BACKGROUND: The epidermis and adnexal epithelium might express different types of keratin (K) during fetal development. OBJECTIVE: The objective is to observe the distribution of K8/18 in the skin of fetuses and to find out the distinction of expressions of K8/18 during fetal development. METHODS: Immunohistochemical analysis was applied to the skin of the scalp and sole of 42 fetuses ranging from 10 to 39 weeks of gestation. Immunohistochemical staining with monoclonal antibodies with CAM5.2 using LSAB kit against K8/18 was conducted. RESULTS: In the skin of the scalp, K8/18 was expressed in the periderm and basal layer of epidermis from the 10th week to the 31st week of fetal gestation. K8/18 was expressed in the hair germ, bulge and basal cells of fetal the infundibulum and sebaceous glands. Root sheath cells were weakly positive but matrix cells were negative. The expression of K8/18 was negative in the basal layer of the sole. Merkel cells, which are located in the basal layer and upper dermis, were positive from the 12th week of gestation. Terminal eccrine ducts and acinar cells were positive after the 20th week of gestation. CONCLUSION: K8/18 in the skin of the scalp and sole of fetuses were expressed in different ways. The expression of K8/18 in the basal cells of the sole were negative while basal cells of the epidermis of the scalp were positive transiently from the 12th to the 31st week of gestation. Early hair germ cells and bulge cells were expressed strongly in hair follicles. Terminal eccrine ducts and acini were expressed strongly in the eccrine gland. Merkel cells located in the basal layer and papillary dermis also express K8/18.
Acinar Cells ; Antibodies, Monoclonal ; Dermis ; Eccrine Glands ; Epidermis ; Epithelium ; Fetal Development ; Fetus ; Germ Cells ; Hair ; Hair Follicle ; Merkel Cells ; Molecular Weight* ; Pregnancy ; Scalp ; Sebaceous Glands ; Skin*

Angiosarcoma is a rare malignant tumor of endothelial cell origin. Histopathologically, varied differentiation may be observed even within the same tumor. Epithelioid angiosarcoma is one subset of poorly differentiated angiosarcoma which is a rare variant. We report a case of epithelioid angiosarcoma of the scalp in a 59-year-old man. The patient had a painful solitary, 2x3 cm sized, dome-shaped, firm, erythematous to purplish nodule with crust on the vertex of the scalp. Histopathologically, the tumor was chiefly composed of solid sheets of atypical epithelioid cells with prominent eosinophilic cytoplasm, a large vesicular nuclei, and occasional intracytoplasmic vacuoles. Well to moderately differentiated areas with irregular vascular channel-like structures lined by atypical hyperchromatic endothelial cells were also seen in the peripheral areas of the tumor. Immunohistochemically, the tumor cells were positive with CD31 which is sensitive marker of endothelial cell.
Cytoplasm ; Endothelial Cells ; Eosinophils ; Epithelioid Cells ; Hemangiosarcoma* ; Humans ; Middle Aged ; Scalp* ; Vacuoles

BACKGROUND: Bowen's disease, also known as squamous intraepidermal carcinoma, is a pre-malignant skin tumor with a potential to progress to an invasive carcinoma. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of Bowen's disease. METHODS: A total of 45 patients with Bowen's disease were enrolled in this study. The hospital charts and histopathological slides from 1994 to 2005 were reviewed retrospectively at Seoul Veterans Hospital. RESULTS: There were thirty-seven cases (82%) of single lesions and eight cases (18%) of multiple lesions. Thirty cases (81%) of solitary Bowen's disease were located in non sun-exposed areas. These included the trunk, extremities and genital area in decreasing order. Seven cases (19%) of solitary Bowen's disease occurred on sun- exposed areas including the face and the dorsum of the hand in decreasing order. Analysis of the clinical character of Bowen's disease was performed and results were as follows: the most common type was patch (20 cases; 44%), plaque (14 cases; 31%) and pigmented lesions (12 cases: 27%). Analysis of the histopathological character of Bowen's disease was performed and results were as follows: the most common type was irregular (18 cases; 46%), psoriasiform (11 cases; 28%) and verrucous, atrophic type in decreasing order. Of 18 cases where surgical removal was performed, there were 2 case (11%) of recurrence. Of 16 cases where cryotherapy treatment was administered, there were 3 cases of recurrence. And of 4 cases where CO2 laser therapy was used, there was 1 case (25%) of recurrence, in 2 cases where multiple or large-sized lesions were observed, clinical recovery processes were monitored after applying isotretinoin and 5-FU combined therapy, as well as surgical removal and cryotherapy combined therapy. CONCLUSION: In Bowen's disease among Koreans, there were many distinctive clinical and histopathological features compared to those of non-Korean cases.
Bowen's Disease* ; Cryotherapy ; Extremities ; Fluorouracil ; Hand ; Hospitals, Veterans ; Humans ; Isotretinoin ; Lasers, Gas ; Recurrence ; Retrospective Studies ; Seoul ; Skin

BACKGROUND: Self-inflicted dermatosis is a kind of self-inflicted skin disease. Most Vietnam veterans from Korea have visited the Veterans Hospitals for dermatological examination to determine the relationship between their skin diseases and Agent Orange. We were suspicious of the possibility that several Vietnam veterans intentionally produced their own skin lesions. OBJECTIVE: We conducted this study to determine the clinical characteristics of self-inflicted dermatoses of Korean Vietnam veterans. METHODS: From January, 1999 to December, 2007, a total 24 Vietnam veterans who were diagnosed as having self-inflicted dermatoses during their dermatological examinations at our hospital were included in this study. We investigated their clinical presentation, the laboratory examinations, the pathologic examinations, the medical records and the associated diseases. RESULTS: Itching was the most common subjective complaint and the duration of the itching was as follows; 20 to 30 yrs (50.0%), 1 to 10 yrs (25.0%), 10 to 20 yrs (20.8%) etc. The skin lesions were all multiple, and the involved area was as follows; upper extremities (83.3%), trunk (75.0%), lower extremities (70.8%) etc. There were two categories of clinical skin presentation. The first was the cases with lesion that were thought to be made by physical trauma such as stinging or excoriation, and the second more common cases had lesions that were thought to be made by chemical agents (70.8%). These cases resembled allergic or toxic irritant dermatitis and the lesions were composed of vesicles, erosions, ulcers and crusts that were within an arm's reach. Only 4 cases admitted to intentionally inflicting their skin lesions because of intense itching, and the others denied that they made the skin lesions by themselves. Skin biopsies were carried out in 19 of the total 24 cases, and the most common finding was spongiotic dermatitis (57.8%). CONCLUSION: This study showed the distribution and characteristics of self-inflicted dermatoses, and the study provides fundamental data for dermatologists to assess patients with self-inflicted dermatoses.
2,4,5-Trichlorophenoxyacetic Acid ; 2,4-Dichlorophenoxyacetic Acid ; Biopsy ; Bites and Stings ; Citrus sinensis ; Dermatitis ; Dermatitis, Irritant ; Hospitals, Veterans ; Humans ; Intention ; Korea ; Lower Extremity ; Medical Records ; Pruritus ; Skin ; Skin Diseases ; Tetrachlorodibenzodioxin ; Ulcer ; Upper Extremity ; Veterans ; Vietnam

No abstract available.
Down Syndrome

We report a case of alopecia neoplastica in a 54-year-old woman, who presented with a 2 month history of a solitary 2X2 cm sized, erythematous hairless plaque on the vertex. Histological findings showed an extensive infiltration of tumor cells in the dermis, resulting in loss of the pilosebaceous structure. Tumor cells infiltrated in sheets or cords of cells, sometimes demonstrating glandular structures, and tumor cells formed small groups or single rows between thickened collagen bundles; the characteristic features of alopecia neoplastica.
Alopecia* ; Breast Neoplasms* ; Breast* ; Collagen ; Dermis ; Female ; Humans ; Middle Aged

BACKGROUND: Catenins are the associated protein with E-cadherin in the formation of adhesion complexes in normal and tumor cells related with epithelial differentiation and development of organ formation as well as in the tumor spread. The present study was aimed to find the distribution of alpha- and gamma-catenins in fetal skin development. OBJECTIVE: The purpose of this study was to observe the distribution of above two adhesion related proteins in the fetal skin during development, and to find its relationship by expression and their distribution pattern. METHODS: Skin was obtained from the scalp, chest, and sole of 21 human fetuses, ranging from 13 to 37 weeks of gestational age. Immunohistochemical staining was performed by the avidin biotin peroxidase complex method on paraffin embedded tissue using the anti-human monoclonal antibody against the human alpha- and gamma-catenins. RESULTS: alpha- and gamma-catenins were expressed strongly in basal cells of the epidermis and germ cells of skin adnexa, such as hair and eccrine glands at 13th week, followed by decreased basal cell expression. Increase in the suprabasal epithelium and differentiated adnexal epithelium, such as outer root sheath cells and eccrine ducts and glands at 18th week, and adult pattern in 23th week of gestation. Both showed similar distribution pattern in skin though gamma-catenin appeared two or three weeks later. alpha- and gamma-catenins are expressed not only in the epithelium of the skin, but also in the mesenchymal cells such as endothelial cells and fibroblasts. Though both catenins are more strongly expressed in the membrane portion, cytoplasmic expression is also noted. CONCLUSION: Both alpha- and gamma-catenin showed basically the same expression distribution pattern in the fetal skin developmental stage, suggesting that both adhesion molecules are highly related to each other in function and development of epidermis and adnexae of the skin in fetal stage.
Adult ; Avidin ; Biotin ; Cadherins ; Catenins ; Cytoplasm ; Eccrine Glands ; Endothelial Cells ; Epidermis ; Epithelium ; Fetus ; Fibroblasts ; gamma Catenin* ; Germ Cells ; Gestational Age ; Hair ; Humans ; Membranes ; Paraffin ; Peroxidase ; Pregnancy ; Scalp ; Skin* ; Thorax

Chondroid syringoma, also known as `mixed tumor of the skin', is a kind of acquired hamartoma of folliculosebaceous-apocrine lineage. Histologically, it is characterized by the biphasic pattern, with epithelial structures enveloped by abundant stroma. We report a case of chondroid syringoma, as an asymptomatic nodule, on the upper lip of a 55-year-old male. Histologically, the tumor had both epithelial components with follicular differentiation and myxochondroid stroma.
Adenoma, Pleomorphic* ; Hamartoma ; Humans ; Lip ; Male ; Middle Aged

Cutaneous leiomyosarcoma is a rare soft-tissue tumor of smooth muscle derivation that accounts for 2%-3% of all soft tissue sarcomas. Cutaneous leiomyosarcomas can be subdivided into dermal and subcutaneous leiomyosarcomas. Because of the different prognosis, it is important to distinguish between dermal and subcutaneous forms. Immunohistochemical stains, such as vimentin, smooth muscle actin (SMA), desmin, CD68, CD34, and S-100, may aid in the recognition of smooth muscle derivation and in the differentiation from other malignant spindle cell tumors. We report a case of cutaneous leiomyosarcoma on the extensor surface of the left thigh in a 61-year-old man.
Actins ; Coloring Agents ; Desmin ; Humans ; Leiomyosarcoma* ; Middle Aged ; Muscle, Smooth ; Prognosis ; Sarcoma ; Thigh ; Vimentin

Mastocytosis is a heterogenous group of disorders characterized by abnormal growth and accumulation of mast cells in one or more organ systems. Urticaria pigmentosa represents the most common form of cutaneous mastocytosis in children and adults. We report a case of adult-onset urticaria pigmentosa in a 53-year-old man. The patient had pruritic multiple scattered well-demarcated brownish macules and papules on whole body for 4 years. Histopathologic examination showed diffuse and perivascular infiltration of lymphocytes and cuboidal mast cells in the upper dermis. Any sign or symptom of systemic involvement was not detected.
Adult ; Child ; Dermis ; Humans ; Lymphocytes ; Mast Cells ; Mastocytosis ; Mastocytosis, Cutaneous ; Middle Aged ; Urticaria Pigmentosa* ; Urticaria*