Choriocarcinoma is one of the malignant tumors of trophoblastic cells characterized by secretion of human chorionic gonadotrophin (hCG). Choriocarcinoma often metastasizes to the lung, liver, and brain but skin metastasis is rare. To our knowledge, only one case of cutaneous metastasis was reported in Korea. A 35-year-old female presented with hemoptysis for 1 month. Biopsy from lung nodules revealed metastatic choriocarcinoma. She was subsequently referred to our clinic for evaluation of a rapidly growing, reddish nodule with bleeding tendency on the scalp. Histologic examination demonstrated biphasic pattern of cytotrophoblasts and hCG-positive syncytiotrophoblasts with multiple foci of hemorrhage - typical histologic features of choriocarcinoma. The patient was diagnosed with metastatic choriocarcinoma. We herein report a case of choriocarcinoma with cutaneous metastasis.
Adult ; Biopsy ; Brain ; Choriocarcinoma ; Chorion ; Female ; Hemoptysis ; Hemorrhage ; Humans ; Korea ; Liver ; Lung ; Neoplasm Metastasis ; Pregnancy ; Scalp ; Skin ; Trophoblasts

BACKGROUND: The survival and growth of melanocytes are controlled by the binding of stem cell factor to its cell surface receptor c-kit+ (CD117). We have observed that c-kit+ melanocytes existed in some lesions of vitiligo, while Melan A+ cells were absent. OBJECTIVE: To verify possible relation between c-kit+ expression and treatment response in non-segmental vitiligo lesions. METHODS: Skin biopsies were done from the center of the 47 lesions from the 47 patients with non-segmental vitiligo. Expression of c-kit+ and Melan A, and amounts of melanin in the epidermis were assessed in each lesion, and treatment responses to excimer laser were evaluated. RESULTS: Thirty-five of the 47 lesions (74.5%) had c-kit+ phenotypes. There was significant difference of c-kit staining value between good responders in 3 months of excimer laser treatment (average of 24 sessions) and the others. CONCLUSION: c-Kit expression in vitiliginous epidermis may be related to better treatment responses to excimer laser.
Biopsy ; Epidermis ; Humans ; Lasers, Excimer* ; MART-1 Antigen ; Melanins ; Melanocytes ; Phenotype ; Proto-Oncogene Proteins c-kit ; Skin ; Stem Cell Factor ; Vitiligo*

Muir-Torre syndrome is defined by concurrent or sequential development of internal malignancy - most commonly colorectal cancer - and sebaceous neoplasm or multiple keratoacanthomas. Recent studies revealed it was caused by mutations in DNA mismatch repair genes, and suggested screening for mismatch repair gene defects may be of value for patients with Muir-Torre syndrome. We, herein, report a patient with Muir-Torre syndrome, who developed breast cancer and extra-ocular sebaceous carcinoma. In addition, we discussed our experience of immunohistochemical staining for mismatch repair protein with a review of the literature.
Breast ; Breast Neoplasms ; Colorectal Neoplasms ; DNA Mismatch Repair ; Humans ; Keratoacanthoma ; Mass Screening ; Muir-Torre Syndrome

Precalcaneal congenital fibrolipomatous hamartomas (PCFHs) are characterized clinically by the presence of unilateral or bilateral, asymptomatic nodules in the medial precalcaneal plantar region of the heel. They are skin colored and usually painless nodules. In most patients, the lesions appear within the first few months of life, but they may also be present at birth. Generally PCFHs are benign, but they can grow in proportion to the growth of the infants. Here, we report the case of a 4-month-old boy with a solitary, localized skin-colored nodule on the precalcaneal plantar region of his right heel, diagnosed as a PCFH.
Hamartoma ; Heel ; Humans ; Infant ; Parturition ; Skin

Pertussis is a representative vaccine-preventable disease. However, there have been recent outbreaks in countries where even higher vaccination against the disease. One reason is the emergence of antigenic variants, which are different to vaccine type. In Korea, reported cases have rapidly increased since 2009. Therefore, we analyzed genotype of strains isolated in 2011-2012 by multilocus sequence typing method. As expected, the genotype profiles of tested genes dramatically changed. The major sequence type changed from ST1 to ST2, and new sequence type (ST8) appeared. In the minimum spanning tree, recent isolates belonging to the ACC-I-ST3 subgroup were detected that were composed of ST2, ST3, and ST6. In particular, the ST2 frequency increased to 81%. The novel ST8 was linked to the increased frequency of ST2. In addition, toxic strains carrying the ptxP3 promoter type were confirmed. This ptxP3 type emerged from 2009 and its frequency had increased to 100% in 2012. Based on these results, it can be inferred that the genotypic changes in the currently circulating strains are strongly associated with the recent increasing of pertussis in Korea. Therefore, the surveillance system should be strengthened, and genetic characterization of the isolates should be expanded to the whole genome sequence level.
*Antigenic Variation ; Antigens/*genetics/immunology/metabolism ; Bacterial Proteins/genetics/metabolism ; Bordetella pertussis/*genetics/isolation & purification/*metabolism ; Genes, Bacterial ; Genotype ; Humans ; Pertussis Toxin/genetics/metabolism ; Promoter Regions, Genetic ; Republic of Korea ; Sequence Analysis, DNA ; Whooping Cough/immunology/*microbiology/pathology

BACKGROUND: Limited data on the incidence and clinical characteristics of adult pertussis infections are available in Korea. METHODS: Thirty-one hospitals and the Korean Centers for Disease Control and Prevention collaborated to investigate the incidence and clinical characteristics of pertussis infections among adults with a bothersome cough in non-outbreak, ordinary outpatient settings. Nasopharyngeal aspirates or nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and culture tests. RESULTS: The study enrolled 934 patients between September 2009 and April 2011. Five patients were diagnosed as confirmed cases, satisfying both clinical and laboratory criteria (five positive PCR and one concurrent positive culture). Among 607 patients with cough duration of at least 2 weeks, 504 satisfied the clinical criteria of the US Centers for Disease Control and Prevention (i.e., probable case). The clinical pertussis cases (i.e., both probable and confirmed cases) had a wide age distribution (45.7+/-15.5 years) and cough duration (median, 30 days; interquartile range, 18.0~50.0 days). In addition, sputum, rhinorrhea, and myalgia were less common and dyspnea was more common in the clinical cases, compared to the others (p=0.037, p=0.006, p=0.005, and p=0.030, respectively). CONCLUSION: The positive rate of pertussis infection may be low in non-outbreak, ordinary clinical settings if a PCR-based method is used. However, further prospective, well-designed, multicenter studies are needed.
Adult ; Age Distribution ; Centers for Disease Control and Prevention (U.S.) ; Cough ; Dyspnea ; Humans ; Incidence ; Outpatients ; Polymerase Chain Reaction ; Sputum ; Whooping Cough