A Case of Spindle Cell Lipoma / 대한피부과학회지

Spindle cell lipoma was first described in 1975 by Enzinger and Harvey as a variant of lipomas. Histopathological findings show the lipomatous tissue to be replaced by a mixture of uniform spindle cells and mature fat cells closely associated with a mucoid matrix and a varying number of collagen fibers. Immunohistochemical staining is reported to give assistance in the differential diagnosis af spindle cell lipoma from other fibrous or neural tumors. Also, it can be used to investigate the origin of the spindle cells. We report a case of spindle cell lipoma in a 41-year-old female. She had a solitary, normal skin colored, bean sized, subcutaneous mass on the forearm. Most of the spindle cells were strongly positive for vimentin, CD34 and NSE, but negative for actin, factor VIII, S-100 protein and neuro- filaments. The tumor was excised. No recurrence was recognized in a 10 month follow up period.

A Case of Plasma Cell Balanitis Controlled by Fusidic Acid Cream / 대한피부과학회지

In 1952, Zoon described eight cases of benign circumscribed chronic balanitis characterized by an extensive infiltration of plasma cells with no evidence of dysplasia of the overlying epidermis. Plasma cell balanitis can often be confused clinically with other conditions, such as erythroplasia of Queyrat, fixed drug eruptions, secondary syphilis, candidiasis and Reiters disease. We report a case of plasma cell balanitis in a 65-year-old man. He complained of a single, red, shiny and smooth patch involving the glans penis and adjacent prepuce. This patch was unresponsive to systemic and topical steroid treatment. Laboratory studies were negative or within the normal range. Histopathological findings showed a band-like mainly plasmacytic inflammatory infiltrate of the upper dermis. This patient was treated once daily with 2% fusidic acid cream topically for 5 weeks. The lesions resolved and no recurrence was observed during 2 years of follow-up.

A Case of Gloves and Socks Syndrome / 대한피부과학회지

Clinical characteristics of papular-purpuric gloves and socks syndrome consist of a purpuric erythema affecting the hands and feet in a gloves and stocking distribution. It is sometimes associated with fever and oral lesions. The disease is self-limiting and resolves within 1 to 2 weeks. Serological studies have shown that there is an association with parvovirus B19 infection in most patients affected by this syndrome. We report a case of gloves and socks syndrome in a 21-year-old female. She had a 4-day history of papular-purpuric eruptions of the hands and feet in a gloves-and-socks distribution. She also complained of fever(up to 39C) during the first 2 or 3 days of clinical onset. The oral mucosa was normal and there were no palpable lymph nodes. Laboratory and histopathological findings were non-specific. However, human parvovirus B19 DNA was detected in the serum by a polymerase chain reaction. Systemic manifestations were transient and disappeared within a few days, whereas the skin lesions resolved gradually over a period of 2 weeks.

p53 Expression in Malignant Melanoma and Melanocytic Nevus / 대한피부과학회지

BACKGROUND: The p53 gene mutations are the most frequent genetic alterations found in human skin cancer. However, many studies on the expression of p53 protein in human melanoma and melanocytic nevus have been controversial. OBJECTIVE: This study was conducted to investigate the differences in p53 protein expression associated with tumor thickness variance, subtypes and, benign and malignant melanocytic tumors. METHODS: Immunohistochemical analysis of p53 protein was performed on the formalin-fixed, paraffin-embedded tissue sections of 22 melanocytic nevi and 29 malignant melanomas(20 primary and 9 metastatic) using anti-p53 monoclonal antibody with an avidin-biotin peroxidase complex procedure. RESULTS: 1. Mutant p53 protein was detected in 55.2%(16/29) of malignant melanomas, whereas mutant p53 protein was not detected in melanocytic nevi.(p<0.05) 2. Metastatic malignant melanoma(8/9, 88.9%) showed a significantly higher p53 protein detection rate compared to primary malignant melanoma.(8/20, 40.0%) (p<0.05). CONCLUSION: The detection rate of p53 protein was higher in malignant melanoma compared to melanocytic nevus. This finding suggests that p53 may play a significant role in the progression and metastasis of malignant melanoma.

bcl-2 Expression in Cutaneous T Cell Lymphoma / 대한피부과학회지

BACKGROUND: The bcl-2 is an oncogene involved in tumorigenesis by blocking apoptosis, or programmed cell death and over-expression of bcl-2 protein has been reported in several malignant tumors such as lung cancer, basal cell carcinoma, breast cancer and malignant melanoma. However, there have been only a few studies about bcl-2 expression of cutaneous T cell lymphoma. OBJECTIVE: The purpose of this study was to examine whether there is any difference in expression of bcl-2 between mycosis fungoides(MF), angiocentric T cell lymphoma, angioimmunoblastic T cell lymphoma, subcutaneous T cell lymphoma and anaplastic large cell lymphoma. We also evaluated the statistical significance between expression of bcl-2 and the prognosis of the diseases. METHODS: Routine paraffin sections of formalin-fixed 36 tissues (14 MF, 7 angiocentric T cell lymphoma, 5 subcutaneous panniculitic T cell lymphoma, 2 anaplastic large cell lymphoma, 1 angioimmunoblastic T cell lymphoma, 1 unspecified peripheral T cell lymphoma, 2 small plaque parapsoriasis, 2 psoriasis and 2 lichen planus) were labelled with anti-bcl-2 monoclonal antibody using an avidin- biotin-peroxidase complex. Normal skin for bcl-2 served as negative controls. RESULTS: The results were as follows. l. All cases of benign inflammatory diseases, small plaque parapsoriasis and patch stages of MF showed positive staining for bcl-2. Therefore, there were no differences in expression of bcl-2 among these diseases. 2. In the plaque and tumor stages of mycosis fungoides, statistically significancant differences in bcl-2 expression were not found during disease progression. 3. bcl-2 expression in peripheral T cell lymphoma (five in seven cases of angiocentric T cell lymphoma showed positive staining but all other peripheral T cell lymphoma was negative) decreased significantly (p0.05). CONCLUSION: These results suggest that the loss of bcl-2 expression may play a significant role in progression of cutaneous T cell lymphoma except in MF and angiocentric T cell lymphoma.

bc1 - 2 Expresseion in Malignant Melanoma and Melanocytic Nevus / 대한피부과학회지

BACKGROUND: The bcl-2 is a newly known oncogene involved in tumorigenisis by blocking apoptosis or programmed cell death. Overexpression of bcl-2 protein has been detected in a variety of human malignancies. However, recent studies of the expression of bcl-2 protein in human melanoma and melanocytic nevus have been controversial. OBJECTIVE: The purpose of this study was to examine whether there are any differences in the expression of bcl-2 protein between melanocytic nevus and rnalignant melanoma. METHODS: Immunohistochemical analysis of bcl-2 protein expression was performed on the formalin-fixed, paraffin-embedded tissue sections of 22 melanocytic nevus and 29 malignant melanomas (20 primary and 9 metastatic) using anti bcl-2 monoclonal antibody with an avidin-biotin peroxidase complex procedure. RESULTS: The results were as follows. 1. The positive rate for bcl-2 protein was observed in 95.4% (21/22) of melanocytic nevus and 95.0% (19/20) of primary malignant melanomas. Therefore, there was no significant difference between the two groups in the positive rate for bcl-2 prtoein. 2. The percentage of stained cells and the staining intensity of bcl-2 protein were significantly increased in melanocytic nevus compared to malignant melanoma (p<0.05). 3. The positive rate for bcl-2 expression of metastatic malignant melanoma [44.4% (4/9)] was significantly decreased compared to that of primary malignant melanoma [95.0%(19/20) ] (p<0. 05). But, there was no significant difference betweeen tumor thickness and histological type of malignant, melanoma in the expression of bcl-2 protein. 4. In melanocytic nevus, immunoreactivity of bcl-2 protein gradually diminished or even disappeared towards the deep dermis. CONCLUSION: the bcl-2 expression was decreased in malignant melanoma compared to melanocytic nevus. It. suggests that the loss of bcl-2 expression may play a significant role in the progression and metastasis of malignant melanoma.

A Case of Spindle Cell Hemangioendothelioma / 대한피부과학회지

Spindle cell hemangioendothelioma was first described in 1986 by Weiss and Enzinger as a low grade angiosarcoma resr mbling a cavernous hemangioma and kaposis sarcoma. Recently, it is suggested to be non neoplastic lesion or reactive process arising from pre-existing vascular mal- formation. We report a case of spindle cell hemangioendothelioma in a 9-month-old boy. He had multiple, variable sized, colorful, cutaneous or subcutaneous nodules on the forearm and hand. The tumor first appeared on the forearm as erythematous patches at birth and grew rapidly with- in 3 months. Histopatholgical findings showed that the lesion was composed of thin walled cavernous spaces mixed with spindle cells and occasional epithelioid endothelial cells containing intracytoplasmic vacuole. Most af the endothelial cells lining the cavernous spaces and intracytoplasmic lumina, were positive for factor VIII associated antigen. But the spindle cells were negative. Atypical vascular structures resembling arteriovenous shunts were noted around the tumor suggesting a reactive proliferation due to disturbance of local blood flow. Several turnors were excised. No recurrence has been recognized in the one year- follow-up period.

A Case of Hypopigmented Mycosis Fungoides / 대한피부과학회지

No abstract available

A Case of Lymphoma en cuirasse / 대한피부과학회지

Lymphomatous involvement of the skin has been reported to occur in approximately 15% to 20% of patients with lymphoma and in 5% it constitutes the initial presentation of lymphoma. In 1986 Saekow et al. described a patient with a progressively enlarging, indurated lymphomatous plaque on the chest and upper abdominal region that had the shape of a breastplate. They used the term lymphoma en cuirasse. We report a case of lymphoma en cuirasse in a 71-year-old female. She had a well defined, erythematous, hard, indurated plaque on the neck and chest. On physical examination, the right supraclavicular, left inguinal and both axillary lymph nodes were palpable. A Bone marrow aspiration test, chest X-ray and cmputerized tomogram revealed bone marrow and lymph node involvement. Histopathologic examination of the involved skin showed that hyperchromatic and anaplastic lymphocytes were clensely packed in the dermis and subcutaneous fat. On immunohistochemical examination, the tumor cells were positive for the leukocyte common antigen and UCHL-1. We tried to treat the patient with combination chemotherapy, but she refused. After discharge, the patient died one week later.

The Effect of All-Trans-Retinoic Acid and Ursolic Acid on the Ultraviolet A Radiation Induced AP-1 (Fos/Jun) Activity in Cultured Human Dermal Fibroblasts / 대한피부과학회지

BACKGROUND: Recently, UVB irradiation was found to activate AP-1, which is known to be a major enhancer factor of the collagenase gene. However, tbe effect of UVA irradiation on the activity of AP 1 in derrnal fibroblasts is unclear. Although all trans-retinoic acid(tRA) has been known to prevent. the AP 1 and collagenase stimulatory effect of UVB irradiation, the effect of tRA and ursolic acid(UsA) on the enhancement of AP-1 activity hy UVA irradiation is unknown. OBJECTIVE: In this stuc y, the effect of UVA irradiation on the AP-1 activity in cultured human dermal fibroblasts was studied. The effect. of tRA and UsA on the enhancement of AP-1 activity by UVA irradiation was also investigated. METHODS: Confluent human dermal fibroblasts were irradiated with 15J/cm of UVA. Drugs were administered and kept in a culture rnedia for 12 hrs before or immediately after UVA irra diation. Nuclear protein extracts were isolated 12 hrs after UVA irradiation and were subjected to gel retardation assay ising oligolabeled DNA probe for AP l binding site. RESULTS: 1. The activity of AP-1 was increased by UVA irradiation and prominent activation was detected at 6 and 12 hrs postirradiation. 2. Compared to the UVA irradiated group, tRA and the high concentration(10(-5)M) of UsA administered before or al ter UVA irradiation inhibited the increase of AP-1 activity. CONCLUSION: These res ilts suggest that UVA irradiation enhance the AP-1 activity, which is known to be a major er hancer factor of the collagenase gene, and tRA and UsA downregulate the 1JVA induced AP-l activity enhancement.

bcl - 2 Expression in Basal Cell Carcinoma , Squamous Cell Carcinoma , Keratoacanthoma , and Trichoepithelioma / 대한피부과학회지

BACKGROUND: The bcl-2, gene is a newly described oncogene involved in tumorigenesis by blocking apoptosis, or programmed cell death and overexpression of bcl-2 protein has been reported in several malignant tumors such as lymphoma, breast cancer, and lung cancer. Though keratinocyte-derived skiri tumors are one of the most common human tumors the detailed molecular mechanism of the keratinocytic tumors is not clear. Also, the differentiation between basal cell carcinoma(BCC) and trichoepithelioma(TE) is sometirnes difficult clinically and histologically. OBJECTIVE: The purpose of this study is to examine whether there is difference in staining pattern of bcl-2 protein in BCC, TE, squamous cell carcinoma(SCC), and keratoacanthoma(KA). We also evaluated the diagnostic value of expression pattern of bcl-2 protein in distinguishing BCC and TE. METHODS: Routine paraffin sections of formalin-fixed forty-four tissues (19 BCC, 9 SCC, 10squamous cell carcinoma in situ : 5 actinic keratosis [AK] and 5 Bowen disease [BD], 5 keratoacanthoma, and 6 (TE) were labeled with anti-bcl-2 monoclonal antibody using a avidin-biotin peroxidase complex. Normal skin for bcl-2 protein served as negative controls. RESULTS: The results were as follows. l. In normal skin, bcl- 2 positivity was observed in the epidermal basal layer, the basal layer of follicular infundibuium, the mesenchymal cells of the follicular papillae, and the eccrine glands. 2. All cases of BCC and TE showed a positive cytoplasmic staining for bcl-2 proein, but all cases of SCC, AK, BD, and KA were negative. 3. In staining pattern, of bcl-2 protein, BCC showed diffuse staining throughout the tumor lobules. In TE, the basaloid cells lining the periphery of each tumor nests and the papillary mesenchymal bodies stained strongly. CONCLUSION: This study shows that BCC express bcl-2 protein, whereas SCC are negative. Our results indicate that proteon from apoptosis mediated by bcl-2 protein may be involved in the neoplastic growth mechanism of BCC. In addition, the ohserved findings in expression pattern of bcl-2 protein in BCC and TE may be of a diagnostic help in distinguishing the borderline cases.

The Effect of High Dose UVA - 1 and UVA - 2 Irradiation on the Expression of Surface Markers of Epidermal Langerhans Cells and Induction of contact Hypersensitivity in Mice Skin / 대한피부과학회지

BACKGROUND: It is knovn that Langerhans cells are damaged fuctionally and morphologically by UV irradiation. Recently, high-dose UVA-1 therapy (340-400nm) was introduced as an effective treatment of severe exacerbated atopic dermatitis. However, the effect of UVA-1 therapy on surface markers and function of epidermal Langerhans cells are still unclear. OBJECTIVE: To determine whether a high dose UVA-1 irradiation affects cutaneous immune system, the effect of UVA-1 on the expression of ATPase and Ia antigen of mouse epidermal Langerhans cells and induction of contact hypersensitivity in mice skin were investigated and were compared to those of UVA-2. METHODS: Balb/c mice were irradiated with 150J/cm and 300J/cm of UVA-1 and UVA-2 in a single dose at one time or 3 fractionated doses for 3 days. The number of Langerhans cells was evaluated using ATPase and immunoperoxidase-stained epidermal sheets. Balb/c mice were irradiated with same manner after induction of contact hypersensiyity by applying 0.5% oxazolone solution and the influence of UV irradiation was evaluated by measuring the ear swelling of mice. RESULTS: 1. The expression of surface markers of Langerhans cells was not affected by 150J/cm and fractionated 300J/cm of UVA-1. However, single irradiation of 300J/cm of UVA-1 reduced signifi-cantly the expression of surface markers. The irradiation of UVA-2 induced more prominent reduction of the expression of surface markers compared to UVA-l. 2. Although the induction of contact hypersensitity was not inhibited in groups irradiated by single or fractionated 150J/cm of UVA-1, it was inhibited in groups irradiated with 300J/cm of UVA-1. The inhibition of contact hypersensitivity induction by UVA-2 irradiation was also more prominent than that by UVA-1. CONCLUSION: These results suggest that epidermal Langerhans cells could be damaged by high doses of UVA-1 and the damage of Langerhans cells by UVA-1 is weaker than that by UVA-2.

Lymphomatoid Papulosis : A Clinical , Histopathologic and Follow - up Study / 대한피부과학회지

BACKGROUND: Lymphomatoic papulosis, a disease with recurrent and hemorrhagic papu-lonodular lesions, shows a benign course clinically but lymhomatous features histopathologically. Although sporadic cases have been reported, we could not find any comprehensive report of clinical and histopathologic features of lymphomatoid papulosis in Korean literature. OBJECTIVE: The purpose of this study was to examine the clinical and histopathologic features and follow up observation of 16 patients with lymphomatoid papulosis. METHODS: We reveiwed the clinical and histopathologic findings, associated diseases, and response to various treatments in 16 patients with lymphomatoid papulosis during the 10 year period from January 1984 to May 1994. RESULTS: The results were summarized as fallows. 1. There were 14 males and 2 females. Sex distribution showed a male predominence with male : female ratio of 7: 1. 2. Age distribution ranged from 20 to 65, with the mean age of 43 years. 3. Duration of symptoms ranged from 4 days to 10 years, with a mean duration of 2.4 years. 4. The lesions were located on the trunk and extremities(7 cases), extremities(7 cases), and trunk(2 cases). 5. The morphology of lesions were papules or plaques(11 cases), and nodules(5 cases). 6. Associated diseases were tuberculosis(2 cases), Behcet's disease(2 cases), Klatskin tumor(1 case), osteomyelitis(1 case), hypertesion and peptic ulcer(1 case), and chronic active hepatitis(1 case). 7. Histopathologic features revealed wedge-shaped superficial and deep perivascular polymorphic infiltrate with pleomorphic cells in all specimens except one. Histopathologic types classified by Willemze's Classification were type A(9 cases), type B(6 cases), and type A and type B(1 case). 8. Treatment including PUVA, methotrexate and systemic steroid had beneficial effect only temporarlly. 9. In one patient, large anaplastic CD30 lymphoma(Ki-1 lymphoma) of the skin and inguinal lymph node developed 3 years after the onset of Lymphomatoid papulosis. CONCLUSION: All pat.ients with lymphomatoid papulosis should be followed up for a long-term period to rule out the development of lymphoma.

Lymphomatoid Papulosis : A Clinical , Histopathologic and Follow - up Study / 대한피부과학회지

BACKGROUND: Lymphomatoic papulosis, a disease with recurrent and hemorrhagic papu-lonodular lesions, shows a benign course clinically but lymhomatous features histopathologically. Although sporadic cases have been reported, we could not find any comprehensive report of clinical and histopathologic features of lymphomatoid papulosis in Korean literature. OBJECTIVE: The purpose of this study was to examine the clinical and histopathologic features and follow up observation of 16 patients with lymphomatoid papulosis. METHODS: We reveiwed the clinical and histopathologic findings, associated diseases, and response to various treatments in 16 patients with lymphomatoid papulosis during the 10 year period from January 1984 to May 1994. RESULTS: The results were summarized as fallows. 1. There were 14 males and 2 females. Sex distribution showed a male predominence with male : female ratio of 7: 1. 2. Age distribution ranged from 20 to 65, with the mean age of 43 years. 3. Duration of symptoms ranged from 4 days to 10 years, with a mean duration of 2.4 years. 4. The lesions were located on the trunk and extremities(7 cases), extremities(7 cases), and trunk(2 cases). 5. The morphology of lesions were papules or plaques(11 cases), and nodules(5 cases). 6. Associated diseases were tuberculosis(2 cases), Behcet's disease(2 cases), Klatskin tumor(1 case), osteomyelitis(1 case), hypertesion and peptic ulcer(1 case), and chronic active hepatitis(1 case). 7. Histopathologic features revealed wedge-shaped superficial and deep perivascular polymorphic infiltrate with pleomorphic cells in all specimens except one. Histopathologic types classified by Willemze's Classification were type A(9 cases), type B(6 cases), and type A and type B(1 case). 8. Treatment including PUVA, methotrexate and systemic steroid had beneficial effect only temporarlly. 9. In one patient, large anaplastic CD30 lymphoma(Ki-1 lymphoma) of the skin and inguinal lymph node developed 3 years after the onset of Lymphomatoid papulosis. CONCLUSION: All pat.ients with lymphomatoid papulosis should be followed up for a long-term period to rule out the development of lymphoma.

Study of the Minimal Erythema Dose and Minimal Melanogenic Dose of UVA - 1 and Minimal Phototoxic Dose of UVA - 1 and UVA - 2 in Young Adult Koreans / 대한피부과학회지

BACKGROUND: Minimal erythema dose(MED), minimal melanogenic dose (MMD) and minimal phototoxic dose(MPD) of UVA-1 in Koreans has not been determined, although MED and MMD of UVB and MPD of UVA-2 in Koreans have been reported. OBJECTIVE: This study was done to measure the MED and MMDs including minimal immediate tanning dose(MITD) and minimal delayed tanning dose(MDTD) of UVA-1 radiation and compare the MPD of UVA-1 with that of UVA-2. METHODS: In this study, a metal halide lamp (SUPUVASUN 3000) and a fluorescent blacklight lamp (Philips TL 20W/09N UVA lamp) were used as the UVA-1 and UVA-2 light sources, respectively. After the determining of Fitzpatrick's skin phototypes, the back skins of young adults were irradiated and the MED, MITD and MDTD of UVA-1 were assessed at 24 hours, 1 hour, and 7 days after irradiation, respectively. The minimal doses of phototoxic reaction, which was induced by oral 8-MOP plus UVA-1 or UVA-2, were assessed visually 72 hours after irradiation. RESULTS: MED,was 61.20+/-11.50J/cm(mean+S.D.). MITD and MDTD of UVA-1 were 48.00+/-8.57J/cm and 65.30+/-12.10J/cm respectively. MPDs of UVA-1 and UVA-2 were 14.88+/-3.88J/cm and 4.40+/-1.69J/cm, respectively. CONCLUSION: In this study, the MED and MMD of UVA-1 radiation and the MPD of UVA-1 and UVA-2 radiation were measured in young adult Koreans. The MITD was less than the MED, and the MDTD was almost the same as the MED. The MPD of UVA-1 was three times higher than that of UVA-2. There vere no significant correlations between the MEDs, MMDs or MPDs and the skin phototypes.

Study of the Minimal Erythema Dose and Minimal Melanogenic Dose of UVA - 1 and Minimal Phototoxic Dose of UVA - 1 and UVA - 2 in Young Adult Koreans / 대한피부과학회지

BACKGROUND: Minimal erythema dose(MED), minimal melanogenic dose (MMD) and minimal phototoxic dose(MPD) of UVA-1 in Koreans has not been determined, although MED and MMD of UVB and MPD of UVA-2 in Koreans have been reported. OBJECTIVE: This study was done to measure the MED and MMDs including minimal immediate tanning dose(MITD) and minimal delayed tanning dose(MDTD) of UVA-1 radiation and compare the MPD of UVA-1 with that of UVA-2. METHODS: In this study, a metal halide lamp (SUPUVASUN 3000) and a fluorescent blacklight lamp (Philips TL 20W/09N UVA lamp) were used as the UVA-1 and UVA-2 light sources, respectively. After the determining of Fitzpatrick's skin phototypes, the back skins of young adults were irradiated and the MED, MITD and MDTD of UVA-1 were assessed at 24 hours, 1 hour, and 7 days after irradiation, respectively. The minimal doses of phototoxic reaction, which was induced by oral 8-MOP plus UVA-1 or UVA-2, were assessed visually 72 hours after irradiation. RESULTS: MED,was 61.20+/-11.50J/cm(mean+S.D.). MITD and MDTD of UVA-1 were 48.00+/-8.57J/cm and 65.30+/-12.10J/cm respectively. MPDs of UVA-1 and UVA-2 were 14.88+/-3.88J/cm and 4.40+/-1.69J/cm, respectively. CONCLUSION: In this study, the MED and MMD of UVA-1 radiation and the MPD of UVA-1 and UVA-2 radiation were measured in young adult Koreans. The MITD was less than the MED, and the MDTD was almost the same as the MED. The MPD of UVA-1 was three times higher than that of UVA-2. There vere no significant correlations between the MEDs, MMDs or MPDs and the skin phototypes.

A Case of Necrolytic Migratory erythema Induced by a Pancreatic Insufficiency / 대한피부과학회지

Necrolytic migratory erythema is a cutaneous reaction pattern with specific histopathologic features that is typically associated with a functioning pancreatic islet cell neoplasm such as a glucagonoma. However, cases without. glucagonoma have also been reported, such as, liver cirrhosis, chronic pancreatitis, celiac sprue etc. Other clinical features include anemia, glossitis and weight loss. We report a case of neccrolytic migratory erythema induced by a pancreatic insufficiency without glucagonoma. A 43-year-old male was seen at our department because of rnultiple erythematous, desquamative and erosive patches on the whole body for 1 month. He also had weight loss(25Kg) and stomatitis. Seven years previously he had a Whipple's procedure for a pancreatic head rupture. The laboratory data showed a low protein and zinc level, and high glucagon level. Histopathologic findings of the case showed epidermal edema and pallor, and superficial epiderrnal necrosis. The patient improved progressively after intravenous infusion of amino acids with a pancreatic enzyme supplementation.

A Case of Carbamazepine Induced pseudolymphoma Syndrome / 대한피부과학회지

The pseudolymphoma syndrome that may mimic malignant lymphoma clinically and histopathologically has been described as a hypersensitivity reaction to anticonvulsant drugs. It consists of the triad of a fever, generalized rash and lyrnphadenopathy. In some cases, varying degrees of malaise, hepatosplenornegaly, abnormal liver function tests, arthralgias, eosinophilia and blood dyscriasias may also be present. We report a case of pseudolymphoma syndrome due to carbamazepine in a 47-year-old man. He had a diffuse edematous and erythematous patches, papules and vesicles associated with high fever, hepatosplenomegaly and lymphadenopathy. The histopathologic finding slowed a dense atypical mononuclear cell infiltrate of the upper dermis associated with Pautriers microabscess like structures and severe dermal edema. Laboratory findings revealed leukocytosis and an abnormal liver function test. Three weeks after the withdrawal of carbamazepine and treatment with oral prednisolone, his skin lesion and general condition markedly improved.

A Case of Hemosiderosis due to Multiple Transfusion / 대한피부과학회지

Hemosiderosis is a disorder characterized by deposits of hemosicerin in multiple organs without organ dysfunction or injury. The color of the skin becomes brown, espeially on sun exposured areas. Mucous mernbranes are also affected in up to 5-25% of cases. A 43-year-old woman visited our clinic due to generalized brown colotation of her skin, including conjunct we and oral mucous mernbrane which she had had for 10 months. She had been treated with multiple he nodialysis combined with periodic transfusion for renal failure 3 times a month during the last 5 yeadrs Her plasma ferrit in level was elevated markedly and TIBC decreased, but cortisol and ACTH levels were within normal limits, Histopathologic findings of the neck skin showed hyperpigmentation of basal layer and deposition of brown pigment wrthin and around the sweat glands. In Fontana-Masson stain, the lower epidermis showed a massive deposition of melanin. Prussian blue stain revealei hemosiderin within snd around, the sweat glands. Hemosiderin could also be noticed on specirnens of thliver biopsy. The patient improved progressively after the rstriction of trasnfusion and treatment of renal failure.

A Case of Woringer - Kolopp Disease ( Pagetoid Reticulosis ) / 대한피부과학회지

Woringer-Kolopp(W-K) disease is a rare, localized, histologically malignant, but clinically indolent lymphoproliferative disorder. It usually shows only a single slowly enlarging skin lesion mainly on the extremities. Some authors have regarded W-K disease as a variant of mycosis fungoides. However, recent studies suggest that W-K disease may represent a spectrum of T cell lymphoproliferative disoreers that may not be related to mycosis fungoides. We report a case of Woringer-Kolopp disease in a 60-year-old male who presented with a solitary slowly growing tumor on his left palm for 3 years. Histopathologic examination showed marked acanthosis and pagetoid infiltration confined to the epidermis. He was treated with 4,000 red electron beam irradiation to the area with complete resolution of the lesion. Three years later, a similar lesion appeared on his left foot dorsum. He was treated as previously with a good response and there has been no new lesion during the last 1 year follow up period.