A Case of Recurrent Superficial Acral Fibromyxoma

Superficial acral fibromyxoma (SAFM) is a rare myxoid tumor that was first described in 2001. The presence of a very slow growing solitary tender mass in the subungual area is the typical clinical feature at presentation. Histopathologically, SAFM is composed of stellate cells in a myxocollagenous matrix with a poorly circumscribed margin. This tumor is thought to be benign, but its natural course is not fully understood. We describe a 15-year-old patient with recurrent SAFM and discuss the proper treatment and follow up.

A Case of Cutaneous Lymphadenoma / 대한피부과학회지

Cutaneous lymphadenoma (CL) is a rare, benign, epithelial neoplasm with a prominent lymphocyte infiltration of unknown histogenesis. Both pilosebaceous and eccrine origins have been suggested, and the current view is that CL is a variant of trichoblastoma with adamantinoid features. We report a case of cutaneous lymphadenoma which developed on the left postauricular area of a 46-year-old woman, plus a review of the related literature.

A Serial Occurrence of Acute Generalized Exanthematous Pustulosis in Childhood Siblings / 대한피부과학회지

Acute generalized exanthematous pustulosis (AGEP) is clinically characterized by the abrupt onset of erythema, non-follicular superficial pustules, fever and rapid spontaneous healing. Other findings such as peripheral neutrophilia and histologically neutrophilic spongiosis and microabscess also suggest AGEP. Its cause was focused on drug and viral infection, but the latter lacks objective evidence as a causative factor. We report two cases of AGEP that serially occurred in siblings without obvious drug history, which strongly suggests there is a possibility that AGEP could be caused by viral infection.

Clinical Evaluation of Acne by Cross Polarizing Photography / 대한피부과학회지

BACKGROUND: Photography is one of the most objective methods in the clinical evaluation of acne. To standardize the quality of photographs, it is essential to standardize variables including focus distance, exposure time, posture and removal of flash glare but this is still insufficient. Cross polarizing photography (CPP) with a stereotactic device (STD) is a possible solution. OBJECTIVE: This study was conducted to determine the feasibility of photographic assessment using CPP with STD instead of direct inspection in Korean acne patients. METHODS: Sixty patients with acne (mean age=23.4, M=29, F=31) were enrolled in this study. Pictures using CPP with STD were taken three times during a 4-week period. Inflamed acne lesions that were counted at each visit were compared to the photographic assessment in a double-blind manner. To assess the quality of the picture, conventional photographs using a digital camera were also taken. RESULTS: The coefficient of correlation between direct lesional counting and photographic counting was 0.80. Photographic counting showed slightly higher results than direct counting. There was also a high coefficient of correlation (ranging from 0.78 to 0.85) among the inter-rater correlation which was 0.92. Photographs taken by CPP with STD showed an excellent quality in evaluating inflamed lesions of acne. Reduced glare and exact posture allowed for the detection of subtle lesions, that could not be seen in conventional pictures. CONCLUSION: Photography using CPP with STD is an objective, convenient and reproducible method for Korean acne patients. This method can be applied in evaluation of therapeutic response in clinics and clinical studies.

A Case of Hemophagocytic Syndrome Caused by Pseudomonas aeruginosa / 대한피부과학회지

Hemophagocytic syndrome is a rare complication of a systemic infection that can have a fatal outcome. The skin manifestations can present as erythematous patches or nodules, purpura, ulcers, or edema. But the histopathologic features solely consist of infiltration of benign histiocytes and hemophagocytosis. We report a case of a 67 year-old male patient diagnosed with hemophagocytic syndrome caused by Pseudomonas aeruginosa infection.

A Case of Alopecia Universalis with Vogt-Koyanagi-Harada Syndrome / 대한피부과학회지

Vogt-Koyanagi-Harada (VKH) syndrome is an idiopathic autoimmune disease involving melanocytes. The characteristic features are uveitis, meningismus, tinnitus, alopecia, vitiligo and poliosis, dependent upon the site of melanocyte location. Among the skin manifestations, alopecia usually appears as discrete, alopecic patches around the head. We report a case of fifty-year-old woman who presented with typical features of VKH syndrome, plus alopecia universalis and nail dystrophy.

Importance of the Patch Test for Patients with Recurrent Facial Erythema / 대한피부과학회지

BACKGROUND: One of the most frequent symptoms encountered at a dermatology out patient clinic is recurrent or persistent facial erythema (red face). The face is exposed to many allergens including metals, cosmetic ingredients and environmental pollutants, therefore, it is very difficult to treat recurrent or persistent facial erythema patients if they are sensitized by these allergens. Although facial erythema could be a manifestation of various diseases, there have only been a limited number of clinical studies. OBJECTIVE: To find out how often patients with recurrent facial erythema were sensitized by contact allergens. METHODS: A total of 136 patients with recurrent or persistent facial erythema were enrolled and the patch test was done. RESULTS: First clinical impressions were allergic contact dermatitis, rosacea, atopic dermatitis, steroid induced rosacea or seborrheic dermatitis in order of frequency. Patch test was performed on 84 patients, and 70 patients (83.3%) showed positivity to one or more antigens. Common antigens included nickel sulfate, cobalt chloride, and fragrance mix in the standard patch tests, and octyl galate, thimerosal, and dodecyl galate in the cosmetic series patch tests. CONCLUSION: Based on our results, we strongly recommend patch test for patients with recurrent or persistent facial erythema.

A Case of Propylthiouracil-induced Lupus Erythematosus / 대한피부과학회지

A 14-year-old girl had a history of Graves' disease and received propylthiouracil (PTU) treatment for 2 years before admission to our hospital. She developed skin rash over her, whole body 1 month before admission, and laboratory examination revealed pancytopenia. Positive antinuclear antibodies, antihistone antibodies and reduced complement levels were noted, although anti-double-stranded DNA and anti-Sm antibodies were negative. A biopsy specimen revealed mild epidermal atrophy and peri-adnexal lymphoid cell infiltration. Linear deposition of IgM along the basement membrane zone was noted by direct immunofluorescence array. After discontinuation of PTU and steroid treatment, eruptions and pancytopenia improved, suggesting drug-induced lupus erythematosus.

Exfoliative Dermatitis Caused by Herbal Extract of Saururus chinesis baill / 대한피부과학회지

Exfoliative dermatitis is caused by various etiologic factors including preceding dermatosis, drug-use, malignancy-related reasons and idiopathies. We present an exfoliative dermatitis caused by topical application of the herbal extract, Saururus chinesis baill. Saururus chinesis bail has been used traditionally as a folk remedy for various kinds of dermatoses in Korea. Therefore, the public should be warned of indiscreetly-used, natural, but not purified, herbal products.