Actinic granuloma develops in the chronically sun-damaged skin of the neck, face, upper chest or arms. Lesions present as skin colored to erythematous papules and plaques that coalesce to form centrifugally enlarging annular patterns. Histologically, elastolytic granuloma is formed by a dense infiltrate of giant cells and histiocytes with active phagocytosis of elastoclastic fibers on the background of solar elastosis in the upper dermis. We report a clinically rare presentation of actinic granuloma, limited to both hands of a 75-year-old female with colon cancer.
Actins ; Aged ; Arm ; Colon ; Colonic Neoplasms ; Dermis ; Female ; Giant Cells ; Granuloma ; Hand ; Histiocytes ; Humans ; Neck ; Phagocytosis ; Skin ; Thorax

Reticulated acropigmentation of Dohi (RAD), dyschromatosis symmetrica hereditaria, is the localized acral form of dyschromatosis universalis hereditaria that has an autosomal dominant pattern of inheritance. RAD is characterized by the mixed hyperpigmented and hypopigmented macules and its bilaterally symmetrical distribution on the back of the hands and feet, wrists, knees, and elbows. The presented case is a 18-year-old female had relatively well demarcated symmetric hyperpigmented and hypopigmented macules and patches on dorsa of hands and feet, forearms, lower legs and face. These pigmentations at first appeared at 3 years old on dorsa of her fingers and toes, thereafter these pigmentations spread progressively to the proximal portion of her body. Her pedigree shows autosomal dominant pattern of inheritance. Histologically, there is markedly decreased basal pigmentation with preserved melanocytes. Immunohistochemical stain for the Melan-A revealed both areas of either decreased or increased Melan-A positive melanocytes in basal layer, which suggests that Reticulated acropigmentation of Dohi is a genetic disorder of functional derangement of melanocytes.
Adolescent ; Elbow ; Female ; Fingers ; Foot ; Forearm ; Hand ; Humans ; Hyperpigmentation ; Hypopigmentation ; Knee ; Leg ; MART-1 Antigen ; Melanocytes ; Pedigree ; Pigmentation ; Pigmentation Disorders ; Skin Diseases, Genetic ; Toes ; Wills ; Wrist

Cutaneous leiomyoma is a rare benign tumor that originates from the smooth muscles derived from arrector pili muscles, the media of dermal blood vessels and the dartos muscle of the scrotum, vulva or nipples. Piloleiomyomas usually occur in the second to third decades of life with an equal incidence in men and women. They can be solitary, but multiple lesions are seen in 80% of these patients. Although multiple leiomyomas are often grouped, unilateral zosteriform pilar leiomyoma is rare. We report here on a rare case of grouped piloleiomyomas that presented as a zosteriform pattern on the right trunk of a 59-year-old woman.
Blood Vessels ; Female ; Humans ; Incidence ; Leiomyoma ; Male ; Middle Aged ; Muscle, Smooth ; Muscles ; Nipples ; Scrotum ; Vulva

Cytomegalovirus(CMV) rarely causes cutaneous rnanifestations. But since the recent development of organ transplants and the increased prevalence of AIDS, various skin manifestations of CMV infection such as varicelliform eruptions, perineal hulcerations, papular, purpurc and vesiculobllous lesions are increasing in immunocompromised subjects, Perineal ulceration is a typical cytomegalovirus-induced skin manifestation which exhibits similar morphology to herpes simplex viral infection. We describe a case of CMV-induced ulcer on labia majora in an AIDS patient, proven by histologic findings and immunohistochemistry. The patient was treated with ganciclovir and the lesion improved two months later.
Cytomegalovirus* ; Ganciclovir ; Herpes Simplex ; Humans ; Immunohistochemistry ; Prevalence ; Skin Manifestations ; Transplants ; Ulcer*

Iressa(R) (ZD 1839, gefitinib) is a new anti-cancer agent which selectively inhibits the epidermal growth factor receptor (EGFR) tyrosine kinase in the pathway of the signal transduction. This agent can induce adverse effects in the cutaneous which are related to the interruption of normal epidermal cell kinetics. We report a case of paronychia in a 65-year-old man, developed in both sides of his finger and toe nails during treatment of non-small cell lung cancer (Stage IV) with Iressa(R) for 7 days. The patient came to our clinic with painful periungal inflammation with granulation tissue formation. The lesion was improved after treatment with topical or systemic antibiotics, Burrow's solution (0.3% aluminum acetate) soaking and electrodessication.
Aged ; Aluminum ; Anti-Bacterial Agents ; Carcinoma, Non-Small-Cell Lung ; Fingers ; Granulation Tissue ; Humans ; Inflammation ; Kinetics ; Lung ; Lung Neoplasms ; Nails ; Paronychia ; Porphyrins ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Signal Transduction ; Toes

Desmoplastic trichoepithelioma is a rare, benign, adnexal tumor of hair follicle origin and is most commonly found on the face of young females. Clinically it presents as a solitary, asymptomatic, firm and annular plaque with a raised border. The histopathological findings show narrow strands of basaloid tumor cells with variable nests in a trabecular pattern and horn cysts in the desmoplastic stroma. This closely resembles morphea type basal cell carcinoma and microcystic adnexal carcinoma. We herein report a case of desmoplastic trichoepithelioma on the cheek of a 22-year-old man, with discussion of the significance of the immunohistochemical stains in the differential diagnosis of similar skin tumors, using antibodies for CD10, CD34, CEA, CK14, CK7 and Bcl-2.
Animals ; Antibodies ; Carcinoma, Basal Cell ; Cheek ; Coloring Agents ; Diagnosis, Differential ; Female ; Hair Follicle ; Horns ; Humans ; Scleroderma, Localized ; Skin ; Young Adult

Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with antitubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort.
Abscess ; Bacteria ; Diagnosis ; Fasciitis, Plantar ; Female ; Follow-Up Studies ; Gram-Positive Cocci ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Nontuberculous Mycobacteria ; Osteomyelitis* ; Polymerase Chain Reaction ; Rehabilitation

Background: As most Candida species cause opportunistic infections, it is helpful for patient care to determine species name of Candida spp. and their distribution in both sterile and non-sterile specimens. We aimed to investigate trends in the distribution of Candida species isolated from a hospital in Korea, along with their antifungal susceptibilities and seasonal variations. Methods: This study was conducted at the Chung-Ang University Hospital and included 8,760 different clinical specimens from March 2011 to December 2022. Identification of the fungal species and its antifungal susceptibility testing were performed using VITEK 2 ID-YST system for six drugs: amphotericin B, caspofungin, fluconazole, voriconazole, micafungin, and flucytosine. Results: The most common fungal species was Candida albicans. The C. albicans positivity rate gradually increased from 2012 to 2022. Since 2020, however, this trend reversed and the non-albicans Candida (NAC) superseded the count of C. albicans. Among the NAC, C. glabrata showed significant increase. When a weekly analysis was performed, C. glabrata was evenly distributed without any noticeable peak; however, the positive rate decreased from late December to early January across all years. Conclusion Monitoring of future trends should necessarily be continued. Our findings revealed that the positive rate for Candida was the lowest in the months of December and January of the studied years, which can be attributed to environmental factors. However, further research needs to be conducted.

Background: As most Candida species cause opportunistic infections, it is helpful for patient care to determine species name of Candida spp. and their distribution in both sterile and non-sterile specimens. We aimed to investigate trends in the distribution of Candida species isolated from a hospital in Korea, along with their antifungal susceptibilities and seasonal variations. Methods: This study was conducted at the Chung-Ang University Hospital and included 8,760 different clinical specimens from March 2011 to December 2022. Identification of the fungal species and its antifungal susceptibility testing were performed using VITEK 2 ID-YST system for six drugs: amphotericin B, caspofungin, fluconazole, voriconazole, micafungin, and flucytosine. Results: The most common fungal species was Candida albicans. The C. albicans positivity rate gradually increased from 2012 to 2022. Since 2020, however, this trend reversed and the non-albicans Candida (NAC) superseded the count of C. albicans. Among the NAC, C. glabrata showed significant increase. When a weekly analysis was performed, C. glabrata was evenly distributed without any noticeable peak; however, the positive rate decreased from late December to early January across all years. Conclusion Monitoring of future trends should necessarily be continued. Our findings revealed that the positive rate for Candida was the lowest in the months of December and January of the studied years, which can be attributed to environmental factors. However, further research needs to be conducted.