A Case of Malignant Hidroacanthoma Simplex / 대한피부과학회지

Malignant transformation of hidroacanthoma simplex into in situ porocarcinoma, also known as hidroacanthoma simplex with invasive growth, is very rare. Malignant hidroacanthoma simplex generally arises in the elderly and occurs most frequently on the lower extremities and trunk. The gross appearance of the tumor tends to vary, and there are nodular lesions or keratotic plaques with or without erosion and/or ulceration. In some cases, it clinically resembles Bowen's disease or seborrheic keratosis. Histopathologically, the tumor appears similar to hidroacanthoma simplex, but the cells are atypical with hyperchromatic nuclei, and many are in mitosis. Here we report an extremely rare case of malignant hidroacanthoma simplex that occurred on the right knee of an 84-year-old Korean woman.

Tinea Incognito on the Face and Neck / 대한의진균학회지

Tinea incognito is a dermatophytosis modified by previous treatments such as prolonged use of corticosteroids. Because the lesions often atypical appearing without classic features of ringworm, the diagnosis can be delayed or missed especially when tinea incognito is on the face and neck. A 75-year-old male patient who had been treated with topical steroids at the local dermatologic clinic for 10 years for the eczematous lesion on the scalp and face and recently the lesions spread throughout his neck and back. Physical examination showed ill-defined erythematous scaly patches on the face, neck and back and reddish crusted papules on the scalp. Potassium hydroxide (KOH) preparation on the left face and right neck showed hyphae and fungus cultures were positive for colonies of Trichophyton rubrum (T. ruburum). The result of DNA sequencing from the colony was identical to that of T. rubrum. The lesions were treated by oral terbinafine and topical isoconazole.

A Case of Rippled-pattern Sebaceoma / 대한피부과학회지

Rippled-pattern sebaceoma, a very rare histologic variant of sebaceoma, manifests as a peculiar arrangement of basaloid cells in linear and parallel rows, resembling Verocay bodies. It represents dermal aggregations composed of small, monomorphous, basaloid, sebaceous germinative cells. It has a tendency to occur in men, with the scalp as the predilection site. To our knowledge, only one case has been reported to date in the Korean dermatologic literature. Here, we report a case of rippled-pattern sebaceoma that appeared as a flesh nodule on the occiput and had been present for 4 years in a 41-year-old man.

Circumscribed Skin Pigmentation due to Iron Extravasation / 대한피부과학회지

No abstract available.

A Study of the Correlation between the Dermoscopic Features and Histologic Subtypes in Dermatofibroma / 대한피부과학회지

BACKGROUND: Dermoscopic features may be useful in verifying the clinical diagnosis and increasing the diagnostic accuracy of dermatofibroma. There have been no systematic analyses of the dermoscopic features of dermatofibroma in Koreans or studies regarding the correlation between dermoscopic features and histologic subtypes. OBJECTIVE: To investigate the dermoscopic features of dermatofibroma in Koreans and to explore the relationship between the dermoscopic features and histologic subtypes of dermatofibroma. METHODS: The study included 83 lesions from 61 patients with dermatofibroma. Dermoscopic examination was performed via hand-held polarized dermoscopy at 10x magnification. Images were documented using a digital camera with a 3-fold optical zoom. RESULTS: The main dermoscopic structures were pigment network (63.9%), white scar-like patch (53.0%), and homogeneous area (50.6%). The frequency of homogeneous area (50.6%), scale (50.6%), ring-like structure (36.1%), exophytic papillary structure (7.2%), and telangiectasia (6.0%) was significantly higher, and globule-like structure (20.5%) and erythema (8.4%) was significantly lower in Koreans than in Caucasians (p<0.05). Eleven dermoscopic patterns including a peripheral delicate pigment network and central white scar-like patch (28.9%) and total delicate pigment network (15.7%) were observed and there was no significant difference compared to Caucasians. Seven histologic types were observed; however, the correlation between dermoscopic features and histologic subtypes was not significant. CONCLUSION: The most common pattern of dermatofibroma was pigment network and central white scar-like patch in both Koreans and Caucasians. A correlation between dermoscopic features and histologic subtypes in dermatofibroma was not found. These results may be helpful in clinically diagnosing dermatofibroma, especially in Koreans.

A Case of Subungual Epidermal Inclusion Cyst / 대한피부과학회지

No abstract available.

A Case of Cutaneous Alternariosis Treated with Fluconazole / 대한의진균학회지

Alternaria is a common saprophytic fungus found in the environment such as soil, air, and a variety of objects. The cutaneous infection caused by this fungus occurs more frequent in patients with immunocompromission than in immunocompetent people. We report a case of cutaneous alternariosis in a 63-year-old woman presented with a tender erythematous patch on the right forearm. She was on medication only for hypertension. Histopathologic examination showed a dermal mixed-cell infiltrate including multinucleated giant cells. PAS staining revealed fungal elements in the dermis. Microscopic examination of the colonies showed muriform conidia. A diagnosis of cutaneous infection due to Alternaria species was made on the basis of the above mentioned findings. Oral administration of fluconazole revealed resolution of her cutaneous lesion.

A Case of Cutaneous Carcinosarcoma / 대한피부과학회지

Carcinosarcoma is a biphasic tumor that has both epithelial as well as mesenchymal components. It most commonly occurs at the esophagus, lung, upper respiratory tract and urinary bladder, however it rarely occurs on the skin. A 62-year-old men presented with a bean sized crusted ulcer on his right cheek. A biopsy specimen revealed atypical sqamous cells mixed with spindle-shaped cells with hyperchromatic nuclei. Furthermore, immunohistochemical study showed positive reactions for AE1/AE3, cytokeratin7, epithelial membrane antigen and vimentin, but negative reactions for S100 protein, CD34 and smooth muscle actin. Based on these histopathological and immunohistochemical findings, we diagnosed this case as cutaneous carcinosarcoma. The patient was treated with complete excision and a local flap.

A Case of Neurofibromatosis with Multiple Pseudoatrophic Macules / 대한피부과학회지

Neurofibroma usually manifests as a soft nodule that protrudes from the skin surface of patients with neurofibromatosis. Pseudoatrophic macule is a rare variant of neurofibroma, and it is described as a slightly depressed macular lesion. To the best of our knowledge, only one case of neurofibromatosis associated with pseudoatrophic macules has been reported in the Korean dermatologic literature. A 20-year-old man presented with multiple round shaped macules scattered on the trunk. The surface of the skin lesion was slightly depressed compared with the normal adjacent skin. He had multiple cafe-au-lait macules on the body and freckles in the axillae and inguinal areas. Histopathologic examination of the depressed macule demonstrated a relatively well-demarcated mass that was composed of spindle cells intermingled with loosely arranged collagen fibers in the dermis. The spindle cells showed a positive reaction for S-100 protein. Herein, we report on a rare case of type 1 neurofibromatosis with multiple pseudoatrophic macules.

Proper Concentration of Diphenylcyclopropenone Solution according to the Anatomical Location and Application Time Interval for the Treatment of Warts / 대한피부과학회지

BACKGROUND: Topical diphenylcyclopropenone (DPCP) application on a daily or weekly basis has been used for the treatment of warts that affect different sites of the body. The concentration of DPCP for the treatment of warts needs to be determined according to the body site. In addition, the therapeutic response to DPCP application intervals needs to be evaluated for the treatment of warts. OBJECTIVE: The purpose of this study was to determine the minimal DPCP concentration required to induce an elicitation reaction in different body sites of patients with warts and to assess the therapeutic response of wart treatment with daily and weekly applications of DPCP. METHODS: Thirty patients with warts were divided into two groups. Each patient in the two groups was sensitized with 0.1% or 0.2% DPCP. After sensitization, in the first group of patients, DPCP was applied to warts daily. In the second group of patients, DPCP was applied to warts weekly. The initial concentration of DPCP was 0.01% for warts located on the palmoplantar area, periungual area and the dorsum of the hand, knee and upper arm. The initial concentration of DPCP was 0.004% for warts on the face. If no reaction was observed, the DPCP concentration (0.01%, 0.025%, 0.05%, 0.1%, 0.25%, 0.5%, 1% and 2%) was increased stepwise. The minimal concentration of DPCP to induce an elicitation reaction and treatment results were evaluated. RESULTS: The minimal concentrations of DPCP to induce an elicitation reaction were as follows: 0.004~0.01% for the face, 0.01~0.025% for the dorsum of the hand, 0.25~1% for the periungual area and 0.5~2% for the palmoplantar area. The results of weekly application of DPCP were similar as compared to the daily application of DPCP for the treatment of warts. CONCLUSION: Although further studies are needed, our study suggests that the DPCP concentration needs to be adjusted according to the body site and that the weekly use of DPCP may be a convenient alternative to daily use to treat warts.

Nipple Shaped Solitary Nevus Lipomatosus Cutaneous Superficialis: Report of a Case and a Review of the Korean Literatures / 대한피부과학회지

Nevus lipomatosus cutaneous superficialis is a fairly uncommon form of connective tissue disorder, and this is characterized by the ectopic deposition of fat lobules in the dermis. There are two clinical variants: the multiple and solitary types. Particularly for the case of the solitary forms, it seems preferable to regard them instead as pedunculated lipofibromas. We report here on a case of a nipple shaped solitary nevus lipomatosus cutaneous superficialis, and we also review the Korean cases. Till now, 22 cases in Koreahave been reported as a solitary nevus lipomatosus cutaneous superficialis and a pedunculated lipofibroma, or both. The review of the Korean cases revealed that solitary nevus lipomatosus cutaneous superficialis almost always exhibits a single skin-colored dome shaped or pedunculated nodule on the thigh and buttock, as well as on the non-girdle area after the 4th decade, and it has no histopathological difference from the multiple forms.

A Case of Borderline Lepromatous Leprosy Presenting in a Immigrant Woman / 나학회지

A 36 year-old woman immigrated from Nepal showed erythematous plaques on her face, buttock and legs one month after the immigration. Before the correct diagnosis was made, the patient had been erroneously treated as anallergic dermatitis for three months. Clinico-pathologically, her skin lesion was borderline lepromatous type leprosy with bacilli positive. We report the case to keep the high index of suspicion for leprosy when we meet with patients from the countries where leprosy is still epidemic.

A Case of Sebaceous Trichofolliculoma / 대한피부과학회지

Sebaceous trichofolliculoma is a rare benign tumor and represents a variant of trichofolliculoma. It presents as a centrally depressed solitary tumor and occurs in areas rich in sebaceous lobules. Microscopically, it shows keratin-filled cystic cavities and sebaceous lobules. The lobules are connected to the cystic wall. Herein we report a case of sebaceous trichofolliculoma on the right cheek in a 64-year-old man.

A Case of Sebaceous Trichofolliculoma / 대한피부과학회지

Sebaceous trichofolliculoma is a rare benign tumor and represents a variant of trichofolliculoma. It presents as a centrally depressed solitary tumor and occurs in areas rich in sebaceous lobules. Microscopically, it shows keratin-filled cystic cavities and sebaceous lobules. The lobules are connected to the cystic wall. Herein we report a case of sebaceous trichofolliculoma on the right cheek in a 64-year-old man.

A Case of Sclerosing Panniculitis / 대한피부과학회지

Sclerosing panniculitis is a subcutaneous disorder characterized by marked woody induration, erythema, edema, telangiectasia, and hyperpigmentation on the lower legs. It often occurs in patients who have venous insufficiency. The histologic features of sclerosing panniculitis are lobular panniculitis with membranocystic fat necrosis and variable septal fibrosis. We report a case of sclerosing panniculitis on the medial side of the left lower leg in a 51-year-old woman.

Two Cases of Linear Alopecia on the Occipital Scalp

Alopecia of a scalp shows various shapes and extents of hair loss, from a small round patch to polymorphous patches or total global alopecia. But alopecia of a linear shape is very rare. Only a few such cases have currently been reported in the medical literature. We recently had the chance to observe and treat two cases of linear alopecia that developed on the occipital scalp. The lesions themselves were like alopecia areata that shows a smooth bald area without any abnormality except the hair loss, but histopathologically, the lesions were compatible with lupus erythematosus profundus.

Two Cases of Linear Alopecia on the Occipital Scalp

Alopecia of a scalp shows various shapes and extents of hair loss, from a small round patch to polymorphous patches or total global alopecia. But alopecia of a linear shape is very rare. Only a few such cases have currently been reported in the medical literature. We recently had the chance to observe and treat two cases of linear alopecia that developed on the occipital scalp. The lesions themselves were like alopecia areata that shows a smooth bald area without any abnormality except the hair loss, but histopathologically, the lesions were compatible with lupus erythematosus profundus.

A Case of Sclerotic Fibroma / 대한피부과학회지

Sclerotic fibroma of the skin is an uncommon benign tumor characterized histopathologically by a well-circumscribed dermal nodule showing hypocellular hyalinized collagen bundles. The bundles are separated by clefts and arranged in a storiform pattern. The histogenesis of this fibroma is uncertain. Herein, we report a case of sclerotic fibroma presenting on the left ala nasi of a 27-year-old woman without Cowden's disease.

A Case of Papular Granuloma Annulare Occurringon the Site of Herpes Zoster: Isotopic Response / 대한피부과학회지

Isotopic response describes the occurrence of a new skin disorder on the site of another, unrelated, and already healed skin disease. The most common cause of isotopic response in the skin is the herpes zoster virus. Variable cutaneous lesions including granulomatous reactions may occur at sites of herpes zoster infections. We report a case of papular granuloma annulare occurring on the site of herpes zoster.

A Case of Axillary Basal Cell Carcinoma / 대한피부과학회지

Exposure to sunlight is the major cause of basal cell carcinoma (BCC). The axilla is not a sun-exposed region, and BCC affecting the axilla is rare. To our knowledge, only 4 cases of axillary BCC have been reported in Korea. We report a case of BCC in the axilla of a 67-year-old man. He presented with a 1 year history of a well-demarcated 2.0x0.5 cm pigmented plaque in his right axilla. The skin lesion was histopathologically diagnosed as BCC. He was treated by surgical excision. There was no recurrence after 1 year of follow-up.