Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy (EPPER) is a disorder characterized by polymorphic papules, vesicles, and excoriations accompanied by a local or general itching sensation which can occur in cancer patients treated with radiotherapy. Histopathologic findings include a superficial and deep perivascular lymphohistiocytic infiltration with eosinophils. Most cases have occurred in patients with cervical cancer. To date, only one case of EPPER associated with breast cancer has been reported. We report a case of EPPER in a patient with breast cancer, who presented with eosinophilic, polymorphic, pruritic skin lesions in and around the irradiated left breast.
Breast Neoplasms* ; Breast* ; Eosinophils* ; Humans ; Pruritus ; Radiotherapy* ; Sensation ; Skin ; Uterine Cervical Neoplasms

Familial multiple lipomatosis is a rare hereditary disorder with a proposed autosomal dominant inheritance. Clinically, multiple well-circumscribed, encapsulated lipomas occur on the extremities and trunk. Familial multiple lipomatosis is often confused with multiple symmetric lipomatosis, which is a condition involving a diffuse fatty infiltration around the neck and shoulders. We report two cases of familial multiple lipomatosis with typical clinical features and familial history. To the best of our knowledge, these are the first cases of familial multiple lipomatosis in Korea.
Extremities ; Korea ; Lipoma ; Lipomatosis* ; Lipomatosis, Multiple Symmetrical ; Neck ; Shoulder ; Wills

Pimecrolimus cream 1% has shown to be effective in patients with a variety of inflammatory cutaneous disorders. And it might be a useful modality in the treatment of seborrheic dermatitis. This prospective study was aimed at assessing the efficacy and tolerability of pimecrolimus cream 1% in the treatment of facial seborrheic dermatitis. Twenty patients were instructed to apply pimecrolimus cream 1% for 4 consecutive weeks. Assessment of the disease severity was performed at baseline and at week 1, 2, and 4. Clinical assessments of erythema, scaling, and pruritus were measured using a 4-point scale (0-3). Global assessments of the disease severity by patients and investigators were performed at each visit. Mean clinical scores of erythema, scaling, and pruritus significantly improved by 87.4%, 91.9%, and 91.5% respectively at week 4 (p<0.001). Improvements in the global assessment of disease severity determined by patients and investigators also showed excellent results. No specific adverse events other than transient burning and tingling sensations were noted. The relapse of facial seborrheic dermatitis was mostly observed between 3 to 8 weeks after the discontinuation of pimecrolimus. We suggest that the topical application of pimecrolimus cream 1% can be an effective and safe alternative for treatment of facial seborrheic dermatitis.
Adult ; Aged ; Dermatitis, Seborrheic/*drug therapy ; Erythema/drug therapy ; Face ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Middle Aged ; Severity of Illness Index ; Tacrolimus/*analogs & derivatives/therapeutic use ; Time Factors ; Treatment Outcome

We report a case of 61-yr-old man with stable psoriasis who progressively developed generalized pustular eruption, erythroderma, fever, and hepatic dysfunction following oral terbinafine. Skin biopsy was compatible with pustular psoriasis. After discontinuation of terbinafine and initiating topical corticosteroid and calcipotriol combination with narrow band ultraviolet B therapy, patient's condition slowly improved until complete remission was reached 2 weeks later. The diagnosis of generalized pustular psoriasis (GPP) induced by oral terbinafine was made. To our knowledge, this is the first report of GPP accompanied by hepatic dysfunction associated with oral terbinafine therapy.
Suppuration/chemically induced ; Psoriasis/*chemically induced ; Naphthalenes/*adverse effects ; Middle Aged ; Male ; Liver Diseases/*chemically induced ; Humans ; Antifungal Agents/*adverse effects ; Administration, Oral

BACKGROUND: Eruptive pseudoangiomatosis (EPA) is a rare, benign, spontaneously regressing childhood exanthem. It is characterized by the sudden onset of several bright red angioma-like papules surrounded by pale halos with a distinct histopathology from true angiomas. OBJECTIVE: This study was performed to evaluate the clinical and histopathologic characteristics of EPA occuring in adults. METHODS: Ten adult patients who visited Pusan National University Hospital and Mok Hye-Soo . Jang Ho-Sun Dermatology Clinic from March 2005 to September 2006 were evaluated. We prospectively evaluated the sex, age, onset season, past medical history including immunosuppressive abnormalities, systemic disorders and other diseases including allergies. We also investigated the relations of mosquito biting, patients' occupations and outdoor activities to occurrence of EPA. In addition, simultaneous occurrence in family members, the clinical, histopathologic, laboratory findings, disease courses and responses to treatment were evaluated. Based on medical records, photographs and pathologic slides, we retrospectively diagnosed another 20 EPA patients suspected as insect bite from October 2003 to March 2005. The same questions were inquired as for the 10 patients who prospectively underwent evaluation. RESULTS: In the study, female predominance (76.7%) was observed and the average age of onset was 54.2 years. Interestingly, there was no child patient during the period of study. Multiple, 2~5 mm sized, red angiomatous papules surrounded by pale halos occurred on exposed areas such as the arms (86.7%), legs (50%), and face (46.7%), although it could also occur to a non-exposed area. EPA occuring in adults usually appeared in summer (80%). The mean disease duration was 3.4 weeks. Although EPA spontaneously regressed, it had the potential of recurrence (46.7%). Histopathologic findings showed dilated dermal blood vessels without the evidence of increase in numbers, and perivascular lymphocytes infiltration. Inside the lumen of dermal blood vessels, plump endothelial cells were found. CONCLUSION: EPA occuring in adults usually happened to exposed sites in summer, so it can be misdiagnosed as insect bite. We suggest that dermatologists should be concerned about EPA in adults and conduct further investigation to have a better understanding of the disease.
Adult ; Age of Onset ; Arm ; Blood Vessels ; Busan ; Child ; Culicidae ; Dermatology ; Endothelial Cells ; Exanthema ; Female ; Hemangioma ; Humans ; Hypersensitivity ; Insect Bites and Stings ; Leg ; Lymphocytes ; Medical Records ; Occupations ; Prospective Studies ; Recurrence ; Retrospective Studies ; Seasons

BACKGROUND: Topical tacrolimus is widely used for the treatment of inflammatory skin diseases like atopic dermatitis, but there are few studies about the effect of topical tacrolimus for allergic contact dermatitis. Allergic contact dermatitis develops in two phases, the clinically silent sensitization phase, and the clinically apparent elicitation phase. OBJECTIVE: The purpose of this study is to investigate whether topical tacrolimus has an effect on both phases of murine contact hypersensitivity and dermatitis of repeated applications induced by diphenylcyclopropenone (DPCP). METHODS: Hairless mice were treated with topical tacrolimus before and after DPCP challenging. The suppressive effect of topical tacrolimus was measured by skin erythema, ear swelling, weight change and cell numbers of local lymph nodes. In addition, a biopsy was carried out and epidermal hyperplasia was investigated microscopically. TNF-alpha mRNA on the mice which were treated with topical tacrolimus to one side of the ears was measured before and after being chronically challenged with DPCP on both ears. RESULTS: Topical tacrolimus pretreatment dramatically supressed inflammatory reactions in the sensitization phase, and treatment of topical tacrolimus after sensitization dramatically supressed inflammatory reactions in the elicitation phase. Topical tacrolimus also dramatically supressed inflammatory reactions in the repeated DPCP-induced dermatitis. CONCLUSION: The data revealed topical tacrolimus could effectively suppress murine contact hypersensitivity and dermatitis of repeated applications induced by DPCP. Putting these results together, topical tacrolimus can be very effective in not only the treatment but also the prevention of allergic contact dermatitis. Larger studies are needed to determine the clinical relevance.
Animals ; Biopsy ; Cell Count ; Dermatitis* ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact* ; Ear ; Erythema ; Hyperplasia ; Lymph Nodes ; Mice ; Mice, Hairless ; RNA, Messenger ; Skin ; Skin Diseases ; Tacrolimus* ; Tumor Necrosis Factor-alpha

Primary cutaneous mucormycosis, a rare form of mucormycosis, develops where a break in the integrity of the skin has occurred as a result of surgery, burns, or other forms of trauma. It is mainly seen in immunocompromised hosts, but can sometimes also occur in immunocompetent hosts too. Various kinds of pathogens including viruses, bacteria, nontuberculous mycobacteria, protozoa, and fungi can show a sporotrichoid spread. However, there has been no report of mucormycosis showing a sporotrichoid distribution. We report a case of primary cutaneous mucormycosis occurring on the dorsal aspect of the right wrist in a 69-year-old immunocompetent woman. In our case, newlydeveloped lesions were distributed in sporotrichoid pattern 5 months after the initial lesion. The patient was successfully treated with a combined therapy of amphotericin B and itraconazole.
Aged* ; Amphotericin B ; Bacteria ; Burns ; Female ; Fungi ; Humans ; Immunocompromised Host ; Itraconazole ; Mucormycosis* ; Nontuberculous Mycobacteria ; Skin ; Wrist

Pilomatricoma is a common, benign, adnexal tumor differentiating towards elements of the hair matrix and shaft. The tumor is usually a deep-seated, solitary, firm nodule with overlying normal epidermis. Lymphangiectatic pilomatricoma is a rare variant of pilomatricoma. Clinically it manifests as flaccid, thick-walled bulla with an underlying palpable, hard tumor. Histopathologically, it is a well-circumscribed dermal nodule composed of basophilic cells, shadow cells, and transitional cells. There can also be extraordinary dilatation of lymphatic vessels in the overlying dermis. We report a case of lymphangiectatic pilomatricoma on the left shoulder of 19-year-old girl which occurred after intralesional injection of steroid.
Basophils ; Dermis ; Dilatation ; Epidermis ; Female ; Hair ; Humans ; Injections, Intralesional ; Lymphatic Vessels ; Pilomatrixoma* ; Shoulder ; Young Adult

Eccrine poroma is a common benign tumor originating from the epidermal sweat duct units. It occurs primarily on feet and hands. However there have been some sporadic cases occurring in other areas, including the scalp. Eccrine poroma occurs mostly in people over 40 years of age, although it can occur at any ages. In general, eccrine poroma lacks melanin pigment clinically and melanocytes on microscopic examination, but either black or yellow skin, melanin granules and melanocytes can be found dispersed within the tumor. We report a case of pigmented eccrine poroma occuring on the scalp of 14-year-old girl. In our case, the patient was much younger than those of the usual onset age and the lesion was located on an unusual occuring site. In addition, the lesion contained melanocytes and melanins.
Adolescent ; Age of Onset ; Child* ; Female ; Foot ; Hand ; Humans ; Melanins ; Melanocytes ; Poroma* ; Scalp* ; Skin ; Sweat

BACKGROUND: Normal human skin is resistant to infection with various kinds of microorganisms by producing anti-microbial chemicals. Human beta defensin-2 (hBD-2) is an anti-microbial peptide that has recently been shown to be expressed in various epithelial cells and inflammatory diseases. However, the expression of hBD-2 in fungus-infected skin is not well-known. OBJECTIVE: This study was performed to investigate the expression pattern of hBD-2 in superficial mycosis. METHODS: Using the immunohistochemical method with formalin-fixed, paraffin-embedded sections, we checked the expression levels and localization of hBD-2 in lesional skin samples of tinea capitis (5 patients), tinea corporis (6 patients), candidiasis (3 patients), Malassezia folliculitis (2 patients), and psoriasis (3 patients) as positive control, and normal skin samples from 6 healthy subjects as negative control. RESULTS: The expression of hBD-2 was not observed in normal skin, but moderate to strong expression of hBD-2 was observed in the epidermis, and the papillary dermal infiltrating cells of psoriasis. In tinea capitis, strong hBD-2 expression was found in the upper spinous layer of epidermis and follicular epidermis, and perifollicular inflammatory cells. In tinea corporis and candidiasis, mild to strong expression of hBD-2 was found in the horny or spinous layer of epidermis and infiltrating inflammatory cells. Strong hBD-2 expression was found in the follicular epidermis and perifollicular inflammatory cells of Malassezia folliculitis. CONCLUSION: These results suggest that hBD-2 plays an important role in cutaneous innate immune defense against fungal infection.
Candidiasis ; Epidermis ; Epithelial Cells ; Folliculitis ; Humans* ; Malassezia ; Psoriasis ; Skin ; Tinea ; Tinea Capitis