Imatinib Mesylate (Gleevec(TM))-induced Lichenoid Drug Eruption Improved by Tentative Dose-reduction and Topical Steroid / 대한피부과학회지

Imatinib mesylate (Gleevec(TM)) is an oral anticancer drug. It works as a selective and competitive inhibitor of tyrosine kinases such as bcr-abl protein, c-kit, and platelet-derived growth factor receptors (PDGFR). Gleevec(TM) is a first-line therapeutic agent for chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors, but causes various adverse cutaneous reactions. We herein report on a case of lichenoid drug eruption induced by Gleevec(TM) in a patient with a malignant gastrointestinal stromal tumor.

Primary Cutaneous Follicular B Cell Lymphoma That Arose on the Scalp / 대한피부과학회지

Primary cutaneous follicular B cell lymphomas are rare entities of an unknown cause, except for those induced by Epstein-Barr virus (EBV) or Borrelia burgdorferi. Follicular B cell lymphoma has been thought to rarely occur primarily in the skin. The lesions are generally solitary plaques or nodules that are localized on the head and neck. It shows considerable variation in the clinical presentation, the histological features, the immunophenotype and the prognosis. In this case, a 79-year-old man presented with a 3-month history of lesions on his head. Clinical examination revealed two deep-seated subcutaneous tumors with uneven surfaces located on the both sides of the frontoparietal area of the scalp. Biopsy of the skin lesion disclosed a massive dermal lymphocytic infiltrate with a follicular pattern. On immunohistochemical staining, the lymphocytes strongly expressed CD20 and Ki-67, but not Bcl-2. He was diagnosed with primary cutaneous follicular B cell lymphoma. This case illustrates a rarely reported example of primary cutaneous follicular B cell lymphoma that arose on the scalp.

Cutaneous Metastasis of Lung Angiosarcoma to the Scalp / 대한피부과학회지

Angiosarcoma is a rare malignant tumor of an endothelial cell derivation and it accounts for less than 2% of all sarcomas. It is a highly aggressive neoplasm with a poor prognosis and most patients die within a short period after presentation. Although angiosarcoma may occur in any location on the body, it rarely arises from major vessels, but has a decided predilection for the skin and superficial soft tissue. A 39-year-old man was referred to our department with an asymptomatic, firm, ulcerative nodule on his scalp that was noticed almost 2 months previously. He had been diagnosed with lung angiosarcoma 9 month earlier. Histopathologically, the skin specimen showed angiosarcoma. The histological findings of the metastatic skin cancer are usually the same as that of the primary cancer. Metastatic cutaneous angiosarcoma is uncommon. Based on these clinical and histopathological findings, our case seems to be skin metastasis at the scalp from the lung angiosarcoma.

Childhood Granulomatous Periorificial Dermatitis

Childhood granulomatous periorificial dermatitis (CGPD), also known as facial Afro-Caribbean childhood eruption (FACE), is a distinctive granulomatous form of perioral dermatitis. It is a condition of unknown etiology, characterized by monomorphous, small, papular eruptions around the mouth, nose and eyes that histopathologically show a granulomatous pattern. It affects prepubescent children of both sexes and typically persists for several months but resolved without scarring. We report a 9 year-old girl with multiple, discrete, monomorphic, papular eruptions of 2-months duration on the perioral and periocular areas. Histopathological examination demonstrated upper dermal and perifollicular granulomatous infiltrate.

A Case of Nevus Anelasticus / 대한피부과학회지

Nevus anelasticus is an elastic tissue disorder that is characterized by perifollicular papules and the fragmentation or absence of elastic tissue. A 17-year-old female presented with multiple erythematous papules on her lower back. These skin lesions first appeared a few years ago and at that time she presented with multiple, flat tapped, coalescing pinkish-red papules that were 0.5 to 1 centimeters in diameter. Histopathologic examination revealed the loss of elastic tissue, with fragmentation of the residual elastic fibers in the upper and mid dermis, and the pattern of the dermal collagen was normal. Herein we report on a rare case of nevus anelasticus and we review the relevant literature.

A Clinical and Histopathologic Study on Actinic Keratosis in the Province of Chungcheongnam-do / 대한피부과학회지

BACKGROUND: Actinic keratoses (AK) have been recognized as precancerous lesions, they have been recently considered to be an early in situ squamous cell carcinoma (SCC). However, there have been few studies to determine the clinical and histopathological characteristics of AK, and especially in the Province of Chungcheongnam-do. Objective: The purpose of this study was to evaluate the clinicopathological characteristics of 80 cases of AK in the province of Chungcheongnam-do. METHODS: The authors evaluated the clinical and histopathological features of 80 patients with AK at Soonchunhyang University Hospital in Cheonan from January 1998 to December 2008. RESULTS: The ratio of male to female patients was 1:4.7. The age distribution ranged from 42 to 93 years old. Single lesions are more common than multiple lesions. The duration of lesions was variable with a mean duration of 25.1 months. The most commonly involved sites were the face and especially the cheek. The color was erythematous in 63.3% of the cases, brownish in 24.5%, dark-brownish in 9.5% and gray in 2.7%. Crust and scale were noted in 37.4% and 22.4% of the cases, respectively. SCC was associated with AK in 6.3% of the cases, basal cell carcinoma was associated with AK in 1.3%, and keratoacanthoma in 1.3%. The most common histopathological types of AK were atrophic types in 20.6%, and this was followed by the hypertrophic types in 18.6% of the cases and the hypertrophic and atrophic types in 14.7% of the cases. CONCLUSION: Our results are similar to those of the previous reports. In addition, we observed a consistently higher incidence in females than males in the Korean reports and a more frequent incidence of single lesions than multiple lesions in the Asian reports. We found that AK is not easily distinguishable from SCC both clinically and cytologically. Thus, we suggest that biopsies and active treatments should be performed on AK lesions.

A Clinical and Histopathologic Study on Actinic Keratosis in the Province of Chungcheongnam-do / 대한피부과학회지

BACKGROUND: Actinic keratoses (AK) have been recognized as precancerous lesions, they have been recently considered to be an early in situ squamous cell carcinoma (SCC). However, there have been few studies to determine the clinical and histopathological characteristics of AK, and especially in the Province of Chungcheongnam-do. Objective: The purpose of this study was to evaluate the clinicopathological characteristics of 80 cases of AK in the province of Chungcheongnam-do. METHODS: The authors evaluated the clinical and histopathological features of 80 patients with AK at Soonchunhyang University Hospital in Cheonan from January 1998 to December 2008. RESULTS: The ratio of male to female patients was 1:4.7. The age distribution ranged from 42 to 93 years old. Single lesions are more common than multiple lesions. The duration of lesions was variable with a mean duration of 25.1 months. The most commonly involved sites were the face and especially the cheek. The color was erythematous in 63.3% of the cases, brownish in 24.5%, dark-brownish in 9.5% and gray in 2.7%. Crust and scale were noted in 37.4% and 22.4% of the cases, respectively. SCC was associated with AK in 6.3% of the cases, basal cell carcinoma was associated with AK in 1.3%, and keratoacanthoma in 1.3%. The most common histopathological types of AK were atrophic types in 20.6%, and this was followed by the hypertrophic types in 18.6% of the cases and the hypertrophic and atrophic types in 14.7% of the cases. CONCLUSION: Our results are similar to those of the previous reports. In addition, we observed a consistently higher incidence in females than males in the Korean reports and a more frequent incidence of single lesions than multiple lesions in the Asian reports. We found that AK is not easily distinguishable from SCC both clinically and cytologically. Thus, we suggest that biopsies and active treatments should be performed on AK lesions.

A Case of White Fibrous Papulosis of the Neck / 대한피부과학회지

White fibrous papulosis of the neck is a rare skin disease that manifests with tiny papules that are distributed on the neck. Thick collagen bundles in the papillary dermis and diminution of the elastic fiber are characteristic on histologic examination. It is thought to be a normal aging process of the skin or an associated disorder. We report here on a case of white fibrous papulosis of the neck of a 49-year-old Korean woman.

Two Cases of Tinea Capitis Caused by Microsporum canis / 대한의진균학회지

Tinea capitis is rare in Korea, especially in adults. Microsporum canis has been the most common cause of tinea capitis in Korea from the middle of the 1970s. The infection may occur from animal to man (zoophilic). We report two cases of tinea capitis occurring in a 60-year-old female and a 73-years-old female who developed a kerion celci form and seborrheic dermatitis-like form. From the two patients Microsporum canis was isolated.

Blastoid Mantle Cell Lymphoma: A Case Report / 대한피부과학회지

Mantle cell lymphoma (MCL) is a low-grade malignant lymphoma derived from a subset of B-cells localized in the mantle zone of the lymphoid follicle. MCL commonly involves extranodal sites, usually as a manifestation of disseminated disease. The immunophenotype of MCL is characterized as CD20+, CD5+ and Cyclin D1+. Blastoid mantle cell lymphoma (BV-MCL) is a rare variant and has a more aggressive clinical course. In the blastoid variant, the genetic profile is often more complex and includes tetraploid chromosomes, CCND1 amplification, a higher incidence of p53 gene mutations, and p16(INK4a) deletions. We report a case of a 62-year-old male patient who presented with erythematous subcutaneous nodules on the lower back. He had been treated for BV-MCL of the testis which had occurred 1 year ago. The analysis of histopathological and immunohistochemical examinations of the skin lesions also revealed a BV-MCL.

A Case of Zoster Duplex Bilateralis

The skin lesions of herpes zoster are classically limited to a single dermatome and most cases of multidermatomal herpes zoster have contiguous skin lesions. Simultaneous involvement of two noncontiguous dermatomes is very rare and it has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 67-year-old woman presented with a group of painful vesicles on the right buttock and thigh, and left anterior chest and back. The Tzanck smear and skin biopsy were consistent with a herpetic infection. We report a rare case of zoster duplex bilateralis.

A Case of Erythema Multiforme Developing after Exposure to Glyphosate Surfactant Herbicide and Alachlor / 대한피부과학회지

Glyphosate surfactant herbicide (N-Phosphonomethyl glycine) is a nonselective herbicide used and studied worldwide because it is less toxic than paraquat is. Alachlor, an acetanilide agrichemical, is a herbicide that is selectively absorbed in the young buds of gramineae weeds. The selective functional mechanism of alachlor is not clear, but it is known to disturb the physio-chemical response. Human abuse can lead to intoxication and injury of the intestinal mucosa, abdominal pain, vomiting, diarrhea, hypotension, dyspnea, metabolic acidosis, respiratory distress, and death. The authors diagnosed a rare case of erythema multiforme without systemic symptoms.