Dermatologic complications attributed to BCG vaccination are rarely seen. We report a case of widespread skin tuberculosis following BCG vaccination. A 28-year old female visited our outpatient clinic because of erythematous plaques and atrophic patches on the upper chest, both axillae, neck and frontal scalp. Her skin lesion had developed on the right shoulder after BCG vaccination.18 years ago, and gradually extended. She was treated under the impression of psoriasis at private clinic for recent 2 years, but her skin lesions were aggravated. Tuberculin skin test revealed positive reaction. Histopathologic examinations from scalp, posterior neck and axilla revealed granulomatous structures composed of giant cells, epithelioid cells and lymphoid cells in the dermis, but tubercle bacilli were not found in AFB stain. After 9 months of treatment with antituberculous medications such as streptomycin, isoniazid, rifampin and ethambutol, her skin lesions were almost healed.
Ambulatory Care Facilities ; Axilla ; Dermis ; Epithelioid Cells ; Ethambutol ; Female ; Giant Cells ; Humans ; Isoniazid ; Lymphocytes ; Mycobacterium bovis* ; Neck ; Psoriasis ; Rifampin ; Scalp ; Shoulder ; Skin Tests ; Skin* ; Streptomycin ; Thorax ; Tuberculin ; Tuberculosis, Cutaneous* ; Vaccination*

BACKGROUND: Alopecia totalis and alopecia universalis are uncomman and developed from 5-10% of the patients with alopecia areata. OBJECTIVE: The authors perfcirmed a study for clinical obervations and the effects of treatments of alopecia totalis and alopecia universalis in order that this study may cointribute to further studies and treatments of them. MEHTODS: The author performed a clinical study of 42 patients with alopecia totalis and alopecia universalis retrospectively in order to evaluate the clinical manifestation. and the effects of treatments from January 1984 to March 1992 at the department of Dermatology, College of Medicine, Chung Ang University. RESULTS: 1. The incidence of alopecia totalis and alopecia universalis was 6.7% (42/623) among the alopecia patients who were occtipied 1.4% (623/44,839) among the all new dermatologic out patients. 2. The age distributions at the onset of disease showed a peak incidenced an age of less than 15 years (52.4%, 22/42) and the average age was 19.7 years. 3. The laboratory fi ndings showed decreased total T cell count in 1 case(1/10), inversed T/T ratio in 6 cases(6/10), poisitive anti-thyroglobulin anti-body in 3 cases(3/11), and abnormal serum levels of testosterone, esradiol and progesterone in 5 cases(5/22), 2 cases(2/14) and 8 cases(8/13), respectively. 4. The effects in the group treated with topical immunotherapy with DPCP(2,3-diphenylcyclopropenone) or DI CB(2,4-dinitrochlorobenzene) revealed no significant difference from those in the group treated with an intralesional injection of triamcinolone acetonide. 5. The response rates to treatment were make ily higher in the patients with alopecia totalis than alopecia uriiversalis, in cases where the duration of disease was less than 5 years, and in the patients associated with psychologic stress. CONCLUSION: These results suggested that alopecia totalis and alopepia aniversalis frequently occur in children, and some of them we eassociated with cell mediated immunity defects, autoantibody and endocrine factors. The patients with alopecia totalis, with short duration if disease and associated with emotional stress showed better therapeutic responses.
Age Distribution ; Alopecia Areata ; Alopecia* ; Cell Count ; Child ; Dermatology ; Humans ; Immunity, Cellular ; Immunotherapy ; Incidence ; Injections, Intralesional ; Outpatients ; Progesterone ; Retrospective Studies ; Stress, Psychological ; Testosterone ; Triamcinolone Acetonide

No abstract available.
Dermatitis, Contact*

Osteoma cutis is a primary cutaneous ossification, which has no preceding trauma or skin disease and no evidence of Albrights hereditary osteodystrophy n the patient or his family. The lesion appears as hard, round to irregular, sharply defined tumor of varying size within the skin or subcutis, and color ranges from flesh-colored to purple or brown. We report herein a case of osteoma cutis in a 32-year-old female, who had a 1 x 1cm sized, asymptomatic, round, flesh colored, hard nodule on the right side of her forehead for 5 years. Histopathologic examination showed mature bone with many ostocytes, osteoblasts, cement lines and Haversian canals in the dermis.
Adult ; Dermis ; Female ; Forehead ; Haversian System ; Humans ; Osteoblasts ; Osteoma* ; Skin ; Skin Diseases

BACKGROUND: Herpes zoster is characterized by vesicular skin lesions over the unilateral sensory dermatomes being caused by the reactivation of varicella-zoster virus and its incidence seems to be increasing recently. OBJECTIVE: The purpose of this study was to elucidate the epidemiology and the clinical characteristics of herpes zoster. METHODS: The authors observed 877 cases of herpes zoster clinically for annual incidence, age, sex, monthly distribution, predilection site, associated disease, and complications at the Department of Dermatology in Chung-Ang University Hospital during a 10 years period(1982.9-1992.8). RESULTS: 1) The annual incidence averaged over 10 years was 2.26%(877 cases of total 38.717 outpatients) being on the increase recently. 2) The age distribution was in the range of 2-86 years old being most prevalent in the 6th decade and there was equal sex ratio(444:433). 3) There was no statistically significant monthly or seasonal variation in the incidence of herpes zoster. 4) The most common anatomical distribution was thoracic dermatome(51.7%), followed by trigeminal(17.1%), cervical(16.1%), lumbar (10.6%), sacral(1.4%)and multiple deramatomic involvement(3.1%). Left or right side was affected in about the same ratio(439:437), and bilateral involvement was in 1 case. 5) Associated disease of herpes zoster were observed in 210 patients(23.9%) ; hypertension(7.0%), diabetes mellitus(4.1%), tuberculosis(1.8%), postoperative status(0.7%), malignancy(0.7%), gastric ulcer(0.7%), and so on, 6) The most common complication of herpes zoster was postherpetic neuralgia(7.4%), followed by eye complication(2.1%), bacterial infection(1.4%), scar formation(0.7%), neurogenic bladder(0.2%), Ramsay-Hunt syndrome(0.2%), motor paralysis(0.1%), herpes zoster generalisatus(0.1%) 7) The incidence of postherpetic neuralgia increased with age and was highest in trigeminal dermatome. 8) Recurrence of herpes zoster was observed in 4 patients(0.5%). CONCLUSION: According to this study, the annual incidence of herpes zoster showed a tendency to increase recently but there was no significant monthly or seasonal variation. The anatomical distribution was most commom on the thoracic dermatome. The incidenc of postherpetic neuralgia increased with age being most common in trigeminal nerve.
Age Distribution ; Cicatrix ; Dermatology ; Epidemiology ; Herpes Zoster* ; Herpesvirus 3, Human ; Incidence ; Neuralgia, Postherpetic ; Recurrence ; Seasons ; Skin ; Trigeminal Nerve

No abstract available.
Tibial Fractures*

No abstract available.

Epidermal cysts slowly growing, intradermal or subcutaneous tumors that usually cease growing after having reached 1 to 5 cm in diameter. We report a case of giant epidermal cyst on the scapular region with the appearance of well delineated huge mass measured 19×17×14cm in size. Its clinical and surgical management are illustrated.
Epidermal Cyst

Mold form fungi such as Fusarium, Acremonium, and Sporothrix species are thought to represent contamination or harmless colonization when isolated from immunocompromised patients. More recently, the pathogenic role of these fungi has been clearly established. The role of implantable subcutaneous central catheters as potential portals of entry for mold form fungus has been underestimated. We describe four cases of implantable subcutaneous central catheter- related mold form fungemia in patients with cancer. One patient responded well only after removal of the implantable subcutaneous central catheter, two patients responded after catheter-removal and IV fluconazole but one patient did not in spite of catheter-removal and amphotericin B.
Acremonium ; Amphotericin B ; Catheters ; Central Venous Catheters* ; Colon ; Fluconazole ; Fungemia* ; Fungi ; Fusarium ; Humans ; Immunocompromised Host ; Sporothrix

PURPOSE: Recently implant surgical guides were used for accurate and atraumatic operation. In this study, the accuracy of two different types of surgical guides, positioning device fabricated and stereolithography fabricated surgical guides, were evaluated in four different types of tooth loss models. MATERIALS AND METHODS: Surgical guides were fabricated with stereolithography and positioning device respectively. Implants were placed on 40 models using the two different types of surgical guides. The fitness of the surgical guides was evaluated by measuring the gap between the surgical guide and the model. The accuracy of surgical guide was evaluated on a pre- and post-surgical CT image fusion. RESULTS: The gap between the surgical guide and the model was 1.4 +/- 0.3 mm and 0.4 +/- 0.3 mm for the stereolithography and positioning device surgical guide, respectively. The stereolithography showed mesiodistal angular deviation of 3.9 +/- 1.6degrees, buccolingual angular deviation of 2.7 +/- 1.5degrees and vertical deviation of 1.9 +/- 0.9 mm, whereas the positioning device showed mesiodistal angular deviation of 0.7 +/- 0.3degrees, buccolingual angular deviation of 0.3 +/- 0.2degrees and vertical deviation of 0.4 +/- 0.2 mm. The differences were statistically significant between the two groups (P<.05). CONCLUSION: The laboratory fabricated surgical guides using a positioning device allow implant placement more accurately than the stereolithography surgical guides in dental clinic.
Dental Clinics ; Surgery, Computer-Assisted ; Tooth Loss