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: Desmosomes are cell-cell adhesion complexes that provide mechanical integrity to keratinocytes by linking them to keratin intermediate filaments. Desmosomes are composed of two major transmembrane proteins, desmoglein and desmocollin. In humans, four desmoglein isoforms have been identified: Dsg1, Dsg2, Dsg3, and Dsg4. Desmogleins are Ca2+-dependent adhesion molecules and play important parts in the formation and maintenance of desmosomes. Desmoglein-1 is the main skin-associated desmosomal cadherin. It is expressed throughout the epidermis, but most prominently in the differentiated layers. OBJECTIVE: The purpose of this study was to observe the distribution pattern of desmoglein-1 in the skin and oral mucosa during fetal development. METHODS: Skin was obtained from the sole and scalp of 35 fetuses, ranging from 10 to 37 weeks of gestational age. Immunohistochemical staining was performed on paraffin embedded tissue using anti-human monoclonal antibody against desmoglein-1. RESULTS: Expression of desmoglein-1 in the epidermis appeared in the upper layer of the sole, but the basal layer was negative at the 10th gestational age. Thereafter, stratification began with stronger expression in the middle layer than in the basal layer of the sole and scalp epidermis. Expression in the middle spinous layer is stronger in the fetal period than in other layers of the epidermis. Expression in the superficial layer seemed to increase in later stages. Expression of desmoglein-1 in hair was strong in the infundibulum, inner root sheath, sebaceous glandular epithelium, and eccrine duct epithelium. Expression of desmoglein-1 in oral lip mucosa was very weak or negative in the upper half of the mucosal epithelium, though the lower half was strongly positive, while the skin side of the mucosa was similar with the sole skin. CONCLUSION: Desmoglein-1 may play a complementary role in the maintenance of epithelial integrity along with other desmogleins, because desmoglein-1 distribution is slightly different from that of desmoglein-3 in epidermis, hair and mucosa in fetal skin development.
Desmogleins ; Desmosomes ; Epidermis ; Epithelium ; Fetus ; Gestational Age ; Hair ; Humans ; Intermediate Filaments ; Keratinocytes ; Keratins ; Lip ; Mouth Mucosa ; Mucous Membrane ; Paraffin ; Protein Isoforms ; Proteins ; Scalp ; Skin

Trichoblastoma is a benign cutaneous neoplasm that consists of follicular germinative cells. We report a case of trichoblastoma in a 58-year-old man. The tumor was presented as a solitary symmetrical shaped pedunculated 5.0x4.0x2.0cm sized multilobular tumor on right lower leg for 2 years. Histopathologic examination showed well circumscribed dermal tumor composed of multilobular tumor islands of palisaded basaloid epithelial cells. The tumoral lobules were concentrically surrounded by hyalinized collagen bundles with fibroblasts. The overall architecture was reminiscent of hair bulbs. Cytokeratin 14 stain showed positive reaction, but cytokeratin 10 stain showed negative reaction. The tumor was completely excised with clear margin. No sign of recurrence has been noted until 9 months later.
Collagen ; Epithelial Cells ; Fibroblasts ; Hair ; Humans ; Hyalin ; Islands ; Keratin-14 ; Keratins ; Leg ; Middle Aged ; Recurrence

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

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*

BACKGROUND: Port-wine stain (PWS) is a congenital capillary malformations characterized by ectasia of capillaries and venules. These vascular channels progress gradually to hyperplasia of soft and hard tissues, manifested as hypertrophy of involved structures. Especially, when these lesions involve the lip, macrocheilia may develop with time. Usually vascular-specific laser treatment is used for PWS, however with no favorable effect with soft-tissue hypertrophy. Therefore, surgical treatment may be necessary in such cases. OBJECTIVE: The subjects were 9 patients who had PWS with lip hypertrophy, who were aged from 9 to 65 years. METHODS: The patients underwent cheiloplasty which include making an incision horizontally on a labial mucosa of the lip, and dissection of hypertrophied soft tissue in the front and back of the orbicularis oris muscle. RESULTS: Of the 9 patients, only 2 had postoperative complication such as mild chewing of the labial mucosa. After a minor revision surgery, these symptoms disappeared. Good to excellent results were achieved in all patients during the final postoperative cosmetic evaluation. CONCLUSION: Surgical correction is appropriate for treatment of three-dimensional tissue deformity such as lip hypertrophy with good cosmetic results and minimal complications.
Aged ; Capillaries ; Congenital Abnormalities ; Cosmetics ; Dilatation, Pathologic ; Humans ; Hyperplasia ; Hypertrophy ; Lip ; Mastication ; Mucous Membrane ; Port-Wine Stain ; Postoperative Complications ; Vascular Malformations ; Venules