Creeping Hair in the Beard Area

No abstract available.

Do Interventional Pain Management Procedures during the Acute Phase of Herpes Zoster Prevent Postherpetic Neuralgia in the Elderly?: A Meta-Analysis of Randomized Controlled Trials

No abstract available.

Treatment of Cultured Sebocytes with an EGFR Inhibitor Does Not Lead to Significant Upregulation of Inflammatory Biomarkers

BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors are being used to treat malignancies originating from epithelia. Unfortunately, blocking the EGFR pathway leads to various side effects, most frequently acneiform eruptions. OBJECTIVE: To probe the mechanism underlying this side effect, we investigated the effect of EGFR inhibitors on cultured sebocytes. METHODS: To examine the effects of an EGFR inhibitor (cetuximab, Erbitux(R) 10 ng/ml) and the effects of EGFR ligands, such as epidermal growth factor (EGF, 10 ng/ml) and transforming growth factor-alpha (TGF-alpha, 5 ng/ml), on the production of inflammatory cytokines in cultured sebocytes, we used reverse transcriptase-polymerase chain reaction, immunocytofluorescence and Western blots. Outcomes included the expression of interleukin (IL)-1, IL-6, tumor necrosis factor-alpha (TNF-alpha), peroxisome proliferator-activated receptor-gamma (PPAR-gamma) and EGFR. RESULTS: There were no significant differences in the expression of IL-1, IL-6, TNF-alpha, PPAR-gamma and EGFR between (a) groups treated with an EGFR inhibitor or an EGFR ligand and (b) the control group, except for a significant increase in the expression of IL-1 in the EGF-treated group. CONCLUSION: EGFR inhibitors and EGFR ligands do not provoke the expression of inflammatory biomarkers in cultured sebocytes. The role of the sebaceous glands in EGFR inhibitor-induced acneiform eruption should be investigated more thoroughly.

Multiple Nevus Sebaceous Occurring on the Scalp and on the Contralateral Side of the Face

Nevus sebaceous (NS) is a benign neoplasm occurring mainly on the face and scalp. It commonly occurs as a solitary, well-demarcated lesion. This paper presents a case of multiple nevus sebaceous, which presented as multiple lesions occurring on the temporal scalp and on the contralateral side of the chin. Multiple NS have only rarely been reported.

Usefulness of a Silicone Wound Contact Layer for Securing a Full Thickness Skin Graft / 대한피부과학회지

BACKGROUND: The tie-over dressing is the classic dressing method for a full thickness skin graft (FTSG) to secure the graft on the skin defect. Although many methods to secure the graft have currently been employed, they have some disadvantages such as stretching discomforts and irregular pressure delivery to the graft, resulting in partial necrosis or surface irregularity. OBJECTIVE: The aim of this study was to evaluate the usefulness of a porous, flexible and distensible silicone wound contact layer (Mepitel(R)) for securing a graft as a bolster fixation in FTSG reconstruction. METHODS: Sixty seven patients with surgical defects following mainly malignant tumor excision were included in this study. After suturing and bolstering the graft in place, a piece of silicone contact layer was used to cover the graft, and then second sutures were placed to apply uniform pressure. RESULTS: Thirty three cases of basal cell carcinoma, 14 cases of malignant melanoma and 10 cases of squamous cell carcinoma were included as a cause of the defects. Forty six defects were located on the head and neck, and the rest were on the trunk and extremities. The size of the surgical defects ranged from 0.5 to 14.0 cm at the greatest diameter (mean: 4.0 cm). One major and 1 minor loss of graft developed. Mild to moderate scar formation, mainly marginal elevation, occurred in 9 patients. Sixty five percents of the patients who had facial defects were satisfied with their results. CONCLUSION: We suggested that a silicone wound contact layer for bolster fixation might be a useful material to secure a FTSG, and this is easy to apply and the resulting cosmesis is good and there are few problems with using it.

A Case of Multiple Primary Cutaneous Melanoma / 대한피부과학회지

According to Western reports, there's a 1~8% possibility that multiple melanomas can occur in one individual. Although two melanomas occurring simultaneously or metachronously on different areas of the skin in a patient are rare and this has not yet been reported in the Korean dermatological literature, there could be two possible explanations. One is cutaneous recurrence/metastasis from a primary cutaneous melanoma (PCM) and the other is development of another new PCM, and this is the so called multiple primary cutaneous melanoma (MPCM). We report here on a 72-year-old man who presented with a subungual melanoma on the right thumb (T2bN0M0, duration: 3 years) and the other melanoma was on the right sole (TisN0M0, duration: 10 years). We could not find any evidence of recurrence/metastasis on the physical examinations and various imaging studies. Pathological differences were shown between the 2 melanomas and, more importantly, the differences were anatomically irrelevant. So, we diagnosed the lesions as MPCM instead of recurrence/metastasis of PCM or other possibilities.

Clinicopathological Observation of Hemangioma of Infancy: The Diagnostic Usefulness of GLUT-1 Immunohistochemical Stain / 대한피부과학회지

BACKGROUND: Hemangioma of infancy (HOI) is one of the most common tumors in childhood. Their clinical features can on occasion look like those of other vascular tumors and malformations, so the correct differentiation of HOI may not always be easy. OBJECTIVE: The purpose of this study was to review the clinicopathological features of HOIs and to particularlyexamine the usefulness of glucose transporter protein isoform-1 (GLUT-1) immunohistochemical stain (IHS) as a specific marker of HOI. METHODS: This study was conducted at the Vascular Anomaly Clinic of Kyungpook National University Hospital during 11 years (1998~2008). Sixty-two cases were selected in addition to selecting other tumors and malformation as a control group. We then reviewed their clinical features and the results of H&E and GLUT-1 IHS for making the differential diagnosis. RESULTS: The male to female ratio was 1 : 2.88. The head and neck were the most commonly involved sites. The complications included ulceration and/or bleeding (12.9%), scarring (9.7%), infection (4.8%), ocular complications (4.8%) like visual axis occlusion, and pain (1.6%). Three phases of proliferating, involuting and involuted of a HOI comprised 11.3%, 37.1% and 51.6% of the lesions, respectively, from the clinical view point and 11.3%, 48.4% and 40.3% of the lesions, respectively, from the pathological point of view. GLUT-1 was positively expressed on almost all of the HOIs (47/57, 82.5%), except for 10 HOIs of the involuted phase and the other controls. CONCLUSION: The clinicopathological findings of this study were similar with those of the previous reports. The expression of GLUT-1 by a HOI can be helpful to make the correct diagnosis from other vascular tumors and malformations.

Verrucous Hemangioma and Angiokeratoma: Their Similarilities and Differences according to the Clinicopathological Features / 대한피부과학회지

BACKGROUND: Verrucous hemangioma (VH) and angiokeratoma (AK) are vascular birthmarks of an unclear nosology and these birthmarks commonly show a superficial hyperkeratotic vascular component. There are both similarilities and differences between VH and AK with some confusion concerning their overlapping features. OBJECTIVE: This study was undertaken to review the clinicopathological features of VHs and AKs and to determine the similarilities and differences between them. METHODS:We retrospectively reviewed 11 VHs and 7 AKs at the Vascular Anomaly Clinic of our hospital over the past 10 years. They were evaluated from the clinicopathologic point of view for factors such as the age of onset, location, size, symptoms, the histopathological epithelial change and involvement of deeper tissue. RESULTS: These birthmarks share common clinical features with the exception of gender and lesion size. Histopathologically, hyperkeratosis, acanthosis and capillary dilatation in the upper dermis were commonly seen. Yet lobular proliferation and dilatation of blood vessels in the deep dermis, or more importantly, the subcutis were detected in VH only. Furthermore there was a case of VH that showed diffusely scattered increased blood vessels in the subcutis, suggesting an evolving stage of VH and there was another case of VH that was erroneously diagnosed as AK via the initial biopsy, and the final diagnosis was changed according to the excised lesion. CONCLUSION:The two diseases share most of their clinicopathological features, but small parts of features like gender, the clinical size and the histological deep dermis/subcutis involvement were differences. Making the correct differential diagnosis between VH and AK through a deep biopsy with appropriate timing and long-term follow-up and/or radiological examination is helpful to avoid erroneous management.

Seven Cases of Acquired Digital Arteriovenous Malformation / 대한피부과학회지

Acquired digital arteriovenous malformation (ADAVM) consists of an abnormal connection between the arteriole and venule in the acral area of extremities, particularly the fingers. Clinically, the lesions appear as small, slightly- elevated, dark brown erythematous macules on the distal part of fingers. The histological specimens shows close approximation between thin-walled venule and thick-walled arteriole and possibly a direct arteriovenous shunt adjacent to each other lying in the dermis. We herein report seven stereotypical cases of ADAVM.

Metastasectomy for a Malignant Melanoma Patient with Soft Tissue Metastasis / 대한피부과학회지

Patients with stage IV metastatic melanoma have been traditionally managed with mainly palliative therapy such as chemotherapy, radiation therapy or biologic therapy, yet their overall survival is unsatisfactory. Several recent series have indicated a long-term survival benefit after complete resection, (termed "metastasectomy") of distant metastatic foci in patients with metastatic melanoma. Unlike other palliative modalities, surgery like metastasectomy can rapidly render a patient clinically disease-free with rather minimal morbidity, a short-term of hospitalization and a quick recovery time. This may prolong the survival and improve the quality of life of patients with stage IV melanoma if all the clinicoradiologically-evident tumors can be completely resected. We report herein on a case of performing metastasectomy in a patient who had malignant melanoma with soft tissue metastasis of the breast (T3a/bN0M1a), even though there was a regrettable result.

A Case of Recalcitrant Pyoderma Gangrenosum Treated by Infliximab / 대한피부과학회지

Pyoderma gangrenosum is an uncommon, neutrophilic, ulcerating, chronic dermatosis with obscure etiology. Many therapeutic modalities have been used in the past, but they have not always provided favorable outcomes. Recently, tumor necrosis factor-alpha inhibitors have been gaining attention in the treatment of recalcitrant pyoderma gangrenosum. A 57-year-old woman presented with painful, recurrent erythematous nodules and ulcers on both legs. She had been treated with systemic steroids, immunosuppressants, dapsone, and colchicine, and she experienced improvement with systemic steroids only. After using infliximab (5 mg/kg), she experienced dramatic improvement in her lesions. Thus, we report a recalcitrant case of pyoderma gangrenosum that was successfully treated with infliximab.

Reconstruction of Defects on the Lower Part of the Nose using Nasalis Island Pedicle Flap / 대한피부과학회지

Reconstruction of surgical defects of the nose, particularly the lower one third, is often challenging. The skin of this area is less mobile and fixed on lower structures without a subcutaneous fatty layer. Thus, dissection of tissues is rather difficult and more bleeding can occur during dissection. Furthermore, flap surgery will fail if the flap extends too far. Local flap surgery is one of the more useful techniques that maintains the function and aesthetics of a normal nose. Among these, the nasalis muscle is relatively easy and provides better outcomes. More importantly, vascular supplies from the underlying muscular structure provide greater viability. Additional movement can be achieved by either dissecting under the transverse nasalis or by dividing the transverse nasalis beyond the midline. We report 5 cases of nasalis island pedicle flaps using nasalis muscles. The final results were relatively satisfactory for both functional and cosmetic aspects.

Two Cases of Lichen Planus Pigmentosus-inversus Arising from Long-standing Lichen Planus-inversus

Lichen planus pigmentosus-inversus (LPP-inversus) is an extremely rare variant of lichen planus (LP), and only a few cases have been reported. Its course is characterized by exacerbations and remissions, and it is known to be more chronic than classical LP is. We report two cases of LPP-inversus and offer the suggestion that LPP-inversus may originate from LP of flexural areas.

A Case of Tinea Corporis Caused by Microsporum ferrugineum / 대한의진균학회지

Microsporum (M.) ferrugineum has almost disappeared in Korea after three cases of tinea capitis that were reported in Jeonbuk province in 1993. It was most common cause of tinea capitis in Korea until 1970s. M. ferrugineum produces abundant chlamydospores. Another characteristic of the species is the production of distorted faviform hyphae and long, straight hyphae with thick septa that resemble segments of bamboo. We report a case of 27-year-old female with tinea corporis caused by M. ferrugineum.

A Case of Squamous Cell Carcinoma with Nodal MetastasisConfirmed by Sentinel Lymph Node Biopsy / 대한피부과학회지

Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer and the majority of such patients can be easily treated with a relatively low risk of recurrence and metastasis. However, there are subgroups of SCC that are at a higher risk, depending on patient's or tumor's characteristics. A greater part of the metastases from these high-risked SCCs spread towards the regional lymph nodes, whereas distant metastases are relatively uncommon. Early identification of nodal metastasis can allow the selective and timely inclusion of possible high-risked SCC patients into more aggressive treatments and meticulous follow-up protocols for achieving potential survival benefit. Therefore, sentinel lymph node biopsy (SLNB) is popular in the management of malignant melanoma, and it may also be useful to detect regional metastasis of high-risked SCCs. This procedure could also spare node-negative patients the morbidity of unnecessary additional therapy, like elective lymph node dissection. We report herein on a case of SCC with regional nodal metastasis, which is confirmed by SLNB.

A Case of Squamous Cell Carcinoma with Nodal MetastasisConfirmed by Sentinel Lymph Node Biopsy / 대한피부과학회지

Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer and the majority of such patients can be easily treated with a relatively low risk of recurrence and metastasis. However, there are subgroups of SCC that are at a higher risk, depending on patient's or tumor's characteristics. A greater part of the metastases from these high-risked SCCs spread towards the regional lymph nodes, whereas distant metastases are relatively uncommon. Early identification of nodal metastasis can allow the selective and timely inclusion of possible high-risked SCC patients into more aggressive treatments and meticulous follow-up protocols for achieving potential survival benefit. Therefore, sentinel lymph node biopsy (SLNB) is popular in the management of malignant melanoma, and it may also be useful to detect regional metastasis of high-risked SCCs. This procedure could also spare node-negative patients the morbidity of unnecessary additional therapy, like elective lymph node dissection. We report herein on a case of SCC with regional nodal metastasis, which is confirmed by SLNB.

Four Cases of Capillary Aneurysm: Clinical Differential Diagnosis with Malignant Melanoma / 대한피부과학회지

Capillary aneurysm is classically described as a suddenly growing dark papule, and is also known as thrombosed capillary or vein. It is clinically significant that the clinical features of capillary aneurysm are closely similar to those of malignant melanoma or dysplastic nevus. The histopathological finding of capillary aneurysm reveals dilated thin-walled venule(s) just beneath the hyperplastic epidermis, lined by a single layer of endothelium and a thrombus in the lumen. This abstract focuses on four patients who presented with a dark black-colored dome-shaped nodule and clinical impression included malignant melanoma, dysplastic nevus, angiokeratoma and lymphangioma circumscriptum. We herein report four cases histologically diagnosed as capillary aneurysm, which should be considered for differential diagnosis.