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: 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*

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

No abstract available.
Down Syndrome

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: 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

BACKGROUND: Desmocollins (Dsc) are calcium-dependent transmembrane glycoproteins of desmosomes that are important in the junction complex of epidermis and maintain structural integrity of the skin from external stressors. Among three Dscs (Dsc 1, 2, 3), Dsc 1 and 3 are distributed on skin. OBJECTIVE: The purpose of this study was to observe the Dsc 1 distribution pattern on the skin and oral mucosa during fetal development. METHODS: Skin was obtained from the sole and scalp of 33 fetuses, ranging from 10 to 37 weeks of gestational age. Immunohistochemical staining was performed on the paraffin-embedded tissue using a Dsc 1 monoclonal antibody. RESULTS: Dsc 1 was expressed in the suprabasal layer but not in the basal layer of the epidermis of the sole at the 10th week of gestation. Thereafter, Dsc 1 expression further increased in the suprabasal layer with initiation of stratification and increased gradually in the granular layers of the sole and scalp epidermis. Dsc 1 was strongly expressed in the superficial layer of the infundibulum and inner root sheath of the hair follicle but was not expressed in the sebaceous cells or other hair components. The eccrine duct epithelium was focally and weakly positive for Dsc 1 expression. Furthermore, Dsc 1 was not expressed in oral mucosa, although the oro-cutaneous portion was strongly expressed in the superficial layer. CONCLUSION: Dsc 1 was strongly expressed in the suprabasal cells of the epidermis during fetal skin development, and expression increased gradually in the granular layer and inner root sheath of the hair follicle. However, Dsc 1 was not expressed in basal cells or in oral mucosa. Dsc 1 may play a role in the maintenance of epithelial integrity as part of desmosomes.
Desmocollins ; Desmosomes ; Epidermis ; Epithelium ; Fetus ; Gestational Age ; Glycoproteins ; Hair ; Hair Follicle ; Mouth Mucosa ; Pregnancy ; Scalp ; Skin

No abstract available.

BACKGROUND: Scientific and epidemiologic studies have shown that several dermatoses of Vietnam veterans were caused by Agent Orange. Most of the previous studies on Vietnam veterans have been about the relationship between systemic diseases including limited dermatoses and Agent Orange, but there have been no clinical studies of dermatoses of Korean Vietnam veterans exposed to Agent Orange. OBJECTIVE: We conducted this study to find out the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange. METHODS: A total of 19, 262 Korean Vietnam veterans who received their first dermatological examination at Seoul Veterans Hospital between January 1997 and December 2003 were included in this study, which consisted of a skin examination and 15-item questionnaire. RESULTS: 1. The distribution of dermatoses groups were as follows: pruritus, psychocutaneous disorders, and neurocutaneous dermatoses (36.1%), dermatomycosis and deep mycosis (20.5%), eczema (11.6%), diseases of the skin appendages (3.6%), epidermal and adnexal nevi and tumors (2.1%), drug eruption, erythema, and urticaria (1.8%), and papulosquamous diseases (1.5%). 2. Pruritus (31.6%) was the most frequent dermatosis in all age groups. 3. The frequency of dermatoses related to exposure to Agent Orange were as follows: seborrheic dermatitis (4.8%), chronic urticaria (1.7%), psoriasis vulgaris (1.2%), xerotic eczema (0.5%), photosensitive dermatitis (0.2%), chloracne (0.1%), soft tissue sarcoma (0.1%), and malignant tumors (0.01%). 4. With regard to regional groups of dispatch in Vietnam, QuiNhon (20.1%) was the most frequent area of dispatch. There was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between Dian, where larger amounts of Agent Orange were sprayed, and the other regional groups. 5. For duration of dispatch in Vietnam, there was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between two groups of duration. CONCLUSION: This study showed the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange, and may be helpful as the fundamental epidemiologic data of dermatoses of Korean Vietnam veterans for dermatologists to examine.
Chloracne ; Citrus sinensis* ; Dermatitis ; Dermatitis, Seborrheic ; Dermatomycoses ; Drug Eruptions ; Eczema ; Epidemiologic Studies ; Erythema ; Hospitals, Veterans ; Humans ; Nevus ; Pruritus ; Psoriasis ; Sarcoma ; Seoul ; Skin ; Skin Diseases* ; Urticaria ; Veterans* ; Vietnam* ; Surveys and Questionnaires

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