A Case of Extramammary Paget's Disease of the Axilla / 대한피부과학회지

Extramammary Paget's disease is a rare cutaneous neoplasm mostly observed on the genital and perineal areas. In Korea, there has only been one report of extramammary Paget's disease occurring in the axilla. We herein report a case of extramammary Paget's disease of the axilla, confirmed by biopsy and immunohistochemical studies.

Tamoxifen Induced Corneal Opacity in Breast Cancer Patient

Since 1970's, Tamoxifen has been used as an antiestrogen agent for adjuvant hormonal therapy, targeting hormone receptor positive breast cancer. Tamoxifen has adverse side effects such as menopausal hot flush, vaginal discharge, irregular menses, thromboembolism, and uterine endometrial carcinoma. Tamoxifen has structure and side effects similar to amphiphilic cationic agents like chlorpromazine, thorazine, amiodarone, and chloroquine. With long period use in high dose, tamoxifen can cause ocular side effects such as retinal crystalline deposition, macular edema, whorl-like corneal opacities, posterior subcapsular lens opacities, optic neuritis, and affected EOG. Recently several reports showed that ocular side effect could happen even in low dose standard treatment. We experienced a case of keratopathy of corneal opacity without disorder of retina, lens, and optic nerve in low dose tamoxifen therapy for breast cancer.

A Case of Twenty Nail Dystrophy Treated with Topical Tretinoin Application / 대한피부과학회지

Twenty-nail dystrophy is a distinctive pattern of nail changes, in which all 20 nails are uniformly affected with excessive longitudinal ridging and loss of luster. It occurs at any age ranging from children to adulthood, however, it is most commonly diagnosed in children. It can be idiopathic or caused by other inflammatory dermatoses, but the exact cause and pathogenesis of these changes are so far unknown. Several treatment modalities have been employed for treatment of twenty-nail dystrophy, such as topical steroid, intralesional steroids injection, and topical PUVA, however, without much success. We herein report a case of an adults, patient with twenty-nail dystrophy which was successfully treated with topical 0.025% Tretinoin cream.

The Efficacy of Intermittent Atropine Penalization in Amblyopic Children Who Have Failed Patching Therapy

PURPOSE: The purpose of this study is to assess the effect of intermittent atropine penalization (AP) in amblyopic children who have failed patching therapy. METHODS: Twenty-one amblyopic (visual acuity in the amblyopic eye >or= 0.3) children (mean age, 7.8 years) who had failed patching therapy were treated with intermittent AP consisting of one drop of atropine 1% in the sound eye, twice per week. The visual acuity was analyzed in the cases of at least 3-month follow-up after intermittent AP. Treatment success was defined as an improvement in final visual acuity of 2 lines more than baseline visual acuity in the amblyopic eye. RESULTS: The cause of amblyopia in the 21 cases was strabismus in 10 and anisometropia in 11. The mean visual acuities (logMAR) of the amblyopic eye were +0.28 before AP and +0.07 after AP. Of the 21 patients, success was achieved in 17 (84.2%), and their mean treatment duration was 7.5 months. The compliance rate with intermittent AP was 90.1%. CONCLUSIONS: Intermittent AP could be considered for amblyopic children (visual acuity in the amblyopic eye >or= 0.3) who have failed patching therapy.

Cilioretinal Artery Occlusion Following the Intranasal Injection of Corticosteroid

PURPOSE: To report a case of cilioretinal artery occlusion following the intranasal injection of corticosteroids. METHODS: A 52-year-old man was referred to the ophthalmologic clinic due to a marked loss of vision in his right eye immediately after endoscopic sinus surgery. At that time, his vision was noted to be counting fingers in the right eye. His pupil was mid-dilated, fixed, and did not respond to light on examination. On ophthalmoscopy, macula edema with retinal ischemia, and a cherry-red spot were seen in the posterior pole of the retina. Ocular massage was carried out immediately after ophthalmologic examination. Three days later, visual acuity in the right eye improved to 0.15. Fluorescein angiography revealed filling defects of the cilioretinal artery and peripheral branches of the retinal arteries. In addition, areas of nonperfusion were observed. RESULTS: During the follow-up periods, macula edema resolved and visual acuity in the right eye improved to 1.2 after 3 months. Fluorescein angiogram was repeated and showed that the filling defects had disappeared. CONCLUSIONS: Retinal artery occlusion can occur after an intranasal injection of corticosteroids due to embolization of retinal circulation. This condition can be improved without complications by no other specific therapy.

A Staged Supra-auricular Interpolation Pedicle Flap for Upper Helical Ear Reconstruction / 대한피부과학회지

Reconstruction of partial ear defects presents a unique and notable challenge to the dermatologist. This is due to the complex architecture of the external ear which is difficult to duplicate surgically. Several procedures are available for correction of defects to the external ear. However, the diversity of external ear shapes shows how difficult it is to achieve a certain solution to this problem. We report a case of auricular squamous cell carcinoma in which the skin defect is reconstructed by a staged supra-auricular interpolation pedicle flap.

A Case of Hair Change and Acneiform Eruption Induced by ZD1839 (Iressa(R)) / 대한피부과학회지

ZD1839 (Iressa(R)) is a new anticancer agent, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that blocks signal transduction pathway implicated in the proliferation and survival of cancer cells and other host-dependent process promoting cancer growth. But this agent can induce cutaneous side effects including acneiform eruption, dry skin, and hair abnormality, which is related with the interruption of normal epidermal and hair follicular kinetics. We report a case of hair change and acneiform eruption induced by ZD1839 (Iressa(R)).

Clinical Assessment of the Patients Diagnosed with Intracranial Lesion at an Ophthalmology Clinic

PURPOSE: Intracranial lesions may produce ophthalmic symptoms as chief complaints. The purpose of this study is to help ophthalmologists make an earlier diagnosis of the presence of an intracranial lesion. METHODS: The medical records of the patients diagnosed with an intracranial lesion at the department of ophthalmology were reviewed retrospectively. RESULTS: The mean age of 38 patients (Male: Female=18: 20) was 42.2 years. Visual disturbance was the most frequent symptom at presentation (63.2%), and there was strabismus, visual field defects, diplopia, and other complaints. The underlying problem was that for 23 patients, there was an initial misdiagnosis for 10 of them as having a retinal lesion or an optic neuropathy in 10, paralytic strabismus in 9, and there were other misdiagnoses as well. There were afferent pupillary defects in 12 and optic disc abnormalities in 8 patients. The most common type of visual field defects was a bitemporal hemianopsia. The final diagnosis was the presence of a brain tumor in 28, cerebral infarction in 5, carotid-cavernous fistula in 3, aneurysm in one, and histiocytosis in one patient. CONCLUSIONS: The patients that presented with ophthalmologic symptoms were diagnosed as having variable intracranial lesions. Therefore, it is important for the ophthalmologist to pay closer attention so as to discover the specific intracranial lesion through the exam of the pupil, the optic disc, and the visual field test.

A Statistical Study of Scalp Tumors (1993-2002) / 대한피부과학회지

BACKGROUND: There were many statistical studies about skin tumors. However, no articles have been reported which focus on the scalp tumors up to the present. OBJECTIVE: The purpose of our study was to analyze the epidemiologic aspect of scalp tumors, and compare them with other data related to skin tumors. METHODS: A statistical analysis was made using 251 cases of scalp tumors which were confirmed by histopathological study from January 1993 to December 2002 at Seoul National University Hospital. RESULT: 1. In the 251 cases of scalp tumors, 197 cases (78.5%) were benign scalp tumors, and 54 cases (21.5%) were malignant scalp tumors. 2. Among the 197 cases of benign scalp tumors, the most common tumor was nevus sebaceus (19.3%), followed by seborrheic keratosis (13.7%), epidermal cyst (10.2%), trichilemmal cyst (9.1%), lipoma (7.7%), intradermal nevus (7.1%), neurofibroma (6.1%). 3. Among the 54 cases of malignant scalp tumors, the most common tumor was metastatic cancer (31.5%), followed by basal cell carcinoma (18.5%), angiosarcoma (9.3%), squamous cell carcinoma (9.3%), lymphoma (7.4%), and so on. 4. Male to female ratio of benign scalp tumor was 1.3:1 and that of malignant scalp tumor was 1.1:1 5. The distribution of age of benign scalp tumor was relatively even from childhood to old age, but that of malignant scalp tumor showed that about 70% of cases were over 4th decade. 6. The distribution of each department which performed scalp biopsy was the following ; department of dermatology (49.2%), plastic surgery (21.8%), neurosurgery (17.3%), general surgery (11.2%), pediatrics (0.5%) at benign scalp tumor and department of dermatology (37%), neurosurgery (20.4%), plastic surgery (16.7%), general surgery (7.4%), internal medicine (7.4%), urology (5.6%), otolaryngology (3.7%) and emergency medicine (1.9%) at malignant scalp tumor.

Three Cases of Lupus Miliaris Disseminatus Faciei Treated by Dapsone / 대한피부과학회지

Lupus miliaris disseminatus faciei(LMDF) is a erythematous to yellowish asymptomatic papular eruption affecting the cental of the face, which runs a chronic course and terminating spontaneously with scarring. Histopathologically, epithelioid cell granuloma with caseation necrosis is seen in the dermis. Although the disease is self limited, the etiology and pathogenesis are unknown, so there is no effective treatment for LMDF. We report 3 cases of LMDF patients treated with Dapsone with effective results compared to natural history of this disease.