The Ethnic Differences of the Damage of Hair and Integral Hair Lipid after Ultra Violet Radiation

BACKGROUND: Genetic factors account for the majority of differences in skin color and hair morphology across human populations. Although many studies have been conducted to examine differences in skin color across populations, few studies have examined differences in hair morphology. OBJECTIVE: To investigate changing of integral hair lipids after ultraviolet (UV) irradiation in three human ethnic groups. METHODS: We studied the UV irradiation induced hair damage in hairs of three human populations. UV irradiation had been performed with self-manufactured phototherapy system. Damaged hair samples were prepared at 12 and 48 hours after UVA (20 J/sec) and UVB (8 J/sec) irradiation. We evaluated the changes of hair lipid using scanning electron microscopy (SEM), transmission electron microscopy (TEM), lipid TEM and HP-TLC. After UV irradiation, hair surface damage was shown. RESULTS: African hair showed more severe damage on hair surface than others. The lipid compositions across human populations were similar, but Asian hair had more integral hair lipids than other groups as a whole. Especially, free fatty acid contents were higher than other lipids. After UV irradiation, lipid contents were decreased. These patterns were shown in all human populations. Asian hair has more integral hair lipid than European or African hair. After UV irradiation, European and African hair samples exhibited more damage because they have less integral hair lipids. However, Asian hair samples have less damage. CONCLUSION: We conclude that integral hair lipid may protect the hair against the UV light.

A Clinical Observation of Cutaneous Malignant Tumors and Premalignant Lesions in Gangwon Province over 10 Years (1999~2008) / 대한피부과학회지

BACKGROUND: The incidence of cutaneous malignant tumors and premalignant lesions has recently increased according to extended life span, social and medical environment changes. However, a few clinical data have been reported on the survey of cutaneous malignant tumors and premalignant lesions in Gangwon province. OBJECTIVE: To investigate the incidence and clinical patterns of cutaneous malignant tumors and premalignant lesions in Gangwon province. METHODS: We reviewed 485 cases of cutaneous malignant tumors and premalignant lesions from January 1999 to December 2008, at the Department of Dermatology at Wonju Christian Hospital. RESULTS: The average annual incidence of cutaneous malignant tumors among the total number of outpatients was 0.51% and that of premalignant lesions was 0.48%. Both incidences tended to increase with time in 10 year intervals. The most common cutaneous malignant tumor was basal cell carcinoma (47.98%), followed by squamous cell carcinoma (24.19%), extramammary paget's disease (7.26%), metastatic cancer (5.65%), malignant melanoma (4.44%), and lastly, lymphoma (4.44%). Among premalignant lesions, actinic keratosis (74.68%) and Bowen's disease (25.32%) were common. The mean age of onset was 67.53 years in cutaneous malignant tumors and 70.51 years in premalignant lesioins. The most common site for both, the cutaneous malignant tumors and premalignant tumors, was the face (63.97% and 81.43%, respectively). The ratio of men to women was 1.11:1 in cutaneous malignant tumors and 1:2.48 in premalignant lesions. CONCLUSION: The incidence of cutaneous malignant tumors and premalignant lesions has gradually increased in Gangwon province. This data will be made available for the study about the association of cutaneous malignant tumors and premalignant lesions.

Atypical Pityriasis Rosea with Palmoplantar Involvement / 대한피부과학회지

Pityriasis rosea, first described by Gilbert in 1860, is a fairly common dermatosis. The exact cause of pityriasis rosea is not known. The earliest clinical finding of a typical case is a herald patch, which is usually on the trunk, and scaly and erythematous daughter macules, which is distributed along the skin cleavage line, such as the 'Christmas tree pattern'. This may be accompanied by Itching. Atypical cases of pityriasis rosea, such as palmoplantar, unilateral, vesicular and inverse forms, have also been reported. There is no difference between typical and atypical cases regarding the presence of a herald patch and/or symptoms. Differences between typical and atypical cases lie in the distribution of skin lesions and the characteristics of daughter macules. Hands and feet, including palms and soles, are rarely involved in pityriasis rosea. Moreover, there are no reported pathologic findings of pityriasis rosea of the palms and soles, even in atypical distributed pityriasis rosea case reports. Here, we report atypical case of pityriasis rosea with palmoplantar involvement with pathologic reports.

Frontal Fibrosing Alopecia with Partial Improvement after Systemic Steroid Administration and Topical Calcineur in Inhibitor Application / 대한피부과학회지

Frontal fibrosing alopecia (FFA) is a rare subtype of cicatricial alopecia. It was first described in 1994 by Kossard as postmenopausal frontal fibrosing alopecia. Patients who suffer from FFA show typical frontal hairline recession, and most patients experience eyebrow loss. It usually affects mainly post-menopausal women but the hormonal change due to menopause is unclear. Etiology of FFA is not clear, but it is assumed that certain autoantigens in the frontal and eyebrow hair follicles play a key role in its pathogenesis. There is no optimal treatment thus far. However, recently, topical calcineurin inhibitor was shown to be effective in early stage FFA via follicular targeted T-cell inhibition. Here, we report a case of a premenopausal 50-year-old female patient suffering from FFA displaying typical clinical features and minimal fibrosis around follicles by histological examination, which were improved by treatment with short-term systemic steroid and long-term topical calcineurin inhibitor.

Aberrant Breast Tissue Associated with Acanthosis Nigricans / 대한피부과학회지

Aberrant breast tissue is a subset of accessory breast tissue, and it exhibits similar consistency to that of the adjacent normal breast tissue, but it lacks an associated nipple complex. It is a developmental anomaly defined as the persistence of breast tissue along the embryonic mammary line. Aberrant breast tissue is most commonly located in the axilla, though it may be present anywhere along the embryonic mammary line. We report here on an 11-year-old girl with aberrant breast tissue and acanthosis nigricans. She had tender masses that became noticeable with the onset of menarche and mottled hyperpigmentation on both axillae. The histopathologic finding of the lesion revealed the typical features of aberrant breast tissue with acanthosis nigricans.

Folliculitis after Tanning Oil Application / 대한피부과학회지

Folliculitis is an inflammatory disease that has various causes. It has been widely reported to be caused by exposure to industrial oil such as cutting oil and diesel oil. A 39-year-old man presented with multiple diffuse erythematous papules with a follicular distribution on the anterior chest, back and shoulder. The histopathologic findings of the papules showed follicular epithelial destruction and a perifollicular inflammatory cellular infiltration. He was diagnosed as having folliculitis. The distribution of lesions matched with the area of tanning oil application was identical to that of the patient's applying tanning oil before the development of skin lesions. We report here on a case of folliculitis due to applying tanning oil. Tanning oil caused the follicular occlusion and dilatation in hairless mice in one experiment.

A Case of Cutaneous Larva Migrans / 대한피부과학회지

Cutaneous larva migrans (CLM) is an uncommon cutaneous creeping eruption caused by the invasion and migration of nematode larvae into the skin. Burrowing larvae produce intensely pruritic, serpiginous, raised erythematous skin lesions. Most cases of CLM reported in Korea involved travelers returning from endemic areas with tropical or subtropical climates. We report herein a case of CLM with no history of travelling to endemic area and briefly review the relevant literature.

Diagnosing Metastatic Merkel Cell Carcinoma Using Positron Emission Tomography-Computed Tomography (PET-CT) / 대한피부과학회지

Merkel cell carcinoma is a rare and lethal skin cancer that mostly occurs in aged persons who are over 60 years old as a dome-shaped purple nodule on the sun-exposed areas of the head, neck and extremities. The mortality rate is high because this tumor has a propensity for local recurrence, regional lymph node metastasis and distant metastasis. Therefore, rapid and precise diagnosis and staging are critical to improve the prognosis. We reported here on a 68-year old man with Merkel cell carcinoma on his right cheek and he had regional cervical lymph node metastasis, as was detected by PET-CT scanning.

A Case of Membranous Lipodystrophy Observed in Lichen Amyloidosis

Membranous lipodystrophy is characterized by the presence of microcysts lined by amorphous, eosinophilic material with an arabesque appearance. We experienced a case of a 72-year-old man who had dark brownish, pruritic papules on the arms, legs, and back. Histopathologic examination of a biopsied lesion showed homogeneous, eosinophilic material in the papillary dermis, as well as membranous lipodystrophy. We report a case of membranous lipodystrophy observed in lichen amyloidosis.

A Case of Lichen Planus Pigmentosus Along the Lines of Blaschko / 대한피부과학회지

Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus that presents clinically as hyperpigmented, dark brown macules or patches in sun-exposed areas and flexural folds. LPP has been described previously as a pigmented form of actinic lichen planus or as erythema dyschromicum perstans. Recently, however, these diseases have been recognized as different clinical entities. Histopathologically, in atrophic epidermis, vacuolar alteration of the basal cell layer and scarce lymphohistiocytic lichenoid infiltration and pigment incontinence are seen. Herein, we report a case of LPP that developed in a unilateral linear pattern, probably in relation to Blaschko's lines.

A Cutaneous Odontogenic Sinus / 대한피부과학회지

Cutaneous odontogenic sinuses are the most common cause of chronic draining sinus tracts on the face and neck. These lesions present as erythematous nodules with surrounding dimples, which intermittently drain purulent fluid. Although most patients do not have dental symptoms, careful questioning of a patient's past symptoms may help the clinician identify a dental etiology. A history of toothache in the affected area that resolves without dental intervention is useful information. Clinical and radiographic examination may reveal carious teeth with radiolucent areas. Elimination of the source of infection by endodontic treatment or tooth removal results in resolution of the sinus tract, typically within 2 weeks. Early precise diagnosis and appropriate dental treatment can circumvent unnecessary and ineffective antibiotic therapy or surgical treatment. We report a case of a cutaneous odontogenic sinus in the right cheek area.

A Case of Pseudolymphoma which Developed after Gold Acupuncture / 대한피부과학회지

Cutaneous pseudolymphoma refers to a heterogeneous group of benign reactive T- or B-cell lymphoproliferative diseases of the skin that resembles cutaneous lymphoma both clinically and histologically. Although most pseudolymphomas develop from unknown causes, various stimuli can induce pseudolymphomas. Pseudolymphomas have developed followed medications, infections, insect bites, ear piercing, and gold. To date, no case of pseudolymphoma developing after gold acupuncture has been reported in the Korean dermatologic literature. We report a case of a 49-year-old female who presented with multiple skin-colored papules on the left lower eyelid that showed features of a pseudolymphoma based on histopathologic assessment.

A Case of Accessory Tragus on the Posterior Neck / 대한피부과학회지

Cervical accessory tragus is a rare congenital malformation presenting at birth as a firm nodule on the neck along the anterior edge of the sternocleidomastoid muscle. It has also been reported under different names, such as elastic cartilage choristoma of the neck, Meckel's cartilaginous remnant, cervical tab, cervical auricle, and wattle. Histologically, cervical accessory tragus is composed of numerous hair follicles, and a prominent connective tissue framework in the subcutaneous fat and central core of cartilage. We report a case of an 8-year-old female who presented with a solitary flesh colored papule on the posterior neck that was histopathologically diagnosed as cervical accessory tragus.

Application of the QuantiFERON(R)-TB Gold Test in Two Cases of Erythema Induratum of Bazin / 대한피부과학회지

Erythema induratum of Bazin is a chronic, nodular subcutaneous eruption usually occurring on the lower legs of young women. Erythema induratum of Bazin hasbeen regarded as a tuberculide, a hypersensitivity response to Mycobacterium tuberculosis. The pathogenesis of erythema induratum of Bazin associated with tuberculosis is still debatable because mycobacteria cannot be cultured from the skin lesions. QuantiFERON(R)-TB Gold test detects INF-gamma released by T cells in response to Mycobacterium tuberculosis-specific antigens, which offers an improved diagnostic test of latent tuberculosis infection. We experienced two cases of erythema induratum of Bazin, which showed normal chest X-ray and negative TB-PCR. However the QuantiFERON(R)-TB Gold test was positive which led us to a diagnosis of latent tuberculosis infection. Both patients were treated with anti-tuberculosis medications, which was followed by successful resolution of the skin lesions. Therefore, we report the application of the QuantiFERON(R)-TB Gold test for the confirmation of latent tuberculosis infection in erythema induratum of Bazin patients.

A Case of Accessory Tragus on the Posterior Neck / 대한피부과학회지

Cervical accessory tragus is a rare congenital malformation presenting at birth as a firm nodule on the neck along the anterior edge of the sternocleidomastoid muscle. It has also been reported under different names, such as elastic cartilage choristoma of the neck, Meckel's cartilaginous remnant, cervical tab, cervical auricle, and wattle. Histologically, cervical accessory tragus is composed of numerous hair follicles, and a prominent connective tissue framework in the subcutaneous fat and central core of cartilage. We report a case of an 8-year-old female who presented with a solitary flesh colored papule on the posterior neck that was histopathologically diagnosed as cervical accessory tragus.

Application of the QuantiFERON(R)-TB Gold Test in Two Cases of Erythema Induratum of Bazin / 대한피부과학회지

Erythema induratum of Bazin is a chronic, nodular subcutaneous eruption usually occurring on the lower legs of young women. Erythema induratum of Bazin hasbeen regarded as a tuberculide, a hypersensitivity response to Mycobacterium tuberculosis. The pathogenesis of erythema induratum of Bazin associated with tuberculosis is still debatable because mycobacteria cannot be cultured from the skin lesions. QuantiFERON(R)-TB Gold test detects INF-gamma released by T cells in response to Mycobacterium tuberculosis-specific antigens, which offers an improved diagnostic test of latent tuberculosis infection. We experienced two cases of erythema induratum of Bazin, which showed normal chest X-ray and negative TB-PCR. However the QuantiFERON(R)-TB Gold test was positive which led us to a diagnosis of latent tuberculosis infection. Both patients were treated with anti-tuberculosis medications, which was followed by successful resolution of the skin lesions. Therefore, we report the application of the QuantiFERON(R)-TB Gold test for the confirmation of latent tuberculosis infection in erythema induratum of Bazin patients.

A Case of Acquired Dermal Melanocytosis Occurring on the Chest / 대한피부과학회지

Dermal melanocytosis, which is histologically characterized by the presence of dermal melanocytes, is most commonly found in Asians and other darkskinned people. It is observed in various congenital conditions such as the nevus of Ota, the nevus of Ito, the Mongolian spot and the blue nevus, and typically appears at birth or in early childhood. However, several cases that have appeared in adult life have been reported as acquired dermal melanocytosis. Herein, we report a unique case of acquired dermal melanocytosis diffusely affecting the left side of the chest of a 45-year old female. Additionally, a review of Korean literature regarding reported cases of unusual acquired dermal melanocytosis will be presented.

A Congenital Solitary Glomus Tumor / 대한피부과학회지

A glomus tumor is a kind of hamartoma that was first described by Masson in 1924. There are two major clinical forms of glomus tumor: solitary and multiple. Solitary glomus tumor which usually occurs in older age is characterized by a painful pink to red colored papule. A 2-week-old female infant presented to our department with a 1.3x0.4 cm sized tumor on her right foot, which had been present since birth. Histopathologic examination showed many vessels lined by thin endothelial cells and multiple rows of glomus cells. Ultrasonography of the foot revealed intense blood supply in the tumor bed. We diagnosed the patient with a congenital solitary glomus tumor, based on history, skin lesion, ultrasonography, and histopathologic findings. We report a case of a congenital, solitary glomus tumor in a 2-week-old female infant.