BACKGROUND: Prurigo nodularis(PN) is a rare recalcitrant pruritic disease. Its pathophysiology is still debatable and a matter of speculation. And, there has been no large case study in Korea. OBJECTIVE: We tried to evaluate the epidemiologic aspects in Korea, and the clinicopathologic correlates of PN. METHODS: 51 patients were included in this study. The patients were divided into atopic and nonatopic groups. All the available clinical and laboratory data including total serum IgE were collected and analyzed. 48 slides were stained in hematoxylin-eosin. For immunophenotyping of cellular infiltrate and identification of neural tissue, 10 cases of them were stained immunohistochemically. They were examined under light microscope. RESULTS: The male to female ratio was 2.4:1. The age was varied from 3 to 64 years, averaging 36.6 years. The age of onset was varied from 2 to 64 years with two peaks in second and fifth decades. The site of predilection were the extremities (96%) and less commonly the trunk (49%). The underlying diseases were present in 23.5% of total patients. The atopic group has relatively younger age and higher total serum IgE level than non-atopic group. There was no significant difference in the recorded pathologic and immunohistopatholgic characteristics between two groups except the deep inflammatory infiltrate and dyskeratosis. There was prominent neural hyperplasia associated with vascular proliferation and inflammatory cellular infiltrate. CONCLUSIONS: There were some epidemiologic differences from western patients. There were about twice as more male patients. Age of onset had some predilections. Atopic and non-atopic groups were different in clinical and some pathologic variables. The former was younger, had higher total serum IgE, and histopathologically, showed more pronounced neural hyperplasia.
Age of Onset ; Extremities ; Female ; Humans ; Hyperplasia ; Immunoglobulin E ; Immunophenotyping ; Korea ; Male ; Prurigo*

The patient was a 41-year-old healthy man, who developed a tender, cord-like serpiginous mass just proximal to the coronal sulcus for two weeks. He was a sexually active, non-promiscuous, married man. We had taken a biopsy, and noticed the subsiding of the lesion without further treatment. Nonvenereal sclerosing lymphangitis of the penis is a rare self-limiting peculiar disorder involving the lymphatics of the penile sulcus. Clinically, it presents as a cord-like nodular penile lesion with characteristic cartilaginous firmness. Histologically, it is described as hypertrophy and sclerosis of the lymphatic vessel walls with mild inflammatory cellular infiltration, and occasional obstruction of the lymphatic vessel. But, because such features including sclerosis varies according to the time when the biopsy was taken, they are not attributable to all cases. Our case shows the same clinical and pathological features of ‘benign transient lymphangiectasis’. Except for the painful cases, no specific treatments are usually warranted.
Adult ; Biopsy ; Humans ; Hypertrophy ; Lymphangitis* ; Lymphatic Vessels ; Male ; Penis* ; Sclerosis ; von Willebrand Factor

The patient was a 34-year-old male who had the dorsum of his right foot burned with strong alkali. Subsequently, the wound changed to an ulcer 3 days after the accident, and it was resistant to conventional treatment. After seventeen days of a granulation tissue-forming period, we applied a suction blistered epidermal graft using an intrinsic heating system we had devised. Suction blistered epidermal grafting is a less painful method with minimal scarring that is applicable to various skin diseases and researches. However, currently used techniques require patients to be immobile for some time and it makes physicians and patients feel uneasy and uncomfortable. The time needed for the suction blister formation is dependent on many factors. Among them, the temperature and the suction pressure are the important factors that can be modified easily. So, we devised a suction device having the capability to heat itself and used a suction machine with a pressure meter. We applied this to the above patient. We present a case of a chemical burn wound treated with suction blistered epidermal grafting.
Adult ; Alkalies ; Blister* ; Burns ; Burns, Chemical* ; Cicatrix ; Foot ; Heating ; Hot Temperature ; Humans ; Male ; Methods ; Skin Diseases ; Suction* ; Transplants* ; Ulcer ; Wounds and Injuries*

In Albright's hereditary osteodystrophy (AHO) including the syndromes of pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP), multiple areas of intracutaneous ossification are often encountered. The characteristic features are short stature, round face, short neck, obesity, cutaneous ossifications, and various skeletal anomalies including short metacarpal and metatarsal bones, curve of radius, and brachydactyly. The patient was a 10-month-old male infant. He presented slightly depressed erythematous hard plaques on the left upper chest and left thigh. We had taken biopsies from both skin lesions, confirming cutaneous ossification or bone formation. He also had the characteristic features of AHO. He had a history of admission due to patent ductus arteriosus and atrial septal defect. The laboratory results showed slightly decreased calcium, increased phosphorus and PTH levels. The patient received no specific corrective measures because his calcium and phosphorus levels were not far from normal values until newly developed similar skin lesions appeared.
Biopsy ; Brachydactyly ; Calcium ; Ductus Arteriosus, Patent ; Heart Septal Defects, Atrial ; Humans ; Infant ; Male ; Metatarsal Bones ; Neck ; Obesity ; Osteogenesis ; Phosphorus ; Pseudohypoparathyroidism* ; Pseudopseudohypoparathyroidism ; Radius ; Reference Values ; Skin ; Thigh ; Thorax

A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.
Aorta, Thoracic ; Aortic Coarctation* ; Cardiopulmonary Bypass ; Heart Failure ; Heart-Assist Devices* ; Humans ; Infant* ; Mitral Valve Insufficiency ; Perfusion ; Sternotomy ; Ventricular Dysfunction, Left* ; Ventricular Function, Left