Bong-Seok Jang

Tumescent superficial liposuction with curettage for treatment of axillary bromhidrosis

Backgrounds  Axillary bromhidrosis is a common but unpleasant and distressing problem faced by many societies, particularly in Asia, where malodour is reflected as a social handicap. Currently, local surgery is the treatment of choice among various non‐surgical and surgical treatment.

Multiple scrotal epidermolytic acanthomas successfully treated with topical imiquimod

Dear Editor, The epidermolytic acanthoma is a rare benign tumor which resembles a wart or seborrheic keratosis clinically and shows characteristic histopathological features of epidermolytic hyperkeratosis. Although it may appear as solitary or multiple forms, it very rarely develops multiple epidermolytic acanthomas localized to the scrotum. A solitary lesion is usually treated by surgical excision, but there is no effective treatment for multiple lesions yet. We report a case of multiple scrotal epidermolytic acanthomas that responded to treatment with topical imiquimod. A 57-year-old man was referred with lesions on the scrotum. The lesions were multiple itchy, verrucoid, whitish or skin-colored papules with an intermittent itching sensation over a 3-year period (Fig. 1a). Itching sensation had made him scratch the scrotum from time to time. There was no personal or familial history of similar lesions or other skin lesions. There was no history of atopy and signs or symptoms of immunosuppression. He had used a topical steroid for the lesions but there was no improvement. A biopsy from a skin-colored papule of the scrotum revealed distinct features of epidermolytic hyperkeratosis. The epidermis showed well-defined areas of orthokeratotic hyperkeratosis and focal acanthosis. The cells of the stratum granulosum and upper layer of the stratum spinosum contained numerous, large, clear, perinuclear spaces. The indistinct boundaries of these cells were formed by a lightly staining eosinophilic substance and clumped keratohyaline material (Fig. 2). With clinical features and histopathological findings, he was diagnosed with multiple epidermolytic acanthomas localized to the scrotum. He had previously been treated with topical glucocorticosteroid without any benefit. Surgical excision of multiple lesions was not a good option for cosmetic results. Therefore, we decided to use the 5% imiquimod cream which has been successfully used as a topical immune response modifier for the treatment of a number of benign, premalignant and malignant conditions. The patient started treatment with 5% imiquimod cream five times a week. After

A case of annular atrophic lichen planus

© 2007 The Authors 989 JEADV 2007, 21, 977–1010 Journal compilation

An unusual complication of systemic lupus erythematosus: bacterial meningitis caused by Streptococcus agalactiae.

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