Localized Involutional Lipoatrophy in a Child

No abstract available.

Localized Involutional Lipoatrophy in a Child

No abstract available.

Topical Tretinoin Treatment for Confluent and Reticulated Papillomatosis / 대한피부과학회지

BACKGROUND: Confluent and reticulated papillomatosis (CRP) is a rare cutaneous disorder, characterized by persistent, scaling brown papules, patches, and plaques located on the trunk, neck, axillae, and shoulders. Many different treatments with variable success have been attempted, and oral minocycline treatment is effective in most patients with CRP. There were a few case reports of CRP responding to topical retinoid, but no clinical studies on the efficacy of the topical retinoid treatment for CRP have been reported. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of the topical tretinoin treatment for CRP. METHODS: A retrospective study was performed based on the medical records and clinical photographs of patients with CRP treated with 0.025% tretinoin cream. RESULTS: Nine patients (4 men and 5 women) were enrolled in the study. The mean age of the patients was 17.4 (11~34) years and the mean age at onset of CRP was 15.1 (3~33) years. The duration of disease varied from 1 month to 7 years. Six of the nine patients showed complete remission, and CRP lesions improved markedly after averagely 6.2 weeks from the beginning of the topical tretinoin treatment. The treatment response was better in patients without itch than in patients with itch (p=0.048). Adverse effects were detected in 3 patients, and were mild irritant contact dermatitis to the topical tretinoin. CONCLUSION: We think that topical 0.025% tretinoin treatment is an effective and safe treatment modality for CRP and this treatment can be an alternative or additional modality to the systemic treatment.

A Clinical Study of Herpes Zoster: Focused on the Characteristics of Pruritus in Herpes Zoster / 대한피부과학회지

BACKGROUND: Herpes zoster is a common dermatologic disorder. However, there have been no reported studies of the characteristics of pruritus in herpes zoster in Korean literature. OBJECTIVE: The purpose of this study is to investigate the epidemiological features and clinical characteristics of pruritus in herpes zoster. METHODS: Retrospective study was performed by reviewing the medical records of 178 patients with herpes zoster. The analyses of age, gender, accompanying symptoms, dermatomal distribution, underlying disease, treatment and complication were performed. RESULTS: The ratio of male to female patients was 2:3. The age distribution ranged from 1 to 87 years old. A total of 76.4% of the patients with herpes zoster experienced pruritus, and 18.4% of the patient with pruritus had pruritus that disrupted normal activities. There were no relationships between the incidence of pruritus and age of patients, gender, dermatomal distribution, and incidence of pain. As the severity of pain increased, the incidence and the severity of pruritus increased (p=0.01, p=0.01). Pruritus was improved within 3 weeks in the 74.3% of the patients with pruritus; however, 9.6% of the patients felt complaint with pruritus over 6 weeks. The duration of the pruritus extended with advancing age (p=0.01). As the severity of pruritus and pain increased, the duration of pruritus increased (p=0.025). CONCLUSION: Pruritus is a common symptom in herpes zoster, and this study describes the general aspects of pruritus in herpes zoster. Advancing age and the severity of the pruritus and the pain are possible risk factors of long-lasting pruritus.

Mycosis Fungoides with Coincidental Ureter Cancer / 대한피부과학회지

An 82-year-old woman presented with a 5-year history of erythematous to brown patches and plaques on both legs, arms and trunk. Histopathological findings of biopsy specimens were consistent with mycosis fungoides, and the tumor cells were positive for CD3 and negative for CD20 in immunohistochemical stain. Imaging studies proposed the suspicion of ureter cancer, and the result of cystoscopic biopsy showed papillary urothelial carcinoma. Mycosis fungoides is the most common type of cutaneous T-cell lymphoma, characterized by variable cutaneous manifestations, including patches, plaques, tumors, and erythroderma. There were several studies concerning the evaluation of the second malignancy risk after cutaneous T-cell lymphoma, however the relationship between mycosis fungoides and ureter cancer is not revealed. This patient is considered a case of mycosis fungoides with coincidental ureter cancer.

Atrophying Pityriasis Versicolor / 대한피부과학회지

Atrophying pityriasis versicolor is a rare variant of pityriasis versicolor. Clinically, atrophying pityriasis versicolor is characterized by well defined, slightly scaly, depressed macules and patches with minimal symptoms. The etiology of the atrophy is unknown, though several hypotheses have been suggested, including immune reaction to antigens of Malassezia species. A 23-year-old male was presented with multiple, slightly brown colored macules and patches on the chest and back. In the potassium hydroxide preparation, lots of yeasts and hyphae were found. A histopathologic study showed multiple yeasts and hyphae on the stratum corneum, focal epidermal thinning, and perivascular lymphocytic infiltration on the upper dermis. The patient was treated with 100 mg itraconazole a day with topical antifungal agents. After 3 weeks of treatment, clinical improvement and mycological improvement were achieved. We present an additional case of atrophying piryriasis versicolor developed on the chest and back with the review of the relevant literature.

A Case of Adenoid Cystic Carcinoma on the Nipple with Axillary Lymph Node Metastasis / 대한피부과학회지

Adenoid cystic carcinoma of the breast is an uncommon type of breast cancer, and it accounts for 0.1% of all breast cancer. In contrast to the aggressive nature of extramammary adenoid cystic carcinoma, adenoid cystic carcinoma of the breast has a more favorable prognosis. A 55-year-old female patient presented with a 6-month history of a tender mass confined to the nipple of the left breast. A skin biopsy showed a linear and tubular pattern of atypical cells, which was consistent with adenoid cystic carcinoma. Left breast conserving surgery with axillary lymph node dissection was performed. The histopathology of the specimen showed a 1.5 cm sized mass localized to the nipple, and the axillary lymph nodes were positive for tumor metastasis.

Clinicopathological Study of Pyogenic Granuloma / 대한피부과학회지

BACKGROUND: Pyogenic granuloma is a common vascular neoplasm of the skin and mucous membranes. However, few comprehensive studies are available on the clinical and histopathological characteristics of pyogenic granuloma. OBJECTIVE: To analyze the clinical and histopathological characteristics of pyogenic granuloma. METHODS: Patients with pyogenic granuloma diagnosed clinically and histopathologically were reviewed retrospectively. RESULTS: Fifty patients (17 males and 33 females) were enrolled, and the mean age of onset was 33.6 years old. The mean lesion size was 6.7 mm. Forty-eight patients had a solitary lesion, whereas two patients had multiple lesions on the skin and mucosa. The most common area for lesions was the head and neck followed by the hands, trunk, and lower extremities. Patient complained of easy bleeding, pain, tenderness, and pruritus. Dermoscopic findings of nine lesions showed patterns of a reddish homogenous area, white scaly collarette, white rail lines, and a hemorrhagic crust. Histopathological findings of all biopsy cases showed a lobular pattern of angiomatous tissue with numerous congested capillaries, a flattened epidermis, a well-formed epidermal collarette, and CD34-positive endothelial cells. Various treatment modalities including surgery and laser have been used, but lesions recurred following a single laser treatment with a pulsed dye laser or long-pulsed Nd:YAG laser. CONCLUSION: A correlation between clinicopathological and dermoscopic findings was useful for the differential diagnosis of other diseases mimicking pyogenic granuloma and to detect recurrence after treatment. Laser treatments were less invasive therapy, but the recurrence rate was higher than that of other surgical modalities when used alone. Additional prospective studies are needed to determine the effectiveness of the various treatment modalities.

A Clinical Study of Herpes Zoster in Children / 대한피부과학회지

BACKGROUND: Herpes zoster is a common dermatologic disorder. However, there has been no reported study of herpes zoster in children exclusively in the Korean literature. OBJECTIVE: The purpose of this study was to analyze epidemiological features and clinical characteristics of herpes zoster in children. METHODS: A retrospective study was performed by reviewing the medical records of 64 patients who were under 12 years old and who had herpes zoster. We searched for cases occurring during a 10-year-period from January 2000 to December 2009. We analyzed for age, gender, accompanying symptoms, dermatomal distribution, underlying disease, treatment and complications. RESULTS: Children under 12 years old account for 2.48% of all herpes zoster patients. The ratio of males to females is 1:1. The number of enrolled patients was increasing according to age (p=0.0004). The number (p=0.0009) and the proportion (p=0.0187) of pediatric patients has been increasing year by year. Underlying diseases were observed in 17.2%, and included asthma, atopic dermatitis, chronic sinusitis, epilepsy and tic disorder. There was no patient with immunocompression. Lesions of herpes zoster were most frequently found in the trigeminal dermatome (35.9%), followed by the thoracic (34.4%), cervical (14.1%), lumbar (9.4%), and sacral (4.7%) dermatomes, and multiple involvement (1.16%). Pain accompanying herpes zoster was reported in 54.7% and pruritus in 71.9%. Complications were observed in 14.1%; the most common one was eye involvement. CONCLUSION: The incidence of accompanying pain in children with herpes zoster is lower than in adults with this disease. However, the incidence of accompanying pruritus was higher in children than in adults. Postherpetic neuralgia did not developed in children.

Morphea Developing at the Site of Healed Herpes Zoster

Wolf's isotopic response describes the occurrence of a new, unrelated disease that appears at the same location as a previously healed skin disease, and the most common primary skin disease of this phenomenon is herpes zoster. Several cutaneous lesions have been described to occur at the site of healed herpes zoster, and granulomatous dermatitis and granuloma annulare have been reported to be the most common second diseases. The pathogenesis of the isotopic response is still unclear. Morphea can develop at the site of regressed herpes zoster and a few such cases have been reported. We present here an additional case of morphea that developed at the site of previously healed herpes zoster, and we review the relevant literature.

A Case of Blaschkitis / 대한피부과학회지

Blaschkitis is an acquired inflammatory dermatosis that develops along the line of Blaschko. It has a similar appearance to lichen striatus but, shows a somewhat different clinical course and histopathologic findings. Spongiotic dermatitis-like histopathology, good response to glucocorticoid therapy and frequent relapses are the characteristic features that can differentiate it from lichen striatus and other dermatoses which follows the line of Blaschko. We report a case of Blaschkitis that showed a typical clinical course and histopathologic findings.

A Case of Woringer-Kolopp Disease on the Leg / 대한피부과학회지

Woringer-Kolopp disease is a rare variant of mycosis fungoides and it is also known as localized pagetoid reticulosis. It presents as a solitary, localized hyperkeratotic patch or plaque on the extremities with a slowly progressive course. A 51-year-old female presented with a 6-year history of a well-defined erythematous plaque with an indurate border on the left leg. The lesion was asymptomatic and it had gradually enlarged. A skin biopsy showed hyperkeratosis and acanthotic epidermis with an infiltration of atypical pagetoid cells, and these cells were revealed to be the cytotoxic T cell phenotype on immunohistochemical staining. We report here on a case of Woringer-Kolopp disease along with a review of the relevant literature.

Kikuchi's Disease Presented with Cutaneous Lesion Showing Diffuse Erythematous Maculopatches / 대한피부과학회지

Kikuchi's disease, or histiocytic necrotizing lymphadenopathy is an idiopathic, benign self-limiting lymphadenitis usually affecting young women. Cutaneous findings in Kikuchi's disease have been reported in 16~40% of cases. A 29-year-old woman presented with pruritic diffuse erythematous maculopatches on whole body accompanied by long-lasting fever and cervical lymphadenopathy. Skin biopsy showed vacuolar degeneration of the basal layer and dermal infiltration of CD68-positive histiocytes. Lymph node fine needle aspiration specimens showed abundant lymphocytes, histiocytes, karyorrhectic debris without neutrophils, consistent with Kikuchi's disease. We present a case of Kikuchi's disease showing generalized skin eruption with a review of literature that describes patterns of skin involvement.

A Case of Palmar Lichen Nitidus Presenting as a Clinical Feature of Pompholyx

Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN.

A Case of Postirradiation Morphea / 대한피부과학회지

A 58-year-old female with breast cancer, who had undergone breast conserving surgery and radiotherapy, presented with a 7-month history of erythematous to brown, indurated plaque confined to the previous radiation field. The patient had no constitutional symptoms. A skin biopsy showed thickened, hyalinized collagen bundles in the dermis, which was consistent with morphea. Postirradiation morphea is a rare complication of radiotherapy. The clinical feature of postirradiation morphea may be similar to cellulitis or cutaneous metastasis, and the diagnosis of this disease is given histopathologically. We present a case of postirradiation morphea and a review of the literature.

A Case of Erythrodermic Dermatomyositis Associated with Gastric Cancer

Erythroderma is an unusual cutaneous finding associated with dermatomyositis. There are only five cases of erythrodermic dermatomyositis reported in the English literature. We treated a case of erythrodermic dermatomyositis associated with a Bormann type 1 gastric cancer. The patient had a generalized, erythematous scaly eruption consistent with erythroderma and Gottron's papules as well as a heliotrope rash; these are the hallmark skin manifestations of dermatomyositis.

Dermoscopic Patterns of Acral Melanocytic Nevi in Koreans / 대한피부과학회지

BACKGROUND: Melanocytic nevi are frequently found in acral skin. Benign melanocytic lesions on acral sites may be difficult to differentiate from early acral melanoma by visual examination even for experienced dermatologists. Dermoscopy is a noninvasive method for evaluating pigmented skin lesions. OBJECTIVE: The purpose of this study was to investigate the clinical and dermoscopic features of acral melanocytic nevi in Koreans. METHODS: We studied 57 patients with acral melanocytic lesions using standard clinical assessment and dermoscopy. The patients were examined for acral melanocytic nevi clinically and by using a dermoscope with a digital imaging system, and the acral nevi larger than 7 mm and the suspicious lesions were excised and examined histopathologically. RESULTS: Sixty five acral melanocytic nevi were observed in 57 patients. Individual lesions were located on the soles (n=32), palms (n=11), and volar aspect of the fingers or toes (n=22). The most common dermoscopic pattern was the parallel furrow pattern (52.3%). The other patterns seen were a latticelike pattern (21.6%), a fibrillar pattern (9.2%), a reticular pattern (6.2%), a globular pattern (4.6%), a nontypical pattern (4.6%) and a transition pattern (1.5%). The frequency of distribution of the fibrillar and reticular patterns was significantly different (p=0.033, p=0.015). CONCLUSION: Dermoscopy proved to be a useful instrument for the evaluation of acral melanocytic lesions. In our series of acral nevi, we observed 7 dermoscopic patterns with varying distributions on anatomical sites. We think that further studies on acral melanocytic nevi with digital follow-up are needed to clarify their evolution.

A Case of Hobnail Hemangioma That Occurred Together with Angiolipoma / 대한피부과학회지

Hobnail hemangioma is a benign vascular tumor that typically presents as a small, solitary lesion on the trunk or limbs of young or middle-aged persons. Characteristically,the tumor has a targetoid appearance where a violaceous papule is surrounded by an ecchymotic rim. Hobnail hemangioma is characterized by a biphasic growth pattern of the neoplastic vascular structures and prominent matchstick-like endothelial cells. Based on the positivity of the endothelial cells for monoclonal antibody D2-40, it has been proposed that this tumor displays lymphatic differentiation. Angiolipomas are benign subcutaneous tumors that consist of mature adipocytes and blood vessels. They are usually multiple and they typically occur in young adults with an obvious male predilection. We describe here a case of hobnail hemangioma that occurred together with angiolipoma in an 8-year-old girl, who had a violaceous papule encircled by a peripheral ecchymotic halo on the left heel.

Treatment of Linear Lichen Planus with Oral Methylprednisolone / 대한피부과학회지

BACKGROUND: Lichen planus is a chronic papulosquamous disease characterized by various clinical manifestations of the skin, mucosa, hair, and nails. Various drugs or physical treatments for lichen planus have been proposed, but the efficacies are often disappointing and controversial. Linear lichen planus is a rare variant of lichen planus, which accounts for 0.2~0.6% of all patients with lichen planus. Systemic corticosteroids remain the most widely used treatment for lichen planus. However, there have been no clinical studies on the effectiveness of this therapy on linear lichen planus despite the fact that linear lichen planus usually lasts for more than 1 year and occasionally results in cosmetic problems. OBJECTIVE: This study evaluated the efficacy and safety of oral methylprednisolone therapy for linear lichen planus. METHODS: Retrospective study was performed by reviewing the medical records and clinical photographs of 12 linear lichen planus patients treated with oral methylprednisolone. The analyses of treatment response to oral methylprednisolone therapy, adverse effects, and recurrence were performed. RESULTS: All the 12 patients who completed the oral methylprednisolone therapy achieved complete response. Most patients showed a marked improvement 1 to 2 weeks after starting oral methylprednisolone therapy. Three of the 12 patients showed recurrence at 9 to 14 weeks after cessation of the treatment. Oral methylprednisolone therapy was generally well-tolerated and no serious adverse effects were observed. CONCLUSION: Oral methylprednisolone therapy is an efficacious, safe, and tolerable treatment modality for linear lichen planus.

A Case of Piloleiomyoma Arising in a BCG Vaccination Site / 대한피부과학회지

BCG is a live attenuated vaccine derived from Mycobacterium bovis. It can give rise to several cutaneous complications including benign and malignant tumors. There are many reports about tumors arising in vaccination sites, especially those of small pox and BCG vaccinations. Reported tumors are basal cell carcinoma, dermatofibroma, melanoma, pilomatricoma and so on. Piloleiomyoma is a rare soft tissue tumor arising from arrector pili muscles. Clinically, piloleiomyomas appear as firm dermal papules and nodules with skin colored, pink, or reddish-brown surfaces. We experienced a case of piloleiomyma arising in a BCG vaccination site, which has not been reported in previous literature. Although several hypotheses have been propsed, there are no identified causes of leiomyoma. Trauma by the vaccination, persistent inflammation, wound healing process, or antigenic stimulation of the innoculation agent could be the possible causes in this case.