We present a case of pyoderma gangrenosum associated with ulcerative colitis. The patients, a 21-year-old women has suffered from skin defect on the left chest and pubic area since 7 days ago. During treatment for pyoderma gangrenosum she developed new gastrointestinal symptoms such as nausea, vomiting, and diarrhea. On colonoscopic examination and biopsy she was diagnosed ulcerative colitis. Prednisolone was given orally in the dose of 60mg/day and mesalamine was given orally in the dose of 1000mg/day for ulcerative colitis. Clinical improvement was observed after 15 days.
Biopsy ; Colitis, Ulcerative* ; Diarrhea ; Female ; Humans ; Mesalamine ; Nausea ; Prednisolone ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Thorax ; Ulcer* ; Vomiting ; Young Adult

Solitary myofibroma is a recently described, uncommon neoplasm of superficial soft tissue and presenting as an asymptomatic nodule of the skin, which mainly occurs in adults. It was thought to be the adult counterpart of infantile myofibromatosis. Although it has histopathological similarity to infantile myofibromatosis, it shows a discrete clinicopathological entity compared with infantile form on the basis of its much later onset, superficial location, invariable solitary occurrence and uniformly benign behavior. A 41-year-old female presented a skin lesion on the posterior neck for 1 year, which was a solitary, painless nodule. The excised tumor was diagnosed as myofibroma by light microscopy and immunohistochemistry.
Adult* ; Female ; Humans ; Immunohistochemistry ; Microscopy ; Myofibroma* ; Myofibromatosis ; Neck ; Skin

Trichoptilosis is a longitudinal splitting or fraying of the distal end of the hair caused by cumulative physical and/or chemical effects on the hair shaft. We present three cases of trichoptilosis patients complaining of alopecia, two cases with the scalp hairs and one case with the pubic hairs. One of the two scalp hair cases showed the hair shaft disorder as a part of a Tourette's syndrome and the other case was caused by scalp pruritus. The patient with pubic hair involvement showed hypochondriasis on his genital area. The cases were thought to be a good example showing the stereotypic change of the hair shaft in various different underlying diseases of the affected patients.
Alopecia ; Hair ; Humans ; Hypochondriasis ; Pruritus ; Scalp ; Tourette Syndrome

Impetigo herpetiformis is a rare, severe dermatologic disorder occurring predominantly in the third trimester of pregnancy. Rarely, it may present during the puerperium, and this suggests that impetigo herpetiformis should be included in the differential diagnosis of puerperal fever, particularly in those cases associated with dermatoses. We report a 32-year-old woman who developed impetigo hermpetiformis during puerperium. She was a primigravida and did not have a previous history of psoriasis. Three days after parturition she developed a severely pruritic pustular rash composed of erythematous patches first presented in both axilla. The patient showed rapid improvement with oral prednisolone 40 mg/day for 5 days, and the lesions healed in 10 days. Follow-up for 12 months revealed no recurrence.
Adult ; Axilla ; Diagnosis, Differential ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Humans ; Impetigo* ; Parturition ; Postpartum Period* ; Prednisolone ; Pregnancy ; Pregnancy Trimester, Third ; Psoriasis ; Recurrence ; Skin Diseases

Lentigo maligna melanoma (LMM) is the least common type of melanoma and most commonly affects the sun-exposed skin of the elderly. We herein report a case of LMM located on the left lower eyelid of an 86-year-old woman. This female patient presented with a longstanding irregular brownish patch containing black macules consistent with LMM. There are several treatment modalities for removing the LMM lesion. However, considering the functional and the aesthetic aspect of the lower eyelid, we performed Mohs micrographic surgery to remove the lesion, and lateral based transposition flap was employed to reconstruct the resultant defect on the left lower eyelid.
Aged ; Aged, 80 and over ; Eyelids ; Female ; Humans ; Hutchinson's Melanotic Freckle* ; Lentigo* ; Melanoma* ; Mohs Surgery* ; Skin

Malignant nodular hidradenoma was first reported by Liu in 1949, and it is an uncommon appendage tumor that presents on head, trunk, or extremities. It has been known as nodular hidradenocarcinoma, malignant clear cell hidradenoma, clear cell hidradenocarcinoma, and accepted as a tumor of the eccrine sweat glands. Histopathologically, tumor is composed of lobulated masses and contains tubular structures with cystic space formation. The cells forming the nest have two populations of clear cells and basophilic polyhedral cells. We report a case of malignant nodular hidradenoma composed of a small proportion of clear cells.
Acrospiroma* ; Basophils ; Extremities ; Head ; Sweat Glands

Discoid lupus erythematosus (DLE) commonly develops on the sun-exposed area such as the bridge of the nose, malar areas, lower lip and ears. Typically lesions have well-defined discoid erythematous patches with adherent scales, horny plugs, telangiectasia, hypopigmentation and atrophy. Topical, systemic and intralesional injection of steroid and antimalarial drugs have been used. However, the most important treatments in DLE are avoidance of sunlight exposure and daily use of high SPF sunscreen. We treated two DLE patients with autologous suction blister graft (ASBG) which has been widely used for treatment of vitiligo. In general, grafted sites tend to be hyperpigmented after ASBG, so we adopted this characteristic to the treatment of DLE for the purpose of achieving natural sun protection. After one month of ASBG, not only increased pigmentation but also improved skin texture of the lesion was observed. We thought ASBG provided the biologically protective barrier to sunlight and somewhat improvement of DLE lesion. Therefore, ASBG could be regarded as one of the options in the therapeutic modalities of DLE.
Antimalarials ; Atrophy ; Blister* ; Ear ; Humans ; Hypopigmentation ; Injections, Intralesional ; Lip ; Lupus Erythematosus, Discoid* ; Nose ; Pigmentation ; Skin ; Solar System ; Suction* ; Sunlight ; Telangiectasis ; Transplants* ; Vitiligo ; Weights and Measures

Kimura's disease is a chronic, inflammatory disorder of unknown origin. It is characterized by clinically recurrent painless swelling on head and neck region, histopathologically multiple lymphoid follicles, increased serum IgE levels, and eosinophilia of tissue and peripheral blood. It has been known that Kimura's disease is the reactive immunological disease. Recently, however, it was suggested the clonal T cell proliferation might contribute to the pathogenesis in the Kimura's disease. But, it is still uncertain that Kimura's disease is of reactive nature or neoplastic origin. A 71-year-old woman visited our clinic with painless violaceous swelling on her right cheek. Skin biopsy was performed and, taken together, Kimura's disease was diagnosed. Tissue section was examined with immunohistochemical stains with markers of lymphocytes, plasma cell, and periendothelial cell, and polymerase chain reaction for the TCR gene rearrangement was performed. We present a case of Kimura's disease investigated by the immunohistochemical study and TCR gene rearrangement test and suggest this case is in the limited favor of the reactive nature of Kimura's disease.
Aged ; Biopsy ; Cell Proliferation ; Cheek ; Coloring Agents ; Eosinophilia ; Female ; Genes, T-Cell Receptor ; Head ; Humans ; Immune System Diseases ; Immunoglobulin E ; Lymphocytes ; Neck ; Plasma Cells ; Polymerase Chain Reaction ; Skin

The perforating disorders comprise a group of unrelated pathologic abnormalities sharing the common characteristic of transepidermal elimination. This phenomenon is characterized by the elimination or extrusion of altered dermal substances and, in some cases, by such material behaving as foreign material. Traditionally, four diseases have been included in this group: Kyrle's disease, perforating folliculitis, reactive perforating collagenosis, elastosis perforans serpiginosum. We describe three cases of perforating disorder which showed different clinical and histopathological figures.
Folliculitis

BACKGROUND: Psoriasis is a chronic relapsing and angiogenic skin disease characterized by variable clinical features. But the pathogenetic process resulting in vascular morphological changes remains to be proven. It is reported that the potent angiogenic factor VEGF is overexpressed in psoriatic epidermis and the level of IGF-II is significantly elevated in tissue fluid and serum of the psoriatic lesion. OBJECTIVE AND METHOD: To find the mechanism of VEGF induction in pathogenesis of psoriasis, we adopt IGF-II as a paracrine inducer of VEGF in psoriasis. To investigate the signaling pathway of IGF-II-induced VEGF, we determined ERK1/2 activity in IGF-II-treated psoriatic cells. RESULT: In this report, we demonstrated that IGF-II induced the expression of VEGF in lesional keratinocytes of psoriasis. And IGF-II stimulated the expression of its receptor, IGFR-I in psoriatic cells. Treatment of anti-IGFR-I neutralizing antibody diminished VEGF mRNA level induced by IGF-II, indicating that VEGF induction by IGF-II may be mediated through IGFR-I. By the treatment of PD98059, specific inhibitor of upstream ERK activator MAP kinase/ERK kinase (MEK), the expression of VEGF induced by IGF-II was dramatically reduced. CONCLUSION: Taken together, these results suggest that IGF-II might regulate angiogenesis by the induction of VEGF through the MAP kinase pathway mediated by IGFR-I in the lesion of psoriasis.
Angiogenesis Inducing Agents ; Antibodies, Neutralizing ; Epidermis ; Insulin-Like Growth Factor II ; Keratinocytes ; Phosphotransferases ; Psoriasis* ; RNA, Messenger ; Skin Diseases ; Vascular Endothelial Growth Factor A*