Neuroendocrine tumors derive from the diffuse neuroendocrine system producing hormonal peptides and/or biogenic amines. Histologically neuroendocrine differentiation includes ultrastructural demonstration of neurosecretory granules and staining with immunhistochemical markers such as neuron-specific enolase, chromogranin, synaptophysin, and cytokeratin. Neuroendocrine carcinoma of the skin is rare but can be shown as an initial manifestation of metastatic neuroendocrine carcinoma as well as primary cutaneous neuroendocrine carcinoma. Histological differentiation between primary cutaneous Merkel cell carcinoma and metastatic neuroendocrine carcinoma of the skin is difficult and clinical correlation is important. We report a case of metastatic neuroendocrine carcinoma of the lung occurring on the scalp as a single nodule in a 65-year-old female who previously diagnosed with adenocarcinoma of the stomach.
Adenocarcinoma ; Aged ; Biogenic Amines ; Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Female ; Humans ; Keratins ; Lung ; Neuroendocrine Tumors ; Neurosecretory Systems ; Peptides ; Phosphopyruvate Hydratase ; Scalp ; Skin ; Stomach ; Synaptophysin

Elephantiasis nostras verrucosa is an uncommon disorder that is characterized by dermal fibrosis, hyperkeratotic verrucous and papillomatous lesions and this is all caused by chronic non-filarial lymphedema secondary to infections, surgeries, tumor obstructions, radiations, congestive heart failure and obesity. We report here on a case of elephantiasis nostras verrucosa that occurred on the left lower leg of a 54-year-old woman who had a past history of extensive skin grafts and recurrent infection.
Elephantiasis ; Female ; Fibrosis ; Heart Failure ; Humans ; Leg ; Middle Aged ; Non-Filarial Lymphedema ; Obesity ; Skin ; Skin Transplantation ; Transplants

We report a case of a 67-year-old man presenting with a 2-week history of erythematous zosteriform indurated confluent nodules and plaques on the right chest which was affected by a herpes zoster infection one month ago. The previous history revealed an adenocarcinoma with malignant pleural effusion on the right lung (stage IV, T4N1M1) 3 months ago. Histopathologic findings showed tumor cells infiltrated throughout the dermis, forming focal glandular structures. We think that the case was the isotopic response in the form of an occurrence of a new skin disorder at the site of another unrelated and already healed skin disease. Many cases of isotopic response have been reported in Korean literature such as lichen planus, granuloma annulare, benign fibrous histiocytoma and reactive perforating collagenosis occurring on the healed site of herpes zoster infection. This is the first report of cutaneous metastatic carcinoma as an isotopic response in Korea.
Adenocarcinoma ; Aged ; Dermis ; Granuloma Annulare ; Herpes Zoster ; Histiocytoma, Benign Fibrous ; Humans ; Lichen Planus ; Lung ; Pleural Effusion, Malignant ; Skin ; Skin Diseases ; Thorax

Corals are the marine organism that belongs to the phylum Cnidaria, and are one of the common causes of superficial injury in the marine environment. In addition to acute reactions such as burning or stinging pain and erythema, coral injuries may present with complications such as foreign body reactions, bacterial infections, and/or localized eczematous reactions. A 23-year-old male presented with an erythematous edematous tender patch with centrally grouped vesicles on the left ankle; the injury had occurred during skin-scuba diving 2 days before. A biopsy of the lesion treated with hematoxylin-eosin stain showed epidermal necrosis with subepidermal blisters and neutrophilic panniculitis. Herein we report a case of cellulitis caused by the nematocyst stings of corals.
Anthozoa ; Aquatic Organisms ; Bacterial Infections ; Biopsy ; Bites and Stings ; Blister ; Burns ; Cellulitis ; Cnidaria ; Diving ; Erythema ; Foreign Bodies ; Humans ; Male ; Necrosis ; Nematocyst ; Neutrophils ; Panniculitis ; Young Adult

Kimura's disease is an uncommon chronic inflammatory disorder of unknown etiology. Clinically, it presents as solitary or multiple subcutaneous nodules, predominantly in the head and neck region, and typically in the preauricular region, forehead, and scalp. Other localizations such as lacrimo-orbital involvement and upper extremities have been reported. The soft tissue localization is often associated with regional lymphadenopathy and, occasionally, with enlargement of the major salivary gland. Orbital, eyelid, and lacrimal involvement by Kimura's disease are rare. The etiology of this disease is still unknown. It is essential to differentiate it with malignant tumor through biopsy. When Kimura's disease is confirmed, the combination of surgical excision and oral steroid appears to be effective therapeutic motality. We report Kimura's disease, along with a review of literature, presenting as facial mass and periorbital swelling in a case of a child.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Child ; Eyelids ; Forehead ; Head ; Humans ; Lymphatic Diseases ; Neck ; Orbit ; Salivary Glands ; Scalp ; Upper Extremity

BACKGROUND: The skin of atopic dermatitis (AD) patients has a high susceptibility to Staphylococcus aureus colonization, and the toxins produced by S. aureus may aggravate AD by acting as superantigens. OBJECTIVE: The purpose of this study was to evaluate the relationship of the skin barrier function, colonization of S. aureus, and the clinical severity of AD. We also examined the predominant toxin genes produced in Korean AD patients. METHODS: Thirty-nine patients with AD were evaluated for clinical severity and skin barrier function by using Severity Scoring of Atopic Dermatitis (SCORAD) index and transepidermal water loss (TEWL). S. aureus was isolated from the forearm, popliteal fossa, and anterior nares of AD patients (n=39) and age-matched controls (n=40); the toxin genes were analyzed by performing multiplex polymerase chain reaction. RESULTS: TEWL showed a statistically significant correlation with clinical severity in patients with AD (p<0.05). TEWL was correlated with the number of S. aureus colonization sites and the presence of nasal colonization, but these results were not statistically significant. S. aureus strains were isolated in 64.1% of the 39 AD patients. The SCORAD index and AD severity were strongly correlated with the number of colonization sites. The predominant toxin gene found in AD patients was staphylococcal enterotoxin a (sea) only, which was produced in 52.6% of patients. The toxin genes sea and toxic shock syndrome toxin-1 (tsst-1) were found together in 42.1%, while tsst-1 only was found in 5.3% of the patients. CONCLUSION: S. aureus strains were isolated in 64.1% of the 39 AD patients. Skin barrier function, as measured by TEWL, revealed a statistically significant correlation with clinical severity in AD patients. The SCORAD index and severity of AD was strongly correlated with the number of colonization. The most common toxin gene was sea in the Korean AD patients and this gene might have an important role in the pathogenesis of AD.
Bacterial Toxins ; Colon ; Dermatitis, Atopic ; Enterotoxins ; Exotoxins ; Forearm ; Humans ; Shock, Septic ; Skin ; Staphylococcus ; Staphylococcus aureus ; Superantigens ; Water Loss, Insensible

Eccrine angiomatous hamartoma (EAH) is a rare benign disease that is characterized by an abnormal proliferation of eccrine glands and vascular elements. It is generally congenital, but it can appear before puberty. It usually presents as a single plaque or nodule, but multiple patch-like lesions are also possible. EAH is mostly asymptomatic, but it is sometimes associated with pain or hyperhidrosis. It generally does not require aggressive treatment, but the lesion can be excised due to pain, enlargement and cosmetic reasons. A 3-week-old Korean female presented with a hemorrhagic skin lesion on the right foot since birth. There was no specific birth history. The lesion first appeared on the third toe of the right foot and quickly spread to almost half of the right foot. Histopathology examination revealed acanthosis in the epidermis and a proliferation of eccrine ducts, glands and capillaries. The eccrine glands were immunohistochemically-positive for carcinoembryonic antigen.
Capillaries ; Carcinoembryonic Antigen ; Cosmetics ; Eccrine Glands ; Epidermis ; Female ; Foot ; Hamartoma ; Hemorrhage ; Humans ; Hyperhidrosis ; Parturition ; Puberty ; Reproductive History ; Skin ; Toes

BACKGROUND: Demodicosis is a common cutaneous disease that is caused by demodex mites, which reside in the pilosebaceous follicles. However, any data of the clinical features and the factors that induce or aggravate demodicosis is lacking in the Korea literature. OBJECTIVE: We aimed to demonstrate the clinical feature and determine the medical or personal history that influences demodicosis. METHODS: We performed a retrospective study to review clinical features, the histopathologic findings and the past medical and personal history of Korean patients who suffer with demodicosis. RESULTS: Thirty-four patients were diagnosed with demodicosis based on the clinical features, the potassium hydroxide examination and/or the skin biopsy specimen. There were 11 males and 23 female patients (mean age: 44.4 years). The mean duration of disease was 15.5 months. The clinical features were classified to acne rosacea-like (n=26), perioral dermatitis-like (n=3), granulomatous rosacea-like (n=2), pityriasis folliculorum (n=2) and demodex abscess (n=1). Skin biopsy was performed on 10 patients and the histopathologic findings showed demodex mites in the follicular infundibulum or sebaceous ducts with a perifollicular and perivascular inflammatory infiltrate in all case. According to the medical history, 17 patients had history of chronic use of topical steroid and calcineurin inhibitor and 5 patients didn't use the soap during washing their face. CONCLUSION: Our findings indicate that demodicosis demonstrates various clinical presentations. If patients with facial eruption chronically use topical steroid or calcineurin inhibitor or they do not use soap, demodicosis should be considered in the differential diagnosis and a potassium hydroxide examination or skin biopsy may be helpful to diagnose and treat the facial eruption.
Abscess ; Acne Vulgaris ; Biopsy ; Calcineurin ; Diagnosis, Differential ; Female ; Humans ; Hydroxides ; Korea ; Male ; Mites ; Pityriasis ; Potassium ; Potassium Compounds ; Retrospective Studies ; Skin ; Soaps

BACKGROUND: Glycosylated hemoglobin (HbA1c) is a useful index of mean blood glucose concentrations over the preceding 2 to 3 months. Elevated HbA1c levels (> 7%) are associated with a higher incidence of microvascular and macrovascular complications in patients with diabetes mellitus. However, the relationship between HbA1c and cardiovascualr disease risk in nondiabetic adults has been unclear. The aim of this study is to estimate the association of HbA1c with cardiovascular disease risk factors and metabolic syndrome in nondiabetic adults. METHODS: The subjects of this study included 533 adults (180 males and 353 females) aged 20~70 years (mean age: 46.9 +/- 10.12 years) without previously diagnosed diabetes who lived in Kangyang country. We examined baseline HbA1c levels and cardiovascular risk factors. Metabolic syndrome was defined based on International Diabetes Federation guidelines. RESULTS: The prevalence of metabolic syndrome significantly increased as HbA1c increased. HbA1c revealed a significant correlation with age (r = 0.258, P < 0.001), BMI (r = 0.152, P < 0.001), waist circumference (r = 0.252, P < 0.001), fasting plasma glucose (r = 0.319, P < 0.001), systolic (r = 0.100, P = 0.021), diastolic (r = 0.115, P = 0.008) blood pressure, total cholesterol (r = 0.232, P < 0.001), triglyceride (r = 0.156, P < 0.001), LDL cholesterol (r = 0.216, P < 0.001), and HDL cholesterol (r = -0.167, P < 0.001). Multiple regression analysis showed that HbA1c had a association with age, fasting plasma glucose, and dyslipidemia. The receiver operating characterstics (ROC) curve analysis determined HbA1c of 5.35% to yield optimal sensitivity and specificity corresponding to the presence of metabolic syndrome. CONCLUSION: The HbA1c level is correlated with cardiovascular risk factors and prevalence of metabolic syndrome in nondiabetic adults.
Adult ; Aged ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diabetes Mellitus ; Dyslipidemias ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Hemoglobins ; Humans ; Incidence ; Male ; Plasma ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Waist Circumference

Sweet syndrome is also called acute febrile neutrophilic dermatosis and this malady is characterized by an abrupt onset of fever, leukocytosis and tender erythematous plaques that are infiltrated by neutrophils. It most commonly occurs in women who are between 30 to 50 years of age. About 50% of the cases are associated with autoimmune disease, sarcoidosis, Behcet's disease and pregnancy. We present here a 48-year-old woman who had tender erythematous tender plaque and nodules with vesicles and pustules over both extremities. She complained of general weakness, chills and arthralgia. We biopsied the nodule and performed laboratory tests. The results of the biopsy were compatible with Sweet syndrome and the laboratory test showed systemic lupus erythematosus. We report here on a case of Sweet syndrome as an initial presentation of systemic lupus erythematosus.
Arthralgia ; Autoimmune Diseases ; Biopsy ; Chills ; Extremities ; Female ; Fever ; Humans ; Leukocytosis ; Lupus Erythematosus, Systemic ; Middle Aged ; Neutrophils ; Pregnancy ; Sarcoidosis ; Sweet Syndrome