Epithelioid hemangiomo, is belong to a group of unusual vascular proliferation accompanying prominent eosinophilic infiltration. It is usually classificed as a subset of angiolymphoid hyperplasia with eosinophilia despite of its peculiar endothelial morphology(i.e., vacuolization and hobnail appearance etc.). Histopathologically, the lesion was characterized by exuberant. proliferation of capillaries, epithelioid-appearing erdothelial cell, endothelial cytoplasmic vacuolization, solid sheets of endothelial cells, massive eosinophilic infiltration and lymphoreticular hyperplasia. The lesions are most common in he head-neck region and are characterized by single or multiple smooth-top papules or plnqu s of varying colors. We report two cases of epithelioid hemangioma occurring on the left auricle and scalp. The chiet complaints were pruritus and they have been early bleeding even in trivial trauma. Microscopically, the lesions were consisted of a prolifration of small to medium-sized blood vessels surraunded by inflammatory infiltrates predominantly composed of lymphocytes, histiocytes and eosinophils. The vessels were lined by epithelioid-appearing endothelial cells haveing enlarged round nuclei and abundant easinophilic or clear cytoplasm. Some vessels showed luminal obliteration by proliferating epithelioid endothelial cells. Occasionally, blood vessels were lined by hobnailor scallop-shaped endothelial cells. In immunohistochemical finolings, the epithelioid endothelial cells or proliferated capillaries were immunoreactive to factor VII-related antigen and negative to lysozyme.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Capillaries ; Cytoplasm ; Endothelial Cells ; Eosinophils ; Hemangioma* ; Hemorrhage ; Histiocytes ; Hyperplasia ; Lymphocytes ; Muramidase ; Phenobarbital ; Pruritus ; Scalp

BACKGROUND: Childhood myelodysplastic syndrome(MDS) is a heterogenous disease complex which has characteristics of cytopenia in one or more hemopoietic cell lines in peripheral blood and of dysmorphisms of hemopoietic precursors in bone marrow, but quite different from adult one. We experienced 22 patients with childhood myelodysplastic syndrome during 9 years from 1987 to 1995 in the Department of Pediatrics, Inje University College of Medicine, Pusan Paik Hospital, Pusan, Korea and performed a clinical study about them to analyze the clinical and hematological features and treatment outcome retrospectively. METHOD: We analyzed their clinical features including age and sex distribution, chief complaints and physical findings on first admission, distribution of subtypes, hematologic features including initial hemoglobin, total WBC and platelet count, and treatment outcome including leukmic transformation and prognostic scores. RESULTS: 1) Of the total 22 patients, 10 were in 0-4 years of age on first admission, 8 in 5-9, and 4 above 10 years of age. The male : female sex ratio was 2.1 : 1. 2) Of the 22 patients, chief complaints on first admission were bleeding tendency in 9 patients(40.9%), pallor in 8(36.4%) and fever in 3(13.6%), in order, and physical findings on first admission were purpura or ecchymoses in 17(77.3%), anemia in 15(68.2%) and hepatosplenomegaly in 8(36.4%), in order. 3) Hematologic findings on first admission were as follows : hemoglobin levels were below 3 g/dl in 1 patient(4.5%), 3-6 g/dl in 10(45.5%), and 6-9 g/dl in 11(50.0%). Initial WBC counts were below 5,000/mm3 in 13 patients(59.1%), 5,000-10,000/mm3 in 5(22.7%) and above 10,000/mm3 in 4(18.2%). Initial platelet counts were below 20,000/mm3 in 10(45.5%), 20,000-50,000/mm3 in 5(22.7%), 50,000-100,000/mm3 in 5(22.7%) and above 100,000/mm3 in 2(9.1%). 4) Of the 22 patients, 12 patients(54.6%) were RA type, 1(4.6%) RAS, and 3(13.6%) RAEB, RAEB-T and JCML types, respectively. 5) According to prognostic scores by Mufti et al(1986), none were in 'good' group, 17 patients(89.5%) in 'intermediate' group with 39.5 months of mean duration of survival(range 4-95 months) and 2(10.5%) in 'poor' group with 18 months of mean duration of surviral(range 17-19) until the last follow-up. However, the subtypes and clinical status seemed not to be related to the prognostic scores. 6) Sixteen patients were treated with low dose cytosine arabinoside(10 mg/m2/12hrs), of whom 7 patients gained long-standing event-free survival, whose treatment regimen was changed to oral 6-TG about 2 years later. All 3 of JCML were treated with A-Triple-V regimen, one of whom was died of sepsis, one was transformed into AML and died of sepsis, while the remained one gained long-standig event-free survival (62 months). 7) Leukemic transformation into AML occured in 7 patients(RA 1, RAEB 2, RAEB-T 3, JCML 1), 6 of whom were dead, while one gained long-standing event-free survival of 34 months. CONCLUSION: We concluded that RA was the most dominant type among our patients, and the frequency to transform into AML was 31,8%, and 31.9% of the patients had long-term survival, and that reliability of prognostic scoring system by Mufti et al(1986) was not high.
Adult ; Anemia ; Anemia, Refractory, with Excess of Blasts ; Bone Marrow ; Busan ; Cell Line ; Cytosine ; Disease-Free Survival ; Ecchymosis ; Female ; Fever ; Follow-Up Studies ; Hemorrhage ; Humans ; Korea ; Male ; Myelodysplastic Syndromes* ; Pallor ; Pediatrics ; Platelet Count ; Purpura ; Retrospective Studies ; Sepsis ; Sex Distribution ; Sex Ratio ; Treatment Outcome

The Melkersson-Rosenthal syndrome consists of the associated of indings of facial nerve paralysis, facial swelling and scrotal tongue. We report a case of MRS where a 20 year old female had diffuse swelling on her face and lips for 10 years. This was also accompaiined with difficulty of facial expression and fissured tongue. The improved with intralesional injection: of triamcinolon acetonide 40mg for 3 consecutive weeks and 2 every other week.
Facial Expression ; Facial Nerve ; Facial Paralysis ; Female ; Humans ; Injections, Intralesional ; Lip ; Melkersson-Rosenthal Syndrome ; Tongue, Fissured ; Young Adult

Malignant histiocytosis(MH) is a rapidly progressive and usally fatal disorder characterized clinically fever, generalized weakness, lymphadeno athy, hepatosplenomegaly accompanied by jaundice, and purpura. The frequency of skin manifestations has been repoterd about 15% of MH patients. Papules, plaques and niidules are commonly met. Histopathologically MH shows infiltrations of atypical histiocyte; with uarious maturity in many organs including skin. We present a case of a 32-year-old female with MH involving not only lymph node, liver, spleen and bone marrow but also skin with vaorious features ; erythematous papules, annular purpuric patches, subcutaneous nodules and hemomagic nodules. Immunohist,ochemically the majority of patients atypical histiocytes in lesional skin shows a-1 antitrysin positive, but lysozyme negative. It may suggest that these are poorly differentiated atypical histiocytes rather than well differentiated ones.
Adult ; Bone Marrow ; Female ; Fever ; Histiocytes ; Histiocytic Sarcoma* ; Humans ; Jaundice ; Liver ; Lymph Nodes ; Muramidase ; Purpura ; Skin Manifestations* ; Skin* ; Spleen

The allergic skin test and RAST are used commonly to demonstrate the presence of skin sensitizing IgE antibody in the diagnosis of allergic disease. To evaluate the agreement rate and correlation between results of skin test and RAST (radioallergosorbent test) in allergic subject, 83 allergic childhood with positive skin test (bronchial asthma: 26, allergic rhinitis: 27, atopic dermatitis and urticaria: 6 bronchial asthma and allergic rhinitis: 24) and 16 nonallergic childhood were studied. The results were as follows. 1) Peripheral eosinophil counts were significantly elevated in groups with bronchial asthma, allergic rhinitis, bronchial asthma & allergic rhinitis except atopic dermatitis & urticaria group in comparison with normal control group. 2) Serum IgE levels were significantly higher in groups with bronchial asthma, allergic rhinitis, bronchial asthma & allergic rhinitis than in normal control group except atopic dermatitis & urticaria group but there was no significant differences among study groups. 3) RAST units of D.p and D.f were significantly higher in study group except atopic dermatitis & urticaria group. RAST units of cockroach, however, were not significantly increased but in D.f, combined group of bronchial asthma & allergic rhinitis was significantly higher than bronchial asthma or allergic rhinits (p<0.05). 4) Each agreement rate between 3+ skin test and positive rate of RAST in D.p, D.f, cockroach was 37.5%, 63.6% and 12.5% respectively and 4+ skin test and positive rate of RAST was 84.0%, 89.1% and 38.4%. 5) Correlation coefficient between skin test and RAST was 0.71 in D.P, 0.59 in D.f and 0.23 in cockroach. In conclusion, there was difference in agreement rate between positive skin test and RAST to each allergen. Agreement rate between positive skin test and RAST was higher in D.p and D.f. These results suggest that RAST can be used simultaneously with skin test for detecting allergens.
Allergens ; Asthma ; Cockroaches ; Dermatitis, Atopic ; Diagnosis ; Eosinophils ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Rhinitis ; Skin Tests* ; Skin* ; Urticaria

No abstract available.
Keloid* ; Recurrence*

No abstract available.
Lymphoma*

BACKGROUND: Apoptosis is a highly selective form of cell suicide with characteristic morphologieal and biochemical features, including chromatin condensation, formation of apoptotic bodies, and DNA fragmentation by the activation of endonucleases. Various cytokines and physical or chemical factors can provoke apoptotic changes in the skin. OBJECTIVE: We investigated the cytotoxic effects with epidermal cytokines and their combinations, K+ ionophores, protein synthesis inhibitor(emetine), inhibitor of endogenous endonuclease(aurintricarboxylic acid, ATA), sodium azide, and retinoic acid witp human epithelial tumor cell lines(A431 cells) to examine the degree of induction of apoptosis in the epidermal keratinocytes. METHODS: Induction of apoptosis was measured in cultured human keratinocytes, keratinocyte cell lines(A-431, HaCat, KB cells), cultured human melanocytes and malignant melanoma cell lines(SK-28, SK-30) using a mixture of ethidium bromide and acridine orange, DNA agarose gel electrophoresis and TUNEL staining. RESULTS: l. In the A-431 cells, (1 to a certain degree, the combination of IFN-gamma and TNF-alpha could only induce apoptosis. Q2 most of K+ ionophores were observed to induce necrosis rather than apoptosis. Q3 emetine, a protein synthesis blocker, was found to induce apoptosis in a dose-dependent pattern. Q4 sodium azide at a concentration of 1% .induced apoptosis rather than necrosis. Q5 retinoic acid inhibit the beuvericin induced apoptosis. 2. In human keratinocytes, Ql more resistant in the induction of apoptosis than any cultured keratinocyte cell lines p aurintricarboxylic acid(ATA)-an endonuclease inhibitor, could inhibit UV induced apoptosis 3. In human keratinocytes and cultured keratinocyte cell lines, c-PAF inhibit the beauvericin induced apoptosis. 4. Human melanocytes is very resistant for the induction of apoptosis by beauvericin. 5. In the melanocytes and melanoma cell lines, sodium azide and beauvericin induced necrosis rather than apoptosis. CONCLUSIONS: The epidermis is continuously exposed to toxic factors which might induce cell death. With the above results, the induction of appeared to be rather resistant, epidermal cell apoptosis which may reflect the existence of some endogenous protective mechanisms in the epidermis to survive at certain toxic environments; melanocytes showed high expression of bcl-2 protein which could play a role in endogenous defense against toxic environments of the epidermis.
Acridine Orange ; Apoptosis* ; Cell Death ; Cell Line ; Chromatin ; Cytokines ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Emetine ; Endonucleases ; Epidermis ; Ethidium ; Humans ; In Situ Nick-End Labeling ; Ionophores ; Keratinocytes ; Melanocytes ; Melanoma ; Necrosis ; Skin ; Sodium Azide ; Suicide ; Tretinoin ; Tumor Necrosis Factor-alpha

No abstract available.
Peptic Ulcer* ; Retrospective Studies*

A 48-year-old male patient had white to ivory colored patches on brown colored bases over the right side of his back for 8 years without accompanying pruritus or pain. Six months prior to the onset of his skin eruption, he received acupuncture for the relief of right sided back pain for 1 month. Histopathologic examination of the white patches showed follicular plugging, epidermal atrophy, focal hydropic degeneration of basal cells, lymphedema of papillary dermis, thickened homogenization of collagen fibers; consistent with findings previously reported in lichen sclerosus et atrophicus. We report this case to document the occurence in an acupuncture site and stress the unusual clinical manifestation of a zosteriform distribution.
Acupuncture ; Atrophy ; Back Pain ; Collagen ; Dermis ; Humans ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Lymphedema ; Male ; Middle Aged ; Pruritus ; Skin