RESUMO
Tinea capitis is an infection of the scalp hair follicles and surrounding skin that primarily occurs in prepubertal children. Microsporum canis remains the most common pathogen causing tinea capitis in Asian countries, including South Korea, although the causative organism of this condition varies across geographical regions and time periods. Systemic antifungal agents are the mainstay treatments for tinea capitis; however, the therapeutic responses to antifungal drugs may vary depending on the causative species, and treatment failure may occur owing to drug resistance. Although dermatophytosis resistant to clinical treatment have been increasingly encountered, recalcitrant tinea capitis cases have rarely been reported. Herein, we report three cases of tinea capitis caused by M. canis in children. All three patients showed unsatisfactory clinical responses to prolonged courses of oral terbinafine or itraconazole without achieving mycological cure; however, they were successfully treated with oral griseofulvin. Although griseofulvin is not currently available or licensed for use in many countries, including South Korea, it is one of the most effective agents against Microsporum species and remains the most widely used first-line treatment for tinea capitis in children, based on dermatology textbooks and reliable treatment guidelines.
RESUMO
Background@#Pityriasis rotunda (PR) is a rare dermatosis characterized by the presence of multiple, strikingly circular or oval-shaped, sharply demarcated, and scaly hyperpigmented patches. Its etiology remains poorly understood. To date, there have been no comprehensive analyses of PR in Koreans. @*Objective@#To investigate the clinical, pathological, and dermoscopic features of PR. @*Methods@#Sixteen patients with PR were evaluated. @*Results@#A female preponderance was observed (male:female ratio 1:7), and the mean age of the patients was 33.2±16.1 years (range, 15∼68 years), with the peak incidence observed in patients in their 20s. Notably, all the lesions developed on the trunk. The most common clinical diagnosis is PR. Histologically, PR appears similar to ichthyosis vulgaris. Hyperkeratosis was mainly ortho-keratotic, with plugs observed within hair follicles, elongated rete ridges, diminished stratum granulosum, enhanced pigmentation of the basal layer, pigmentary incontinence, and sparse superficial perivascular lymphoid cell inflammatory infiltrate. Periodic acid-Schiff staining was negative for fungi. Hyperpigmented patches with occasional scales were separated from each other by paler striae on dermoscopy. @*Conclusion@#PR commonly presents as multiple round lesions of variable sizes on the trunk of patients in their 20s. They showed characteristic findings, including hyperkeratosis with relative focal hypogranulosis, histopathologically, and some lesions showed dark and light brown polygonal patches with paler striae arranged dermoscopically, in a mosaic pattern. This was a retrospective single-center study with a small sample size; however, we believe that this paper will contribute to the clarification and understanding of PR.
RESUMO
Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months.His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy.
RESUMO
Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months.His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy.
RESUMO
Nontuberculous mycobacteria are ubiquitous environmental organisms that are rare pathogens in immunocompetent individuals. However, cutaneous nontuberculous mycobacteria infections have been increasingly associated with invasive procedures, including surgery, liposuction, filler injection, intramuscular injection, mesotherapy, piercing, acupuncture, and cupping therapy. Herein, we report the first case of cutaneous nontuberculous mycobacteria infection caused by the East-Asian traditional treatment ‘Gua Sha’, also known as scraping, coining or spooning in English. A 35-year-old healthy female presented with widespread, painful skin nodules and pustules on her upper and lower extremities that had developed after Gua Sha treatment for body contouring. Histopathologic examination of the lesions revealed granulomatous inflammation in the dermis and the culture isolates were identified as Mycobacterium massiliense with molecular identification. The patient was successfully treated with intermittent incision and drainage of persistent nodules and oral clarithromycin based on antimicrobial susceptibility testing. We recommend implementation of a standard safety protocol for Gua Sha practitioners to minimize the risk of infection transmission.
RESUMO
BACKGROUND: Cutaneous carcinosarcoma is a rare biphasic tumor comprising malignant epithelial and heterologous mesenchymal elements. Data on the clinical and histopathologic characteristics of this tumor in Asian populations are not available. The purpose of this study was to investigate the clinicopathologic and immunohistochemical features of cutaneous carcinosarcoma in the Korean population. METHODS: We retrospectively reviewed the records of 11 patients with cutaneous carcinosarcoma who were diagnosed from 2006 to 2016. RESULTS: The mean patient age at diagnosis was 71.5 years (range, 43–96 years) and there was a men predilection. The most common site of cutaneous carcinosarcoma was the head and neck (8/11, 72.7%). Histopathologically, most tumors showed a characteristic morphology consisting of two types of tumor cells, varied differentiated epithelial cells (such as basal or squamous cells) and spindle cells with transition zones between the two components. These two cell types also demonstrated variable immunohistochemical characteristics. CONCLUSION: Although the number of cases in this study was limited, our results provide valuable insight into the clinical and histopathologic characteristics of cutaneous carcinosarcoma in the Korean population.
Assuntos
Humanos , Masculino , Povo Asiático , Carcinossarcoma , Diagnóstico , Células Epiteliais , Cabeça , Pescoço , Patologia , Estudos RetrospectivosRESUMO
No abstract available.
Assuntos
Humanos , Ceratodermia Palmar e Plantar , Pitiríase Rubra Pilar , Pitiríase , IrmãosRESUMO
Amputation of the lower extremities followed by the use of an artificial leg is very common. However, malignancy arising in an amputation stump is an extremely rare event. In this report, we describe a case of squamous cell carcinoma arising in the amputation stump of a 56-year-old Korean man. To the best of our knowledge, similar cases have not been previously reported in Korea.
Assuntos
Humanos , Pessoa de Meia-Idade , Cotos de Amputação , Amputação Cirúrgica , Membros Artificiais , Carcinoma de Células Escamosas , Células Epiteliais , Coreia (Geográfico) , Extremidade InferiorRESUMO
No abstract available.
Assuntos
Humanos , Alopecia em Áreas , Alopecia , Cabelo , Próteses e ImplantesRESUMO
It is well recognized that the deposition of mucin occurs in areas of eruption in patients with lupus erythematosus. However, nodular cutaneous mucinosis is regarded as a rare distinctive cutaneous mucinosis in which the mucin deposition occurs in areas other than the sites of eruption in patients with systemic lupus erythematosus and manifests as a clinically specific lesion. Although several cases have been described in the literature, there have been only two reported cases in Korean literature. Thus, we report an interesting case of nodular cutaneous mucinosis that occurred in a young man. A 16-year-old man visited our clinic presenting with multiple soft subcutaneous nodules on his back for 6 months. He denied any other symptoms. Histological examination showed diffuse mucin deposition throughout the superficial and mid-reticular dermis. The abnormal laboratory values were as follows: a positive antinuclear antibody, increased anti-dsDNA, and reduced WBC count and C3 levels. He was diagnosed with nodular cutaneous mucinosis with systemic lupus erythematosus and treated with oral hydroxychloroquine and methylprednisolone. Our report is of interest owing to the rarity of developing nodular cutaneous mucinosis as an initial presentation of systemic lupus erythematosus.
Assuntos
Adolescente , Humanos , Anticorpos Antinucleares , Derme , Hidroxicloroquina , Lúpus Eritematoso Sistêmico , Metilprednisolona , Mucinoses , MucinasRESUMO
Sebaceous carcinoma (SC) is a neoplasm derived from the adnexal epithelium of the sebaceous glands, and most studies on this neoplasm have been conducted in Caucasians. We retrospectively reviewed the records of 29 patients with SC (16 extraocular and 13 ocular lesions) who were diagnosed from 2001 to 2014 to analyze the clinical and histopathological features of SC in the Korean population. Sixteen of the patients were women and 13 were men. There was an equal sex distribution for extraocular lesions, and a female predilection (M:F = 1:1.6) for ocular lesions. The mean ages at presentation of extraocular and ocular lesions were 69.19 ± 37.19 (range, 32–87) and 67.46 ± 24.46 (range, 43–85) years, respectively. Most lesions occurred in the eyelid (13/29, 44.83%), and most extraocular lesions occurred in the head and neck area (13/16, 81.25%). There was no recurrence or death during the follow-up period. Most lesions were poorly differentiated (extraocular, 43.75%; ocular, 38.46%), had a lobular infiltrative growth pattern (extraocular, 68.75%; ocular, 76.92%), and were basaloid (extraocular, 56.25%; ocular, 61.54%). Only 5 cases (2 extraocular and 3 ocular lesions) showed pagetoid spread. Extraocular lesions were marginally more common than the ocular form. There were higher incidences in elderly patients, who also had the highest incidence of eyelid lesions. The proportion of cells with sebaceous differentiation and prominent growth patterns were variable. Our results show that SC may not be very aggressive in Koreans.
Assuntos
Idoso , Feminino , Humanos , Masculino , Epitélio , Pálpebras , Seguimentos , Cabeça , Incidência , Coreia (Geográfico) , Pescoço , Patologia , Recidiva , Estudos Retrospectivos , Glândulas Sebáceas , Distribuição por Sexo , Centros de Atenção TerciáriaRESUMO
The development of cutaneous sarcoidosis as a paradoxical adverse event of tumor necrosis factor alpha (TNF-α) blockers has been reported in the literature; however, an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy has not yet been reported. Herein, we report the first case of an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy and review previous studies of cutaneous sarcoidosis. A 6-year-old Korean girl who had been suffering from juvenile rheumatoid arthritis presented with generalized erythematous skin eruption involving more than about 90% of her body surface area. After 14 months of etanercept treatment, the new erythematous skin eruption had developed and progressed into generalized erythroderma. Exclusion of suspected co-medication had been performed based on medication history. She had no other systemic symptoms, and ophthalmologic and neurologic examinations were normal. Histopathologic findings of the skin lesion revealed diffuse non-caseating granulomatous infiltrates composed of epithelioid histiocytes with sparse lymphocytes involving the entire dermis. Periodic-acid-Schiff and acid-fast stains were negative, and acid-fast bacilli was not detected by polymerase chain reaction of the skin biopsy. Based on clinicopathologic findings, she was diagnosed with etanercept-induced sarcoidal granuloma. After discontinuation of the suspected agent, the lesions spontaneously disappeared.
Assuntos
Criança , Feminino , Humanos , Artrite Juvenil , Biópsia , Superfície Corporal , Corantes , Dermatite Esfoliativa , Derme , Etanercepte , Granuloma , Histiócitos , Linfócitos , Exame Neurológico , Reação em Cadeia da Polimerase , Sarcoidose , Pele , Fator de Necrose Tumoral alfaRESUMO
The development of cutaneous sarcoidosis as a paradoxical adverse event of tumor necrosis factor alpha (TNF-α) blockers has been reported in the literature; however, an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy has not yet been reported. Herein, we report the first case of an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy and review previous studies of cutaneous sarcoidosis. A 6-year-old Korean girl who had been suffering from juvenile rheumatoid arthritis presented with generalized erythematous skin eruption involving more than about 90% of her body surface area. After 14 months of etanercept treatment, the new erythematous skin eruption had developed and progressed into generalized erythroderma. Exclusion of suspected co-medication had been performed based on medication history. She had no other systemic symptoms, and ophthalmologic and neurologic examinations were normal. Histopathologic findings of the skin lesion revealed diffuse non-caseating granulomatous infiltrates composed of epithelioid histiocytes with sparse lymphocytes involving the entire dermis. Periodic-acid-Schiff and acid-fast stains were negative, and acid-fast bacilli was not detected by polymerase chain reaction of the skin biopsy. Based on clinicopathologic findings, she was diagnosed with etanercept-induced sarcoidal granuloma. After discontinuation of the suspected agent, the lesions spontaneously disappeared.