Erythr odysesthesia syndrome is a. peculiar toxic reaction due to anti-cancer drug. lt is characterized by a painful, purple-colored patch on the palms and soles, and may form bullae. We report a case of erythrodysesthesia syndrome in a 46-year-old woman. 5-FU and leucovorin were administered for 5 days because of her colon cancer. Two weeks after anti-cancer therapy, purple-colored erosive patch appeared on the face, and 10 days later, purple-colored vesicular patches were seen on both palms and soles, accompanied with pain. Histopathologic examination reveals a severe epidermal necrosis. Individual keratinocyte shows cytologic atypia and apoptotic body.
Colonic Neoplasms ; Female ; Fluorouracil* ; Humans ; Keratinocytes ; Leucovorin ; Middle Aged ; Necrosis

No abstract available.
Drug Therapy* ; Pregnancy*

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

Anemia is a common cause of referrals to gastroenterologists. Only a small number of anemia cases result from vascular abnormalities. Visceral artery aneurysms and pseudoaneurysms are rare forms of vascular disease that have significant potential for rupture, resulting in potentially life-threatening hemorrhaging. We present the case of a 70-year-old female patient with a pseudoaneurysm of the superior mesenteric artery complicated with rupture, who had no abdominal pain and only anemia.
Abdominal Pain ; Aged ; Anemia* ; Aneurysm ; Aneurysm, False* ; Arteries ; Female ; Humans ; Mesenteric Artery, Superior* ; Referral and Consultation ; Rupture* ; Vascular Diseases

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

BACKGROUND: A policy development research project entitled "Feasibility study and development of clinical pathology laboratory inspection and accreditation system and its impact" was funded by the Ministry of Health and Welfare, Republic of Korea in 1998 to standardize and improve laboratory performances, hence to accomplish cost effectiveness of laboratory testing throughout the country. METHODS: The authors developed applicable inspection standards including 1) qualification and the role of laboratory director, 2) quality control and quality improvement, 3) facility and safety, and 4) inspection application requirements and detailed checklists for each laboratory discipline were developed accordingly. The College of American Pathologists Inspection and Accreditation Program was used as the model. Checklists for laboratory areas contain questionnaires with corresponding scores. The score is assigned from 2 to 4 according to the impact of the question to the outcome of the test. Checklists are for laboratory management (203 questions), hematology (146), routine chemistry (126), special chemistry (198), urinalysis (85), microbiology (282), immunology and serology (70), blood bank (246), HLA laboratory (117), flow cytometry (102), cytogenetics (137), molecular biology (232), and independent laboratory (542). The philosophy involved in the program was fairness, consistency, courteousness, consultation, and providing guidelines for future developments. Experts' consensus on subject matter was obtained before checklists were in use. Cut-off for accreditation was based on a score of 80%. Three dry and four wet workshops were held to produce 69 trained inspectors. While conducting wet workshops, 2 CAP accredited university hospital laboratories and 1 non-accredited university hospital laboratory as well as 1 CAP accredited large commercial laboratory were inspected by using newly developed checklists. RESULTS: All 4 laboratories were accredited with the mean score of 94%. The most common deficiencies were lack of proper documentation on quality control, outdated reagents in use, etc. CONCLUSIONS: The laboratory I and A program was successfully tested for its feasibility and we confirmed that its nationwide implementation was ready.
Accreditation* ; Allergy and Immunology ; Blood Banks ; Checklist ; Chemistry ; Consensus ; Cost-Benefit Analysis ; Cytogenetics ; Education ; Financial Management ; Flow Cytometry ; Hematology ; Indicators and Reagents ; Korea* ; Laboratories, Hospital ; Molecular Biology ; Pathology, Clinical* ; Philosophy ; Policy Making ; Quality Control ; Quality Improvement ; Republic of Korea ; Urinalysis ; Surveys and Questionnaires

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

The Brunner's gland adenoma is characterized by a nodular proliferation of histologically normal Brunner's gland, accompanied by ducts and scattered stromal elements. First descrived by Salvioli in 1876, the tumor is relatively rare, with 119 cases reported by 1977, The most common benign tumor of the small bowel is the adenoma, 25% of which occur in the duodenum. They make up 30% to 50% of all hyperplastic polyps of the duodenum. Most frequently these tumors are discovered in patients in the fourth to sixed decades of life, though the age in reported caes ranges from l 1 days to 80 years. The benign tumors of the duodenum 30% to 50% contain elements of Brunner's gland and 10.6% of them are adenomas of Brunner's gland. We report a case of Brunner's gland adenoma treated by endoscopic polypectomy in 63 year-old woman, and reviewed the literatues of adenoma of the Brunne'r gland.
Adenoma* ; Duodenum ; Female ; Gastrointestinal Hemorrhage ; Humans ; Middle Aged ; Polyps

We report a case of rosacea-like tinea faciei in a 62-year-old female. The lesions were manifested by 2.0x2.0 cm and 2.0x2.0 cm-sized, two, pruritic, well-demarcated, erythematous macules on the nose and left ala nasi. Histopathologic examination of the skin lesion showed chronic dermal inflammation with presence of fungal hyphae in the honey layer of the epidermis. Fungal culture of the biopsy specimen grew out typical white cottony colonies of Trichophyton rubrum. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Skin lesions improved one month after the treatment, and recurrence has not been observed.
Biopsy ; Epidermis ; European Continental Ancestry Group ; Female ; Honey ; Humans ; Hyphae ; Imidazoles ; Inflammation ; Middle Aged ; Naphthalenes ; Nose ; Recurrence ; Skin ; Tinea ; Trichophyton