Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft

Relapsing polychondritis (RP) is an uncommon systemic disease that is characterized by episodic and progressive inflammation of the cartilaginous structures, which can be very debilitating and in some instances life-threatening. The pathogenic pathways of RP are largely unknown. However, several hypothesis have been suggested. We had an interesting case of aggravation of RP due to the infection. Graft cartilage on the nasal tip was affected by RP also. This case can give a clue of revealing the pathogenesis of RP. We introduce a case with a review of the literature.

Kaposi's Sarcoma in a Patient with Iatrogenic Cushing's Syndrome / 대한피부과학회지

Kaposi's sarcoma (KS) is a multifocal proliferative vascular tumor involving cutaneous and extra-cutaneous tissues. KS has been reported in patients treated with immunosuppressive agents for autoimmune diseases. However, KS has rarely been reported in patients with iatrogenic Cushing's syndrome. A 77-year-old woman was evaluated with multiple asymptomatic violaceous nodules and plaques on both lower legs. She had been diagnosed with iatrogenic Cushing's syndrome and had been treated with low-dose corticosteroid replacement therapy for >10 years. A histopathologic study showed extensive vascular proliferation in the dermis with spindle-shaped cells. Immunohistochemical staining for CD31, CD34, human herpesvirus (HHV)-8, and D2-40 was positive. We hereby report a case of KS in a patient with iatrogenic Cushing's syndrome.

Vitamin K1 Dermatitis / 대한피부과학회지

Vitamin K1 dermatitis is a cutaneous adverse reaction to vitamin K1, and this malady presents as an erythematous eczematoid patch or pseudoscleroderma. At first, liver disease was thought to be related to vitamin K1 dermatitis. However, it is no longer considered as being related to liver disease due to the increasing case reports of patients with vitamin K1 dermatitis and who are without liver disease. Type IV hypersensitivity reaction was suspected to be the cause of this reaction. This disease can be easily ignored because of its low incidence. We hereby report on a case of vitamin K1 dermatitis that was confirmed by a skin test.

Pedunculated Sclerotic Fibroma Resembling Soft Fibroma / 대한피부과학회지

Sclerotic fibroma is a rare skin neoplasm that can occur seen sporadically or in association with Cowden's disease. Clinically, it presents as asymptomatic flesh-colored or pinkish slow-growing papules or nodules with a wide anatomical distribution. We report a rare case of pedunculated type of sclerotic fibroma resembling soft fibroma, which has not been reported in Korea.

Birt-Hogg-Dube Syndrome, a Rare Case in Korea Confirmed by Genetic Analysis

Simple benign tumors can present as part of a syndrome with substantial mortality. Fibrofolliculomas are benign skin tumors most often associated with the Birt-Hogg-Dube syndrome (BHDS). The most life-threatening complication of this syndrome is renal cancer and other major features include multiple lung cysts and spontaneous pneumothorax. We present the case of a 54 year-old man with multiple flesh-colored papules on his face confirmed histologically as fibrofolliculomas. He had a history of recurrent pneumothorax and chest computed tomography showed multiple lung cysts. To confirm the diagnosis of BHDS, we conducted gene analysis that revealed a single nucleotide duplication in the folliculin (FLCN) gene (Exon 11, C.1285dupC). BHDS confirmed by the FLCN gene mutation is rarely reported in Korea. Appropriate investigation is recommended whenever a patient with benign skin tumors is encountered.

A Case of Cutaneous Inflammatory Myofibroblastic Tumor

Pseudo-inflammatory tumors are also known as plasma cell granuloma, inflammatory pseudo-tumor and inflammatory myofibroblastic tumor, and these tumors are a group of highly variable proliferations of myofibroblastic cells that are associated with a prominent inflammatory infiltrate. This tumor is known to most commonly occur in the lungs, bladder and gastrointestinal system with only a few cases having been reported in the skin. A previously healthy 26-year-old man presented with a 6-year history of an intermittently pruritic lesion on his back. On the histologic examination, there were spindle cells in fascicles and a mixed inflammatory cellular infiltrate of plasma cells and lymphocytes. A diagnosis of inflammatory fibroblastic tumor was made and the nodule was surgically removed. We report here on an additional case of this rare cutaneous entity, and it is probably the first such report from Korea.

A Case of Kikuchi's Disease Presenting with Unique Facial Involvement

Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare, self-limited lymphadenopathy, typically in young women, that usually remits spontaneously and does not recur. KD is clinically characterized by cervical lymphadenopathy and a high fever. Extranodal involvement (skin, arthritis, meningitis) rarely occurs. When KD is involved in a skin lesion, it presents with various shapes, but rarely manifests with symmetrically distributed, erythematous, firm nodules only on the face. In this report, we describe a patient with KD and unique skin manifestations.

Poststeroid Panniculitis in an Adult / 대한피부과학회지

Poststeroid panniculitis is a very rare complication of corticosteroid therapy, and this is characterized by firm subcutaneous nodules on the cheek, neck or upper trunk within days or weeks following rapid systemic steroid tapering or cessation in childhood. It can be identified by the clinical features and a history of using steroid, and if necessary, with a biopsy. There have been just 2 reported cases in adulthood, one was an autopsy case of a 28-year woman and another was a 60-year-old man after massive administration of corticosteroids for congestive heart failure. Herein, we report a case of panniculitis accompanied by Cushing's syndrome in an adult after long-term misuse of systemic steroid for rosacea.

A Case of Foreign Body Granuloma with Skin Necrosis Occurring after Bee Sting Therapy / 대한피부과학회지

Bee sting therapy is sometimes used for the treatment of chronic recalcitrant neuralgia and arthralgia and chronic eczema in traditional Korean herbal medicine. The stings of many insects are withdrawn after stinging. However, in certain cases, retained sting materials at the treatment site may induce granulomatous inflammation. A 76-year-old man presented with an erythematous plaque containing a central ulcer and granulation tissue after he had undergone bee sting therapy for a palpable subcutaneous nodule in the right axilla area and eczema on the back. The biopsy specimen showed a granulomatous response marked by histiocytes and giant cells surrounding foreign material. Histologic examination of the subcutaneous nodule in the right axilla showed mature fat cells consistent with a lipoma. Thus, we report a rare case of a foreign body granuloma with skin necrosis occurring after bee sting therapy.

A Case of Interdigital Pilonidal Sinus in the Foot / 대한피부과학회지

An interdigital pilonidal sinus is considered a rare occupational disease related to individuals with short hair. We describe a case of a 44-year-old man who presented with a tender nodule with a purulent discharge in the fourth interdigital web space of the left foot. The biopsy specimen showed a sinus tract surrounded by keratin and squamous epithelium, and the track contained acute and chronic inflammatory cells. The skin lesion was improved with occlusion of the fistula by using 100% bichloracetic acid. We herein report on a rare case of a interdigital pilonidal sinus in the foot, and this occurred with no relation to the patietn's occupation.

The Study of EGFR Expression on Malignant Skin Tumor and Molecular Labelling Using Gold Nanoparticles / 대한피부과학회지

BACKGROUND: The potential benefits of a molecular characterization of cancer are clear. Because of this, there is pressing need to perform in vivo imaging of the molecular features of cancer. However, before designing an appropriate molecular targeting technique utiilizing a cancer-related target molecule such as epidermal growth factor receptor (EGFR), it is necessary to characterize the exact expression of the target molecule. OBJECTIVE: The objective of this study was twofold. Our first goal was to characterize the expression of EGFR in skin cancer, and second, to develop nanoparticles conjugated with antibodies, demonstrating their use as optical probes for detecting cancer cells in vitro. METHODS: We performed immunhistochemical analysis of EGFR expression in skin cancer using monoclonal antibodies. Gold nanoparticles were synthesized and allowed to conjugate to anti-EGFR in epithelial cancer tissue. Following an incubabtion period, we recorded surface plasmon resonance images using gold nanoparticles conjugated to anti-EGFR antibodies. RESULTS: Specific membranous binding of EGFR was detected in all of the 10 non-melanoma skin cancers. Surface plasmon resonance images using gold nanoparticles also showed light scattering around tumor cells. CONCLUSION: These ex vivo results demonstrate that optical imaging using gold nanoparticles can allow selective detection of human epithelial cancer cells. Our study demonstrates the potential of gold nanoparticles to target, probe, and illuminate cancer cells making them an effective biomolecular cancer detection tool.

Clinical Findings and Recurrence Rate of 123 Skin Cancers Treated with Mohs Microscopic Surgery / 대한피부과학회지

BACKGROUND: Mohs micrographic surgery (MMS) is a specialized type of minimal marginal surgery that offers cure rates superior to other options in the treatment of skin cancer. But only a few reports have been published on the long term outcome of MMS in Korean literatures. OBJECTIVE: Our purpose was to report the clinical findings and recurrence rates of all patients with cutaneous malignancy treated with MMS. METHODS: We retrospectively evaluated 123 patients who had been diagnosed with cutaneous malignant tumors and had been treated with MMS and tumor reconstruction. The main outcome measures were patient demographics, duration of tumor, site, preoperative tumor size, method of reconstruction, and recurrence after MMS. RESULTS: The case series comprised 123 patients (51.2% female and 48.8% male) with a mean age of 65.8 years. Most tumors (78.0%) were on the face and 56.6% of all type of skin tumor were located on the left side. The most common skin tumor was basal cell carcinoma (67.5%). The local flap was the most common method to repair surgical defects (49.6%). Recurrence after MMS was diagnosed in 3 of the 123 patients (2.44%). CONCLUSION: MMS may be a safe and satisfactory method for the treatment of cutaneous malignant tumors and the low recurrence rate with MMS emphasizes the importance of margin controlled excision.

A Case of Congenital Melanocytic Nevi Following Blaschko's Lines / 대한피부과학회지

Nevus spilus, also known as speckled lentiginous nevus, is a relatively common cutaneous lesion that is characterized by multiple pigmented macules within a pigmented patch. It may be congenital or acquired, and it can show the histological features of congenital melanocytic nevus (CMN). The possible relationship between nevus spilus and CMN has been contentious. We report a case of a congenital nevus that followed the line of Blaschko and clinically manifested as nevus spilus, but showed the histological features of CMN.

A Case of Acute Diffuse and Total Alopecia of the Female Scalp / 대한피부과학회지

Diffuse alopecia areata is the least common clinical type of alopecia, and this diffuse form lacks the characteristic hairless patches of alopecia and it begins as diffuse hair loss. Diffuse alopecia areata has been poorly characterized. In 2002, there was a suggestion to define this form of alopecia areata as acute, diffuse and total alopecia of the female scalp (ADTAFS). ADTAFS is characterized by a marked female predominance, tissue eosinophilia and a uniquely short clinical course. We report here on one case of ADTAFS.