Clinicopathological Characteristics of Caruncular Tumors in Koreans

PURPOSE: To investigate the clinical characteristics and histological features of tumors in caruncles. METHODS: We conducted a retrospective chart review of 126 eyes of 126 patients who underwent incisional or excisional biopsy of conjunctival masses between March 2008 and December 2016. RESULTS: Twenty-four patients (19.0%) including 10 males and 14 females had a mass located on the caruncle. The mean age at diagnosis was 41.8 ± 13.4 years (range, 15–67 years). Most patients (75%) visited us for a cosmetically visible mass without other symptoms. The mean duration of symptoms was 73.8 ± 113.0 months (range, 1–240 months). The most common histological diagnosis was a melanocytic tumor (50%) followed by a sebaceous gland tumor (12.5%), an epidermoid cyst (12.5%), and papilloma (12.5%). The symptom duration of the melanocytic tumor was significantly longer than other types of tumors (153.6 ± 139.8 months, p = 0.025). CONCLUSIONS: Caruncular tumors accounted for 19% of all conjunctival tumors. The most common pathological diagnosis of a caruncular tumor was a melanocytic tumor, which had a characteristically long symptom duration.

The Diagnostic Significance of Infiltration Pattern and Perilesional Lymphoid Cell Infiltrate in Dermatofibroma

No abstract available.

Large Superficial Basal Cell Carcinoma Arising in the Scalp

Superficial basal cell carcinoma (sBCC), a rare sub-type of basal cell carcinoma, can frequently occur in younger patients. This cancer type preferentially develops on the trunk. However, other subtypes of BCC can occur in the head and neck, probably secondary to sunlight exposure. Especially, sBCC on the scalp has been rarely-reported, accounting for 0.7~0.8% of all sBCC cases. We report a case of 71-year-old female with a large sBCC of the scalp, an unusual site of sBCC.

Commments to "Mycosis Fungoides Palmaris et Plantaris in Children" / 대한피부과학회지

No abstract available.

Comments to "Primary Cutaneous CD30+ Anaplastic Large Cell Lymphoma That Developed after Lymphomatoid Papulosis" / 대한피부과학회지

No abstract available.

Pseudoxanthoma Elasticum Presenting as Localized Skin Lesion without Systemic Involvement / 대한피부과학회지

Pseudoxanthoma elasticum (PXE) is a heritable disorder of elastic tissue and it has many systemic manifestations. PXE is a systemic disorder that most markedly affects the elastic tissues in the skin, retina and blood vessels. Defects in the ABCC6 gene lead to calcification of elastic tissue. We herein report on two cases of pseudoxanthoma elasticum that presented with focal involvement on the skin of the neck without marked wrinkling.

Narrowband Ultraviolet B Phototherapy of Early Stage Mycosis Fungoides in Korean Patients

BACKGROUND: Narrowband UVB (NBUVB) is currently used to treat early mycosis fungoides (MF). There are a number of reports on the efficacy and safety of NBUVB in Caucasians, but little data is available for Asians. OBJECTIVE: This study was designed to evaluate the effectiveness and safety of NBUVB for early stage MF in Korean patients. METHODS: We enrolled 14 patients (12 men, 2 women; age range, 10~64 years) with clinically and histologically proven MF. Three patients were stage IA, and the others were stage IB. The patients received NBUVB phototherapy three times a week. The starting dose was 70% of the minimal erythema dose and was increased in 20 percent increments if the previous treatment did not cause erythema. Clinical response, total number of treatments, total cumulative dose, duration of remission and side effects were investigated. RESULTS: Eleven of 14 patients (78.6%) achieved complete remission within a mean of 15.36+/-5.71 weeks (range, 5~27 weeks), 31.0+/-7.4 treatments (range, 16~39 treatments) and a mean cumulative UVB dose of 31.31+/-12.16 J/cm2 (range, 11.4~46.8 J/cm2). Three of the 14 patients (21.4%) achieved a partial remission. After discontinuation of treatment, 6 of 11 patients (54.5%) with complete remission relapsed after a mean of 8.5+/-4.09 months. No serious adverse effects were observed except for hyperpigmentation (7/14, 50%). CONCLUSION: Our data suggest that NBUVB therapy is safe and effective for the treatment of early stage MF in Korean patients.

Comments to "Pr imary Cutaneous CD30+ Anaplastic Large Cell Lymphoma That Developed after Lymphomatoid Papulosis" / 대한피부과학회지

No abstract available.

Lymphomatoid Papulosis with Pseudocarcinomatous Hyperplasia / 대한피부과학회지

Lymphomatoid papulosis (LyP) is a chronic lymphoproliferative disorder characterized by the appearance of crops of papules, nodules, and sometimes large plaques at different stages of development. Pseudocarcinomatous hyperplasia (PCH) presents with extreme proliferation of the epidermis with downgrowth into the dermis, which histologically mimics the features of squamous cell carcinoma. However, squamous cells usually are well differentiated, and atypicalities, such as individual cell keratinization, nuclear hyperplasia, and hyperchromasia, are minimal or absent. PCH has rarely been reported in LyP. Here, we showed that PCH associated with LyP may closely resemble squamous cell carcinoma, thereby giving rise to wrong diagnosis and treatment.

The Efficacy of Photodynamic Therapy with Methyl 5-aminolaevulinate for the Treatment of Viral Wart / 대한피부과학회지

BACKGROUND: Photodynamic therapy (PDT) with methyl 5-aminolaevulinate (MAL) has proven to be useful for the treatment of a wide variety of benign and malignant dermatologic conditions. More recently, this therapeutic modality has emerged as an alternative therapy for viral wart. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of PDT for treating viral warts with using a light-emitting diode (LED) device and MAL. METHODS: Fifteen patients with a total of 34 warts were treated with MAL under an occlusive dressing for 3 hours and this was followed by irradiation with a LED device at a wavelength of 633+/-3 nm and a fluence of 37 J/cm2. The treatment was repeated at 1~2 weeks until all the lesions cleared. The side effects, including pain, hyperpigmentation and pruritus, were recorded on a progress chart. The intensity of pain was assessed by using a 5-point verbal rating scale (VRS). RESULTS: A total of 34 warts from 15 patients (9 males and 6 females) were treated with MAL-PDT. The sites of the lesion were classified as periungal (26%), sole (18%) and others (56%). After an average of 2.15+/-0.61 therapeutic sessions (MAL+PDT) for 34 warts, the number of complete, partial and no responses were 27/34 (79.4%), 7/34 (20.6%) and 0/34 (0%), respectively. The overall complete response rates were 66.7% for the periungal warts, 50% for the sole warts and 94.7% for the others. The pain after the first treatment was more intense and deeper as compared with that after the second treatment. There were no recurrences of the warts that had a complete response during the follow-up period (from 6 to 12 months). CONCLUSION: We suggest that MAL-PDT is an effective and safe alternative therapy for viral warts.

Efficacy of Ultraviolet A1 Phototherapy in Recalcitrant Skin Diseases

BACKGROUND: Ultraviolet (UV) radiation has been used for decades to treat a variety of skin diseases. UVA1 was used initially as an effective treatment for acute exacerbated atopic dermatitis. Since then, UVA1 has been attempted for recalcitrant skin diseases. OBJECTIVE: This study examined the efficacy of UVA1 phototherapy in three recalcitrant skin diseases. METHODS: This retrospective study reviewed the efficacy and follow-up of 26 patients with atopic dermatitis (AD), mycosis fungoides (MF) and localized scleroderma (LS). SUPUVASUN 3000 (Mutzhas Co., Munich, Germany) and SELLAMED 3000 (Sellas Medizinische Gerate GmbH, Gevelsberg, Germany) were the UVA1 equipment used. Irradiation was performed in accordance with the disease. Low-dose (20 J/cm2), medium-dose (65 J/cm2) and high-dose regimens (100 J/cm2) of UVA1 therapy were employed. The frequency of the therapy ranged from 3 to 5 times weekly. The therapeutic effectiveness was assessed according to the clinical examination before and after the last treatment. RESULTS: In patients with AD, complete and partial remission was achieved in four (80%) and one (20%) patient, respectively. In patients with MF, complete and partial remission was observed in thirteen (86.7%) and two (13.3%) patients, respectively. In patients with LS, complete and partial remission was observed in three (50%) and three (50%) patients, respectively. CONCLUSION: UVA1 phototherapy is an effective treatment modality for acute exacerbated AD, MF and LS.

Acute Edema Blisters in an Immobilized Patient / 대한피부과학회지

Edema blisters is an acute bullous disease that occurs following acute lower leg edema in patients with heart, renal and liver disease. Most of the affected patients are elderly, immobile and have been hospitalized for a long time. These clinical situations are commonly observed, but this can be misdiagnosed as other bullous diseases, especially friction blisters and bullous pemphigoid. We herein report a case of acute edema blisters in a 74-year-old female who presented with a tense bullae based on an edematous lower leg.

Cowden Syndrome Accompanied by Multiple Sclerotic Fibroma on the Face / 대한피부과학회지

Cowden syndrome (CS) is a rare genodermatosis that is characterized by multiple hamartomatous tumors of an ectodermal, mesodermal and endodermal origin. CS is associated with an increased risk of malignancy and especially breast cancer, thyroid cancer, uterine cancer and renal cell carcinoma. The characteristic features of the disease are mucocutaneous findings, including multiple facial trichilemmomas, oral mucosal papillomatosis and acral keratoses. Multiple sclerotic fibroma is also known to be a clue to diagnose CS. We herein emphasize that multiple sclerotic fibromas of the skin are an important marker of CS, which may also be helpful for making an early diagnosis.

A Case of Botryomycosis at the Excoriation Site in a Patient with Chronic Eczema / 대한피부과학회지

Botryomycosis is a chronic, granulomatous and suppurative infection. The skin is the most frequently affected organ. The most common species is Staphylococcus aureus, followed by Pseudomonas aeruginosa. Clinically, the skin lesions most commonly affect the hands and feet and they can appear as nodules, ulcers, sinuses, fistulae and verrucous plaques. Histopathologic examination reveals grains with surrounding eosinophilic material and inflammatory cells. We report here on a case of botryomycosis at the excoriation site in a 90-year-old female patient with chronic eczema.

A Case of Recalcitrant Hidradenitis Suppurativa Treated with Secondary Healing and a Split Thickness Skin Graft after Exteriorization / 대한피부과학회지

Hidradenitis Suppurativa (HS) is a chronic relapsing disease that involves the apocrine gland-bearing skin. It results in sinus tract formation, fibrosis and scarring. Many different treatments for HS have been reported, including topical and systemic antibiotics, intralesional steroids, systemic retinoids, hormonal therapies and immnunosuppressive agents, but they all have limited beneficial effects. Surgical treatments, including wide exteriorization with secondary intention, a skin graft and a flap can be effective treatments for recalcitrant HS. We present here the case of a 26-year-old man with recurred inguinal and axillary HS, and this was treated with secondary healing and a split thickness skin graft after exteriorization. Based on our experience, it is suggested that secondary healing and a split thickness skin graft after exteriorization are effective for recalcitrant HS with multiple interconnected tracts and abscesses.

The Inhibitory Effect of Phytoclear-EL1 on Melanogenesis

BACKGROUND: Phytoclear-EL1, an extract from Euphorbia lathyris seeds, has a whitening effect due to inhibition of tyrosinase activity. OBJECTIVE: The purpose of this study was to investigate the inhibitory effect of phytoclear-EL1 on melanogenesis. METHODS: Cultured B-16 melanoma cells and 30 human volunteers were used for in vitro and in vivo studies, respectively. Phytoclear-EL1 was added to the cultured B-16 melanoma cells, and applied to UVB-induced hyperpigmented lesions of human volunteers twice daily for 7 weeks. Changes in the number of B-16 melanoma cells, as well as changes in morphology, melanin content, and tyrosinase activity, were measured and then compared with the normal control and the 10(-3)M arbutin groups. Also, the effect of phytoclear-EL1 on UVB-induced hyperpigmented lesions was examined through subjective and objective measurements. RESULTS: In the in vitro study (p<0.05), the number, melanin content, and tyrosinase activity of cultured B-16 melanoma cells were decreased in the 5microgram/ml phytoclear-EL1 group compared to the control group. On objective assessment with a chromameter, the 0.2% phytoclear-EL1 group had a larger difference in the mean L values before and 7 weeks after applying phytoclear-EL1 as compared to the other groups. On subjective assessment by both the researchers and subjects 7 weeks after applying experimental materials, the 0.2% phytoclear-EL1 group and positive control (3% arbutin) had higher scores than the placebo groups. These results demonstrated that phytoclear-EL1 in vivo and in vitro had an inhibitory effect on melanogenesis. CONCLUSION: Phytoclear-EL1 may be a candidate extract in the control of hyperpigmentary disorders.

A Case of Delayed Hypersensitivity Reaction due to Hyaluronic Acid (Restylane(R)) / 대한피부과학회지

Hyaluronic acid fillers have been proposed as an alternative to other temporary skin fillers for treating facial skin lines and providing soft tissue augmentation. There is no antigenic specificity for species or tissue; thus, these agents have a low potential for allergic or immunogenic reaction. However, there are a few reports about allergic hypersensitivity reactions to hyaluronic acid. We report here on the case of a woman who developed a delayed hypersensitivity reaction to the non-animal stabilized hyaluronic acid filler, Restylane(R).

A Case of Telangiectatic Cutaneous Metastasis from Carcinoma of the Breast / 대한피부과학회지

The incidence of cutaneous metastases of primary tumor has been reported to be rare, as compared with metastasis of other internal organ. Carcinoma of the breast is most common cause of cutaneous metastasis in women. We report here on a case of telangiectactic metastatic breast carcinoma in a 65-year-old female who had violaceous plaques and vesicles over the right side of the neck. Histopathological examinations of the cutaneous lesion revealed aggregations of tumor cells within the dilated blood vessels in the dermis.

A Case of Pseudolymphoma Syndrome Induced by Vancomycin / 대한피부과학회지

We report here on a case of a patient who experienced fever, skin eruption and lymphadenopathy 1 month after the beginning of vancomycin treatment. Generalized mild pruritic erythematous pin-head to rice-grain sized confluent scaly papules and plaques appeared on the whole body. Skin biopy showed the characteristic findings of pseudolymphoma mimicking mycosis fungoides. The skin lesions and general symptoms improved after discontinuation of vancomycin and starting steroid therapy. The patient was diagnosed with pseudolymphoma syndrome due to vancomycin. Pseudolymphoma syndrome shows clinical features that are different from those of usual drug eruptions, and the histologic findings are similar to mycosis fungoides. Thus, a thorough understanding of the clinical and histologic features of this entity may aid making a diagnosis, establishing treatment plans and determining the prognosis.

A Case of Primary Cutaneous Anaplastic Large Cell Lymphoma Mimmicking Keratoacanthoma / 대한피부과학회지

Pseudoepitheliomatous hyperplasia with a massive neutrophil infiltrate associated with primary cutaneous anaplastic large cell lymphoma has been rarely reported. Herein we report on a 33-year-old man who presented with multiple asymptomatic erythematous walnut-sized rapidly growing tumors on the axilla, trunk and left inguinal area for 1 month. The histopathologic features showed a keratoacanthoma-like epithelial hyperplasia in the epidermis and several large atypical lymphoid cells with nuclear plemorphism and abundant cytoplasm in the dermis. The atypical cells were obscured by a rich infiltrate of neutrophils and some eosionophils. Immunohistochemical studies confirmed the majority of the large anaplastic cells in the dermis were CD30+ cells. In addition, the expressions of anaplastic lymphoma kinase (ALK) and epithelial membrane antigen (EMA) were negative. There was no evidence of extracutaneous involvement. The patient was diagnosed with primary cutaneous anaplastic large cell lymphoma (ALCL) and he was treated with low dose methotrexate (15 mg/week). We think that this case was challenging both clinically and histologically.