Congenital Dermatofibrosarcoma Protuberans Treated with Wide Excision / 대한피부과학회지

Dermatofibrosarcoma protuberans is a fibrohistiocytic tumor with intermediate malignancy that usually appears in adults. The congenital type is very rare, and only three cases have been reported so far in the Korean literature. A 2-month-old girl presented with a firm reddish-gray nodule on the middle of her back that had been present since birth. Histopathologically, the lesion was composed of fascicles of densely packed uniform spindle cells arranged in a storiform (mat-like) pattern. The cells had hyperchromatic nuclei and rare mitotic figures. On immunohisto-chemistry, the tumor cells were positive for CD34. Based on these findings, we made the diagnosis of congenital dermatofibrosarcoma protuberans. She underwent wide excision, and there was no evidence of recurrence during 24 months of follow-up. Our report is of interest because of the rarity of congenital dermatofibrosarcoma protuberans and its earliest detection reported in Korea.

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.

Chondroid Syringoma: Clinical, Pathological, and Immunohistochemical Study of 23 Cases / 대한피부과학회지

BACKGROUND: Chondroid syringoma is a rare benign tumor composed of epithelial and stromal elements. Studies of chondroid syringoma are lacking in Korea and controversy still exists regarding the stromal cell origins. OBJECTIVE: To investigate the clinicopathological and immunohistochemical characteristics of chondroid syringoma in Korea. METHODS: We included 23 patients who were diagnosed with chondroid syringoma. RESULTS: There was a predilection for males (M : F=2.3 : 1), and the mean patient age was 50.4+/-15.4 years (range 22~78 years), peaking in the forties. Of the 23 cases, 22 (95.7%) had it on the head and neck. There were 21 apocrine type cases and 2 eccrine type cases. Apocrine type cases showed decapitation secretion as well as follicular and sebaceous differentiations. Myxohyaline matrix was present in all cases, and in some cases, chondroid, lipomatous, and osseous metaplasias were also observed. In apocrine type cases, inner cell layers displaying tubuloglandular structures expressed cytokeratin, carcino-embryonic antigen, and epithelial membrane antigen, while outer cell layers expressed vimentin, S-100 protein, neuron-specific enolase, and smooth muscle actin. Stromal cell immunophenotypes were similar to those of the outer layer. CONCLUSION: Chondroid syringoma was most commonly observed on the head and neck in middle-aged males. The apocrine type was far more common than the eccrine type and showed various differentiating characteristics. The matrix may contain myxohyaline stroma with alterations, including chondroid, lipomatous, and osseous metaplasias. Our immunohistochemical study suggests that myoepithelial cells play an important role in the histogenesis of chondroid syringoma and matrix production.

Circumscribed Skin Pigmentation due to Iron Extravasation / 대한피부과학회지

No abstract available.

A Case of Multiple Foreign Body Granuloma due to Mesotherapy / 대한피부과학회지

No abstract available.

Multiple Digital Mucous Cysts in a Farmer / 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 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.

Halo Congenital Nevus Associated with Extralesional Vitiligo / 대한피부과학회지

Halo nevus is a pigmented nevus surrounded by a round or oval depigmentation. Of patients with halo nevus, 18 to 26% patients have vitiligo, either involving the nevus or at a distant site. While the exact etiology of halo formation and vitiligo is unknown, several theories suggest that common immunologic mechanisms are involved in the destruction of melanocytes of both phenomena. Unlike common melanocytic nevus, congenital nevus associated with both halo formation and concurrent extralesional vitiligo is very uncommon and only one case has been reported in the Korean dermatological literature. A 19-year-old female presented with surrounding depigmentation around a congenital hairy nevus on the left forearm. Simultaneously, vitiligo appeared on the lowerabdomen and surrounding regions of both areola. The halo depigmented lesion around congenital nevus and the periareolar vitiliginous lesion shared some histological and immunohistochemical features. These findings further support common immunological mechanisms of pigment destruction in both phenomena.

Tinea Incognito with Changes in Clinical Feature Related to Antifungal Treatment / 대한의진균학회지

Clinical features of the dermatophyte infections of the glabrous skin can be altered by inappropriate treatment such as topical steroid treatment. We describe a case of dermatophyte infection with changes in clinical feature related to antifungal treatment. A 23-year-old woman presented with reddish annular scaly lesions on her right forearm. On the basis of the detection of hyphae on KOH examination, oral terbinafine 250 mg/day in combination with topical isoconazole was used for 3 weeks, but scattered papulopustules on erythematous bases occurred. Histopathologic examination revealed the presence of hyphae within the follicular infundibulum. Oral itraconazole 100 mg/day was administered for 2 weeks in combination with topical flutrimazole and produced a good clinical response. At her visit about 7 weeks after stopping itraconazole, agminated papulopustules on erythematous bases were seen on her right forearm. Trichophyton mentagrophytes was isolated on the culture of skin scraping from the surface of agminated lesions. She was successfully treated with oral fluconazole 150 mg weekly for 6 weeks and topical flutrimazole and isoconazole.

Foreign Body Granuloma Following Dried Honey Bee Venom (Apitoxin Inj) Injection / 대한피부과학회지

Bee sting therapy is sometimes used for the treatment of chronic recalcitrant neuralgia and arthralgia in traditional Korean herbal medicine, but retained sting materials at the treatment site may induce granulomatous inflammation. Recently, dried honey bee venom (Apitoxin Inj, Guju Pharma. Co., Seoul, Korea) has been approved by the Korea Food and Drug Administration (KFDA) as an anti-inflammatory drug. The adverse events associated with dried honey bee venom injection include itching, edema, pain, headache, fever and myalgia, but foreign body granuloma caused by drug injection has not been previously reported. We herein report two interesting cases of foreign body granuloma induced by dried honey bee venom injection.

Nicolau Syndrome in Which Split-thickness Skin Graft Was Required for Reconstruction / 대한피부과학회지

Nicolau syndrome is a rare adverse reaction and characterized by the acute onset of necrosis of the skin and soft tissue following intramuscular drug injection. Conservative treatments with dressings, debridement, and pain control are the mainstay of therapy. Surgical intervention such as skin graft is rarely required. We report a case of 21-year-old man with this syndrome on the right buttock after an intramuscular injection of diclofenac in which skin graft was necessary. The lesion eventually required debridements and split-thickness skin graft for reconstruction because it was very extensive and not successfully treated by the conservative method for four months.