A 24-year old woman presented with hemorrhagic vesicles on her legs. She had taken sibutramine (Reductil(R), Abbott Labs., Seoul, South Korea) for 3 months and developed skin lesions the week before. A skin biopsy showed leukocytoclastic vasculitis with conspicuous eosinophilic infiltration of the tissue. These lesions showed improvement after discontinuation of sibutramine. However, 3 months later the skin lesions recurred on other sites on the lower extremities when the patient was rechallenged with the same drug for 2 weeks. Herein, we report the first case of necrotizing vasculitis induced by sibutramine.
Biopsy ; Cyclobutanes ; Eosinophils ; Female ; Humans ; Leg ; Lower Extremity ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

Transurethral resection (TUR) is the gold standard treatment of non-muscle invasive bladder cancers. Recurrence occurs in approximately half of the patients with bladder cancer after initial TUR. Most recurrent bladder cancers present as polypoid masses with intraluminal growth originating from the mucosa. To the best of our knowledge, there has been no report on imaging findings of recurrent bladder cancers located within the subepithelial and intramural layers. Recurrent cancers within the intramural layer are difficult to detect with cystoscopy; they are also difficult to remove surgically. Imaging studies reveal the most important indicators for diagnosing subepithelial recurrent cancers. Here, we present a rare case of a recurrent bladder cancer within the subepithelial layer detected on imaging.

Transurethral resection (TUR) is the gold standard treatment of non-muscle invasive bladder cancers. Recurrence occurs in approximately half of the patients with bladder cancer after initial TUR. Most recurrent bladder cancers present as polypoid masses with intraluminal growth originating from the mucosa. To the best of our knowledge, there has been no report on imaging findings of recurrent bladder cancers located within the subepithelial and intramural layers. Recurrent cancers within the intramural layer are difficult to detect with cystoscopy; they are also difficult to remove surgically. Imaging studies reveal the most important indicators for diagnosing subepithelial recurrent cancers. Here, we present a rare case of a recurrent bladder cancer within the subepithelial layer detected on imaging.

Neurofibromatosis type 1 (NF-1) has a variety of localized or systemic manifestations. Among them, Cerebrovascular dysplasia can be very rare finding of neurofibromatosis which can be very rarely seen. Here we report a case of 17-year-old boy representing bilateral giant fusiform aneurysms of extracranial internal carotid arteries and intracranial aneurysms of left middle cerebral artery. He showed no related symptoms at all, but screening for vascular lesions and close monitoring is warranted in NF-1 patients considering that it can be symptomatic unexpectedly.
Adolescent ; Aneurysm ; Carotid Artery, Internal ; Humans ; Intracranial Aneurysm ; Mass Screening ; Middle Cerebral Artery ; Neurofibromatoses ; Neurofibromatosis 1

Dermatitis neglecta (unwashed dermatosis) presents as pigmented hyperkeratotic plaques with adherent scales which clinically resembles psoriasis. This condition is the result of avoiding washing the affected areas, so the lesions are characteristically resolved with normal washing or with gentle wiping from an alcohol swab. We report a 29-year-old man who presented with an asymptomatic hyperkeratotic scaly plaque on umbilicus. A skin biopsy was done under the clinical impression of psoriasis. During skin biopsy, gentle swabbing with H2O2 and saline gauze was done. The patient revisited our clinic 10 days after the skin biopsy and the hyperkeratotic lesion had cleared. Histologic examination showed orthokeratotic hyperkeratosis and anastomosing rete ridges. There has been no previous report of dermatitis neglecta with histologic confirmation, and so this case could be the first report to provide the histologic characteristics of dermatitis neglecta. Because this condition might be overlooked and underdiagnosed, recognizing its existence and cause are important to avoid unnecessary biopsies and potentially aggressive therapeutic measures.
Adult ; Biopsy ; Dermatitis ; Humans ; Psoriasis ; Skin ; Umbilicus ; Weights and Measures

Cutaneous lymphadenoma is a rare distinctive benign adnexal tumor of unknown histogenesis. It usually presents as a slowly growing, skin-colored nodule on the head and neck. Histologically, this tumor is composed of dermal lobules with a biphasic pattern of epithelial and lymphoid cells. We report two additional examples of this peculiar neoplasm.
Head ; Lymphocytes ; Neck

We report a case of cutaneous Mycobacterium (M.) abscessus infection in a 32-year-old woman who presented with a red infiltrated plaque on her left shin. No history of prior trauma was reported, but she had a history of habitual leg shaving. Skin biopsy specimen showed neutrophilic abscesses with poorly defined granulomas in the lower dermis and subcutaneous tissue, as well as some acid-fast bacilli. The microorganism was identified as M. abscessus by tissue culture and PCR-restriction fragment length polymorphism (PCR-RFLP) analysis. The patient was treated with clarithromycin and cefaclor for 4 months, and there was no evidence of recurrence at 6 month follow-up.
Abscess ; Adult ; Biopsy ; Cefaclor ; Clarithromycin ; Dermis ; Female ; Follow-Up Studies ; Granuloma ; Humans ; Leg ; Mycobacterium ; Neutrophils ; Recurrence ; Skin ; Subcutaneous Tissue

A 6-day-old infant presented with a deeply bluish cystic mass below the right medial canthus. She had been born healthy. Under the impression of a hemangioma brain computed tomography was conducted. As a result, a diagnosis of congenital dacryocystocele was made. We present this case to show that it is important for a dermatologist to correctly identify congenital dacryocystoceles and appropriately refer the infant to a pediatric ophthalmologist prior to performing invasive measures.
Brain ; Hemangioma ; Humans ; Infant

We report here on a 63-year-old woman who presented with recurrent bruise-like infiltrative plaques on the left leg without systemic symptoms or laboratory abnormalities. The histopathologic findings showed an infiltration of panniculus by small to medium-sized atypical lymphocytes. But the prominent lymphoid atypia, fat necrosis, vascular thrombosis, erythrophagocytosis and striking dominance of CD8+ lymphocytes seen in subcutaneous panniculitis-like T-cell lymphoma (SPTCL) were not detected. The diagnosis of atypical lymphocytic lobular panniculitis (ALLP) was made based on these histopathologic and clinical features. The lesions responded well to systemic steroid treatment. But the CD4/CD8 ratio in the later lesion was more decreased than that of the initial lesion, and the patient is under clinical follow up.
Fat Necrosis ; Female ; Follow-Up Studies ; Humans ; Leg ; Lymphocytes ; Lymphoma, T-Cell ; Middle Aged ; Panniculitis ; Strikes, Employee ; Thrombosis