No abstract available.
Biopsy*

No abstract available.
Adenocarcinoma* ; Scrotum* ; Stomach Neoplasms*

No abstract available.
Cataract* ; Chlorpromazine* ; Skin Pigmentation* ; Skin*

A 70-year-old female was referred for brown-to-gray colored papules and nodules on her lower legs. She had been diagnosed with diffuse large B-cell lymphoma (DLBCL) in her stomach, and myelodysplastic syndrome (MDS) by bone marrow biopsy. Three years after complete remission of DLBCL, she experienced DLBCL recurrence in her small bowel and was hospitalized. MDS had been stationary, but during the treatment of DLBCL, her laboratory findings suggested signs of leukemia. Bone marrow biopsy was done, and acute monoblastic leukemia (AMoL) was diagnosed. After 1 cycle of chemotherapy for AMoL, skin lesions developed, and her skin biopsy showed cutaneous T-cell lymphoma (CTCL). Terminal deoxynucleotidyl transferase staining and CD123 staining were negative, and bone marrow re-biopsy conducted after the skin lesion developed still showed monoblastic proliferation. Whether the CTCL represented with an AMoL lineage switch could not be completely proved due to the absence of molecular or clonal marker evaluations, but the possibility of coexistence of three different malignancies was higher. During treatment, a neutropenic fever developed, and the patient died due to sepsis. We herein report a rare case of CTCL accompanied by AmoL and DLBCL.

Background: Accuracy in histological subtyping of basal cell carcinoma (BCC) is crucial for determining the appropriate treatment modality. Previous studies have assessed the concordance rateof punch biopsy and excision in subtyping BCC however, they did not calculate this rate according to the BCC location or in Asian populations. Objective: This study compared the concordance rate of punch biopsy and excision for each BCC location. Methods: This study included 192 patients who underwent both punch biopsy and excision. BCC subtypes identified by punch biopsy and excision were compared to calculate the concordance rate. The differences in the rates of misdiagnosis according to the BCC location were also determined. Results: The overall concordance rate of punch biopsy and excision was 78.1% (150/192). The proportion of aggressive type was higher for excision than for punch biopsy. The false-positive rate, defined as the rate of misidentified nonaggressive type, was 19.7% (26/132) and was highest for nodular-type BCC. Additionally, most discrepancies occurred in BCCs located in the face, especially in the H-zone. Conclusion Owing to the inconsistencies in the results of punch biopsy and excision and the high false-positive rate of punch biopsy, dermatologists should be aware of the possibility of an aggressive type BCC even if it is identified as anonaggressive type in punch biopsy. Moreover, more aggressive treatment should be considered in cases of BCCslocated on the face, especially in the H-zone, as the discrepancy rate is higher.

Solitary fibrous tumor (SFT) is a relatively uncommon mesenchymal neoplasm that usually arises in the pleura, but also has been reported in numerous extrapleural locations, including cutaneous site. The skin lesion presents as a circumscribed nodule or tumor, mainly on the head and neck. A 41-year-old male presented with 6 months history of nail lesion without symptom on the left third finger. The lesion is slightly yellowish discoloration with subungual erythematous nodule and distal onycholysis. Biopsy specimen from the nail lesion showed the spindle cells form patternless pattern with hypercellular and hypocellular area. And small blood vessels and dilated vascular spaces were present. The result of special stain for specimen showed that positive for CD34, Bcl-2, and CD99 but negative for S-100, FactorXIIIa, and smooth muscle action. Recognition of this uncommon location of SFT is important because of possible confusion with other subungual tumors, including glomus tumor, fibroma and other fibrohistiocytic tumors like dermatofibrosarcoma protuberans, superficial acral fibromyxoma and cellular digital fibroma. Here in, we report a case of SFT of subungual region. We think this case is interesting because of uncommon location and may be helpful to more understand the character of this disease.

A 62-year-old female, with previous history of asthma andhypertension, presented with generalized hyperpigmentedskin lesion, found a year ago. Physical examination revealedbrown colored lichenified and sclerotic patches on the lowerabdomen and flexural areas of extremities. Punch biopsywas performed and histopathological examination revealedhyperkeratosis, follicular plugging and thinning in epidermis.In dermoepidermal junction, cleft like space separating atrophicepidermis and dermis was seen. Also, lichenoid lymphocyticinfiltration was observed in mid-dermis. Based onclinical and histopathological findings, a diagnosis of generlaizedlichen sclerosus et atrophicus (LSA) was made.Other laboratory examinations were unremarkable. As thereis no standard treatment for LSA, the patient received varioustreatments including topical steroid, tacrolimus and narrow-band ultraviolet B therapy. The skin lesion has softenedand its color improved after treatment. LSA is defined as infrequentchronic inflammatory dermatosis with anogenitaland extragenital manifestations. Generalized type is rare andgenital involvement is the most frequent and often the onlysite of involvement. We report this case as it is an uncommontype of LSA with generalized hyperpigmented and scleroticskin lesion in a postmenopausal female patient.

Neonatal hypocalcemia and congenital heart defects has been known as the first clinical manifestation of the chromosome 22q11.2 deletion syndrome (22q11DS). However, because of its wide clinical spectrum, diagnosis of 22q11DS can be delayed in children without classic symptoms. We report the case of a girl with the history of imperforate anus but without neonatal hypocalcemia or major cardiac anomaly, who was diagnosed for 22q11DS at the age of 11 after the onset of overt hypocalcemia. She was born uneventfully from phenotypically normal Korean parents. Imperforate anus and partial cleft palate were found at birth, which were surgically repaired thereafter. There was no history of neonatal hypocalcemia, and karyotyping by GTG banding was normal. At the age of 11, hypocalcemia (serum calcium, 5.0 mg/dL) and decreased parathyroid hormone level (10.8 pg/mL) was noted when she visited our Emergency Department for fever and vomiting. The 22q11DS was suspected because of her mild mental retardation and velopharyngeal insufficiency, and a microdeletion on chromosome 22q11.2 was confirmed by fluorescence in situ hybridization. The 22q11DS should be considered in the differential diagnosis of hypocalcemia at any age because of its wide clinical spectrum.
22q11 Deletion Syndrome* ; Anal Canal* ; Anus, Imperforate ; Calcium ; Child* ; Cleft Palate ; Delayed Diagnosis* ; Diagnosis ; Diagnosis, Differential ; DiGeorge Syndrome ; Emergency Service, Hospital ; Female* ; Fever ; Fluorescence ; Heart Defects, Congenital ; Humans ; Hypocalcemia* ; Hypoparathyroidism ; In Situ Hybridization ; Intellectual Disability ; Karyotyping ; Parathyroid Hormone ; Parents ; Parturition ; Velopharyngeal Insufficiency ; Vomiting

BACKGROUND: A number of studies have suggested an increased frequency of cardiovascular (CV) diseases in patients with psoriasis. OBJECTIVE: In this study, we assessed the awareness among psoriasis patients and dermatologists in private primary clinics about the increased CV risk linked to psoriasis, and examined the screening behaviors of dermatologists for CV risk factors in psoriasis patients. METHODS: We distributed questionnaires to dermatologists in primary clinics and to psoriasis patients about their awareness of the increased CV risk factors related with psoriasis. RESULTS: One hundred four patients and 50 dermatologists were included. 64.4% of patients and 92% of dermatologists answered that they know about the increased risk of CV diseases in psoriasis patients. However, far fewer dermatologists than expected followed the screening guidelines for CV risk factors. We found that the duration (p<0.0001) and severity (p<0.0001) of psoriasis were related to patient's awareness. A significant correlation between dermatologists' awareness and the number of psoriasis patients they treated each month was also observed (p<0.024). CONCLUSION: This study may help promote the idea that psoriasis patients require education about their increased CV risk factors and that dermatologists require further education about screening practices to detect CV risk in psoriasis patients.
Cardiovascular Diseases ; Education ; Humans ; Mass Screening* ; Psoriasis* ; Risk Factors* ; Surveys and Questionnaires

Lichen nitidus (LN) is an uncommon, usually asymptomatic cutaneous eruption characterized by the presence of multiple, small, flesh-colored papules. The epidemiologic and pathophysiologic characteristics of LN have not yet been defined. Furthermore, LN has rarely been described in association with other cutaneous diseases. We herein report 3 cases of LN associated with various cutaneous diseases, including lichen striatus, oral lichen planus, and psoriasis vulgaris.
Lichen Nitidus* ; Lichen Planus ; Lichen Planus, Oral ; Lichens ; Mouth ; Psoriasis