Fatal Cutaneous gamma/delta T-Cell Lymphoma with Central Nerve System Metastasis

Cutaneous gamma/delta T-cell lymphoma is an extremely rare and highly aggressive tumor that is often resistant to treatment, such as polychemotherapy and radiotherapy. Due to the complexity of clinical, pathologic, and immunohistochemical features of this disease entity, the physician should perform a careful evaluation; however, treatment should be rapid and aggressive. We present a case of fatal cutaneous gamma/delta T-cell lymphoma of a 55-year old woman who died after recurrence with central nerve system metastasis.

Impact of Psoriasis on Quality of Life: Relationship between Clinical Response to Therapy and Change in Health-related Quality of Life

BACKGROUND: Psoriasis exerts significant, negative, impact on patients' quality of life (QOL). Recently, the relationship between QOL and skin lesion improvement has been emphasized in the treatment of psoriasis patients. OBJECTIVE: The purpose of study was to compare the QOL in psoriasis and other skin diseases, and to evaluate the generic QOL, skin specific QOL, stress, depression and anxiety before and after treatment in patients. METHODS: A total of 138 patients with psoriasis were recruited in this study and 83 patients complete the questionnaire at week 16. Questionnaires were comprised of generic WHO QOL scale, dermatology specific questionnaires (Skindex-29), psoriasis life stress inventory (PLSI), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). Clinical response was assessed by the PASI. RESULTS: After treatment, health-related QOL was improved and PASI improvement showed smaller correlation with Skindex-29, compared with the correlations between self-reported severity score (SRSS) improvement and Skindex-29. Regression analysis revealed that duration, SRSS, stress, and depression were factors affecting baseline HRQOL in patients, and age, duration, and SRSS were predictors associated with HTQOL score changes. CONCLUSION: Treatment improved HRQOL, BAI, BDI, and PLSI scores. Psoriasis may become more burdensome in groups of patients who suffer long disease duration, high SRSS, depression, and stressful environments.

A Case of Tinea Faciei Caused by Trichophyton mentagrophytes with Atypical Presentation / 대한의진균학회지

Tinea faciei is a dermatophyte infection of the glabrous part of facial skin most commonly caused by the Trichophyton species. Tinea faciale has been classified as part of tinea corporis but recently for its unique features, it is being considered a separate disease entity. Tinea faciale is a relatively rare dermatophytosis and is characterized by clinical polymorphism, which leads to frequent misdiagnosis and mistreatment with corticosteroids. Long term treatment with glucocorticoids can subsequently lead to tinea incognito. Herein we describe an unusual case of tinea faciei caused by T. mentagrophytes in a 40-year-old women with erythematous facial eruptions, initially misdiagnosed as allergic contact dermatitis and rosacea. By using mycological and histological examinations, dermatophytosis caused by Trichophyton mentagrophytes was confirmed. Oral terbinafine was administered together with topical clotrimazole and hydrocortisone for 4 weeks.

Perforating Lichen Nitidus Associated with Oral Lichen Planus / 대한피부과학회지

Lichen planus is an unique, common inflammatory disorder that affects the skin, mucous membranes, nails and hair. Oral lichen planus is among the more common mucosal conditions with an unknown etiology. Lichen nitidus is an uncommon, usually asymptomatic cutaneous eruption that is characterized by the presence of multiple, small, flesh colored papules. Perforation in lichen nitidus is a rare phenomenon. Lichen nitidus is distinguished from lichen planus on both clinical and histologic grounds. However, the possibility that lichen nitidus represents a micropapular variant of lichen planus has never been definitively excluded. Herein, we report on a case of perforating lichen nitidus associated with oral lichen planus.

A Case of Pressure Urticaria Treated with a Leukotriene Inhibitor / 대한피부과학회지

Delayed pressure urticria is a type of physical urticaria, characterized by the appearance of painful swelling for a few hours after physical stimulus. A 27-year-old woman suffered from pressure urticaria for eight months. The patient was unresponsive to conventional antihistamine, glucocorticoid, cyclosporine and azathioprine. Since the patient was treated with 10 mg/day montelukast and 1 mg/day ketotifen for 10 months, erythema and wheals have not developed. We report a case of pressure urticaria treated with a leukotriene inhibitor.

A Case of Congenital Isolated Collagenoma on the Scalp / 대한피부과학회지

Collagenomas, or connective tissue nevi of the collagen type, represent a hamartomatous overgrowth of normal collagen. Isolated collagenoma is rare and most commonly presents in childhood. We herein report a rare case of congenital isolated collagenoma on the scalp without any associated abnormality. A 4-year-old boy with normal development presented with 2x1.5 cm sized, soft, dome-shaped brownish nodule on the scalp. Histopathologic study revealed collagen bundles with thickened appearance, a condition consistent with collagenoma.

A Case of Milia en Plaque on the Finger / 대한피부과학회지

Milia en plaque (MEP) is an unusual and rare variant of milia characterized by tiny papules overlying an erythematous plaque. The majority of cases have been described as occurring around the ears. The histopathologic finding is consistent with milia. Despite its benign nature and lack of symptoms, MEP raises cosmetic concerns. We report a case of MEP occurring on the left 3rd finger, an unusual location, in a 2-year-old girl.

A Case of Diffuse Plane Xanthoma Associated with Diffuse Large B Cell Lymphoma / 대한피부과학회지

Diffuse plane xanthoma is a group of plane xanthomas that present in yellow to yellowish-brown flat patches on the periorbital area, neck, upper trunk and flexural folds. It is rare and often associated with reticulo-endothelial malignancies such as multiple myeloma, monoclonal gammopathy of unknown significance and other lympho-proliferative disorders. We report a case of diffuse plane xanthoma associated with monoclonal gammopathy of unknown significance and diffuse large B cell lymphoma in a 75 year-old woman.

A Case of Infantile Digital Fibromatosis in a 12-Year-Old Child, and This Was Treated with a CO2 Laser / 대한피부과학회지

Infantile digital fibromatosis is a rare benign fibrous tumor that may typically present as a solitary or multiple lesions on the fingers and toes with the histopathological features of fibroblasts with intracytoplasmic inclusion bodies. It commonly presents at the time of birth or it develops within the first year. We reported here on a case of a 12-year-old female with a solitary asymptomatic dome-shaped, firm erythematous nodule on the left 5th finger of 3 years duration. The lesion was histopathological diagnosed as infantile digital fibromatosis. We treated the lesion with a CO2 laser and recurrence was not identified during the 10-month follow-up period.

The Acute Effect of Estrogen on Vascular Responses and Plasma Endothelin-1 Level in Postmenopausal Women

BACKGROUND AND OBJECTIVES: Although estrogen replacement therapy has been associated with reduction of cardiovascular events in postmeno-pausal women (PMW), the underlying mechanisms are pooly understood. Because the beneficial effect of estrogen on vasomotor function and production of vasoconstrictive endothelin-1 may be a mechanism by which cardiovascular disease events are reduced, we accessed the acute effect of estrogen on endothelial dependent, independent vasodilaton and plasma endothelin-1 level and investigated whether the acute effect of estrogen on vascular response is related to reduced circulating plasma endothelin-1 level. MATERIALS AND METHOD: The diameter of the brachial artery at rest, during reactive hyperemia (FMV) and to response to nitroglycerine (NMV) were measured using high resolution ultrasound. Twenty-one PMW, 523 years old, 8 of whom had hypercholesterolemia were included and randomized to receive placebo, conjugated estrogen 2.5 mg and 5.0 mg with one week between each investigation. FMV and plasma endothelin-1 were assessed before and 30 minutes after iv administration of each substance. Sublingual nitroglycerine (NG) was given at the end of each investigation and NMV was measured. RESULTS: FMV and plasma endothelin-1 were not changed after placebo administration. FMV increased sinigicantly only after administration of CE 5.0 mg in healhy PMW and both after administration of CE 2.5 and 5.0 mg in PMW with hypercholesterolemia. NG induced more significant vasodilation after administration of estrogen than placebo in only PMW with hypercholesterolemia. Plasma endothelin-1 level decreased significantly after administration of CE 5.0 mg in PMW with hypercholesterolemia. We could not find direct correlation between increase of FMV and decrease of plasma endothelin-1 level. CONCLUSION: IV administration of conjugated estrogen improves endothelium-dependent vasodilation in PMW and may improve endothelium-independent vasodilation in PMW with hypercholesterolemia. These finding may be partly originated by reduced plasma endothelin-1 level after estrogen administration.

Cytomegalovirus Retinopathy in Aequired Immunodeficieney Syndrome

Cytomegalovirus retinopathy(CMV)is a necrotizing retinitis which can occur as a late manifestation of the Acquired immunodeficiency syndromde(AIDS), which rapidly increases in number after original description of the disease in 1981 by Gottliebet al. We experienced a patient, who complained of decreased visual acuity of the left eye only we initially diagnosed the patient as CMV retinitis, and during the course of treatment, finally diagnosed the patient as CMV retinitis with AIDS, and the patient was subdivided into Group IV, Subgroup C by center for disease control classification system To our knowledge, for about 10% of the patient of the CMV retinopathy, AIDS was diagnosed like same manner as we did, but we couldn't find any report in korea, so we report this case with a review of literatures.

Clinical Study of Traumatic Hyphema

We reviewed 114 patients who were admitted and treated at the Chonju Presbyterian Medical Center between 1986 and 1990 for nonperforating traumatic hyphema. Of these 114 cases, 103 (90.4%) were male and 11 (9.6%) were female. Mostly, they were under 20 years of age. Grade I hyphema (bleeding less than one third of anterior chamber) was 72 cases (63.2%). The causes of injuries were blows to the eye (56 cases, 49%) and projectile objects (45 cases, 39.5%). Associated injuries to the eye and periocualr structures occurred in 78 patients (68.4%), which were angle recession (23.7%), eyelid laceration (20.2%), increased intraocular pressure (16.7%), traumatic cataract (14.0%). Secondary hemorrhage occurred in 15 patients (13.2%) and was significantly more frequent among patients whose initial hyphema filled more than one therd of the anterior chamber. The final visual acuity were worse in eye with associated ocular injuries such as vitreo-retinal disorders, traumatic cataracts, etc.

Clinical Study of Traumatic Hyphema

We reviewed 114 patients who were admitted and treated at the Chonju Presbyterian Medical Center between 1986 and 1990 for nonperforating traumatic hyphema. Of these 114 cases, 103 (90.4%) were male and 11 (9.6%) were female. Mostly, they were under 20 years of age. Grade I hyphema (bleeding less than one third of anterior chamber) was 72 cases (63.2%). The causes of injuries were blows to the eye (56 cases, 49%) and projectile objects (45 cases, 39.5%). Associated injuries to the eye and periocualr structures occurred in 78 patients (68.4%), which were angle recession (23.7%), eyelid laceration (20.2%), increased intraocular pressure (16.7%), traumatic cataract (14.0%). Secondary hemorrhage occurred in 15 patients (13.2%) and was significantly more frequent among patients whose initial hyphema filled more than one therd of the anterior chamber. The final visual acuity were worse in eye with associated ocular injuries such as vitreo-retinal disorders, traumatic cataracts, etc.

A Case of Optic Disc Pit

Optic disc pits are an uncommon congenital anomaly of the optic nerve head. Serous detachment of the macula is a well known complication in patients with an optic disc pit Although spontaneous reattachment has been reported, most eye with macular detachment associated with optic disc pit have a poor visual prognosis inspite of treatments. We have experienced a case of optic disc pit associated with serous macular detachment, that has been treated with argon pure green laser photocoagulation, reporting it with a review of literature.