Tinea capitis is a fungal infection of the scalp and hair. It is very common in children and unusual in adults. We evaluated the clinical and mycologic aspects of tinea capitis in 6 adult patients registered in Kyunghee University Hospital from January 2003 to December 2003. The isolated dermatophytic flora of the patients consisted of Trichophyton rubrum (83%) and Microsporum canis (17%). When tinea capitis occurs in adults the clinical features may be atypical and this may delay the diagnosis. The necessity for heightened clinical suspicion and diagnostic tenacity in the evaluation of adults with scalp dermatitis and/or alopecia for possible tinea capitis is underscored.
Adult* ; Alopecia ; Child ; Dermatitis ; Diagnosis ; Hair ; Humans ; Microsporum ; Scalp ; Tinea Capitis* ; Tinea* ; Trichophyton

Only a few reports have focused on ocular motor paralysis in herpes zoster ophthalmicus. We report a case of ocular motor paralysis resulting from herpes zoster. The patient, an 80-yr-old woman, presented with grouped vesicles, papules, and crusting in the left temporal area and scalp, with diplopia, impaired gaze, and severe pain. Her cerebrospinal fluid analysis was positive for varicellar zoster virus IgM. Magnetic resonance imaging was performed to rule out other diseases causing diplopia; there were no specific findings other than old infarctions in the pons and basal ganglia. Therefore, she was diagnosed of abducens nerve palsy caused by herpes zoster ophthalmicus. After 5 days of systemic antiviral therapy, the skin lesions improved markedly, and the paralysis was cleared 7 weeks later without extra treatment.
Abducens Nerve Diseases/*complications/*diagnosis/therapy ; Acyclovir/*therapeutic use ; Aged, 80 and over ; Antiviral Agents/therapeutic use ; Female ; Herpes Zoster/*complications/*diagnosis/therapy ; Herpes Zoster Ophthalmicus/complications/diagnosis ; Humans ; Skin Diseases, Viral/complications/diagnosis/therapy ; Treatment Outcome

Kerion celsi is a highly inflammatory, supprative fungal infection of the scalp caused mainly by zoophilic dermatophytes transmitted from animals to man. We report a case of kerion celsi caused by Trichophyton (T.) mentagrophytes in 9 year-old male, who showed 10 x 9 cm and 2 x 1 cm sized, markedly inflammatory, boggy masses on the scalp and erythematous scaly patch on the philtrum. Cultures from a scalp lesion of the patient on Sabouraud glucose agar showed T. mentagrophytes. Treatment was done systemically with steroid and antifungal agents.
Agar ; Animals ; Antifungal Agents ; Arthrodermataceae ; Child ; Glucose ; Humans ; Lip ; Male ; Scalp ; Tinea Capitis* ; Trichophyton*

Castleman's disease, also known as angiofollicular lymphoid hyperplasia or giant lymph-node hyperplasia, is an unusual form of a lymphoproliferative disorder, and is divided clinically into a solitary and a multicentric form. The multicentric form of Castleman's disease is almost always of the plasma cell type. This can coexist with Kaposi's sarcoma in some cases. Kaposi's sarcoma is a multicentric, proliferative, vascular tumor involving cutaneous and visceral tissue. Iatrogenically-developed, immunosuppression-associated Kaposi's sarcoma is usually the result of immunosuppressive therapy. A 61-year-old man diagnosed as the plasma cell type of Castleman's disease, who had been treated with prednisolone for 2 years, was referred to the department of dermatology with numerous skin lesions consisting of confluent, violaceous-colored papules and plaques on his palm and soles. Histologic examination of the cutaneous lesions showed consistency with Kaposi's sarcoma. We report a rare case of Kaposi's sarcoma associated with multicentric Castleman's disease.
Dermatology ; Giant Lymph Node Hyperplasia* ; Herpesvirus 8, Human ; Humans ; Hyperplasia ; Lymphoproliferative Disorders ; Middle Aged ; Plasma Cells ; Prednisolone ; Sarcoma, Kaposi* ; Skin

Cutaneous larva migrans (CLM) is a rare serpiginous creeping eruption caused by accidental penetration and migration in the skin with a larval form of nematodes. It is caused by hookworm larvae, which are present in the feces of infected dogs and cats. Most cases of CLM in Korea have been shown to involve travelers returning from tropical areas or hot climates. We experienced four patients who had pruritic serpiginous linear eruptions on their skin after traveling to the endemic areas (Boracay island in Philippine). After treatment with albendazole, the skin lesions resolved with post-inflammatory hyperpigmentation. We report herein these four cases, together with a literature review of CLM cases in Korea.
Albendazole ; Ancylostomatoidea ; Animals ; Cats ; Climate ; Dogs ; Feces ; Humans ; Hyperpigmentation ; Korea ; Larva ; Larva Migrans* ; Philippines* ; Skin

PURPOSE: The symptoms of dizziness are common in the emergency department, accounting for 1~2% of all emergency department visits. Central vertigo, especially stroke is a leading concern when these symptoms occur in isolated condition. However, no method is available to discriminate isolated central vertigo from peripheral vertigo. The objectives of the present study were to evaluate the clinical usefulness of the simple prediction method of central vertigo among patients presenting with the symptoms of dizziness in the emergency department. METHODS: A three-year retrospective study with symptoms of dizziness was performed in a university teaching hospital between 1st January 2005 and 31st December 2007. Multivariate logistic regression analysis of all clinical parameters was performed for a model comprising 10 variables to form a St. Mary's dizziness prediction score. RESULTS: A total of 1058 patients were enrolled. Among central vertigo patients, 70 were ischemic stroke, 8 vertebrobasilar insufficiency, 3 hemorrhagic stroke and 1 had a brain tumor. The odds ratio of the predictor variables were (1) 2.13 for men, (2) 7.18 for disequilibrium, (3) 3.49 for headache, (4) 7.17 for falling tendency, (5) 2.96 for risk factor score 1, and (6) 8.71 for risk factor score 2. Each of these variables was assigned a score 1 or 2 to obtain a total of 8. The risk of central vertigo was 2.64%, 25.60%, and 84.21% for the low, intermediate, and high risk groups, respectively. CONCLUSION: St. Mary's dizziness prediction score is a simple and relatively reliable tool for accessing the symptoms of dizziness and diagnosing isolated central vertigo in the emergency department.
Accounting ; Brain Neoplasms ; Diagnosis, Differential ; Dizziness ; Emergencies ; Headache ; Hospitals, Teaching ; Humans ; Logistic Models ; Male ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Stroke ; Vertebrobasilar Insufficiency ; Vertigo

Transdermal drug delivery is applicable to only a few drugs because the stratum corneum is an excellent barrier to percutaneous absorption. Iontophoresis is a non-invasive technique which increases the drug deliveries into the skin through an electric current. In iontophoretic systems, the movement of ionized drugs is facilitated by electrical energy according to the basic electrical principles of "like charges repel each other and opposite charges attract". Iontophoresis has been explored for many dermatological applications with considerably successful reports. This article reviews the principles and advantages/limitations of iontophoresis, the factors affecting iontophoresis and its applications in various dermatological conditions.
Fees and Charges ; Iontophoresis ; Skin ; Skin Absorption

159 histologically proved cases of lung cancer have been reviewed at the Department of Internal Medicine, Yeungnam University Medical School for the past two years and six months from January, 1984 to July 1986. 1. The age distribution ranged from 27 to 87 years and 69.2% of the patient were distributed between the ages of 51 and 70. 2. The ratio of male and female was 4.6 : 1 (131 males, 28 females) 3. Chief complains were in order of dyspnea, chest pain, cough, hemoptysis and weight loss. 4. Localization on chest film. Right was more than left (right 58.6%, left 36.2%) and the most frequent site is right upper lung field (33 cases, 21.7%) 6. 76.8% of case was diagnosed histologically under the bronchoscopic biopsy. 8. The most common treatment was conservative therapy In general. However chemotherapy was most common treatment of the small cell type carcinoma.
Age Distribution ; Biopsy ; Chest Pain ; Clinical Study* ; Cough ; Drug Therapy ; Dyspnea ; Female ; Hemoptysis ; Humans ; Internal Medicine ; Lung Neoplasms* ; Lung* ; Male ; Schools, Medical ; Thorax ; Weight Loss

PURPOSE: This study was conducted to see the effect of alcohol ingestion on clinical features of acute drug intoxicated patients. METHODS: We prospectively investigated drug intoxicated patients who visited the emergency department 6 hours after acute poisoning from January 2004 to December 2007. Patients were classified into two groups according to serum alcohol levels: an alcohol group (serum alcohol level>10 mg/dl) and a non-alcohol group. The type of toxic material, age, sex, duration of time to arrive to the emergency department (ED) after poisoning, mean arterial pressure, respiratory rate, base excess level, AST level, serum creatinine level, cause of poisoning, suicide attempt, past psychiatric history, discharge against medical advice rate, and admission rate were checked. The initial and final Poisoning Severity Score (PSS), the Glasgow coma scale, the length of stay in the intensive care unit (ICU), the usage of a mechanical ventilator, and death rate were also checked. RESULTS: The study enrolled 222 intoxicated patients of which 75 fell into the non-alcohol group and 147 into the alcohol group. Alcohol ingestion of acute poisoning in males was higher than in females. The AST level and discharge against medical advice rates in the alcohol group were higher than the non-alcohol group. The base excess level, length of stay in ICU, past psychiatric history rate, and admission rates in the non-alcohol group were higher than the alcohol group. The PSS were not correlated with alcohol consumption between the two groups. CONCLUSION: Alcohol ingestion is not associated with PSS. However, alcohol ingestion is commonly found in acute drug intoxicated patients. The discharge against medical advice rate in the alcohol group was higher than the non-alcohol group.
Alcohol Drinking ; Arterial Pressure ; Creatinine ; Eating ; Emergencies ; Female ; Glasgow Coma Scale ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Prospective Studies ; Respiratory Rate ; Severity of Illness Index ; Suicide ; Ventilators, Mechanical

PURPOSE: We compared diagnostic accuracy using transverse scans and combined transverse and coronal reformation images in the MDCT diagnosis of acute appendicitis. METHODS: MDCT was performed in 100 patients with acute non-traumatic abdominal pain who visited the emergency department. One half was diagnosed acute appendicitis by radiologic and histologic findings and the other half was not. Transverse scan and combined transverse and coronal reformation images were interpreted by six emergency physicians. Emergency physicians included two board physicians, two senior residents, and two junior residents. For comparison of diagnostic value, the chi-square test and cross tabs test were done. RESULTS: For all emergency physicians except one senior resident, the added coronal reformation images tended to increase the diagnostic accuracy. For board physicians, it increased the diagnostic accuracy from 81.5% to 91% (p=0.003). Senior residents increased from 82.5% to 91.5% (p=0.005), junior residents increased from 75.5% to 87% (p=0.002). The diagnostic accuracy of board physicians and senior residents were higher than junior residents for both image types. CONCLUSION: Coronal reformation images improve the accuracy of emergency physicians in the MDCT diagnosis of acute appendicitis.
Abdominal Pain ; Appendicitis ; Emergencies ; Humans