Subungual Posttraumatic Ectopic Nail.

Ectopic nail is defined as the malformation of nail tissue in a location other than the usual nail unit. We present a 12-year-old boy with a single dystrophic thumb nail after an injury. The nail was observed under the original nail and it is linked to the original nail plate by longitudinal bridge formation with parallel growth. According to these clinical findings, the diagnosis of subungual posttraumatic ectopic nail was made.

A Rare Case of Atypical Myxoid Cellular Neurothekeoma in a 6-Year-Old Girl.

Neurothekeoma (nerve sheath myxoma)is a benign tumor of probable nerve sheath origin. The atypical cellular variant of this tumor, showing a peculiar histologic pattern, has been very rarely reported in the literature. The atypical variant of cellular neurothekeoma is characterized by features such as large size, deep penetration extending into skeletal muscle and/or subcutaneous fat, diffuse infiltration borders, vascular invasion, high mitotic rate and marked cytologic pleomorphism. We describe a rare form of atypical myxoid cellular neurothekeoma in a 6-year-old girl.

A clinicopathologic study of thirty cases of acquired perforating dermatosis in Korea.

BACKGROUND: Acquired perforating dermatosis (APD) is histopathologically characterized by transepidermal elimination of materials from the upper dermis. APD can be divided into four diseases: Kyrle's disease, perforating folliculitis, elastosis perforans serpiginosa, and reactive perforating collagenosis. APD is usually associated with systemic diseases, especially diabetes mellitus or chronic renal failure. So far, there have only been a few Korean studies of APD, which have a limited number of patients. OBJECTIVE: The aim of this study is to evaluate the clinical and histopathologic characteristics of 30 cases of APD and to examine the association with systemic diseases. METHODS: We retrospectively reviewed the medical records and biopsy specimens of 30 patients who were diagnosed with APD. RESULTS: The mean age was 55.5 years, and the average duration of the lesion was 7.8 months. The lower extremities (73.3%) were the most frequently occurring sites of the lesion. Twenty-five patients (83.3%) had pruritus, and Koebner's phenomenon was present in 11 patients. Patients of 63.3% had at least one systemic disease. Diabetes mellitus (n=17, 56.7%) and chronic renal failure (n=10, 33.3%) were the most commonly associated conditions. Most patients received topical steroids (93.3%) and antihistamines (80.0%). The most common histopathologic type was reactive perforating collagenosis (n=23, 73.3%). CONCLUSION: In this study, most patients had a systemic association to the diseases. Therefore, we suggest that further evaluation is necessary for patients who present with APD. This includes reviewing patient's comprehensive past medical history, clinical exam, and additional diagnostic testing to check for the possibility of associated systemic diseases.

The reverse nasolabial flap with a cartilage graft for the repair of a full-thickness alar defect: a single-stage procedure.

A 65-year-old woman with a deeply infiltrating basal cell carcinoma in the right ala underwent full-thickness excision of most of the ala, including the alar rim, crease, and the adjacent cheek, leaving a 'through-and-through' defect. Reconstruction was performed by using the reverse nasolabial flap and a cartilage graft across the alar defect, harvested from the concha, to prevent nostril collapse and to maintain the alar shape. The reverse or turnover nasolabial flap is a variant of the conventional nasolabial flap; however, it may be more suited for the repair of a full-thickness, lateral alar defect. The reverse nasolabial flap functions both as an inner liner and an outer cover and the repair is performed as a single-stage procedure. Furthermore, this flap can provide both excellent function and excellent cosmetic outcome.

Hybrid cysts: a clinicopathological study of seven cases.

Hybrid cysts develop from more than two components of the pilosebaceous unit. The pathogenesis of this unusual disease has not yet been elucidated. The aim of this study was to assess the clinical and histopathological features of hybrid cysts. Histological sections of seven cases indexed as hybrid cysts were reviewed from 1996-2009 at the Department of Dermatology, Eulji Medical Center, Seoul, Korea. Hospital charts and slides were retrospectively evaluated. All cases had a combination of an epidermal cyst and a pilomatricoma with sharp transitional zones. The epidermal cyst lining was composed of thickened stratified squamous epithelium with a granular layer. Basophilic cells, shadow cells and the contents of the pilomatricoma were present in all lesions. There were no differences in the clinical features between patients with hybrid cysts and others with single cystic lesions. There were five women and two men, ranging in age from 11 to 50 years (mean 27 years). The most common sites were the upper extremities. None of the patients had any sign of Gardner's syndrome. Hybrid cysts are an interesting pathological phenomenon. Further study is needed to analyze hybrid cysts to improve our understanding of their pathogenesis and development from tumours of the pilosebaceous unit.

Squamous Cell Carcinoma Developing within Lesions of Disseminated Superficial Actinic Porokeratosis.

Disseminated superficial actinic porokeratosis (DSAP) consists of multiple annular, hyperkeratotic lesions that have a bilateral distribution on sun-exposed areas, particularly the extremities. DSAPs have a wider distribution than porokeratosis of Mibelli and usually develop during the 3rd or 4th decade of life. Squamous cell carcinoma that arises in the classical type of porokeratosis of Mibelli is well-documented, but there are only a few reports of squamous cell carcinoma in DSAP. Here, we describe a 62-year-old man with DSAP who developed squamous cell carcinoma on his right forearm.

A clinical and histopathological study of 122 cases of dermatofibroma (benign fibrous histiocytoma).

BACKGROUND: Many variants of dermatofibromas have been described, and being aware of the variants of dermatofibromas is important to avoid misdiagnosis. OBJECTIVE: We wanted to evaluate the clinical and pathologic characteristics of 122 cases of dermatofibromas. METHODS: We retrospectively reviewed the medical records and 122 biopsy specimens of 92 patients who were diagnosed with dermatofibroma in the Department of Dermatology at Eulji Hospital of Eulji University between January 2000 and March 2010. RESULTS: Nearly 80% of the cases occurred between the ages of 20 and 49 years, with an overall predominance of females. Over 70% of the lesions were found on the extremities. The most common histologic variant was a fibrocollagenous dermatofibroma (40.1%). Other variants included histiocytic (13.1%), cellular (11.5%), aneurysmal (7.4%), angiomatous (6.5%), sclerotic (6.5%), monster (4.9%), palisading (1.6%) and keloidal dermatofibromas (0.8%). There were 9 dermatofibromas (7.3%) that were the mixed type with two co-dominant histologic features. CONCLUSION: The results of this study are consistent with previous reports on the clinical features of dermatofibromas. However, we observed several characteristic subtypes of dermatofibroma and we compared the frequency of the histologic subtypes.

Subdermal minimal surgery with hyaluronic acid as an effective treatment for neck wrinkles.

BACKGROUND: Neck wrinkles are common, troublesome aesthetic deformities for which a limited number of treatments exist. Although previous study has demonstrated the safety and efficacy of subdermal minimal surgery technology in treatment of acne scarring, this technology has never been applied to treatment of wrinkles. OBJECTIVE: To evaluate the efficacy and safety of subdermal minimal surgery technology in the treatment of horizontal neck wrinkles. MATERIALS AND METHODS: All 12 enrolled participants were Koreans (Fitzpatrick skin types II-IV) with horizontal neck wrinkles. Participants underwent up to four sessions of treatment with subdermal minimal surgery technology at 4-week intervals. Wrinkle assessments were conducted at baseline and 2 months after the final treatment session. Participants and physicians evaluated improvement using pre- and post-treatment photographs. RESULTS: All participants completed the study. Improvement of wrinkling by at least 50% was observed at 6 months (2 months after the final treatment session) in more than half of the participants, as determined according to physician and participant evaluation. CONCLUSION: Findings from this preliminary study demonstrate that use of subdermal minimal surgery technology results in an effective decrease of the appearance of neck wrinkles.

Successful treatment of argyria using a low-fluence Q-switched 1064-nm Nd:YAG laser.

BACKGROUND: Argyria is a rare skin disease caused by cutaneous deposits of silver granules as a result of exposure to silver substrates or ingestion of silver salt. This pigmentation change causes cosmetic problems, and there was previously no recognized effective treatments for argyria. OBJECTIVE: To evaluate the treatment effect of a low-fluence Q-switched 1064-nm Nd:YAG laser on argyria. SUBJECTS AND METHODS: Case report of a 49-year-old with a history of ingestion of a colloidal silver solution daily for approximately one year as a traditional remedy. RESULTS: After seven sessions of treatment, the patient's skin color returned to normal. CONCLUSION: A low-fluence Q-switched 1064-nm Nd:YAG laser provided safe and effective treatment for the skin discoloration associated with argyria.

A Case of Tubular Apocrine Adenoma with Syringocystadenoma Papilliferum that Developed in a Nevus Sebaceus.

Tubular apocrine adenoma (TAA) is a very rare sweat gland tumor. TAA and syringocystadenoma papilliferum (SCAP) rarely develop together in a nevus sebaceus (NS). Herein, we report on a 40-year-old Korean woman with TAA associated with SCAP that developed in a NS located on the scalp.

A nodular syphilid presenting as a pseudolymphoma: mimicking a cutaneous marginal zone B-cell lymphoma.

Syphilis has been referred to as the great imitator, the great mimic, and the great masquerader. It often presents with clinical and histological findings similar to many other dermatological conditions. We report a patient presenting with nodular plaques, a rare form of secondary syphilis. The histological features revealed a pseudolymphoma mimicking a cutaneous marginal zone B-cell lymphoma. Syphilis should be considered in the differential diagnosis of a cutaneous lymphoreticular process.