A 69-year-old man presented with annular lichen planus involving both forearms, hand dorsa, wrists, inner sides of the thighs, knees and ankles. He was treated initially with systemic corticosteroids and etretinate, but rernission and recurr ence of the skin lesions were observed. During the follow-up, we found erythrasma on all his toewebs and both soles. After administration of erythromycin for the treatment of erythrasma, lesions of the lichen planus rapidly improved. Five months later, some lesions of lihen planus and erythrasma had recurred. After administration of erythromycin, the lesions of lichen planus improved again. No recurrence was observed for the following 8 months. We suspect that eradication of the chronic focus of infection and the anti-inflammatory effect, of erythromycin may lead to supression of abnormal immunological reactions and resolution of lichen planus.
Acitretin ; Adrenal Cortex Hormones ; Aged ; Ankle ; Erythrasma ; Erythromycin* ; Etretinate ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Knee ; Lichen Planus* ; Lichens* ; Recurrence ; Skin ; Thigh ; Wrist

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

No abstract available.
Gas Chromatography-Mass Spectrometry* ; Mass Screening* ; Neuroblastoma*

BACKGROUND: Mycosis fungoides(MF) is a form of cutaneous T cell lymphoma with clonal differentiation of helpr' T cell. It has a patch, plaque, and tumor stage. But pathogenetic factors controlling the development and progression of MF are still unclear. Apoptosis plays a major role in developmental biology and homeostasis. The bcl-2 oncogene prolongs ce11 life by inhibiting apoptosis. The mutant pS3 gene induces apoptosis indirectly. Ki-67 antigen is the cell proliferation marker. Recently, it has been shown that the relationships among them are important in the tumorigenesis of the various tumors. OBJECTIVE: The aim of this study was to examine the expression of these genes and apoptotic rate and clarify the relationship among them in the development and progression of MF. METHODS: The eighteen specimens from 8 patients with MF and 10 specimens from benign lymphocytic infiltrating diseases including 5 lichen planus, 3 lupus erythematosus, and 2 contact dermatitis were included. We performed immunoperoxidase staining(LSAB technique) using monoclonal antibodies including bc1-2, p~53, and Ki-67(MIB1). We used ApoptaqTM(Oncor) in situ labelling kit for detecting apoptotic cell.
Antibodies, Monoclonal ; Apoptosis* ; Carcinogenesis ; Cell Proliferation ; Dermatitis, Contact ; Developmental Biology ; Homeostasis ; Humans ; Ki-67 Antigen ; Lichen Planus ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides* ; Oncogenes

OBJECTIVES: The objective of this study was to investigate the relationship between perceived stress and coping strategies in 138 patients with coronary artery diseases. METHODS: Global assessment of recent stress(GARS) scale and perceived stress response inventory(PSRI) were used to measure perception for stressors and stress responses. Coping scale was used to measure coping strategies. RESULTS: Scores of perceived stress related to work, job, interpersonal area, changes in relationship, sickness or injury, financial area, and overall global areas showed significant positive correlations with escape-avoidance. Also scores of perceived stress related to sickness or injury, financial problems, overall global areas showed significant correlations with accepting responsibility. Scores related to financial area showed significant positive correlation with planful problem solving and positive reappraisal. Escape-avoidance had a significantly positive correlation with negative emotional response, lowered cognitive function and general negative thinking, self-depreciative thinking, impulsiveaggressive thinking, general somatic symptoms, specific somatic symptoms, passive-responsive careless behavior and impulsive-aggressive behavior. Distancing had a significantly positive correlation with negative emotional response, lowered cognitive function and general negative thinking, general somatic symptoms and passive-responsive careless behavior. Confrontive coping, self-control, seeking social support, accepting responsibility, planful problem solving, and positive reappraisal were more frequently used in men than in women. Education had a significantly positive correlation with confrontive coping, self-control, seeking social support, accepting responsibility, planful problem solving, and positive reappraisal. CONCLUSION: The above results suggest that coping strategies of patients with coronary artery disease may be affected by types of perceived stressors, sex, and level of education, and that escapeavoidance and distancing may be the most ineffective coping strategies used in these patients.
Coronary Artery Disease* ; Coronary Vessels* ; Education ; Female ; Humans ; Male ; Problem Solving ; Thinking

Objectives: Skin cancer is a prevalent type of malignancy, necessitating efficient diagnostic tools. This study aimed to develop an automated skin lesion classification model using the dynamically expandable representation (DER) incremental learning algorithm. This algorithm adapts to new data and expands its classification capabilities, with the goal of creating a scalable and efficient system for diagnosing skin cancer. Methods: The DER model with incremental learning was applied to the HAM10000 and ISIC 2019 datasets. Validation involved two steps: initially, training and evaluating the HAM10000 dataset against a fixed ResNet-50; subsequently, performing external validation of the trained model using the ISIC 2019 dataset. The model’s performance was assessed using precision, recall, the F1-score, and area under the precision-recall curve. Results: The developed skin lesion classification model demonstrated high accuracy and reliability across various types of skin lesions, achieving a weighted-average precision, recall, and F1-score of 0.918, 0.808, and 0.847, respectively. The model’s discrimination performance was reflected in an average area under the curve (AUC) value of 0.943. Further external validation with the ISIC 2019 dataset confirmed the model’s effectiveness, as shown by an AUC of 0.911. Conclusions This study presents an optimized skin lesion classification model based on the DER algorithm, which shows high performance in disease classification with the potential to expand its classification range. The model demonstrated robust results in external validation, indicating its adaptability to new disease classes.

Chromosomal abnormalities are higher in twin gestations than in the singleton population. Turner's syndrome(gonadal dysgenesis) variety may result from chromosome loss during gametogenesis in either parent or a mitotic error during one of the early cleavage divisions of the fertilized zygote. The vast majority of 45, XO conceptions result in first or second-trimester miscarriage. Fetuses with Tumer's syndrome commonly exhibit posterior nuchal cystic hygromas and generalized edema. Recently we experienced one fetal demise in twin pregnancy. The affected fetus was associated with Turner's syndrome which was diagnosed by amniocentesis and karyotyping. The fetus was associated with cystic hygroma which was antenatally diagnosed by ultrasonogram. The unaffected fetus had normal karyotype and was delivered through cesarean section without any abnormalities. we report this case with brief review of literatures.
Abortion, Spontaneous ; Amniocentesis ; Cesarean Section ; Chromosome Aberrations ; Edema ; Female ; Fertilization ; Fetus ; Gametogenesis ; Humans ; Karyotype ; Karyotyping ; Lymphangioma, Cystic ; Parents ; Pregnancy ; Pregnancy, Twin* ; Turner Syndrome ; Ultrasonography ; Zygote

BACKGROUND: Caudal block is useful when anesthesia for surgery or treatment for chronic pain is needed, but this procedure has a failure rate of up to 25% even when it performed byan experienced physician. This high failure rate is usually due to improper needle placement. METHODS: After gaining approval of the ethics committee, 46 patients received caudal blocks under ultrasound guidance; these were performed after the anatomical structures in the sacral hiatus had been measured with ultrasound. All these procedures were performed by the same anesthesiologist. The position and direction of the needle were identified using fluoroscopy by injecting a radio-opaque contrast through the needle. The time taken from thelidocaine injection to verification of the needle was measured and the planned nerve block was then carried out. RESULTS: All cases of needle insertion into the sacral canal under ultrasound guidance were successful. The average duration of the procedure and the trial count were 134.1 +/- 10.1 seconds and 1.2 +/- 0.1, respectively. In 12 of the 46 cases (26%), the needle deviated either left or right in the sacral canal, so the direction of the needle had to be adjusted. The distance between two cornua, the depth of the sacral hiatus and the thickness and length of the sacrococcygeal ligament were 17.1 +/- 0.4, 3.9 +/- 0.3, 2.3 +/- 0.1 and 24.9 +/- 0.9 mm, respectively. CONCLUSIONS: Ultrasound guidance can increase the success rate of inserting a needle into the sacral canal. However, even when ultrasound is used, the needle can deviate either left or right in the sacral canal.
Anesthesia ; Chronic Pain ; Ethics Committees ; Fluoroscopy ; Humans ; Ligaments ; Needles* ; Nerve Block ; Ultrasonography*

Kerion celsi is an inflammatory type of tinea capitis, which occurs chiefly in children between the ages of 4 and 14 years. We report a case of kerion celsi caused by Trichophyton(T.) mentagrophytes in 69 year-old man, who showed a 8x8 cm sized, erythematous boggy mass with pustules and crusts on the right occipital scalp. Cultures from scalp lesion and infected hair on Sabouraud dextrose agar media showed T. mentagrophytes. Histopathologic findings showed inflammatory cell infiltration in entire dermis and many spores around the hair shaft. The skin lesion was successfully treated with terbinafine (250 mg/ day) for 8 weeks. This case is reported with three interesting facts: Kerion celsi caused by T. mentagrophytes has been rarely reported in Korean literatures; Kerion celsi is occuring in an aged man with decreased cellular immunity after chemotherapy; Kerion celsi caused by T. mentagrophytes responded well to oral terbinafine.
Agar ; Aged ; Child ; Dermis ; Drug Therapy ; Glucose ; Hair ; Humans ; Immunity, Cellular ; Scalp ; Skin ; Spores ; Tinea Capitis* ; Trichophyton*

BACKGROUND: The skin over the lower one third of the nose is less mobile and cannot be easily recruited for the closure of even small defects. In addition, the texture and color of the nose are so unique that neither distant nor nearby skin can always provide a good match. Therefore, when we reconstruct the surgical defect of lower one third of the nose, we must consider the reconstruction method, defect site or size, recurrence of the lesion such as basal cell carcinoma, patient age, general health state, and functional and cosmetic aspects. The bilobed flap is a useful tool for reconstruction of the nose but is occasionally complicated by pincushioning effect or trapdoor deformity. OBJECTIVE: The propose of this study was to evaluate the usefulness of a geometric design of bilobed flap for use in reconstructing defect on the lower one third of the nose. METHODS: From Februrary 1999 to March 2001, we reconstructed defects on the lower one third of the nose after Mohs surgery of basal cell carcinoma in 6 patients using the geometrical design of bilobed flap. Patients were reviewed for complications and cosmetic results. RESULTS: Cosmetically acceptable results were seen in all patients. Significant pincushioning and trapdoor deformity were not presented postoperatively in any patients. CONCLUSION: The geometrical design of bilobed flap is an excellent choice for reconstruction of defects of the lower one third of the nose, particularly around the nasal tip, because of the good skin match and low incidence of complication.
Carcinoma, Basal Cell* ; Congenital Abnormalities ; Humans ; Incidence ; Mohs Surgery* ; Nose* ; Recurrence ; Skin