Therapeutic Effect of Sclerotherapy on Venous Malformations / 대한피부과학회지

BACKGROUND: Although surgical excision is the standard method for the treatment of venous malformations, this procedure often leads to massive bleeding and cosmetic problems. Sclerotherapy for venous malformations has recently been reported, whereas sclerotherapy for varicose veins, leg telangiectasias and hemorrhoids has well been established. PBJECTIVE: To assess the usefulness of sclerotherapy for venous malformations. METHOD: Fourteen patients who had venous malformation were treated with sclerotherapy using sodium tetradecyl sulfate (Thromboject(R), Omega Laboratories, Ltd., Montreal, Canada). Clinical efficacy was evaluated by physical examination and comparison of photographs. RESULTS: In patients with venous malformations, 71.4% of the eases showed moderate to marked improvement. Side effects were noted in 6 patients, however, they were trivial and transient and no treatment was needed. CONCLUSION: Sclerotherapy can be recommended as an effective method for the treatment of venous malformations. It has milder and fewer side effects than other treatment modalities, and it also yields superior cosmetic results.

A Case of Acrokeratoelastoidosis / 대한피부과학회지

Acrokeratoelastoidosis (AKE) is a rare skin disorder initially described by Costa, which is inherited by autosomal dominant, but also may be sporadic. Clinically, it consists of small, firm papules with occasional keratosis or umbilication, characteristically along the margins of hands and feet. Histopathologically, it shows hyperkeratosis, acanthosis in the epidermis and fragmentation and rarefaction of elastic fibers-elastorrhexis-in the dermis. A 32-year-old man presented with multiple papules along the border of the hands and feet, and from histopathology, AKE was diagnosed. Herein we report a case of acrokeratoelastoidosis and review the clinical and histopathologic features, etiology, differential diagnosis and treatment.

Papulonodular Mucinosis Associated with Systemic Lupus Erythematosus: Cutaneous Lupus Mucinosis / 대한피부과학회지

Cutanenous lupus mucinosis is a rare variant of lupus erythematosus eruptions. A 36-year-old female presented with a 1-year history of 1-2cm sized, skin colored, multiple nodules on the back. She had previously been diagnosed as having systemic lupus erythematosus 10 years ago. A complete blood count showed lymphopenia. Antinuclear antibodies (ANA) were positive at a titer of 1: 640. Anti-Sm and ds-DNA were also positive. Histopathological findings showed that the collagen fibers in the upper dermis were loosely arranged and separated by amorphous materials. These materials were all positive for alcian blue staining. This case is compatible with cutaneous lupus mucinosis.

A Case of Deep Penetrating Nevus / 대한피부과학회지

Deep penetrating nevus is a distinctive entity first described by Seab et al. in 1989. This is a variant of melanocytic nevus found on the face, the upper part of the trunk, and the proximal part of the limbs of young adults. It is often deeply pigmented with some variegation in color, and it may lead one to a misdiagnosis of blue nevus or malignant melanoma. Histopathologically the lesions are composed of loosely organized nests of slightly to distinctively pleomorphic pigmented cells that deeply penetrated reticular dermis and often extended into the subcutis. There have been no report of deep penetrating nevus in the Korean literature. We report a case of deep penetrating nevus occurring on the chest in a 19-year-old male.

A Case of Discrete Papular Mucinosis / 대한피부과학회지

Papular mucinosis, or lichen myxedematosus is one of the rare cutaneous diseases characterized by papular-lichenoid eruptions, in which mucin deposits in the dermis without thyroid dysfunction. A 31-year-old male presented with 3-5mm sized waxy, flesh-colored, multiple firm papules on the upper and lower extremities and trunk for 5 months. He did not have any familial medical history. None of the laboratory findings, including serum protein electrophoresis, was significant. Skin biopsies were performed from papules of his trunk and arm. Histopathological findings showed that the collagen fibers in the upper dermis were loosely arranged and separated by amorphous materials. These materials were all positive for alcian blue, colloidal iron, mucicarmine, and Giemsa staining. This case is compatible with discrete papular mucinosis which is the rare subtype of localized papular mucinosis.

Comparative Study of Glycolic Acid Peeling vs. Tretinoin Peeling in Facial Pigmentary Lesions / 대한피부과학회지

BACKGROUND: Chemical peels using glycolic acid and tretinoin are known to be safe and effective for treating facial pigmentary lesions. OBJECTIVE: We evaluated and compared the efficacy of tretinoin and glycolic acid peeling for facial pigmentary lesions by using a digital camera and L*a*b* color scale in Adobe Photoshop 5.5(R) METHODS: Thirty eight patients with facial pigmentary lesions were treated with 50% glycolic acid and 1% tretinoin peelings. The treatment was performed 2-3 times per week for a period of 2 weeks and a half. Exposure time was 2 minutes for the glycolic acid and 6 hours for the tretinoin. Before and after the treatment, pigmentary lesions were evaluated using self evaluation forms and the L*a*b* color system (Commission International de I'Eclairage) in Adobe Photoshop 5.5(r) (Adobe Systems Incorporated, USA). Corneometer (Corneometer(r) CM820, Courage Khazaka Electronic GmbH, Germany) was used for the evaluation of skin hydration before and after the treatment. RESULTS: Facial pigmentary lesions were significantly improved in 10 out of 38 patients after 50% glycolic acid peeling and in 12 out of 38 patients after 1% tretinoin peeling. The state of hydration of the treated skin improved significantly after the peeling using both 50% glycolic acid and 1% tretinoin. CONCLUSION: Topical 1% tretinoin peeling is as effective as 50% glycolic acid peeling in the treatment of facial pigmentary lesions and more frequent peeling results in quicker improvement than the previous studies without significant side effects.

A Case of Cutaneous Cryptococcosis Resembling Verrucous Granuloma / 대한의진균학회지

We report a case of cutaneous cryptococcosis resembling verrucous granuloma on the lower lip in a 18-year-old female. She presented with a 3x1.5 cm sized painful verrucous granuloma with white, yellowish crust on the lower lip for 1 year. She had gotten many shunt operations for unexplained hydrocephalus. Histopathological examination showed numerous encapsulated round spores, epithelioid cells and giant cells in the dermis. A tissue culture on Sabouraud's dextrose agar without cycloheximide showed whitish creamy colonies. The organism was identified as Cryptococcus neoformans. The lesion disappeared with the treatment of oral itraconazole (100 mg/day) for 12 weeks.