Efficacy and Safety of Fexofenadine in the Treatment of Pruritus Associated with Eczema / 대한피부과학회지

BACKGROUND: Fexofenadine (Allegra(R)) is a H1-receptor selective antihistamine which exhibits consistent efficacy and safety in the treatment of allergic diseases. We thought that fexofenadine may be useful in treatment of the pruritus associated with eczema. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of fexofenadine in the treatment of pruritus associated with eczema. METHODS: In this study, patients with atopic and allergic contact dermatitis were divided into a group given fexofenadine 180 mg once daily with topical prednicarbate treatment group or a topical prednicarbate treatment only group, for 1 week. The primary efficacy parameter was the mean change from baseline in pruritus score, and the secondary parameters were the mean change in the incidence of scratching, the mean change in visual analogue scale (0~100 mm) of pruritus, and a comparison of patient satisfaction. RESULTS: 435 patients were included and the mean age was 32.9 years old. The mean pruritus score at baseline was 3.55 point in fexofenadine group and 3.51 point in the control group. Regarding the mean change in pruritus score, fexofenadine significantly decreased the severity of pruritus compared with the control group (p<0.05). There were no significant differences in the decrease in the incidence of scratching between the two groups. A decrease in pruritus levels utilizing visual analogue scale was significant in the fexofenadine group (p<0.05) and patient satisfaction was significantly higher in the fexofenadine group (p=0.0192). There was no significant difference in the incidence of adverse events between two groups (p=0.6237). CONCLUSION: Fexofenadine administered 180 mg once daily in combination with topical prednicarbate treatment was effective and well tolerated in this study.

A Study on the Effect of Topical 5% Lidocaine Patches on Postherpetic Neuralgia

BACKGROUND: Postherpetic neuralgia (PHN) is the most common and serious complication of herpes zoster and its incidence is increasing in the aging population. Despite the many approaches thath have been proposed to treat postherpetic neuralgia, none of the therapies are satisfactory in their efficacy and safety. OBJECTIVE: Assessment of the effectiveness and safety of the 5% lidocaine patch, a targeted peripheral analgesic, for the treatment of postherpetic neuralgia. METHOD: Fifteen patients with established PHN completed a three-session, random-order, double-blind, vehicle-controlled study. A maximum of three patches were applied to the most painful area for 12 hours, twice in two consecutive days (i.e., 12 hours on followed by 12 hours off). Two sessions were done with the 5% lidocaine patches and one session with a placebo patch. The sessions were conducted at least 7 days apart. RESULTS: The 5% lidocaine patch significantly reduced the mean VAS scores (pain intensity) at the time points from hours 12 to 72 compared with baseline (individual time points p<0.001 to p=0.033) and from hours 12 to 72 compared with the vehicle patch (individual time points p<0.001 to p=0.015). The lidocaine patch also provided significantly greater pain relief on the 6-item scale compared with the vehicle patch (individual time points p<0.001 to p=0.04). The patches were well tolerated by all patients. Neither systemic side effects nor significant skin irritation were noted. CONCLUSION: This study demonstrates that use of the 5% lidocaine patch resulted in statistically significant pain relief. Patients suffering from PHN will find the patches easy to use and there is minimal risk of systemic toxicity

Three Cases of Congenital Smooth Muscle Hamartomas

Congenital smooth muscle hamartomas (CSMHs) usually appear at birth as skin-colored or slightly hyperpigmented patches or plaques on the trunk or extremities and are often covered by and increased amount of vellus hair. Histopathologically, it represents a proliferation of smooth muscle bundles within the dermis(1,2). We herein report on three cases of localized CSMHs; Case 1 was a 2-month-old boy who presented with a skin-colored, 6x5cm-sized plaque with folds, hypertrichosis and pseudo- Darier's sign on the face, an unusual site. But there was no hyperpigmentation. Case 2 and 3 were both 1-month-old boys who presented with typical hyperpigmented, hairy plaques on the lateral aspect of the left thigh.

A Case of Chondroid Syringoma with Small Tubular Lumina

Chondroid syringoma is an uncommon, benign neoplasm of sweat gland origin. It clinically presents as a slowly-growing intradermal or subcutaneous nodule, and is usually observed on the head and neck of middle-aged to elderly people. Histologically, two types of chondroid syringoma can be recognized: one common type has tubular and cystic lumina and the other extremely rare type has small tubular lumina. We herein report a rare case of chondroid syringoma with small tubular lumina.

A Case of Secondary Cutaneous Diffuse Large B-Cell Lymphoma

We report here on a case of secondary cutaneous diffuse large B-cell lymphoma (DLBCL) that occurred in a 67-year-old man who had a 2-month history of nodular growing masses on the left cheek, plus palpable lymph nodes on the left cervical area. The histopathological findings showed a diffuse infiltration of large atypical lymphocytes with nuclear atypia throughout the entire dermis. These showed positive CD20, bcl-2 and the post-germinal center marker, MUM-1. According to the WHO (World Health Organization) classification, this lymphoma is considered to be diffuse large B-cell lymphoma of the post-germinal center (GC) B-cell type with a secondary cutaneous manifestation. We treated the patient with systemic chemotherapy (CHOP) and anti-CD20 monoclonal antibodies. During the course of treatment, new skin lesions developed on his neck, so we changed the regimen to cytosin- arabinoside and cisplatin. But he died of pneumonia after the third cycle.

A Case of Adenomatous Hyperplasia of the Minor Salivary Glands

Adenomatoid hyperplasia of the minor salivary glands is a rare clinicopathologic entity with an unknown etiology. The clinical features of the lesion are nodular, non-painful swellings, and the histologic features are aggregates of normal-appearing, salivary gland tissue, in excess of what would be anticipated for the anatomic site. This tumor is of significance because of its clinical resemblance to salivary gland tumors. Although this lesion may occur at any site on the oral mucosa, the labial mucosa is known to be the least common site. We herein report a rare case of adenomatous hyperplasia of the minor salivary glands located on the lower labial mucosa.

A Clinicopathologic Study on Eccrine Tumors / 대한피부과학회지

BACKGROUND: Various eccrine tumors are rather common diseases in clinicians. However, data on the clinicopathologic features of eccrine tumors in Korea are limited. OBJECTIVE: The purpose of this study was to investigate the clinicopathologic characteristics of eccrine tumors in Korea. METHODS: Two hundred and sixty five cases of eccrine tumors, seen from 2002 to 2004 in Korea, were retrospectively analyzed clinically and histopathologically. RESULTS: The most common eccrine tumors identified within Koreans were syringoma (61%), followed by eccrine poroma (13%), eccrine hidrocystoma (9%), and nodular hidradenoma (6%). Moreover, eccrine tumors were usually found to occur in middle-aged woman as multiple asymptomatic skin-colored papules. The most common site of occurrence was the face (45%), followed by the neck (9%), scalp (5%), foot (5%), abdomen (4%), and vulvar (3%). CONCLUSION: The results of this study will be useful and fundamental data on eccrine tumors for clinicians and pathologists.

A Case of Intramuscular Lipoma on the Chin / 대한피부과학회지

Intramuscular lipoma, also referred to as an infiltrating lipoma, is a rare, benign uncapsulated tumor that originates between skeletal muscle bundles and infiltrates through the intramuscular septa. These lipomas are generally found on the upper or lower limbs, but rarely occur on the face. We report a case of intramuscular lipoma of the chin, which has not ever been reported in Korea. Histopathological findings showed mature adipocytes infiltrating muscle in a diffuse manner. The lesion was excised completely and has shown no evidence of recurrence.

A Case of Leser-Trelat Sign Associated with Adenocarcinoma of the Rectum

No abstract available.

A Case of Allergic Contact Dermatitis to Sodium Fusidate

No abstract available.

A Case of Sea Anemone Dermatitis / 대한피부과학회지

Sea anemone dermatitis, caused by the toxin of sea anemones (member of phylum Cnidaria), is characterized by erythematous papules, wheals, or vesicles, accompanied by pain and itching. A 25-year old woman presented with multiple erythematous papules on her right forearm, after contact with a sea anemone while scuba diving. She took both courses of an acute toxic reaction and a delayed allergic reaction.

The Morphology of Scalp Whorls and Anterior Hairlines in Koreans / 대한피부과학회지

BACKGROUND: Although scalp whorls and the anterior hairline are important parts for the morphology of the scalp hair pattern, only a few studies on them have been reported. OBJECTIVE: This study was performed to obtain data about the classification and incidence of various scalp whorl patterns, the average heights of the anterior hairlines, and the types of anterior hairlines and their incidence. METHOD: We evaluated the number, direction and location of the parietal scalp whorls, measured the heights of the frontal and temporal hairlines according to the 5 standard lines, and identified the shape of the anterior hairlines in 484 men and 171 women. RESULTS: Of the 655 subjects, 89.6% had single parietal scalp whorls, while 6.9% had double whorls. The single clockwise type was more common than the single counterclockwise types, and the location of single whorls were in the middle, right and left, in decreasing order of frequency. Of the double whorls, cases of the same direction were more common than those of opposite directions. The average height of the anterior hairline was higher in men than women. For the classification of the anterior hairline, the linear type was the most common in men and the round type more common in women. CONCLUSION: We describe the present results as a guideline for the further study of hair-related abnormalities and also for the esthetic design of hair transplantations.

A Case of Extranodall NK/T-cell Lymphoma, Nasal type / 대한피부과학회지

NK/T-cell lymphomas which are characterized by the biphenotype of the NK-cell and the T-cell are divided into nasal and non-nasal NK/T-cell lymphoma, non-nasal NK/T-cell lymphoma is then further subdivided into primary cutaneous and 4 subtypes of secondary cutaneous lymphoma such as nasal type, aggressive, blastic(blastoid), and other specific NK-like T-cell lymphoma. Primary cutaneous NK/T-cell lymphoma is a very rare condition and defined as a lack of extracutaneous disease for at least 6 months from the time of diagnosis. We herein report a case of non-nasal NK/T-cell lymphoma, which is consistent with primary cutaneous type.

A Case of Intravascular Large B Cell Lymphoma / 대한피부과학회지

Intravascular large cell lymphoma (angiotropic large cell lymphoma) is a rare, multifocal, intravascular neoplasm of lymphoid cells that preferentially involves the vasculature of the skin and central nervous system. We report a 33-year-old man who had asymptomatic purpuric patches on both thighs, left arm, and left flank. A biopsy specimen showed intravascular collections of tumor cells with irregular nuclear contour and prominent nucleoli. These cells were positive for CD45, CD20, but negative for CD3, and CD56. The clinicopathologic features and immunohistochemical profiles were diagnostic of intravasculr large B cell lymphoma.

Comparative Evaluation of Hair Density and Grouped Hair Unit Pattern between Androgenetic Alopecia and Normal Scalp

BACKGROUND: Human hair usually emerges from the scalp in groups of 2 or 3-hair units. Hair densities and grouping patterns in androgenetic alopecia (AGA) patients are known to be different from those in normal adults, but no comparative study has ever before been made in Korea. Therefore we have developed some technical improvements on phototrichogram methodology to evaluate the differences between these two groups. BACKGROUND: Objectives: This study was performed to quantify Koreans' hair characteristics at each site (vertex, occipital, temporal) of the scalp according to the age and to compare the differences of hair characteristics of AGA and normal adults using phototrichogram. METHODS: Hairs in the precisely defined circle at each (vertex, temporal, occipital) site of the scalp in 37 AGA male patients and 15 healthy male volunteers were evaluated according to age. Each circumscribed area of the scalp, centered with a dot tattoo to ensure reproducibility, was photographed just after shaving, and named 'primary image'. Two days later, the same area was again photographed, and named 'secondary image', from which the hair density and the grouping pattern of hair follicular units were determined by the image analyzer program. RESULTS: The results can be summarized as follows: 1. In normal adult males, the range of hair density was 117~13/cm2~140~16/cm2, with the hair density of the occiput being significantly higher than that of the temple. No significant differences in hair density were shown between vertex and occiput. 2. In AGA male patients, the range of hair density was 102~23/cm2-137~17/cm2, and the differences of the hair density between vertex and occiput were statistically significant. 3. The numbers of grouped hair units per square centimeter in the non-bald adult male group ranged from 59~11/cm2 to 73~14/cm2. The most common grouped hair unit was a 2-hair unit, followed by a 1-hair unit and a 3-hair unit group. 4. In the AGA group, the numbers of grouped hair units per square centimeter ranged from 57~6/cm2 to 72~12/cm2, showing no significance with the control group. The most common grouped hair unit was a 1-hair unit, followed by a 2-hair unit and a 3-hair unit group. CONCLUSIONS: The AGA group compared remarkably with the normal adult male group, showing a lower hair density with a larger proportion of 1-grouped hair units. Based on the data about hair density and hair grouping patterns in AGA patients, surgeons can estimate the area of donor scalp with the most probable number of follicular units in hair trans-plantation procedures.

Extraocular Sebaceous Carcinoma

Sebaceous carcinoma is an uncommon neoplasm usually associated with ocular adnexa. This malignancy may occur at any anatomic site that contains sebaceous glands. Despite the widespread anatomic distribution of sebaceous glands, extraocular sebaceous carcinoma occurs with far less frequency. We report a case of an 87-year-old Korean woman with extraocular sebaceous carcinoma treated with total excision.

A Case of Kaposi's Sarcoma Occurring in Membranous Glomerulonephritis / 대한피부과학회지

Kaposi's sarcoma is a neoplasm of multifocal origin which manifests primarily as vascular nodules in the skin and other organs. Kaposi's sarcoma in iatrogenically immunocompromised patients is the result of immunosuppressive therapy in organ-transplant recipients, autoimmune disease patients and cytotoxic chemotherapy in cancer patients. We report a case of Kaposi's sarcoma in a 50-year-old man who developed well-defined purple-colored papules and plaques on both hands and feet after prednisolone treatment for underlying membranous glomerulonephritis. The histologic finding showed abnormally proliferated and dilated vessels, vascular slits, spindle-shaped cells and extravasated erythrocytes in the dermis. He was treated with cryotherapy, and the dosage of prednisolone was reduced. Improvement was seen in 6 weeks

Kaposi Sarcoma in Patient with Membranous Glomerulonephropathy during Corticosteroid Therapy / 대한신장학회잡지

Membranous glomerulonephropathy is a common cause of nephrotic syndrome in adults. Kaposi sarcoma is a well-known entity with distinct clinical forms such as nodular cutaneous lesions, generalized lymphadenopathy and visceral involvement. Incidence of Kaposi sarcoma is greater in patients with immunosuppression, particularly those having undergone renal transplantation, but also in patients with other underlying disorders treated with immunosuppressive therapy, notably, corticosteroids. We present a case of Kaposi sarcoma in patient with membranous glomerulopathy during corticosteroid therapy. A 49- year-old man was admitted with a complain of facial and leg edema, 5-kg weight gain for 1 month, and foamy urine. Kidney biopsy showed membranous glomerulopathy. We started corticosteroid therapy to the patient. Two month later, his 24 hr urinary protein was decreased to 2.1 g/day. But, the well defined, various-sized, purple-colored papules and plaque appeared on the both hands and feet. He underwent skin biopsy, which revealed abnormally proliferated and dilated vessels, vascular slits, spindle-shaped cells and extravasated erythrocytes in the dermis. The findings were in accordance with Kaposi sarcoma. So he received cryotherapy with discontinuing corticosteroid. Four months after cryotherapy, skin lesions were cleared leaving slight hypopigmentation and amount of proteinuria was preserved without definite aggravation.

A Case of Bednar Tumor / 대한피부과학회지

Bednar tumor is an uncommon pigmented subtype of dermatofibrosarcoma protuberans(DFSP). The histopathological finding is characterized by a typical storiform pattern composed of spindle-shaped cells resembling DFSP except for the presence of melanin-containing cells scattered within the lesion. The origin of the spindle-shaped cells and melanin-containing cells within the tumor remains unknown. We report a case of Bednar tumor in a 26-year-old woman on the right shoulder which was presented as asymptomatic, firm, black-colored, 1x1.5 cm nodule over 2 years. Histologically, the proliferated spindle-shaped cells showed a cartwheel pattern and stained positively with CD34, similar to those of a common DFSP. The tumor was widely excised and there is no evidence of recurrence from follow-up of 6 months.

A Case of Allergic Contact Dermatitis to Dermovate(R) and Eumovate(R) Ointment / 대한피부과학회지

Allergic contact dermatitis to topical corticosteroids seems to occur more frequently than previously supposed. But it is not easily recognized because the allergic condition for which the steroid is mostly prescribed masks the sensitization. Moreover, corticosteroids evoke some anti-inflammatory effect, even in case of steroid hypersensitivity. A 40-year-old man visited our department for the evaluation of aggravated skin lesion of trunk. Previously he was treated with Dermovate(R) and Eumovate(R) ointment for chronic dermatitis. He was patch tested to the Korean standard series, with Dermovate(R) and Eumovate(R) ointment as is. Patch test showed positive reactions to both ointments.