Darier’s disease is characterized by greasy and scaly papules that primarily affect seborrheic and intertriginous areas which is caused by a mutation in the ATP2A2 gene. Histopathologically, the disease is characterized by acantholysis and dyskeratosis. Among the diverse presentations, the segmental type follows a linear distribution along the lines of Blaschko. Herein, we present a case of a 54-year-old male with generalized erythematous papules that had been linearly distributed across his body for two decades. Lesions on his trunk and extremities were confined to the right side, whereas those on the scalp and face exhibited multiple segmental presentations. Histopathological examination revealed acantholysis and dyskeratosis in the epidermis, confirming the diagnosis of type 1 segmental Darier’s disease. This case underscores the rarity of type 1 segmental Darier’s disease, particularly with multiple segmental involvement and highlights the complexity and variability of this dermatological condition.

Lichen amyloidosis is characterized by coalescent hyperpigmented papules with a predilection for the extremities and is accompanied by severe chronic pruritus. Various therapies have been attempted; however, there is no uniformly recognized effective treatment. In the first case, a 60-year-old man with a 37-year history of intractable itching presented with hyperkeratotic brown papules and coalescing plaques on the trunk and extensor surfaces of the extremities. The second case involved a 31-year-old man who presented with brownish macules and papules with a rippled pattern on the upper back and lower extremities. Histological examination of the lesions from both patients revealed epidermal hyperplasia and amorphous material deposited in the papillary dermis, which tested positive on Congo red staining. Although both patients were diagnosed with lichen amyloidosis, several treatment modalities showed limited efficacy. Subsequently, dupilumab, a treatment for severe pruritus, was administered to both patients, resulting in significant improvements.

A 34-year-old male with acne was presented with a 1-year history of multiple tiny subcutaneous nodules on his face, particularly on both cheeks. Physical examination revealed asymptomatic, palpable, and hard nodules with an acne scar. The skin lesions were more obvious when the cheeks were inflated. A skin biopsy revealed multiple focal bony trabeculae with osteoblasts in the dermis. A diagnosis of multiple miliary osteomas cutis was done. Multiple miliary osteoma cutis is a rare benign extraskeletal ossification that is considered relatively common and under-reported because of its asymptomatic behavior. Osteoma cutis is generally observed in middle-aged females with a history of acne. Male involvement rarely occurs, especially at a young age, as observed in this patient. Topical retinoids were prescribed, but the lesions did not abate at 3 months follow-up.

Traumatic tattoos are abnormal pigmentations caused by embedded foreign particles due to various injuries, including explosions, abrasions, or traffic accidents. Traumatic tattoos caused by pencils are common and considered trivial because they are usually confined to the injured site without any complications. A 4-year-old girl presented with a 5-month history of a grey-to-bluish patch on her left cheek. Histopathological examination revealed many pigment granules surrounding the blood vessels and appendages diffused from the mid to the lower dermis. Various staining methods were employed to verify that colorants caused the tattoo. To our knowledge, there have been no reports of traumatic tattoos caused by colored pencils that spread rapidly beyond the injured areas. In particular, various unexpected traumas can occur frequently in children; therefore, an accurate diagnosis is essential by differentiating it from other acquired pigmentary disorders

BACKGROUND/OBJECTIVES: Isoflavones are estrogen-like compounds found in plants and their health effects remain equivocal. We investigated dietary isoflavone intake and its associated factors in Korean breast cancer survivors, with a comparison to cancer-free women. SUBJECTS/METHODS: The usual dietary intake of breast cancer survivors (n = 981, mean age 52 yrs) in 9 hospitals between 2012 and 2019 was assessed using 3-day food records or food frequency questionnaires (FFQs). They were age-matched to 2,943 cancer-free women who completed FFQs as part of a nationwide study conducted between 2012 and 2016. We used the flavonoid database of common Korean foods and the Phenol-Explorer database to estimate isoflavone intake. The contribution of each food or food group to the total isoflavone intake was calculated. The adjusted least-squares means of dietary isoflavone intake according to lifestyle and clinical factors were calculated using generalized linear models. RESULTS: Breast cancer survivors had a higher mean dietary isoflavone intake (23.59 mg/day) than cancer-free women (17.81 mg/day). Major food sources, including tofu, soybeans, and doenjang, contributed to over 70% of the isoflavone intake in both groups. When we estimated dietary isoflavone intake according to lifestyle characteristics, isoflavone intake increased with higher scores of adherence to the American Cancer Society dietary guidelines but decreased with increasing body mass index in both groups. Among cancer-free women, dietary isoflavone intake was higher among those who had never smoked and among dietary supplement users. Among breast cancer survivors, dietary isoflavone intakes did not vary with clinical characteristics, including time since surgery and estrogen receptor status. CONCLUSION Breast cancer survivors were more likely to consume isoflavones than agematched cancer-free women. Dietary isoflavone intake was associated with healthy lifestyle characteristics in women both with and without breast cancer. Further research is needed to understand the role of the higher isoflavone intake among breast cancer survivors compared to cancer-free women on their prognosis.

Darier’s disease is characterized by greasy and scaly papules that primarily affect seborrheic and intertriginous areas which is caused by a mutation in the ATP2A2 gene. Histopathologically, the disease is characterized by acantholysis and dyskeratosis. Among the diverse presentations, the segmental type follows a linear distribution along the lines of Blaschko. Herein, we present a case of a 54-year-old male with generalized erythematous papules that had been linearly distributed across his body for two decades. Lesions on his trunk and extremities were confined to the right side, whereas those on the scalp and face exhibited multiple segmental presentations. Histopathological examination revealed acantholysis and dyskeratosis in the epidermis, confirming the diagnosis of type 1 segmental Darier’s disease. This case underscores the rarity of type 1 segmental Darier’s disease, particularly with multiple segmental involvement and highlights the complexity and variability of this dermatological condition.

Lichen amyloidosis is characterized by coalescent hyperpigmented papules with a predilection for the extremities and is accompanied by severe chronic pruritus. Various therapies have been attempted; however, there is no uniformly recognized effective treatment. In the first case, a 60-year-old man with a 37-year history of intractable itching presented with hyperkeratotic brown papules and coalescing plaques on the trunk and extensor surfaces of the extremities. The second case involved a 31-year-old man who presented with brownish macules and papules with a rippled pattern on the upper back and lower extremities. Histological examination of the lesions from both patients revealed epidermal hyperplasia and amorphous material deposited in the papillary dermis, which tested positive on Congo red staining. Although both patients were diagnosed with lichen amyloidosis, several treatment modalities showed limited efficacy. Subsequently, dupilumab, a treatment for severe pruritus, was administered to both patients, resulting in significant improvements.

A 34-year-old male with acne was presented with a 1-year history of multiple tiny subcutaneous nodules on his face, particularly on both cheeks. Physical examination revealed asymptomatic, palpable, and hard nodules with an acne scar. The skin lesions were more obvious when the cheeks were inflated. A skin biopsy revealed multiple focal bony trabeculae with osteoblasts in the dermis. A diagnosis of multiple miliary osteomas cutis was done. Multiple miliary osteoma cutis is a rare benign extraskeletal ossification that is considered relatively common and under-reported because of its asymptomatic behavior. Osteoma cutis is generally observed in middle-aged females with a history of acne. Male involvement rarely occurs, especially at a young age, as observed in this patient. Topical retinoids were prescribed, but the lesions did not abate at 3 months follow-up.