The anterior maxillary sinus walls are the most frequently injured sites in midfacial fractures. The maxillary sinus is a difficult surgical site for reduction and fixation due to its narrow surgical field, and has a chance of developing sinusitis when sufficient treatment is not given. In this study, the methods developed by the authors for managing such are introduced. Two small openings were made on both sides of the fracture line, then a suture knot was tied instead of wiring for reduction and fixation. Then an absorbable mesh was applied on top of the fracture site, with a suture knot for additional fixation. This method was applied on an actual patient, and it was a convenient method despite the narrow surgical field that was provided. The authors believe that using suture knots to fixate fractured segments and absorbable mesh is relatively convenient and economically efficient when it comes to the reduction and fixation of the maxillary sinus wall fracture with several fragments.
Humans ; Maxillary Sinus* ; Sinusitis ; Sutures*

Background: It is necessary to perform antifungal susceptibility testing of dermatophytes. Etest (AB Biodisk, Sweden) is a rapid, easy-to-perform in-vitro antifungal susceptibility test. Objective: The purpose of this study was to investigate the minimal inhibitory concentration (MICs) of dermatophytes isolated from skin using Etest. Methods: 21 species of dermatophytes (12 strains of T. rubrum, 7 strains of T. mentagrophytes, M. canis and M. gypseum) and two standard strains (Aspergillus flavus KCTC 6905, Aspergillus fumigatus KCTC 6145) were tested MIC endpoints of Etest for itraconazole (ITZ) and amphotericin B (AMB) were read after 72, 96, and 120 hours incubation for each strains on RPMI 1640 agar. Results: MIC of ITZ was 0.12~0.47 microg/mL on T. rubrum, 0.012~1.0 microg/mL on T. mentagrophytes, 0.012 microg/mL on M. canis, and 0.023 microg/mL on M. gypseum. MIC of AMB was 0.094~0.5 microg/mL on T. rubrum, 0.032~1.0 microg/mL on T. mentagrophytes, 0.19 microg/mL on M. canis, and 0.032 microg/mL on M. gypseum. One strain of T. mentagrophytes isolated from patient with tinea pedis showed ITZ-resistant. Conclusion: This study showed that Etest represented a simple and efficacious method for antifungal susceptibility testing of dermatophytes.
Agar ; Amphotericin B ; Arthrodermataceae ; Aspergillus fumigatus ; Humans ; Itraconazole ; Skin ; Sprains and Strains ; Tinea Pedis

Norwegian scabies is a crusted rash that's caused by a massive infestation with the mite Sarcoptes scabiei. The characteristic skin lesions of this form are gross scaling and hyperkeratotic plaques, and especially on the hands, feet, face, nails and scalp with varying degrees of pruritus. It is often seen in the individuals with human immunodeficiency virus infection, the elderly, immunocompromised patients and institutionalized persons. We report here on a case of Norwegian scabies on an 86-year-old patient who was living in an eldercare hospital, and the patient presented with localized, pruritic, erythematous patches with thick yelolwish crusts on the scalp.
Aged ; Aged, 80 and over ; Exanthema ; Foot ; Hand ; HIV ; Humans ; Immunocompromised Host ; Institutionalization ; Mites ; Nails ; Pruritus ; Sarcoptes scabiei ; Scabies ; Scalp ; Skin

Merkel cell carcinoma is a rare aggressive primary skin cancer which mostly occurs in the elderly on sun-exposed skin. It usually presents as a solitary dome-shaped red or purple nodule on the head, neck and extremities. The mortality rate is higher than the rate for malignant melanoma because its local recurrence is common. Agent Orange, an herbicide widely used as a defoliant in the Vietnam War, contains dioxin contaminants and can cause several dermatoses and skin cancers. We report a case of multiple Merkel cell carcinoma in a 65-year-old male with lesions on the head and neck, who had been exposed to Agent Orange during Vietnam War.
2,4,5-Trichlorophenoxyacetic Acid ; 2,4-Dichlorophenoxyacetic Acid ; Aged ; Carcinoma, Merkel Cell ; Citrus sinensis ; Extremities ; Head ; Humans ; Male ; Melanoma ; Neck ; Recurrence ; Skin ; Skin Diseases ; Skin Neoplasms ; Tetrachlorodibenzodioxin ; Veterans ; Vietnam

PURPOSE: To reconstruct the midface, local flaps such as nasolabial flaps have been frequently used. These local flaps, however, have the shortcomings of requiring a secondary operation or limitations in the movement of the flap. Thus, new methods have been developed. This paper reports a case wherein the basal cell carcinoma on the cheek was resected and the skin and soft tissue defect was successfully treated using a facial artery perforator flap. METHODS: A 68-year-old female consulted the authors on the basal cell carcinoma that developed on her cheek. The mass was fully resected and revealed a 2.3 x 2.3 cm defective region. Using a Doppler ultrasonography, the facial artery path was traced, and using a loupe magnification, the facial artery perforator flap was elevated and the defective region was covered with the flap. RESULTS: The flap developed early venous congestion, but it disappeared without any treatment. Six months after the surgery, the patient was satisfied with the postoperative result. CONCLUSION: The facial artery perforator flap has a thin pedicle. It offers a big arc of the rotation that allows free movement and one-stage operation. These strengths make the method useful for the reconstruction of the midface among other procedures.
Aged ; Arteries ; Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Hyperemia ; Perforator Flap ; Skin ; Ultrasonography, Doppler

We report a case of tinea corporis arising in previous burn area which shows tinea imbricata-like clinical appearance in a 69-year-old male. He showed round, 5.0x5.0 cm sized, fine scaly, well-defined erythematous patch with concentrically arranged rings of scales on the right forearm. Histopathologically, PAS staining revealed fungal hyphae in the horney layer of the epidermis. Fungal culture of scales of the lesions on Sabouraud's dextrose agar showed typical Trichophyton verrucosum. He was treated with oral terbinafine (250 mg/day) and topical lanoconazole for 1 month. Skin lesions improved one month after the treatment, and recurrence has not been observed
Agar ; Aged ; Burns ; Epidermis ; Forearm ; Glucose ; Humans ; Hyphae ; Imidazoles ; Male ; Naphthalenes ; Recurrence ; Skin ; Tinea ; Trichophyton ; Weights and Measures

Dermatophytes usually do not invade beyond the epidermis. However, mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state, such as diabetes mellitus, lymphoma, and long term steroid use may allow penetration of the fungi into dermis. We report a case of trichophytic granuloma of the thigh caused by Trichophyton(T.) rubrum in a 21-year-old chinese male, who showed a pruritic, 17x10 cm sized, erythematous to brownish patch with multiple papules on the left thigh for 3 months. Fungal culture of the biopsy specimen grew out typical white cottony colonies of T. rubrum. Histopathologic examination of the skin lesions showed chronic granulomatous inflammation and fungal elements in the dermis. After one month of itraconazole therapy (200 mg/day), lesions were completely cleared.
Arthrodermataceae ; Asian Continental Ancestry Group ; Biopsy ; Dermis ; Diabetes Mellitus ; Epidermis ; Fungi ; Granuloma ; Humans ; Inflammation ; Itraconazole ; Leg ; Lymphoma ; Male ; Skin ; Thigh ; Trichophyton ; Young Adult

Mycobacterium (M.) fortuitum is a rapidly growing mycobacterium. It is classified as Runyon's group IV with M. abcessus and M. chelonae that are mostly found in water and soil. M. fortuitum infection usually occurs after trauma, surgery or procedures such as acupuncture that cause cutaneous or soft tissue manifestations. We report a case of cutaneous infection due to M. fortuitum in a 72-year-old woman with erythematous deep-seated nodules on her left hand. She inflicted a minor injury to her left hand in a farm. Culture from skin biopsy specimens on 3% Ogawa medium yielded bacterial colonies after 5 days. The microorganism was subsequently identified as M. fortuitum by PCR-restriction fragment length polymorphism analysis. The skin lesions were improved by antibiotic therapy with clarithromycin for 6 months.
Acupuncture ; Aged ; Biopsy ; Clarithromycin ; Female ; Hand ; Humans ; Mycobacterium ; Mycobacterium fortuitum ; Skin ; Soil

Trichorrhexis nodosa (TN) is the most common hair shaft anomaly and is caused by physical or chemical trauma. It is characterized by nodular swellings of the hair shaft accompanied by frayed fibers and loss of cuticle. The fibers then fracture and the shaft breaks with the resultant appearance of a splayed paintbrush or fan-like array. Trichorrhexis nodosa is classified into congenital TN and acquired TN. Acquired TN is further classified into three groups, acquired localized TN, acquired proximal TN, and acquired distal TN. To date, no case of distal trichorrhexis nodosa has been reported in Korean dermatologic literature. We herein report a case of acquired distal trichorrhexis nodosa in a 12-year-old boy.
Child ; Hair ; Humans

Porokeratosis is a genodermatosis that is characterized by abnormal epidermal keratinization with the histologic finding of a cornoid lamella. Linear porokeratosis is an uncommon variant that presents a characteristic linear nevoid distribution along the Blaschko's lines and linear porokeratosis has the highest potential for malignant degeneration of all the porokeratoses. Many treatment modalities have been used, but the treatment outcomes are variable and the treatments are poorly standardized. We report here on a case of linear porokeratosis in a 48-year-old female who showed localized, linear, brownish macules with a well-demarcated hyperkeratotic border on the left lower abdomen and back.
Abdomen ; Female ; Humans ; Keratins ; Middle Aged ; Porokeratosis