Surgical experiences in pediatric pilomatricoma: punch incision and elliptical excision.

BACKGROUND: As pilomatricoma is a common adnexal skin tumor often occurring in exposed areas, dermatologists focus on minimizing postsurgical scarring. METHODS: This retrospective study included patients aged < 19 years who underwent surgical treatment for pilomatricoma at a single university hospital from 2015 to 2021. Patient demographics, tumor characteristics, and surgical outcomes were analyzed according to the surgical methods including punch incision and elliptical excision. RESULTS: Overall, 75 patients and 79 lesions were included in the study. The mean age of the patients was 8.4 years, and 48 patients (64.0%) were females. The face was the most common site of pilomatricoma (51.9%), and within the face, the cheeks were the most common sites. No recurrence was observed in the elliptical excision group, while one case of recurrence (4.5%) was observed in the punch incision group. The mean length of the wound was 2.00 cm in the elliptical excision group, which was longer than that in the punch incision group (0.49 cm; p < .001). CONCLUSIONS: Considering that surgery is the gold standard treatment for pilomatricoma, punch incision may be useful as an alternative surgical option for pilomatricoma in children.

Primary Cutaneous Cryptococcosis in an Older Immunocompetent Patient: A Case Report.

Cryptococcus neoformans is an encapsulated yeast that can be found in pigeon droppings, hay, and dust. Primary cutaneous cryptococcosis (PCC) without systemic involvement is recognized as a distinct clinical condition and is rarely reported in immunocompetent patients. A 78-year-old woman with no history of other diseases except for hypertension presented with a painful diffuse erythematous plaque along with oozing on left forearm that had lasted for 7 weeks. She was treated with cefoperazone/sulbactam for 3 weeks under suspicion of bacterial cellulitis, although the lesions aggravated without any improvement. We performed bacterial and fungal cultures as well as incisional biopsy. The pathogen was identified as Cryptococcus neoformans following sequence analysis of the internal transcribed spacer gene. The patient was treated with fluconazole 400 mg/day for 3 months, and there was no evidence of recurrence after 3 months of follow-up.

Two Cases of Aquagenic Wrinkling of the Palms in Korean Healthy Women: Easily Overlooked Disease.

Aquagenic wrinkling of the palms (AWP) is a rare condition, which is characterized by appearance of whitish papules and plaques and an excessive wrinkling and swelling of the palmar skin after exposure to water. Herein, we report two cases of AWP. A 17-year-old woman presented prickling focal various sized whitish papules, plaques with wrinkles on both palms after water contact for 6 months ago. Histologic findings were consistent with AWP. A 26-year-old woman presented asymptomatic multiple various sized whitish papules, plaques with wrinkles on both palms after water contact for 1 year ago. Both patients underwent a cystic fibrosis transmembrane conduct receptor test but were negative and improved without any treatment.

Usefulness of the Psoriatic Arthritis Screening and Evaluation Questionnaire to Monitor Disease Activity in Management of Patients with Psoriasis: Findings from the EPI-PSODE Study.

BACKGROUND: Psoriasis and psoriatic arthritis (PsA) are included in the group of immune-mediated inflammatory diseases (IMIDs) caused by systemic inflammation; however, indicators for monitoring inflammatory activity in patients with psoriasis, such as the Psoriasis Area and Severity Index (PASI), are limited. OBJECTIVE: To determine whether the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire can be used to monitor disease activity in patients with psoriasis. METHODS: This was a multicenter, noninterventional, cross-sectional study. Demographic factors and PASI and PASE scores were collected to investigate associations between each. RESULTS: PASE data were available for 1,255 patients, of whom 498 (39.7%) had a score of ≥37. Compared with the group with PASE score <37, the group with score ≥37 had a higher proportion of women (34.9% vs. 48.8%, p<0.0001), older mean age at diagnosis (36.4 vs. 41.7 years, p<0.0001), more severe disease activity using PASI and body surface area measures (p=0.0021 and p=0.0008, respectively), and higher mean body mass index (23.7 vs. 24.1, p=0.0411). In a multiple linear regression model, PASE score was positively associated with cutaneous disease activity (p<0.0001). CONCLUSION: After risk-adjustment, PASE was positively associated with PASI, which suggests that PASE can be sensitive to disease activity. Since psoriasis is regarded as one of the IMIDs, PASE may be utilized as a tool not only to screen PsA but also to monitor disease activity.

A Study of Skin Disease of the External Ear in Older Adults According to Anatomical Location.

BACKGROUND: Due to its anatomical location, the external ear is easily exposed and damaged due to trauma, weathering, and inflammation. Therefore, depending on the patient's age, different cutaneous diseases can occur. In addition, because of its small percentage of the overall body area, patients and doctors may miss observing dermatologic diseases of the ear. The purpose of this study was to provide information on the most common dermatologic diseases according to the location on the external ear. METHODS: This retrospective study was conducted on patients who visited the Department of Dermatology of Chosun University Hospital in the past 7 years. RESULTS: We included 269 patients and categorized their ear lesions according to 8 anatomical locations and 5 types of dermatologic diseases. In older patients over 60 years of age, the most common site of dermatologic disease was the postauricular region (33.9%), followed by the antihelix (19.4%), and earlobe (12.9%). The most common dermatologic disease was benign tumor (53.2%), followed by malignant and premalignant tumors (32.3% and 9.7%, respectively). CONCLUSION: The proportion of older adults with premalignant and malignant diseases was relatively high and these were most commonly observed in the antihelix and postauricular area. Therefore, it is important to aware the need for the examination, diagnosis, and treatment of disease in the antihelix and postauricular area.

Rapid growing superficial cutaneous leiomyosarcoma of the face.

Leiomyosarcomas are uncommon malignant smooth muscle tumors, mainly derived from vessels or viscera. Superficial leiomyosarcomas are a rare soft tissue sarcoma arising from the dermis or subcutaneous tissue in the skin. According to tumor origin and location, they are divided into cutaneous and subcutaneous leiomyosarcoma. They have distinctly different histologic and prognostic features from each other. Superficial leiomyosarcomas show a predilection for the proximal extremities and tend to be slow growing. We report one rare case of superficial cutaneous leiomyosarcoma on the right temporal area of face, which showed an extremely rapid growing mass within 3 months.

Cutaneous extraskeletal osteosarcoma on the scar of a previous bone graft.

Extraskeletal osteosarcoma (ESOS) is a very rare malignant tumor of mesenchymal origin. It is rarer than osseous osteosarcoma and there are very few reports of the skin being a primary site. Most reported cutaneous ESOS were accompanied with metastasis in other organs. A 56-year-old man presented with a painful, 1.5×0.8 cm sized, brown-colored nodule on the right girdle area for 3 months. The histologic findings revealed a tumor that was confined to the dermis without connection to the subcutaneous tissue. In addition, there were large amounts of thin and lace-like bony trabeculae and osteoid with neoplastic cells in a highly pleomorphic sarcomatous stroma.

Genetic study in a case of birt-hogg-dubé syndrome.

Birt-Hogg-Dubé syndrome (BHDS) is an autosomal dominantly inherited disorder characterized by multiple trichodiscomas, fibrofolliculomas, and acrocordons. There is also an increased risk of developing renal neoplasms and lung cysts/spontaneous pneumothorax. We present a 43-year-old man with multiple, 2~4 mm sized, dome-shaped, and skin-colored papules on his cheek and neck. On the basis of clinical finding and histopathologic examination on the cheek lesion, it was diagnosed as multiple trichodiscomas. Subsequently, molecular analysis revealed a mutation in the folliculin gene. We report a rare case of BHDS with a proved gene mutation.

Calcinosis cutis in systemic lupus erythematosus: a case report and review of the published work.

Calcinosis cutis is a common clinical feature of dermatomyositis and scleroderma but rarely reported in association with systemic lupus erythematosus (SLE). Calcinosis cutis in SLE occurs without calcium and phosphorus metabolic abnormalities and may be localized or generalized. The pathophysiology remains unclear and no effective therapy is currently available. We report a 30-year-old woman with a 13-year history of SLE who developed multiple calcinosis cutis around both knees and we review the relevant published work.

A case of human immunodeficiency virus infection initially presented with disseminated herpes zoster.

Herpes zoster is characterized by unilateral grouped vesicles along the distribution of a single dermatome. Disseminated herpes zoster usually is defined as a generalized eruption of more than 20 extra-dermatomal vesicles occurring within a week of the onset of classic dermatomal herpes zoster. It occurs chiefly in old or debilitated individuals, and especially in patients with underlying malignancy, immunosuppressive therapy, or human immunodeficiency virus (HIV) infection. A 51-year-old man presented with segmental grouped vesicles on the left upper trunk and arm, and a varicella-like eruption over the entire body. Tzanck smear preparation and punch biopsy done on the vesicles of the trunk indicated a herpetic infection. Later, he was found to be HIV-positive. We report a rare case of HIV infection initially presenting with disseminated herpes zoster.

Case of pigmented neurofibroma with hypertrichosis with no association to neurofibromatosis.

Pigmented neurofibroma (PNF) is a rare cutaneous tumor that has been observed in patients with or without neurofibromatosis (NF). This tumor is histologically characterized by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiations. Hypertrichosis is the excessive growth of hair on non-androgen-dependent areas of the body. It has been reported that hypertrichosis may sometimes overlie a neurofibroma. We highlight a case of PNF with hypertrichosis on a 17-year-old woman with no associated NF. We also discuss the possible underlying pathogenic mechanism of a localized hypertrichosis in PNF patients.

Case of herpes zoster duplex bilateralis.

Non-contiguously simultaneous development of herpes zoster is very rare. It is named either herpes zoster duplex unilateralis or bilaterarlis, depending on whether one or both sides of the body are involved. Herein, we report a 21-year-old man, who had been treated for ulcerative colitis with prednisolone, and presented with painful grouped vesicles of the lower abdomen and back in a relatively symmetrical distribution. A Tzanck smear and punch biopsy were performed on the vesicles of the back. We report a rare case of symmetrical herpes zoster duplex bilateralis.

A simple technique for treatment of nasal telangiectasia using trichloroacetic acid and CO2 laser.

BACKGROUND: Nasal telangiectasia is a common disfiguring condition and may cause significant psychological distress. Although lasers are effective in treating such lesions, there are many disadvantages, such as purpura, scarring, and cost. OBJECTIVE: To assess the effectiveness of a combination therapy of CO2 laser and trichloroacetic acid (TCA) for nasal telangiectasia. METHODS: Twenty patients with nasal telangiectasia were treated with CO2 laser 2 weeks after modified sclerotherapy using 80% TCA. RESULTS: After one treatment session, all patients had excellent results with more than 75% vessel clearance. There were mild side effects, such as transient erythema and fine frosting. After follow-up of 1 year, there were no relapses. CONCLUSION: We conclude that CO2 laser after modified sclerotherapy using 80% TCA appears to be a simple, effective, and inexpensive method for the treatment of nasal telangiectasia.

A case of pulmonary carcinosarcoma with persistent mild fever.

Carcinosarcoma is defined as a malignant tumor with an admixture of carcinoma and sarcoma. Pulmonary carcinosarcoma accounts for about 0.27 percent of all lung neoplasms. It occurs frequently in males, particularly in smokers between 50 and 80 years of age. Preoperative diagnostic tests, such as sputum cytology, percutaneous fine needle biopsy and bronchoscopy, have a low yield in detection of pulmonary carcinosarcoma. The diagnosis is verified by postoperative pathologic findings and by immunohistochemical investigations in many cases. Surgical resection is the treatment of choice. As the metastasis to regional lymph nodes and distant organ is common at diagnosed time, the prognosis is quite poor. We report a case of pulmonary carcinosarcoma presented with persistent mild fever and blood-tinged sputum in a 66-year-old male.