Muchz-Habermann disease is cutaneous disease of unknown etilogy and characterized by a, polymorphous eruption consisting of papulosquamous, bemorrhagic, ulceronecrotic lesion eventually into varioliform scars. It is also classified into parapsoriasis group according to Broq with parapsoriasis en guttata (pityriasis lichenoides chronica), parapsoriasis en plaques, parapsoriasis en lichenoides. The 61-year-old male patient visited to Dermatologic Department of Severance Hospital due to sudden onset of generalized eruption. He presented pea to fingr tip sized erythematous, silvery maculo-papulo-squamous eruptions on trunk, extre- mities and buttock, but didnt complain of any subjective symptoms except markel fatigue. Skin biopsy was done on right forearm and was confirrr.ed to pityriasis lichenoides et varioliformis acuta by histopathologic finding. The lesion was completely controlled by oral tetracycline 2. Ogm per daily for first 4 wecks and reduced dosage l. Ogin per day for second 2 weeks.
Biopsy ; Buttocks ; Cicatrix ; Fatigue ; Forearm ; Humans ; Male ; Middle Aged ; Parapsoriasis ; Peas ; Pityriasis Lichenoides* ; Pityriasis* ; Skin ; Tetracycline

A clinicopathological study of 12 cases of pityriasis lichenoides chronica and 14 cases of small plaque parapsoriasis was performed. Patients with pityriasis lichenoides chranica ranged in age from 15 to 62 years (mean, 30 years) with male predominance. They had erythematous or reddish scaly papules occuring mostly on both trunk and extremities(92%). The lesions were about the size of r ice grains or small peas. Patients with small plaque parapsoriasis ranged in age from 8 to 67 years(mean, 33 years) and presented yellowish or erythematous scaly maculies and patches comrnonly involving the trunk and extremities(64%). The size of the lesions were larger than those of pityriasis lichenoides chronica. Histopatbologically, the distinct feature of pityriasis lichenoides chronica was vacuolar alteration at the dermoepidermal junction characterizing interface dermatitis. The microscopic findings of small plaque parapsoriasis were, although not as distinct as in pityriasis lichenoides chronica, those af either spongiotic dermatitis or superfirial peri vascula dermatitis. We conclude from this study that these two conditions have different clinical and histologic features and we propose that the term guttate parapsoriasis shauld not be used as a synonym of either pityriasis lichenoides rhronica or small plaque parapsoriasis.
Edible Grain ; Dermatitis ; Humans ; Ice ; Male ; Parapsoriasis* ; Peas ; Pityriasis Lichenoides* ; Pityriasis*

We report a case of para.psoriasis variegata in a 19 year-old male patient wha has brownish flat scaly papules that are confluent in a retiform pattern characterized by symmetrical distribution on trunk and upper extremities. A skin biopsy specimen showed hyperkeratosis, focaI parakeratosis, hyperpigmentation of basal cell layer, and a mild lymphocytic perivascular infiltrate. No evidence was found for a relationship to lymphoma.
Biopsy ; Humans ; Hyperpigmentation ; Lymphoma ; Male ; Parakeratosis ; Parapsoriasis* ; Skin ; Upper Extremity ; Young Adult

No abstract available.
Pityriasis Lichenoides* ; Pityriasis*

No abstract available.
Pityriasis Lichenoides* ; Pityriasis*

BACKGROUND: Mycosis fungoides(MF) is a representative of cutaneous T-cell lymphoma and progresses through clinical stages, such as initial pre-mycotic(macule or patch), plaque, and tumor stage. Although lesions of plaque and tumor stage show typical features, those of pre-mycotic stage are commonly non-specific that precise diagnosis of early MF remains elusive. OBJECTIVES: This study attempted to elucidate the clinical and histopathologic features of early MF. METARIALS AND METHODS: We investigated 11 cases of MF stage Ia(based on TNM staging system) that visited the department of dermatology at the Seoul National University Hospital for the past decade year(1988-1998). Medical records and biopsy slides were reviewed. RESULTS: The results were as follows : 1. Clinical characteristics: Lesions were relatively well-defined erythematous scaly patches or plaques on lower abdomen, buttocks, proximal extremities or whole body. Clinically initial diagnoses were large plaque parapsoriasis in nine cases and in the remainders, poikiloderma atrophicans vasculare and MF, respectively. Duration of disease ranged from one month to 41 years, averaging 15.2 years. 2. Treatments: Follow-up of 8 patients was continued and all showed partial responses to application of topical steroids or BCNU(carmustine) and PUVA therapy. 3. Histopathologic findings: Epidermotropism was found in all cases and can be the most important pathologic finding, but typical Pautriers microabscesses were found in a few cases. Mild spongiosis was seen in epidermis and superficial perivascular infiltration was the most common finding in dermis. Lichenoid infiltration with epidermal psoriasiform change was found in two cases. Atypism of infiltrating cells was found in all cases and more prominent in epidermis. CONCLUSION: Lesions of early mycosis fungoides were relatively non-specific erythematous patches/plaques but characteristically, patients had relatively long duration of stationary disease status and showed good responses to treatments. Histopathologically, variable degree of epidermotropism was the most constant finding.
Abdomen ; Biopsy ; Buttocks ; Dermatology ; Dermis ; Diagnosis ; Epidermis ; Extremities ; Follow-Up Studies ; Humans ; Lymphoma, T-Cell, Cutaneous ; Medical Records ; Mycosis Fungoides* ; Neoplasm Staging ; Parapsoriasis ; PUVA Therapy ; Seoul ; Steroids

BACKGROUND: Parapsoriasis described a group of cutaneous disease that can be characterized by scaly patches or slightly elevated plaques that have a resemblance to psoriasis, hence the nomenclature. Up to now, a uniformly accepted definition of parapsoriasis remains lacking. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathological features of parapsoriasis in Korea. METHODS: The clinical charts, photographs and skin biopsy slides of patients who had been clinically diagnosed as parapsoriasis at the initial visit were reviewed. Then the evaluation of age at onset, sex distribution, disease duration, anatomical distribution, clinical features of the skin lesions, associated symptoms, family history, co-existing disease, and histopathologic features were conducted. Six cases from small plaque parapsoriasis group and four cases from large plaque parapsoriasis group were investigated for the presence of TCR gene rearrangement using a PCR technique. RESULTS: The male to female ratio was 1: 1.2. The average ages of onset in large plaque type and small plaque type were 44.7 and 32.9 years respectively. 1) According to the clinical classification, 7 (29%) of the patients had large plaque type and 17 (71%) had small plaque type. 2) Many lesions of large plaque parapsoriasis group exhibited varying degrees of epidermal atrophy, fine wrinkles and telangiectasia. 3) Large plaque parapsoriasis showed more histologic changes consisting of epidermal atrophy, exocytosis and atypical lymphocytes. 4) Monoclonal T-cell receptor gene rearrangement was not detected in all of 10 patients with large and small plaque parapsoriasis. CONCLUSION: In our study, some of our findings are in agreement with those already in the literature, whereas others, particularly the male to female ratio and constitutional symptoms, differ. Our results also indicate that there are many clinical and pathological differences between large plaque and small plaque parapsoriasis.
Atrophy ; Biopsy ; Classification ; Exocytosis ; Female ; Genes, T-Cell Receptor ; Hospital Distribution Systems ; Humans ; Korea ; Lymphocytes ; Male ; Parapsoriasis* ; Polymerase Chain Reaction ; Psoriasis ; Sex Distribution ; Skin ; Telangiectasis

No abstract available.
Methotrexate* ; Pityriasis Lichenoides* ; Pityriasis* ; Prednisolone*

No abstract available.
Child* ; Humans ; Pityriasis Lichenoides* ; Pityriasis*

BACKGROUND: Recently, the molecular pathologic investigation for clonality in lymphomas has been introduced and has gained a role in the diagnosis of lymphomas. In fact, the clonality test using TCRGR phenomenon has been done by Southern blot analysis (SBA) and polymerase chain reaction (PCR) for molecular pathologic diagnosis of T cell lymphomas. However, it is difficult to perform SBA with paraffin embedded specimens or with samples of small skin biopsies. OBJECTIVE: We investigated the efficacy of PCR amplification of TCR gene in paraffin em-bedded cutaneous T cell lymphomas. METHODS: Iii this study, the clonality was assessed by polymerase chain reaction (PCR) analysis of T cell receptor gamma (TCR) gene from the DNA extracts obtained from paraffin em-bedded tissues (PET) of malignant T cells, B cell lymphomas, and benign cutaneous T cell proliferative disorders. Heteroduple-x-analyses were also performed to rule out the false positives. RESULTS: Among the total of 62 cases analyzed, monoclonality was observed in 4 out of 10 mycosis fungoides, 7 out of 9 cutaneous T cell lymphomas excluding mycosis fungoides, 1 out of 3 angiocentric lymphomas, 2 out of 2 lymphomatosis papulosis, 1 out of 7 large plaque parapsoriasis, and 1 out of 2 T cell lymphomas in other organs. No monoclonality was observed in 9 inflammatory cutaneous diseases, 5 small plaque parapsoriasis, 4 cutaneous B cell lymphomas, and 11 B cell lymphomas in lymph nodes. CONCLUSION: The results suggest that the PCR method and heteroduplex analysis used in this study were not only practical but also efficacious for the diagnosis of cutaneous T cell lymphomas using tissues embedded in paraffins.
Biopsy ; Blotting, Southern ; Diagnosis ; DNA ; Gene Rearrangement* ; Genes, T-Cell Receptor ; Heteroduplex Analysis* ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides ; Paraffin ; Parapsoriasis ; Polymerase Chain Reaction* ; Receptors, Antigen, T-Cell* ; Skin ; T-Lymphocytes