Fibrous dysplasia is a common benign disorder of bone in which normal bone marrow is replaced with fibro-osseous tissue. As PET/CT is increasingly used for the staging of different malignant disease, incidentally found fibrous dysplasia with increased FDG uptake may mimic metastasis. We report on a 46-year-old woman with fibrous dysplasia who underwent PET/CT because of suspected recurrence of breast cancer and was misdiagnosed as a bony metastasis with a focal FDG uptake on left proximal femur. This lesion was interpreted as fibrous dysplasia based on MRI in addition to the plain radiographs. We conclude that MRI in addition to radiography may help to differentiate fibrous dysplasia mimicking metastasis on PET/CT in the patients with malignancy.
Bone Marrow ; Breast ; Breast Neoplasms ; Female ; Femur ; Humans ; Hydrazines ; Middle Aged ; Neoplasm Metastasis ; Recurrence

Cushing's disease is an ACTH-producing pituitary corticotrope adenoma. This pituitary adenoma exhibits an unrestrained ACTH secretion resulting in hypercortisolemia. A 27-year-old female visited us with a 3-year history of diffuse hair loss on the scalp. Her past medical history included recently-developed hypertension and 10 years of increased weight gain and oligomenorrhea. Central obesity, hirsutism, acne, violet striae on the abdomen, lower and upper extremities, and christmas tree-shaped alopecia on the scalp were observed upon physical examination. The secretion of cortisol was not suppressed in both a low and high dose dexamethasone suppression test. A brain MRI detected a pituitary microadenoma in the sella turcica. Based on the clinical and laboratory findings, we diagnosed androgenetic alopecia associated with Cushing's disease. After surgical removal of the pituitary adenoma, the alopecia showed a remarkable improvement. We report a case of Cushing's disease found in a patient with androgenetic alopecia.
Abdomen ; Acne Vulgaris ; Adenoma ; Adrenocorticotropic Hormone ; Adult ; Alopecia* ; Brain ; Dexamethasone ; Female ; Hair ; Hirsutism ; Humans ; Hydrocortisone ; Hypertension ; Magnetic Resonance Imaging ; Obesity, Abdominal ; Oligomenorrhea ; Physical Examination ; Pituitary Neoplasms ; Scalp ; Sella Turcica ; Upper Extremity ; Viola ; Weight Gain

Vitiligo has been associated with various disorders including thyroid disease, type I diabetes, alopecia areatal and pernicious anemia. It has been purported to be caused by autoimmune response. Vitiligo and alopecia areata occurring in the same patient has often been found, but colocalization of these two diseases has been rarely reported. It is suggested that this concurrence can result from a nonspecific immune mechanism affecting not only the melanocyte but the epithelium of the hair follicle as well. Thus colocalization can occur due to costimulation of a helper T-cell-mediated immunologic response or through inactivation of a suppressor-mediated response and other composite mechanisms such as neurogenic factors, stress and infection. We report a 17-year-old Korean female who presented with a 1-year history of alopecia and depigmentation on the same site of the left eyebrow. We diagnosed this skin lesion as colocalization of vitiligo and alopecia areata by both clinical and histopathological findings.
Adolescent ; Alopecia Areata* ; Alopecia* ; Anemia, Pernicious ; Autoimmunity ; Epithelium ; Eyebrows ; Female ; Hair Follicle ; Humans ; Melanocytes ; Skin ; Thyroid Diseases ; Vitiligo*

We present a case of annular polycylic type of subacute lupus erythematosus which fulfilled the criteria of systemic lupus erythematosus and was associated with protein losing enteropathy. A 37-year-old male had erythematous annular rashes with several painful, scattered ulcers and a generalized edematous appearance. Abnormal laboratory findings were hypoalbuminemia, low complement, positive Anti-Ro, La, and ANA in a speckled pattern. Tc-99m human serum albumin scintigraphy revealed extravasation within the small bowel. The histopathologic findings showed vacuolar degeneration, upper dermal edema and cleft with perivascular lymphocytic infiltration. Direct IF revealed granular deposition of IgG along the dermo-epidermal junction. The patient was treated with intravenous steroids and oral hydroxychloroquine.
Adult ; Complement System Proteins ; Edema ; Exanthema ; Humans ; Hydroxychloroquine ; Hypoalbuminemia ; Immunoglobulin G ; Lupus Erythematosus, Cutaneous* ; Lupus Erythematosus, Systemic ; Male ; Protein-Losing Enteropathies* ; Radionuclide Imaging ; Serum Albumin ; Steroids ; Ulcer

Castleman's disease, also known as angiofollicular lymphoid hyperplasia or giant lymph-node hyperplasia, is an unusual form of a lymphoproliferative disorder, and is divided clinically into a solitary and a multicentric form. The multicentric form of Castleman's disease is almost always of the plasma cell type. This can coexist with Kaposi's sarcoma in some cases. Kaposi's sarcoma is a multicentric, proliferative, vascular tumor involving cutaneous and visceral tissue. Iatrogenically-developed, immunosuppression-associated Kaposi's sarcoma is usually the result of immunosuppressive therapy. A 61-year-old man diagnosed as the plasma cell type of Castleman's disease, who had been treated with prednisolone for 2 years, was referred to the department of dermatology with numerous skin lesions consisting of confluent, violaceous-colored papules and plaques on his palm and soles. Histologic examination of the cutaneous lesions showed consistency with Kaposi's sarcoma. We report a rare case of Kaposi's sarcoma associated with multicentric Castleman's disease.
Dermatology ; Giant Lymph Node Hyperplasia* ; Herpesvirus 8, Human ; Humans ; Hyperplasia ; Lymphoproliferative Disorders ; Middle Aged ; Plasma Cells ; Prednisolone ; Sarcoma, Kaposi* ; Skin

Ceramides are the main lipid component maintaining the lamellae structure of stratum corneum, as well as lipid second messengers for the regulation of cellular proliferation and/or apoptosis. In our previous study, psoriatic skin lesions showed marked decreased levels of ceramides and signaling molecules, specially protein kinase C-alpha (PKC-alpha) and c-jun N-terminal kinase (JNK) in proportion to the psoriasis area and severity index (PASI) scores, which suggested that the depletion of ceramide is responsible for epidermal hyperproliferation of psoriasis via downregulation of proapoptotic signal cascade such as PKC-alpha and JNK. In this study, we investigated the protein expression of serine palmitoyltransferase (SPT) and ceramidase, two major ceramide metabolizing enzymes, in both psoriatic epidermis and non-lesional epidermis. The expression of SPT, the ceramide generating enzyme in the de novo synthesis in psoriatic epidermis, was significantly less than that of the non-lesional epidermis, which was inversely correlated with PASI score. However, the expression of ceramidase, the degradative enzyme of ceramides, showed no significant difference between the lesional epidermis and the non-lesional epidermis of psoriatic patients. This might suggest that decreased expression of SPT protein is one of the important causative factors for decreased ceramide levels in psoriasis.
Adolescent ; Adult ; Amidohydrolases/*biosynthesis/metabolism ; Apoptosis ; Cell Proliferation ; Ceramidases ; Ceramides/chemistry ; Child ; Epidermis/metabolism ; Female ; Humans ; JNK Mitogen-Activated Protein Kinases/metabolism ; Male ; Models, Biological ; Protein Kinase C-alpha/metabolism ; Psoriasis/*blood/diagnosis ; Serine C-Palmitoyltransferase/*biosynthesis

PURPOSE: The purpose of this study was to evaluate the effects of a sex education program, which was based on the Health Belief Model, on knowledge related to sexually transmitted diseases and sexual autonomy among university students. METHOD: A non-equivalent control group, pretest-posttest design was used. The four session program was delivered to 18 students during 4 weeks; the control group consisted of 23 students. The theme of the first session was "sex, gender, and sexuality: all our concern", "dangerous sex" for the second session, " safe sex" for the third session, and "right sex for you and me" for the fourth session. RESULT: At follow-up, the knowledge related to sexually transmitted diseases and sexual autonomy were significantly greater in the intervention group than in the control group. CONCLUSION: A sex education program with several sessions within the theoretical frame of HBM was effective to improve knowledge related to sexually transmitted diseases and sexual autonomy. The results suggest the potential of a systematic sexual education program to teach healthy sex and to extend the program for other various populations.
Universities ; Students/*psychology ; Sexually Transmitted Diseases/*prevention & control ; *Sexual Behavior ; *Sex Education ; Personal Autonomy ; Male ; Humans ; Female ; Adult

Palmar digital vein thrombosis causing one or more nodules seems to be a relatively rare condition. Only 20 cases of palmar digital vein thrombosis have been reported worldwide in the English language literature. It presents with a painful, firm and blue nodule located at or in close proximity to one of the flexion creases. The etiology remains unknown, but changes in the vessel wall related to the anatomic characteristics of the palmar digital veins may play a role, along with intraluminal stasis. Two patients with blue nodule located in close proximity to flexion creases on the volar side of the finger presented to our hospital. Histological examination showed organizing thrombus within the dilated vessel. We report here on these two cases of palmar digital vein thrombosis.
Fingers ; Glycosaminoglycans ; Humans ; Thrombosis ; Veins

Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's lymphoma, and this tumor is predominantly composed of large lymphoid cells that have a strong expression of CD30. Two major groups of ALCL have been described. The first is a spectrum of CD30+ lymphoproliferative disorders, including primary cutaneous ALCL and lymphomatoid papulosis. The second is systemic nodal ALCL, which can be subdivided into two groups: anaplastic lymphoma kinase (ALK)-positive and ALK-negative. The relative frequency of ALCL in Korea is about 19% of all cutaneous lymphomas. Solitary or multiple large nodular tumoral lesions confined to one body compartment are the most common presentation. We report here on a case of CD30 (+)/ALK (-) primary systemic ALCL in a 77 year-old-male, and the skin lesion manifested as multiple papules, plaques and tumors on the trunk, buttocks and upper and lower extremities.
Buttocks ; Korea ; Lower Extremity ; Lymphocytes ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Phosphotransferases ; Receptor Protein-Tyrosine Kinases ; Skin

Trichilemmal cysts are cysts of epithelial origin with a distinctive keratinization pattern that simulates that of the human anagen hair follicle between bulge and sebaceous gland and in the sac surrounding catagen hairs. This type of keratinization of the outer root sheath epithelium occurs when it is freed from the internal cover of its inner root sheath. Over 90 percent of trichilemmal cysts occur on the scalp. The others are located on the face, neck and trunk. A 34-year-old female had a solitary, skin-colored nontender subcutaneous nodule on the 5th finger of her right hand. We clinically diagnosed this skin lesion as an epidermal cyst. However, histopathologic examination revealed a stratified squamous epithelium without a granular layer, which corresponded to trichilemmal keratinization. The contents of the cyst consisted ofa homogenous eosinophilic material. The cyst was diagnosed as a trichilemmal cyst.
Adult ; Eosinophils ; Epidermal Cyst ; Epithelium ; Female ; Fingers ; Hair ; Hair Follicle ; Hand ; Humans ; Keratins ; Neck ; Scalp ; Sebaceous Glands ; Skin