Loss of Heterozygosity and PCR Artifacts in a Microsatellite Analysis of Psoriasis and Colorectal Cancer

Although a loss of heterozygosity (LOH) is commonly observed using microsatellite markers in a cell-proliferating malignant disorder, controversial findings of psoriasis, a keratinocyte-outgrowth disease, remain to be explained. It was hypothesized that unstable natures of the microsatellite markers for the polymerase chain reaction (PCR) might give a rise to either a false-positive or -negative LOH. Twentyone frozen skin tissues and 33 formalin-fixed paraffin-embedded archives were obtained from patients with psoriatic plaques and colorectal cancers, respectively. In the frozen psoriatic skin, two of the 17 microsatellite markers selected from 11 chromosomal arms were associated with artifact LOHs that were not reproduced in repeated PCRs. The remaining 15 stable microsatellite markers with few PCR artifacts demonstrated a borderline-level LOH in cases with an ambiguous heterozygosity such as a juxtaposed allelic band. Infrequent LOHs (3 out of 242 heterozygous markers, 1.2%) were detected in psoriatic cases with two separate alleles. In colorectal cancers, a set of the 15 stable microsatellite markers identified a minimal borderline-level LOH at the cut-off point that was same with that of psoriasis. These results indicate that the selection of reproducible microsatellite sequences and the cautious criteria for informative heterozygosity are required to obtain the reliable LOH results from variable genomic DNAs, and that psoriatic lesions harbor few LOH.

The Expression of c-erbB-1 and c-erbB-2 in the Various Skin Tumors

BACKGROUND: c-erbB-1 (epidermal growth factor receptor) and c-erbB-2 oncoprotein have common tyrosine kinase activities, and alteration in their expression has been defined in various visceral tumors. However, relatively little is known about their expression in skin tumors. OBJECTIVE: Our aim was to evaluate the distribution and expression pattern of c-erbB-1 and c-erbB-2 in skin neoplasms. METHODS: We have undertaken an immunohistochemical survey of c-erbB-1 and c-erbB-2 in the tissue specimens of keratoacanthoma (KA), actinic keratosis (AK), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). RESULTS: Membranous c-erbB-1 expression had a tendency to be down-regulated in some specimens of SCC and dysplastic portions of AK. In invasive lesions of SCC, we observed increased cytoplasmic accumulation of c-erbB-1. Most specimens of BCC showed rather decreased expression of c-erbB-1 compared with other skin tumors. c-erbB-2 oncoprotein showed strong cytoplasmic staining in SCC, especially in the invasive tumor mass, and in some deeply dysplastic or hyperplastic portions of AK, though the difference of intensity was not striking between tumors. BCC revealed relatively weaker expression of c-erbB-2 than other skin tumors, which was similar in pattern to c-erbB-1. CONCLUSION: The expression patterns of c-erbB-1 and c-erbB-2 are altered in various skin neoplasms, and seem to be related to the dysplastic status or differentiation level of tumor cells.

Multiple Cutaneous Focal Mucinosis with Widespread Skin Lesion / 대한피부과학회지

Cutaneous focal mucinosis is a condition with an asymptomatic, small, dermal, white to flesh-colored papule with a predilection for the face, neck, trunk, and extremities. This is usually presented as solitary lesion but rarely as multiple papules or nodules. Histologically, a localized area of the collagen in the upper dermis is largely replaced by homogenous mucinous material in which spindle-shaped fibroblasts are scattered. We report a case of cutaneous focal mucinosis which was presented as multiple lesions covering widespread skin lesion throught the face, chest and back.

A Case of Solitary Fibrofolliculoma / 대한피부과학회지

Fibrofolliculoma is a rare benign follicular neoplasm histopathologically characterized by central dilated follicular infundibulum surrounded by well-circumscribed, thick mantle of fibrotic tissue, with anastomosing strands of follicular epithelium extending into the stroma. This condition usually occurs in multiple and rarely solitarily. Herein we report on a 34-year-old man with a solitary, skin colored, bean sized nodule on his chin which histopathologically shows a typical fibrofolliculoma.

A Case of Aplasia Cutis Congenita / 대한피부과학회지

Aplasia cutis congenita(ACC) is a rare skin condition in which localized or widespread areas of skin are absent at birth. Clinically, lesions usually appear circular or oval, sharply outlined ulcer, resulting in healing with scarring. The most common site of this condition is scalp, especially on the vertex although other areas of the body may also be involved. Other congenital malformations have been associated with aplasia cutis congenita. Herein we report a 6-year-old male infant with round, well-marginated, smooth surfaced, brownish scar about 2 cm diameter on the vertex of scalp. The lesion was erythematous, crusted ulcer at the time of birth. Histopathologic finding of the lesion showed flattening and thinning of epidermis, fibrosis in the dermis and the absence of adnexal structures except single immature hair follicle.

The Expression of IL-4 and Interferon-gamma Genes in Peripheral Blood Mononuclear Cells of Patients with Severe Atopic Dermatitis:Evaluation in Proportion to Serum IgE Levels

BACKGROUND: It is not yet clear whether the abnormal cytokine production in relation to serum IgE levels in atopic dermatitis (AD) is associated with the amount of mRNA of cytokine gene. OBJECTIVE: Our purpose was to delineate the effect of reciprocal correlation in the level of mRNA between interleukin-4 (I") and interferon-gamma (IFN-γ) in severe AD. METHODS: We examined 15 cases including 5 AD patients with high serum IgE (>2,000 kU/liter), 5 AD patients with low serum IgE (<100 kU/liter), and 5 healthy controls. Using semi quantitative reverse transcription-polymerase chain reaction, IL-4 and IFN-γ gene expressions in peripheral mononuclear cells (PBMC) were examined. RESULTS: 1) IL-4 gene expression in spontaneous PBMC was higher in AD patient groups than in control group, significantly higher only in AD patient group with high serum IgE level (p < 0.05). 2) IFN-γ gene expression in spontaneous PBMC showed increased tendency in AD patient groups than in control group without statistical significance. 3) IL-4 and IFN-γ gene expressions in stimulated PBMC were not different among all three groups. CONCLUSION: In light of our results, high and low IgE subgroups in AD can exist and AD may not be R characterized by the shift in the reciprocal relationship between IL-4 and IFN-γ when T cells are stimulated under antigen presenting cell-independent conditions.

Two Cases of Type V Hyperlipoproteinemia and Eruptive Xanthomas associated with Diabetes Mellitus

We report two cases of type V hyperlipoproteinemia and eruptive xanthomas associated with diabetes mellitus in a 44-year-old woman and a 25-year-old woman. They had asymptomatic, diffuse, erythematous yellowish papules on the extremities and buttocks. The laboratory studies showed increased serum blood glucose, total cholesterol, triglyceride, increasing pre-β and chylomicron bands on electrophoresis of lipoprotein. Histopathologic findings of erythematous yellowish papules on the thigh and buttock revealed aggregation of foam cells in the dermis. They have been treated with diet control, hypoglycemic agent (gliclazide) and hypolipidemic drug (gemfibrozil), and are under continued supervision.

Immunohistochemical Detection of p16,p21,and TGF-β in Cutaneous Epithelial Tumors

BACKGROUND: It has been known that p16, p21, and TGF-β are related to cellular proliferation and malignant transformation but the results of the previous studies are controversial. OBJECTIVE: This study was performed in order to investigate the possible role of p16, p21, and TGF-β in relation to the cellular proliferation and malignant transformation in various skin tumors. METHODS: For immunohistochemical staining we examined sections (4um thick) of formalin-fixed, paraffin-embedded tissue from 11 cases of squamous cell carcinoma (SCC), 13 cases of basal cell carcinoma (BCC), 7 cases of actinic keratosis, 5 cases of keratoacanthoma, and 4 cases of normal skin for control. Following conventional deparaffinization, the three step immunoperoxidase method was performed using the streptavidine-biotin complex and monoclonal antibodies. All sections were counterstained with hematoxylin. The expression of p16, p21, and TGF-β was evaluated and graded in relation to the intensity of cytoplasmic immunostaining of positive epidermal cells. RESULTS: p16, p21, and TGF-β were detected mainly in the cytoplasm. The p21 positive cells were localized exclusively in the upper squamous layer and were not visualized in the basal layer. The expression of p21 was higher in SCC than BCC (P value=0.03). The expression of p21 in normal control was higher than skin tumors, but there was no significant difference among these tumors. There was a significant loss in the expression of p16 and TGF-β in various skin tumors compared with normal control, but no difference in the expression of p16 and TGF-β among these skin tumors. CONCLUSION: 1. p21 is possibly related to the differentiation of epidermal cells, because p21 was observed not in basal cells but in squamous and granular cells of the normal epidermis and the higher expression of p21 was demonstrated in SCC compared to BCC. 2. It may imply that loss of expression of p16 may play a critical role in malignant trans-formation but not in tumor progression of human malignant skin tumors, because the significant loss of the expression of p 16 was found in SCC and BCC when normal skin and there was no difference in the expression of p16 among various skin tumors but the expression of p16 of SCC is higher than that of actinic keratosis (P value=0.04). 3. It may imply that the loss of the expression of TGF-β may play a critical role in malignant transformation, because the significant loss of expression of TGF-β was found in various skin tumors when compared to normal skin, but there was no difference in the expression of TGF-β among various skin tumors.

A Case of Generalized Perforating Granuloma Annulare with Diabetes Mellitus / 대한피부과학회지

Generalized perforating granuloma annulare is a rare variety of granuloma annulare presenting a distinct clinical pattern. We, herein, report a case of generalized perforating granuloma annulare with diabetes mellitus, which developed on a 73 year-old-female who had pruritic generalized small papular lesions with central umbilication, especially on the back and lower extremities for 1 month. Histopathologic examination showed an epidermal perforation and transepidermal elimination of necrobiotic material. The epidermal perforation was communicated with areas of necrobiotic collagen surrounded by palisading granuloma in the dermis.

A Case of Giant Verrucous Desmoplastic Spitz Nervus / 대한피부과학회지

No Abstract Available.

Efficacy and Safety of a 1-Week Itranconazole 400 mg/day Regimen for Hyperkeratotic TineaPedis/Manus: Open Label Multicenter Study / 대한의진균학회지

No abstract available.

A Case of Corporis Showing Tinea Imbricata-like Clinical Appearance / 대한의진균학회지

We, here in, report a case of tinea corporis which shows tinea imbricata-like clinical appearance. A 19-year-old man was presented with a 40-day history of annular patches with polycyclic rings on the right forearm. KOH staining, culture, PAPD PCR revealed this lesion as tinea corporis by Trichophyton rubrum showing tinea imbricata-like clinical appearance.

A Case of Calcinosis Cutis following heel sticks / 대한피부과학회지

Cacinosis cutis is an uncommon disorder caused by the abnormal deposition of calcium phosphate into the skin. We report a case of calcinosis cutis affecting a 10 month-year-old infant who received many heel sticks to obtain blood for examination in a neonatal intensive care unit.

A Case of Calcinosis Cutis following heel sticks / 대한피부과학회지

Cacinosis cutis is an uncommon disorder caused by the abnormal deposition of calcium phosphate into the skin. We report a case of calcinosis cutis affecting a 10 month-year-old infant who received many heel sticks to obtain blood for examination in a neonatal intensive care unit.

Two Cases of Congenital Onychodysplasia of the Index Fingers / 대한피부과학회지

Congenital onychodysplasia of the index fingers(COIF) is characterized by hypoplasia or dysplasia of the nails peculiarly restricted to the index fingers. The cause is unknown, but clinical study suggested that ischemia of the finger at a certain period of fetal life might play an important role in its pathogenesis. Major characteristics of this condition are anonychia, micronychia, and polyonychia restricted to the index fingers. We report two cases of COIF, one of which was presented with anonychia of the left index finger, micronychia of the right index finger, and ventricular septal defect of the heart in a 2-week-old male baby, and the other which was presented with polyonychia of the right index finger in a 1-month-old male baby.

Steroid Therapy in Phenytoin Hypersensitivity Syndrome Patient

No abstract available.

A Case of Necrotizing Fasciitis / 대한피부과학회지

Necrotizing fasciitis, first described by Wilson in 1952, is one of the most dramatic infectious diseases which develops at the level of superficial fascia and involves the overlying dermis. Clinical diagnosis is often initially confused with cellulitis, and delay in the diagnosis and treatment is associated with high mortality in the range from 30% to 70%. Early diagnosis and prompt excision of all devitalized tissue are critical because any remaining necrotic tissue will continue the rapidly progressive infectious process. We, herein, report a 64-year-old man who was presented with a typical clinical course of necrotizing fasciitis.

Two Cases of Pedunculated Lipofibroma / 대한피부과학회지

Pedunculated lipofibroma is a rare disorder characterized by ectopic deposits of mature adipose tissue in the dermis. It is a dorne shaped or sessile papule which occurs at any site and develops later in life. We, herein, report two cases of pedunculated lipofibroma which have developed on the chin of a 64-year-old man and the buttock of a 47-year-old woman.

Immucohistochemical of White Hair in Alopecia Areata / 대한피부과학회지

BACKGROUND: There had been some reports of resistant white hair remaining in the alopecic patch area or regenerating white hair prior to emergence of black hair on the patients with alopecia areata. But relatively few studies pointed out this subject yet. OBJECTIVE: The purpose of this study was to evaluate the histopathologic property of white and marginal hair follicles in alopecia areata patients using immunohistochemical markers. METHODS: Eight patients with alopecia areata who had white hair on his scalp were selected, then obtained biopsy samples from white hair follicles, and marginal black hair follicles respectively. Immunohistochemical staining had been done with CD4, CD8, Mel-5, c-kit antibodies on both groups. Then, two different observers counted perifollicular infiltrated cells and the data scored with SAS program for statistical analysis. RESULTS: The results were as follows 1. Decreased ratio of CD4 lymphocyte to CDS lymphocytes were observed on the white hair area (CD4: CD8=1.85: 1, 53.85%) (CD4: CD8=1.16: 1, 85.71%) but statistically not significant differences were seen and the ratio between them proved to be in the regeneration stage alopecia areata. 2. Significantly lower levels(P<0.05) of Mel-5/c-kit positive ratio of melanocyte observed on white hair area(c-kit: Mel-5 = 3.84: 1, 26.01%) compared with marginal hair area(c-kit: Mel-5 = 1.74: 1, 57.33%), furthermore decreased ratio of Mel-5(+) cells(black: white = 2.17: 1, 46.14%), but increased ratio of c-kit (+) cells(black: white = 1: 1, 99.16%) were observed on the white hair area: more Mel-5(-), c-kit(+) cells(precursor melanocyte) were observed on the outer root sheath of white hair area. CONCLUSION: Consequently, we propose that the regenerating white hair area contained much more precursor type melanocytes and it is related to the whitish nature of regenerating hair.

A Case of Malignant Peripheral Nerve Sheath Tumor in Neurofibromatosis / 대한피부과학회지

Malignant peripheral nerve sheath tumor is a neoplasm that most often arises in anatomically discernible peripheral nerves or neurofibroma. A 37-year-old woman presented with a rapid growing pedunculated, huge mass on the left breast for 1 month. She has suffered from neurofibromatosis type 1 with multiple cafe au lait spots and neurofibromas. The huge mass has developed from a subcutaneous nodule on the left breast. The clinical and histopathological data showed a malignant peripheral nerve sheath tumor. Since no sign of the metastasis was observed, local excision was performed. We, herein, report a case of malignant peripheral nerve sheath tumor developed in the patient of nurofibromatosis type 1.