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

Cutaneous mycobacterial infection can occur with Mycobacterium tube culosis or other mycobacterial agents. The commonest of the group IV rapidly growing mycobacteia Mycobacterium fortuitum, has widespread distribution in natur, and is an uncommon causative agent of human mycobacterial infection. We report herein a case of Mycobacterium fortuitum infection follcwiiig an antibiotics susceptibility test. This 24-year-old man suffered fram ulcerative itchy nodules on the left forearm where the antibiotics susceptibility test was don. The skin biopsy specimen revealedly. iphohistiocytic granulomatous infiltration in the dermis. Culture of the tissue specimen revealed rapicly growing yellowish colonies, which was isolated to Mycobacoterium fortuitum. Among 3 biovariants of M. fortuitum, our case was revealed to he biovariant fortuiiam: Surgical excision was performed followed by the administration of antiliiiitics, and no sign of relapse was noted until now, 1 year since.
Anti-Bacterial Agents* ; Biopsy ; Dermis ; Forearm ; Humans ; Mycobacterium fortuitum* ; Mycobacterium* ; Recurrence ; Skin ; Ulcer ; Young Adult

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

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*

We report a case of Mycobacterium(M.) fortuitum infection in a 65-year-old female who presented with erythematous to purplish colored tender nodules and plaques with curst and purulent discharge on both upper and lower extremities along the sites of acupuncture. The culture of surgically excised specimen in 3% Ogawa media yielded slightly yellowish colored colonies within 2 days. Several tests for identification of the species were performed and growth on 5% NaCl, negative niacin test, positive results in nitrate reduction, catalase, urease and iron uptake tests were noted. Excision of the lesions followed by administration of minocycline and ciprofloxacin showed no sign of relapse to data a year after treatment.
Acupuncture* ; Aged ; Catalase ; Ciprofloxacin ; Female ; Humans ; Iron ; Lower Extremity ; Minocycline ; Mycobacterium fortuitum* ; Mycobacterium* ; Niacin ; Recurrence ; Urease