In the case of IIc type of early gastric cancer occuring from the area of ulcer sear, endoscopic differentiation between it and beoign ulcer scar is occasionally very difficult, due to the absence of characteristic malignant features. The presence of the irregular granular mucosal changes on the area of ulcer scar may be very helpful in the differential diagnosis between early gastric cancer and benign ulcer sear. And underetanding of the malignant cycle of early gaetric cancer is very important for the diagnosis of the depressed forms of early gastric cancer, We experienced and report a cases of IIc type of early gastric cancer diagnosed before operation by the endoscopic finding of irregular granular mucoeal changes on the area of ulcer scar and showing part of malignant cycle.
Cicatrix* ; Diagnosis ; Diagnosis, Differential ; Stomach Neoplasms* ; Ulcer*

Pulmonary aspergilloma may usually demonstrate the classic "air-crescent sign" in the conventional radiograph. However, this lesion is often seen as a pulmonary nodule or is obscured by the surrounding scarred and fibrotic lung tissue, which may limit the value of the conventional techniques and hinder the diagnosis. We retrospectively analysed the plan film findings of 44 lesions of 40 patients and CT findings of 29 lesions of 26 patients with pulmonary aspergilloma with special emphasis upon the atypical manifestation. The cases with classic "air-meniscus sign" in conventional radiograph accounted for 50%, while 30%, presented with a pulmonary nodule and 20% were unrecognized forms due to surrounding parenchymal lesion. CT findings of 28 aspergillomas were analyzed according to the shape of the intracavitary space(space between the cavity wall and the fungal ball) and the fungal ball itself. The intracavity space showed "air-meniscus sign" (62%), filling cavity (28%), peripheral air bubble (3%) and high density due to hemorrhage (3%), in descending order of frequency, The shape of the fungal ball itself showed homogeneous low density mass (62%) and spongeform or irregular air bubble contained mass (34%), CT was more accurate than conventional radiograph in the diagnosis and evaluation of number and location of atspergilloma, particularly in the case of atypical presentaion and was useful to assess the associated disease and to predict postoperative outcome.
Cicatrix ; Diagnosis ; Hemorrhage ; Humans ; Lung ; Retrospective Studies

Keratoacanthoma is a not uncommon skin tumor characterized by rapid growth of a smooth dome-shaped nodule with a central plug of keratin, usually followed by spontaneous involution. Because the tumor leaves a nunsightly scar, this is one of the reasons why these lesions should be treated. Excision is desirable if the diagnosis is in doubt. But surgical removal may be difficult, alternative treatment approaches should be considered. We report two cases of keratocathoma successfully treated by intralesional injection of 5-fluorouracil.
Cicatrix ; Diagnosis ; Fluorouracil* ; Injections, Intralesional* ; Keratoacanthoma* ; Skin

Macrostomia, also called a transverse or lateral facial cleft, is a relatively rare malformation. Although many surgical procedures have been introduced, and no gold standard has yet been established. Moreover, most papers published in Korea were based on the results of the research conducted on the very limited number of patients, and for this reason its findings do not offer sufficient clinical reliability. We devised a modified commissuroplasty as follows: First, new commissure was placed 1 or 2mm inside when compared with the opposite side so that the commissure may not look longer than usual because of the scar on the side. Second, z-plasty of about 5mm was performed on the nasolabial fold to prevent the displacement of the new commissure on its lower part and avoid a continuation of a scar with the medial flap placed upward. We treated 32 cases of macrostomia from August 1, 1998 to July 1, 2002. We obtained relatively satisfactory clinical results by using this modified commissuroplasty. Based on our experience, we intend to present a clinical analysis and an operation technique of our own derived from the classic commissuroplasty, so that we may contribute to the diagnosis and treatment of the patients in the future.
Cicatrix ; Diagnosis ; Humans ; Korea ; Macrostomia* ; Nasolabial Fold

Orbital fracture represents one of the common lesions encountered today with our modern mechanized life. Reduction of these fracture is important in preventing the untoward complications that may ensue such as diplopia and enopththalmos. Although various types of incision have been employed to approach the orbital floor and infraorbital rim, subcilliary and transconjunctival approach are most commonly used. The subcilliary approach has been used for a number of years successfully although it does have shortcommings such as cutaneous scar and ectropion in many cases. The conventional transconjunctival approach provides limited exposure, so it can be used only with small fractures. In order to avoid above problems, it is preferable to use a paracanthal transconjunctival incision: however, it is combined with severance of the lower limb of the lateral canthal tendon approximately 2mm from the canthus. We have used this technique in fifty one cases with diagnosis varying from blow-out fracture to extensive facial fracture. We found that this approach provides good exposure and gives an excellent postoperative result with a concealed apparent cutaneous scarring and no scleral or corneal complications and visualization of the orbital floor and rim with minimal morbidity and insignificant cosmetic impact. In contrast to previously reported similar approaches, it is simple to use in traumatic and congenital lesions that go beyond the orbital floor.
Cicatrix ; Diagnosis ; Diplopia ; Ectropion ; Lower Extremity ; Orbit* ; Orbital Fractures* ; Tendons

Endometriosis at the site of episiotomy scar following vaginal delivery is rare condition among the extrapelvic endometriosis implantation. We have experienced a case of episiotomy scar endometriosis. The precise anatomical location of the endometriotic lesion is confirmed using preoperative anal endosonogarphy. We believe anal endosonography to be essential when history, digital examination, and proctoscopy are not conclusive in the differential diagnosis of perianal pain or mass. The treatment of choice is complete surgical excision of the lesion and the surgical excision usually obtain permanent cure. We report a case of endometriosis at the site of episiotomy scar.
Cicatrix* ; Diagnosis, Differential ; Endometriosis* ; Endosonography ; Episiotomy* ; Female ; Proctoscopy

Endometriosis is the aberrant presence of endometrial tissue outside the uterine cavity. We report a case of cutaneous endometriosis which developed on the scar of a uterine myomectomy in a 35-year-old female. The patient presented with a bean-sized, oval-shaped, erythematous nodule, which was located where a drain tube had been inserted. During her first visit to our clinic, she felt slight pain upon light touch to the lesion. She was not menstruating at this time. The lesion had been getting bigger and she reported that the pain was aggravated during menstruation. Diagnosis was confirmed by histopathologic examination, which showed multiple endometrial glands with decidualized stroma, and hemosiderin pigment. Many dermatologists are not familiar with cutaneous endometriosis. Therefore, we present this case as a good example which shows pathognomonic symptoms and characteristic histopathologic findings of cutaneous endometriosis.
Adult ; Cicatrix ; Diagnosis ; Endometriosis* ; Female ; Hemosiderin ; Humans ; Menstruation ; Uterine Myomectomy

Atrophic dermatofibrosarcoma protuberans is a rare variant of DFSP, which presents as a depressed violaceous scar like lesion with atrophic plaque. Although atrophic DFSP is identical to classical DFSP in location, treatment, prognosis and histology, clinical diagnosis is sometimes difficult for the atrophic lesion. We report a 36-year-old male presented with asymptomatic firm violaceous depressed atrophic lesion and a skin colored almond shaped, subcutaneous nodule on the left subclavicular area. Histopathologically the tumor shows the spindle-shaped cell arranged in cart wheel pattern. The tumor cells were stained positively for CD 34 on immunohistochemical stain.
Adult ; Cicatrix ; Dermatofibrosarcoma* ; Diagnosis ; Humans ; Male ; Prognosis ; Prunus dulcis ; Skin

Congenital dermatofibrosarcoma protuberans (DFSP) is an extremely rare skin tumor that is commonly misdiagnosed, or is often diagnosed long after the initial presentation. Although many cases of DFSP are diagnosed in adulthood, there are some differences between adult DFSP and congenital DFSP. We report a case of congenital DFSP that was initially misdiagnosed as a simple vascular lesion. The delay in diagnosis led to the considerable growth of the lesion, such that a huge scar was left after the surgical treatment. The major differences between adult and congenital DFSP are discussed through a literature review. Clinicians should be aware of the characteristics of congenital DFSP, to reduce misdiagnosis and the delay of diagnosis from the initial presentation.
Adult ; Age of Onset ; Cicatrix ; Dermatofibrosarcoma* ; Diagnosis ; Diagnostic Errors ; Humans ; Skin

Congenital dermatofibrosarcoma protuberans (DFSP) is an extremely rare skin tumor that is commonly misdiagnosed, or is often diagnosed long after the initial presentation. Although many cases of DFSP are diagnosed in adulthood, there are some differences between adult DFSP and congenital DFSP. We report a case of congenital DFSP that was initially misdiagnosed as a simple vascular lesion. The delay in diagnosis led to the considerable growth of the lesion, such that a huge scar was left after the surgical treatment. The major differences between adult and congenital DFSP are discussed through a literature review. Clinicians should be aware of the characteristics of congenital DFSP, to reduce misdiagnosis and the delay of diagnosis from the initial presentation.
Adult ; Age of Onset ; Cicatrix ; Dermatofibrosarcoma* ; Diagnosis ; Diagnostic Errors ; Humans ; Skin