원저 : 융합성 망상 유두종증의 임상적 및 병리조직학적 관찰

Clinical and Histopathological Observation of Confluent and Reticulated Papillomatosis Ho Sun Jang, M.D., Doo Chan Moon, M.D., Kyung Sool Kwon, M.D., Tae Ahn Chung, M.D. Department of Dermatology, College of Medicine, Pusan National University, Pusan, Korea Confluent and reticulated papillomatosis is a rare but clinically distinct dermatosis of which the etiology is unknown. We observed the clinical and histopathological findings of 14 patients of confluent and reticulated papillomatosis who had visited Pusan National University Hospital, and studied mycologically Pityrosporum orbiculare. The results were as follows : 1. The mean age of onset was 17.7 Years and the most common site of initial involvement was epigastrium(57.1%), and the most common sites of involvement were abdomen(85.7%), and back(85.7%). 2. Positive KOH/Parker ink direct smears were observed in 9 cases, and they were treated with oral and topical antifungal agents. Six out of the patients were responsive to these treatment. 3. Skin biopsy was performed in 13 patients. The major histologic features were hyperkeratosis, focal acanthosis, papillomatosis, parakeratosis, slight atrophy of stratum malpighiii, decreased granualr cell layer, hypermelanosis of basal cell layer, and slight perivascular infiltrate of mononuclear cells. Periodic acid-Schiff stain showed Pityrosporum orbiculare yeasts in the stratum corneum in 7 cases. 4. The cultrued Pityrosporum orbiculare colonies were inoculated on the inner ear surface of 5 rabbits, and one week after inoculation, thick yellowish scaly crusts were seen in 3 of 5 rabbits. Therefore, we believe that Pityrosporum orbiculare may play an important role in the pathogenesis of confluent and reticulated papillomatosis. (Kor J Dermatol 29(4) : 471-480, 1991)