficacy of imiquimod in treatment of verruca plana. METHOD: Fifteen patients with verruca plana were treated with 5% imiquimod cream that was self-applied 3 times a week and left in place overnight. Assessment for responses and side effects was performed every 2 weeks until clinical cure or up to 12 weeks. RESULTS: 10 of 15 (66.7%) patients achieved a excellent result (>75% improvement), and 11 (73%) patients achieved a good result (>50% improvement). With regard to the location of the lesions, 10 of 12 (83%) patients with lesions on the face and neck achieved a clear result (>95% improvement), but only 2 of 7 (28%) patients with lesions on the extremities achieved a clear result. Local inflammatory reactions were the most common adverse events, however, they were generally mild and transient. CONCLUSION: 5% imiquimod cream, applied by the patient, is an effective treatment modality for verruca plana.

Wells' Syndrome Associated with Esophageal Squamous Cell Carcinoma / 대한피부과학회지

Wells' syndrome or eosinophilic cellulitis is a recurrent inflammatory dermatosis, characterized clinically by acute dermatitis resembling cellulitis. The histopathologic findings show diffuse dermal eosinophilic infiltration and characteristic `flame figures'. The etiology and pathogenesis are unknown, however, various associated disorders such as hematological diseases, infections, arthropod bites, drugs, and surgery have been documented. Wells' syndrome has previously been reported in only 4 cases of non-hematological malignancy. A 57-year-old man with esophageal squamous cell carcinoma developed recurrent, mildly tender, urticarial plaques on the trunk and left forearm. A skin biopsy specimen revealed histopathologic findings compatible to Wells' syndrome. Skin lesions resolved with systemic corticosteroids therapy without recurrence until now. We report a case of Wells' syndrome associated with esophageal squamous cell carcinoma

Central Trichoptilosis Associated with Trichorrhexis Nodosa and Pili Torti

A 12-year-old girl presented with a 1-week duration of hair loss associated with splitting of the hair ends and whitish dots on the occipital hairs. On microscopic examination, a longitudinal splitting of the hair shaft with reconstitution of the normal hair distal to the fracture, nodular swellings, with the appearance of broomsticks pushed into one another, at the site of whitish swellings, and the flattening and twisting of the hair shaft around the long axis were demonstrated. Minor trauma to injury-prone hair is a common cause of hair shaft defects, however the reports with the combined conditions are insufficient in the literature. We describe a patient with central trichoptilosis associated with localized trichorrhexis nodosa and pili torti.

A Case of Giant Cell Tumor of Tendon Sheath on the Palm / 대한피부과학회지

A 36-year-old female presented with a 5-month history of an indurated asymptomatic nodule on the left palm. A skin biopsy was done and the histopathological findings were consistent with those of a giant cell tumor of tendon sheath (GCTTS). A GCTTS occurs in the tendon sheath of digits or in the joints of the extremities, and most commonly involves the distal fingers. However, palmar involvement of this tumor is unusual. We present a case of GCTTS on the palm.

A Case of Abdominal Protrusion Caused by Herpes Zoster / 대한피부과학회지

Segmentally distributed cutaneous eruptions along with sensory change and pain are frequently seen in herpes zoster. Occasionally it affects motor nerves in the segments corresponding to the involved sensory dermatomes, causing a flaccid paralysis. Motor weakness following herpes zoster infection has been well documented, with about half of the cases involving the cranial nerves and the other half involving the extremities. Interestingly, myotomal paresis involving the thoracic segment is unusual. We report a case of segmental herpes zoster paralysis presenting as an abdominal protrusion.

A Case of Purpura Annularis Telangiectodes (Majocchi's disease) / 대한피부과학회지

Purpura annularis telangiectodes is an uncommon pigmented purpuric eruption that is seen more commonly in young adult females, and it is one of the subgroups of pigmented purpuric dermatoses. Clinically, the disease is characterized by symmetrical telangiectatic, purpuric, annular patches with a predilection for the lower extremities and buttock. We report a case of purpura annularis telangiectodes (Majocchi disease) on the lower extremities of a 31-year-old male patient.

A Case of Sebaceous Epithelioma / 대한피부과학회지

Sebaceous epithelioma is a rare skin appendage tumor with sebaceous differentiation and appears as yellow papules, nodules, or plaques, most commonly in areas with large numbers of sebaceous glands, such as the face. Histopathologically, sebaceous epitheliomas are composed of circumscribed nodules consisting predominantly of basaloid cells and foci of sebaceous differentiation. We report a case of sebaceous epithelioma which appeared as a yellowish to erythematous patch on the forehead in a 55-year-old woman.

A Case of Locally Invasive Basal Cell Epithelioma Presented as a Subcutaneous Mass / 대한피부과학회지

Basal cell epithelioma(BCE) is the most common malignant tumor of the skin, and locally invasive neoplasm, rarely metastatic, yet capable of significant local destruction and disfigurement. Radiotherapy has been reported to have high local cure rate and good cosmetic results in the treatment of BCE, and therefore may be an alternative treatment when excision is not functionally or cosmetically feasible, especially in the high risk areas. We report a 73-year-old female with locally invasive BCE presented as a subcutaneous mass on the left nasolabial fold area.

A Case of Carcinoma en Cuirasse from Thyroid Cancer / 대한피부과학회지

A 52-year-old male had presented with painful swelling on the left shoulder. The lesion had progressed to involve the left chest, neck, and arm, and 3 months later, evolved into brown to light purplish hard plaque mimicking the feature of scleroderma. A skin biopsy findings were consistent with metastatic carcinoma, and neck MRI and thyroid sonogram revealed primary thyroid cancer of left lobe. The patient's condition was carcinoma en cuirasse, an uncommon clinical feature of metastatic skin cancer. Skin metastasis of thyroid cancer is rare, and to our knowledge, there is not any documented case of carcinoma en cuirasse from thyroid cancer. We present a case of carcinoma en cuirasse from thyroid cancer.

A Clinical Study on The Labial Diseases / 대한피부과학회지

BACKGROUND: Diseases of the lips are common, however the clinical investigations of the labial lesions are not sufficient. OBJECTIVE: The purpose of this study was to investigate the epidemiological aspects of the labial diseases with the brief review of the common labial diseases. METHODS: We retrospectively reviewed the data on 117 patients biopsied for the labial lesions at Sanggye Paik Hospital between August, 1989 and May, 2003. RESULTS: The ratio of male to female was 1: 1.54(46: 71). The general age distribution was relatively even, however the age distribution was quite different in each disease. The frequent labial diseases were mucocele, pyogenic granuloma, actinic cheilitis, Fordyce's condition, hemangioma, squamous cell carcinoma, verruca, venous lake, etc., in order of frequency. Vascular disorders and the diseases associated with ultraviolet radiation, such as actinic cheilitis and squamous cell carcinoma, are relatively frequent. Among 117 cases, 29 cases(24.8%), 78 cases(66.7%), and 9 cases(7.7%) involved upper lip, lower lip, and both lips, respectively. And the frequency of the diseases varied according to the locations. CONCLUSION: The result of our study was different from others and we consider the discrepancy resulted from the regional and racial difference. Further investigations of a wider and larger nature are necessary to understand the epidemiology of labial diseases.

A Case of Epithelioid Sarcoma / 대한피부과학회지

Epithelioid sarcoma is a rare soft tissue neoplasm of uncertain origin and occurs most commonly on the distal extremities of young adult males. It usually presents as a slowly growing dermal or subcutaneous nodule, however it is characterized by multiple recurrences and metastases. Its slowly growing pattern and confusing histopathologic findings often result in inaccurate or delayed diagnosis. We describe a 38-year-old female of epithelioid sarcoma on the hand, emphasizing that clinicians should consider the possibility of this disease in case of nodular or ulcerated lesion of the extremities, especially distal upper extremities.

A case of acne keloidalis nuchae treated by surgical excision / 대한피부과학회지

A 43-year-old man presented with well-defined purple to skin-colored 2X1cm sized plague and various sized papules on the posterior neck. Histopathological findings were follicular and perifollicular inflammation with plasma cells, lymphocytes and neutrophils and dermal fibrosis shown as hypertrophic scar tissue. The patient was diagnosed as acne keloidalis nuchae and treated by surgical excision. We report a case of acne keloidalis nuchae showing typical clinical and histopathological findings.

A Case of Cutaneous Leiomyoma Clinically Mimicking Mondor's Disease / 대한피부과학회지

A 45-year-old man presented with linear cord-like nodules on the left chest and abdomen. He complained of episodic pain and mild tenderness of the lesion. The clinical impression was Mondor's disease and skin biopsy was done. The histopathologic findings revealed a poorly circumscribed tumor composed of interlacing smooth muscle fiber bundles with intermingled collagen, consistent with cutaneous leiomyoma. We report a case of cutaneous leiomyoma clinically mimicking Mondor's disease.

A Case of Verrucous Carcinoma / 대한피부과학회지

Verrucous carcinoma(VC) is a low grade and well-differentiated, unusual variant of squamous cell carcinoma, presenting as a warty tumor. It is often underdiagnosed because of its gross appearance and slow growing pattern, and histologically, the diagnosis of VC is usually difficult as a result of its cellular benignity. We present a case of VC on the foot, which had been treated as a wart for over eight months and treated with amputation. VC shoud be considered in the differential diagnosis for any warty lesion, especially, intractable long-standing warty lesion, and the diagnosis for VC is based on the combination of the history of the lesion, clinical features, and histopathological findings from an adequately deep specimen.

A Case of Cutaneous Leiomyosarcoma on the Face / 대한피부과학회지

Leiomyosarcoma is a relatively rare soft tissue sarcoma of smooth muscle derivation. Superficial or cutaneous leiomyosarcomas, which are very rare and account for less than 3% of the cutaneous soft tissue sarcoma, are subdivided into two groups; a dermal form and a subcutaneous form. Cutaneous leiomyosarcoma may occur anywhere on the body, but there is a predilection for the extremities, especially the thighs. However, leiomyosarcoma of the face is exceedingly rare. We present a case of cutaneous dermal leiomyosarcoma on the face.

A Case of Rhinocerebral Mucormycosis Presenting with Facial Palsy / 대한피부과학회지

Mucormycosis is an opportunistic fungal infection affecting patients with diabetes or immune-compromised status, caused by species of the Mucoraceae family. Rhinocerebral mucormycosis, the most frequent form of mucormycosis, is characterized by a rapidly progressive and usually fatal course. Common initial symptoms of rhinocerebral mucormycosis include facial pain, facial swelling, headache, fever and blood-tinged rhinorrhea, however, facial palsy is relatively rare. We describe a diabetic female considered rhinocerebral mucormycosis presenting with facial palsy.

A Case of Cutaneous Metastasis of Signet-Ring Cell Gastric Carcinoma / 대한피부과학회지

Signet-ring cell(SRC) is formed by intracytoplasmic accumulation of various substances which push the nucleus to the cellular border so that the cell looks like a signet ring. Most cutaneous SRC neoplasms are metastatic adenocarcinomas. SRC, when seen in skin, may indicate that the primary origins are from the stomach, colon or breast. The SRC formations in cutaneous neoplasms other than metastatic adenocarcinoma have also been reported such as SCC, BCC, metastatic melanoma etc. We experienced a case of cutaneous metastasis of SRC gastric carcinoma which the first symptom was skin lesion of the scalp.

The Efficacy of Peeling with Amino Acid Filaggrin Based Antioxidants(AFAs) / 대한피부과학회지

BACKGROUND: Amino acid Filaggrin based Antioxidants(AFAs) is a recently invented peeling agent and the clinical report of the effects of AFAs peeling is insufficient. OBJECTIVE: The purpose of this study was to investigate the efficacy of peeling with AFAs. METHODS: This is a retrospective case study for the 41 patients treated with AFAs peeling at Sanggye Paik Hospital between January, 2002 to April, 2003. The therapeutic efficay was evaluated by the degree of satisfaction of both the patients and practitioners, regarding the number of peelings and the concentration of AFAs. Adverse effects were also evaluated. RESULTS: The results of this study were as follows. Of the 41 patients, 20 were acne, 14 were melasma, 4 were freckle, 2 were postinflammatory hyperpigmentation, and the other was an acne scar patient. The satisfaction rates of the patients were excellent(> or =70% improved) 17, good(50-70%) 11, fair(30-50%) 8, and poor(<30%) 5 out of 41 cases. And those of the practitioners were respectively 18, 14, 4, and 5 out of 41 cases. The satisfaction rates tended to increase as the number of peelings increased, while the concentration of AFAs showed little relation with the therapeutic effect. 4. The adverse effects were immediate vesiculation probably due to allergic reaction(3/41), persistent erythema(2/41), persistent irritation(2/41), pigmentation(1/41), and tingling sensation(1/41). CONCLUSION: AFAs peeling is an effective treatment modality in Korea and several repeelings improve the therapeutic effect. But futher studies on the adverse effects of this procedure are necessary.

Solitary Mastocytoma on the Scalp

Nine-month-old female infant was seen with a 7-month history of a nodule on the right temporal scalp, which had gradually increased in size. Stroking of the lesion resulted in urtication and blistering and there were no other cutaneous lesions. The histology showed subepidermal bulla formation and a dense infiltration of mast cells in the papillary and reticular dermis. We present an infant with solitary mastocytoma on the scalp, a rare site.

A Case of Sister Mary Joseph's Nodule / 대한피부과학회지

A metastatic umbilical carcinoma from internal malignancy is known as Sister Mary Joseph's nodule. A 56-year-old man presented with a progressively enlarging umbilical nodule. Skin biopsy was done and the patient was diagnosed as metastatic adenocarcinoma of umbilicus. Search for the primary tumor revealed gastric adenocarcinoma with metastasis to perigastric lymph node, portal vein and intrahepatic duct. Sister Mary Joseph's nodule, a rare form of cutaneous metastasis, generally carries very poor prognosis. We describe a case of Sister Mary Joseph's nodule preceding a diagnosis of gastric cancer with review of the literature, and emphasize the importance of careful evaluation of any umbilical nodule.