Penile melanosis is a beniign macular hyperpigmentation of the penile shaft and/or glans. Clinically the lesions are irregular in outline and show variegated pigmentation. The main differential diagnostic problem is with acral levtiginous melanoma. A 28-year-old man was seen with slowly growing, asymptomatic, multifocal, and variegated hyperpigmented maculs on the glans penis of 28-year-duration. The post and family history were non-contributory. Hostogologic examination showed acanthosis and basal layer hyperpigrnentation but atypical melanocytes were not seen. Fontana-Masson stain showed increased melanin pigmentation with dendritic elongation of melanocytes in the basal layer of the epidermis. Little is known about the natural history and melnona risk of penile melanosis and we believe that a long-term follow-up is warranted. This patient showed no change during the follow-up period of 2 years and we will continue to monitor him long-term.
Adult ; Epidermis ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Male ; Melanins ; Melanocytes ; Melanoma ; Melanosis* ; Natural History ; Penis ; Pigmentation ; Vitiligo

BACKGROUND: Lichen planus(LP) & lichenoid drug eruption(LDE) are similar in clinical manifestations and may pose difficulty in differentiation. OBJECTIVE & METHOD: We observed the clinical feature of 9 LDE patients and campared the histopathologic findings of LDE(11 specimens in 9 pateints) and LP(11 specimens in 11 patients). RESULTS: Age of onset was predominant in old age, ranging from 49 to 71 years old. Causative drugs could be proved in seven patients and were ethanb atol in two cases, and thyroigen, pentazocin, furosemide, captopril and 5 fluorouracil in each of 5 cases. In the other two cases, either of INH, RIF or EMB was suspected as a causitire agent. Blood eosinophilia was present in 5 of the 6 exmmined patients. Comparative histolgjc features of LDE and I.P were as follows. (No. of specimen LDE/LP). parakeratosis (81), focal epidermal atrophy (8/0), focal loss of granular layer (9/0), colloid bodies in the gram laor horny layer (7/2), many necrotic keratinocytes (1/0), focal vacuolar alteration in the basal layer (5/0), extravasated RBC in the epidermis or derrnis (2/0), superficial and deep pervacular infiltrate (11/2), an infiltrate around the sweat glands(2/1), an infiltrate of eosinohils(11/0), an infiltrate of plasma celis(4/1). CONCLUSION: LDE eouJd be differentiated from LP by cruhistory, cutaneous manifestations, blood eosinophilia and histopathologic findings. Histoetologic findings that were indicative of LDE were focal parakeratosis, colloid bodies in the gr nular or horney layer, focal epidermal atrophy, eosinophils and plasma cells in the cellula: ir filtrate and an infiltrate around deep vessels.
Age of Onset ; Aged ; Atrophy ; Captopril ; Colloids ; Drug Eruptions* ; Dust ; Eosinophilia ; Eosinophils ; Epidermis ; Fluorouracil ; Furosemide ; Humans ; Keratinocytes ; Lichen Planus* ; Lichens* ; Parakeratosis ; Plasma ; Plasma Cells ; Sweat ; Yeasts

BACKGROUND: Melanin pigmentation plays a major role in normal skin color. The rates of melanin synthesis by melanocytes appear to be regulated by ultraviolet-B(UVB) radiation and chemicals, though the precise mechanisms modulating human epidermal pigmentation are unknown. Several chemicals including arbutin kojic acid(KA), pentadecenoic acid (PDA) and glycolic acid (GA) have been suggested as a meanogenesis inhibitory compounds because of their chemical or biological similarties with hydroquinone or their tyrosinase inhibitory effect. OBJECTIVE: The purpose of this study was to evaluate the inhibitory effect of arbutin, GA, KA and PDA on UV-induced melanogenesis in the vitro and in vivo pigmentary system. METHODS: Cultured normal melanocytes and B-16 melanoma cells, and C57BL mice and human volunteers were used for in vitro and in vivo studies respectively. They were administered to UVB irradiated or nonirradiated cultured normal human melanocytes, and B-16 melanoma cells. For the in vivo study, these chemicals were topically applied to C57BL mice and human volunteer skin after UVB irradiation, Numeric and morphologic changes and melanin content were measured in cultured normal human melanocytes and B-16 melanoma cells. In the C57BL mice, numeric and morphologic changes of split-COPA stained melanocytes were assessed. In the human volunteers, gross pigementary changes were evaluated. RESULTS: 1. The number and melanin content of cultured melanocytes initially decreased after UVB-irradiation, but the melanin content increased 5 days after irradiation. 2. Cell numbers of irradiated or nonirradiated cultured human melanocytes decreased in arbutin(10-3M), KA(10-3M, 10-5M), PDA(10-3M) groups. Those of the cultured B-16 melanoma cells decreased only in the arbutin(10-3M) group after UVB irradiation. 3. Melanin contents of cultured human melanocytes decreased in arbutin(10-3M, 10-5M), KA(10-3M, 10-5M) and PDA(10-3M) groups. Those of cultured B-16 melanoma cells decreased in arbutin(10-3M, 10-5M) groups after UVB-irradiation or nonirradiation. 4. The number of split-DOPA(+) melanocytes decreased in the groups treated with KA 1% for 3, 5 and 7 weeks, KA 0.1%, arbutin 3%, arbutin 5% for 5 and 7 weeks and PDA 5.0% for 7 weeks in the C57BL mice. 5. The number of split-DOPA(+) melanocytes decreased in the groups treated with KA 1.0%, PDA 5.0%, arbutin 3% and arbutin 5% for 5 and 7 weeks and KA 0.1% for 7 weeks in UVB irradiated C57BL mice. 6. Visible inhibition of UVB-induced yperpigmentation was observed in arbutin applied sites in 4 of the 6 volunteers 3 weeks after the application. GA did not show an inhibitory effect on UVB-induced hyperpigmentation in all subjects. CONCLUSION: Arbutn, KA, PDA had a suppressive effect on melanization of nonirradiated melanocytes and melanoma cells as well as UVB-induced hyperpigmentation. It is suggested that these drugs might be candidates as compounds that may control hyperpigmentary disorders.
Animals ; Arbutin* ; Cell Count ; Healthy Volunteers ; Humans ; Hyperpigmentation ; Melanins ; Melanocytes ; Melanoma ; Mice ; Mice, Inbred C57BL ; Monophenol Monooxygenase ; Pigmentation ; Skin ; Volunteers

Woringer-Kolopp(W-K) disease is a rare, localized, histologically malignant, but clinically indolent lymphoproliferative disorder. It usually shows only a single slowly enlarging skin lesion mainly on the extremities. Some authors have regarded W-K disease as a variant of mycosis fungoides. However, recent studies suggest that W-K disease may represent a spectrum of T cell lymphoproliferative disoreers that may not be related to mycosis fungoides. We report a case of Woringer-Kolopp disease in a 60-year-old male who presented with a solitary slowly growing tumor on his left palm for 3 years. Histopathologic examination showed marked acanthosis and pagetoid infiltration confined to the epidermis. He was treated with 4,000 red electron beam irradiation to the area with complete resolution of the lesion. Three years later, a similar lesion appeared on his left foot dorsum. He was treated as previously with a good response and there has been no new lesion during the last 1 year follow up period.
Epidermis ; Extremities ; Follow-Up Studies ; Foot ; Humans ; Lymphoproliferative Disorders ; Male ; Middle Aged ; Mycosis Fungoides ; Pagetoid Reticulosis* ; Skin