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Biomedical subjects

K C Moon

Publications and source records attributed to K C Moon.

At least 91 records · Page 5Linked to original sources
PubMed1999

Cutaneous extravascular necrotizing granuloma (Churg Strauss granuloma).

Churg Strauss granuloma (cutaneous extravascular necrotizing granuloma) is a distinct entity which is associated with systemic immunoreactive or autoimmune diseases in a majority of cases. Typically, Churg Strauss granuloma presents as symmetrical papules or nodules on the extremities. There are two histological patterns: the classic pattern reveals palisading granuloma with central degenerated collagen, interspersed polymorphonuclear leukocytes, and leukocytoclastic debris; the focal basophilic necrosis pattern does not show palisading granuloma. We report two cases of Churg Strauss granuloma with different histopathological patterns.

Adult↗
PubMed1999

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/microL) and decreased hemoglobin (8.8 g/dL). Other laboratory results were negative or within normal limits. Skin examination showed multiple, discrete, crust-like, brownish papules over the erythematous base on the face, upper extremities, and lower extremities. With the clinical impressions of irritated verruca vulgaris, seborrheic keratosis, or cutaneous fungal infection, a skin biopsy was taken from a papule on the left shin, and histopathologic examination revealed several pronounced hyperkeratotic and parakeratotic columns, and characteristic cornoid lamellae in the stratum corneum. Beneath the cornoid lamellae, the granular layer was decreased. A number of round or oval, dyskeratotic, homogenized eosinophilic cells with pyknotic nuclei were scattered in the prickle cell layer below the cornoid lamellae. A mild lymphohistiocytic infiltrate was observed in the papillary dermis and around the blood vessels in the upper dermis. Also, actinic degeneration was present in the upper dermis.

Aged↗
PubMed1999

POEMS syndrome with xanthomatous cells. Polyneuropathy Organomegaly Endocrinopathy M-protein Skin changes.

A diffuse xanthomatous infiltration was detected on a biopsy of the hyperpigmented patches in a 40-year-old man with POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin changes) syndrome. Multiple biopsies of the hyperpigmented patches showed diffuse or perivascular foamy histiocytes in the upper and mid dermis, a sparse infiltrate of lymphocytes, fibrosis, hyperpigmentation of the basal layer, and capillary proliferation. The foamy cells were positive for periodic acid-Schiff (PAS) with diastase, oil red-O, and CD68. To our knowledge, this is the first case with foamy histiocytes without xanthomatous-appearing skin lesions in POEMS syndrome. It would be worth searching for xanthomatous histiocytes in the hyperpigmented skin of patients with POEMS syndrome.

Adult↗
PubMed1999

Methotrexate nodulosis.

Methotrexate (MTX) nodulosis in patients with rheumatoid arthritis treated with MTX has become a well recognized phenomenon. It has not been described in patients receiving MTX for treatment of other diseases, e.g., dermatological or malignant diseases. Recently, MTX nodulosis was described in a patient with psoriasis and arthritis. The pathophysiology and treatment of MTX nodulosis are yet unsettled. We experienced a case with dermatomyositis who developed multiple subcutaneous nodules after treatment with MTX. In our patient, numerous, small, symmetrically distributed, grouped subcutaneous nodules were seen on a V-shaped area of the anterior chest, both axillary areas, and the medial sides of both upper arms and thighs. We histopathologically examined a nodule and started treatment with hydroxychloroquine after discontinuation of MTX. The histopathology revealed septal panniculitis, and the nodules have been under regression. MTX nodulosis may be a drug-specific phenomenon. Discontinuation of MTX and replacement with hydroxychloroquine are recommended in severe cases. Awareness of this entity is important for diagnosing and treating cases of multiple nodules developing after the administration of MTX, which is widely used for many dermatological diseases.

Arm↗
PubMed1999

Cellular neurothekeoma with possible neuroendocrine differentiation.

We report a case of cellular neurothekeoma showing unusual immunohistochemical findings and occurring on the left upper arm of a healthy 48-year-old woman. She presented with a 1 cm, red, asymptomatic, dermal nodule of 1 year duration. A biopsy showed dermal proliferation of plexiform fascicles of spindle-shaped or polygonal cells with plentiful eosinophilic cytoplasms. The immunohistochemical profile included negative stains for S-100, CD34, factor XIIIa, CD68, HMB45, cytokeratins, and EMA, strongly positive stains for neuron specific enolase (NSE), synaptophysin, and chromogranin A, and focally positive ones for NKI/C3 and alpha-smooth muscle actin. Ultrastructural analysis showed undifferentiated mesenchymal cells with cytoplasmic projections and abundant RER. Although we couldn't find any confirmative cell type in this cellular tumor, we believe that cellular neurothekeoma is predominantly composed of undifferentiated cells that can exhibit features of neuroendocrine cells in addition to fibroblastic or myofibroblastic ones, suggesting a divergent cell origin.

Biopsy, Needle↗
PubMed1999

Juvenile chronic myelogenous leukemia, neurofibromatosis 1, and xanthoma.

The triple association of leukemia, xanthomatous skin lesions, and neurofibromatosis 1 (NF) was first described by Royer et al. in 1958. Most of the leukemias were of the juvenile chronic myelogenous type (JCML). We describe a 7-year-old male child with xanthoma, neurofibromatosis 1, and juvenile chronic myelogenous leukemia. His mother also had NF1. We suggest that the presence of xanthomas and NF1 in a young child should raise awareness of the possible development of JCML, especially in patients with a family history of NF1.

Bone Marrow↗
PubMed1999

Subcutaneous emphysema with spontaneous pneumomediastinum and pneumothorax in adult dermatomyositis.

We describe a 32-year-old patient with adult dermatomyositis who developed dyspnea and worsening of pre-existing infarcted skin lesions of the fingers. Chest radiographs showed diffuse hazy reticulonodular infiltration in both lungs, subcutaneous emphysema, pneumomediastinum, and pneumothorax. The pulmonary symptoms and cutaneous lesions gradually improved with a high dose of prednisolone. Although subcutaneous emphysema and pneumomediastinum occur frequently in association with traumatic disruption of cutaneous and mucosal barriers and assisted ventilation, it has rarely been observed in patients with interstitial pneumonitis in connective tissue diseases. Although dermatomyositis and subcutaneous emphysema are all relatively well-known diseases to dermatologists, the occurrence of spontaneous pneumomediastinum and pneumothorax and subsequent subcutaneous emphysema in connective tissue diseases such as dermatomyositis is unfamiliar. We discuss the possible mechanisms of this condition.

Adult↗
PubMed1999

Congenital CD34-positive granular cell dendrocytosis.

Granular cell tumors involving the skin are mostly acquired lesions. The Schwann cell origin of these lesions is supported by positive immunostaining for S-100 protein and myelin basic protein. S-100- granular cell lesions rarely have been described in association with fibrous papules or dermatofibromas. The congenital variety of S-100- granular cell tumors occurs almost exclusively in the gingiva. The cell origin of these lesions is not well delineated. We report a hitherto undescribed case of a congenital cutaneous lesion which is histologically characterized by diffuse dermal infiltrates of S-100- but CD34+ granular dermal dendrocytes. The granular appearance of these CD34+ dendrocytes is attributed to an abundance of phagolysosomes. The pathogenetic mechanism of this unusual lesion remains to be elucidated.

Antigens, CD34↗
PubMed1998

Four cases of pustulotic arthro-osteitis.

We describe four cases of pustulotic arthro-osteitis. All of them suffered from anterior chest wall symptoms, such as swelling and pain on the sternoclavicular joint, sternal angle area, sternocostal joint, and costochondral junction. Although chest X-ray findings were all normal, 99mTc-scintigraphy revealed increased uptake in the affected areas in all cases. Laboratory examinations including rheumatoid factor were negative or normal except for elevation of the erythrocyte sedimentation rate and C-reactive protein in 2 cases. After treatment with non-steroidal anti-inflammatory drugs and etretinate or topical PUVA, the skin lesions on the palms and soles and the arthro-osteitis were moderately improved. Pustulotic arthro-osteitis should be considered when a patient with pustulosis palmoplantaris complains of anterior chest wall pain and other joint pain.

Adult↗
PubMed1998

Diagnostic pitfalls of Merkel cell carcinoma and dramatic response to chemotherapy.

Merkel cell carcinoma (MCC) is an unusual malignant tumor that arises from neuroendocrine cells with features of epithelial differentiation. We describe a MCC patient with unusual clinical, histopathological, and immunohistochemical features. Although the microscopic, immunohistochemical, and ultrastructural characteristics of MCC have been well defined, diagnostic difficulties remain, particularly in distinguishing it from lymphoma involving the skin, as suggested by our case. This is an unusual case in which dense lymphoid infiltration masked the true tumor. All the immunohistochemical markers of MCC except neuron-specific enolase (NSE) were negative. The dramatic response to primary chemotherapy was also very noteworthy.

Adult↗
PubMed1998

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 10x6 cm in size, relatively ill-defined, skin colored, and comprised of confluent nodules. Histopathologic examination revealed histology compatible with cutaneous mesenchymal hamartoma.

Adipocytes↗
PubMed1998

Eosinophilic pustular folliculitis (Ofuji's disease) in myelodysplastic syndrome.

We describe a case of eosinophilic pustular folliculitis (EPF, Ofuji's 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. We suggest that the immunologic abberations ascribed to myelodysplastic syndrome and the increase in the eosinophil cell line in the bone marrow might play roles in the development of EPF in our case.

Adrenal Cortex Hormones↗
PubMed1998

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

BACKGROUND: Traumatic tattoos result from mechanical penetration of the skin by foreign-body particles associated with puncture, abrasive, or explosive trauma. Until the recent development of the Q-switched lasers, it was not possible to remove tattoo pigments without scar and pigmentary changes. OBJECTIVE: The objective of this study was to determine the effectiveness of the Q-switched alexandrite laser (wavelength, 755 nm; pulsewidth, 100 ns), in treating the 27 cases of Asian skin with 36 traumatic tattoos and to observe any side effects such as scarring or pigmentary change. METHODS: The results of treatments on 16 patients with 19 penetrant tattoos, 10 patients with 16 abrasive tattoos and 1 patient with bomb explosion were clinically analyzed. RESULTS: Greater than 76% removal of tattooed pigments required an average of 1.7 treatment sessions in penetrant tattoos in contrast with 2.4 sessions in abrasive tattoos. The excellent removal of traumatic tattoos required 7.5 J/cm2 except the scarred region of one explosive tattoo and one abrasive tattoo on soil. There were no permanent side effects such as scar or permanent pigmentary changes. CONCLUSION: In conclusion, the Q-switched alexandrite laser is a safe and highly effective modality for removal of various traumatic tattoos without scar or permanent pigmentary change in Asian skin.

Adolescent↗
PubMed1998

Two cases of linear focal elastosis (elastotic striae).

Linear focal elastosis (LFE) or elastotic striae was first described by Burket in 1989 in three elderly men. They presented with striae-like yellow palpable bands on their backs. Burket described many fine wavy bundles of elastic fibers separating the collagen in the middle to reticular dermis under microscopic examination. Until recently, there have been about 14 reported cases of LFE; elderly males are predominant. We encountered two Korean teen-aged males with linear, reddish, palpable bands and some atrophic bands across their backs. Histopathological examination revealed that elastosis was not as prominent as in previously reported cases. Our cases might represent early-evolving LFE.

Adolescent↗