We reported a case of Norwegian scabies in 14-year-old male with sepsis, pneumonia, pyopneumothorax and auto immune hemolytic anemia which subsequently became a source of ward epidemic of classical scabies, totalling 25 cases including physicians, nurses, other patients in the same ward and their families. The organisms of scabies on the KOH examination began to decrease 3-5 days after treatment, but they were detccted on the nail, elbow and fingerweb 19 days after treatment.
Adolescent ; Anemia, Hemolytic ; Elbow ; Humans ; Male ; Pneumonia ; Scabies* ; Sepsis

No abstract available.
Condylomata Acuminata* ; Dermoscopy* ; Diagnosis, Differential* ; Lymphangioma* ; Vulva*

The long term administration of anti-convulsants on children with convulsive disorders may cause osteomalacia, depending on the dosage, duration, type and combination of anti-convulsants administred. Fifteen children, comprising 10 male and 5 female, dignosed with convulsive disorders and administered with phenobarbital for a long term period of more than 9 months but less than 84 months and 15 healthy children of a similar age-group were selected for the investigation the density of she spinal backbone of each individual was measured by means of the "QDR-2000 X-ray bone densitometer's (made by Hologic company) which uses the double energy X-ray absorption technique. The levels of serum calcium, phosphrus and alkaline phosphatase for each child were also measured for comparative analysis. The results were as follows: 1) The mean bone density for the healthy group of chlidren was 0.69+/-0.09g/cm(2) and that for the group of children administered with phenobarbital was 0.59+/-0.07cm(2) indicating a significant decrease in density for the latter group (p<0.05). 2) As for the relationship between the duration of phenonbarbital and the decrease in bone mineral density, 5 of 6 patients(83%) administered with phenobarbital for more than 4 years showed a decrease in bone mineral density and 5 of 9 patients (56%) administered with phenobarbital for less than 4 years showed a decrease in bone mineral density. 3) the mean vitamin D level for the healthy group of chlidren was 26.8+/-2.5pg/ml indicating a significant decrease in vitamin D3 level for this group(p<0.05). 4) The mean serum alkaline phospatase evel for the health group of children was 240+/-50u/L and 462+/-110u/L for those administered with phenobarbital. This indicate a significant increase in ALP for phenobarbital group(p<0.05). 5) The posphorus and calcium levels were within the normal range for all the groups of children.
Absorption ; Alkaline Phosphatase ; Bone Density* ; Calcium ; Child* ; Cholecalciferol ; Female ; Humans ; Male ; Osteomalacia ; Phenobarbital* ; Reference Values ; Vitamin D

No abstract available.
Dermoscopy ; Melanoma*

PNP is a rare autoimmune mucocutaneous blistering disease associated with neoplasms, most frequently of the lymphoproliferative type. As PNP is clinically characterized by polymorphous mucosal lesions and cutaneous eruptions, it is important to differentiate it from erythema multiforme, Stevens-Johnson syndrome, lichen planus, and other bullous diseases. A diagnosis of PNP can be confirmed by immunologic studies such as direct and indirect immunofluorescence, immunoblotting, immunoprecipitation. Rare PNP cases related to nonhematological solid tumors have been reported. A 54-year-old male visited us with generalized pruritic scaly lichenoid lesions on the whole body from 5 weeks prior to his first visit. He also presented with extensive painful ulcers and erosions on the oral mucosa and lips for 2 months. Histopathologic findings showed lichenoid infiltration with vacuolar interface change, lichenoid interface dermatitis, keratinocyte apoptosis, and suprabasal acantholysis with cleft. Indirect immunofluorescence using normal human skin showed IgG deposition at the intercellular space. Immunoblotting using normal epidermal extracts in the serum of patient detected antibody to the 190 kDa (envoplakin), 210 kDa (periplakin) molecules polypeptides. He also had a hepatocellular carcinoma and chemoradiotherapy done before. The diagnosis of paraneoplastic pemphigus (PNP) was made. To our knowledge, there are only two reports of PNP associated with hepatocellular carcinoma worldwide, yet no report in Korean literature. Herein, we report the first case of PNP associated with hepatocellular carcinoma in Korea.
Acantholysis ; Apoptosis ; Blister ; Carcinoma, Hepatocellular* ; Chemoradiotherapy ; Dermatitis ; Diagnosis ; Erythema Multiforme ; Extracellular Space ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoblotting ; Immunoglobulin G ; Immunoprecipitation ; Keratinocytes ; Korea ; Lichen Planus ; Lip ; Male ; Middle Aged ; Mouth Mucosa ; Pemphigus* ; Peptides ; Skin ; Stevens-Johnson Syndrome ; Ulcer

Iododerma is a rare cutaneous eruption that occurs after oral, parenteral or topical administration of iodides. Acneiform papulopustular lesions are the most common skin reactions of iododerma and erythematous, vesiculobullous, vegetative, and pustular psoriasis-like lesions appear less commonly. A 40-year-old woman with post-thyroidectomy presented with pustular and crusted patches with erythematous and indurated bases on the face and well-defined purplish crusted desquamative plaques on the lower legs at 10 days after radioactive iodine-131 ablation. Based on clinicopathological findings and history, she was diagnosed with iododerma following radioactive iodine ablation. Hypersensitivity to iodine is more uncommon in iodine-131 therapy compared with other iodine-containing substances since the quantity of sodium iodide is infinitely small. As iododerma following radioactive iodine ablation is a rare entity, so clinicians need to know about the possibilities of developing the skin lesion along with other early side effects before administering iodine-131 therapy.
Administration, Topical ; Female ; Humans ; Hypersensitivity ; Iodides ; Iodine ; Leg ; Skin ; Sodium Iodide ; Thyroid Gland ; Thyroid Neoplasms

Spitz nevus is a benign melanocytic nevus, common in children or young adults, and it has histological features that are confused with those of malignant melanoma. Polypoid Spitz nevus is the benign counterpart of polypoid malignant melanoma. A 22-year-old woman presented with a solitary 1.5×1.5 cm-sized firm polypoid erythematous nodule on the left thigh. On dermoscopy, pink to yellowish lagoons intermingled by white fibrous septa were found but milky red globules or irregular linear vessels were not found. Therefore, melanoma almost could be ruled out cautiously. Histopathology showed symmetrical, well-circumscribed, polypoid architecture with predominant dermal nests of spindle cells. Immunohistochemically, the nevus cells were strongly positive for S-100 protein and negative for HMB-45. Thus, the diagnosis of polypoid Spitz nevus was made. Herein, we report a case of polypoid Spitz nevus that was differentiated from polypoid melanoma by histopathologic and dermoscopic findings.
Child ; Dermoscopy ; Diagnosis ; Female ; Humans ; Melanoma ; Nevus ; Nevus, Epithelioid and Spindle Cell* ; Nevus, Pigmented ; S100 Proteins ; Thigh ; Young Adult

No abstract available.
Mycoplasma pneumoniae* ; Pneumonia, Mycoplasma* ; Vasculitis*

No abstract available.
Humans ; Kidney Failure, Chronic ; Porphyria Cutanea Tarda* ; Porphyrias* ; Renal Dialysis*

BACKGROUND: As the immunocompromised population has increased in recent years, the number of cutaneous nontuberculous mycobacterial (NTM) infections has also risen. However, since this affliction has no pathognomonic clinical or histological features, the diagnosis and treatment of cutaneous NTM infections are often delayed. OBJECTIVE: The aim of this study was to investigate the microbiological, clinical, and histological findings of cutaneous NTM infections. METHODS: We reviewed medical records and histologic slides of 10 patients diagnosed with cutaneous NTM infections confirmed by culture or polymerase chain reaction. RESULTS: All patients except one were immunocompetent, and 5 of 10 patients had preceding factors including trauma, liposuction, and intralesional triamcinolone injection. Microbiologically, of the 10 infections, 5 were caused by Mycobacterium marinum, 3 by Mycobacterium fortuitum, and 1 each by Mycobacterium chelonae and Mycobacterium ulcerans, respectively. Of the 5 patients with M. marinum, 2 had a fish-related job and 1 reared fish at a home aquarium. The most common clinical presentation was erythematous nodules (7/10). Histologically, irregular acanthosis (4/10), mixed cell infiltrate of lymphocytes, histiocytes, neutrophils (9/10), suppurative granuloma (7/10), microcysts lined by neutrophils (5/10), fibrosis (4/10), and panniculitis (7/10) were identified. CONCLUSION: We found microcysts lined by neutrophils in 50% of the samples and considered this finding to be a diagnostic marker of NTM infection. These clinicopathologic features will assist clinicians in diagnosing NTM infection more rapidly and accurately.
Diagnosis ; Fibrosis ; Granuloma ; Histiocytes ; Humans ; Lipectomy ; Lymphocytes ; Medical Records ; Mycobacterium chelonae ; Mycobacterium fortuitum ; Mycobacterium marinum ; Mycobacterium ulcerans ; Neutrophils ; Nontuberculous Mycobacteria ; Panniculitis ; Polymerase Chain Reaction ; Triamcinolone