We report a case of histiocytoid hemangioma (angiolymphoid hyperplasia with eosinophilia) in a 60 year-old female patient who was effectively treated with dapsone. The therapeutic effect of dapsone may support the hypothesis that immunologically mediated reactive process plays a role in the pathogenesis of histiocytoid hemangioma.
Dapsone* ; Female ; Hemangioma* ; Humans ; Hyperplasia* ; Middle Aged

Infection-induced panniculitis develops either through direct inoculation or as a manifestation of sepsis. However, it has rarely been considered as a disease entity within broader context of panniculitis. Moreover, panniculitis associated with a cardiac abscess without the evidence of sepsis has not been reported. We describe a case of infection-induced panniculitis associated with a cardiac abscess. We suggest that infection should be considered as a potentially important etiology of panniculitis, especially in the case of immunosuppression, and in such a case, meticulous efforts should be done to find the focus of infection.
Abscess* ; Immunosuppression ; Panniculitis* ; Sepsis

BACKGROUND: Actinic granuloma is an annular inflammatory reaction that develops in skin that has had long-term sun-exposure. OBJECTIVES: The purposes of this study were aimed to characterize the clinical and histopathologic features of actinic granuloma. METHODS: Examinations were performed on eight patients with actinic granuloma regarding the age, sex, duration, clinical morphology, distribution, associated diseases, and treatment and course. Histo-pathologic studies of ten specimens obtained from eight patients were performed with special stains, such as Verhoeff-van Gieson, Gomori-Methenamin silver and alcian blue.
Actins* ; Alcian Blue ; Coloring Agents ; Granuloma* ; Humans ; Silver ; Skin

We report a case of Winkelmann granuloma in a 63-year-old man. nstopathological findings of the biopsy specimens from the lesions of the ear, finger and iliac crest area were compatible with Winkelmann granuloma. Winkelmann granuloma is a rare disorder showing an association with systemic immunoreactive disorders. Although our patient did not have any definite systemic disease, he had characteristic clinical and histopathological findings of Winkelmann granuloma, arthralgia, an elevated erythrocyte sedimentation rate, positivity to the rheumatoid factor and antinuclear antibodies. Therefore, we believed that he was strongly suspected to have an unclassifiable systemic immunoreactive disease.
Antibodies, Antinuclear ; Arthralgia ; Biopsy ; Blood Sedimentation ; Ear ; Fingers ; Granuloma* ; Humans ; Middle Aged ; Rheumatoid Factor

In about 20 to 30 percent of cases with organoid nevus (nevus sebaceus), benign and/or ma-al lignant tumors of the epidermis and adnexae may develop. We describe a 71-year-old woman with sebaceous carcinoma and basal cell epithelioma developed in organoid nevus.
Aged ; Carcinoma, Basal Cell* ; Epidermis ; Female ; Humans ; Nevus* ; Organoids*

BACKGROUND: The hypereosinophilic syndrome(HES) represents a leukoproliferative process likely caused by a number of disorders, all of which are marked by sustained over-production of eosinophils. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of HES. METHODS: The medical records and hist opathological slides of patients with HES who had skin biopsies performed in our department were reviewed. Criteria for the diagnosis of HES include (1) peripheral blood eosinophilia with eosinophil counts greater than 1,500/L for at least 6 months; (2) no evidence of parasitic, allergic, or other known causes of eosinophilia; and (3) presumptive signs and symptoms of multiple organ involvement. RESULTS: Four male and three female patients were included. HES developed in adulthood or old age (mean, 43.4 years). Because only the patients with cutaneous involvement were included, all the patients showed skin lesions. Heart, liver, stomach, nervous system, lymph nodes, and lung were involved organs in decreasing order of frequency. At the onset of HES, 40 to 80% of white blood cells were eosinophils in peripheral blood. White blood cell count and serum IgE level were elevated in all the tested patients. In six patients (85.7%), the level of serum erythrocyte sedimentation rate was elevated. Persistent hypereosinophilia (>1,500/L) was present for longer than 6 months in all patients. Stool examination and skin test for parasitic infestation all gave negative results. All the patients were not taking any medication. Histopathological examinations revealed perivascular mixed inflammatory cell infiltration; predominantly eosinophils in the stomach, liver, and nerve as well as in the skin. Interestingly, two patients who were presented with skin lesions showed the findings of eosinophilic vasculitis. In these patients, the skin lesions were consisted of Raynaud's phenomenon, digital gangrene, and several erythematous plaques. The most common cutaneous manifestations were papules and nodules on the extremities. The main treatment modality was systemic steroid. Except for one patient presented with central nervous system involvement of HES, all the patients were in a well-controlled state. In one patient with the typical clinical and hematologic features of HES, Hodgkin's disease followed. After the complete remission of Hodgkin's disease with chemotherapy, HES subsided. CONCLUSIONS: HES is a heterogenous collection of disorders marked by hypereosinophilia and organ damage. Most common cutaneous manifestations were papules and nodules on the extremities. Raynaud's phenomenon and digital gangrene can be the primary manifestation of HES in which cases cutaneous lesions showed eosinophilic vasculitis. Five patients (71%) responded well to systemic steroids. HES may be a herald of malignancy such as Hodgkin's disease. Further investigation will be mandatory ro elucidate the etiology and pathogenesis of HES.
Biopsy ; Blood Sedimentation ; Central Nervous System ; Diagnosis ; Drug Therapy ; Eosinophilia ; Eosinophils ; Extremities ; Female ; Gangrene ; Heart ; Hodgkin Disease ; Humans ; Hypereosinophilic Syndrome* ; Immunoglobulin E ; Leukocyte Count ; Leukocytes ; Liver ; Lung ; Lymph Nodes ; Male ; Medical Records ; Nervous System ; Skin ; Skin Tests ; Steroids ; Stomach ; Vasculitis

Purpura fulminans may be seen in three different clinical settings: (1) in the neonatal period from protein C and S deficiencies, (2) during severe bacterial infections such as “sepsis-associated” purpura fulminans, and (3) during the convalescence of an otherwise benign “preparatory” infectious disease most commonly involving the skin. We report a case of a 20-month-old male child with purpura fulminans as a presenting sign of disseminated intravascular coagulopathy (DIC). He had suffered from fever of unknown origin for a month. Although purpura fulminans is not a common disorder to dermatologists, the awareness of this disorder may be the clue to diagnose and treat underlying diseases.
Bacterial Infections ; Child ; Communicable Diseases ; Convalescence ; Fever of Unknown Origin ; Humans ; Infant ; Male ; Protein C ; Purpura Fulminans* ; Purpura* ; Skin

BACKGROUND: Porokeratosis is a disorder of epidermal keratinization which is characterized by the presence of cornoid lamellae. Since the original description of the plaque form of Mibelli, various types of porokeratosis have been reported. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and biological features of porokeraosis. METHODS: The hospital charts and slides of 29 patients with porokeratosis were reviewed. Only the cases showing characteristic cornoid lamellae by histopathological examinations were included. RESULTS: Female patients outnumbered the male ones (M:F = 1:2.2). Ages of the onset of porokeratosis varied from infancy to 68 years. Disseminated superficial actinic porokeratosis (DSAP) was the predominant type (22 cases). The Mibelli type was seen in 3 cases and the linear type in 4 cases. Only one case had a family history of porokeratosis. Two patients had complained of pruritus in the lesions, which were the DSAP and linear type, respectively. In that linear type, squamous cell carcinoma developed. Eight patients had other associated diseases. Although 6 patients were treated with CO₂ laser, topical isotretinoin or cryotherapy, the lesions tended to recur, persist or even progress. CONCLUSIONS: Porokeratosis showed various clinical features. DSAP was the predominant type. Two patients complained of itching of the lesions, which were the DSAP and linear types, respeciively. Within that linear type, squamous cell carcinoma developed. We speculate that pruritus might be an ominous sign of malignant transformation of the porokeratosis. We suggest that the Mibelli type and linear type of porokeratosis should be either excised or destroyed, or in widespread cases close follow-up should be mandatory.
Carcinoma, Squamous Cell ; Cryotherapy ; Female ; Follow-Up Studies ; Humans ; Isotretinoin ; Male ; Porokeratosis* ; Pruritus

We describe a 38-year-old woman with an adenoma of anogenital mammary-like glands on the left labium major. Adenomas of anogenital mammary-like glands have been rarely reported with various nomenclatures in the English literature. The knowledge of this rare disease entity may be important to diagnose and treat the lesions arising on the anogenital areas.
Adenoma* ; Adult ; Female ; Humans ; Rare Diseases

Lichenoid keratosis (LK), a lichen planus-like keratosis, is a rather frequent skin disorder that has some histological features similar to lichen planus. However, the classification system for LK has not been settled. We report two cases of LK and propose a new classification for LK correlating with clinicohistopathological findings.
Actins* ; Classification ; Keratosis* ; Lichen Planus ; Lichens ; Skin