The authors aimed to apply a nonsurgioal and atraumatic method for avulsing dystrophic nails due to onyohomyoosis by using 22.25% urea ointment under occlusive dressing. One hundred and eighty-nine nails with onychomycosis in fifty-five patients were treated by this rnethod. The results obtained a,re as follows: 1. Of a total of 82 fingernails and 107 toenails in 55 patients, all fingernails and 103 toenails showed an excellent response with easy removal of the diseased nails. 2. The duration tha.t the occluded urea ointment remained in place before sucessful avulsion was 6.7(range, 3 to 18) days for fingernails, and 9.1(range, 3 to 18) days for toenails with onychomycosis. 3. Of 4 nails of control group which were treated with white petrolatum, none showed the significant improvernent. 4. The problems during this treatment were; severe irritation with pain(l case), mild irzitation and/or itching(5 cases), and pin-point bleeding on curettage of nail bed (19 cases). It is suggested the urea treatment has many advantages and seemed to be ideal for patients with digital vascular insufficiency and increased susceptibility to infection.
Curettage ; Hemorrhage ; Humans ; Nails ; Occlusive Dressings ; Onychomycosis* ; Petrolatum ; Urea*

We present a case of bullous congenital ichthyosiform erythroderma in a two year old female, in whom no hereditary background was found. The skin lesion was characterized clinically by blister formation with generalized erythematous hyperkeratosis which was especially prominent on the flexural surfaces of extremities and intertriginous areas. The histopathologic examination revealed marked hyperkeratosis, cavity changes of the malpighian cells with perinuclear vacuoles and markedly thickened granular layer containing many keratohyaline granules.
Blister ; Extremities ; Female ; Humans ; Hyperkeratosis, Epidermolytic* ; Skin ; Vacuoles

Clinical study on 62 patients (26 males and 36 females) with neurofibromatosis seen during past ten years at the Department of Dermatology, Pusan National Universitg Hospital, was made the variable clinical manifestations of the disease and Riccardis ciassification were emphasized. The results were as follows . 1) Family history was noted in 32 cases(51.6%) and exhibited autosomal dominant inheritance pattern. 2) Cutaneous neurofibromas were found in 52 cases(83.8%). 3) Cafe-au-lait spots, measuring greater than 1.5cm in its longest diameter, were found in 60 cases(96.8%) and 44 cases(71.0%) had more than 6 in number. 4) Among associated abnormalities were,' mental retardation(20,9%), skeletal abnormalities(11.2%), seizure, severe headache, etc. 5) According to Riccardis classification, 38 cases could be classified as type I, 28 cases(73.7%); type II, 0 case ; type III, 1 case(2.6%); type IV, 3 cases(7, 9%); type V, 1 case(2.6%); type VI, 4 cases(10.5%); type VII, l case(2.6%); and type VIII, 0 case.
Busan ; Cafe-au-Lait Spots ; Classification* ; Dermatology ; Headache ; Humans ; Inheritance Patterns ; Male ; Neurofibroma ; Neurofibromatoses* ; Seizures

We report a case of rhinocerebral mucormycosis in a 63-year-old female with a 1-year history of poorly controlled diabetes mellitus. She had black necrotic ulcers on the hard palate, bloody nasal discharge, swelling of the left side of her face, left blepharoptosis, proptosis, and conjunctival injection. Histopathological examination of the palatal lesion showed large, nonseptate, right-angled branching fungal hyphae in the dermis, and Rhizopus species was isolated on Sabouraud's agar media. The patient was treated with a combination of amphotericin B and surgical debridements but died of asphyxia one month after admission. This is a relatively uncommon, opportunistic infection occurring in a diabetic woman, and only several cases are reported in the Korean literature up to date.
Agar ; Amphotericin B ; Asphyxia ; Blepharoptosis ; Debridement ; Dermis ; Diabetes Mellitus ; Exophthalmos ; Female ; Humans ; Hyphae ; Middle Aged ; Mucormycosis* ; Opportunistic Infections ; Palate, Hard ; Rhizopus ; Ulcer

Granuloma pyogenicum is a benign vascular tumor and usually occurs as a single lesion. But in a few instances, the development of multiple satellite lesions has been observed following excision or irritation of the primary lesion. Multiple satellite granuloma pyogenicum is a very rare variant of granuloma pyogenicum and occurs most commonly on the back, chest, or trunk, particularly in the interscapular region during childhood. We report a case of multiple granuloma pyogenicum which occurred on the unusual site of the scalp in a 70-year-old woman. The patient presented with a reddish pedunculated nodule with multiple satellite lesions on the right temporal area. The histopathologic findings of the primary and satellite lesions showed many newly formed capillaries and characteristic epidermal collarettes. The lesions were treated by surgical excision and electrodesiccation.
Aged ; Capillaries ; Female ; Granuloma, Pyogenic* ; Humans ; Scalp ; Thorax

A 51-year-old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 6 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy, The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Female ; Humans ; Hypertrophy ; Middle Aged ; Pigmentation

We experienced a case of generalized granuloma annular e in a 68-year-old man. Many factors have been implicated in the genesis of this disease, but in this case no etiologic factors were identified. He was treated successfully with systemic corticosteroid for about l year.
Aged ; Granuloma Annulare* ; Granuloma* ; Humans

Great difficulty may be encountered in the differentiation of basal cell carcinoma from trichoepithelioma snd, in some cases, it may even be irnpossible. Immunohistochemical methods using peanut agglutinin(PNA) which is glycoprotein of non-immune origin selectively binding to galactose-N-acetyl-galactosa-mine are increasingly used in dermatopathology to improve the diagnosis and differential diagnosis. Using PNA, anti-PNA antibody, and peroxidase antiperoxi-dase(PAP) technique, normal skin specimens, basal cell carcinomas, trichoepitheliiomas, and a variety of different skin tumors were studied, and different PNA Ibinding sites between basal cell carcinomas and trichoepitheliomas were observed. The results were as follows : l. In normal skin, except the basement membrane, epidermis and hair follicle epithelium showed a cell membrane staining of PNA, which stained weakly in the Ibssal cell layer. Sebaceous glands revealed membranous and cytoplasmic staining of PNA, but sweat ducts and duct coi1s were mostly negative. 2. 34 of 36(94.4%) basal cell carcinoma sections demonstrated peritumorous PNA-positive bands, and none of 5 trichoepithelioma sections showed peritumorous PNA-binding. 3. Peritumorous PNA-positive bands were strongly positive in solid and keratotic basal cell carcinomas, but decreased or absent in the vicinity of the ulceration or the dense inflammatory infiltration. 4. None of the other skin tumors(squamous cell carcinoms, keratoscanthoma, Bowens disesse and actinic keratosis} showed a periturnorous PNA-positive band. Therefore, we believe that the PNA staining on paraffin-embedded sections using PAP technique can be a useful probe for the differentiation of basal cell carcinoma from trichoepithelioma.
Actins ; Basement Membrane ; Carcinoma, Basal Cell* ; Cell Membrane ; Cytoplasm ; Diagnosis ; Diagnosis, Differential ; Epidermis ; Epithelium ; Glycoproteins ; Hair Follicle ; Peanut Agglutinin* ; Peroxidase ; Sebaceous Glands ; Skin ; Sweat ; Ulcer

We have studied the effects on wound healing of moist conditions in rabbit, achieved by covering excised wounds with the polyurethane film dressings, and dry conditions, by exposure to air during the period from day 1 to day 21 after injury. We have quantified the rate of dermal repair by means of differenetial cell counts of neutrophils, macrophages, fibroblasts, and endothelial cells. The rate of re-epithelialization was also examined. The resuts were as follows: 1. There was an acceleration of the inflammatory phase of repair in the moist wounds. The late phase of inflammation began more rapidly. On day 3 after injury there were 150% more macrophages (p<0.01) and 70% fewer neutrophils (p<0.01) in moist wounds. It was also observed the presence of significantly more fibroblasts (p<0.01) in the moist wounds than the dry wounds. 2. There was also more rapid increase in the number of proliferative phase cells-fibroblasts (p<0.01) and endothelial cells (p<0.01) in moist wounds. the lower content of neutrophils (p<0.05) and the higher number of fibroblasts (p<0.01) which were observed in moist wounds on day 7 after injury suggested that healing was by then well advanced into the proliferative phase. 3. On day 14 after injury, the decrease in the number of fibroblasts in moist wounds suggested that this group entered the remodeling phase of repainr. The lower total cell count in moist wounds than in dry on day 21 after injruy suggested a more rapid progress through the remodeling phase. 4. The reepithelialization of moist wounds was faster than that of dry wounds. These findings suggested that moist wounds occluded with polyurethane film dressing healed more rapidly and in a more orderly manner than did dry wounds, both epidermal and dermal repair being accelerated.
Acceleration ; Bandages* ; Cell Count ; Endothelial Cells ; Fibroblasts ; Inflammation ; Macrophages ; Neutrophils ; Polyurethanes* ; Re-Epithelialization ; Wound Healing* ; Wounds and Injuries*

Letterer-Siwe disease is one of Langerhans cell histiocytosis, with Hand-Schuller-Christian disease and eosinophilic granuloma, characterized by proliferation of Langevha is cell. The clinical course of Letterer-Siwe disease is acute fulmunant of casionally fatal, involving skin and many other internal organs, such as the lymph node, liver, spleen, ung and bone. We present 3 cases of Letterer-Siwe disease with characteristic cutaneous findings and revealed Langerhans granules by imrriunohistochemical stain and electronmicrc scopic examination. All patients died in spite of combined chernotherapy.
Eosinophilic Granuloma ; Histiocytosis, Langerhans-Cell ; Humans ; Liver ; Lymph Nodes ; Skin ; Spleen