A Case of Purely Epithelioid Peripheral Nerve Sheath Tumor / 대한피부과학회지

The purely epithelioid malignant peripheral nerve sheath tumor(MPNST) is a rare form of MPNST, first described by McCormack et al. in 1954. This tumor type differs from ordinary epithelioid MPNST because of absence of spindle cell components. The patient was 25-year-old woman with palpable bean-sized subcutaneous mass on the right upper arm for 8 months which enlarged gradually. On physical examinations, we could not find a evidence of lymphadenopathy or von Reklinghausen's disease. Microscopically the tumor showed well circumscribed encapsulated nodular pattern composed of epithelioid cells. The cells were plump round or polygonal cells which had vesicular nuclei and prominent nucleoli with abundant eosinophilic and some clear cytoplasms. Immunohistochemical study showed the cells being positive for S-100 protein and neuron specific enolase and negative for HMB-45, cytokeratin and vimentin. We report a case of purely epithelioid malignant peripheral nerve sheath tumor which is located superficially without evidence of von Recklinghaunsen's disease or associated peripheral nerve.

A Case of Lentigo Maligna Melanoma / 대한피부과학회지

We report herein a case of lentigo maligna in a 60-year-old female that progressed to lentigo maligna melanoma. She had an uneven dark brownish pigmented and irregular-bordered macule on the right cheek, which gradually extended peripherally over the last 20 years and became 2.5x2.5cm in size. A dark brownish nodule developed in the inferior portion of the macule 7 months ago. The histopathologic findings were consistent with lentigo maligna and lentigo maligna melanoma. The lesion was excised with a surgical margin of 1cm and a full thickness skin graft was performed.

p53 Protein and Ki-67 Antigen Expression in Keratoacanthoma and Keratoacanthoma-like Squamous Cell Carcinoma / 대한피부과학회지

BACKGROUND: Differential diagnosis of keratoacanthoma(KA) from squamous cell carcinoma(SCC) is often difficult, especially when SCC has KA-like features(KA-like SCC). A number of recent studies have been attempted to separate these two entities with the use of immunohistochemical stains. But the results were inconsistent and the studies with KA-like SCC are rarely reported. OBJECTIVES: The purpose of this study was to examine the expression patterns of p53 protein and Ki-67 antigen on KA and KA-like SCC using immunohistochemical staining method and to evaluate the usefulness of this method in distinguishing each other. METHODS: We performed immunoperoxidase staining(LSAB technique) using monoclonal antibody to p53 protein(PAb1801) and Ki-67 antigen(MIB1) on the formalin-fixed, paraffin-embedded biopsy specimens obtained from 12 patients with KA, 8 patient with KA-like SCC, and 10 patients with well-differentiated SCC. RESULTS: The results were as follows; 1) There was a significant difference in the p53 expression between KA(25%) and SCC group (KA-like SCC=88%, SCC=100%). 2) Mean Ki-67 labeling index was slightly higher for SCC group(KA-like SCC=30.72%, SCC= 31.23%) than for KA(25.30%), but this difference was not statistically significant. 3) In Ki-67 expression, KA showed more pheriperal basal pattern(91%), whereas SCC group showed more diffuse pattern(77%). CONCLUSION: Our results suggest that KA and SCC are distinct entities of different nature and that these immunohistochemical staining methods can be useful methods in differentiating KA-like SCC from KA.

p53 Protein and Ki-67 Antigen Expression in Keratoacanthoma and Keratoacanthoma-like Squamous Cell Carcinoma / 대한피부과학회지

BACKGROUND: Differential diagnosis of keratoacanthoma(KA) from squamous cell carcinoma(SCC) is often difficult, especially when SCC has KA-like features(KA-like SCC). A number of recent studies have been attempted to separate these two entities with the use of immunohistochemical stains. But the results were inconsistent and the studies with KA-like SCC are rarely reported. OBJECTIVES: The purpose of this study was to examine the expression patterns of p53 protein and Ki-67 antigen on KA and KA-like SCC using immunohistochemical staining method and to evaluate the usefulness of this method in distinguishing each other. METHODS: We performed immunoperoxidase staining(LSAB technique) using monoclonal antibody to p53 protein(PAb1801) and Ki-67 antigen(MIB1) on the formalin-fixed, paraffin-embedded biopsy specimens obtained from 12 patients with KA, 8 patient with KA-like SCC, and 10 patients with well-differentiated SCC. RESULTS: The results were as follows; 1) There was a significant difference in the p53 expression between KA(25%) and SCC group (KA-like SCC=88%, SCC=100%). 2) Mean Ki-67 labeling index was slightly higher for SCC group(KA-like SCC=30.72%, SCC= 31.23%) than for KA(25.30%), but this difference was not statistically significant. 3) In Ki-67 expression, KA showed more pheriperal basal pattern(91%), whereas SCC group showed more diffuse pattern(77%). CONCLUSION: Our results suggest that KA and SCC are distinct entities of different nature and that these immunohistochemical staining methods can be useful methods in differentiating KA-like SCC from KA.

A Case of Disseminated Pagetoid Reticulosis / 대한피부과학회지

Pagetoid reticulosis(PR) is a rare lymphoproliferative disorder that has been divided into the localized and disseminated type. There has been ongoing debate about the nature of PR. Some authors have regarded PR as a variant of mycosis fungoides(MF). However recent reported cases suggest that PR may represent a spectrum of lymphoproliferative disorders that may not be related to MF. We report a case of a 65-year-old woman who had an erythematous plaque on the anterior chest, buttock and lower extremities for 2 years. Histologically there was dense infiltrate of predominantly CD8-/CD30+ atypical mononuclear cells in the epidermis that produce a pagetoid appearance. We believe this is the first reported case of disseminated pagetoid reticulosis in the Korean literature.

A Case of Warty Dyskeratoma / 대한피부과학회지

We report a case of warty dyskeratoma in a 65-year-old man. He had a asymptomatic solitary 1 x 1 cm sized, round, light-brownish colored, centrally depressed nodule on the right forehead for several yearss. Histopathological findings showed two large cup-shaped keratin-filled invagination of acanthotic epidermis, suprabasal cleft formation with corps ronds, grains and numerous villi at the lower portion of the invagination, the characteristic features of warty dyskeratoma.

A Case of nevus Sebacens of Jadassohn Associated with Various Epidermal Appendage Tumors / 대한피부과학회지

We report a case of nevus sebaceus of Jadassohn in a 31-year-old female associated with various epidermal appendage tumors, such as syringocystadenoma papilliferum, sebaceus adenoma and eccrine hidrocystoma. We supposed that the multiple lesions seem to support the concept of nevus sebaceus arising from the pluripotential primary epithelial germ.

Two Cases of Cutaneous Mucinosis on the Scar Site / 대한피부과학회지

We report herein two cases of cutaneous mucinosis in a 59 and a 55 year-old woman which occurred by asymptomatic cystic nodule on the previous biopsy scar site respectively. The histopathologic findings revealed focal accumulation of mucin and proliferation of fibroblasts in the dermis. We suppose that trauma may cause these cases.

A Case of Herpes Zoster Meningoencephaliti / 대한피부과학회지

Herpes zoster can be associated with a number of neurologic complications but meningoencephalitis with herpes zoster is rarely seen. We report a case of herpes zoster ophthalmicus followed by the meningoencephalitis, which developed during treatment with acyclovir infusion. A 73-year-old male patient developed a fever and mental confusion on the third day of the treatment. Neurological examination revealed neck stiffess, increased deep tendon reflex and positive Babinski sign. The cerebrospinal fluid examination revealed increased opening pressure, increased protein and a lymphocytic pleocytosis. The glucose level was decreased, which is a very unusual feature in viral meningoencephalitis.