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We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematous painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematoas painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are'observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. Treatment with INH, myambutol and rifampin resulted in some improvment on the chest and considerable improvement on the skin and intestine within 6 months.
Anal Canal ; Barium ; Dermis ; Enema ; Ethambutol ; Granuloma ; Humans ; Intestines ; Middle Aged ; Ovum ; Parasites ; Proteus ; Rifampin ; Skin ; Skin Tests ; Sputum ; Subcutaneous Tissue ; Thorax ; Tuberculin ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer ; Urinalysis ; Wounds and Injuries

3.Resurfacing of Pitted Facial Acne Scars with a Pulsed Erbium: YAG laser.

Sung Dae KWON ; Soo Nam KIM ; Young Chul KYE

Annals of Dermatology 1999;11(1):5-8

BACKGROUND: Laser resurfacing has beneficial effects for the treatment of several skin conditions. Recently, the pulsed erbium:YAG laser has been shown to be a highly effective treatment for several kinds of pitted facial scars. OBJECTIVE: The purpose of this study was to assess the efficacy and safety of pulsed erbium:YAG laser skin resurfacing at the setting of low or high energy for pitted acne scars. METHODS: 65 patients with pitted acne scars were included in this study. All patients had skin types III or IV. All patients were instructed to use tretinoin cream 0.05% nightly for 2-4 weeks prior to the laser treatment. The pulsed erbium:YAG laser with a 2 mm handpiece at the setting of 500 mJ/pulse, 3.5-5 W in 45 patients and 1,000 mJ/pulse, 7-10 W in 20 patients was used. Two weeks after laser treatment, topical application of hydroquinone 4%, tretinoin 0.05%, and hydrocortisone 1% cream was recommended for 2-4 weeks. Facial photographs were obtained at baseline and 2 week intervals postoperatively. The results of treatment were evaluated for the changes of skin texture and color at 1 month, 3 months, and 6 months. RESULTS: In 45 cases treated with 500 mJ/pulse energy, pitted acne scars were improved about 46.7 % on average and no erythema and postinflammatory hyperpigmentation was observed after 6 months. In 20 cases treated with 1,000 mJ/pulse energy, pitted acne scars were improved about 64% on average and erythema in two patients and postinflammatory hyperpigmentation in one patient were observed after 6 months. CONCLUSION: The results of laser treatment for pitted facial acne scars at the setting of high energy are better than those of laser treatment at the setting of low energy.
Acne Vulgaris* ; Cicatrix* ; Erbium* ; Erythema ; Humans ; Hydrocortisone ; Hyperpigmentation ; Lasers, Solid-State* ; Skin ; Tretinoin