A 58-year-old man presented with a 1-year history of a black mass measuring 2.0×0.5 cm on the right nasolabial fold. No pain, tenderness or itching was associated with the lesion which was pathologically diagnosed by biopsy as basal cell carcinoma.

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INTRODUCTION

The introduction of Mohs micrographic surgery minimized the loss of normal tissue while also enabling complete tumor resection. Thenceforth, Mohs micrographic surgery was used for various cutaneous neoplasms, and it was reported as the most efficient treatment method with regard to the recurrence rates and aesthetic aspects, relative to those of the various other methods that were being applied before. So far, a single-bladed scalpel that can be used for removing common malignant skin lesions has been used. The double-bladed scalpel, with its improved ability to excise uniform strips of tissue, was originally created to harvest donor strips for hair transplantation. …Read the rest of this article

This case is rare in that it occurred in an uncommon extranuchal site, and interesting in that nuchal-type fibroma was recently described. Cli­nically, this case resembled lipoma, but physical examination revealed that the lesion had more dense tissue than lipomas. And it had morphologi­cally distinct features from other fibrous tumors.

In 1988, Enzinger and Weiss first described nuchal-type fibroma as a rare fibrous growth oc­curring chiefly in the interscapular and paraspinal regions. Michal et al described the clinicopatho- logic features of 52 cases of nuchal-type fibroma in 1999. The ages of patients ranged from 3 to 68 years, and according to the report nuchal-type fibroma occurs predominantly in males. The nuchal region is the most commonly affected area, but about one-third of cases affected extranuchal sites. Extranuchal sites most often involved the back or scapular region, shoulder, and face. However, other sites of involvement were the forearm, anterior neck, knee, and truncal region.

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A 29-year-old man without any particular medical history presented to our institution with a 6-year history of asymptomatic lump on the coccyx area. The patient complained that it had been gradually growing. On physical examination, the lesion was 3 x 4 cm sized, not tender, subcutaneous mass on the left side of coccyx area (Fig. 1). There were no other specific physical and laboratory findings. MRI scans revealed a relatively ill-defined lesion on subcutaneous fat layer of posterior to coccyx. This lesion appeared low signal intensity on both T1 and T2-weighted images, and measured 4.0 x 3.6 x 1.7 cm. It was attached to, but had not extended into, the coccyx (Fig. 2).

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INTRODUCTION

Nuchal-type fibroma is a rare, tumor-like pro­liferation originally described by Enzinger and Weiss. One case was also reported in Korean dermatologic literature. This process chiefly occurs in the dorsocervical area of adult patients, but may arise elsewhere in the subcutis. Affected patients’ ages mainly ranged from 25 and 60 years. This lesion may be seen as a firm fibrofatty mass, and it consists of hypocellular dense bundles of collagen with interspersed fat tissue, nerve fiber, etc. In early stage, nuchal-type fibromas were always reported on the posterior neck, therefore the term “nuchal fibroma” was picked up by authors. But, the term “nuchal-type fibroma” was proposed as the extranuchal lesions were also described. …Read the rest of this article

Most cases of port-wine stain (PWS) are congenital, but the acquired form of PWS has only recently been described. In 1939, Traub reported the first case of acquired port-wine stain (APWS). The average age of onset of APWS is usually after 1 year. M-any cases of acquired PWS have since been reported – , , but there has been little discussion about treatment. There have been only two reports investigating the efficacy of laser therapy in APWS. Dinehart et al found that APWS had generally a faster response to the PDL treatment than CPWS, however, they could not explain the exact mechanism because some patients responded rather poorly to laser treatment. Lanigan2 supposed that APWS’s telangiectatic nature, relatively sparse number and superficial site of ectatic vessels probably explained why the response was better than CPWS to laser therapy. Therefore, he concluded that patients with APWS could be expected to respond well to PDL therapy and fewer treatments were required than those patients with CPWS. But in these articles, only small numbers of patients were studied and the therapeutic results were not same in all patients with APWS. As for our experience of long pulsed dye laser in APWS therapy, the result was rather similar to that of Dinehart et al. The response to PDL in patients with APWS was controversial, so we undertook this study to find out whether there are some differences of histo- pathologic features of the two entities or not.

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In capillary malformations, there are two types: port-wine stain (PWS) and telangiectasia. PWS is one of the most common types of capillary malformation and occurs as pink to red macules or patches, usually on a unilateral side. The color of the lesion tends to gradually deepen with time. The lesion grows proportionately and becomes raised and nodular as a result. Although the initial nature is similar to PWS, fading macular stains, referred to as stork bite or salmon patch, are located most commonly on the nape of the neck, the eyelids, and the glabella and may disappear spontaneously between 1 and 3 years of age. In these cases, there is no need for treatment.

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