With the recent increase in reported cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), fears of breast implants have increased. In particular, some patients now desire expander removal without implant insertion. In the case described herein, a 41-year-old female patient who had undergone a skin-sparing mastectomy with expander insertion due to breast cancer requested expander removal due to fear of BIA-ALCL during expansion. The authors modified the Goldilocks technique to prevent a chest wall deformity due to expansion. The expanded skin was sufficiently thick, as it was engrafted with acellular dermal matrix, and some of it was de-epithelized and rolled in. The patient’s chest wall depression was completely corrected and an acceptable breast mound was created. To summarize, this technique was used to correct a chest wall deformity and to form a breast mound in a patient who underwent expander removal without implant insertion.

Poliosis circumscripta describes a localized patch of white hair due to deficiency of melanin in the hair follicles. It is a feature of various conditions such as piebaldism, Vogt-Koyanagi-Harada syndrome, tuberous sclerosis, vitiligo, recent herpes zoster infection, or overlying a scalp neurofibroma. We report a rare case of poliosis circumscripta associated with halo nevus of the scalp. A 24-year-old woman presented with a 10 year history of an asymptomatic, pinkish nodule on the scalp which had overlying poliosis. On histopathological examination, dermal nevus cells were observed and the hair follicles of the depigmented patch were found to be devoid of pigment.
Female ; Hair ; Hair Follicle ; Herpes Zoster ; Humans ; Melanins ; Neurofibroma ; Nevus ; Nevus, Halo* ; Piebaldism ; Scalp* ; Tuberous Sclerosis ; Uveomeningoencephalitic Syndrome ; Vitiligo ; Young Adult

Palisaded neutrophilic and granulomatous dermatitis is a newly described disease associated with connective tissue disorders, such as rheumatoid arthritis or lupus erythematousus. Cases associated with rheumatoid arthritis are also termed rheumatoid papules. We report a 27-year-old woman who presented with two erythematous, tender papules on her left elbow. She had rheumatoid arthritis and was being treated with an oral steroid, methotrexate and nonsteroidal antiinflammatory drugs. Histopathologic examination showed degenerative collagen with basophilic fibrinoid materials and neutrophils surrounded by palisaded epithelioid cells in the upper dermis.
Adult ; Arthritis, Rheumatoid ; Basophils ; Collagen ; Connective Tissue ; Dermatitis* ; Dermis ; Elbow ; Epithelioid Cells ; Female ; Humans ; Methotrexate ; Neutrophils*

Onychomycosis is caused by dermatophytes usually, but some species of non-dermatophytic molds and yeasts are also associated with invasion of nails. Fusarium (F.) verticillioides is a non-dermatophytic mold, which are common soil saprophytes. Onychomycosis due to Fusarium species almost always involves great toe nails and occurs infection easily in the presence of trauma, onychodystrophy and prior onychomycosis. We report a first case of onychomycosis caused by Fusarium verticillioides in a 48-year-old man. He presented with proximal white superficial onychomycosis for 3 months. Fungal culture showed whitish cottony colonies and microscopic examination of colonies showed microconidia in a chain from monophialide. We diagnosed onychomycosis caused by Fusarium verticillioides and treated by itraconazole 200 mg daily and 5% amorolfine nail lacquer for 3 months.
Arthrodermataceae ; European Continental Ancestry Group ; Fungi ; Fusarium ; Humans ; Itraconazole ; Lacquer ; Middle Aged ; Morpholines ; Nails ; Onychomycosis ; Soil ; Toes ; Yeasts

BACKGROUND: Dermatophytoses in children are commonly seen but relatively infrequent than adults. Dermatophytoses in children can be different clinically and mycologically from those in adults in that children experience rapid physical changes and they have different skin features and environments from those of adults. OBJECTIVE: The goal of this research is to understand the clinical and mycological characteristics of dermatophytoses in children. METHODS: This clinical and mycological investigation was made with 15,684 patients under age 18 who were diagnosed with dermatophytoses from April, 1976 to March, 2005. RESULTS: The results can be summarized as follows: 1. The incidence of dermatophytoses in children to total number of pediatric outpatients was 6.4%. Male patients were 9,475 and female patients were 6,209 leaving male to female ratio of 1.5:1. Dermatophytoses showed high incidence in the age group between 13 and 18 (7,009). 2. Tinea pedis was 4,020 cases and the most common, followed by tinea cruris, tinea capitis, tinea corporis, tinea unguium, tinea faciale. Tinea capitis largely increased in 1980s and is falling off through 1990s, tinea pedis tends to increase since 1990s. The onsets in summer were the most eminent. 3. Among 15,684 cases, 9,395 cases (59.9%) yielded isolated strains on fungal culture. Trichophyton (T.) rubrum was 5,049 strains (53.7%) and the most common among the total isolated 9,395 strains followed by Microsporum (M.) canis, and T. mentagrophytes. M. canis was the most commonly isolated organism in tinea capitis and tinea manus but in other cases T. rubrum was. CONCLUSIONS: Dermatophytoses in children are different clinically and mycologically from those in adults and vary with the change of the times.
Adult ; Child ; Female ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Skin ; Tinea ; Tinea Capitis ; Tinea Pedis ; Trichophyton

Steatocystoma is a benign adnexal tumor originating from the pilosebaceous duct junction which can be classified into two groups (steatocystoma simplex and steatocystoma multiplex). Steatocystoma simplex, which presents as a solitary lesion, is very rare. Steatocystoma simplex occurs most commonly on the face and the case reported herein involving the scalp is extremely rare. A 49-year-old man presented for evaluation and treatment of a solitary papule on the right parietal scalp which had persisted for a period of 1 year. The histopathologic examination revealed a thin-walled cyst consisting of stratified squamous epithelium with hyaline cuticle that lacked a stratum granulosum. Based on clinical and histologic findings, we diagnosed this case as steatocystoma simplex of the scalp and report this rare case.
Epithelium ; Humans ; Hyalin ; Methylmethacrylates ; Middle Aged ; Polystyrenes ; Scalp

Papuloerythroderma of Ofuji is an uncommon dermatological disorder of unknown etiology and is characterized by a pruritic eruption of widespread confluent papules in vast sheets over the skin, but spares the skin folds (the so-called 'deck-chair' effect). We present a case of a patient with papuloerythroderma of Ofuji of unknown cause. Treatment with oral and topical corticosteroids, antihistamines, and narrow-band UVB phototherapy proved to be ineffective in helping the condition but considerable clinical improvement was obtained with cyclosporine.
Adrenal Cortex Hormones ; Cyclosporine* ; Histamine Antagonists ; Humans ; Phototherapy ; Skin

Nevus of Nanta is a pigmented nevus associated with secondary ossification. We describe a case of nevus of Nanta with no evidence of Albright's hereditary osteodystrophy. A 26-year-old Korean woman presented with a small asymptomatic brownish nodule on the right forehead. Histopathologic examination revealed nests of nevus cells in the dermis. Round ossification was in the base of intradermal nevus.
Adult ; Dermis ; Female ; Forehead ; Humans ; Nevus* ; Nevus, Intradermal ; Nevus, Pigmented

Sporotrichosis is a chronic cutaneous fungal infection caused by Sporothrix (S.) schenckii. It is subdivided into three groups by clinical manifestation: lymphocutaneous, fixed cutaneous, disseminated sporotrichosis. Lymphocutaneous sporotrichosis is most common type and involves upper extremities usually. The incidence of lymphocutaneous sporotrichosis on the face is very low, especially in children. We report a case of lymphocutaneous sporotrichosis on face in a 10-month-old girl. The lesions represented linear three small erythematous papules on the right cheek. The fungal culture on Sabouraud's dextrose agar showed dark brown to black colored wrinkled colonies. The microscopic examination showed septated, branched mycelia and clustered conidia in slide culture of S. schenckii. The patient was treated with oral administration of potassium iodide and the lesions were cured completely.
Administration, Oral ; Agar ; Cheek ; Child ; Glucose ; Humans ; Incidence ; Infant ; Potassium Iodide ; Spores, Fungal ; Sporothrix ; Sporotrichosis ; Upper Extremity

We report a case of 45 year old man with a porokeratosis of Mibelli on his scrotum. He presented with 4 year history of an annular pruritic skin lesion on his scrotum. The skin lesion showed an initial rapid growth, but then stabilized without further change. Histologic examination revealed a typical cornoid lamella consisting of packed parakeratotic cells. Porokeratosis in the genital area is rare, but can occur in a generalized form with genital area involvement or a localized form confined to the genital area.
Humans ; Middle Aged ; Porokeratosis* ; Scrotum ; Skin