The Incidence of Birthmarks in Korean Newborn Infants

PURPOSE: Birthmarks are commonly observed during neonatal period and its prevalence varies between races and countries. Most skin lesions are transient and not require medical treatment. But some birthmarks have potential medical significance and may be the first sign of systemic medical problems. We carried out a prospective study to determine the prevalence of birthmarks in Korean newborn infants. METHODS: From October 2012 to January 2013, 1,964 Korean newborn infants who were born in Cheil General Hospital, Kwandong University College of Medicine were evaluated for the presence of birthmarks within 48 hours after birth. RESULTS: Among 1,964 newborn infants, 980 (49.9%) infants were male and 984 (50.1%) were female. The most common pigmentary birthmark was Mongolian spot (97.1%), which was mostly presented on sacrogluteal area, and was followed by nevocellular nevi (0.8%), cafe-au-lait spot (0.8%), and sebaceous nevi (0.2%). Among vascular birthmarks, the most common lesion was salmon patch (30.8%), and followed by port-wine stain (0.2%) and hemangioma (0.2%). The common other lesions were sebaceous hyperplasia (37.4%), erythema toxicum neonatorum (10.2%), milia (4.1%), skin appendage (2.6%), anal dimple (1.2%), auricular pit (0.9%), miliaria (0.5%), aplasia cutis congenita (0.2%) in the order of frequency. CONCLUSION: We studied the prevalence of the birthmarks in Korean newborn infants. The most common pigmentary birth mark was mongolian spot, and the most common vascular birthmark was salmon patch in Korean newborn infants.

Simultaneous Involvement of Nervous and Gastrointestinal Systems in Behcet's Disease

No abstract available.

Epidemiological Features of Childhood Atopic Dermatitis in Suwon / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease and its prevalence has recently increased. Epidemiological research for associated factors of AD has recently been reported. However, a large population study on the factors affecting the disease development and progression in childhood AD has not yet been carried out in Suwon. OBJECTIVE: We investigated the prevalence of AD in elementary school students and the associated factors of the disease development and progression in Suwon. METHODS: This study was carried out among 1,330 elementary school students from April to July, 2009. First, a questionnaire study (International Study of Asthma and Allergies in Childhood, ISSAC) which covered clinical manifestations, environment, and life style was performed. Then, two dermatologists examined the skin of students with symptoms suspicious of AD and evaluated the severity using the Eczema Area and Severity Index (EASI) score. RESULTS: The prevalence of AD among the elementary school students in Suwon as evaluated by questionnaire was 22.9%. However, the prevalence confirmed by two dermatologists was 6.7%. The average EASI score measured by the two dermatologists was 3.52+/-3.05. The most common age of onset was under 2 years, followed by 2~4 years. The two major risk factors of AD showing statistical significance were parental past history of atopic disease and moving to a new residence within a year after birth. CONCLUSION: These results suggest that certain genetic and environmental factors may affect the prevalence of childhood AD in Suwon.

A Case of Birt-Hogg-Dube Syndrome

Birt-Hogg-Dube syndrome (BHDS) is an autosomal dominant genodermatosis characterized by cutaneous hair follicle tumors (fibrofolliculoma or trichodiscoma), pulmonary cysts, and increased risk of renal neoplasia. The genetic alteration for BHDS has been mapped to chromosome 17p12q11, and the gene in this region has been cloned and believed to be responsible for the BHDS. Mutations in the BHD gene (also known as FLCN) have been described in the patients with BHDS. We present a case of a 30-yr-old Korean woman with multiple mildly pruritic papules on her face and neck area. The patient had several firm, flesh-colored, dome-shaped, papular lesions measuring between 2 to 5 mm. Except for a history of pneumothorax her medical records were not remarkable. Mutation analysis of the BHD gene was performed, and a novel deletion mutation (p.F519LfsX17 [c.1557delT]) causing truncation of the gene product, folliculin, was found in the exon 14. The actual incidence of BHDS is unknown, but it is most likely underdiagnosed. So it is imperative that doctors recognize the skin lesions of BHDS and institute proper screening to detect other manifestations of the disease. Here, we report a case of BHDS with a novel mutation, which is the first report in Korea.

A Case of Idiopathic Eruptive Macular Pigmentation Limited to Flexural Areas

Idiopathic eruptive macular pigmentation is a rare condition characterized by asymptomatic pigmented macules involving the neck, trunk, and proximal portions of the extremities. On histopathologic examination, there was increased pigmentation of the basal layer in otherwise normal epidermis and scattered melanophages in the papillary dermis. We report a case of a 26-year-old woman with idiopathic eruptive macular pigmentation involving only the flexural areas of the body. This condition should be considered in the differential diagnosis of flexural hyperpigmented skin lesions.

A Case of Atrophia Maculosa Varioliformis Cutis

Atrophia maculosa varioliformis cutis (AMVC) is a type of idiopathic noninflammatory macular atrophy that occurs in young individuals. It is clinically characterized by shallow, sharply demaracated depressions of various shapes. Considering that atrophia maculosa varioliformis cutis can be mistaken as scarring and artifact dermatitis, it is important for physicians to distinguish this condition and to diagnose it correctly.

A Case of Primary Cutaneous Anaplastic Large Cell Lymphoma with Extensive Inflammatory Cell Infiltration / 대한피부과학회지

Primary cutaneous anaplastic large cell lymphoma (ALCL) is composed of large cells with anaplastic, pleomorphic cytomorphology and the expression of the CD30 antigen by the majority (more than 75%) of tumor cells. Recently some variants of ALCL with extensive inflammatory cell infiltration have been reported. A 34-year-old male presented with multiple tumors over the arm, groin, and legs. The tumors of the right groin showed ulceration and purulent discharge. The biopsy specimens revealed extensive infiltrate of large atypical lymphoid cells with mixed inflammatory cells consisting of numerous eosinophils and neutrophils. Immunohistochemical staining was positive for CD3, CD4, and CD30. TCR-gamma gene rearrangement was detected. There was no evidence of extracutaneous involvement. We report a case of primary cutaneous ALCL, associated with marked inflammatory cell infiltration. Diagnosis in such cases is challenging because the large atypical lymphoid cells may be easily obscured by the massive infiltrate of eosinophils and neutrophils.

Erythema Nodosum: Clinicopathologic Correlations and Their Use in Differential Diagnosis

PURPOSE: Typically, a diagnosis of erythema nodosum (EN) is based on clinical features. However, other diseases manifest with inflammatory nodules of the lower limbs in addition to EN, such as the EN-like lesions of Behcet's disease (BD). The purpose of this retrospective study was to investigate the frequency of histologically proven EN among diseases diagnosed clinically as EN, to determine underlying causes of EN, and to compare clinical and histologic features between EN and other diseases. PATIENTS AND METHODS: We selected 99 patients diagnosed clinically with EN and performed skin biopsies. All pathologic slides were evaluated and diagnosed; and after histologic diagnoses were made we reviewed the patients' medical records. RESULTS: Among the 99 patients diagnosed clinically with EN, 47 were biopsy-verified EN. The EN-like lesions of BD and nodular vasculitis were both in the primary differential diagnosis of EN. No definite difference in clinical features exists among these three diseases. Histologically, EN demonstrated septal panniculitis in the majority of patients. Lobular panniculitis was frequently observed in NV, and mixed or mostly lobular panniculitis was observed in the EN-like lesion. Vasculitis was rarely observed in EN; however lymphocytic vasculitis was observed frequently in EN-like lesions and neutrophilic vasculitis was observed in NV. The frequency of granulomatous inflammation was highest in NV. Some cases of patients with typical BD demonstrated classic EN lesions. CONSLUSION: It was extremely difficult to clinically differentiate EN from EN-like lesions or NV. We feel skin biopsy is mandatory for the diagnosis of lower extremity erythematous nodular lesions.

Two Cases of Dermatofibroma with Atrophic Features / 대한피부과학회지

Atrophic dermatofibroma is an uncommon variant of dermatofibroma. It lacks the classic clinical features of a dermatofibroma and is often misdiagnosed. Clinically, it is characterized by inward puckering or flat lesions which on palpation become depressed or "sink in" during biopsy. Histologically, it appears similar to dermatofibroma except that it is accompanied by dermal atrophy of more than 50% of the locoregional dermis. We report two cases of dermatofibroma with atrophic features. Dermatologists should consider a diagnosis of atrophic dermatofibroma when evaluating of atrophic, depressed lesions.

A Case of Polypoid Sinusoidal Hemangioma / 대한피부과학회지

Sinusoidal hemangioma is a rare variant of deep hemangioma. Clinically it develops in adults, predominantly females, and presents as a painless, bluish, solitary, deep dermal or subcutaneous nodule. Histologically they are characterized by a well-circumscribed lobulated architecture composed of dilated interconnecting, thin-walled vascular channels that frequently show a pseudopapillary pattern and a back-to-back arrangement with scanty intervening stroma. We report an unusual case of sinusoidal hemangioma, which showed polypoid growth on the trunk of a 39-year-old male.

A Case of Deep Penetrating Nevus / 대한피부과학회지

Deep penetrating nevus is a recently described variant of melanocytic nevi. It's clinical and histopathological features can be confused with malignant melanoma, blue nevus, Spitz nevus, pigmented spindle cell nevus, or congenital melanocytic nevus. Histopathologically, the lesions are characterized by loosely-organized nests of slightly to distinctively pleomorphic pigmented cells which deeply penetrate the reticular dermis and often extend into the subcutis. We report a case of deep penetrating nevus on the right arm of a 21-year-old female.