Sun Namkoong

Reliability on Intra-Laboratory and Inter-Laboratory Data of Hair Mineral Analysis Comparing with Blood Analysis

Background Nowadays, although its clinical value remains controversial institutions utilize hair mineral analysis. Arguments about the reliability of hair mineral analysis persist, and there have been evaluations of commercial laboratories performing hair mineral analysis. Objective The objective of this study was to assess the reliability of intra-laboratory and inter-laboratory data at three commercial laboratories conducting hair mineral analysis, compared to serum mineral analysis. Methods Two divided hair samples taken from near the scalp were submitted for analysis at the same time, to all laboratories, from one healthy volunteer. Each laboratory sent a report consisting of quantitative results and their interpretation of health implications. Differences among intra-laboratory and interlaboratory data were analyzed using SPSS version 12.0 (SPSS Inc., USA). Results All the laboratories used identical methods for quantitative analysis, and they generated consistent numerical results according to Friedman analysis of variance. However, the normal reference ranges of each laboratory varied. As such, each laboratory interpreted the patients health differently. On intra-laboratory data, Wilcoxon analysis suggested they generated relatively coherent data, but laboratory B could not in one element, so its reliability was doubtful. In comparison with the blood test, laboratory C generated identical results, but not laboratory A and B. Conclusion Hair mineral analysis has its limitations, considering the reliability of inter and intra laboratory analysis comparing with blood analysis. As such, clinicians should be cautious when applying hair mineral analysis as an ancillary tool. Each laboratory included in this study requires continuous refinement from now on for inducing standardized normal reference levels.

Extramammary Paget's Disease of External Genitalia with Bowenoid Features

Extramammary Pagets disease (EMPD) is an uncommon intraepithelial adenocarcinoma, primarily affecting the apocrine-bearing skin. Bowen disease is an intraepithelial squamous cell carcinoma having the potential to become invasive carcinoma. The histopathological concomitant features between EMPD and Bowen disease have been described. One theory is that primary EMPD arises multicentrically, within the epidermis from the pluripotent stem cells. Herein, we describe a case of EMPD that had bowenoid features, and review the previous cases associated with the origin of EMPD.

A Case of Familial Comedonal Darier's Disease

Dariers disease is a genetic disorder of keratinization with autosomal dominant inheritance. Its appearance is usually in the form of greasy, crusted, keratotic yellow-brown papules and plaques found particularly on seborrheic areas of the body. However, there are some clinical variants showing atypical skin lesions. Here we report an unusual case of Dariers disease, which mainly showed prominent comedonal papules over the face.

Successful Hair Transplantation for Treatment of Acquired Temporal Triangular Alopecia

Temporal triangular alopecia (TTA) may be congenital. It usually develops in childhood and is rarely acquired in adulthood.1,2 Some authors suggest that TTA is characterized by vellus hair formation and is similar to androgenetic alopecia, its prototype.3–5In TTA with small patchy hair loss, simple

Deep penetrating benign fibrous histiocytoma of the foot associated with throbbing pain.

Compared to cutaneous benign fibrous histiocytoma (BFH), deep-seated BFH is very rare and poorly recognized. Both cutaneous and deep-seated BFH are usually asymptomatic. We herein report a 25 year-old woman who presented with a painful mass in her foot that was poorly controlled by analgesics and associated with walking difficulty. After preoperative ultrasonographic evaluation, the mass was completely excised and histologic exam showed spindle cells loosely arranged in storiform architecture, with CD34-, desmin-, S-100-, focal CD68+, vimentin+, smooth muscle actin+, and factor XIIIa+. The patient was diagnosed with deep-seated BFH based on the histologic, radiologic and intraoperative findings.

A Case of Gardner's Syndrome Associated with Desmoid Tumor

Desmoid tumors are uncommon benign neoplasm of the fibroblasts. They occur rarely in the general population, but they are comparatively common in patients with familial polyposis coli with or without other elements of Gardners syndrome. Herein, we report a 16-year-old woman with Gardners syndrome complicated by desmoid tumors on the right subscapular area.

Topical tacrolimus does not negatively impact acute skin wound healing.

Despite the increasing use of topical tacrolimus, there is little information about its effect on skin wound healing. To determine effects on acute cutaneous wound healing, two full‐thickness skin wounds were imparted on the backs of 45 hairless mice, which were then divided into vehicle‐, topical tacrolimus‐ and topical steroid‐treated group. Each drug was topically applied once daily. The wound area was assessed by using dermoscopic images every two days after wounding. At 3, 7 and 11 days after wounding, 10 wounds in each group were collected for semi‐quantitative analysis of histological features including re‐epithelialization, polymorphonuclear leucocytes, fibroblasts and collagen. We also checked the mRNA expression levels of EGF, TGF‐β, TNF‐α and IL‐1α. While topical application of clobetasol propionate was found to delay re‐epithelialization and infiltration of polymorphonuclear leucocyte, topical treatment with tacrolimus showed patterns similar to that of the vehicle. In the tacrolimus‐treated group, mRNA expression levels of IL‐1α and TGF‐β were slightly decreased, while the others were similar with the vehicle‐treated group. Unlike steroid, topical tacrolimus, therefore, did not disturb the wound healing process in a murine skin wound model.

Large dermal non neural granular cell tumor on the surgical wound site.

Granular cell tumors (GCTs) can be divided into neural type with S-100 reactivity and non-neural type without that. The latter has not been widely recognized and there are only fewer reports available when compared to conventional GCT. A 65-year-old man was presented with the presence of a painless mass on his back. The mass had developed into a small nodule on the scar developed because of previous surgery carried out 2 years ago. The tumor consisted of large, polygonal cells comprising of an enormous number of faintly eosinophilic small granules in the cytoplasm. The cytoplasmic granules were stained positively for periodic acid-Schiff stain. Immunohistochemical stains for S-100 protein and neuron-specific enolase were found to be negative. Herein, we report the appearance of a very rare case of non neural GCT developed on the surgical scar in support with relevant literature reviews.

Pigmented epithelioid melanocytoma developed in a patient with Becker nevus syndrome

1 Niiyama S, Satoh K, Kaneko S et al. Segmental neurofibromatosis. Acta Derm Venereol 2005; 85: 448–449. 2 Krishnan RS, Angel TA, Orengo IF et al. Bilateral segmental neurofibromatosis: a case report and review. Int J Dermatol 2001; 40: 409– 411. 3 López L, Dominguez M, Novales C et al. Segmental neurofibromatosis of facial localization. Int J Dermatol 2005; 44: 583–586. 4 Dang JD, Cohen PR. Segmental neurofibromatosis and malignancy. Skinmed 2010; 8: 156–159. 5 Tinschert S, Naumann I, Stegmann E et al. Segmental neurofibromatosis is caused by somatic mutation of the neurofibromatosis type 1 (NF1) gene. Eur J Hum Genet 2000; 8: 455–459.

A Case of Eccrine Spiradenoma in a Patient with Neurofibromatosis

Neurofibromatosis is a systemic hereditary disorder with varied manifestations in bone, soft tissue, the nervous system and skin. Cutaneous manifestations of neurofibromatosis are characterized by café-au-lait macules, multiple neurofibromas, Lisch nodules and intertriginous freckling. Some benign or malignant tumors such as juvenile xanthogranuloma, pheochromocytoma, and malignant melanoma can accompany neurofibromatosis. But, in the English literature, no case of eccrine spiradenoma associated with neurofibromatosis has been reported. Eccrine spiradenoma is a benign uncommon neoplasm of skin adnexa. It presents as a painful, slow-growing and solitary nodule on the head or upper trunk. Here, we report a rare case of eccrine spiradenoma in a patient with neurofibromatosis.