The Value of PCR Detection of TCR gamma Gene Rearrangement in the Diagnosis of Early Mycosis Fungoides / 대한피부과학회지

BACKGROUND: The diagnosis and differential diagnosis of mycosis fungoides(MF) is often difficult, clinically and histologically. A variety of inflammatory dermatoses may be seen with similar clinical and histological features. Given the limitation of histologic diagnosis in the early MF, an ancillary method to demonstrate a clonal T cell proliferation would be helpful. Recent attempts to enhance diagnostic sensitivity have involved T-cell receptor(TCR) gene rearrangement studies, using polymerase chain reaction(PCR) technique. OBJECTIVE: The purpose of this study was the value of PCR detection of TCR gamma gene rearrangement in the diagnosis of early MF. MATERIALS AND METHODS: Thirty-two cases of paraffin embedded tissue(PET) from patients of early MF were investigated for the presence of TCR gamma gene rearrangement using a nested PCR technique and analyzed by polyacrylamide gel electrophoresis(PAGE). As a control, PET from patients of 6 psoriasis, 3 lichen planus, 1 neurodermatitis, and 1 allergic contact dermatitis were tested. RESULTS: Monoclonal TCR gamma gene rearrangement was detected in 28 out of 32 (88%) patients with early MF and in none out of 11 patients with inflammatory skin diseases. CONCLUSION: TCR gamma gene rearrangement studies on lesional skin using PCR may be helpful as an adjunct to the histopathologic diagnosis of early MF.

CD44 Standard and Variants Expression in Keratinocytic Tumor / 대한피부과학회지

BACKGROUND: The CD44 antigen is a widely distributed cell surface glycoprotein implicated in multiple physiological cellular functions including cell-cell adhesion, cell-substrate interaction and cell activation. In the skin, CD44 is normally expressed in epidermal keratinocytes and hair follicular, sebaceous and eccrine epithelial cells. The precise functions of CD44 are not yet clearly understood, though they appear to be involved in the mechanism of tumor invasion and metastasis. OBJECTIVE: The purpose of this study is to investigate the immunohistochemical expression of the CD44 molecule in the epidermal keratinocytic tumors with different biologic behaviors, such as squamous cell carcinoma(SCC),basal cell epithelioma(BCE), actinic keratosis(AK), bowen's disease, keratoacanthoma(KA), trichoepithelioma. METHODS: Routine paraffin sections of formalin-fixed 33 tissues (15 SCC, 23 BCE, 9 AK, 7 KA, 7 bowen's disease, 5 trichoepithelioma, 2 psoriasis, 2 lichen planus) were labeled with anti-CD44 monoclonal antibody using avidin-biotin- peroxidase complex. Normal skin served as the negative control. RESULTS: The results are as follows. 1. In SCC and KA, peripheral parts of the lesion were prominently stained. CD44v6 showed the strongest expression, followed by CD44s and CD44v4/5. The horn cyst and the keratin region of the horn pearl were not stained. The degree of staining was weaker in KA compared to SCC. 2. The degree of staining was weaker in BCC and TEE compared to SCC. The staining was more prominent at the center of the lesion than in the peripheral region. In TEE, stronger staining was found at the center or in the squamous epithelial region. 3. Among the seven cases of Bowen's disease, 4 cases were diffusely stained with all three CD44 types. In the other three cases, local staining with the standard type and diffuse staining with CD44v4/5 and CD44v6 were seen. 4. In AK, the early lesion showed decreased expression of CD44 in all three types. However, those with mature lesion and progression to SCC showed increased degree of staining in all three types of CD44. CONCLUSION: These results suggest that expression of CD44 in these keratinocytic tumors is not related to malignant transformation and metastasis, but instead may be related tumor differentiation.

CD44 Standard and Variants Expression in Keratinocytic Tumor / 대한피부과학회지

BACKGROUND: The CD44 antigen is a widely distributed cell surface glycoprotein implicated in multiple physiological cellular functions including cell-cell adhesion, cell-substrate interaction and cell activation. In the skin, CD44 is normally expressed in epidermal keratinocytes and hair follicular, sebaceous and eccrine epithelial cells. The precise functions of CD44 are not yet clearly understood, though they appear to be involved in the mechanism of tumor invasion and metastasis. OBJECTIVE: The purpose of this study is to investigate the immunohistochemical expression of the CD44 molecule in the epidermal keratinocytic tumors with different biologic behaviors, such as squamous cell carcinoma(SCC),basal cell epithelioma(BCE), actinic keratosis(AK), bowen's disease, keratoacanthoma(KA), trichoepithelioma. METHODS: Routine paraffin sections of formalin-fixed 33 tissues (15 SCC, 23 BCE, 9 AK, 7 KA, 7 bowen's disease, 5 trichoepithelioma, 2 psoriasis, 2 lichen planus) were labeled with anti-CD44 monoclonal antibody using avidin-biotin- peroxidase complex. Normal skin served as the negative control. RESULTS: The results are as follows. 1. In SCC and KA, peripheral parts of the lesion were prominently stained. CD44v6 showed the strongest expression, followed by CD44s and CD44v4/5. The horn cyst and the keratin region of the horn pearl were not stained. The degree of staining was weaker in KA compared to SCC. 2. The degree of staining was weaker in BCC and TEE compared to SCC. The staining was more prominent at the center of the lesion than in the peripheral region. In TEE, stronger staining was found at the center or in the squamous epithelial region. 3. Among the seven cases of Bowen's disease, 4 cases were diffusely stained with all three CD44 types. In the other three cases, local staining with the standard type and diffuse staining with CD44v4/5 and CD44v6 were seen. 4. In AK, the early lesion showed decreased expression of CD44 in all three types. However, those with mature lesion and progression to SCC showed increased degree of staining in all three types of CD44. CONCLUSION: These results suggest that expression of CD44 in these keratinocytic tumors is not related to malignant transformation and metastasis, but instead may be related tumor differentiation.

A Case of Cutaneous Angiomyolipoma / 대한피부과학회지

We report a case of cutaneous angiomyolipoma which occurred on the sole. A 31-year-old man visited our clinic with 1.3 x1.2 cm sized dome-shaped erythematous nodule on the left sole. There were no signs of tuberous sclerosis. Histopathologic examination showed a well-circumscribed subcutaneous nodule composed of an intimate mixture of blood vessel, smooth muscle, and mature fat. We treated it with a total surgical excision.

A Case of Becker's Nevus Associated with Ipsilateral Breast Hypoplasia / 대한피부과학회지

We report a case of Becker's nevus associated with ipsilateral breast hypoplasia in a 13-year-old female. Three years esrlier, she noticed a palrn-size hyperpigmented area on her left chest. The lesion showed a well defined geographic border. No hypertrichosis was seen. Hypoplasia was apparent on the left breast. A histopathologic finding showed a slightly hyperpigmented epidermis and some rectangular rete ridges with flat bases.

A Case of Mycosis Fungoides Palmaris et Plantaris / 대한피부과학회지

Mycosis fungoides palmaris et plantaris is an uncommon expression of mycosis fungoides that manifests primarily on the palms and the soles. The lesions may be quite hyperkeratotic and mimic various inflammatory palmoplantar dermatoses. A biopsy is recommended in the evaluation of recalcitrant palmoplantar dermatoses. We report a case of mycosis fungoides palmaris et plantaris in a 36-year-old woman presented with hyperkeratotic plaque on her palms and soles.