We reoprt an unusual case of Sweet's syndrome associated with bacterial meningitis in a 38-year-old woman. Sweet's syndrome is associated with various diseases. The etiology and pathogenesis are still undefined. The patient presented with fever, headache, and cerebrospinal fluid finding of bacterial meningitis. This is the first reoprted case of Sweet's syndrome assoclated with bacterial meningitis.
Adult ; Cerebrospinal Fluid ; Female ; Fever ; Headache ; Humans ; Meningitis, Bacterial* ; Sweet Syndrome*

We report a case of xanthelasma palpebrarum (XP) with bilateral extensive and disfiguring involvement of all four eyelids. The patient was a 28-year-old woman and noticed this condition eight years ago. Physical examination showed yellowish flat topped bilateral extensive plaques around the eyes. Laboratory result was remarkable for a decrease of a serum high density lipoprotein cholesterol (HDL-C). Other laboratory findings were within normal limits. Histopathologic findings showed diffuse infiltrations of foamy cells, histiocytes and foreign body giant cells in the dermis. Electronmicroscopic examination showed that the dermal infiltrate was composed of lipid laden histoncytes showing multiple villi which indicated an activated state of histioncyte. Bilateral and extensive XP is very rare. Only two cases have been reported in the literatures as far as we know.
Adult ; Cholesterol, HDL ; Dermis ; Eyelids ; Female ; Giant Cells, Foreign-Body ; Histiocytes ; Humans ; Physical Examination

BACKGROUND: Neopterin is released from monocytes/macrophages specifically by stimulation with interferon-γ. Therefore the increase refers to the activation of T lymphocytes. OBJECTIVE: Our objective was to examine the potential role of neopterin in the cell mediated immune response to Behçet's disease. METHODS: We studied 67 patients of Behçet's disease classified by Shimizu and a control group of 30 normal healthy people. Serum neopterin was detected by radioimmunoassay technique. RESULTS: The serum neopterin concentration of the group with Behçet's disease was significantly elevated, compared with the control group (6.36 nmol/ml vs 3.63 nmol/ml). The increase of neopterin concentration was well correlated to the clinical severity of the diseases in increasing order. CONCLUSION: Our data suggest that the T lymphocyte derived IFN-γ which stimulates the production of neopterin has some role in the pathogenesis and clinical severity of Behçet's disease.
Humans ; Interferon-gamma ; Lymphocytes ; Neopterin* ; Radioimmunoassay ; T-Lymphocytes

BACKGROUND: Although the precise pathogenesis of the Behçet's disease is not yet undertween the severity of Behçet's disease and the serum cytokine level. development of cytokine research has made it possible to find out if there is an association between the severity of Behçet's syndrome and the serum cytokine level. OBJECTIVE: Our purpose was to elucidate whether the immunopathological mechanism is associated with the serum tumor necrosis factor (TNF) and interleukin-1β (I1,1β) which are predominantly produced by monocytes/macrophages, and mterleukm-6 (IL-6). METHOD: Sixty seven patients of Behçet's disease and ten healthy adults as a control group were studied. Serum TNF and IL-6 levels were detected by enzyme immunoassay and serum IL-lβ levels by radioimmunoassay. RESULTS: There were no statistically significant differences in the serum levels of TNF, IL-1β, TL-6 compared with the control group. CONCLUSION: These data suggest that the immunopathological reactions of the Behçet's disease are not associated with a monocyte/macrophage dependent mechanism, possibly due to other immunocompetent cells.
Adult ; Humans ; Immunoenzyme Techniques ; Interleukin-6* ; Methods ; Necrosis* ; Radioimmunoassay ; Tumor Necrosis Factor-alpha

Calcinosis cutis results from deposits of calcium and phosphorus in the skin. Calcinosis cutis may be divided into four major categories: dystrophic, metastatic, idiopathic and iatrogenic. A 19-year-old female presented with multiple brown or skin-colored, stony hard plaques on the face, trunk, arm and thigh for 18 months. She did not have any familial and medical history. None of the laboratory findings, including serum calcium, phosphate and autoantibodies for connective tissue disease, was significant. X-ray examination of bones evidenced multiple reticulated heterotrophic calcifications and whole body bone scan evidenced increased radiotracer uptake according to cutaneous or subcutaneous tissue. This case is compatible with idiopathic calcinosis universalis. Treatment with diltiazem was started.
Arm ; Autoantibodies ; Calcinosis* ; Calcium ; Connective Tissue Diseases ; Diltiazem ; Female ; Humans ; Phosphorus ; Skin ; Subcutaneous Tissue ; Thigh ; Young Adult

BACKGROUND: Oral lichen planus (OLP) is a relatively common chronic inflammatory oral mucosal disease of unknown cause. Oral lesions in OLP are chronic, rarely undergo spontaneous remission, are potentially premalignant and are often a source of morbidity. OBJECTIVE: The purpose of our investigation was to describe the clinical characteristics of 35 patients with biopsy- proven OLP. METHODS: We reviewed the medical records and clinical photographs of 35 patients who had been diagnosed with OLP during the last 5 years, from January 2001 to March 2006. We identified average age of onset, gender distribution, presence of family history, clinical types, location of the oral lesion, symptoms, associated dermatologic and systemic disease and treatment modalities. RESULTS: Of the 35 patients, 65.7% were women and 34.3% men. The average age of onset for men was 41.2 years and for women was 52.4 years (overall average age of onset was 48.5 years). Only 5 patients had a family history of OLP, which had not been proven by histologic examination. Of the 35 OLP patients, the reticular type was found in 45.7%, the erythematous type in 31.4% and erosive type in 22.9% of patients. The most common site of oral lesions was the buccal mucosa, which was found in 57.1% of the patients. The lips were the second most commonly involved site at 48.6%, then the tongue at 8.6% and gingiva at 5.7%. Except for the 4 asymptomatic patients, the rest of the patients complained of various symptoms such as a pain, a burning sensation, pruritus and irritation. Many cutaneous and systemic diseases were associated with OLP patients. 3 patients had concomitant cutaneous lichen planus. Only 1 patient was found to be infected with hepatitis C virus. Various treatments had been tried by all patients. Oral squamous cell carcinoma developed in 1 patient at sites previously diagnosed by biopsy as OLP. CONCLUSION: This is the first clinical study of OLP patients in the Korean dermatologic literature. The clinical features of patients in this survey share many similarities with those reported previously, but showed some differences too. The clinical findings of OLP should be evaluated in much larger groups of patients and more experimental investigations should be conducted to find out exact pathogenesis and effective treatments for OLP.
Age of Onset ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Female ; Gingiva ; Hepacivirus ; Humans ; Lichen Planus ; Lichen Planus, Oral* ; Lip ; Male ; Medical Records ; Mouth Mucosa ; Pruritus ; Remission, Spontaneous ; Sensation ; Tongue

BACKGROUND: Interleukin-2 receptor (IL-2) is expressed and released predominantly activated T lymphocyte. Increased serum levels of soluble IL-2R have been noted in a variety of autoimmune diseases and in conditions associated with T lymphocyte activation. OBJECTIVE: We aimed to examine whether the T lymphocyte activation has any association with the pathogenesis of Behçet's disease. METHOD: We have measured the serum level of soluble IL-2R in serum samples obtained from 67 patients with Behçet's disease and 30 healthy people as a control group, using a double-antibody sandwich enzyme-linked immunosorbent assay technique. RESULTS: Serum soluble IL-2R levels were found to be significantly elevated in the group of Behçet's disease as compared with the control group. No significant differences were found within clinical subtypes of Behçet's disease. CONCLUSION: These findings suggest the presence of an ongoing T lymphocyte activation in this disease process.
Autoimmune Diseases ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-2* ; Lymphocyte Activation ; Lymphocytes ; Methods ; Receptors, Interleukin-2*

BACKGROUND: Interleukin-2 receptor (IL-2) is expressed and released predominantly activated T lymphocyte. Increased serum levels of soluble IL-2R have been noted in a variety of autoimmune diseases and in conditions associated with T lymphocyte activation. OBJECTIVE: We aimed to examine whether the T lymphocyte activation has any association with the pathogenesis of Behçet's disease. METHOD: We have measured the serum level of soluble IL-2R in serum samples obtained from 67 patients with Behçet's disease and 30 healthy people as a control group, using a double-antibody sandwich enzyme-linked immunosorbent assay technique. RESULTS: Serum soluble IL-2R levels were found to be significantly elevated in the group of Behçet's disease as compared with the control group. No significant differences were found within clinical subtypes of Behçet's disease. CONCLUSION: These findings suggest the presence of an ongoing T lymphocyte activation in this disease process.
Autoimmune Diseases ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-2* ; Lymphocyte Activation ; Lymphocytes ; Methods ; Receptors, Interleukin-2*

Morphologic features of Malassezia(M.) furfur in the horny layer from clinical lesions of tinea versicolor were examined by scanning electron microscopy and compared with the appearance of fungus in the horny layer from normal skin and in culture. In skin lesions of tinea versicolor, M. furfur showed a variety of growth and reproduction patterns. Although the main patterns were budding yeast forms, various patterns suggesting yeast-mycelial conversion were observed and mycelial hyphae were more prominent in the deeper horny layer than in the superficial layers. However, in the skin of normal persons and in culture, M. furfur existed only as yeast forms and no mycelial hyphae or yeast-mycelial conversion forms were seen. This suggests that the morphologic change of M. furfur, from a yeast form to a mycelial hypha one, may play a role in the induction of the clinical lesion of tinea versicolor.
Biopsy ; Comparative Study ; Human ; Malassezia/isolation and purification/*ultrastructure ; Male ; Microscopy, Electron, Scanning ; Skin Diseases, Infectious/microbiology/pathology ; Tinea Versicolor/*microbiology

Morphologic features of Malassezia(M.) furfur in the horny layer from clinical lesions of tinea versicolor were examined by scanning electron microscopy and compared with the appearance of fungus in the horny layer from normal skin and in culture. In skin lesions of tinea versicolor, M. furfur showed a variety of growth and reproduction patterns. Although the main patterns were budding yeast forms, various patterns suggesting yeast-mycelial conversion were observed and mycelial hyphae were more prominent in the deeper horny layer than in the superficial layers. However, in the skin of normal persons and in culture, M. furfur existed only as yeast forms and no mycelial hyphae or yeast-mycelial conversion forms were seen. This suggests that the morphologic change of M. furfur, from a yeast form to a mycelial hypha one, may play a role in the induction of the clinical lesion of tinea versicolor.
Biopsy ; Comparative Study ; Human ; Malassezia/isolation and purification/*ultrastructure ; Male ; Microscopy, Electron, Scanning ; Skin Diseases, Infectious/microbiology/pathology ; Tinea Versicolor/*microbiology