BACKGROUND: Psoriasis is characterized by chronic recurrent erythematous skin plaques that exhibit epidermal hyperplasia, inflammatory cell accumulation and abnormalities of the papillary dermal vasculature. Psoriatic skin lesions show enlargement and increased tortuosity of cutaneous microvessels without formation of new vessel sprouts, that is, inflammatory angiogenesis. Placental growth factor (PlGF) and Tie-2 were reported to be up-regulated during inflammatory angiogenesis. Tazarotene is the first receptor-selective retinoid and its effects include normalizing keratinocyte differentiation, reducing keratinocyte proliferation and reducing inflammation. OBJECTIVE: Our study evaluated the clinical efficacy of topical tazarotene treatment and clarified histological changes and possible action mechanisms of this agent in respect of inflammatory angiogenesis. METHODS: We selected patients with symmetric psoriatic lesions and applied 0.1% tazarotene gel (Tazorac(R)) versus calcitriol 3 microgram/g gel (Silkis(R)) twice a day for 12 weeks with a right-left comparison. We grouped the patients with treatment modalities. Clinical efficacy, which was measured by the overall lesional assessment (OLA) scores, was assessed at each visit in 2 week' intervals until treatment closed. Skin biopsies were performed before the treatment started and again at 4 weeks and 12 weeks after treatment. Immunohistochemistry of PlGF, Tie-2 and factor-VIII was performed to elucidate the anti-angiogenetic effect of tazarotene. RESULTS: At the completion of 12 weeks of treatment, the OLA score of tazarotene-treated lesions was more reduced than that of calcitriol-treated lesions combined with phototherapy, it was more effective. Several histologic features such as epidermal hyperplasia, inflammatory cell infiltration and vessel dilation/tortousity were improved with decreased PlGF and Tie-2 expressions. CONCLUSION: These results indicate that tazarotene is an effective topical agent for psoriasis by blocking inflammatory angiogenesis.
Biopsy ; Calcitriol ; Humans ; Hyperplasia ; Immunohistochemistry ; Inflammation ; Keratinocytes ; Microvessels ; Phototherapy ; Psoriasis* ; Skin

This study was conducted to evaluate the quantitative and qualitative aspects of Korean websites related to nutrition education. A total of 30 websites were ultimately selected through 4 major Internet search engines, including Naver, Yahoo, Daum, and Nate, using several key words (i.e., nutrition education, dietary life education, nutrition information, nutrition management, etc.). A systematic review was conducted for each of the selected websites based on the American Library Association (ALA) website checklist and a data abstract form that was adapted from a previous study. Approximately two thirds of the websites were established between 2002 and 2005, and 46.6% were administrated by public health centers or schools/colleges. The most frequently targeted group was the generally healthy population (30.0%). Among the various topics of nutrition information provided, "balanced diet" was the topic most often provided by the websites. Also, an increasing trend for utilizing multimedia tools was observed; however, little technical support or instruction was provided by the websites. Only 50.0% and 63.3% of the sites clearly stated their operators and sources of provided information, respectively. Overall, the purposes of sites were clearly stated, and were not overshadowed by advertising. And most features of design, stability, and content were found to be appropriate, but several aspects, such as establishing a help/FAQ menu, regularly updating nutrition information, and converting provided information into a database for easier search and update, needed improvement. In addition, active operational strategies are greatly needed to encourage the application of materials found on sites into real educational settings.
Checklist ; Internet ; Library Associations ; Multimedia ; Public Health ; Search Engine

Clear cell acanthoma is a rare, benign, epidermal tumor. These tumors usually present as solitary lesions, often localized on the lower legs of middle aged or elderly individuals. Pigmented clear cell acanthoma, a variant of clear cell acanthoma, presents as macroscopically visible brown to black-colored, flat or dome-shaped, sharply-dermacated papules or nodules. Histopathologic findings in these tumors reveal markedly epidermal hyperplasia, with exception of the cells in the basal layer. Also, most of the epithelium showed pallor and slight enlargement. With these pigmented type tumors, dermal melanophages are often noticeable on low-power magnification, plus increased melanocytes with melanin granules in the epidermis. A 41-year-old man presented with a 7-year history of a 1.2x0.8cm sized, black plaque on the right inner thigh. The histologic findings revealed the typical features of pigmented clear cell acanthoma.
Acanthoma* ; Adult ; Aged ; Epidermis ; Epithelium ; Humans ; Hyperplasia ; Leg ; Melanins ; Melanocytes ; Middle Aged ; Pallor ; Thigh

BACKGRUND & OBJECTIVE: Prognosis of alopecia areata have been attributed to various factors; age of onset, duration before treatment, extent of hair loss, clinical type of alopecia areata, sex, nail changes or accompaniment of atopy. The study on prognostic factors has only been conducted from statistical data of patients and individualized medical conditions. The histopathologic findings of alopecia areata have been investigated by the minute pathologic changes associated with the hair growth cycle in the transverse section. Moreover, these findings were used mainly for diagnostic purpose, but clinical significance of histopathologic severity in prognosis has not been established to date. METHODS: A clinical study, including histopathological and clinical evaluation was conducted on 108 alopecia areata patients between July 1997 and August 2005 at the Department of Dermatology, Dong-A University Hospital. The evaluation criteria INCLUDED: sex, age, age at onset, duration before treatment, clinical types, extent of hair loss, nail changes, accompaniment of atopy, and scalp biopsy finding. The clinical types of alopecia areata were classified as follows; patchy, subtotalis, totalis, and universalis. The extent of hair loss before treatment was classified into 5 grades (S1~S5), according to the method designed by Olsen and Canfield. Clinical improvements after treatment were classified into 5 grades according to degree of regrowth and reduction of the alopecia areata area. Biopsy findings were classified into 4 grades (type I, II, III, and IV) according to classification by Uno and Orecchia. RESULTS: The mean age was 28.6 years, without any sex predominance. The severe histopathologic gradings were significantly associated with early age of onset (p=0.008), a long disease duration before treatment (p=0.003), a greater extent of hair loss (p=0.009), and poor response to treatment (p=0.036). The histopathologic gradings were not significantly associated with sex (p=0.657), clinical types of alopecia areata (p=0.529), nail changes (p=0.746), or accompaniment of atopy (p=0.924). CONCLUSION: Histopathologic gradings in alopecia areata, using vertical sections are significantly associated with prognostic factors such as age of onset, extent of hair loss, disease duration before treatment, as well as the response to treatment. Therefore we consider that the histopathologic grading system is recommendable as an independent prognostic factor in alopecia areata, in addition to the well-known clinical prognostic factors. They may also be used to predict the response to treatment.
Age of Onset ; Alopecia Areata* ; Alopecia* ; Biopsy ; Classification ; Dermatology ; Hair ; Humans ; Prognosis ; Scalp

Signet-ring cells are cells in which the nucleus is crescentically compressed with a cellular border, so that the cell looks like a signet-ring. Many cutaneous signet-ring cell neoplasms originate from the stomach, lung and breast, and these appear to be the most common sites of origin. In skin, the appearance of signet-ring cells within a neoplasm can indicate metastatic adenocarcinoma of the stomach, lung and breast. Thus, the primary origin and other metastatic sites should be evaluated. A 44-year-old man presented with a six month history of cutaneous swelling on the left axillary and left supraclavicular area. Histopathologic findings of the axillary lesion showed signet-ring cells in the lymphatics. These clustered cells were PAS-positive, diastase-resistant, and stained with colloidal iron and CEA. During the work-up study to find the primary origin, we discovered advanced gastric cancer and multiple lymph node metastases.
Adenocarcinoma* ; Adult ; Breast ; Colloids ; Edema* ; Humans ; Iron ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Skin ; Stomach ; Stomach Neoplasms

Lichen planus is a chronic papulosquamous disease chracterized by various clinical manifestations of the skin and mucous membrane. Although its etiology is not fully understood, lichen planus has been associated with viral infection, autoimmune disease, psychologic factors, and medications. Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of lichen planus. The former includes antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8+ cytotoxic T cells, the latter includes mast cell degranulation and matrix metalloproteinase activation. A large variety of topical and systemic therapies are available for the treatment of lichen planus. Also, topical pimecrolimus (Elidel(R) 0.1% cream) may be used because of its inhibitory effect on activated T cells and mast cell degranulation. Recently, it has been shown to be effective in the treatment of oral and genital lichen planus. But, its effect in cutaneous lichen planus has not been reported to date. We report on the successful use of topical pimecrolimus in the management of a generalized lichen planus patient.
Antigen Presentation ; Autoimmune Diseases ; Homicide ; Humans ; Keratinocytes ; Lichen Planus* ; Lichens* ; Mast Cells ; Mucous Membrane ; Skin ; T-Lymphocytes

Pigmented neurofibroma is a rare cutaneous tumor accounting for less than 1% of all neurofibroma. It is characterized histologically by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiation. The origin of these tumors are unknown, and they show a storifom pattern. In our case, the patient had giant cafe au lait patches on the left trunk which had been present since birth, freckles on both axilla, and two dark-red colored plaques which had appeared 2 years ago. Histologic examination revealed pigmented neurofibromas showing the melanin-laden, pigmented cells within the upper dermis and plexiform neurofibromas in the subcutaneous tissue. We describe a case of pigmented neurofbroma in a 13-year-old male patient.
Adolescent ; Axilla ; Dermis ; Humans ; Male ; Melanosis ; Neurofibroma* ; Neurofibroma, Plexiform ; Parturition ; Subcutaneous Tissue

Spitz nevus is a variant of melanocytic nevus which is histopathologically defined as large spindle and/or epithelioid cells. Angiomatoid Spitz nevus is a rare histologic variant of desmoplastic Spitz nevus characterized by prominent vasculature. We present a case of angiomatoid Spitz nevus, celluar type, that has not been reported before. We provide another example to show the remarkable diversity of Spitz nevus.
Epithelioid Cells ; Nevus, Epithelioid and Spindle Cell ; Nevus, Pigmented

Calvus, callus, plantar warts and piezogenic papules are well known to cause discomfort and disturbance of gait in ordinary physical and sports activities. Furthermore, calcifying aponeurotic fibroma, whose mass slowly grows on the palms and soles of children and young adults, leads to pain, disturbance of gait, and even to skeletal deformities. A 22-year-old woman noticed an elevated subcutaneous mass on the left plantar surface of her big toe, which was accompanied with pain, tenderness and gait disturbance. The histologic findings showed an ill-circumscribed fibroblastic proliferation with foci of calcification and chondroid differentiation. After total excision of the mass, the patient became free of the above symptoms and the lesion did not recur for 9 months.
Bony Callus ; Child ; Congenital Abnormalities ; Female ; Fibroblasts ; Fibroma* ; Gait* ; Humans ; Sports ; Toes ; Warts ; Young Adult

Pseudocyst of the auricle is an uncommon condition, which typically presents as an asymptomatic, noninflammatory swelling of the external ear. Most of the patients are usually young, healthy males without trauma. Histological examination is characterized by the intracartilaginous accumulation of serous fluid without an epithelial lining. The pathogenesis is unknown. Some theories about the release of lysosomal enzymes or inflammatory mediators and embryologic dysplasia of the auricle cartilage have been suggested. Treatment of pseudocyst of the auricle has usually involved a simple aspiration and compressive dressing, but this may often cause the fluid to reaccumulate. Treatment by surgical excision may result in a permanent deformity and scar of the auricle. Therefore, various treatments have been suggested. We report a case of pseudocyst of the auricle successfully treated by incisional biopsy only.
Bandages ; Biopsy* ; Cartilage ; Cicatrix ; Congenital Abnormalities ; Ear, External ; Humans ; Male