We presented a case of Reiters syndrome consisting of conjunctivitis, arthritis, and skin lesions, occurring in 20-year-o1d male. He had neither an episode of dysentery nor a history of sexual exposure before onset of syndrome. The skin lesions had begun with erythernatous scaly patches on the inguinal region and scalp, and later followed by generalized pustular, psoriasiform and/or hyperkeratotic crusted lesions on the erythematous base. Yellowish discoloration and onycholysis of nails and shallow ulcer of glans penis were observed. Arthritis of the knee and shoulder joints were developed, accompanied by pain, swelling, limited motion, wasting and weakness of both lower extremities. In laboratory investigation, urinalysis, stool examination for parasites and occult blood, renal function test, blood VDRL, and X-ray of chest, both knee. joints, shoulder joint and thoracolumbar spine were within normal limit or negative except for leukocytosis(24, 500/mm), increased ESR(90 mm/hr) and hypoalbuminemia(2.6 g/dl), and he was associated with HLA-A3, A 9, B5, and Rw 49 Histopathologically skin biopsy specimen showed extensive hyperkeratosis, paralceratosis, elongated rete ridges, spongiform macropustule of Kogoj. He was treated effectively with antibiotics, corticosteroid, and methotrexate for two months without recurrence till now.
Anti-Bacterial Agents ; Arthritis ; Biopsy ; Conjunctivitis ; Dysentery ; Hematologic Tests ; HLA-A3 Antigen ; Humans ; Joints ; Knee ; Lower Extremity ; Male ; Methotrexate ; Occult Blood ; Onycholysis ; Parasites ; Penis ; Recurrence ; Scalp ; Shoulder Joint ; Skin ; Spine ; Thorax ; Ulcer ; Urinalysis

Keratosis punctata of palmar creases has been considered an uncommon variant of keratosis punctata, which itself is considered rare condition. Clinically our case, 32-year-old seaman, shows cup-shaped depression of the epidermis of varying size, from 1-3mrn in diameter, limited to the large flexor creases of the palms and digit. The histologic features are hyperkeratotic and slight acanthotic central epidermal depression without parakeratosis and loss of granular layer. A sparse mononuclear infilterate are seen arround the capillaries in the dermal papillas. No relationship to arsenical agents, syphilis, or genetic factors can be ascertained by history.
Adult ; Capillaries ; Depression ; Epidermis ; Humans ; Keratosis* ; Parakeratosis ; Syphilis

A 6-year-old boy presented in December 1986 with a 1-year history of a nonpruritic flesh-colored papular eruption that began on the dorsum of left hand and gradually appeared on other areas, such as upper and lower extremities, trunk and external genitalia. Complete blood cell count. urinalysis, VDRL, stool examination, liver function test and chest X-ray were negative or within normal limits. On physical examination, he had uniform, pinhead-sized, flat-topped, shiny, discrete paples on the whole body surface. No oral lesions were found. Histopathologically skin biopsy specimen showed a circumscribed nest of infiltrate consisted of lymphocvtes, histiocytes and a few epitheloid cells. The cell nest was separated from the overlying flattened epidermis by a large space. Direct immunofluorescent test was negative. He had been treated with systemic corticosteroid for two months without recurrence until nowadays.
Biopsy ; Blood Cell Count ; Child ; Epidermis ; Genitalia ; Hand ; Histiocytes ; Humans ; Lichen Nitidus* ; Lichens* ; Liver Function Tests ; Lower Extremity ; Male ; Physical Examination ; Recurrence ; Skin ; Thorax ; Urinalysis

We present a case of mycosis fungoides of an 52-year-old woman who showed multiple pruritic erythematous papules, plaques with ulcers on the trunk, extremities and face. Her skin biopsy specimens were studied irnmunohistochemically with, monoclonal antibodies against T cells(80%, Leu-4, OKT11), T-cell subsets (60% Leu-3a, OKT4a, 40% OKT8) and Langerhans cell(OKT6). We think that this case should be considered in the differential diagnosis of adult T-cell leukemia/lymphoma. The proliferating cells were negative for anti-Tac.
Adult ; Antibodies, Monoclonal ; Biopsy ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Middle Aged ; Mycosis Fungoides* ; Skin ; T-Lymphocyte Subsets ; T-Lymphocytes ; Ulcer

A 61-year-old female had neurofibromas situated on the right side of upper trunk, shoulder and neck in the distribution of dermatomes C3 and C4(right), which developed 3 years ago. There were not cafe-au-lait spots, axillary frecklings, or Lisch nodule (iris pignented hamartoma). Biopsy specimen showed collagenous wavy fibrils among which spindle-shaped and round cells were embedded as seen in the typical neurofibroma. This case was considered to be a segmental form of von Recklinghausen's disease.
Biopsy ; Cafe-au-Lait Spots ; Collagen ; Female ; Humans ; Middle Aged ; Neck ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Shoulder

BACKGROUND: Mycosis fungoides(MF) is a form of cutaneous T cell lymphoma with clonal differentiation of helpr' T cell. It has a patch, plaque, and tumor stage. But pathogenetic factors controlling the development and progression of MF are still unclear. Apoptosis plays a major role in developmental biology and homeostasis. The bcl-2 oncogene prolongs ce11 life by inhibiting apoptosis. The mutant pS3 gene induces apoptosis indirectly. Ki-67 antigen is the cell proliferation marker. Recently, it has been shown that the relationships among them are important in the tumorigenesis of the various tumors. OBJECTIVE: The aim of this study was to examine the expression of these genes and apoptotic rate and clarify the relationship among them in the development and progression of MF. METHODS: The eighteen specimens from 8 patients with MF and 10 specimens from benign lymphocytic infiltrating diseases including 5 lichen planus, 3 lupus erythematosus, and 2 contact dermatitis were included. We performed immunoperoxidase staining(LSAB technique) using monoclonal antibodies including bc1-2, p~53, and Ki-67(MIB1). We used ApoptaqTM(Oncor) in situ labelling kit for detecting apoptotic cell.
Antibodies, Monoclonal ; Apoptosis* ; Carcinogenesis ; Cell Proliferation ; Dermatitis, Contact ; Developmental Biology ; Homeostasis ; Humans ; Ki-67 Antigen ; Lichen Planus ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides* ; Oncogenes

Idiopathic CD4+ T lymphocytopenia (ICL) is a new disease entity characterized by depletion of helper T cells apparently without any evidence of HIV infection. We report a case of ICL associated with Kaposis sarcoma (KS) and pneumocystis carinii pneumonia (PCP) in a 34-year old woman. She developed violaceous, protruding masses on scalp, back, both extremities, palms, soles, left. first toe and peritonsillar region for 2 months. These lesions were confirmed as KS by histopathologic findings. Chest X-ray and HRCT findings represented PCP and KS. Absolute deficiency of CD4+ T cell was detected in the count of T cell subsets. Serologic tests for HIV-1, 2 and HTLV I, -II were negative. And she was absent any defined immunodeficiency or therapy associated with decreased levels of CD4+ T cells. By CDC criteria, a diagnosis of ICL was made. Because of aggravation of PCP and lung involuement of KS, she died at 22nd day after admission.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Extremities ; Female ; HIV Infections ; HIV-1 ; Humans ; Lung ; Lymphopenia* ; Pneumonia, Pneumocystis ; Sarcoma, Kaposi* ; Scalp ; Serologic Tests ; T-Lymphocyte Subsets ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; T-Lymphocytopenia, Idiopathic CD4-Positive ; Thorax ; Toes

BACKGROUND: Calcinosis cutis may occur when connective tissue is abnormal (dystrophic), or where calcium or phosphate levels in the blood are high(metastatic); alternatively, there may be no obvious underlying cause(idiopathic). The exact incidence of calcinosis cutis in dermatologic patients is not well-kniown and the pathomechanism of it remains to be elucidated. OBJECTIVE: This study was performed to analyze the incidence, clinical and histopathological features of calcinosis cutis. METHODS: We studied 72 patients with calcinosis cutis who visited our department between January 1985 and December 1996. The patients were classified into 3 types (dystrophic, metastatic, and idiopathic) and were analyzed clinically and histopathologically. Results : The results were summerized as follows; 1. There were 60 cases(83.3%) and 12 cases(16.7%) of the dystrophic and idiopathic types, respectively but the metastatic type was not observed. The frequency of dystrophic calcification in individual disorders was 88.2% in pseudoxanthoma elasticum, 66.7% in trichilemmal cyst and dermatomyositis, and 64.6% in pilomatrichoma. 2. In the idiopathic type, it was common in females aged over 50 years and the mean duration of lesions was 2.8+/-2.0 years. The predilection site was the flank(5 cases) and most of the lesions(7 cases) showed skin-colored nodules 3. Histopathologically, calcified material of the idiopathic type was located predominently in the dermis(10 cases) and was present as large masses surrounded by a foreign body reaction. 4. In the dystrophic type, calcified deposits were noted predominently within the shadow cells of pilomatricoma, in the degenerated elastic fibers of pseudoxanthoma elasticum, and in the keratinized area of basal cell carcinoma, squamous cell carcinoma, trichilemmal cyst, and epidermal cyst. Foreign body reactions with giant cells and mononuclear cell infiltrations were often found around large deposits of calcium. Conclusion : The incidence of calcinosis cutis in dermatologic patients is relatively low, but a variety of disorders can be associated with cutaneous calcification. Therefore, dermatologists should be familiar with the different forms of cutaneous calcification and the dermatoses that manifest them.
Calcinosis* ; Calcium ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Connective Tissue ; Dermatomyositis ; Elastic Tissue ; Epidermal Cyst ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Humans ; Incidence ; Pilomatrixoma ; Pseudoxanthoma Elasticum ; Skin Diseases

A 28-year-old female devei,oped five rice-sized erythematous telaniectatic solid papules of her left side of cheek and numerous light brownish flat papules of her face two years before visiting our department of dermatology. Biopsy results of the erythematous papule vere dermal infiltration by well-differentiated, however, somewhat atypical and varying sized plasma cells involving epidermis, and the flat papule was that of verwca plana. Bone marrow aspirate was essentially normal. Primary cutaneous plasmacytoma is a rare disease. A significant proportion of patients with this ent on to develop systemic disease with a poor prognosis. Our patient was not treatead, bit only excised partially for biopsy. All skin lesions involuted two years later spontaneously and rema ns well until now six years later without recurring.
Adult ; Biopsy ; Bone Marrow ; Cheek ; Dermatology ; Epidermis ; Female ; Humans ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Rare Diseases ; Skin

Cytophagic histiocytic panniculitis is a histiocytic disorder which is characterized by recurrent subcutaneous nodules, fever, pancytopenia, and abnormal hepatocyte function. Most patients had systemic involvement with hepatosplenomegaly and pancytopenia and, after a chronic course, usually developed a hemorrhagic diathesis that led to death. Rarely reported cases were shown to have had a non-fatal course. We report herein a case of cytophagic histiocytic panniculitis in the trunk and both upper arms of 34-year-old woman who had a benign course and also showed histopatholoigcally lipomembranous change in the subcutaneous lesion.
Adult ; Arm ; Female ; Fever ; Hemorrhagic Disorders ; Hepatocytes ; Humans ; Pancytopenia ; Panniculitis*