Papular Xanthoma in a Child / 대한피부과학회지

Papular xanthoma is a rare normolipemic xanthomatous skin disease that primarily occurs in adults. While this rare disorder has been documented in children before, all but one case reported in the literature involved a normal lipid profile. The skin lesions of adult papular xanthoma appear to be persistent, whereas in children they generally self-heal within 1~5 years. Here, we describe a typical case of papular xanthoma in a 22-month-old boy who presented with numerous reddish-yellow papulonodules, 2~8 mm in diameter, mainly on the face, but also on the upper and lower extremities, and trunk, for 15 months. The lipid profile was normal, and histological studies showed a diffuse monomorphous infiltrate of foamy cells, with some Touton giant cells, in the dermis. The foamy cells stained positive for Cluster of Differentiation (CD) 68, and the Periodic Acid Schiff (PAS) stain was negative. These findings are consistent with the diagnosis of papular xanthoma.

A Case of Giant Basal Cell Carcinoma on the Pubic Area / 대한피부과학회지

No abstract available.

New Onset Guttate Psoriasis Following Pandemic H1N1 Influenza Vaccination

Since the introduction of H1N1 influenza vaccine in the wake of the 2009 H1N1 pandemic, many serious and non-serious vaccine-related adverse events have been reported. The vaccination could induce pain, erythema, tenderness, and induration on injected areas. These symptoms usually disappear in a few days after the vaccination. In this case, we observed a 26-year-old woman with multiple erythematous scaly macules scattered on the extremities and trunk. She was injected with an inactivated split-virus influenza A/H1N1 vaccine without adjuvant (Greenflu-S(R), Green Corp.) on her left deltoid area 10 days earlier. The first lesion appeared on the injection site three days after the vaccination, and the following lesions spread to the trunk and extremities after a few days. Histopathological examinations showed neutrophilic collections within the parakeratotic cornified layer, moderate acanthosis, diminished granular layer, elongation and edema of the dermal papillae, and dilated capillaries. The lesions were successfully treated with topical steroids and ultraviolet B phototherapy within three weeks, and there was no relapse for the following fourteen months. We assumed that pandemic vaccination was an important trigger for the onset of guttate psoriasis in this case.

Clinical and Histopathological Analysis of Inflammatory Lesions on the Lips / 대한피부과학회지

BACKGROUND: Inflammatory labial lesions are quite common in dermatology. However, a few studies have been performed regarding the clinical and histopathological findings of inflammatory labial diseases. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological features of inflammatory labial diseases. METHODS: We retrospectively reviewed the data of 48 patients who underwent biopsy for inflammatory labial lesions between June 2005 and December 2012. Clinical features and histopathological findings of the lesions were investigated, and they were compared to each other for differential diagnosis. RESULTS: The most frequent inflammatory labial diseases were actinic cheilitis (25%), oral lichen planus (23%), plasma cell cheilitis (23%), oral lichenoid lesion (17%), and eczema (12%). Most of the labial lesions were located on the lower lip (87%). We found a broad overlap in the clinical features of lesions with each other, and in many cases, clinical impressions were inconsistent with their final diagnosis. Histopathologically, the degree of eosinophilic infiltrates in actinic cheilitis was comparable to those in eczema. Oral lichen planus showed orthokeratotic hyperkeratosis rather than parakeratosis, and oral lichenoid lesion displayed more frequent perivascular and deep inflammatory cell infiltrates than oral lichen planus. CONCLUSION: The diagnosis of inflammatory labial diseases may be challenging, because inflammatory labial diseases often show similar clinical features and have a broad overlap in histological features. Therefore, clinico-pathologic correlation is necessary to confirm the diagnosis and for proper management.

Pagetoid Bowen's Disease on the Vulva / 대한피부과학회지

No abstract available.

Churg-Strauss Syndrome Showing Green Colored Polycyclic Patches / 대한피부과학회지

Churg-Strauss syndrome (CSS) or allergic granulomatous angiitis is a rare systemic vasculitis with tissue and blood eosinophilia. A 37-year-old woman with a 2-year history of allergic rhinitis and asthma presented with polycyclic patches on both extremities and trunk. Laboratory studies revealed peripheral blood eosinophilia, hyper-IgE, and positivity for ANA (1:40, speckled pattern). Skin biopsy specimens showed endothelial cell swelling, perivascular and interstitial eosinophilic infiltration with nuclear dust in the dermis. She was treated with methylprednisolone and showed an improvement in symptoms. Two years later she developed a tingling sensation on her right hand and right lower extremity along with aggravation of skin lesions. The skin examination revealed erythematous papules and greenish patches on buttock and finger joints. On the histological examination of the patches on the buttock, prominent extravascular eosinophilic infiltration, endothelial cell swelling and degenerative collagen fibers were observed in the dermis.

An Atypical Inflammatory Disseminated Superficial Porokeratosis / 대한피부과학회지

Disseminated superficial porokeratosis (DSP) is a keratinization disorder characterized by multiple small lesions with a slightly elevated, sharply defined ridge over the whole body. Inflammatory DSP has common clinical features, which involve a several-year history of asymptomatic DSP and the sudden appearance of intensively pruritic erythematous papules over the entire body. These lesions subside within several months, leaving a brownish atrophic lesion. We report on a 64-year-old man who displayed an atypical clinical feature of inflammatory DSP.