Merkel Cell Carcinoma Concurrent with Bowen's Disease

Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous malignancy of the elderly and immunocompromised patients. It is occasionally found coexisting with other diseases, such as squamous cell carcinoma, basal cell carcinoma, actinic keratosis, miscellaneous adnexal tumors, and rarely Bowen disease. A 75-year-old woman presented with a 6-month history of an irregularly shaped erythematous patch on the left mandibular angle. Three months later, a 1.5x1.0 cm sized painless and rapidly growing erythematous nodule developed on the patch. Microscopically, the patch lesion was consistent with that of Bowen disease. The nodular lesion showed a number of small uniform hyperchromatic cells with scanty cytoplasm. It showed dense small-cell like nodular infiltration in the dermis. Immunohistochemical staining for cytokeratin 20 showed a positive result with a dot-like perinuclear pattern. Additionally, the result for thyroid transcription factor-1 was negative, which is positive in small cell neuroendocrine carcinoma. From these findings, we diagnosed this lesion as MCC concurrent with Bowen disease.

Halo Seborrheic Keratosis in a Patient with Vitiligo / 대한피부과학회지

Depigmented halos surrounding cutaneous lesions have been the common description of many diseases, including benign melanocytic nevus, acquired blue nevi, malignant melanoma and neurofibromatosis. To the best of our knowledge, a halo around seborrheic keratosis has not been reported in the Korean dermatologic literature, and only two cases have been described abroad. Though vitiligo is known to be frequently associated with this halo phenomenon, the exact etiopathogenesis of vitiligo and the halo phenomenon is still unknown. Herein, we report on a case of halo seborrheic keratosis in a patient with vitiligo.

Clinico-serologic Manifestation and Serologic Response to Treatment of Syphilis / 대한피부과학회지

BACKGROUND: Recently, there has been an increase in the prevalence of syphilis in Korea and in case reports of treatment failures of syphilis. OBJECTIVE: This study was designed to explicate the clinical and laboratory features of syphilis, underlying diseases of the VDRL false-positive group, and responses to treatment of patients with syphilis. METHODS: Between January 2001 and June 2010, we selected 115 patients with reactive results on the VDRL test. We evaluated several characteristics including their age, gender, clinical stage, skin lesion, serologic result, the rate and the underlying diseases of the VDRL false-positive group, and their serologic responses to syphilis treatment. RESULTS: There was no significant difference in the incidence of syphilis by gender except in the case of primary syphilis. The annual incidence of syphilis has shown a significant upward trend, especially in the younger age group (10~39 years). Using a serum VDRL titer of 8 as a cut-off value, we found a significant difference between early and latent syphilis. The rate for the VDRL false-positive group was 24.3%. Treatment failures were not reported and the median time to a successful serological response for patients with early syphilis treated with penicillin was 106 days. The Jarish-Herxheimer reaction occurred in 13.7%, and these symptoms were self-limited without any treatment. CONCLUSION: The annual incidence of syphilis in Korea has shown a significantly upward trend, especially in the younger age group. All responses evaluated were reported for those treated successfully without having any significant adverse effects. Thus, continued surveillance and adequate treatment of syphilis is important not only to enhance disease control but also to improve public health.

Neutrophilic Dermatosis of Dorsal Hands with Concomitant Involvement of the Ankle / 대한피부과학회지

Neutrophilic dermatosis of the dorsal hands (NDDH) is a recently described skin disorder regarded as a localized variant of acute febrile neutrophilic dermatosis (Sweet syndrome). The lesions of NDDH are characterized by erythematous plaques, pustules, and hemorrhagic bullae on the dorsal surface of the hands. Herein, we report a case of NDDH in a 52-year-old man with concomitant involvement of the ankle. The patient presented with well-demarcated erythematous papules, patches, and plaques on the dorsum of the hands as well as erythematous papules on the left ankle for 3 days. The lesions responded rapidly to systemic corticosteroid therapy.

Change of the Growth Rate of Great Toenails According to Topical Antifungal Medication / 대한의진균학회지

BACKGROUND: Numerous environmental, physiological, and pathological factors, and some medications are known to influence the speed of nail growth. OBJECTIVE: Our purpose was to know the effect of topical antifungal drug, amorolfine, on the growth rate of nails. METHODS: First study was performed to patients with distal subungual onychomycosis affecting at least one side of great toe nail (64 cases). The growth rate of affected toe nails was memasured according to the treatment groups, oral itraconazole alone (21 cases), combination of oral itraconazole and amorolfine (23 cases), and amorolfine alone (20 cases). Also, the growth rate of toe nails in the controls who have tinea pedis without onychomycosis (22 cases) was measured. Another study was performed to healthy volunteers without onychomycosis, tinea pedis and any other dermatologic and systemic disease (21 cases). The growth rate of normal toe nails before and during application of amorolfine was measured. RESULTS: There was no statistically significant difference in the growth rate of affected toe nails between monotherapy group with oral itraconazole alone and combination therapy group with oral itraconazole and amorolfine in patients with onychomycosis (p>0.05). There was no statistically significant difference when comparing the growth rate of affected toe nails of patients with onychomycosis treated with amorolfine alone with that of normal toe nails of the controls (p>0.05). There was no statistically significant difference in the growth rate of normal toe nails between before and during application of amorolfine in healthy volunteers (p>0.05). CONCLUSION: Topical antifungal medication might not influence the growth rate of nails.

Inhibitory and Eliminating Effects of Yeast-extracted Melanoston on Pigmentation and Preexisting Pigmentation, Respectively / 대한피부과학회지

BACKGROUND: Melanoston is a new melanogenesis inhibitor isolated from yeast. However, little is known about the mechanism of this agent in melanogenesis and also its clinical effectiveness on hyperpigmented lesions. OBJECTIVE: The purpose of this study was to examine the inhibitory effect of melanoston on in vivo activity of tyrosinase. METHODS: We assessed tyrosinase activity, which participates in the synthesis of melanin pigment and resides in melanocytes of guinea pig's epidermis, using immunohistochemical methods after application of 0.1% and 0.01% melanoston on the skin of guinea pigs. We also conducted an 8-week clinical trial on 30 women volunteers to determine the clinical efficacy and safety of melanoston. Participants were instructed to apply melanoston and vehicle on 7 small areas of skin on both forearms for 8 weeks, before and after UVB exposure, and they were examined daily for the first week, then weekly thereafter. RESULTS: The lowest level of tyrosinase activity was observed at the 3rd week after application of 0.1% and 0.01% melanoston on the skin of guinea pigs, and melanoston had a relatively strong inhibitory effect on tyrosinase, as compared with vehicle and arbutin. Differences in the degree of pigmentation between areas treated with 0.5% melanoston and application of vehicle only, and between before and after UVB exposure were considered to be significant (p<0.001, on each time). CONCLUSION: We conclude that melanoston has an inhibitory effect on melanogenesis and some eliminating effect on preexisting pigmentation.

A Case of Poroid Hidradenoma / 대한피부과학회지

Poroid hidradenoma is a benign tumor with eccrine differentiation. It is a recently described variant of a group of neoplasms known as poromas. This neoplasm shows architectural characteristics of hidradenoma (tumor cells confined within the dermis in both solid and cystic components) and cytologic characteristics of poroid neoplasm (poroid and cuticular cells). We herein report a case of poroid hidradenoma in a 51-year-old woman who presented with a solitary, bluish, tender nodule on the lateral aspect of her right thigh.

A Case of Lichen Spinulosus with an Histologic Finding of Follicular Mucinosis

No abstract available.

A Case of Desmoplastic Trichoepithelioma / 대한피부과학회지

Desmoplastic trichoepithelioma is a rare benign adnexal tumor of hair follicle origin. Clinically it is solitary, asymptomatic, white or yellowish and the center is frequently depressed, but not ulcerated. The three critical histologic features are narrow strands of tumor cells, keratinous cysts, and desmoplastic stroma. We present a case of desmoplastic trichoepithelioma in a 61-year-old man who had an asymptomatic, firm, annular nodule with a depressed center and an elevated border on the nose.