Fixed Drug Eruption due to Iopromide (Ultravist(R))

A 69-year-old male presented with several painful erythematous patches on both palms and trunk several days after receiving iopromide (Ultravist(R), Shering, Berlin, Germany). A fixed drug eruption (FDE) due to iopromide was suspected clinically. However, at that time, the patch test with iopromide at the lesion site gave negative results. Three years later, the patient was mistakenly administered iopromide again and patches with vesicles recurred on the same sites as well as on the genitalia. This episode was repeated once again after 1 year. In all episodes, the skin lesion resolved after application of topical steroids. Although a patch test with iopromide was negative in our case, we made a diagnosis of FDE due to iopromide because the skin lesions occurred again at the previously involved area after re-exposure to iopromide. To date, only three cases of FDE caused by non-ionic monomers have been documented in the English literature. Herein, we report on an interesting case of FDE caused by iopromide.

Atypical Porokeratosis Developing Following Bone Marrow Transplantation in a Patient with Myelodysplastic Syndrome

Porokeratosis is an abnormal disease of keratinization of epidermis. It is clinically characterized by margins covered with keratin layer and it typically has an atrophied macule with a protruded, circular form. Histopathologically, it shows the findings of cornoid lamella. Risk factors for its development include organ transplantation, long-term use of corticosteroids, immunocompromised status, including AIDS, and exposure to ultraviolet light. We herein report a case of atypical porokeratosis in a 38-year-old man who developed porokeratosis involving multiple sites following bone marrow transplantation for myelodysplastic syndrome.

Breast Cancer Cutaneous Metastasis at Core Needle Biopsy Site

Cutaneous metastasis from breast cancer can occur by direct invasion, lymphatic and vascular spread as well as iatrogenic implantation. Metastasis that occurs by iatrogenic implantation after needle biopsy is very rare but the potential risk must be considered. In this report, we describe a case of breast cancer cutaneous metastasis that occurred by iatrogenic implantation following core needle biopsy. A 53-year-old woman presented with a 1x1 cm sized erythematous nodule at the biopsy site after breast conserving surgery for primary cancer. Histopathological findings confirmed cutaneous metastasis. The possibility of this consequence must be considered when performing needle biopsies.

Prevalence of Atopic Dermatitis among Korean Adults Visiting Health Service Center of the Catholic Medical Center in Seoul Metropolitan Area, Korea

The point prevalence of atopic dermatitis (AD) among Korean adults visiting the Health Service Center for health check-ups was assessed. AD was diagnosed based on the questionnaires filled by patients and through physical examination by dermatologists. A total of 3,563 persons completed the questionnaires, and 2,032 persons were examined by the dermatologists. According to the questionnaires, the prevalence of AD was 7.1%, and from the dermatologists' examination, it was 2.6% overall, which decreased with age significantly. The prevalence in men was higher than that of women. Grading the severity of AD according to their eczema area and severity index scores, 70.6% were classified as being mild, 25.5% moderate, and 3.9% severe. Interestingly, concomitance of psoriasis and AD was found in 0.5% of those examined by the dermatologists. Our results suggest that AD is one of the most common skin diseases not only in children but also in adults in Korea.

A Significance of High Levels of Total Serum IgE in Herpes Zoster / 대한피부과학회지

BACKGROUD: Herpes zoster is caused by the reactivation of varicella zoster virus. Many factors are involved in the reactivation of viruses, but most of them are unknown, except for immunosuppression and old age. A relationship between an increased level of total serum IgE and viral infection has been observed in a few previous studies. OBJECTIVE: The purpose of this study was to evaluate the quantitative changes, as well as the role of the total serum IgE, in patients suffering with herpes zoster. METHODS: We retrospectively reviewed the medical records and laboratory data of 205 patients with herpes zoster. We evaluated the clinical findings such as the affected dermatomes, the duration of illness and the persistence of herpes zoster-associated pain. The relationships of the clinical findings and the level of total serum IgE, which was measured by competitive chemiluminescence immunoassay, were also evaluated. RESULTS: The level of total serum IgE was elevated in 95 (46.3%) of 205 patients with herpes zoster and who did not have any medical history that would influence the level of total serum IgE. The amount of elevation of the total serum IgE was higher in the younger patient group than that in the older patient group. However, there were no statistically significant relationships between the level of total serum IgE and the clinical features. CONCLUSION: The level of total serum IgE in patients with herpes zoster was increased to more than the normal level. This may contribute to an overt defect of the cellular immune system in patients with herpes zoster.

A Case of Tungiasis after Traveling to Congo / 대한피부과학회지

Tungiasis is an ectoparasitic disease that is caused by the penetration of Tunga penetrans into the epidermis of the host. Tungiasis is indigenous to South Americaand the Caribbean regions, but it has spread to Latin America, India, and sub-Saharan Africa. The area of soft skin such as the soles, toes, webs and subungual regions are the favored sites for sand flea embedding. As the flea enlarges within epidermis a pruritic, painful white or erythematous papulonodule develops. A black central punctum is characteristic. A 32-year-old woman presented with a small black crust on the right sole after traveling to an endemic area(Congo). Histopathologic examination revealed the internal organs of the arthropod embedded intothe epidermis, which allowed a definitive diagnosis of tungiasis. Although tungiasis is common in endemic areas, there has been no report of tungiasis in the Korean literature. We report herein an interesting case of tungiasis in a patient after traveling to Congo.

Treatment of Acne with Isotretinoin in a Patient with Apert's Syndrome / 대한피부과학회지

Apert's syndrome is a rare autosomal dominant disease that's characterized by craniosynostosis and severe syndactyly of both the hands and feet. It is caused by a mutation of the fibroblast growth factor receptor (FGFR) type-2 gene. The development of widespread acne, involving the face, chest, back and forearms, is a characteristic finding at puberty in Apert's syndrome patients. The acne of Apert's syndrome patients is generally resistant to conventional therapy, including topical agents and/or oral antibiotics, but it shows a good response to isotretinoin. We report here on a case of acne that was successfully treated with isotretinoin in a teenager with Apert's syndrome.

A Case of Diffuse Neurofibroma / 대한피부과학회지

Diffuse neurofibroma is an uncommon variant of neurofibroma that usually presents on the head and neck. It is common in children and young adults. Clinically, the lesion presents as large, poorly circumscribed swelling. A 25 year-old female presented with diffuse swelling on the occipital region of the scalp for several years. Magnetic resonance imaging showed 8x9 cm sized, ill defined infiltration on the occipital scalp. The histologic examination revealed unencapsulated loosely arranged spindle cells within the dermis and subcutaneous tissue. Meissnerian differentiation was observed within the tumor cells. The tumor cells were positive for S-100 protein. We report a case of diffuse neurofibroma on the occipital region of the scalp.

An Unusual Juvenile Xanthogranulomaon a Finger MCP Joint

Juvenile xanthogranuloma (JXG) is a benign self-limited histiocytic proliferative disorder that usually occurs in early childhood. JXG appears as reddish to yellow, papules, or nodules, and although the head, neck, and trunk are the most frequent locations, it can occur at any body site. However, JXG involving the finger is rare. Histologically, JXG is characterized by an ill-defined, unencapsulated, dense histiocytic infiltrate within the dermis, some of which is contained in Touton giant cells, foreign body giant cells and foamy cells. Because the cutaneous lesions spontaneously regress, treatment is not usually indicated. The authors report a case of JXG in a 4-year-old girl who had tender, yellowish papule on the ventral aspect of the MCP joint of the right fourth finger consistent with JXG.

A Case of Sclerodermatous Chronic Graft versus Host Disease Associated with Cicatricial Alopecia / 대한피부과학회지

Cutaneous chronic graft versus host disease (GVHD) has been classified into lichenoid and scleroderma-like forms. However, some atypical cutaneous manifestation may be prevalent. A 9-year-old boy was diagnosed with acute lymphoblastic leukemia in March 2004 and underwent unrelated matched bone marrow transplantation (uBMT) in February 2005. However, one month after transplantation, he started suffering from acute GVHD. After clinical recovery, extensive sclerotic patch or plaque with alopecia developed. The scalp biopsy showed atrophy of the epidermis, inflammatory cell infiltration and sclerosis in the dermis which were consistent with cicatricial alopecia. We report a case of sclerodermatous chronic cutaneous GVHD showing cicatricial alopecia.