Three Cases of Recalcitrant Pediatric Tinea Capitis Successfully Treated with Griseofulvin

Tinea capitis is an infection of the scalp hair follicles and surrounding skin that primarily occurs in prepubertal children. Microsporum canis remains the most common pathogen causing tinea capitis in Asian countries, including South Korea, although the causative organism of this condition varies across geographical regions and time periods. Systemic antifungal agents are the mainstay treatments for tinea capitis; however, the therapeutic responses to antifungal drugs may vary depending on the causative species, and treatment failure may occur owing to drug resistance. Although dermatophytosis resistant to clinical treatment have been increasingly encountered, recalcitrant tinea capitis cases have rarely been reported. Herein, we report three cases of tinea capitis caused by M. canis in children. All three patients showed unsatisfactory clinical responses to prolonged courses of oral terbinafine or itraconazole without achieving mycological cure; however, they were successfully treated with oral griseofulvin. Although griseofulvin is not currently available or licensed for use in many countries, including South Korea, it is one of the most effective agents against Microsporum species and remains the most widely used first-line treatment for tinea capitis in children, based on dermatology textbooks and reliable treatment guidelines.

Clinical, Pathological, and Dermoscopic Features of Pityriasis Rotunda / 대한피부과학회지

Background@#Pityriasis rotunda (PR) is a rare dermatosis characterized by the presence of multiple, strikingly circular or oval-shaped, sharply demarcated, and scaly hyperpigmented patches. Its etiology remains poorly understood. To date, there have been no comprehensive analyses of PR in Koreans. @*Objective@#To investigate the clinical, pathological, and dermoscopic features of PR. @*Methods@#Sixteen patients with PR were evaluated. @*Results@#A female preponderance was observed (male:female ratio 1:7), and the mean age of the patients was 33.2±16.1 years (range, 15∼68 years), with the peak incidence observed in patients in their 20s. Notably, all the lesions developed on the trunk. The most common clinical diagnosis is PR. Histologically, PR appears similar to ichthyosis vulgaris. Hyperkeratosis was mainly ortho-keratotic, with plugs observed within hair follicles, elongated rete ridges, diminished stratum granulosum, enhanced pigmentation of the basal layer, pigmentary incontinence, and sparse superficial perivascular lymphoid cell inflammatory infiltrate. Periodic acid-Schiff staining was negative for fungi. Hyperpigmented patches with occasional scales were separated from each other by paler striae on dermoscopy. @*Conclusion@#PR commonly presents as multiple round lesions of variable sizes on the trunk of patients in their 20s. They showed characteristic findings, including hyperkeratosis with relative focal hypogranulosis, histopathologically, and some lesions showed dark and light brown polygonal patches with paler striae arranged dermoscopically, in a mosaic pattern. This was a retrospective single-center study with a small sample size; however, we believe that this paper will contribute to the clarification and understanding of PR.

Cutaneous Mycobacterium massiliense Infection Caused by Skin Coining ‘Gua Sha’ in Korean Healthy Female

Nontuberculous mycobacteria are ubiquitous environmental organisms that are rare pathogens in immunocompetent individuals. However, cutaneous nontuberculous mycobacteria infections have been increasingly associated with invasive procedures, including surgery, liposuction, filler injection, intramuscular injection, mesotherapy, piercing, acupuncture, and cupping therapy. Herein, we report the first case of cutaneous nontuberculous mycobacteria infection caused by the East-Asian traditional treatment ‘Gua Sha’, also known as scraping, coining or spooning in English. A 35-year-old healthy female presented with widespread, painful skin nodules and pustules on her upper and lower extremities that had developed after Gua Sha treatment for body contouring. Histopathologic examination of the lesions revealed granulomatous inflammation in the dermis and the culture isolates were identified as Mycobacterium massiliense with molecular identification. The patient was successfully treated with intermittent incision and drainage of persistent nodules and oral clarithromycin based on antimicrobial susceptibility testing. We recommend implementation of a standard safety protocol for Gua Sha practitioners to minimize the risk of infection transmission.

Sarcomatoid Squamous Cell Carcinoma of the Lower Lip: A Case Report / 대한피부과학회지

Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months.His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy.

Sarcomatoid Squamous Cell Carcinoma of the Lower Lip: A Case Report / 대한피부과학회지

Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months.His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy.

Pityriasis Amiantacea: An Epidemiologic Study of 44 Cases in Korean Patients

No abstract available.

Cutaneous Carcinosarcoma: a Clinicopathologic and Immunohistochemical Analysis of 11 Korean Cases

BACKGROUND: Cutaneous carcinosarcoma is a rare biphasic tumor comprising malignant epithelial and heterologous mesenchymal elements. Data on the clinical and histopathologic characteristics of this tumor in Asian populations are not available. The purpose of this study was to investigate the clinicopathologic and immunohistochemical features of cutaneous carcinosarcoma in the Korean population. METHODS: We retrospectively reviewed the records of 11 patients with cutaneous carcinosarcoma who were diagnosed from 2006 to 2016. RESULTS: The mean patient age at diagnosis was 71.5 years (range, 43–96 years) and there was a men predilection. The most common site of cutaneous carcinosarcoma was the head and neck (8/11, 72.7%). Histopathologically, most tumors showed a characteristic morphology consisting of two types of tumor cells, varied differentiated epithelial cells (such as basal or squamous cells) and spindle cells with transition zones between the two components. These two cell types also demonstrated variable immunohistochemical characteristics. CONCLUSION: Although the number of cases in this study was limited, our results provide valuable insight into the clinical and histopathologic characteristics of cutaneous carcinosarcoma in the Korean population.

Subungual Exostosis of the Little Finger: A Case Report and Review of the Literature in Korea / 대한피부과학회지

No abstract available.

Squamous Cell Carcinoma Arising in an Amputation Stump / 대한피부과학회지

Amputation of the lower extremities followed by the use of an artificial leg is very common. However, malignancy arising in an amputation stump is an extremely rare event. In this report, we describe a case of squamous cell carcinoma arising in the amputation stump of a 56-year-old Korean man. To the best of our knowledge, similar cases have not been previously reported in Korea.

A Case of Spiny Keratoderma on Both Hands and Feet in a Middle-aged Man / 대한피부과학회지

No abstract available.

Familial Pityriasis Rubra Pilaris in Siblings / 대한피부과학회지

No abstract available.

Isolated Phthiriasis Palpebrarum in an Elderly Woman: Diagnosis and Treatment Using by Dermoscopy

No abstract available.

Role of Hair Prostheses (Wigs) in Patients with Severe Alopecia Areata

No abstract available.

Multiple Oral Syphilitic Chancres in a Homosexual Man / 대한피부과학회지

No abstract available.

Nodular Cutaneous Mucinosis as an Initial Presentation of Systemic Lupus Erythematosus / 대한피부과학회지

It is well recognized that the deposition of mucin occurs in areas of eruption in patients with lupus erythematosus. However, nodular cutaneous mucinosis is regarded as a rare distinctive cutaneous mucinosis in which the mucin deposition occurs in areas other than the sites of eruption in patients with systemic lupus erythematosus and manifests as a clinically specific lesion. Although several cases have been described in the literature, there have been only two reported cases in Korean literature. Thus, we report an interesting case of nodular cutaneous mucinosis that occurred in a young man. A 16-year-old man visited our clinic presenting with multiple soft subcutaneous nodules on his back for 6 months. He denied any other symptoms. Histological examination showed diffuse mucin deposition throughout the superficial and mid-reticular dermis. The abnormal laboratory values were as follows: a positive antinuclear antibody, increased anti-dsDNA, and reduced WBC count and C3 levels. He was diagnosed with nodular cutaneous mucinosis with systemic lupus erythematosus and treated with oral hydroxychloroquine and methylprednisolone. Our report is of interest owing to the rarity of developing nodular cutaneous mucinosis as an initial presentation of systemic lupus erythematosus.

Intestinal Pseudoobstruction Associated with Herpes Zoster / 대한피부과학회지

No abstract available.

A Case of Bilateral Tinea Manus and the Frequency of the Superficial Fungal Hand Infection (1997-2016) / 대한의진균학회지

Dermatophytosis of the palm of the hands (tinea manus) tends to involve one hand. We encountered a case of bilateral tinea manus in a patient with type 1 diabetes mellitus and bilateral tinea pedis. A 57-year-old man presented for evaluation of hyperkeratotic lesions on both his palms and soles. Skin examination revealed hyperkeratotic scaly lesions on the palmar surfaces of his hands and plantar surfaces of his feet. Yellow discoloration and thickening were observed on both his nails. Fasting venous plasma glucose concentration and hemoglobin A1c levels were 332 mg/dL and 7.5%, respectively. Fungus cultures revealed white colonies with brown color on the reverse side in a 14-day incubation period. Trichophyton rubrum infection was identified using polymerase chain reaction with amplified internal transcribed spacer regions. He was treated with oral fluconazole (150 mg/week) and topical flutrimazole spray. In addition, we examined the frequency of 77 superficial fungal hand infections (age, sex, seasonal distributions and coexisting fungal infections) among patients who visited the dermatologic clinic of Chonbuk University Hospital between January 1997 and December 2016.

Subcutaneous Angiomyxolipoma: Report of a Case and Review of the Literature / 대한피부과학회지

Angiomyxolipoma is a recently described and rare variant of lipoma that is characterized by the proliferation of adipose tissue with a myxoid stroma and multiple thick and thin-walled blood vessels. A 51-year-old man presented with a tender subcutaneous nodule on his right arm. The tumor was completely removed by excisional biopsy, and the histopathologic features revealed a thin fibrous capsule with incomplete fibrous septa extending into the lesion, dividing it into lobules of different sizes. The fat cells were mature, with a single vacuole and an eccentric nucleus. The vascular component consisted of groups of capillaries and occasional vessels of larger caliber. Erythrocytes were present within the lumen, and myxoid stroma was found. He was diagnosed as having angiomyxolipoma. Herein, we report a rare case of subcutaneous angiomyxolipoma of the arm. We also review and discuss such cases in the literature.

Tumor Necrosis Factor Alpha Blocker-Induced Erythrodermic Sarcoidosis in with Juvenile Rheumatoid Arthritis: A Case Report and Review of the Literature

The development of cutaneous sarcoidosis as a paradoxical adverse event of tumor necrosis factor alpha (TNF-α) blockers has been reported in the literature; however, an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy has not yet been reported. Herein, we report the first case of an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy and review previous studies of cutaneous sarcoidosis. A 6-year-old Korean girl who had been suffering from juvenile rheumatoid arthritis presented with generalized erythematous skin eruption involving more than about 90% of her body surface area. After 14 months of etanercept treatment, the new erythematous skin eruption had developed and progressed into generalized erythroderma. Exclusion of suspected co-medication had been performed based on medication history. She had no other systemic symptoms, and ophthalmologic and neurologic examinations were normal. Histopathologic findings of the skin lesion revealed diffuse non-caseating granulomatous infiltrates composed of epithelioid histiocytes with sparse lymphocytes involving the entire dermis. Periodic-acid-Schiff and acid-fast stains were negative, and acid-fast bacilli was not detected by polymerase chain reaction of the skin biopsy. Based on clinicopathologic findings, she was diagnosed with etanercept-induced sarcoidal granuloma. After discontinuation of the suspected agent, the lesions spontaneously disappeared.

Tumor Necrosis Factor Alpha Blocker-Induced Erythrodermic Sarcoidosis in with Juvenile Rheumatoid Arthritis: A Case Report and Review of the Literature

The development of cutaneous sarcoidosis as a paradoxical adverse event of tumor necrosis factor alpha (TNF-α) blockers has been reported in the literature; however, an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy has not yet been reported. Herein, we report the first case of an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy and review previous studies of cutaneous sarcoidosis. A 6-year-old Korean girl who had been suffering from juvenile rheumatoid arthritis presented with generalized erythematous skin eruption involving more than about 90% of her body surface area. After 14 months of etanercept treatment, the new erythematous skin eruption had developed and progressed into generalized erythroderma. Exclusion of suspected co-medication had been performed based on medication history. She had no other systemic symptoms, and ophthalmologic and neurologic examinations were normal. Histopathologic findings of the skin lesion revealed diffuse non-caseating granulomatous infiltrates composed of epithelioid histiocytes with sparse lymphocytes involving the entire dermis. Periodic-acid-Schiff and acid-fast stains were negative, and acid-fast bacilli was not detected by polymerase chain reaction of the skin biopsy. Based on clinicopathologic findings, she was diagnosed with etanercept-induced sarcoidal granuloma. After discontinuation of the suspected agent, the lesions spontaneously disappeared.