Livedo reticularis is a mottled bluish discoloration of the skin which occurs in a netlike pattern and is not a diagnosis in itself, but is a nonspecific reaction pattern. It may be classified as idiopathic and secondary livedo reticularis. Decompression sickness can occur during decompression after diving into deep sea water or during a rapiid ascent from sea level, and is one of the many causes of the secondary livedo reticularis. We report a case of livedo reticulris which developed in a patient with decompression sickness. A biopsy from the purpuric patch revealed an unusual histopathologic finding that resembles those of bullae and sweat gland necrosis in drug induced coma.
Biopsy ; Coma ; Decompression Sickness* ; Decompression* ; Diagnosis ; Diving ; Humans ; Livedo Reticularis* ; Necrosis ; Seawater ; Skin ; Sweat Glands

Lung cancer is one of the most common types of malignancy in western nations with serious health problem, and it has become the leading cause of cancer death of males, second only to stomach cancer, in Korea. A review of the histopathology of 1363 cases (1231 patients) of lung carcinoma, diagnosed at the Keimyung University Medical center from 1987 to 1996, was performed to reclassify the type of carcinomas and to investigate the change in the distribution of histologic types of lung carcinoma according to age, sex and year. Among the 1363 cases, 132 patients underwent a surgical operation after biopsy. The diagnosis of each case was proven by histopathologic analysis of surgical specimens (13.2%) and biopsy materials (86.8%). The histologic types in our study were basically based on modified WHO classification (1982) and on new WHO classification (1999). The classification of small cell carcinoma was based on International Association for the Small Cell Lung Cancer (IASLC, 1988). Of the 1231 patients with lung carcinoma, 1012 were male and 219 were female (male to female ratio was 3.6:1). According to the analysis of age distribution, the most prevalent age group was 60~69 years in both sex as (n=516, 42.0%). Changing trends in sex distribution of lung carcinoma patients showed that the proportion of men had decreased throughout the years, whereas the proportion of women had significantly increased. Histologically, squamous cell carcinoma was the most common (n=624, 50.7%), followed by small cell carcinoma (21.1%), adenocarcinoma (18.1%), large cell undifferentiated carcinoma (2.1%), adenosquamous carcinoma (0.4%), and large cell neuroendocrine carcinoma (0.4%), in order of frequency. In men, squamous cell carcinoma was the most frequent type (55.1%). In women, adenocarcinoma was the most frequent type (39.7%). In both sexes, adenocarcinoma was the most common type in patients under the age of 40 (n=12, 41.4%), while squamous cell carcinoma proved the most frequent type in patients over the age of 40 (n=617, 51.3%). Changing trends of histologic types of lung cancer showed that the incidences of squamous cell carcinoma had significantly decreased throughout the years, whereas those of adenocarcinoma and small cell carcinoma had increased. In conclusion, the results showing increases in the percentage of female patients and in the number of cases of adenocarcinoma were noteworthy, and well correlated with other related reports.
Academic Medical Centers ; Adenocarcinoma ; Age Distribution ; Biopsy ; Carcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Lung* ; Male ; Sex Distribution ; Small Cell Lung Carcinoma ; Stomach Neoplasms

PURPOSE: The purpose of this research was to determine the effects of a safety management program on safety accident-related knowledge, attitude and behavior of elementary school students in Korea. METHODS: This study adopted nonequivalent control group pretest-posttest design. The number of subjects was 34 in the experimental group and 31 in the control group. The safety management program was performed for approximately 50 minutes each session, once a week for 8 weeks. Data were collected from March 14th to June 23th, 2006, and analyzed by chi2 test and independent t-test with SPSS WIN 16.0. RESULTS: There were statistically significant differences in safety-related knowledge (t=3.010, p=.006) and behavior (t=18.833, p=.001) between the experimental group and the control group. The score of attitude was different between the experimental group and the control group but the difference was not statistically significant. CONCLUSION: The safety management program used in this study was appropriate for elemental school students and affected safety-related knowledge and behavior of elementary school students. Therefore safety education should be provided systematically for elementary schools over the whole country.
Accident Prevention ; Education ; Humans ; Korea* ; Safety Management*

Skin atrophy is one of the most common side effects of topical steroid use and results from decreased skin proalphaI collagen mRNA production due to specific alterations in collagen gene transcription or from reduced collagen mRNA stability. This report describes a case of a 8 year-old-girl who visited our hospital with a complaint of ambiguous genitalia. She was observed to have atrophic labia majora and atrophic striae resembling scrotal rugae. However, her serum levels of FSH, LH, 17-KS, 17-OHCS, 5-DHT, DHT and DHEA-S were all in normal range and her karyotype was 46,XX. Abdominal and pelvic ultrasonogram showed a normal uterus and ovaries. Careful history taking revealed frequent use of steroid ointment due to vulvar pruritus for 2 years and she was finally diagnosed to have atrophy of external genitalia induced by long-term use of topical steroid.
Atrophy* ; Collagen ; Disorders of Sex Development ; Female ; Genitalia* ; Karyotype ; Ovary ; Pruritus ; Reference Values ; RNA Stability ; RNA, Messenger ; Skin ; Ultrasonography ; Uterus

Lentigo maligna melanoma(LMM) is the least common type of melanoma and most commonly affects the sun-exposed skin of the elderly. We herein report a case of LMM evolved from lentigo maligna(LM). A 71-year-old female presented with a longstanding irregular brown patch containing two black papules on the left cheek which developed 8 months ago. Histopathologic findings were consistent with LM and LMM. We performed a wide excision and dufourmental flap for reconstruction with no recurrence for 30 months. Sun exposure has been known as the most important etiologic factor for the development of malignant melanoma including LMM and the incidence has an increasing tendency. Thus, skin biopsy is recommended in the evaluation of a longstanding irregular brown patch on the face to prevent LMM.
Aged ; Biopsy ; Cheek ; Female ; Humans ; Hutchinson's Melanotic Freckle* ; Incidence ; Lentigo* ; Melanoma* ; Recurrence ; Skin ; Solar System

BACKGROUND: Although rubella is a mild exanthematous viral infection and its incidence has been greatly decreased after effective vaccination, epidemics of rubella has been noted at 5- to 7-year intervals. But there has been few report about the clinical and histopathologic study of rubella in Korean literatures. OBJECTIVE: The purpose of this study was to review the clinical and histopathologic characteristics of rubella of 1996 outbreak. METHODS: We reviewed the clinical features and histopathologic findings in 50 patients diagnosed as rubella in Department of Dermatology, Presbyterian Medical Center from January 1996 through to May 1996. RESULTS: 1. The male-female ratio was 1: .17. The age distribution was 13-32 years and 72% of patients were aged 16-25 years. 2. Erythematous maculopapular rash on whole body was developed in all patients. Eighty two percent of the patients had fever and lymphadenopathy, and 36% of the patients had petechiae of soft palate. The main prodromal symptoms were sore throat(50%), headache(34%), and upper respiratory symptoms(22%), as order of frequency. 3. Positive serologic test for rubella IgM antibody was 79.5%. 4. The most common abnormal laboratory finding was leukopenia(58%), and followed by positive ASO(34%), the presence of atypical lymphocytes(21%), and thrombocytopenia(8%). 5. Histologically, epidermal changes were mild to moderate vacuolopathy(92.3%), the presence of dyskeratotic cells(30.8%), spongiosis(23.1%), and exocytosis(15.4%). Dermal findings were mild superficial perivascular lymphohistiocytic infiltration(100%), upper dermal edema(53.8%), perivascular edema(38.4%), pigmentary incontinence(30.8%), and the presence of extravasated RBC(23.1%). Eosinophil infiltration(15.4%) and the presence of large nucleated lymphocytes(92.3%) were also observed. Conclusions: According to the results of our study about rubella outbreak in 1996, clinical signs and symptoms were similar to those of previously described. Histologically, superficial perivascular dermatitis with mild to mederate vacuolar interface change was a main feature and large nucleated lymphocytes were frequently noted.
Age Distribution ; Dermatitis ; Dermatology ; Eosinophils ; Exanthema ; Fever ; Humans ; Immunoglobulin M ; Incidence ; Lymphatic Diseases ; Lymphocytes ; Palate, Soft ; Prodromal Symptoms ; Protestantism ; Purpura ; Rubella* ; Serologic Tests ; Vaccination

We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

Occasionally, erythema multiforme has been reported to occur in association with allergic contact dermatitis to various substances including paraquat(Gramoxone(R)). In these cases the erythema multiforme has ranged from mild localized exanthem to life-threatening toxic epidermal necrolysis. We report a case of toxic epidermal necrolysis developed from erythema multiform due to contact of paraquat.
Dermatitis, Allergic Contact ; Erythema ; Erythema Multiforme ; Exanthema ; Paraquat ; Stevens-Johnson Syndrome*

BACKGROUND: Pigmented basal cell carcinoma(PBCC) is a clinical and histological variant of BCC, which is known to show better prognosis than non-PBCC. There has been no report about the PBCC among Korean patients. OBJECTIVE: Our purpose was to identify the clinical and histologic characteristics of PBCC and to determine whether this correlated with prognosis. METHODS: A clinical and histological survey was done with 62 lesions of 56 cases of PBCC that visited the Department of Dermatology, Presbyterian Medical Center during the last 10 years(1988 - 1998). Some results were then compared with results of non-PBCC. RESULTS: 1. The frequency of BCC in the total number of new outpatients was 0.34%, and 83.6% of BCC contained pigment histologically. 2. The male-female ratio was 1.24:1, and 92.9% of the patients with PBCC were older than the age of 40 years with the mean age of 62.9 years. 3. 88.7% of the PBCC occurred on the face, especially on the nose(38.7%), cheek(19.4%), and eyelid(17.7%). Clinically, most of the tumors were noduloulcerative(77.4%) and diffuse pigmentation was more common than dotted. 4. The most frequent histologic types were nodulocystic(43.6%) and mixed(43.6%) type followed by superficial(6.4%), micronodular(1.6%), adenoid (1.6%), infiltrative(1.6%), basosquamous(1.6%) types. Histologically 51.6% of the tumors were associated with ulceration, and 71% of the tumors were associated with infiltration of inflammatory cells. 5. Fontana-Masson stains showed pigment is melanin and it was found in both tumor nests and surrounding dermis in most cases(95.0%). Hypertrophic melanocytes with prominent dendrites were seen in the tumor nodule(77.8%) and in the normal epidermis overlying tumor(22.2%). 6. Margins were examined for evidence of residual tumor in 48 lesions that were excised. In 4 lesions(8.3%) were the margin positive for tumor. This was statistically not significant (p>0.05) compared with 10 excisions of non-PBCC in which 2(20%) showed positive margins. CONCLUSION: High incidence of PBCC is a characteristic feature in Korean patients, and PBCC showed better prognosis than non-PBCC because it is more frequently excised with adequate margins.
Adenoids ; Carcinoma, Basal Cell* ; Coloring Agents ; Dendrites ; Dermatology ; Dermis ; Epidermis ; Humans ; Incidence ; Melanins ; Melanocytes ; Neoplasm, Residual ; Outpatients ; Pigmentation ; Prognosis ; Protestantism ; Ulcer

This study was aimed to investigate management conditions and dietitians' perception for improvement of school milk programs. Using an online sampling method, collected data from 1,723 dietitians nationwide were analyzed. The results show that 44.4% of respondents carried out the cyclic school milk program, providing various types of dairy products either weekly or monthly. Further, 80.3% of respondents answered that preference survey results were a determining factor in their choice of school milk provider, and 55.9% said that a school steering committee made the decision on relevant facts of the school milk program. For diversification of school milk type, 60.5% of respondents wanted to maintain the current system, and 39.5% answered that milk type needed to be diversified. The respondents preferred fermented milk products, functional milk, and processed milk, in order, if school milk type is diversified. To improve perception and knowledge about milk, 66.0% of respondents thought that nutrition education by a nutrition teacher would be the most effective, and parent's letters or a nutrition newsletter would be helpful. More than half of respondents (55.0%) disagreed with a merged program for school foodservice and milk.
Cultured Milk Products ; Dairy Products ; Surveys and Questionnaires ; Education ; Humans ; Milk* ; Nutritionists ; Periodicals as Topic