No abstract available.
Histiocytosis, Sinus* ; Lip*

Necrolytic migratory erythema (NME) is a typical cutaneous manifestation of glucagonoma syndrome. The entire syndrome consists of NME, glucose intolerance, weight loss, anemia, glossitis, diarrhea, and increased glucagon levels. We herein report a patient with glucagonoma syndrome who was diagnosed as having NME. A 48-year-old male presented with a 2-month history of painful erythematous, desquamative, erosive papules and plaques on both lower extremities. Histological examination revealed an intraepidermal cleft, the presence of vacuolated, pale epidermal cells, and necrosis in the upper epidermis. His glucagon level was 2650 pg/ml, with the upper limit of a normal range being 250 pg/ml. The patient was treated with octreotide, and showed an improvement of the skin eruption with normalization of the glucagon level within 4 weeks.
Anemia ; Diarrhea ; Epidermis ; Glossitis ; Glucagon ; Glucagonoma* ; Glucose Intolerance ; Humans ; Lower Extremity ; Male ; Middle Aged ; Necrolytic Migratory Erythema* ; Necrosis ; Octreotide ; Reference Values ; Skin ; Weight Loss

BACKGROUND: The incidence of metastatic skin cancer has been reported to be relatively low. Because the diagnosis is not so difficult, cutaneous metastasis could be an important clue to discover the hidden internal malignancy, if found before recognizing primary cancer, or play a significant role to determine therapeutical plans and prognosis if found after diagnosis of primary cancer. MATERIAL AMD METHODS: This study was made upon the 68 cases of metastatic skin cancer, which had been confirmed histopathologically in the department of dermatology, Kosin University Gospel hospital from January, 1986 to August, 2003. Age and sex distributions, sites of primary cancer, time of detection, localization of the lesions, morphologic and histopathologic findings were examined by the review of medical records, clinical photographs, and pathologic slides. RESULTS: 1. The mean age at the time of diagnosis was 56.6 years and most patients were distributed over 5 decades. The male to female ratio was 1: 1.3. 2. Metastasis from breast carcinoma consisted of 19 cases, this was the most common primary cancer, followed by lung cancer, melanoma, and stomach cancer. In men, lung cancer and stomach cancer were the most common primary neoplasm, while breast cancer was the most frequent in women. 3. 50 of the cases were detected after diagnosis of primary cancer and during therapy. The other 18 cases were detected before the internal malignancy was recognized. 4. The localization of metastatic skin cancer was widespread over the whole body. The majority of cutaneous metastasis was predisposed to the surface near primary cancer, but distant metastases such as alopecia neoplastica on the scalp were also observed. 5. The most common morphologic features were single or multiple nodules, while inflammatory and indurated plaques were also found. 6. Histopathologic examination revealed that adenocarcinoma was the most common pathologic type, followed by squamous cell carcinoma and melanoma. The histopathologic features of cutaneous metastasis generally mimicked that of primary tumors. CONCLUSION: Generally, metastatic skin cancer is detected after the diagnosis of primary cancer showing subsequent treatment failure and poor prognosis. In some cases, however, cutaneous metastasis can be the earliest sign to recognize internal malignancy. Especially in the cases of metastatic skin cancer originating from the kidney, liver and thyroid gland, cutaneous features are the most significant evidences to presume the site of origin without any other findings. Therefore, it is important to recognize the clinical and histopathologic findings of metastatic skin cancer for the most successful diagnostic, therapeutic and prognostic determination.
Adenocarcinoma ; Alopecia ; Breast Neoplasms ; Carcinoma, Squamous Cell ; Dermatology ; Diagnosis ; Female ; Humans ; Incidence ; Kidney ; Liver ; Lung Neoplasms ; Male ; Medical Records ; Melanoma ; Neoplasm Metastasis ; Prognosis ; Scalp ; Sex Distribution ; Skin Neoplasms* ; Skin* ; Stomach Neoplasms ; Thyroid Gland ; Treatment Failure

Keratoacanthoma is a rapidly growing cutaneous tumor with a histopathologic pattern often suggestive of a squamous cell carcinoma (SCC). It may be viewed as an aborted malignancy which only rarely progresses into an aggressive SCC. It is most likely arising from hair follicle that has the tendency of spontaneous resolution. The diagnosis of keratoacanthoma is based on clinical, histopathologic features and biologic behavior. A 75-year-old woman presented with a 1-month history of a rapidly enlarging exophytic tumor on the lower lip. A biopsy was performed leading to a diagnosis of keratoacanthoma. We report a case of keratoacanthoma on the lower lip, because the mucosal area is an unexpected location.
Aged ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Hair Follicle ; Humans ; Keratoacanthoma* ; Lip*

Amyloidosis is a disorder of protein metabolism characterized by the extracellular deposition of abnormal protein fibrils. We report a case of macular amyloidosis due to nylon towel on his back. A 61-year-old male presented with asymptomatic hyperpigmented macules on the scapulae for 6 years. He had a habit of scrubbing his back for many years with a rough nylon towel while taking a bath. The histologic examination revealed liquefaction degeneration and homogenous eosinophilic deposition in the papillary dermis. In Congo red, amyloid material stained positively and in anti-keratin antibody staining. He had neither clinical nor laboratory evidence of systemic amyloidosis. A diagnosis of friction amyloidosis was made on histological and immunohistopathological findings.
Male ; Humans

Nodular scabies is a clinical variant of classic scabies with uncertain cause. The cutaneous manifestations consist of firm, erythematous nodules focally affecting genitalia, groin and axillae, and no case of generalized involvement has been reported in the literature. On histopathologic examination, mites and excretas were known to be seldom found in the stratum corneum, but if serial sections are studied, they can be seen in as much as 20% of the cases. The dermis shows dense superficial and deep perivascular mixed cell infiltration composed of lymphocytes, histiocytes, plasma cells, eosinophils, and atypical mononuclear cells, which should be distinguished from many types of lymphomas. We herein report a case of nodular scabies that clinically affected whole body and histopathologically revealed mite and eggshells in the stratum corneum and perivascular mixed cell infiltration throughout the dermis.

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder that is characterized by aggressive arterial and aortic disease, often involving the formation of aortic aneurysms. We describe the cases of two children with LDS who were diagnosed with aortic root aneurysms and successfully treated by valve-sparing aortic root replacement (VSRR) with a Valsalva graft. VSRR is a safe and suitable operation for children that avoids prosthetic valve replacement.
Aneurysm ; Aorta ; Aortic Aneurysm ; Aortic Diseases ; Child* ; Connective Tissue ; Humans ; Loeys-Dietz Syndrome* ; Transplants

Granuloma annulare is a benign, granulomatous disease that presents clinically as papules and plaques, often in an annular configuration. It has been reported following tuberculin skin tests, insect bites, sun exposure, trauma, and various viral diseases. Several types of cutaneous lesions have previously been described at the site of herpes zoster scars. These include granuloma annulare, lymphoma, pseudolymphoma, granulomatous diseases, and lichen planus. We report a case of granuloma annulare at a herpes zoster scar site.
Cicatrix ; Granuloma Annulare* ; Granuloma* ; Herpes Zoster* ; Insect Bites and Stings ; Lichen Planus ; Lymphoma ; Pseudolymphoma ; Skin Tests ; Solar System ; Tuberculin ; Virus Diseases

Kikuchi's disease(Histiocytic necrotizing lymphadenitis) is an idiopathic, self-limiting disease typically affecting cervical lymph nodes in young adults. Cutaneous involvement has been reported in 16-40%. We report a case of Kikuchi's disease in 10-year-old female that showed asymptomatic erythematous papules on the face accompanied by cervical lymphadenopathy. The histopathologic examination of the skin revealed diffuse dermal lymphohistiocytic infiltrate, a large amount of nuclear dust with absence of neutrophils, which is characteristic of Kikuchi's disease. In general, histopathologic findings of skin biopsy show a mirror image of that of lymph nodes involved in Kikuchi's disease. Therefore, it is important to recognize cutaneous manifestations of this entity, because we can avoid invasive lymph node biopsy. if skin lesions involved show typical histopathologic findings of Kikuchi's disease.
Biopsy ; Child ; Dust ; Female ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neutrophils ; Skin ; Young Adult

No abstract available.