A 72-year-old woman developed pruritic erythematous patches on sun-exposed areas for 2 months following treatment with hydrochlorothiazide (Dichlozid) for hypertension. A phototest revealed a decreased minimal erythemal dose to UVA (MED(UVA)=2 J/cm²). A photopatch test with 0.5%, 1%, and 5% hydrochlorothiazide ointment revealed no response. Two weeks after discontinuation of hydrochlorothiazide, the skin lesions improved with complete loss of photosensitivity without any therapy. At that time, an oral provocation phototest with hydrochlorothiazide was performed and it showed a decreased MED to UVA (MED(UVA)=2 J/cm²).
Aged ; Dermatitis, Phototoxic* ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Skin

Partial Unilateral Lentiginosis (PUL) is a rare pigmentary disorder characterized by the numerous lentigines confined to a body segment, with a sharp demarcation at the midline. We report two cases of PUL. A 38-year-old woman had asymptomatic discrete small hyperpigmented macules that were scattered on the T7~L1 dermatomes on the left side of her trunk and were clearly demarcated in the midline on both anterior and posterior sides. In the other case, an 18- year-old woman had hyperpigmented macules that were scattered on the left neck, shoulder, and anterior chest. Other anomalies including neurofibromatosis, neurologic anomalies, and multiple lentiginous syndrome were not related in both cases. We report two cases of PUL having no other anomalies.
Adult ; Female ; Humans ; Lentigo* ; Neck ; Neurofibromatoses ; Shoulder ; Thorax

A 55-year-old Korean female patient who presented with longitudinal black pigmentation affecting the right thumbnail is described. Direct microscopic examination of nail tissue in 15% potassium hydroxide and cultures on Sabourauds glucose agar revealed Candida species. Cardida species as a cause of longitudinal melanonychia has, to our knowledge, been described only once in the literature. Our case may be the second one.
Agar ; Candida* ; Female ; Glucose ; Humans ; Middle Aged ; Pigmentation ; Potassium

We herein report a case of Richters syndrome(RS) that was discovered following an investigation of a skin lesion. RS represents an acute transformation of chronic lymphocytic leukemia(CLL) to highly malignant large cell lymphoma such as diffuse large B-cell lymphoma(DLBCL). RS is characterixed by abrupt B-symptoms, rapidly progressive lymphadenopathy, hepatosplenomegaly, frequent extranodal involvement, hypercalcemia and an unfavorable clinical course. The patient is a 31-year-old male with skin lesions on his face. He had been previously diagnosed with CLL. At his presentation, CLL and DLBCL manifestly co-existed. Our multistage analysis suggested that DLBCL and CLL might arise from a different B-cell clone. He showed a poor clinical response to systemic chemotherapy.
Adult ; B-Lymphocytes ; Clone Cells ; Drug Therapy ; Humans ; Hypercalcemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lymphatic Diseases ; Lymphoma* ; Male ; Skin

We report a case of myelodysplastic syndrome (MDS) with unique histopathological findings in which numerous infiltrated neutrophils exhibited nuclear segmentation anomalies. In comparison with well-described neutrophilic dermatoses of myelodysplastic syndrome such as Sweets syndrome and pyoderma gangrenosum, this case took a rapid and aggressive clinical course. We suggest that a nuclear segmentation anomaly, pseudo Pelger-Hiiet anomaly, is likely to reflect acute transformation of MDS and can be a poor prognostic marker.
Myelodysplastic Syndromes ; Neutrophils* ; Pyoderma Gangrenosum ; Skin Diseases ; Sweet Syndrome

Mucinous carcinoma can occur in non-cutaneous visceral sites and may metastasize to the skin. Thus it is important to exclude the possibility of a non-cutaneous visceral primary tumor before diagnosing primary mucinous carcinoma of the skin (PMCS). We describe a PMCS with unusual histopathological 6ndings. Although the microscopical, immunohistochemical, and ultrastructural characteristics of PMCS have been well defined, only less than sixty cases have been published since the disease was first reported by Lennox. This is an unusual case where combined features of apocrine carcinoma and predominant cribriform patterns reminiscent of adenoid cystic carcinoma exist in part, with highly anaplastic cellular features and frequent mitosis. To our knowledge, there have been no reports of this rare neoplasm in Korea.
Adenocarcinoma, Mucinous* ; Carcinoma, Adenoid Cystic ; Korea ; Mitosis ; Mucins* ; Skin*

Extramammary Paget's disease (EMPD) typically presents as an eczematous, eroded or crusted plaque. Only a few cases with depigmentation have been reported. We herein report a patient with a depigmented scrotal patch as the sole finding of EMPD. Since he had concurrent rectal cancer, we stained the tissue with gross cystic disease fluid protein-15 (GCDFP-15) and cytokeratin 20 (CK20) in order to differentiate primary/secondary EMPD. This case represents coincidental primary EMPD and rectal cancer, of which the initial features of EMPD were unusual.
Adenocarcinoma* ; Cytochrome P-450 CYP1A1 ; Humans ; Keratin-20 ; Paget Disease, Extramammary* ; Rectal Neoplasms*

Keratoacanthoma is a rapidly growing tumor that histologically resembles squamous cell carcinoma. Surgical excision is a desirable therapeutic option, but several other treatment modalities are available. We report on two cases of keratoacanthoma that were treated with imiquimod 5% cream. Imiquimod was applied daily for the first 6 or 7 days, and then reduced to alternate days according to the tolerance and erythema severity of the patient. In both patients, the tumors fully regressed after five weeks of treatment.
Carcinoma, Squamous Cell ; Erythema ; Humans ; Keratoacanthoma*

Chronic radiodermatitis may develop after repetitive exposure to small doses of ionizing radiation over an extensive period of time. Therefore, it is most likely to occur in people who work with ionizing radiation. The clinical symptoms of chronic radiodermatitis include atrophy, telangiectasia, sclerosis, pigmentary changes of the skin, ulceration and the development of malignancy. Cases of chronic radiodermatitis have occasionally been reported in physicians performing interventional procedures. Herein, we report a case of chronic radiodermatitis involving the 4th finger web and 5th finger of a radiologist, who suffered from chronic myelogenous leukemia shortly afterwards. The lesion on the 5th finger eventually progressed into squamous cell carcinoma.
Atrophy ; Carcinoma, Squamous Cell* ; Fingers ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Radiation, Ionizing ; Radiodermatitis* ; Sclerosis ; Skin ; Telangiectasis ; Ulcer

Adenomatoid hyperplasia of the minor salivary glands is a rare clinicopathologic entity with an unknown etiology. The clinical features of the lesion are nodular, non-painful swellings, and the histologic features are aggregates of normal-appearing, salivary gland tissue, in excess of what would be anticipated for the anatomic site. This tumor is of significance because of its clinical resemblance to salivary gland tumors. Although this lesion may occur at any site on the oral mucosa, the labial mucosa is known to be the least common site. We herein report a rare case of adenomatous hyperplasia of the minor salivary glands located on the lower labial mucosa.
Hyperplasia* ; Mouth Mucosa ; Mucous Membrane ; Salivary Glands ; Salivary Glands, Minor*