No abstract available.
Laser Therapy ; Nevus, Intradermal

BACKGROUND: Arborizing vessels (AVs) are dermoscopically defined as telangiectasias with distinct treelike branching, and are a characteristic feature of basal cell carcinoma (BCC). However, AVs are observed in various conditions other than BCC. OBJECTIVE: The aim of this study was to investigate skin diseases showing AV and investigates dermoscopic differences between BCC and non-BCC. METHODS: Dermoscopic images showing AV were prospectively collected and classified into BCC/non-BCC. Non-BCC was further classified into tumors (benign cystic, benign non-cystic, premalignant, and malignant) and non-tumors. We compared AV focusing, widest diameter of stem vessels, widest diameter ratio of stem vessel to first branch, and number of ramifications between groups. RESULTS: Among 124 images, 54.0% were BCC and 46.0% were non-BCC. Non-BCC included epidermal cysts, hypertrophic scars/keloids, intradermal nevi, actinic keratoses, etc. The proportion of focused AV in BCC was significantly higher and the proportion of unfocused AV in BCC was lower than that of premalignant and malignant non-BCC. The widest diameter ratio of stem vessel to first branch was higher in non-BCC. Number of ramifications was significantly less in benign cystic non-BCC than BCC. CONCLUSION: Various skin diseases showed AV, so that diagnoses other than BCC should be considered. The findings in this study could help discriminate BCC from non-BCC.
Carcinoma, Basal Cell* ; Dermoscopy* ; Diagnosis ; Epidermal Cyst ; Keratosis, Actinic ; Nevus, Intradermal ; Prospective Studies ; Skin Diseases* ; Skin* ; Telangiectasis

BACKGROUND: Malignant melanomas represent pigmented skin lesions and should be distinguished from melanocytic nevi. However, differential diagnosis of malignant melanomas and melanocytic nevi is often challenging. Wilms' tumor 1 (WT1) protein is a specific immunomarker of Wilms' tumor, and several studies revealed that various malignant tumors have WT1 expression. OBJECTIVE: The purpose of this study was to evaluate the usefulness of WT1 staining for differentiating malignant melanoma from melanocytic nevi. METHODS: We selected 50 cases of melanocytic nevi (12 cases of junctional nevi, 19 of compound nevi, and 19 of intradermal nevi) and 35 cases of malignant melanoma (7 cases of malignant melanoma in situ and 28 cases of invasive melanomas) from clinicopathologically proven cases in the Department of Dermatology of Yeungnam University Medical Center. Immunohistochemistry analysis of WT1 was performed, and the labeling index of WT1 expressions was measured. RESULTS: The mean labeling indices of junctional nevi, compound nevi, intradermal nevi, malignant melanoma in situ, and invasive melanomas were 1.9%±2.8%, 23.6±21.2%, 25.7±23.5%, 5.7±5.2%, and 66.1±32.0%, respectively. The labeling index of malignant melanoma in situ was higher than that of junctional nevi. The labeling index of invasive melanoma was higher than those of compound nevus and intradermal nevus. When the WT1 cut-off point to distinguish melanomas from melanocytic nevi was 27.2%, the sensitivity and specificity were 68.6% and 74%, respectively. When a WT1 cut-off point of 75% was used, the sensitivity and specificity were 40% and 100%, respectively. The mean labeling indices of stages I, II, III, and IV malignant melanoma were 29.5%±30.4%, 68.8%±33.9%, 79.5%±6.4%, and 77.7%±18.8%, respectively, and those of Tis, T1, T2, T3, and T4 were 5.7%± 4.8%, 8.0%±0%, 69.5%±18.5%, 61.9%±28.6%, and 78.6%±30.0%, respectively. CONCLUSION: WT1 staining could be a potential diagnostic tool for differentiating malignant melanomas from melanocytic nevi because the WT1 labeling indices of melanomas were significantly higher than those of melanocytic nevi. WT1 staining may be helpful in predicting the depth and prognosis of malignant melanomas.
Academic Medical Centers ; Dermatology ; Diagnosis, Differential ; Immunohistochemistry ; Melanoma* ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented* ; Prognosis ; Sensitivity and Specificity ; Skin ; Wilms Tumor

BACKGROUND: There have been many changes to the social and medical environment in Korea and many studies showed a steady increase of cutaneous tumors. But none of them included a data occurring from head and neck. OBJECTIVE: To investigate the incidence and distribution of the cutaneous tumors of the head and neck. METHODS: A total of 1,415 cases of head and neck cutaneous tumors were obtained from pathology specimen at Department of Dermatology between 2010 and 2014. RESULTS: Among 1,415 cases of head and neck cutaneous tumors, 871 cases (61.5%) were benign tumors, 271 cases (19.2%) were malignant tumors, and 273 cases (19.2%) were premalignant lesions. The most common benign head and neck cutaneous tumors was epidermal cyst with 188 cases (21.6%), followed by 173 cases (19.9%) of seborrheic keratosis, 71 cases (8.2%) of intradermal nevi. Among the 271 cases of malignant head and neck cutaneous tumors, there were 164 cases (60.5%) of basal cell carcinoma, 89 cases (32.8%) of squamous cell carcinoma, 5 cases (1.8%) of malignant melanoma. The predilection sites of malignant head and neck tumors were face (87.5%), ear (4.8%) and neck (4.0%). Of the premalignant lesions, there were 210 cases (76.9%) of actinic keratosis, 36 cases (13.2%) of Bowen's disease and 27 cases (9.9%) of actinic cheilitis. CONCLUSION: In our study, the proportion of malignant tumors and premalignant lesion in head and neck tumors was higher than previous reports. Also, the percentage of woman in malignant tumors and premalignant lesions was higher than man, unlike previous studies. However, these results had limitation associated with retrospective study in a single institution, and further prospective study with multi-center is required for confirmation.
Actins ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Clinical Study* ; Dermatology ; Ear ; Epidermal Cyst ; Female ; Head* ; Humans ; Incidence ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Melanoma ; Neck* ; Nevus, Intradermal ; Pathology ; Prospective Studies ; Retrospective Studies

PURPOSE: To evaluate the long-term follow-up results of the eyelid margin tumor resection using a radio-frequency electrosurgical unit. METHODS: We retrospectively reviewed the medical records of 53 patients (55 eyes) diagnosed with eyelid margin tumor and who underwent eyelid tumor resection using a radio-frequency electrosurgical unit more than 5 years prior. Age, gender, undergoing a biopsy, recurrence,- and complications were examined through phone questions and the out-patient department. RESULTS: The study included 23 eyes of 22 males and, 32 eyes of 31 females, (age range 8.6-76.8 years). Surgical success rate was 95% (52 of 55 eyes) and mean follow-up period was 8.9 years. Thirty-four of 55 patients underwent a biopsy, and the most common cases were intradermal nevus and compound nevus (13 cases each), 2 cases of basal cell carcinoma (5.9%), 2 cases of actinic keratosis (5.9%), and, 2 cases of chronic inflammation (5.9%). Other cases included 1 case of squamous papilloma (2.9%) and 1 case of fibrosis (2.9%). There were 3 cases of recurrence. Eyelash-related complications after surgery occurred in 3 cases of trichiasis or distichiasis. CONCLUSIONS: Eyelid margin tumor resection using a radio-frequency electrosurgical unit is simple and showed high success rate. Additionally, it is considered as an effective method in the eyelid margin tumor resection due to low recurrence and complication rates in the long-term follow-up.
Biopsy ; Carcinoma, Basal Cell ; Eyelids* ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Inflammation ; Keratosis, Actinic ; Male ; Medical Records ; Nevus ; Nevus, Intradermal ; Outpatients ; Papilloma ; Recurrence ; Retrospective Studies ; Trichiasis

BACKGROUND: The incidence of scalp tumors has increased, despite medical advances and environmental improvement. However, few studies have reported the clinical and histopathologic features of scalp tumors. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathologic features of scalp tumors. METHODS: We retrospectively reviewed the clinical and histopathologic features and occurrence rates of scalp diseases in 418 patients whose lesions were biopsied in the department of dermatology between January 2004 and December 2013. RESULTS: The mean age of patients exhibiting scalp tumors was 44.9 years old. The male to female ratio was 1:0.69. The most common benign scalp tumor diagnosed was seborrheic keratosis (22.6%) followed by epidermal inclusion cyst (15.3%), intradermal nevus (8.7%), sebaceous nevus (7.1%), actinic keratosis (5.2%), pyogenic granuloma (3.0%), neurofibroma (2.5%), compound nevus (2.2%), epidermal nevus (1.1%), dermatofibroma (1.1%), and hemangioma (1.1%). The most malignant scalp tumor diagnosed was basal cell carcinoma (34.6%) followed by squamous cell carcinoma (32.7%), metastatic cancer (11.5%), angiosarcoma (7.7%), Bowen's disease (7.7%), lymphoma (3.8%), and apocrine adenocarcinoma (1.9%). CONCLUSION: This study provides data on the incidence of scalp tumors. The results of our study were different from previous studies possibly owing to regional differences between reported patient populations. We advise physicians to appropriately diagnose and treat scalp tumors at the earliest suspicion of malignancy.
Adenocarcinoma ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Female ; Granuloma, Pyogenic ; Hemangioma ; Hemangiosarcoma ; Histiocytoma, Benign Fibrous ; Humans ; Incidence ; Keratosis, Actinic ; Keratosis, Seborrheic ; Lymphoma ; Male ; Neurofibroma ; Nevus ; Nevus, Intradermal ; Retrospective Studies ; Scalp*

No abstract available.
Nevus, Intradermal

BACKGROUND: Melanomas need to be differentiated from benign melanocytic lesions during diagnosis. However, it is difficult to differentiate them using histopathology alone, since both neoplasms have broad morphological spectrums and subtle differentiating features. OBJECTIVE: To evaluate the usefulness of Ki-67/Melan-A double staining for differentiating melanoma from benign melanocytic nevi. METHODS: We selected 20 cases of intradermal nevi, 20 cases of compound nevi, 5 cases of dysplastic nevi, and 25 cases of melanoma from clinicopathologically proven cases reviewed by the Department of Dermatology at our medical center. Ki-67/Melan-A double staining was performed, and the Melan-A verified Ki-67 index (Ki-67-M index) and Ki-67 index were measured. The immunopositivity was measured in the deepest third of the lesions. RESULTS: The Ki-67-M index of intradermal nevi, compound nevi, dysplastic nevi, and melanoma were 0.4+/-0.9%, 1.0+/-1.1%, 4.3+/-1.7%, and 24.1+/-10.9%, respectively. The best Ki-67/Melan-A cut-off point to distinguish melanomas from benign melanocytic nevi was 5%; the sensitivity and specificity were 100% and 97.7%, respectively. Immunopositivity in the deepest third of the intradermal nevi, compound nevi, and melanoma, were 10.5%, 20%, and 100%, respectively; the sensitivity and specificity for diagnosing melanoma were 100% and 84.6%, respectively. The sensitivity and specificity of combined Ki-67-M and immunopositivity in the deepest third for diagnosing melanoma were 100% and 97.7%, respectively. CONCLUSION: The Ki-67-M index and immunopositivity in the deepest third of melanoma were significantly higher than that of benign melanocytic nevi. Therefore, Ki-67/Melan-A double staining is a potentially valuable diagnostic tool for differentiating melanoma from benign melanocytic nevi.
Dermatology ; Diagnosis ; Dysplastic Nevus Syndrome ; MART-1 Antigen ; Melanoma* ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented* ; Sensitivity and Specificity

Neurofollicular hamartoma is an unusual, previously described neoplasm characterized by a stroma composed of proliferation of spindle cells and hyperplastic pilosebaceous units. The stroma has light microscopic and immunohistochemical features consistent with neuroid differentiation showing positive S-100 antigen. Lesions are almost invariably located on the face with strong predilection for the nose or nasolabial fold. A 35-year-old man presented with a solitary, skin-colored, dome-shaped papule that had been present on his right temple area for a few years. Clinical differential diagnosis included basal cell carcinoma, angiofibroma and intradermal nevus. Clinically, the lesion presents as a small, skin-colored, dome-shaped firm papule, 3 to 7 mm in diameter. Although clinical aspects of the lesion are not diagnostic, the histological features are very typical. Herein, we report a rare case of neurofollicular hamartoma on the right temple area.
Adult ; Angiofibroma ; Carcinoma, Basal Cell ; Diagnosis, Differential ; Hamartoma ; Humans ; Light ; Nasolabial Fold ; Nevus, Intradermal ; Nose

Atypical junctional melanocytic hyperplasia is a rare condition with unknown etiology. It is characterized by focal atypical melanocytic proliferation limited in the basal layer. Although this lesion is difficult to separate from melanoma in situ (MIS), it could be distinguished from MIS by the lack of several features, including lateral spread, upward epidermal migration, marked cytologic atypia, finely granular "smoky" melanin pigment, mitotic figures, and a subjacent host inflammatory response. In one study, atypical junctional melanocytic hyperplasia was found in 6.2% (25/400) of otherwise normal intradermal nevi. However, to our knowledge, no case of atypical junctional melanocytic hyperplasia with intradermal nevus has ever been published in Korean dermatologic literatures. Herein, we report a rare and interesting case of atypical junctional melanocytic hyperplasia with intradermal nevus.
Hyperplasia ; Melanins ; Melanoma ; Nevus, Intradermal