DPCP(diphencyclopropenone) has been used for the treatment of alopecia areata or verruca. Common side effects due to topical treatment with DPCP are pruritus, blistering, cervical lymphadenopathy and urticaria. Rarely, vitiligo can be induced by topical treatment with DPCP as a complication on the pigmentary system. Herein we report a case of vitiligo induced by DPCP in a patient with malignant melanoma. She was diagnosed with malignant melanoma in her 4th toe, Rt., a year ago. As part of adjuvant therapy, DPCP was topically applied to the inguinal area every week. After 4 months, vitiligo appeared on the area of DPCP application.
Alopecia Areata ; Blister ; Humans ; Lymphatic Diseases ; Melanoma* ; Pruritus ; Toes ; Urticaria ; Vitiligo* ; Warts

The major problem of the treatment of the sacral ulcer is that the area is under too much pressure. Thus, in a case of skin graft after the removal of a lesion, if the padding is not enough, the ulcer will recur. The gluteus maximus muscle has an abundant volume of subcutaneous fat and muscle, and provides the pressure site with enough padding. Therefore, the gluteus maximus musculocutaneous flap has been most commonly used for the treatment of the sacral pressure ulcer. We herein report a case of malignant fibrous histiocytoma in the sacral area treated with the gluteus maximus musculocutaneous flap.
Histiocytoma, Malignant Fibrous* ; Myocutaneous Flap* ; Pressure Ulcer ; Skin ; Subcutaneous Fat ; Transplants ; Ulcer

Extramammary Paget's disease is a rare malignancy occuring mainly in apocrine gland- bearing areas such as vulva, scrotum, perianal area, and axilla. Histopathologically, the Paget's cells are usually confined within the epidermis and may be associated with underlying adenocarcinoma. Although surgical excision is the treatment of choice, the clinical demarcation of the lesion is still a frequent problem in the treatment of extramammary Paget's disease. We tried photodynamic diagnosis to determine the surgical margin of extramammary Paget's disease and with surgical excision guided by photodynamic diagnosis successfully treated two cases.
Adenocarcinoma ; Axilla ; Diagnosis* ; Epidermis ; Paget Disease, Extramammary* ; Scrotum ; Vulva

Giant cell tumor of tendon sheath is a benign histiocytic proliferation of the articular and peritendinous synovial tissue and manifests as a painless, firm, smooth, subcutaneous mass which occurs predominantly on the hand where it is typically located adjacent to the interphalangeal joints of the hands, especially the terminal interphalangeal joints. Histologically, it is characterized by the presence of multinucleated giant cells. We herein report a case of giant cell tumor of tendon sheath located on the fingertip with the involvement of overlying skin, which shows rare location and unusual clinical manifestation.
Giant Cell Tumors* ; Giant Cells* ; Hand ; Joints ; Skin ; Tendons*

Early diagnosis and treatment are essential for a successful treatment of malignant tumor. The malignant melanoma is notoriously acknowledged as threatening and known to readily metastasize during the early stages. The solid tumors including malignant melanoma frequently metastasize to regional lymph nodes via lymphatic vessels. During the latest clinical amelioration, it has been clearly conspicuous that early discovery of metastatic pathological alteration in sentinel lymph nodes could prevent prophylactic regional lymph node dissection. Additionally, an application of an appropriate treatment is conceivable by accurately recognizing the stages of the illness. For malignant melanoma clinically without palpable lymph nodes, through the application of lymphoscintigraphy and vital dye staining, we report two cases of malignant melanoma, microscopically metastasized in the sentinel lymph node and review the previous literatures.
Early Diagnosis ; Lymph Node Excision ; Lymph Nodes* ; Lymphatic Vessels ; Lymphoscintigraphy ; Melanoma*

A 38-year-old man presented with a black pigmented patch overlying his upper lip, a part of the gingiva and the hard palate. An intradermal tumor mass was palpated at the central portion of the pigmented patch of the upper lip. Diphenylcyclopropenone (DPCP) is a potent contact sensitizer that could stimulate non-specific immunity. We report a case of desmoplastic malignant melanoma (DMM) in which an atypical lentiginous pigmentation disappeared with topical DPCP immunotherapy and the dermal tumor mass was removed by a surgical wedge-shaped excision. Though an atypical lentiginous pigmentation of DMM sometimes undergoes extensive spontaneous regression, in our case it could be attributed to the therapeutic effect of topical DPCP immunotherapy rather than a spontaneous regression.
Adult ; Gingiva ; Humans ; Immunity, Innate ; Immunotherapy ; Lip ; Melanoma* ; Palate, Hard ; Pigmentation*

Lichen nitidus is a rare, usually asymptomatic chronic inflammatory dermatosis composed of numerous, tiny, discrete, flesh colored, shiny papules. Since the disease is asymptomatic and self-limiting, the specific treatment is not required in most cases. But when the lesion is generalized, symptomatic, persistent, interfering with outlook, the treatment is required. Diphenylcyclopropene (DPCP), a potent contact sensitizing agent has been used for refractory wart and alopecia areata based on its ability to induce delayed hypersensitivity reaction or nonspecific cell-mediated immunity. We report two cases of lichen nitidus improved after topical DPCP application.
Alopecia Areata ; Hypersensitivity, Delayed ; Immunity, Cellular ; Immunotherapy* ; Lichen Nitidus* ; Lichens* ; Skin Diseases ; Warts

Acral lentiginous melanoma has a poor prognosis, because it has relatively short radial growth phase than lentigo maligna melanoma does. A 50 year-old female was presented with a 4X5cm-sized irregularly pigmented patch developed on the left palm. Initial punch biopsy examinations revealed atypical melanocytes only in the epidermis. But, after complete excision, melanoma cells were also observed in the upper dermis. We report an unusual case of acral lentiginous melanoma which showed vertical growth phase after twenty years of radial growth phase.
Biopsy ; Dermis ; Epidermis ; Female ; Humans ; Hutchinson's Melanotic Freckle ; Melanocytes ; Melanoma* ; Middle Aged ; Prognosis

BACKGROUND: Photodynamic therapy(PDT) is a kind of non-invasive photochemotherapy, which is designed to kill the target cells through photodynamic reaction. It has been reported that PDT is very effective in superficial lesions, including extramammary Paget's disease. Yet, there has been no clinical trial for the treatment of extramammary Paget's disease using PDT in Korea. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of PDT in treating extramammary Paget's disease METHOD: Seven patients with anogenital extramammary Paget's disease were treated repeatedly with local PDT using topical ALA 20% and intralesional injection of hematoporphyrin derivative (HpD), and systemic PDT using HpD. Fluences of 125-200J/cm2 and intensities of 50-100mW/cm2 were used. RESULT: The clinical outcomes were disappointing. All the patients experienced only partial responses despite repeated treatments. But side effects were minimal. CONCLUSION: PDT is not effective enough for the treatment of extramammary Paget's disease to be used as a primary therapy. It would be better to use as an adjuvant to other treatment methods. Photodynamic sensitization, also known as photodynamic diagnosis, might help us define a more reliable border of the extent involved and the surgical margin to be excised.
Diagnosis ; Hematoporphyrin Derivative ; Humans ; Injections, Intralesional ; Korea ; Paget Disease, Extramammary* ; Photochemotherapy*

BACKGROUND: Photodynamic therapy(PDT) is a kind of non-invasive photochemotherapy, which is designed to kill the target cells through photodynamic reaction. It has been reported that PDT is very effective in superficial lesions, including extramammary Paget's disease. Yet, there has been no clinical trial for the treatment of extramammary Paget's disease using PDT in Korea. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of PDT in treating extramammary Paget's disease METHOD: Seven patients with anogenital extramammary Paget's disease were treated repeatedly with local PDT using topical ALA 20% and intralesional injection of hematoporphyrin derivative (HpD), and systemic PDT using HpD. Fluences of 125-200J/cm2 and intensities of 50-100mW/cm2 were used. RESULT: The clinical outcomes were disappointing. All the patients experienced only partial responses despite repeated treatments. But side effects were minimal. CONCLUSION: PDT is not effective enough for the treatment of extramammary Paget's disease to be used as a primary therapy. It would be better to use as an adjuvant to other treatment methods. Photodynamic sensitization, also known as photodynamic diagnosis, might help us define a more reliable border of the extent involved and the surgical margin to be excised.
Diagnosis ; Hematoporphyrin Derivative ; Humans ; Injections, Intralesional ; Korea ; Paget Disease, Extramammary* ; Photochemotherapy*