A Case of Benign Symmetric Lipomatosis / 대한피부과학회지

Benign symmetric lipomatosis is a rare disease of undetermined cause characterized by massive symmetric depositions of adipose tissue, predominantly on the neck, shoulder, back, and upper extremities. A 60-year-old man with chronic alcoholism was referred to our clinic for symmetric, skin-colored, non-tender masses on the posterior neck, both clavicular areas, abdomen, and back for about 10 years. He had been managed for tingling sensation on both hands in the neurologic department. Nerve conduction velocity studies were consistent with sensorimotor polyneuropathy and histopathologic findings revealed that the reticular dermis was replaced by normal uncapsulated mature fat cells. We report a rare case of benign symmetric lipomatosis associated with polyneuropathy.

A Case of Unilateral Idiopathic Atrophoderma of Pasini and Pierini

Idiopathic atrophoderma of Pasini and Pierini(IAPP) is an uncommon condition of unknown etiology and typically affects persons in the second and third decades of life. IAPP consists of asymptomatic grey to brown depressed lesions with "cliff drop" borders, which are usually bilateral and located on the trunk. A 40-year-old woman visited our department because of unilateral atrophic lesions on the abdomen, right arm, and posterior aspect of right thigh for 20 years. Laboratory evaluations were normal and histologic examination revealed significantly decreased thickness in dermis. We report an unusual case of idiopathic atrophoderma of Pasini and Pierini presenting unilateral distribution.

Eosinophilia-Myalgia Syndrome not Associated with the Ingestion of Nutritional Supplements

Eosinophilia-myalgia syndrome(EMS) is a systemic illness that occurred as an epidemic by ingestion of over-the counter L-tryptophan preparation in the United States in October 1989. We report a Korean case of EMS not associated with the ingestion of either L-tryptophan or other nutritional supplements such as lysine and niacin.

A Case of Zoster Duplex Bilateralis

Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.

Expression of iNOS mRNA and Effect of NO on IL-3 Production in Dendritic Epidermal T Cell / 대한피부과학회지

BACKGROUND: Stimulation of iNOS with subsequent release of NO may play a critical role in pathophysiology or host defense reactions. NO can be produced by several cell types that reside in the skin. Increasing data indicate that NO serves as an autocrine and paracrine mediators in diverse and complex cellular processes throughout the skin. OBJECTIVE: The aim of the present study was to elucidate whether dendritic epidermal T cell can express iNOS and generate NO. In addition to that, this study was to evaluate whether NO may play a certain role in IL-3 production of activated dendritic epidermal T cell. METHODS: iNOS mRNA was isolated by RT-PCR at 12, 24, 48, 72 hours after stimulation and NO was measured by the Griess method. IL-3 levels were assessed with a basic cell proliferation bioassay system using supernatants from T cells cultured in 96 well plates. Units of IL-3 in the culture supernatants were measured using the cytokine-dependent DA-1 cell line. RESULTS: 1. NO generation was increased by UVB 100mJ/cm2 irradiation, concanavalin-A and lipopolysaccharide stimulation in dendritic epidermal T cell. The amount of NO was highest in LPS. 2. The expression of iNOS was increased by UVB 100mJ/cm2 irradiation, concanavalin-A and lipopolysaccharide stimulation in dendritic epidermal T cell. Induction of iNOS revealed peak at 72 hours after concanavalin-A and lipopolysaccharide stimulation, but in UVB irradiation that of iNOS was not observed except at 48 hours. 3. NO may play a role in IL-3 production in activated dendritic epidermal T cell. CONCLUSION: The results strongly suggest that the expression of iNOS and NO production in dendritic epidermal T cell are upregulated by UVB, concanavalin-A and lipopolysaccharide, and NO may play a role as mediator in IL-3 production of activated dendritic epidermal T Cell as autocrine manner.

A Clinical Study of Skin Diseases in Elderly Patients(IV) / 대한피부과학회지

BACKGROUND: With the advance of socioeconomy and medical science, the population of the aged has been significantly increased. Therefore it needs to be studied the fundamental epidemiologic survey of dermatologic disease in the elderly. OBJECTIVES: The purpose of this study is to evaluate the prevalence of common dermatoses in the elderly and to compare these to previous studies. METHOD: 1,916 out-patients over 65 years old who had visited the Department of Dermatology, University Hospital and Yongsan Hospital, College of Medicine, Chung Ang University from January, 1996 to December, 2001 were analyzed retrospectively. RESULTS: 1. The incidence of aged group over 65 years old to total number of out-patients(24,723) was 7.7%(1,916 cases). 2. The ratio of male to female was 1.06 : 1(986:930). 3. The frequent skin diseases were herpes zoster(12.0%), benign tumor(9.0%), pruritus(8.9%), onychomycosis/tinea pedis(7.7%), contact dermatitis(7.2%), seborrheic dermatitis(5.4%). 4. Eczema was the most common disease group which revealed 18.5%. The second most frequent group was viral infection(15.3%), followed by fungal infection(12.7%), tumor(12.0%), urticaria, drug eruption and erythema(9.4%), pruritus(8.9%), papulosquamous disease(2.8%) and bacterial infection(2.6%). 5. The most common disease in each disease group were as follows : contact dermatitis in eczema, herpes zoster in viral infection, onychomycosis and tinea pedis in fungal infection, urticaria in urticaria, drug eruption and erythema group, generalized pruritus in pruritus group, psoriasis in papulosquamous disease and folliculitis in bacterial infection, respectively. 6. Among 235 cases of skin tumor, 175 cases(74.5%) were benign and the remaining 60 cases(25.5%) were premalignant or malignant. The frequency of benign tumor was in order of seborrheic keratosis, epidermal cyst, skin tag and lipoma, respectively. In malignancy, there were basal cell carcinoma, squamous cell carcinoma and cutaneous metastatic carcinoma. CONCLUSION: Compared to previous studies, tumor and pruritus showed a increasing tendency but eczema a decreasing tendency.

Eosinophil Counts in Peripheral Blood, Serum Total IgE, Eosinophil Cationic Protein, IL-4 and Soluble E-selectin in Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Since the management of atopic dermatitis often needs prolonged administration of medication, the laboratory index reflecting disease severity is necessary for optimal treatment for this disease. OBJECTIVES: The purpose of this study is to evaluate peripheral eosinophil counts, serum total IgE, eosinophilic cationic protein(ECP), IL-4 and soluble E-selectin as severity indices or disease marker. METHOD: A total of 21 patients with atopic dermatitis and 21 normal controls were evaluated for the symptoms and signs according to SCORAD index and measured for peripheral eosinophil counts, serum total IgE, ECP, IL-4 and soluble E-selectin. RESULTS: Peripheral eosinophil counts, serum total IgE, ECP and soluble E-selectin levels of patients with atopic dermatitis were significantly increased compared with those of normal control(p0.05). CONCLUSION: ECP and soluble E-selectin were good serum marker reflecting the severity of atopic dermatitis.

A Case of Nevoid Basal Cell Carcinoma Syndrome with Multiple, Symmetrically Distributed Basal Cell Carcinomas / 대한피부과학회지

Nevoid basal cell carcinoma syndrome is a rare inherited disorder characterized by multiple cutaneous basal cell carcinoma, pits of the palms and soles, cysts of the jaws, and ectopic calcification of cranial membranes. The patient was a 66 year old female. She complained of multiple, symmetrically distributed black-colored papules on the both sides of the neck. On physical examination, multiple pits were detected in the palms and soles. The histopathologic findings of the papules showed variable shaped and sized tumor nests composed of basaloma cells. On PNS CT for search of metastasis of the cancer, odontogenic keratocyst was detected at the Lt. alveolar process of maxilla by accident. We diagnosed her nevoid basal cell carcinoma syndrome and the lesions on both sides of the neck were removed completely.