A Case of Trichilemmal Horn

Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.

A Case of Fordyce's Disease with Wide Distribution

Fordyce's disease is a condition known as ectopically located sebaceous glands on the vermilion borders of the lips and oral mucosa. Clinically, it is groups of minute, yellowish, globoid macules and papules. Histologically, it is characterized by sebaceous glands not associated with hair follicles. We report on a 40-year-old man with Fordyce's disease showing particularly wide distribution on the buccal mucosa and upper lip.

Linear Focal Elastosis Associated with Striae Distensae in an Atopic Patient / 대한피부과학회지

We report a case of linear focal elastosis associated with striae distensae. A 20-year-old man presented with asymptomatic, several, striae-like yellow palpable bands extending horizontally in the lumbar region. Histologic examination revealed many fine wavy and fragmented bundles of elastic fibers in the dermis. Striae distensae were also presented in the buttock, axilla. He had been treated with topical steroids for atopic dermatitis since childhood. This patient can be one more case to support the association between linear focal elastosis and striae distensae.

A Case of Trichotillomania Associated with Diffuse Neurofibroma / 대한피부과학회지

A 13-year-old girl presented in our unit with progressive alopecia and a long history of edematous scalp in the occiput. Biopsy specimen of a lesion showed two-type pathologic abnormality consisting of diffuse neurofibroma in the lower portion and trichotillomania in the upper portion. Since the tumor spread diffusely through the lower dermis and subcutaneous fat tissue without destroying surrounding structures, we concluded that the trichotillomania might result from repetitive scratching or other traumatic behavior at the same site of underlying diffuse nerurofibroma. We reported a case of the concomitant occurrence of trichotillomania associated with diffuse neurofibroma.

A Case of Steatocystoma Multiplex on the Face in a Family / 대한피부과학회지

We describe a family with a two-generation history of steatocystoma multiplex with an unusual clinical manifestation. A 7-year-old boy had multiple asymptomatic, small, yellowish cysts on the face since birth. His father and 4-year-old brother also presented several similar persistent cysts localized to the face. This family had no other abnormality on physical examination. The cysts discharged oily yellow material when incised. Biopsy of several lesions disclosed that the cysts had typical features of steatocystoma multiplex histologically.

Two Cases of Lichen Nitidus Treated with Diphenylcyclopropenone Immunotherapy / 대한피부과학회지

Lichen nitidus is a rare, usually asymptomatic chronic inflammatory dermatosis composed of numerous, tiny, discrete, flesh colored, shiny papules. Since the disease is asymptomatic and self-limiting, the specific treatment is not required in most cases. But when the lesion is generalized, symptomatic, persistent, interfering with outlook, the treatment is required. Diphenylcyclopropene (DPCP), a potent contact sensitizing agent has been used for refractory wart and alopecia areata based on its ability to induce delayed hypersensitivity reaction or nonspecific cell-mediated immunity. We report two cases of lichen nitidus improved after topical DPCP application.

Disappearing Atypical Lentiginous Pigmentation of the Desmoplastic Malignant Melanoma

A 38-year-old man presented with a black pigmented patch overlying his upper lip, a part of the gingiva and the hard palate. An intradermal tumor mass was palpated at the central portion of the pigmented patch of the upper lip. Diphenylcyclopropenone (DPCP) is a potent contact sensitizer that could stimulate non-specific immunity. We report a case of desmoplastic malignant melanoma (DMM) in which an atypical lentiginous pigmentation disappeared with topical DPCP immunotherapy and the dermal tumor mass was removed by a surgical wedge-shaped excision. Though an atypical lentiginous pigmentation of DMM sometimes undergoes extensive spontaneous regression, in our case it could be attributed to the therapeutic effect of topical DPCP immunotherapy rather than a spontaneous regression.

A Case of Eruptive Steatocystoma Multiplex on the Scalp / 대한피부과학회지

A 46-year-old man had noticed an asymptomatic, small, yellowish, papular eruption on the scalp about one year ago. Since then, the lesions had slowly increased in size and number. There was no family history of similar lesions. An incision made into the cysts discharged oily yellow material. Biopsy of a lesion disclosed that the cysts had typical features of steatocystoma multiplex histologically. This case was a unique eruptive variety of steatocystoma multiplex on the scalp.

Hirsutoid Papillomas of Vulvae

Hirsutoid papillomas of vulvae present as smooth or filiform papules located on the inner surfaces of the labia minora. This disease is usually considered as anatomical variants of the vestibular mucosa. Differentiation from condyloma acuminata is important to avoid unnecessary treatment. Herein we report a case of hirsutoid papillomas of vulvae in a 21-year-old female who complained of pruritic papules on the vulva of one year's duration. Papules were located on the inner surfaces of the left labia minora and vestible of the vulva. Clinically, they were quite similar to condyloma acuminata. Histologically, however, the epithelium was devoid of features of human papillomavirus(HPV) infections such as koilocytosis, double nucleation, and dyskeratosis.

Clinical and Mycological Studies of Dermatophytosis in Human Transmitted from Infected Rabbits / 대한의진균학회지

BACKGROUND: Recently, as rabbits have become a popular pet in Korea, there has been an increase in reports of dermatophytosis in humans as a result of frequent contact with rabbits. OBJECTIVE: The purpose is to investigate the clinical and mycological features of dermatophytosis in humans transmitted from rabbits. METHODS: Seventeen cases of dermatophytosis, developed after contact with rabbits, were clinically evaluated from November, 1999 to May, 2000. Mycologic studies were carried out from the lesions of rabbits and humans. RESULTS: Dermatophytes were cultured from 15 of 17 (88.2%) specimens from the lesions of humans. Trichophyton (T.) mentagrophytes, granulosum-asteoroid form, was isolated in 12 specimens (70.6%) and Microsporum (M.) canis was isolated in 3 specimens (17.6%). Human infection showed a high incidence in young children under age 10 (52.9%), with female predominance (2 times), and high familial incidence, and mainly being tinea faciale and tinea corporis. Tinea capitis also was observed in four cases, and M. canis was isolated from two of them. CONCLUSION: Rabbits can be an infectious source of human ring-worm due to T. mentagrophytes and M. canis. These zoophilic dermatophytes can be frequently transmitted to humans and induce inflammatory lesions. Therefore, epidemiologic studies of the prevalence of dermatophytes in healthy or infected rabbits, and sanitary measure are necessary.

A Case of Trichilemmal Carcinoma on the Lower Lip / 대한피부과학회지

We report a case of Trichilemmal carcinoma in a 75-year-old man who was presented with an exophytic nodule on the lower lip. The tumor was composed of glycogen-rich cytoplasmic cells with PAS-positive, diastase-labile and had a characteristic trichilemmal keratinization. The trichilemmal carcinoma is well known to have originated from the outer root sheath of the hair follicle in the hair bearing area. It is interesting that our case had developed on the lip, an exceptional site for a follicular tumor : the hair follicle could not be seen. It might have been developed from an ectopic follicle or at the follicle of vermillion border and grew up into the lip.

Diagnosis of Causative Fungi of Onychomycosis Using Polymerase Chain Reaction and Restriction Enzyme Analysis / 대한의진균학회지

BACKGROUND: Onychomycosis has become one of the common fungal infection. However, highly reliable and sensitive methods of detecting and identifying causative fungi of onychomycosis are not established yet. Polymerase chain reaction (PCR) analysis of clinical specimens including blood, sputum, urine, and cerebrospinal fluid collected from patient systemically infected fungus is known as a sensitive diagnostic method. But it has been questionable whether PCR analysis is also applicable to onychomycosis. OBJECTIVE: The purpose of this study was to develop a DNA-based diagnostic method to improve the sensitivity and specificity of detection and identification of pathogenic fungi of onychomycosis. METHODS: To detect the fungi in the nail, PCR was performed by using 4 sets of primer (TR1 & TR2, NS5 & NS6, B2F & B4R and CA1 & CA2) designed in conserved sequences of the small ribosomal subunit (185-rRNA) genes and restriction enzyme analysis of amplified product by Hae III was done to identify species. Nail specimens were obtained from 19 cases of onychomycosis confirm by fungus culture. RESULTS: 1. Preparation of nail powder, which is necessary for removal of keratin, and composition of lysis buffer with guanidinium thiocyanate, Tris-HCl, and beta -mercaptoethanol are the most proper modalities for isolation of fungal DNA from fungus-infesting nails. 2. Specific fragments of the 18S-rRNA gene of fungi, 581 bp, 308 bp, 688 bp and 1106 bp were amplified respectively. From sequences of 18S-rRNA gene of fungi by universal primers, dermatophytes (Trichophyton rubrum, Trichophyton mentagrophytes) and yeast (Candida albicans) yielded identical products. 3. Using Hae III endonuclease, digested patterns of fragment of Trichophyton rubrum and Candida albicans resulted in different pattern. CONCLUSION: This method released enough DNA from fungus-infected nails to result in proper amplification and it can be possible to differentiate dermatophytes, yeasts, and molds using Hae III endonuclease. The present study is the first one to demonstrate the feasibility of this molecular biologic approach to identify fungi in the infected nail. Therefore, precise detection and identification of the causative fungi would be of help in investigating distribution of the causative fungi of onychomycosis as well as appropriate treatment of the disease.

Five Cases of Shiitake Dermatitis / 대한피부과학회지

Shiitake (Lentinus edodes) is a kind of mushroom which is cooked and eaten as a food in Chinese, Japanese and Korean meals. It is nowadays the second most commonly produced edible mushroom in the world. In 1985, a case characterized by itchy skin eruptions after the ingestion of raw shiitake mushrooms was reported and was termed as toxicodermia. Here we report five cases of shiitake dermatitis which developed after ingestion of raw or cooked shiitake mushrooms. All patients complained of severe itching and showed linear grouped erythematous papules after scratching(Kobner phenomenon). To our knowledge, this is the first report of shiitake dermatitis in the Korean literature.

Neonatal Lupus Erythematosus

Neonatal lupus erytematosus is a distinct subset of lupus erythematosus. It is characterized by cutaneous findings exhibiting the morphology of subacute cutaneous lupus erythematosus, congenital heart block, and anti-Ro/SSA and/or anti-La/SSB autoantibodies which result from the transplacental passage of maternal autoantibodies. We report a case of a 12-week-old female infant who presented with characteristic clinical and histopathological features of cutaneous neonatal lupus erythematosus but without evidence of congenital heart block. Initial serological studies reveled the presence of anti-La/SSB anti-bodies and antinuclear antibodies. 5 months later, follow-up serology was negative in accordance with a clinical remission.

A Case of Verrucous Hemangioma

We report a case of a 6-month-old female who had had verrucous hemangioma since birth. The lesions were dark red, verrucous surfaced, hyperkeratotic papules on the right sole. A histopathological examination showed hyperkeratosis, papillomatosis, irregular acanthosis, lobular proliferation and dilatation of blood vessels in the deep dermis with a gap devoid of vessel proliferation in the mid dermis.