The term "fixed drug eruption" was coined by Louis Brocq in 1894 to describe a special type of reaction to antipyrine. It is now known that many drugs can cause a fixed drug eruption. Notorious offenders have included phenolphthalein, quinine and barbiturates. We present a case of multiple fixed drug eruption appearing in a 20 year-old male patient who has generalized slate-blue colored pigmentation on neck, trunk and extremities. The area of total pigmented skin lesions are over 50% of body surface. We could confirm the fixed drug eruption by positive phenobarbital provocation test.
Antipyrine ; Barbiturates ; Criminals ; Drug Eruptions* ; Extremities ; Humans ; Male ; Neck ; Numismatics ; Phenobarbital ; Phenolphthalein ; Pigmentation ; Quinine ; Skin ; Young Adult

Eosinophilic fasciitis is a syndrome which is characterized by scleroderma-like skin involvement, eosinophilia and hypergammaglobulinemia without significant systemic changes. The primary pathological alterations are thickening and inflammation of the deep fascia. The majority of the cases that have been reportecd respond to systemic corticosteroids. We describe a 19-year-old male patient with eosinophilic fasciitis. On physical examination, he showed tender, edematous, indurated and tight skin in the back and both lower legs, and the laboratory findings showed eosinophilia and mild hypergammaglobulinemia. He also had Raynaud phenomenon, mild dyspnea, abdominal pain, pulmonary function abnormalities and roentgenographic evidence of pulmonary fibrosis. Result of a biopsy showed sclerosis of dermia and intense infiltrations of eosinophils, lymphocytes and histiocytes and fibroais of panniculus and fascia. Treatment with systemic corticosteroids showed complete resolution of the skin lesions, but after withdrawal new scleroderma-like skin lesions developed in the dorsum of feet.
Abdominal Pain ; Adrenal Cortex Hormones ; Biopsy ; Dyspnea ; Eosinophilia ; Eosinophils ; Fascia ; Fasciitis* ; Foot ; Histiocytes ; Humans ; Hypergammaglobulinemia ; Inflammation ; Leg ; Lymphocytes ; Male ; Physical Examination ; Pulmonary Fibrosis ; Raynaud Disease ; Sclerosis ; Skin ; Young Adult

We report a case of inflammatory linear verrucous epidermal nevus which was treated with an aromatic analog of vitamin A acid, Ro 10-9359, with significant effect, The patient is a 17-year-old woman who has had linear verrucous patches involving the entire length of the extensor surface of the right arm, right scapular area and anterior upper part of the right chest with persistent itching sensation of 10 years' duration. The patient was treated with oral Ro 10-9359 75mg daily, and showed marked improvement of the skin lesions after seven days of treatment, but the patient was lost to follow up.
Adolescent ; Arm ; Etretinate ; Female ; Humans ; Lost to Follow-Up ; Nevus, Sebaceous of Jadassohn* ; Pruritus ; Sensation ; Skin ; Thorax ; Tretinoin

No abstract available.
Encephalitis, Arbovirus* ; Prognosis*

Incontinentia pigmenti achromians (Ito) begins during childhood and is characterized by progressive appearance of bizarre patchy or whorl-like hypopigmentation without any preceeding or associated inflammatory changes in a fashion that resembles a negative piture of pigmentation in patients with incontinentia pigmenti. Mental, bony and ocular symptoms are not infrequently found in association with incontinentia pigmenti achromians. The incidence is high in the female sex, and there is no hereditary background. A 24-year-old Korean soldier was first seen in May 1974 in dermatologic clinic of Capital Armed Forces General Hospital. Bizarre, reticulated, linear and whorllike hypopigmented macular lesions were noted. On the skin of the trunk and both extremities. The lesions started at the age of 4 year and developed without any inflarnmatory signs Family history did not disclose any type of pigmentation The disorder, and mental, bony and occular manifestations were not found. Biopsy specimen demonstrated that the amount of melanin in the basal layer was decreased in the hypopigmented area, and reveals neither inflammatory changes nor dropping off of melanin granules into the dermis.
Arm ; Biopsy ; Dermis ; Extremities ; Female ; Hospitals, General ; Humans ; Hypopigmentation ; Incidence ; Incontinentia Pigmenti ; Melanins ; Military Personnel ; Pigmentation ; Pigmentation Disorders ; Skin ; Young Adult

Malignant melanoma is rare in Asian and one of the poorer prognostic disease. Approximately 25% of all patients with malignant melanoma has been occured at the site of pigmented leasion. Primary location of melanome on palm is known to be 1.3% which is rarer than that of the other site. This report is a case of 65 year old man who has a walnut sized bluish-black tumor(4*5*3cm) on left palm which developed from the brownish black spot. According to the patients statement the spot was started since childhood and gradually increase in size since last 5 years. The mass, however, was rapidly growing with superficial ulceration since 3 months previously. No metastatic skin leasion was found around the tumor mass and left upper extremity. There were no palpable tymphnodes in the left axillary and epitrochlear area. Skin biopsy specimen showed findings consistent with malignant melanoma and cell composition was predominant in the fusiform cell than the cuboidal cell, and exillary lymphnode showed only dermatopathic changes. Bone X-ray of left hand and chest X-ray showed no abnormal findings and metastatic sign. B-E(bellow elbow) smputations on left foream was performed. During postoperativ he has had general and no metastatic signs.
Aged ; Asian Continental Ancestry Group ; Biopsy ; Hand ; Humans ; Juglans ; Melanoma* ; Skin ; Thorax ; Ulcer ; Upper Extremity

Sclerosing lymphangitis of the penis is a peculiar disorder characterized by painless, firm, cord-like lesion in the coronary sulcus of the penis. Histologic findings include thickened lymphatic collecting vessels, fibrin thrombi and few inflammatory changes. The etiology is unknown, but the condition is benign and self-limited. We describe herein a 27-year-old man who had a typical painless, tender, firm, cord-like lesion in the coronary sulcus. Histologic findings disclosed a markedly thickened and fibrosed lymphatic vessel with a organizing thrombus. Whatever the cause of thrombi formation, it is prohable that the thrombi formation would be a main pathologic process, followed by the thickening of the vessel wall.
Adult ; Fibrin ; Humans ; Lymphangitis* ; Lymphatic Vessels ; Male ; Penis* ; Thrombosis

PURPOSE: The purpose of this study was to evaluate and compare the predictive ability of three mortality scoring systems; Acute Physiology and Chronic Health Evaluation(APACHE) III, Simplified Acute Physiology Score(SAPS) II, and Mortality Probability Model(MPM) II in discriminating in-hospital mortality for intensive care unit(ICU) patients with spontaneous intracerebral hemorrhage. METHODS: Eighty-nine patients admitted to the ICU at a university hospital in Daejeon Korea were recruited for this study. Medical records of the subject were reviewed by a researcher from January 1, 2003 to March 31, 2004, retrospectively. Data were analyzed using SAS 8.1. General characteristic of the subjects were analyzed for frequency and percentage. RESULTS: The results of this study were summarized as follows. The values of the Hosmer-Lemeshow's goodness-of-fit test for the APACHE III, the SAPS II and the MPM II were chi-square H=4.3849 p=0.7345, chi-square H= 15.4491 p=0.0307, and chi-square H=0.3356 p=0.8455, respectively. Thus, The calibration of the MPM II found to be the best scoring system, followed by APACHE III. For ROC curve analysis, the areas under the curves of APACHE III, SAPS II, and MPM II were 0.934, 0.918 and 0.813, respectively. Thus, the discrimination of three scoring systems were satisfactory. For two-by-two decision matrices with a decision criterion of 0.5, the correct classification of three scoring systems were good. CONCLUSION: Both the APACHE III and the MPM II had an excellent power of mortality prediction and discrimination for spontaneous intracerebral hemorrhage patients in ICU.
APACHE ; Calibration ; Cerebral Hemorrhage* ; Classification ; Discrimination (Psychology) ; Hospital Mortality ; Humans ; Critical Care ; Korea ; Medical Records ; Mortality* ; Physiology ; Retrospective Studies ; ROC Curve

A retrospective study was made of the previous medical records of 32 infants with congenital syphilis borne from mothers with untreated syphilis at Severence Hospital, Yonsei University College of Medicine during the years 1,972 through 19g3, These infants had a VDRL titer higher than 1: 8 with reactive FTA-ABS test and were also subjected to radiologic examinations. Radiologic changes and clinical features were analyzed, The following results were obtained: Of the total of 32 infants with congenital syphilis under 5 months of age, those under 1 month of age, were the most common group numbering a total of twelve. Of 32 infants with congenital syphilis, twenty-nine(91%) showed skeletal changes upon radiologic examination, Among them the different sites of bone involvernent revealed that the femur(92%) was the most commonly affected bone, followed by the humerus(88%), tibia(81%,), fibula(80%), ulna(72%), radius (68%). Among the same 29 infants a study of the presence of various abnormal bone changes showed that periostitis was the most common, being involved in 83%, the others being metaphysitis and periostitis(72%), metaphysitis(66%). 3. Among the clinicaI features presented in the 32 infants with congenital syphilis, hepatomegaly was the most common(63%,), followed by erythema with desquamation(47%), pneumonia(38%), maulopapules(34%).
Erythema ; Fluorescent Treponemal Antibody-Absorption Test ; Hepatomegaly ; Humans ; Infant ; Medical Records ; Mothers ; Periostitis ; Radius ; Retrospective Studies ; Syphilis ; Syphilis, Congenital*

We report a case of para.psoriasis variegata in a 19 year-old male patient wha has brownish flat scaly papules that are confluent in a retiform pattern characterized by symmetrical distribution on trunk and upper extremities. A skin biopsy specimen showed hyperkeratosis, focaI parakeratosis, hyperpigmentation of basal cell layer, and a mild lymphocytic perivascular infiltrate. No evidence was found for a relationship to lymphoma.
Biopsy ; Humans ; Hyperpigmentation ; Lymphoma ; Male ; Parakeratosis ; Parapsoriasis* ; Skin ; Upper Extremity ; Young Adult