No abstract available.
Free Tissue Flaps* ; Head* ; Neck*

Plexiform neurofibroma is considered to be pathognomic of neurofibromatosis type 1 (NF1). Herein we report a solitary plexiform neurofibroma which is not associated with NF1. A 61-year-old man presented with asymptomatic skin colored nodules on the medial side of his left great toe. No other abnormalities were found in his personal or family history. Clinically, the tumor was simulating the appearance of mucous cysts. Microscopically,it was a plexiform neurofibroma located in the dermis which seemed to originate from small superficial nerves. This case would seem to confirm that the superficial form of plexiform neurofibroma involving small nerves in the dermis or subcutis is not necessarily pathognomic for NF1.
Dermis ; Humans ; Middle Aged ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Skin ; Toes

BACKGROUND: TSH receptor blocking antibody (TRBAb) is a pathogenic factor in the vast majority of patients with primary myxedema. It has been reported that TRBAbs are found in some patients with chronic goitrous autoimmune thyroiditis (Hashimoto's thyroiditis), but the significance or the role of TRBAb in Hashimotos thyroiditis is not clear, We recently reported that hTSHR-CHO cells which express the functional human TSH receptors are more sensitive and are better in detecting functional TSH receptor antibodies in Graves patients than FRTL-5 cells. We are to investigate the biological role of TRBAb in Hashimotos thyroiditis by measuring thyroid stimulation blocking antibody (TSBAb) activities of Hashimoto's IgG's using hTSHR-CHO cells. Moreover, we are to see if there is any difference in epitope recognition between Hashimotos TRBAb and myxedema's TRBAb by measuring TSBAb activities with mutant receptor expressing cell lines, Mcl+2 and Mc 2 in those patients. METHOD: We measured TSBAb activities of IgGs from patients with primary myxedema (PM, n= 10) and those with hypothyroid (n 20) or euthyroid (n 17) Hashimoto's thyroiditis (HT) using wild type hTSHR-CHO cells (WT) and two chimeric receptor expressing cell lines, Mcl+2 and Mc2. RESULTS: TSBAb activities measured by WT were higher in hypothyroid HT than in euthyroid HT (30.0+-23.2% vs. 6.1+-28.7, p<0.05), and TSBAb-positive rate tend to be higher in the former (20%, 5/20) than in the latter (0%, 0/17, p=0.07). TRBAbs from PM (n=4) had high TBII activities and had persistent blocking activities despite of the replacement of amino acid residue 8~165 of extracellular domain of TSHR with those of rat LH/CGR (Mcl +2). However, TRBAbs from HT (n=4) had no TBII activity at all and lost blocking activities when measured with Mcl+2. CONCLUSION: TRBAbs are found in 20% of hypothyroid patients with Hashimotos thyroiditis in assay using hTSHR-CHO cells, and they seem to play a role in the development of hypothyroidism in some patients with Hashimotos thyroiditis. TRBAbs of Hashimotos thyroiditis are different in epitope recognition from TRBAbs of primary myxedema.
Animals ; Antibodies* ; Cell Line ; Humans ; Hypothyroidism ; Immunoglobulin G ; Myxedema ; Rats ; Receptors, Thyrotropin* ; Thyroid Gland* ; Thyroiditis* ; Thyroiditis, Autoimmune

BCG (Bacillus Calmette-Guerin), which produces resistance to tuberculosis infection, is a vaccine containing live, attenuated Mycobacterium bovis. It induces specific and nonspecific dermatologic complications. The specific reactions include scrofuloderma-like, lupus vulgaris-like, lichen nitidus-like, lymphadenitis and tuberculid. We report a case of papular tuberculid, which was presented as 3-5mm sized erythematous papules on the extremities and face, and BCGitis had developed around the vaccination site after BCG vaccination. Histopathologic examination of the papule and lymph node showed granuloma, consisting of epithelioid cells and lymphocytes.
Epithelioid Cells ; Extremities ; Granuloma ; Lichens ; Lymph Nodes ; Lymphadenitis ; Lymphocytes ; Mycobacterium bovis* ; Tuberculosis ; Tuberculosis, Cutaneous* ; Vaccination*

We report a case of bilateral chondrodermatitis nodularis chronica helicis, on both helices, in a 60-year-old male patient. He presented with a 1-year history of two tender, firm, dark-brownish, 0.4x0.4cm-sized nodules with central ulceration on both helices. He had no history of trauma. A punch biopsy specimen taken from the nodule revealed central ulceration, hyperkeratosis, and irregular acanthosis of the epidermis. Within the dermis, there was inflammatory cell infiltration, dilatation and proliferation of vessels, and some eosinophilic collagen degeneration associated with degenerative cartilage. Based on these clinical and histologic findings, we diagnosed this as a rare case of bilateral chondrodermatitis nodularis chronica helicis occurring on both helices. We treated the lesions with intralesional steroid injections.
Biopsy ; Cartilage ; Collagen ; Dermis ; Dilatation ; Eosinophils ; Epidermis ; Humans ; Male ; Middle Aged ; Ulcer

Calcinosis cutis is the abnormal deposition of calcium phosphate into the skin. It is classified as dystrophic if the calcium is deposited in previously damaged tissue, and serum calcium and phosphorous levels are normal. We report a case of symmetric dystrophic calcinosis cutis on the both proximal arms of a 77-year-old woman who received a subcutaneous injection at each arm 30 years ago.
Aged ; Arm ; Calcinosis* ; Calcium ; Female ; Humans ; Injections, Subcutaneous* ; Skin

Cutaneous gnathostomiasis has also been called larva migrans profundus and nodular migratory eosinophilic panniculitis. Human gnathostomiasis is caused mainly by the nematode Gnathostoma spinigerum. It causes migratory cutaneous, erythematous, indurated plaques and serious visceral sequelae. Medical treatment with mebendazole, albendazole, and ivermectin has been disappointing. Surgical excision of the parasite is the treatment of choice when possible.
Albendazole ; Eosinophils ; Gnathostoma ; Gnathostomiasis* ; Humans* ; Ivermectin* ; Larva Migrans ; Mebendazole ; Panniculitis ; Parasites

To test the hypothesis that hyperinsulinemia and/or abnormalities of red cell membrane Na^+ transport are concerned in the pathogenesis of hypertension, we investigated the relationship between blood pressure, insulin level and red cell membrane Na^+ transport in patients with acromegaly which is frequently associated with hypertension, hyperinsulinemia and abnormalities of red cell membrane Na^+ transport.The results were as follows;1) BMI and both systolic and diastolic blood pressure were significantly higher in patients with acromegaly than in control subjects.2) Fasting glucose and insulin levels were higher, and both serum glucose and insulin responses after a 75g glucose load were significantly increased in patients with acromegaly as compared with control subjects.3) Vmax of Na^+-Li^+ countertransport were significantly higher in patients with acromegaly than in control subjects while red cell Na^+ concentration and Vmax of Na^+, K^+ ATPase were similar in the two groups.4) In multiple stepwise regression analysis, age was directly correlated with both systolic and diastolic blood pressure in acromegaly. On the other hand both insulin level and red cell membrane Na^+ transport showed little correlation with either systolic or diastolic pressure. 5) Prevalence of hypertension in acromegaly was 39%(9 out of 23) and only age except for blood pressure was significantly higher in hypertensive acromegalic patients than in normotensive acromegalic patients while GH level, insulin levels and red cell membrane Na^+ transport were similar in the two groupsThese results suggest that hyperinsulinemia or abnormalities of red cell membrane Na^+ transport are not causally related to hypertension in patients with acromegaly.
Acromegaly ; Adenosine Triphosphatases ; Blood Glucose ; Blood Pressure ; Cell Membrane ; Fasting ; Glucose ; Hand ; Humans ; Hyperinsulinism ; Hypertension ; Insulin ; Prevalence

We report a case of solitary vellus hair cyst on the forehead in a 48 year-old, female patient. She had an asymptomatic, solitary, bluish, 0.3x0.3cm sized papule on the forehead for 1 year. There was no family history of similar lesions. A punch biopsy specimen taken from the papule revealed a cystic structure in the dermis lined by squamous cell epithelium which contained laminated keratinous material and vellus hairs. Based on this histologic finding, we diagnosed this case as solitary vellus hair cyst occurring on the unusual site of the forehead.
Biopsy ; Dermis ; Epithelium ; Female ; Forehead* ; Hair* ; Humans ; Middle Aged

Linear lichen planus, a variant of lichen planus, accounts for 0.24-0.62% of all patients with lichen planus. Clinically, it consists of itchy linearly distributed violaceous papules, usually lasts for more than 1 year and the mucous membranes may also be affected. This disorder shows the same histologic findings of lichen planus, which is characterized by a band like dermal inflammatory cell infiltration with hyperkeratosis, focal hypergranulosis, acanthosis, excytosis and the presence of Civatte body. We report a 66-year-old man showing typical clinical and histological features of linear lichen planus with pruritus.
Aged ; Humans ; Lichen Planus* ; Lichens* ; Mucous Membrane ; Pruritus