Clear cell acanthoma on areola / 영남의대학술지

Clear cell acanthoma (CCA) is an asymptomatic benign lesion of unknown origin that typically appears as a brownish, dome-shaped papule on the leg. It has an unusual clinical feature in that it appears as chronic eczema, Bowen disease, or Paget disease on the areola. Its histopathologic findings are well-demarcated psoriasiform acanthosis with pale keratinocytes (clear cells) that are rich in intracellular glycogen, which stain positively with Periodic acid-Shiff. We report herein on a young female patient with CCA on the areolar areas.

Infantile Perianal Pyramidal Protrusion / 대한피부과학회지

A 2-year-old girl presented with a month history of a tender, erythematous pyramidal protrusion on the perineum, anterior to the anus. She had suffered painful defecation due to the protrusion, but had no history of constipation. The family history was negative, and physical examination showed no evidence of associated anal fissuring or skin atrophy. Histological examination revealed epidermal hyperplasia, dermal edema, and hemorrhage with inflammatory cell infiltration. The patient was treated with a CO2 laser to relieve painful defecation. Infantile perianal pyramidal protrusion (IPPP) is characterized by a solitary protrusion observed in the perineal and perianal area. Since IPPP is predominantly observed in female children in the perineal area, it can be misdiagnosed as sexual abuse, anogenital warts, or hemorrhoids. The disease is generally benign and may resolve spontaneously, with the exception of the lichen sclerosus-associated type. Physicians should be aware of IPPP to make an accurate diagnosis.

A Case of Bullous Dermatomyositis / 대한피부과학회지

No abstract available.

Malignant Hidroacanthoma Simplex with Seborrheic Keratosis / 대한피부과학회지

No abstract available.

Lymphomatoid Papulosis Following Anaplastic Large Cell Lymphoma in a Child / 대한피부과학회지

Patients with lymphomatoid papulosis have an increased risk (approx. 5% to 20%) of developing a malignant lymphoma such as mycosis fungoides, anaplastic large cell lymphoma (ALCL) and Hodgkin's disease before, during, or after lymphomatoid papulosis occurs. However, it is very rare that lymphomatoid papulosis occurs after ALCL, especially in childhood. An 11-year-old boy who had been diagnosed with ALCL 3 years prior and treated with chemotherapy and peripheral blood stem cell transplantation developed multiple scaly papules on his trunk and both extremities. Histopathologic and immunohistochemical examination of the scaly papules revealed lymphomatoid papulosis. The patient was cured with narrow band UVB treatment and there has been no relapse in lesions 10 years later. We report a case of lymphomatoid papulosis following allogenic stem cell transplantation for ALCL.

A Case of Cutaneous Infection by Alternaria alternata / 대한의진균학회지

Alternaria(A.) species are common saprophyte found in the environment such as soil, air, and plants. They are not usually pathogenic in humans but recently, infections by these fungi have occasionally been reported, occurring mostly in immunocompromised patients. They can cause hypersensitivity pneumonitis, bronchial asthma, or allergic rhinitis and rarely skin infection. A 76-year-old man presented with multiple erythematous papules, plaque and pustules with purpuric patches on both forearms and dorsal hands for 6 months. He had been treated for Parkinson's disease and dementia for 3 years but had not been taking any immunosuppressants. Direct smear with KOH was negative. Histopatholoigically, neutrophilic abscess, suppurative granulomatous inflammation and round spores were observed in the dermis. Periodic acid-Schiff and Methenamine silver stains revealed round to oval shaped spores. The biopsy specimen was cultured in potato dextrose agar and a cottony olive green to gray colored colony with black to brown reverse grew at 7 days of culture. The slide culture stained with lactophenol-cotton blue showed brown septated hyphae and obclavate conidia with brown muriform septation. The nucleotide sequences of the ribosomal internal transcribed spacer region of cultured colonies and paraffin blocks of biopsy specimen were identical to that of A. alternata. He was treated with topical ketoconazole cream application for 4 months, and healed leaving hyperpigmentation with scales.

A Case of Scar-like Intralymphatic Histiocytosis / 대한피부과학회지

Intralymphatic histiocytosis (ILH) is a rare, chronic cutaneous condition characterized by the presence of dilated lymphatic vessels containing aggregates of mononuclear histiocytes within lumina. ILH presents with asymptomatic and poorly demarcated, erythematous plaques or livedo reticularis-like lesions, usually located on the extremities. ILH is often associated with rheumatoid arthritis, metal joint implants, and mastectomy scars of breast cancer patients, but its pathogenesis remains uncertain. A 69-year-old woman with osteoarthritis, who had a past history of cancer in the left breast, presented with asymptomatic, linear-shaped, scar-like erythematous plaques on the right elbow for a month. Approximately a month before her visit, she had been treated with an intraarticular corticosteroid injection on the right elbow in a local clinic. Histopathologic findings showed irregularly dilated vessels with intraluminal cells in the superficial and deep dermis. In double immunohistochemical staining with CD68/D2-40, endothelial cells lining the vessels were positive for D2-40 staining, which is a marker for lymphatic endothelial cells, and intraluminal cells were positive for CD68 staining, which is a marker for histiocytes. We present the findings of a patient with a rare condition of intralymphatic histiocytosis with scar-like morphology of the plaques.

A Case of Localized Skin Infection Due to Scedosporium apiospermum Diagnosed by DNA Sequencing of the Internal Transcribed Spacer Region / 대한의진균학회지

Scedosporium apiospermum is an asexual state of Pseudallescheria boydii which has been isolated from soil, sewage, and decaying vegetation. It can cause cutaneous infections by traumatic implantation of the contaminant due to penetrating injury. This ubiquitous fungus cause not only mycetoma, but also infections of variety of body sites including the skin. The localized skin infection due to this organism is much rare than mycetoma. We report a case of cutaneous S. apiospermum infection occurred in 80-year-old male. The skin lesion was manifested by a 8.0 x 4.0 cm-sized erythematous plaque with pustules and crusts on the dorsum of right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored cottony colonies of S. apiospermum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of S. apiospermum strain IHEM 23829. The patient was treated with oral fluconazole for 3 months.

Fast-growing multiple symmetric lipomatosis / 영남의대학술지

Multiple symmetric lipomatosis (MSL) is a rare disease characterized by symmetrical massive fatty deposits on the face, neck, shoulders, and upper trunk. We report a 74-year-old man who complained of painless subcutaneous nodules on his posterior neck that developed 3 weeks earlier. In a week, variably-sized similar lesions developed on both his shoulders and upper extremities. At the time of his hospital visit, several firm nodules as big as a walnut to a child's fist and with the normal-skin-hue were observed on his posterior neck, both shoulders, upper extremities, and trunk. The histological examination of his upper left arm revealed more mature adipocytes without encapsulation in the subcutaneous tissue. MSL was generally known to occur slowly over months or years. However, this is an unusual case that showed a fast-growing nature.

Chromoblastomycosis Caused by Fonsecaea monophora / 대한의진균학회지

Chromoblastomycosis is a chronic subcutaneous mycotic infections caused by dermatiaceous fungi. Clinically, chromoblastomycosis presents frequently with erythematous or nodular plaque. In Korea, 10 cases of chromoblastomycosis have been reported and Fonsecaea pedrosoi is the most common agent. A 61-year-old woman who was diagnosed as chronic inflammatory demyelinating polyneuropathy 3 years ago, and had been treated with systemic corticosteroids and azathioprine, presented with pruritic, scaly erythematous plaques on the right forearm for 3 years. She had no history of trauma. Histological examination showed pseudoepitheliomatous hyperplasia, mixed granulomatous inflammatory cell infiltrate and multinucleated giant cells with sclerotic cells in the dermis. Tissue culture showed slowly growing, dark brown, velvety colony. DNA was extracted from the cultured colonies and the DNA sequence of the internal transcribed spacer (ITS) region of the clinical sample was matched for that of Fonsecaea monophora. The patient was treated with local heat therapy and topical terbinafine application.

A Case of Blastic Plasmacytoid Dendritic Cell Neoplasm in Child / 대한피부과학회지

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and highly aggressive hematopoietic malignancy which is derived from the precursors of plasmacytoid dendritic cells and is more infrequent in children than in adults. Formerly known as blastic NK-cell lymphoma or CD4+/CD56+ hematodermic neoplasm, the BPDCN is reclassified into the group of acute myeloid leukemia and related neoplasm by WHO in 2008. An 8-year old girl is being presented with bruise-like subcutaneous nodules with purpura on her right cheek from the performed biopsy. Histological examinations show sheet-like dense infiltrations of medium-sized lymphoid cells with irregular nuclei in the entire dermis. Immunohistochemical stainings of tumor cells were positive for CD4, CD56, LCA, TCL-1, TdT and focal positive for CD3, CD7, CD45RO and negative for CD20, CD30, CD34, EBV. The PET-CT scans indicate hot uptakes in the bone marrows which are suggestive of malignant infiltrations, and bone marrow biopsy findings are consistent with BPDCN of leukemic transformations. We present a rare case of BPDCN which affects the pediatric patient.

Chancre Presenting as Nipple Eczema / 대한피부과학회지

No abstract available.

Isolation Rates of Fungi from Dogs and Horses in Shelters and Soil near Them / 대한의진균학회지

BACKGROUND: Soil is one of the main habitat of fungi and important infection source of dermatophytosis. Objective: This study was performed to assess influence of dogs and horses to distribution of keratinophilic fungi (KPF) in soil. METHODS: We visited 3 dog shelters and 3 horse riding grounds in Daegu and Kyeongbuk province from September to November 2012 and examined isolation rates of fungi from 88 soil samples, 16 dogs and 16 horses. By the distance away from the animal shelters, soil samples were divided into 3 groups consist of near, 10 m and 100 m. Hair and scales from skin of the dogs and the horses were collected by Mackenzie's brush technique. RESULTS: Of the 88 soil samples examined, 35 (39.7%) yielded KPF and were all dermatophytes including Microsporum(M.) gypseum (34.1%) and Trichphyton(T.) ajelloi (5.6%). Isolation rates of KPF from the soil were observed in 79.3% of near, 40% of 10 m, and 0% of 100 m from animal shelters. Of the 16 samples from dogs, 6 (37.5%) yielded positive dermatophyte cultures and they were identified as M. canis 31.2% (5/16) and T. eboreum 6.2% (1/16). Of the 16 samples from horses, 1 (6.2%) yielded positive dermatophyte culture and it was T. eboreum. CONCLUSION: In this study, isolation rates of KPF especially M. gypseum and T. ajelloi were higher in the soil closer to the animal shelters. Soil nearby the dogs and the horses, the environment rich in keratinous material, is conducive for the growth of dermatophytes. But M. gypseum and T. ajelloi that rich in the soil were not isolated from skin of the dogs and the horses. Their pathogenicity might be low. We consider that if not human have immune deficiency or skin injury, they do not cause infection.

A Case of Localized Axillary Syringomas / 대한피부과학회지

No abstract available.

Fingernail Onychomycosis Due to Aspergillus niger

Onychomycosis is usually caused by dermatophytes, but some species of nondermatophytic molds and yeasts are also associated with nail invasion. Aspergillus niger is a nondermatophytic mold which exists as an opportunistic filamentous fungus in all environments. Here, we report a case of onychomycosis caused by A. niger in a 66-year-old female. The patient presented with a black discoloration and a milky white base and onycholysis on the proximal portion of the right thumb nail. Direct microscopic examination of scrapings after potassium hydroxide (KOH) preparation revealed dichotomous septate hyphae. Repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide produced the same black velvety colonies. No colony growth occurred on SDA with cycloheximide slants. Biseriate phialides covering the entire vesicle with radiate conidial heads were observed on the slide culture. The DNA sequence of the internal transcribed spacer region of the clinical sample was a 100% match to that of A. niger strain ATCC 16888 (GenBank accession number AY373852). A. niger was confirmed by KOH mount, colony identification, light microscopic morphology, and DNA sequence analysis. The patient was treated orally with 250 mg terbinafine daily and topical amorolfine 5% nail lacquer for 3 months. As a result, the patient was completely cured clinically and mycologically.

A Case of Herpes Zoster Oticus Involving Glossopharyngeal Nerve without Facial Nerve Palsy / 대한피부과학회지

No abstract available.