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

No abstract available.
Biopsy*

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.

BACKGROUND: There have been increasing patients with nail diseases at a dermatology department. Some nail disorders in children may differ from those observed in adults in terms of their incidence or manifestations. OBJECTIVE: The aim of this study was to explore the frequency and nature of nail alterations in pediatric patients. METHODS: We retrospectively reviewed the medical records and clinical photos of 2,514 patients under 18-year-old with nail disorders who had visited Hallym University Sacred Heart Hospital between January 2003 and December 2013. RESULTS: The number of pediatric patients with nail disorders has been increased since 2008. Among 2,514 patients, infectious nail diseases were most common (64.4%). Others included; other unclassified nail change (21.4%), traumatic nail disorders (7.9%), nail involvement of dermatologic diseases (4.6%), nail change with systemic conditions (0.7%), tumors involving nail apparatus (0.6%), and congenital or inherited conditions (0.1%). Unlike adults, pediatric patients showed small proportion of onychomycosis but large proportion of traumatic nail diseases CONCLUSION: Most common nail disease in children was viral wart, and this result differed from that of adults in previous studies. Pediatric nail alterations have been increasing major concerns in patients who visit dermatologic clinics so that recognizing the frequency and manifestation of nail disorders in children can be helpful of evaluating pediatric patients with nail change.
Adolescent ; Adult ; Child* ; Dermatology ; Heart ; Humans ; Incidence ; Medical Records ; Nail Diseases ; Onychomycosis ; Retrospective Studies ; Warts

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

Balloon cell melanoma, an uncommon histopathological variant of malignant melanoma, was first described by Gardner and Vazquez in 1970. This condition is histopathologically characterized by the presence of balloon cells with varying sizes and atypical nuclei. An 84-year-old woman presented with a solitary, dome-shaped, walnut-sized, brownish nodule on the posterior aspect of the left ear with bleeding, having only detected the nodule 2 weeks prior. Histopathologically, the lobulated tumor mass revealed copious melanin pigment and many balloon cells with clear cytoplasm, atypical nuclei, and variable size. Immunohistochemically, the tumor mass showed positive reaction to S-100 protein and HMB 45 staining. We herein report a typical case of balloon cell melanoma, which developed primarily on the skin.
Aged, 80 and over ; Cytoplasm ; Ear ; Female ; Hemorrhage ; Humans ; Melanins ; Melanoma ; S100 Proteins ; Skin