A Case of Multiple Plexiform Schwannomas

Plexiform schwannoma is a relatively rare, benign peripheral nerve sheath tumor that can be located either in the deep soft tissues or in the dermis or subcutaneous tissue. This tumor may occur singly or as multiple lesions and may be localized to one anatomic site or diffusely distributed. Plexiform schwannoma should be differentiated with plexiform neurofibroma or other plexiform malignant tumors. We describe a case of a 6-year-old patient with multiple cutaneous plexiform schwannomas who had no other stigmata of neurofibromatosis 1 or family history suggesting a genetic disorder. The histopathological study revealed a tumor composed of multiple intradermal or subcutaneous interlacing and interconnecting fascicles and nodules that vary in size and shape. Characteristic Antoni A type cellular tissue showing frequent nuclear palisading and Verocay bodies were observed within well circumscribed elongated nodules.

Keratoacanthoma in Co-existence with Nevus Sebaceus

Nevus sebaceus of Jadassohn has been referred to as a organoid nevus that classically evolves through three stages and may be associated with a range of skin tumors, and of these, syringocystadenoma papilliferum and basal cell carcinoma have been commonly reported to occur. The occurrence of keratoacanthoma is a very rare event in nevus sebaceus. Herein we report on a 23-year-old man with nevus sebaceus of the cheek. He represents a keratoacanthoma arising within nevus sebaceus.

A Case of Cutaneous Metastasis from Esophageal Carcinoma

We report a case of cutaneous metastatic carcinoma from an esophageal carcinoma in a 54-year-old male who complained of several pinhead-sized erythematous tender papules on the up-per chest. He had been admitted to the department of internal medicine for esophageal carcinoma. Radiological examinations revealed a luminal narrowing below the level of carina on esophagography, and a mass on the mid esophagus, left atrium and pulmonary vein on the chest CT scan. On endoscopy, about 30cm from the central incisor, a huge polypoid mass with a central ulceration and dirty surface margin was noted. Histopathological examination of the skin and esophageal biopsies showed the same atypical squamous cells with distinctive nucleoli, nuclear membrane and intercellular bridge, which were consistent with the squamous cell carcinoma of nonkeratinizing large cell type, suggesting these cutaneous lesions were metastasized from the esophageal carcinoma.

A Comparison Study of Prick Test and Chemiluminescent Assay / 대한피부과학회지

BACKGROUND: Prick test is most frequently used in clinical procedures because its simplicity and safety of application and better correlation with clinical history as well as specificity and high reproducibility. The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of radioallergosorbent test(RAST). The CLA permits quick, simultaneous detection of total and specific IgE in human serum. The CLA has shown good sensitivity, specificity, and a good correlation with the RAST and skin prick test. OBJECTIVE: The purpose of this study was to find causative allergens and to evaluate the clinical significance of CLA comparing the results of the CLA with those of the prick test in dermatologic outpatients. METHODS: We performed the prick test with 51 allergens(Bencard Ltd. Brentford, England) in 448 patients, and CLA with 35 allergens(Boehringer mannheim Korea. green cross inc.) in 280 patients with dermatologic diseases. RESULTS: 1. The positive reaction rate was highest in third decade and decreased over the age of 40 in prick and CLA. 2. The positive reaction rate of prick test(52.8%) was higher than that of CLA(25.0%). 3. The positive reaction rate to single allergens and compound allergens was 14.2% and 38.6% in the prick test and 2.5% and 22.5% in the CLA respectively. 4. In the prick test, the positive allergens, in descending order, were House dust 114(25.4%), D. farinae 88(19.6%), D. pteronyssinus 79(17.6%), Mixed inhalants 61(13.6%), and Threshing 47(10.5%). In the CLA Thistle 35(12.5%), Dandelion 31(11.1%), D. farinae 30(10.7%), D. pteronyssinus 29(10.4%), and Cat fur 12(4.3%). 5. The results of the CLA to common 2 allergens showed a concordance rate of 84.6%, sensitivity of 58.9%, and specificity of 86.1% compared with those of prick test. CONCLUSION: CLA may be a useful alternative method and shows a good correlation with the prick test. Combination of the two method results in a high diagnostic accuracy for the cause of allergic diseases.

Three Cases of Generalized Lichen Nitidus

Lichen nitidus(LN) is an uncommon chronic inflammatory disease of shiny, flat-topped, flesh-colored uniform papules most commonly located on the penis, forearms and wrists, lower abdomen, and thighs. LN almost has localized distribution, but in rare cases, it may become generalized. In Korea, three cases of generalized LN were reported. We report here three cases of generalized lichen nitidus in 31-year-old man, 8-year-old boy, and 6-year-old girl who had generalized numerous pinhead-sized, erythematous to flesh-colored, shiny papules. Microscopically, they had typical appearance of LN.

A Case of Cutaneous Diffuse Large B-Cell Lymphoma / 대한피부과학회지

We report a case of cutaneous B cell lymphoma in a 65-year-old male who had several bizarre shaped erythematous to brownish plaques on the both shins for 2 months. An abdominal CT scan revealed gastrohepatic ligament, retroperitoneal, mesenteric and bilateral external iliac lymphadenopathies. Histologic examinations revealed diffuse dense infiltration of the large atypical cells with vesicular nucleus and prominent nucleoli in the entire dermis. They showed a positive reaction to the LCA, CD20 and kappa light chain in the immunohistochemical study, suggesting that these neoplastic lymphoid cells are B cell lineage. We treated him with COPBLAM-V regimen. In the course of treatment, new skin lesions developed on both upper arms and herpes zoster on the left thigh. So we changed the regimen into IMVP-16. No relapses have been found up to the present date for 9 months.

A Case of Cavernous Angioleiomyoma / 대한피부과학회지

Angioleiomyoma is a solitary subcutaneous tumor characterized by proliferation of vascular smooth muscle cells. Angioleiomyoma is classified into three histological subtypes; solid, venous and cavernous according to its dominant feature. The solid type is most common but the cavernous type is very rare. We report a case of cavernous angioleiomyoma in a 58-year-old male who complained of a tender tumor on the dorsum of his left hand.

Chronic Mucocutaneous Candidiasis in Korea / 대한의진균학회지

Chronic mucocutaneous candidiasis (CMCC) is a general term used to denote a complex group of disorders characterized by a recurrent and persistent infection of the skin, mucous membranes and nails with organism of the genus candida, most frequently Candida albicans. It is often associated with an endocrinopathy and cell mediated immunopathy. CMCC is not a single disease entity, but rather a final common pathway for multiple predisposing abnormalities of the immune system that ranges from severe, life-threatening immunodeficiency syndromes to subtle deficiencies, especially of cell mediated immunity. Conditions that have been associated with CMCC include; candida esophagitis or laryngitis, endocrinopathies (usually hypoparathyroidism, hypadrenalism, hypothyroidism), circulating autoimmune antibodies, diabetes mellitus, vitiligo with antibodies to melanocytes, iron deficiency, chronic active hepatitis, pernicious anemia, malabsorption, alopecia totalis, dental enamel dysplasia, keratoconjunctivitis, pulmonary fibrosis, KED syndrome (keratitis, ichthyosis, and deafness), and recurrent pyogenic, viral or other fungal infections. When CMCC first appaears in adulthood, it is often associated with a thymoma. There is virtually no propensity for disseminated, visceral candidiasis. A suitable clinical classification of the major subtypes of CMCC was described by Lehner and Wells et al into six groups. Kirkpatrick et al found the mean age of onset of CMCC to be 3 years and both boys and girls are affected equally. We review CMCC and 5 reported CMCC cases in the dermatologic literatures in Korea.