We herein report a case of subcutaneous panniculitic T-cell lymphoma which occurred in a 48-year-old Korean woman. Her disease presented as multiple subcutaneous nodules on the arms, legs, and abdomen, with systemic symptoms and signs. From the results of immunophenotypic studies, we suggest her disease may originate from cytotoxic T-lymphocytes. The patient had a protracted course of multiple dark-red-colored subcutaneous nodules on both arms, legs, and abdomen for 1 year, often with fever, chills, and malaise. Histopathologic findings for the subcutaneous nodule in the lower abdomen revealed diffuse infiltration of atypical lymphocytes in the subcutis, with extensive fat necrosis and karyorrhexis and a bean-bag cell appearance with engulfed lymphocytes in some histiocytes. The immunophenotypic studies showed a cytotoxic T-lymphocyte profile, i. e., LCA+, lysozyme+, UCHL1+, CD8+, CD20-, CD30-, and CD56-. In situ hybridization studies for the Epstein-Barr virus genome resulted in a negative finding. A lymphadenopathy was found in the right upper paratracheal area on the chest CT associated with pancytopenia and abnormal LFT findings. She received high-dose chemotherapy with autologous blood stem cell transplantation, but died after 6 months.
Abdomen ; Arm ; Chills ; Drug Therapy ; Fat Necrosis ; Female ; Fever ; Genome ; Glycogen Storage Disease Type VI ; Herpesvirus 4, Human ; Histiocytes ; Humans ; In Situ Hybridization ; Leg ; Lymphatic Diseases ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Middle Aged ; Pancytopenia ; Stem Cell Transplantation ; T-Lymphocytes* ; T-Lymphocytes, Cytotoxic ; Tomography, X-Ray Computed

We report herein a case of primary cutaneous diffuse large B-cell lymphoma with multiple skin lesions in a Korean woman. A 56-year-old woman presented with rapidly growing multiple sub-cutaneous nodules in her right flank and right upper arm. Microscopic examination of skin biopsy specimen showed diffuse infiltrates of large atypical lymphocytes with vesicular nuclei, prominent nucleoli and moderate degree of mitotic figures in deep dermis and subcutis. Immunophenotypic studies revealed the lymphoid infiltrates reacted with CD45, CD20 and bcl-2 protein, but none of the sections expressed CD3, bcl-6 protein and CD30. In physical examination and staging work-up, we could not find any other extracutaneous or systemic involvement. She was treated with 2 cycles of high-dose multiagent chemotherapy with the Vanderbilt and the BEAM regimen combined with the autologous peripheral blood stem cell transplantation. Until now, 10 months after termination of treatment, she has shown improvement of all skin lesions and no development of extracutaneous disease.
Arm ; B-Lymphocytes* ; Biopsy ; Dermis ; Drug Therapy ; Female ; Humans ; Lymphocytes ; Lymphoma, B-Cell* ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Physical Examination ; Skin

We investigated the effects of KGF and EGF, together with extracellular calcium, on the growth of cultured psoriatic keratinocytes, in order to establish a new chemically defined medium for culturing psoriatic keratinocytes using a modified form of MCDB 153 media. We compared the cell growth pattern under various culture conditions, including growth factors (KGF or EGF), and extracellular calcium concentrations, attachment and/or matrix factors (type I collagen coating or 3T3 fibroblast layering), culture durations, and types of cultured cells such as normal human epidermal keratinocytes (NHEK) and psoriatic keratinocytes. In order to achieve the above objective, semiquantitative RT-PCR for K16 mRNA, direct immunofluorescence with K8.12 as the markers of regenerating keratinocytes, and microscopic observation for cell colony formation were performed. The results are summarized as follows: 1. Psoriatic keratinocytes were grown optimally at 0.15 mM calcium, irrespective of growth factors or even in free control. They also grew well at 20 nM KGF. 2. KGF and/or EGF played an active role in cell growth, especially in the 5 days' culture. The growth stimulatory effect of EGF was suppressed by 0.5 mM calcium, but the effect of KGF was sustained at this calcium concentration. Furthermore, KGF exhibited a cell Survival effect of 18 days on type I collagen coating, and also in 12 days' culture on 3T3 fibroblast layering. 3. Cultured psoriatic keratinocytes were more vulnerable to extracellular calcium than NHEK with regard to optimal calcium concentration; they grew best at 0.15 mM, which was much lower than 1.5 mM in NHEK. 4. 3T3 fibroblasts exerted a favorable effect on cell growth and survival, especially in 12 days' culture, which may have been due to the paracrine effect of endogenous KGF from the 3T3 feeder cells, and cell reattachment/pile-up properties. To improve the culture method for psoriatic keratinocytes, the study suggests we should consider the optimal extracellular calcium concentration, introduce feeder cell layering to increase cell reattachment/pile-up, and supplement the mesenchymal paracrine growth factors such as KGF to exert a favorable effect on cell growth and survival.
Calcium* ; Cell Culture Techniques ; Cell Survival ; Cells, Cultured ; Collagen ; Collagen Type I ; Epidermal Growth Factor* ; Feeder Cells ; Fibroblast Growth Factor 7* ; Fibroblasts ; Fluorescent Antibody Technique, Direct ; Humans ; Intercellular Signaling Peptides and Proteins ; Keratinocytes* ; RNA, Messenger

BACKGROUND: Chronic actinic dermatitis (CAD) is a rare disease worldwide. It has been defined on the basis of three criteria: 1) clinical - a persistent eczematous eruption on sun- exposed area with possible extension into non-exposed areas, 2) photobiological - a reduction in the minimal erythema dose to UVB irradiation, and possibly longer wavelengths, and 3) histologic - an appearance consistent with chronic eczema, with or without the presence of lymphoma-like changes. However, only a few clinicohistopathologic and photobiological analyses of CAD have been undertaken in Korea. OBJECTIVE: To explore photoallergens and/or allergens causing or thought to be associated with CAD in Korean patients, and to compare the photopatch or patch test results in Korea with those from other countries. METHODS: Thirty-five Korean patients with CAD were enrolled for this study. Photopatch tests were carried out by applying two sets of the Scandinavian photopatch series to each patient. Two days after application, the photopatch tests were analysed, and one set of the photoallergens was irradiated with 50% of the MED-UVA. Both sets of photoallergens were examined 2 days later. A European standard series was used to assess the patch tests. At two and four days after application, patch tests were analysed. RESULT: Twenty-seven of the 35 patients (77.1%) who had photopatch tests showed positive responses; balsam of Peru, promethazine HCl, perfume mix, fentichlor, chlorhexidine digluconate, and chlorpromazine HCl were the common photoallergens that elicited a positive response. Twenty-one of the 35 patients (70%) showed allergy to nickel, chrome, and/or ammoniated mercury. Noticeably, photoallergens such as balsam of Peru, perfume mix, cobalt, and captan revealed positive reactions in the patch tests, too. CONCLUSION: In 77.1% and 74.3% of CAD patients, photoallergens and allergens were identified, respectively. Among them, 57.1% showed positive reactions including both photopatch and patch tests. After the most frequent photoallergens, perfume and spices, and phenothiazines or related antihistamines ranked next and were found to be a unique characteristic to Korea. Photopatch and patchtests are the method for detecting photoallergens and allergens as important initiating agents and are the diagnostic tool for the epidemiologic study of CAD.
Allergens ; Captan ; Chlorhexidine ; Chlorpromazine ; Cobalt ; Eczema ; Epidemiologic Studies ; Erythema ; Histamine Antagonists ; Humans ; Hypersensitivity ; Korea ; Nickel ; Patch Tests* ; Perfume ; Peru ; Phenothiazines ; Photosensitivity Disorders* ; Promethazine ; Rare Diseases ; Spices

Median raphe cyst of the penis is an uncommon entity that usually presents as a cystic lesion on the ventral aspect of the penis, and which has a broad spectrum of histopathological appearances. It occurs most commonly near the glans penis, but may occur anywhere from the urethral meatus to the anus. It is solitary and measures only a few millimeters in diameter. Surgical excision is the treatment of choice. Recently we observed an 18-year-old male patient who had had a median raphe cyst since 5 years ago near the urethral orifice of the glans penis.
Adolescent ; Anal Canal ; Humans ; Male ; Penis*

Interferon has been tried as a drug of choice in patients with chronic active hepatitis by hepatitis B virus infection since Greenberg has reported the effectiveness of interferon in 1976. The effects of interferon therapy have been reported variably and various complications such as fever, myalgia, arthralgia, flu-like symptoms, temporary leukopenia and thrombocytopenia, alopecia, cardiovascular symptoms and autoimmune diseases have been reported. But rhabdomyolysis has been rarely reported in the interferon therapy of chronic hepatitis B. There were some cases of rhabdomyolysis with acute renal failure in the interferon therapy which was designed for chemotherapy of malignant melanoma and for chronic active hepatitis C virus infection. We reported a case of rhabdomyolysis with acute renal failure developed during the interferon therapy in a patient with chronic active hepatitis B.
Acute Kidney Injury* ; Alopecia ; Arthralgia ; Autoimmune Diseases ; Drug Therapy ; Fever ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic* ; Humans ; Interferons* ; Leukopenia ; Melanoma ; Myalgia ; Rhabdomyolysis* ; Thrombocytopenia