A Case of Cutaneous Metastasis from Urothelial Carcinoma of the Urinary Bladder / 대한피부과학회지

Cutaneous metastasis from bladder cancer is very rare. A 48-year-old man presented with a 5 month history of a dome-shaped nodule on his scalp. Histopathologic examination of the skin lesion revealed the proliferation of atypical cells, which were similar to those of urothelial carcinoma of the urinary bladder. We herein report on a case of cutaneous metastasis from urothelial carcinoma of the urinary bladder with a review of the Korean literature.

Detection of Human Papilloma Virus DNA in Seborrheic Keratosis of Korean Skin

BACKGROUND: DNA of epidermodysplasia verruciformis(EV)-associated human papillomaviruses (HPVs) has been detected in benign and malignant skin tumors and other proliferative diseases of epithelial origin. The objective of this study was to determine the association of EV-associated HPV DNA in nongenital seborrheic keratoses(SK) in Korean patients. SUBJECTS AND METHODS: Forty biopsy specimens were collected from patients with nongenital SK and cutaneous SCC and controls. All tissue samples were examined by PCR. RESULTS: By polymerase chain reaction(PCR), EV-associated HPV DNA was detected in 15 of 40 nongenital SK(37.5%) compared with 1 of 40 cutaneous squamous cell carcinomas(SCC) samples and 3 of 40 healthy controls. Detected viruses in SK included HPV 20(n=6), HPV 23 (n=2). The rest tested positive for HPV 5, 16, 17, 22, 25, 37, and RTRX4. CONCLUSION: Our findings suggest that EV-associated HPV may be involved in the pathogenesis of nongenital SK of Asian skin.

Skin Metastasis of Neuroendocrine Carcinoma Arising in the Rectum

Neuroendocrine carcinoma is known to have features of neuroendocrine and epithelial differentiation through immunohistochemical and biochemical investigation. Cutaneous metastatic neuroendocrine carcinoma must be differentiated from Merkel cell carcinoma, a primary cutaneous neuroendocrine carcinoma and metastatic carcinoma from other visceral disease. Cutaneous metastases from neuroendocrine carcinomas of a variety of sites including the uterus, vulva, gall bladder and fallopian tubes have been reported. We report a 58-year-old Korean man with a metastatic skin tumor on his scalp from rectal neuroendocrine carcinoma.

A Case of Superficial Epithelioma with Sebaceous Differentiation / 대한피부과학회지

Superficial epithelioma with sebaceous differentiation is a rare-benign neoplasm, which is characterized by a superficial plate-like proliferation of basaloid to squamoid cells with broad attachments to the overlying epidermis. Herein, we describe a male patient with superficial epithelioma with sebaceous differentiation.

Two Cases of Eccrine Porocarcinoma / 대한피부과학회지

Eccrine porocarcinoma is a very rare, locally-aggressive, potentially fatal, malignant cutaneous neoplasm that arises from the intraepithelial ductal portion of the eccrine sweat gland. Eccrine porocarcinoma may develop either spontaneously or from a longstanding benign eccrine poroma. Herein, we describe two cases of eccrine porocarcinoma and review the related literature.

A Case of Xanthogranuloma on the Palm / 대한피부과학회지

Xanthogranuloma is a benign, fibrohistiocytic lesion that presents as a yellowish, cutaneous papule or nodule. Although the head, neck, and trunk are the most common sites for xanthogranuloma, it can appear at any site on the body. We report a rare solitary xanthogranuloma on the palm of 24-year-old man.

A Case of Verrucous Carcinoma Arising on the Anogenitalia of Young Woman / 대한피부과학회지

Verrucous carcinoma is a slowly-growing, well-differentiated, low grade squamous cell carcinoma with little tendency to metastasize. There have been several case reports of this tumor but its occurrence at a young age is extremely rare. Herein we report a case of verrucous carcinoma arising on the anogenitalia of a young woman with pancytopenia.

A Case of Keratoelastoidosis Marginalis / 대한피부과학회지

Keratoelastoidosis marginalis is a rare skin disorder. Clinically it consists of small, firm, linear hyperkeratotic papules, characteristically along the margin of the hands. Histopathologically it shows hyperkeratosis, acanthosis, solar elastosis, and degeneration of collagen and elastic fibers. Long-term ultraviolet radiation exposure and chronic trauma are considered to be precipitating factors. Herein, we report a case of keratoelastoidosis marginalis and a review of the related literature.

A Case of Rhinocerebral Mucormycosis Misdiagnosed as Herpes Zoster / 대한피부과학회지

Mucormycosis is an opportunistic fungal infection frequently associated with diabetes mellitus or an immunocompromised status. Rhinocerebral mucormycosis, the most frequent form of mucormycosis, is characterized by facial pain, swelling, fever, blood-tinged rhinorrhea and shows a rapidly progressive course. Herein, we describe an immunocompromised and diabetic woman with rhinocerebral mucormycosis initially misdiagnosed as herpes zoster.

A Case of Cellular Neurothekeoma / 대한피부과학회지

Cellular neurothekeoma is a rare, benign, cutaneous neoplasm of uncertain histogenesis and usually presents as a solitary papule or nodule on the head or neck area of children and young adults. Cellular neurothekeoma was thought to represent a cellular variant of nerve sheath myxoma but this neoplasm is histologically different from nerve sheath myxoma. Cellular neurothekeoma is characterized by a fasciculated, somewhat well-circumscribed proliferation of epithelioid and spindle cells. Herein, we report a case of cellular neurothekeoma with a review of related literature.

Clinical Observation of 13 Cases of Dermatitis Artefacta / 대한피부과학회지

BACKGROUND: Dermatitis artefacta is a self-inflicted skin disease. Laboratory investigations, including histopathologic examination, are usually negative and do not give a clue to the correct diagnosis. OBJECTIVE: Over an eleven-year period from 1995 to 2005, 13 patients were diagnosed with dermatitis artefacta at the Asan Medical Center. We evaluated the patients' age and sex, the clinical characteristics of skin lesions, the presence of underlying psychological disease, and the clinical course. METHODS: We obtained the clinical information from record reviews of 13 patients diagnosed at the Asan Medical Center between 1995 and 2005. RESULTS: The male-female ratio was 1 to 1.6. The mean age at diagnosis was 44.7 years. There were 10 cases (76.9%) that had a history of psychological disease such as schizophrenia, depression, or avoidant personality disorder. The skin lesions were multiple in 76.9% of the patients. The clinical appearance included papules, excoriations, and ulcers. The face and extremities were the favored sites. The average number of outpatient visits was 4.3 times among the 6 outpatients. CONCLUSION: Greater awareness of dermatitis artefacta may bring about earlier correct diagnosis and treatment. The management of dermatitis artefacta needs close cooperation with a mental health professional.

A Case of Condyloma Lata with HIV Infection / 대한피부과학회지

Both human immunodeficiency virus (HIV) and syphilis are sexually transmitted and affect the same patient groups. Syphilis may enhance the transmission of HIV, probably through the increased incidence of genital ulcers, and may accelerate development of immunodeficiency in HIV-infected people. Conversely, HIV infection causes reactivation of dormant syphilis and is often associated with unusual, non-typical features of syphilis. Condyloma latum is one of the cutaneous manifestations of secondary syphilis, is highly infectious, and shows moist papules that coalesce into plaques typically located on the genitals, perianal area, and axilla. Herein, we present a case of condyloma lata, which developed on the perianal area after anal sexual intercourse, in a patient with HIV infection.

A Case of Steatocystoma Multiplex: Successful Treatment with Mini-incisions

No abstract available.

A Case of Cutaneous Cytomegalovirus Infection in a Renal Transplant Patient / 대한피부과학회지

Cutaneous infection by cytomegalovirus (CMV) is rare, and its clinical manifestations vary from purpuric papules to nodules, plaques, vesicles, bullaes, and ulcers. Cutaneous CMV is difficult to diagnose, clinically as well as histopathologically, because the microscopic changes induced by CMV are easily overlooked due to the sparcity of the typical change. We report a case of coinfection of the herpes simplex virus and CMV in a renal transplant patient. Knowledge of the histopathologic features of CMV infection helped us to diagnose it promptly and to start early treatment.

Therapeutic Effect of Low-dose Methotrexate on Lymphomatoid Papulosis / 대한피부과학회지

BACKGROUND: The treatment of patients with lymphomatoid papulosis is unsatisfactory. Because a curative therapy is not available and none of the available treatment modalities affects the natural course of the disease, the short-term benefits of active treatment should carefully be balanced against the potential side effects. OBJECTIVE: The purpose of this study was to determine the effectiveness and safety of methotrexate in the treatment of lymphomatoid papulosis. METHOD: Twelve patients with a clinicopathological diagnosis of lymphomatoid papulosis were treated with low-dose methotrexate (5-20mg/week), and clinical efficacy and adverse effects were evaluated. RESULTS: The male-to-female ratio was 1: 1.4, and age distribution ranged from 11 to 65 years, with a mean age of 41 years. Histopathologic types classified by Willemze's classification included type A (10 cases), type B (0 cases), and type C (2 cases). All patients responded to low-dose methotrexate, and the level of control was judged to be `excellent' (no or rare lesions between doses), `good' (few lesions between doses), `fair' (improvement but new lesions continued to develop), or `poor' (no improvement observed) in 7 (58%), 2 (17%), 3 (25%), and 0 (0%) of patients respectively. All three patients in the `fair' group (the group relatively less responsive to methotrexate) were female and included both patients who were histopathologic type C. Adverse effects only included nonspecific gastrointestinal discomfort in two patients. CONCLUSION: Low-dose methotrexate (5-20mg/week) is effective and well-tolerated in most patients with lymphomatoid papulosis.

A Case of Sparganosis with Eosinophilic Panniculitis in a Patient with Rectal Cancer / 대한피부과학회지

Sparganosis is an infection by sparganum, the generic term for the migrating plerocercoid larva of a tapeworm of the species Spirometra. The clinical appearance of sparganosis is usually a soft palpable, sometimes migratory, subcutaneous nodule, and microscopically, an elongated tract-like cavity, with or without a parasite body associated with eosinophilic infiltration, may be seen. Herein we present a case of sparganosis with eosinophilic panniculitis, which developed in a patient who had suffered from rectal adenocarcinoma about 5- months before presenting to our department with the skin lesion.

Prognostic Value of Peak Flow Rate and Post Void Residual Urine Measured by Abdominal Compressing Immediately after TURP / 대한비뇨기과학회지

PURPOSE: Although a transurethral resection of the prostate (TURP) is the most effective treatment method for benign prostatic hyperplasia (BPH), it is difficult to predict the exact prognosis with this method. The peak flow rate (PFR) and post void residual urine (PVR), measured by abdominal compressing immediately after TURP in the operating room, were evaluated to see if they correlated with the surgical outcome. MATERIALS AND METHODS: Fifty patients, having undergone TURP, had their PFR and PVR measured by abdominal compressing, both before and after TURP in the operating room. The abdomen was compressed to 100cm H2O of intravesical pressure with a concrete test hammer. All patients were requested to undergo uroflowmetry, and their international prostate symptom scores (IPSS) were assessed, 3 months after surgery. RESULTS: The PFR and PVR, measured by abdominal compressing immediately after TURP, correlated well with the PFR measured 3 months after the TURP (p<0.05). Higher PFR, lower PVR and a greater improvement in the IPSS were observed, but these were not statistically significant. CONCLUSIONS: In conclusion, the PFR and PVR, measured by abdominal compressing immediately after TURP, are thought to be a good parameter for predicting the prognosis of TURP.

Changes of Nitric Oxide and Cell Proliferation after Bacillus Calmette-Guerin and Nitric Oxide Synthase Inhibitor Treatment on Murine Bladder Tumor-2 Cell Line / 대한비뇨기과학회지

PURPOSE: We hypothesize that the cytolytic activity of Bacillus Calmette-Guerin (BCG) may act through nitric oxide (NO) production, and that cell death is correlated with apoptosis, changes of NO and cell proliferation following BCG and/or nitric oxide synthase (NOS) inhibition treatment of a murine bladder tumor-2 (MBT-2) cell line. If these cell lines show cell death due to apoptosis was also determined. MATERIALS AND METHODS: NO production and proliferation activity of the MBT-2 cell line were measured after stimulation, with BCG and/or L-NAME, using an enzyme- linked immunosorbent assay (ELISA). After incubation of the MBT-2 cells with BCG and/or L-NAME, the cell cycle was analysis was performed by immunocytometry. RESULTS: The production of NO in the MBT-2 cells was significantly increased by the BCG. The BCG had direct dose-dependent cytotoxic effects on the MBT-2 cell line. After the L-NAME treatment, both the NO production and cytotoxicity were decreased (p<0.05). When the MBT-2 cells were cultured with BCG, the apoptotic cell ratio increased compared to that of the MBT-2 cells treated with L-NAME (p<0.05). CONCLUSIONS: The up-regulation of the production of NO following BCG treatment of the MBT-2 cell line may be due, in part, to the cytolytic action of the BCG. The cell death, when BCG was instilled, correlated with apoptosis.

Effect of Finasteride on Sexual Function in Patients with Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: The aim of this study is to evaluate the change in sexual function after treatment with finasteride in patients with benign prostatic hyperplasia using the validated International Index of Erectile Function (IIEF). MATERIALS AND METHODS: Sixty patients, who were treated with 5mg finasteride daily due to a benign prostatic hyperplasia, were assessed with the IIEF questionnaires prior to treatment and after 3 months of medication. Nine patients were excluded due to an erectile dysfunction. The patients' age ranged 50 to 78 years with a mean age of 63.3 years (by age group: 50-59 years, n=13; 60-69 years, n=27; 70-79 years, n=11). The total IIEF scores and all 5 IIEF domains scores were calculated to investigate the change in sexual function. RESULTS: The mean total IIEF scores decreased significantly from 43.24+/-15.02 to 37.00+/-17.78 after administering finasteride (p<0.05). The mean decrease in the total IIEF scores for the men in their fifties, sixties and seventies were 4.69, 7.59 and 4.73, respectively, and was most prominent in the sixties. Among the mean scores of each IIEF domain, the erectile function scores decreased from 17.53+/-6.83 to 15.04+/-7.78 (p<0.05), the intercourse satisfaction scores decreased from 7.59+/-2.86 to 6.25+/-3.43 (p<0.05), the orgasm function scores decreased from 6.37+/-2.65 to 5.16+/-3.07 (p<0.05), the sexual desire scores decreased from 5.47+/-1.71 to 4.86+/-2.06 (p<0.05), and the overall satisfaction scores decreased from 6.27+/-2.44 to 5.69+/-2.62 (p<0.05). CONCLUSIONS: With this IIEF questionnaire, the generalized sexual function decreased after finasteride treatment in patients with benign prostatic hyperplasia, particularly in those aged 60-69 years.

Surgical Treatment and Prognosis for Gastric Cancer in the Elderly

PURPOSE: The number of elderly patients who undergo surgery for gastric cancer has increased in recent years due to a life expectancy. To prevent fatal complications and increase the survival rate in gastric cancer patients, this study endeavored to clarify the risk factors contributing to postoperative complications in elderly patients undergoing a radical gastrectomy. METHODS: Between January 1997 and December 1998, 176 patients underwent a gastrectomy for gastric cancer. For this review, the patients were divided into two groups; 30 patients over 70 years of age (older group) and 102 patients below 70 years of age (younger group), were prepared. A retrospective study was performed to examine the factors related to the high rate of complications and to compare the operative and general complications. RESULTS: The incidences of preoperative combined disease were 56.6% in the older group and 31.3% in the younger group (p<0.05), but no significant difference in the incidence of postoperative complications (36.6% versus 38.2%) was found between the two groups. The most common postoperative complications were wound infections, pulmonary disorders, and intraabdominal infections. CONCLUSION: Despite the increased rate of preoperative combined disease in older patients, patients over 70 years are able to tolerate a radical gastrectomy for gastric cancer when optimal perioperative management is provided and blood loss is reduced.