Kyoung-Ae Jang

Viral folliculitis on the face.

The common clinical presentations of herpes simplex virus (HSV) and molluscum contagiosum (MC) are well known to dermatologists. However, folliculitis due to these viruses is an infrequently reported entity and might be considered a sign of immunosuppression [such as infection with human immunodeficiency virus, (HIV)], especially in cases of folliculitis due to MC. The purpose of this study was to describe the clinical and histopathological characteristics of viral folliculitis due to HSV and MC. We retrospectively collected all our cases with histologically proven folliculitis due to HSV and MC between 1994 and 1999. A total of seven patients aged 7–54 years was identified. Prior to establishment of the diagnosis of folliculitis due to HSV and MC, they were treated with topical antibiotics or topical steroids, without improvement. Tentative diagnoses were bacterial folliculitis, syringoma, perifollicular fibrosis, contact dermatitis or pseudolymphoma. Biopsy of the lesions revealed multiple molluscum bodies in the follicular epithelium with sparing of the epidermis in four patients, and ballooning degeneration and intranuclear viral inclusions in the follicular epithelium in the other three. Three patients had evidence of underlying immune suppression, such as pregnancy, chronic viral hepatitis B and nasopharyngeal carcinoma. One patient had suffered from epilepsy for 4 years. Testing for HIV by enzyme‐linked immunosorbent assay was negative in the four patients in whom this was performed, and T‐cell subsets were normal in the three patients in whom these were quantified. In cases of molluscum folliculitis treated with simple curettage, the lesions cleared without scarring or recurrence. In cases of herpetic folliculitis, the lesions improved with antihistamines or aciclovir. MC or HSV should be considered in cases that present with folliculitis‐like dermatoses but which are refractory to anti‐infective and anti‐inflammatory treatment.

Successful removal of freckles in Asian skin with a Q-switched alexandrite laser.

Background. Although freckles are light‐brown macules most frequently observed in individuals with red or blond hair and blue or gray eyes, freckles are common to Asian people, including Koreans. Treatment may be requested on cosmetic grounds. Objective. The objective of this study was to determine the effectiveness of the Q‐switched alexandrite laser (wavelength 755 nm; pulse width 100 nsec) in treating the 197 cases of Asian skin with freckles and to observe any side effects such as pigmentary changes or scarring. Methods. One hundred ninety‐seven patients with freckles were treated with the Q‐switched alexandrite laser at 8‐week intervals and clinically analyzed. Results. More than 76% removal of freckles required an average of 1.5 treatment sessions with 7.0 J/cm2. No scarring, long‐standing pigmentary changes, or textural changes were seen in laser‐irradiated skin. Conclusion. The Q‐switched alexandrite laser is a safe and highly effective modality for removing freckles without scarring or permanent pigmentary changes in Asian skin.

Tinea pedis in Korean children

Background Tinea pedis is an infrequent disease in children before the age of puberty. There are few epidemiologic and clinical data regarding cases of tinea pedis observed in children.

A case of guttate psoriasis following Kawasaki disease

We report a case of guttate psoriasis following Kawasaki disease, in a patient with Staphylococcus aureus demonstrated in a throat swab. We suggest that preceding staphylococcal infection can play a key role in the pathogenesis of some cases of guttate psoriasis, possibly by the production of superantigens.

Expression of cutaneous lymphocyte‐associated antigen and TIA‐1 by lymphocytes in pityriasis lichenoides et varioliformis acuta and lymphomatoid papulosis: immunohistochemical study

Background: Pityriasis lichenoides et varioliformis acuta (PLEVA) and lymphomatoid papulosis (LyP) are benign self‐healing cutaneous eruptions that may be clinically and histologically similar. The purposes of this study were to evaluate immunohistological characteristics of PLEVA and LyP and to investigate whether Epstein‐Barr virus (EBV) may be present in PLEVA and LyP.

Eosinophilic Pustular Folliculitis (Ofuji's Disease) in Myelodysplastic Syndrome

We describe a case of eosinophilic pustular folliculitis (EPF, Ofujis disease) in a 12‐year‐old male who suffered from myelodysplastic syndrome. Bone marrow study revealed an increase in the eosinophil cell line without peripheral blood eosinophilia in our case.

Nasal and nasal type CD56+ natural killer cell/T‐cell lymphoma: a case with rapid progression to bone marrow involvement

We describe herein a case of CD56+ natural killer cell lymphoma (NKCL) that showed unusual clinical manifestations and a fulminant course of disease. A 70‐year‐old male patient presented with rapidly growing skin lesions and fever; a nasal lymphoma was subsequently detected and bone marrow involvement developed within a few weeks. Although the time relationship is not clear, bone marrow involvement could be dissemination from localized disease of nasal and nasal type NKCL. As seen in our case, the course can be excessively aggressive and fulminant even when it first appeared as a localized disease, and CD56 positivity, which is a specific characteristic of NKCL, may serve as a factor showing a poor prognosis for a malignant lymphoma.

The hyperkeratotic variant of disseminated superficial actinic porokeratosis (DSAP)

A 78‐year‐old South Korean man was referred to us from the Medical Intensive Care Unit (MICU) for an opinion. He was comatose and was on ventilatory care due to aspiration pneumonia. Multiple tiny papules had developed 10 years previously and since then the number and size had been increasing gradually. He had been diabetic for the past 4 years, and had Parkinson’s disease diagnosed 1 year previously. Laboratory examinations revealed an elevated level of white blood cells (WBCs) (25,000/μL) and decreased hemoglobin (8.8 g/dL). Other laboratory results were negative or within normal limits.

PROGEROTD SYNDROME: ASSOCIATION WITH CONNECTIVE TISSUE DISEASE?

clue to spinal cord disease. Because of the losses of motor and sensory nerve functions of the lower right extremity, his foot was paretic and prone to develop callosities with nail dystrophy due to recurrent mechanical trauma. Hence antifugal therapy was of no benefit. In-growing toenails, nail brittleness, nail plate striations, and pterygium inversum unguis are reported to occur in hemiplegia, paraplegia, and tetraplegia, and peripheral neuropathies (3-5). In the recent literature on tethered spinal cord syndrome, chronic nonhealing skin ulcers have been mentioned in uncorrected cases (6) but onychodystrophy has not been reported (7-10). Even in textbooks and monographs on nail disease, tethered spinal cord has not been included in the list of possible causes of unilateral nail dystrophy (1,9,10). In conclusion, patients with tethered spinal cord may suffer from nail dystrophy and discoloration and develop callosities.

Cutaneous Mesenchymal Hamartoma on the Foot

We report a 16‐year‐old man with a cutaneous mesenchymal hamartoma on the left foot since infancy. Clinically, the lesion was 10 × 6 cm in size, relatively ill‐defined, skin colored, and comprised of confluent nodules. Histopathologic examination revealed histology compatible with cutaneous mesenchymal hamartoma.