Cephalometric Evaluation of the Midfacial Soft Tissue Changes on Smiling

Submucosal Schwannoma of Tongue: A Case Report and Brief Review of Literature

A Case of Kerion Celsi Caused by Microsporum canis Probably Transmitted from Hamster / 대한의진균학회지

Kerion celsi is an inflammatory type of tinea capitis. It is usually seen with zoophilic pathogens, with common examples being Microsporum(M.) canis, Trichophyton(T.) mentagrophytes and T. verrucosum. Hamster is the mammal which belongs to the rodent family, usually small in size and frequently nocturnal in their habits and small pet kept in many countries today. We report a case of kerion celsi caused by M. canis probably transmitted from hamster in a 8-year-old boy. The patient had various sized, erythematous boggy nodules and pustules with irregular hair loss on the scalp for 2 months. Culture from a scalp lesion of patient on Sabouraud's dextrose agar showed M. canis. He was treated with 125 mg of terbinafine daily for 12 weeks and short term therapy of low dose of prednisolone. Skin lesions were cured without recurrence.

A Case of Aggressive NK/T-cell Lymphoma/Leukemia with Cutaneous Involvement in Adolescence

NK/T-cell lymphoma (NKTCL) is characterized by the expression of the NK-cell antigen CD56. Non-nasal NK/T-cell lymphomas are subdivided into primary cutaneous and 4 subtypes of secondary cutaneous lymphomas; nasal type, aggressive, blastic (blastoid), and other specific NK-like cell lymphoma. Aggressive NK/T-cell lymphoma/leukemia is a rare leukemic variant of nasal type NKTCL. We herein report a rare case of aggressive NK/T-cell lymphoma/leukemia with cutaneous involvement in adolescence.

A Case of Acquired Distal Trichorrhexis Nodosa / 대한피부과학회지

Trichorrhexis nodosa (TN) is the most common hair shaft anomaly and is caused by physical or chemical trauma. It is characterized by nodular swellings of the hair shaft accompanied by frayed fibers and loss of cuticle. The fibers then fracture and the shaft breaks with the resultant appearance of a splayed paintbrush or fan-like array. Trichorrhexis nodosa is classified into congenital TN and acquired TN. Acquired TN is further classified into three groups, acquired localized TN, acquired proximal TN, and acquired distal TN. To date, no case of distal trichorrhexis nodosa has been reported in Korean dermatologic literature. We herein report a case of acquired distal trichorrhexis nodosa in a 12-year-old boy.

The Clinical Features of Herpes Zoster Ophthalmicus in Inpatients / 대한피부과학회지

BACKGROUND: There have been many studies about herpes zoster in the Korean dermatologic literature. However, few studies have reported on herpes zoster ophthalmicus, and especially in inpatients. OBJECTIVE: The purpose of this study was to investigate the clinical features of herpes zoster ophthalmicus in inpatients. Methods: During an 8-year-period from January 2000 to December 2008, 130 patients with herpes zoster ophthalmicus were evaluated in regard to the annual, monthly and seasonal incidences, the age incidence and the gender ratio. The patients with herpes zoster ophthalmicus were further assessed concerning the dermatomic distributions, the associated diseases and their complications. RESULTS: The averaged annual incidence over the eight years was 8.7% out of the total 1,496 inpatients. The male to female ratio was 1:1.1. There were no marked seasonal variations. Among the age groups, the incidence rate was highest in the seventh decade (25.4%). The dermatomal distribution was the ophthalmic branch of the trigeminal nerve (93.1%), followed by the ophthalmic and maxillary branches of the trigeminal nerve (6.2%) and a generalized distribution (0.7%). The frequency of associated diseases was in descending order: hypertension, diabetes mellitus, gastric ulcer and malignancy. The most common complication of herpes zoster ophthalmicus was ocular complication (70.8%), followed by postherpetic neuralgia (50%). Ocular complications were observed in 92 patients (70.8%), and these complications included conjunctivitis (62.3%), keratitis (26.9%), uveitis (10.0%), scleritis (1.5%) and glaucoma (1.5%). The frequency and severity of ocular complication were higher in the patients with Hutchinson's sign (p<0.05). CONCLUSION: Herpes zoster ophthalmicus is associated with substantial ocular complications and postherpetic neuralgia. Therefore, patients with herpes zoster ophthalmicus (and especially those with Hutchinson's sign) should receive immediate antiviral therapy and ophthalmologic consultation.

The Clinical Features of Herpes Zoster Ophthalmicus in Inpatients / 대한피부과학회지

BACKGROUND: There have been many studies about herpes zoster in the Korean dermatologic literature. However, few studies have reported on herpes zoster ophthalmicus, and especially in inpatients. OBJECTIVE: The purpose of this study was to investigate the clinical features of herpes zoster ophthalmicus in inpatients. Methods: During an 8-year-period from January 2000 to December 2008, 130 patients with herpes zoster ophthalmicus were evaluated in regard to the annual, monthly and seasonal incidences, the age incidence and the gender ratio. The patients with herpes zoster ophthalmicus were further assessed concerning the dermatomic distributions, the associated diseases and their complications. RESULTS: The averaged annual incidence over the eight years was 8.7% out of the total 1,496 inpatients. The male to female ratio was 1:1.1. There were no marked seasonal variations. Among the age groups, the incidence rate was highest in the seventh decade (25.4%). The dermatomal distribution was the ophthalmic branch of the trigeminal nerve (93.1%), followed by the ophthalmic and maxillary branches of the trigeminal nerve (6.2%) and a generalized distribution (0.7%). The frequency of associated diseases was in descending order: hypertension, diabetes mellitus, gastric ulcer and malignancy. The most common complication of herpes zoster ophthalmicus was ocular complication (70.8%), followed by postherpetic neuralgia (50%). Ocular complications were observed in 92 patients (70.8%), and these complications included conjunctivitis (62.3%), keratitis (26.9%), uveitis (10.0%), scleritis (1.5%) and glaucoma (1.5%). The frequency and severity of ocular complication were higher in the patients with Hutchinson's sign (p<0.05). CONCLUSION: Herpes zoster ophthalmicus is associated with substantial ocular complications and postherpetic neuralgia. Therefore, patients with herpes zoster ophthalmicus (and especially those with Hutchinson's sign) should receive immediate antiviral therapy and ophthalmologic consultation.

A Case of Axillary Adenoid Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common skin cancer with a steadily increasing incidence. Ultraviolet radiation is considered the single most important risk factor for BCC, because the tumor occurs most frequently in sun-exposed areas of the body, with approximately four of five BCCs occurring on the face. BCC occurs infrequently in non-sun-exposed skin. The axilla is one of the most sun-protected areas of the body, and BCC arising at this site is very rare. We herein report a case of adenoid BCC which arose from the axilla in a 33-year-old woman.

A Case of CD30 Positive ALK-Negative Systemic Anaplastic Large Cell Lymphoma Involving Bone Marrow / 대한피부과학회지

CD 30 positive anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's lymphoma, a tumor that is composed of mostly mast cells expressing CD30 antigens. According to the 2005 World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification, it can be classified as systemic ALCL and primary cutaneous CD30 positive T-cell lymphoproliferative disorder. Systemic ALCL can be subclassified into ALK positive and negative. There have been many cases of primary cutaneous CD30 positive T-cell lymphoproliferative disorder, but reports of systemic ALCL have been rare. We report a case of CD30 positive/ALK negative systemic anaplastic large cell lymphoma involving bone marrow in a 51 year-old-male who showed two pruritic, 1.5x1.0x0.8 cm and 1.0x0.5x0.4 cm sized, erosive, erythematous nodules on the right thigh and calf.

A Case of Pediculosis Palpebrarum in a Girl / 대한피부과학회지

Pediculosis (phthiriasis) palpebrarum is a rare disease which occurs on the eyelashes and is caused by Phthiriasis pubis (crab louse). The common symptoms are pruritus, irritation and foreign body sensation, but it is rarely associated with ocular diseases such as blepharitis, conjunctivitis or secondary bacterial infection. We report a case of pediculosis palpebrarum in a 3-year-old girl who had several lice and many nits on both eyelashes, and this was accompanied with blepharitis. She was treated by removal of lice and nits with fine forces, then application of petrolatum ointment twice a day for 7 days.

A Case of Ganglion on the Sole / 대한피부과학회지

Ganglion is a relatively-common, benign, soft tissue tumor that is almost always located near a joint capsule or tendon sheath. The common location is around the wrist, ankle or foot dorsum. We report a case of ganglion in a 53-year-old woman who presented with a solitary, tender, 1.0x1.0 cm sized, normal skin-colored, deep-seated nodule on the left sole. She had been treated by total excision of the tumor and recurrence has not been observed to date.

A Case of Type IV Hyperlipoproteinemia and Eruptive Xanthoma Associated with Diabetes Mellitus / 대한피부과학회지

We report a case of type IV hyperlipoproteinemia and eruptive xanthoma associated with diabetes mellitus in a 38-year-old male patient. He had multiple, erythematous, yellowish papules on the trunk, extremities and buttocks. Laboratory examinations showed an increase in serum blood glucose, cholesterol and triglyceride. Lipoprotein electrophoresis revealed increased pre-beta bands and a plasma standing test showed turbid plasma. Analysis of lipoprotein revealed an increase of triglyceride levels in the plasma. A skin biopsy from the lesion revealed a xanthoma. We diagnosed the patient as having type IV hyperlipoproteinemia with eruptive xanthoma. After 3 months of treatment with diet restrictions and fenofibrate, the serum level of triglyceride was reduced to a normal level, and the skin lesions disappeared.

A Case of Kerion Celsi Caused by Trichophyton tonsurans / 대한의진균학회지

We report a case of kerion celsi caused by Trichophyton(T.) tonsurans in a 14-year-old student of a middle school wrestling team. The lesion was on the scalp for 1 month and 6.5X5.0X1.0 cm sized, markedly inflammatory, swollen, boggy pus exuding plaque. Culture from the scalp lesion of the patient on Sabouraud dextrose agar showed T. tonsurans. The patient was treated with 250 mg of terbinafine daily for 12 weeks and short term therapy of low dose of prednisolone. Skin lesions were completely cured and recurrence is not observed to date.

A Case of Localized Skin Infection Due to Scedosporium apiospermum / 대한피부과학회지

Scedosporium(S.) apiospermum is the asexual stage of Pseudallescheria boydii. It has been isolated from soil, plant debris, polluted water and sewage. It is an opportunistic organism with low virulence. Infection may occur via direct inoculation. This ubiquitous fungus causes not only mycetoma, but also infections of a variety of body sites including the skin. Localized skin infection without granule or grain production due to this organism is much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection which occurred in a 69-year-old woman. The lesion was manifested by a 5.0 x 4.0 cm-sized, scaly erythematous plaque on the dorsum of the right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored floccose colonies of S. apiospermum. The patient was treated with 200 mg of itraconazole daily for 3 months. Skin lesions were completely cured and recurrence has not been observed to date.

A Case of Localized Skin Infection Due to Paecilomyces lilacinus / 대한피부과학회지

Paecilomyces (P.) lilacinus is a saprophytic filamentous fungus, mostly found in soil and very rarely pathogenic to humans. Although it has been reported to cause endophthalmitis, endocarditis and pulmonary infection, localized skin infection due to P. lilacinus has been rarely reported. We report a case of localized skin infection by P. lilacinus in an 83-year-old man. The lesion was manifested by a 7.0x5.0 cm-sized erythematous plaque on the left wrist. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed velvety whitish pink colonies of P. lilacinus. The patient was treated with 200 mg of itraconazole daily for 3 months. The skin lesion was completely cured and recurrence has not been observed to date.

A Case of Tinea Barbae Caused by Trichophyton mentagrophytes / 대한피부과학회지

We report a case of tinea barbae in a 51-year-old man, who presented with erythematous pustules on the upper lip, and a relatively well-defined pustular patch on his left cheek. Histopathologically, fungal hyphae were found in the hair shaft upon PAS staining. A fungal culture from scales and tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical Trichophyton mentagrophytes. The patient was treated with 250 mg of terbinafine, 10 mg of prednisolone and 300 mg of roxithromycin daily for the first week, then 250 mg of terbinafine combined with topical lanoconazole for 4 weeks. The skin lesions improved 5 weeks after treatment, and recurrence has not been observed.

Malignant Eccrine Poroma of the Left Upper Eyelid Resembling Cutaneous Horn / 대한피부과학회지

Malignant eccrine poroma is a rare skin appendage tumor, originating from the intraepidermal eccrine duct. It develops either spontaneously or in an eccrine poroma of long-standing duration. It usually affects older people and is located most commonly on the lower extremities. We report a case of an 84 year old woman with a malignant eccrine poroma on the left upper eyelid, which resembled a cutaneous horn. She presented with a solitary, tender, firm, 0.4x0.4x0.9 cm-sized, silvery-white colored papule on the left upper eyelid. She was treated with surgical excision and to date shows no recurrence.

Lymphangioma Circumscriptum of the Scalp Resembling Nevus Sebaceus / 대한피부과학회지

Lymphangioma circumscriptum is a rare, congenital benign hamartous malformation caused by the saccular dilatation of lymph channels lined by normal, single-cell, lymphatic endothelia that present as local eruptions of persistent, grouped, translucent vesicles. The predilection sites of lymphangioma circumscriptum are the tongue, axilla, abdomen, buttocks & groin, but scalp lesions are rare. We report a case of lymphangioma circumscriptum on the scalp of a 12 year old girl, which resembled a nevus sebaceous. She had a solitary, asymptomatic, 4.5 x 4.5 cm sized, normal skin-colored to yellowish grouped vesicular plaque on the scalp.

Subcutaneous Mycoses in Korea / 한양의대학술지

The subcutaneous mycoses are infections caused by fungi that have been introduced directly into the dermis or subcutaneous tissue from puncture wounds, abrasions, or other trauma. The skin lesion of subcutaneous mycosis is a verrucous plaque or abscess that forms at the site of probable trauma in an exposed area of the body. The most commom subcutaneous mycosis in Korea is sporotrichosis. In recent years the dematiaceous fungi, characterized by having melanin in their cell walls, have become significant due to increasing cause of subcutaneous mycoses in Korea. The subcutaneous mycoses caused by demataceous fungi contain chromoblastomycosis, phaeohyphomycosis, and eumycotic mycetoma.

Two Cases of Fixed Cutaneous Sporotrichosis / 대한의진균학회지

Sporotrichosis is a chronic infectious disease caused by Sporothrix(S.) schenckii. Regional lymphatic sporotrichosis is common type, accounting for 75% of the cases. But fixed cutaneous sporotrichosis is seen in 20% of cases. We report two cases of fixed cutaneous sporotrichosis in a 48-year-old man and 8-year-old boy. The lesions were manifested by erythematous plaques on right arm and left cheek, respectively. The fungal culture from biopsy specimen on Sabouraud's dextrose agar showed dark brown to black, moist and wrinkled colonies of S. schenckii. Histopathologically, pseudoepitheliomatous hyperplasia and chronic granulomatous inflammation were observed on H & E stain. The patients were treated with surgical excision of lesion & oral administration of 30 drops of saturated solution of potassium iodide three times a day and 100 mg of itraconazole daily for 3 months, respectively. Skin lesions were completely cured and recurrence is not observed to date.