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A 30-year-old woman presented with generalized erythematous papules and confluent plaques on the whole body of a month duration. The lesions gradually grew up during last few days. She was diagnosed with mycosis fungoides about seven years ago. After then, she was treated with psoralen and ultraviolet A, acitretin, methotrexate, and ultraviolet A-1. On physical examination, variable sized erythematous papules and confluent plaques were observed on the whole body. And there were spare skin folds. A skin biopsy was taken from the skin lesions. What is your diagnosis?
Eosinophilic pustular folliculitis (EPF) is an inflammatory disease characterized by pruritic follicular papulopustules of unknown etiology. EPF is clinically characterized by annular configurations on the face, trunk, and extremities. EPF rarely affects the palms and soles where hair follicles are absent. Histopathologically, a number of eosinophils infiltrate around and into hair follicles. A 44-year-old man visited us with pruritic plaques on the face, crusted patches and pustules on the both palms and soles. Histopathologic findings of the pustule on the palms and soles showed spongiosis and intraepidermal vesicular formations containing numerous eosinophils, with dermal perivascular infiltrates consisting of eosinophils and lymphocytes. Histopathologic findings of facial lesion showed dense eosinophils and lymphocytes around hair follicles. Another patient who 28-year-old man visited us with pruritic papules and pustules on the face, trunk, and soles. Histopathologic findings of the pustules on the sole and face were similar with those of the preceding patient. The diagnosis of EPF with palmoplantar involvement was made. The patients were treated with oral dapsone, resulting in a significant improvement in skin lesions. Herein we report two cases of EPF manifested on the face and palmoplantar areas. (Korean J Dermatol 2015;53(2):138∼143)
Iododerma is a rare cutaneous eruption that occurs after oral, parenteral or topical administration of iodides. Acneiform papulopustular lesions are the most common skin reactions of iododerma and erythematous, vesiculobullous, vegetative, and pustular psoriasis-like lesions appear less commonly. A 40-year-old woman with post-thyroidectomy presented with pustular and crusted patches with erythematous and indurated bases on the face and well-defined purplish crusted desquamative plaques on the lower legs at 10 days after radioactive iodine-131 ablation. Based on clinicopathological findings and history, she was diagnosed with iododerma following radioactive iodine ablation. Hypersensitivity to iodine is more uncommon in iodine-131 therapy compared with other iodine- containing substances since the quantity of sodium iodide is infinitely small. As iododerma following radioactive iodine ablation is a rare entity, so clinicians need to know about the possibilities of developing the skin lesion along with other early side effects before administering iodine-131 therapy. (Korean J Dermatol 2013;51(1):53∼56)
Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. As palmoplantar lichen planus do not usually have the classically clinical features of lichen planus, a biopsy is very useful. Histopathologic findings are identical to classic lichen planus. According to literature, similar lichen planus may be found elsewhere on the body in palmoplantar lichen planus. We report a case of lichen planus limited to the soles in a 50 year-old female, who presents with erythematous hyperkeratotic crusted pruritic plaques on both soles. (Korean J Dermatol 2007;45(8):855∼857)
서기석 ( Kee Suck Suh ),백재우 ( Jae Woo Baek ),강동영 ( Dong Young Kang ),강진석 ( Jin Seuk Kang ),김태권 ( Tae Kwon Kim ),전영승 ( Young Seung Jeon ),박진형 ( Jin Hyung Park ),김상태 ( Sang Tae Kim ) 대한피부과학회 2010 大韓皮膚科學會誌 Vol.48 No.9
Hidradenitis Suppurativa (HS) is a chronic relapsing disease that involves the apocrine gland-bearing skin. It results in sinus tract formation, fibrosis and scarring. Many different treatments for HS have been reported, including topical and systemic antibiotics, intralesional steroids, systemic retinoids, hormonal therapies and immnunosuppressive agents, but they all have limited beneficial effects. Surgical treatments, including wide exteriorization with secondary intention, a skin graft and a flap can be effective treatments for recalcitrant HS. We present here the case of a 26-year-old man with recurred inguinal and axillary HS, and this was treated with secondary healing and a split thickness skin graft after exteriorization. Based on our experience, it is suggested that secondary healing and a split thickness skin graft after exteriorization are effective for recalcitrant HS with multiple interconnected tracts and abscesses. (Korean J Dermatol 2010;48(9):799~803)
Angioedema with eosinophilia is classified as the episodic and transient types according to the clinical course, the presence of recurrence and the response to treatment. Episodic angioedema with eosinophilia is characterized by recurrent angioedema, urticaria, periodical weight gain, peripheral eosinophilia and fever. The pathophysiologic mechanism is unknown, but it has been suggested that T-lymphocytes, eosinophils and cytokines may be the causes of this disorder. We report here on a 35-year-old woman with episodic angioedema and weight gain that she experienced about 3 days before the onset of menstruation. (Korean J Dermatol 2009;47(10):1162∼1165)
Background: Bowenoid papulosis occurs primarily on the genitalia of young adults and this is characterized by multiple, apparently benign maculopapular lesions. Bowenoid papulosis shows the histopathological findings of a squamous cell carcinoma in situ, but it follows a largely benign clinical course. If it is misdiagnosed as malignant tumor, unnecessary excessive therapy may be performed. Therefore, exact recognition of this entity is important. Objective: The purpose of this study is to examine the clinical and histopathologic features and outcomes of Bowenoid papulosis. Methods: Twelve patients who had been diagnosed with Bowenoid papulosis between June 1996 and September 2007 were reviewed clinicopathologically. Results: The mean age of the patients was 34.8 years (range: 23∼57 years), and the mean duration of Bowenoid papulosis until presentation was 6.3 months (range: 5∼48 months). Nine patients were males and 3 patients were females. Eleven patients (92%) had multiple lesions. The average size of the individual lesions was 1.4×0.6 cm in diameter. The colors of the papules were red to black. Seven of 9 male patients had lesions on the penile shaft, with 6 of those occurring at the proximal shaft. The other 2 male patients had lesions on the scrotum and perianal area, respectively. Three female patients had lesions on the labium major, labium major and clitoris, and perianal area respectively. Nine patients (75%) presented without symptom and 3 (25%) presented with mild pruritus. The histopathologic features were as follows: a rete ridge of approximately equal length and breadth throughout the entire lesion (100%), skipped areas of normal keratinocytes between zones of atypical keratinocytes (100%). necrotic keratinocytes (92%), parakeratosis (83%), mitotic figures (83%), vacuolated cells resembling owl`s eyes (83%), multinucleated cells (67%), residual changes of typical condyloma acuminatum (17%), involvement of acrotrichia (100%) and involvement of acrosyringia (100%). Eleven patients were effectively treated with surgical excision (8 patients), CO2 laser (2 patients), diphenylcyclopropenone (DPCP) and immunotherapy (1 patient) and 1 patient underwent biopsy only. We followed 12 patients for an average 78.1 months (from 24 to 137 months). During this period, no recurrence or malignant transformation was observed. Conclusion: Bowenoid papulosis shows a form of squmaous cell carcinoma in situ for its histopathology, but it hardly ever progresses to squmaous cell carcinoma. On our long term follow-up, there was no malignant transformation. Thus, excessive treatment of Bowenoid papulosis by amputation of the external genitalia is not necessary. Therefore, a through understanding of the clinical and histopathologic features of this entity is necessary for making the diagnosis, the treatment planning and determining the prognosis. (Korean J Dermatol 2008; 46 (11): 1463∼1469)