Dermal melanocytosis is characterized by the presence of ectopic melanocytes in the dermis. The most common forms include the Mongolian spot, blue nevus, nevus of Ota, and nevus of Ito. Some types of dermal melanocytosis do not fit into any of these morphologic categories, however. Our case demonstrated an extensive amount of uniform deep blue patches of nevi with unilateral distribution on the left face, neck, chest, shoulder, and back. On histopathologic examination, a number of elongated melanocytes scattered throughout the dermis were found. We herein report a case of congenital unilateral dermal melanocytosis.
Dermis ; Melanocytes ; Mongolian Spot ; Neck ; Nevus ; Nevus of Ota ; Nevus, Blue ; Shoulder ; Thorax

Psoriasis is considered to be an autoimmune disease of abnormal keratinocyte proliferation induced by T lymphocytes. An association with several cytokines has been suggested. Interferon (IFN) is a cytokine secreted by virus-infected cells and has the ability to prevent further infection of cells that were exposed to it. It has therefore been used as a therapeutic agent for many chronic viral diseases such as chronic hepatitis C. Recently, however, IFN has also been considered to be a triggering factor in the development of psoriasis. We describe an 18-year-old woman presenting with guttate psoriasis, who suffered soft tissue sarcoma and underwent chemotherapy containing IFN-alpha. This is possibly the first case of guttate psoriasis associated with IFN-alpha in the Korean literature.
Female ; Humans

Dyschromatosis universalis hereditaria is a rare pigmentary disorder that's characterized by the presence of both small and irregular sized hyperpigmented and hypopigmented macules in a generalized distribution. The pattern of inheritance is thought to be autosomal dominant, but some sporadic and autosomal recessive inheritance cases have also been reported. We report here on a case of a-15-year old female patient with dyschromatosis universalis hereditaria, which is compatible with autosomal dominant inheritance. The patient presented with numerous small and irregularly sized hyper-and hypopigmented macules on her face, trunk and both the arms and legs, but not on the palms and soles. By analysis of her familial pedigree, we found an autosomal dominant pattern of inheritance. The biopsy specimen taken from the hyperpigmented macules showed increased melanin granules and pigmentation in the basal cell layer of the epidermis. Various therapeutic trials have been introduced to treat these lesions, but there have been few reports of simple effective treatments for the hyper-and hypopigmented lesions. So, we tried treating the hyperpigmented macules with a Q-switched Nd:YAG laser and we obtained a successful result.
Arm ; Biopsy ; Epidermis ; Female ; Humans ; Hyperpigmentation ; Leg ; Melanins ; Pedigree ; Pigmentation ; Pigmentation Disorders ; Skin Diseases, Genetic ; Wills

Pyoderma gangrenosum is a rare destructive inflammatory skin disease. The lower extremities are most commonly affected, but the head and neck are rarely affected. We call the cases in which the head and neck are involved malignant pyoderma, which could be lethal. We report here on a case of malignant pyoderma in a 66-year-old man. His condition was markedly aggravatedin spite of the medical treatment. The lesions were improved by adjuvant surgery, including aggressive ulcer excision and grafting of autologous skin.
Aged ; Head ; Humans ; Lower Extremity ; Neck ; Pyoderma ; Pyoderma Gangrenosum ; Skin Diseases ; Transplants ; Ulcer

Nevus sebaceous (NS) is a congenital hamartomatous disorder of the skin and its adnexa, usually involving the scalp or the face. It characteristically evolves and changes morphology with time. Various benign and malignant neoplasms can develop in association with NS. Most common benign or malignant tumors developed within the NS are syringocystadenoma papilliferum and trichoblastoma or basal cell epithelioma. We now report a case of NS associated with sebaceous adenoma, basal cell epithelioma, and eccrine poroma in a 63 year old male.
Adenoma ; Carcinoma ; Carcinoma, Basal Cell ; Humans ; Male ; Nevus ; Poroma ; Scalp ; Skin

Nevus sebaceous (NS) is a congenital hamartomatous disorder of the skin and its adnexa, usually involving the scalp or the face. It characteristically evolves and changes morphology with time. Various benign and malignant neoplasms can develop in association with NS. Most common benign or malignant tumors developed within the NS are syringocystadenoma papilliferum and trichoblastoma or basal cell epithelioma. We now report a case of NS associated with sebaceous adenoma, basal cell epithelioma, and eccrine poroma in a 63 year old male.
Adenoma ; Carcinoma ; Carcinoma, Basal Cell ; Humans ; Male ; Nevus ; Poroma ; Scalp ; Skin

OBJECTIVE: To evaluate the causes, methods of delivery, and maternal complications in cases of fetal death in utero(FDIU) at Samsung Medical Center. METHODS: There were 92 cases of FDIU among 25,195 deliveries at Samsung Medical Center during 7 years from 1994 to 2001. In these cases, perinatal autopsy and placental biopsy was performed in 35 and 71 cases, respectively. All the clinical informations were obtained by reviewing medical records retrospectively. RESULTS: The overall incidence of FDIU was 0.37%. Most of FDIU occurred in 25 to 29 years old group(43.5%). Recurrence rate of FDIU was 3.3%. Most of FDIU were low birth weight(79.3%) and preterm(79.6%). The modes of delivery were induced labor(68.5%), laparotomy(18.5%), and the spontaneous delivery(13.0%). The causes of FDIU were chorioamnionitis(15.2%), placental abruption(14.1%), severe preeclampsia(11.9%), congenital and chromosomal anomaly(6.5%), but it was unexplained in 27.2%. There were 25 cases with maternal complications and the most common complications were intra-/postpartum fever(18.5%), postpartum hemorrhage(8.7%) and DIC(8.7%). CONCLUSION: The causes of FDIU could not be determined in only about 1/4 cases at Samsung Medical Center. Since FDIU recurred in 3.3%, thorough studies including perinatal autopsy and chromosomal study must be made on stillborn infants and placenta to determine the recurrent causes.
Adult ; Autopsy ; Biopsy ; Fetal Death* ; Humans ; Incidence ; Infant ; Medical Records ; Parturition ; Placenta ; Postpartum Period ; Recurrence ; Retrospective Studies

OBJECTIVE: The purpose of this study was to evaluate the perinatal outcomes in pregnancies complicated by preterm premature rupture of membranes (PROM) during the second trimester. METHODS: Thirty-two consecutive pregnancies with PROM at 20-28 weeks of gestation were studied retrospectively. The goals of management were to prolong the pregnancies to 32 weeks through active expectant management and to avoid fetal compromise through close monitoring and active intervention. All medical records of mothers and neonates were reviewed. RESULTS: Total 30 pregnant women with rupture of membranes at 20-28 weeks were included. Rupture of membranes occurred at 20-25 weeks(mean 24.2) in 14 women and at 26-28 weeks(mean 27.2) in 16 women. The median latency periods to delivery were 309 hours and 234 hours when rupture of membranes occurred at 20-25 weeks and at 26-28 weeks, respectively. Overall incidences of clinical and histologic chorioamnionitis were 10% and 72%. There were no fetal deaths and 8 neontal deaths. When rupture of membranes occurred at 20-25 weeks and at 26-28 weeks, the perinatal survival rates were 50% and 94%, respectively. CONCLUSION: Active expectant management of second-trimester PROM offers better perinatal survival than previously thought.
Chorioamnionitis ; Female ; Fetal Death ; Humans ; Incidence ; Infant, Newborn ; Latency Period (Psychology) ; Medical Records ; Membranes* ; Mothers ; Pregnancy ; Pregnancy Trimester, Second ; Pregnant Women ; Retrospective Studies ; Rupture* ; Survival Rate

OBJECTIVE: To determine the clinical value of human papillomavirus deoxyribonucleic acid(HPV DNA) testing by polymerase chain reaction(PCR), specifically to examine whether HPV testing could identify the women with Pap smears read as mostly atypical squamous cells of undetermined significance(ASCUS) or more. METHODS: HPV DNA testing by PCR for 3 high-risk cancer associated genotypes(HPV 16, 18, 33), repeat Pap smears and colposcopically directed punch biopsies were performed concurrently on 169 women referred for cervical cancer screening test with a previous Pap smear read as ASCUS or more. RESULTS: HPV DNA testing positivity was significantly associated with abnormal cytology and high-grade squamous intraepithelial lesion(HSIL) and squamous cell carcinoma(SCC) in histology(P=0.034). The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) of Pap smear and HPV testing for identifying 38 cases of histologically confirmed HSIL and carcinoma by different triage protocols(HPV positive or HSIL or SCC) among 169 women were 65.8%(25/38), 85.5%(112/131), 56.8%(25/44) and 89.6%(112/125), respectively. Also sensitivity, specificity, PPV and NPV were varied by ages and more higher in older. CONCLUSION: HPV DNA testing by PCR appears to offer an effective means by which women whose cervical Pap smears have been read as ASCUS or more could be triaged for colposcopically directed biopsy. The sensitivity for HSIL could be maintained in high and specificity markedly improved by HPV genotypes 16, 18, 33.
Biopsy ; Chromosome Aberrations* ; Female ; Genotype ; Human Papillomavirus DNA Tests ; Humans ; Mass Screening ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Triage ; Uterine Cervical Neoplasms

BACKGROUND: Intravenous recombinant tissue plasminogen activator (r-tPA) infusion is the only established treatment for acute ischemic stroke so far. We explored whether the demonstrated efficacy of r-tPA could be applied to communi-ty-based hospitals in Korea and whether the immediate improvements after r-tPA infusion had any predicting value for long-term outcomes. METHODS:Twenty-six patients (mean age, 69; 46% female) with acute ischemic stroke were treated with r-tPA, abiding by the National Institute of Neurological Disorders and Stroke (NINDS) protocol. The Neurological status was measured with the National Institutes of Health Stroke Scale (NIHSS) at baseline, at 1 hour after r-tPA , at 24 hours, and at 7 days and the functional outcome was evaluated with the modified Rankin scale (mRS) and Barthel Index at 90 days after stroke. RESULTS: Of 26 patients, 16 (62%) made full recovery or became independent, 4 (15%) had severe physical disability, and 6 (23%) patients died. Three patients (11.5%) had intracranial hemorrhage (asymptomatic, 2; symptomatic, 1). There were no significant differences in age, sex, risk factors, baseline NIHSS scores, hemorrhagic complication, initial brain CT abnormalities, and onset to needle time between good (full recovery or mRS 0-2) and poor groups (mRS 3-5 or death) at day 90, except for the improvement of NIHSS examined at 1 hour after r-tPA (repeated measured ANOVA test, p<0.01). CONCLUSIONS The NINDS r-tPA protocol is feasible in the community-based hospitals in Korea with the safety and efficacy comparable to the results of NINDS r-tPA trials. In addition, we suggest that the immediate neurological improvement after r-tPA be a predictor for favorable long-term outcomes. (J Korean Neurol Assoc 19(4):364~369, 2001)
Brain ; Cerebral Infarction ; Humans ; Intracranial Hemorrhages ; Korea ; National Institute of Neurological Disorders and Stroke ; National Institutes of Health (U.S.) ; Needles ; Risk Factors ; Stroke* ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; Treatment Outcome