We report a case of anosacral cutaneous amyloidosis in a 74 year-old-man. The skin finding is a patch of the size of a childs palm on the sacral area, consisting of brownish macular lines that radiate frorn the anus. Histopathology revealed defiosits of homogenous eosinophilic mateial s in the papillary dermis. Congo red staining and dylon staining was positive. Immuohistochemical staining using anti SAP antibodies and anti-keratin antibodies showed positive reactions.
Amyloidosis* ; Anal Canal ; Antibodies ; Child ; Congo Red ; Dermis ; Eosinophils ; Humans ; Skin

We reviewed the 43 medical records of patients with cellulitis or erysipelas who had been admitted at the depar1ment of dermatology of Seoul National University Hospital and followed them up for mean 21.6 months. The results were as follows. 1. The sex ratio of patients with cellulitis was 1:1.4 and the average age was 49 years. 2. The lower extremity as the most frequently invloved site of cellulitis with the frequency of 58.1% (25 cases), with the head and neck being involved in 16 cases(37.2%) and trunk and upper extremity in 1 case each(2.3% ). 3. The portals of infecticin were suspected in 33 cases(76% ), where tinea pedis was detect,ed in 18 cases(41.9%), previous skin infeection 10 cases(23.3%) and trauma in 9 cases(20.9%). 4. Initial systemic symptoms were fever(76.7%), chill(65.1%) and headache(37.2%). Erythema(100%), local heating(90,7%), tenderness(88.4%), swelling(86.0%), ulcer(16.3%), bulla(14.0%), lymphangitis(9.2%) and lymphadenit,is(9.2%) were found in the skin lesions. 5. The laboratory findings revealed leukocytosis in 35.7%, elevaed ESR in 86.8% positive 6. ASO titer in 63.0% and positive CRP in 80%, Microorganism. were detected in only 1 of 15 blood cultures, in 2 of 4 bulla fluid cultures and in 7 of 9 bus cultures. There was no growth of causative microorganisms in 3 tissue cultures and 9 saline needle aspiration cultures. Penicillin was used as primary antibiotics in 19 cases, which changed to another antibiotics due to lack of improvement in 3 cases and cefazolin was used in 21 cases, which changed in 2 cases due to the same reason. 7. Average admission priod was 11 days(range from 3 to 20 days) and 30.2% of patients wit.h cellulitis experienced recurrence, but 48% on low extrernity in contrast with 6.7% on head and neck.
Anti-Bacterial Agents ; Cefazolin ; Cellulitis* ; Dermatology ; Erysipelas ; Head ; Humans ; Leukocytosis ; Lower Extremity ; Medical Records ; Neck ; Needles ; Penicillins ; Recurrence ; Seoul ; Sex Ratio ; Skin ; Tinea Pedis ; Upper Extremity

BACKGROUND: Chronic cutaneous lupus erythematosus(CCLE) is a well-known disease entity. But there has been no data about its clinical behavior and histopathologic features in Korea. OBJECTIVES: This study was conducted to elucidate the clinical, laboratory, and histopathologic features of CCLE, and the relationship between CCLE and SLE. MATERIALS AND METHODS: We investigated 48 cases of CCLE that visited the department of dermatology at the Seoul National University Hospital from January 1990 to June 1997. Medical records and biopsy slides were reviewed.
Biopsy ; Dermatology ; Korea ; Lupus Erythematosus, Cutaneous* ; Medical Records ; Seoul

The allopurinol hypersensicivity syndrome is a rare, but life thereaning immunologic reaction of allopurinol therapy, characterized by multiple abnormalities such as fever, rash, decreased renal function, hepatocellular injury, leukocytosis, and eosinophila. It may require prolonged hospitalization and occasionally involves residual morbidity. Three patients developed erythematous skin eruption three to five weeks after beginning therapy with allopurinol. The clinical, laboratory, and histologic findings of these patients were compatible with a allopurinol hyperensitivity syndrome.
Abnormalities, Multiple ; Allopurinol* ; Exanthema ; Fever ; Hospitalization ; Humans ; Hypersensitivity* ; Leukocytosis ; Skin

Porencephaly is relatively rare condition defined by an defect or a defect or cavity in the cerebrum owing to a developmental malformation or to a destructive lesion. Fory-five porencephaly patients diagnosed by Brain CT were clinically analyzed and the following results were obtained. 1) By the age group presenting initial symptoms, the peak incidence was from 1 month to below 3 years old. 2) In initial symptoms, seizure, spastic weakness, headache were showed in order of frequency. But 7 cases (15.5%) were asymptomatic. 3) The latency of diagnosis after presenting initial symptoms from the symptom onset time to 10 years. 4) The subsequent symptoms were as follows: spastic weakness, speech disturbance, gait disturbance, mental retardation, sensory loss and seizure showed independently or combined. 5) As etiologic factor, 21 cases (46.7%) were congenital, 16 cases (35.5%) were post-traumatic or post-operative and 8 cases (17.8%) were perinatal. 6) The prognosis was seen various from mild to severe. Out of 45 cases, 29 cases (64.4%) were no complications. But the prognosis in patients with post-traumatic or postoperative etiological factors was poor. With the advent of brain CT and the resultant capability of detecting structural defect and cerebral lesions responsible for epilepsy or focal neurologic signs, porencephaly was seen to be readily recongizable by CT examination. Since porencephaly is a significant contributor to the spectrum of CNS lesion and benign condition, ist recognition is important in determining prognosis and therapy.
Brain ; Cerebrum ; Child, Preschool ; Diagnosis ; Epilepsy ; Gait ; Headache ; Humans ; Incidence ; Intellectual Disability ; Muscle Spasticity ; Neurologic Manifestations ; Prognosis ; Seizures

BACKGROUND: It is a popular notion that cutaneous ageing includes two distinct phenomenon; true ageing, a universal presumably inevitable change attributable to the passage of time alone, and photoageing, changes attributable to chronic habitual sun exposure that are neither universal nor inevitable. Numerous investigations with experimental animals, in vitro skin models have been conducted, although, few histological studies to date have attempted to announce fundamental morphological changes with innate ageing. OBJECTIVE: We compared skin derived from the breast of old and young persons using light microscopy to discern structural changes in epidermal and dermal morphology with advancing age. METHODS: The histological, immunohistochemical studies were performed with normal skin sections of thirty donors who were diagnosed with breast cancer. They were classified into three age cohort groups; nine into group I (22 to 38), twelve into group II(40 to 52), and nine into group III(54 to 87). We chose the breast as an area that might closely resemble intrinsically aged skin. This region is relatively shielded from photoageing by its anatomical location. Analysis of data was performed using the Kruskal-Wallis and ANOVA test for dermal parameters based on a 5-point rating scale, and a simple regression test for a positive rate of immunoreactants. Results : 1. Light microscopic appearance of aged skin revealed a more flattened epidermis than young skin. There was no trend for an increase in epidermal melanin content per unit area on Fontana-Masson staining. There was an age-associated decrease in the Ki-67 positive rate(p<0.001), the density of Ki-67 positive cells declined approximately 1.16% per decade in photoprotected skin(p<0.001). The number of S-100 positive cells declined approximately 4.4/mm width along the dermo-epidermal juction per decade in photoprotected skin(p<0.001). The expression of differentiation markers(keratin 1, involucrin, filaggrin, loricrin) were not different among the three age cohort groups. 2. With advancing age, there was an attenuation in the number and diameter of elastic fibers in the papillary dermis and an increase in the number and straightness of the same fibers in the reticular dermis. The collagen fibers are arranged in sparse bundles in disarray, and/or aggregates of loosely woven, straight fibers in the aged skin. There was an apparent, age-related decrease in the stainability of ground substances in the papillary dermis on colloidal iron staining. Conclusions : Our data documents semi-quantitative differences among three groups in intrinsically aged breast skin and provide the framework for future research to evaluate the ageing process.
Animals ; Breast ; Breast Neoplasms ; Cohort Studies ; Collagen ; Colloids ; Dermis ; Elastic Tissue ; Epidermis ; Humans ; Iron ; Melanins ; Microscopy ; Skin* ; Solar System ; Tissue Donors

A clinical investigation of the patients with pustulosis palmaris et plantaris (PPP) was made on 36 patients who were seen at the Department of Dermatology, Seoul National University Hospital, from January 1986 through June 1987. The results were summarized as follows : 1. In this series of 36 patients, 14 patients(38.9%) were male and 22 patients (61.1%) were female. Females are more subject to the affection than males. 2. The mean age of onset in male was 30.6 years and in female it was 38.4 years, indicating a earlier onset in male. The peak age of incidence in male was between 20 and 29 years and in female, between 40 and 49 years. 3. The sites of involvement were mostly bilateral hands and feet. 4. the season of the year did not influence the severity of the skin lesions in 68.9%. 5. Nine patients(28.1%) had psoriasis-like skin lesions and 14 patients(43.1%) had nail changes out of 32 patients with PPP. 6. No direct relationship could be found between pustular eruptions and focal infections, such as tonsilitis, otitis, dental abscess and sinusitis. 7. Remmission of the pustular eruptions could be achieved in 5 out of 10 patients treated with etretinate and in 4 out of 11 patients treated with ketoconazole for more than 4 weeks' treatment
Abscess ; Acitretin ; Age of Onset ; Dermatology ; Etretinate ; Female ; Focal Infection ; Foot ; Hand ; Humans ; Incidence ; Ketoconazole ; Male ; Otitis ; Palatine Tonsil ; Psoriasis* ; Seasons ; Seoul ; Sinusitis ; Skin

BACKGROUND: Lichen planus is a papulosquarnous disease characterized by pruritic violaceous papules most commonly an the extremities of middle-aged adults. It may or may not be accompanied by oral and genital mucous membrane involvement. Its course is generally self-limited for a period of several months to years, but it may last indefinitely. OBJECTIVE: This study was performed to find the clinical characteristics of lichen planus. METHODS: Thirty-five cases of lichen planus comfirrned clinically and histopathologically were analyzed. RESULTS: The incidenc of lichen planus was 0.073% of the total number of dermatologic patients. The age distribution was in the range of 14-63 years old being most prevalent in the 6th decade and there was ariequal sex ratio. The most common site of involvement was the mucous membrane, and the extremities were more common than the trunk. Pruitus or pain and discomfort developed in 28 pat,ients(80% ). In most cases, the treatment was topical corticosteroid and antihistamine. Sixteen cses improved within 1 month to 2 years. Five cases recurred in the improved cases. CONCLUSION: The clinical analysis of 35 patients with lichen planus was performed. The incidence of lichen planus was 0.073% of the total number of dermatologic patients. Males and females were equally affected Mucous membrane involvement was detected in 21 patients(60%).
Adult ; Age Distribution ; Extremities ; Female ; Humans ; Incidence ; Lichen Planus* ; Lichens* ; Male ; Mucous Membrane ; Sex Ratio

BACKGROUND: There is concem about the rising incidence of skin cancer. However, few articles have reported the change in the clinical and epidemiological aspects of skin cancer. OBJECTIVE: We performed this study in order to clarifiy the recent changes in cutaneous premalignant and malignant lesions. METHODS: A statistical analysis was made using 101 cases of cutaneous premalignant lesions and 205 cases of ma]ignant tumors out of a total number of 20,175 new outpatients that visited the Department of Dermatology at the Seoul National University Hospital during a 6 year period(1990-1995). RESULTS: The frequency of premalignant lesions was 0.50% and that of malignant tumors was 1.02%. The frequency showed an increasing tendency compared to previous reports. In the premalignant lesion cases, actinic keratosis was most common and represented a figure of 82.2%. Among the malignant tumors, basal cell carcinoma was most frequent at 24.4%. Age, sex and anatomical site distribution of basal cell carcinoma, malignant melanoma was no different. The mean age of squamous cell carcinoma was greater than in previous reports and main preceding lesions were actinic keratosis and cheilitis. The frequency of lymphoma was markedly increased but the reason for this remains to be determined. CONCLUSION: Our findings showed the continous increasing incidence of skin cancers and emphasize the need for public eduacation, early diagnosis and proper treatment.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Dermatology ; Early Diagnosis ; Humans ; Incidence ; Keratosis, Actinic ; Lymphoma ; Melanoma ; Outpatients ; Seoul ; Skin Neoplasms ; Statistics as Topic*

We report a case of hereditary angioedema in a 48-year old female patient. She experidenced facial edema and dyspnea 5 to 6 times for a year. Similar episodes developed on some members of her family, especially her sisters and father. We examined her and her sister's serum complement levels. The results showed decreased levels of C1 esterase inhibitor and C4, compared to normal levels. We treated the patient with danazol effectively.
Angioedemas, Hereditary* ; Complement C1 Inhibitor Protein ; Complement System Proteins ; Danazol ; Dyspnea ; Edema ; Fathers ; Female ; Humans ; Middle Aged ; Siblings