No abstract available.
Lichen Sclerosus et Atrophicus* ; Lichens*

No abstract available.
Pityriasis Rubra Pilaris ; Pityriasis ; Ustekinumab

Background: Sweet syndrome is characterized by tender erythematous plaques and nodules with predominantly dermal neutrophilic infiltrates. Sweet syndrome is relatively rare in children and adolescents. To date, only a few cases have been reported in Korean literature. Objective: The aim of this study was to investigate the clinical and histopathological features of Sweet syndrome in Korean children and adolescents. Methods: A retrospective study was conducted on 15 pediatric patients (aged ＜18 years) who were diagnosed with Sweet syndrome between 1991 and 2019. We reviewed the clinical and histopathological features of Sweet syndrome. Results: The age of the 15 patients ranged from 4 months to 17 years. Among the 15 patients with Sweet syndrome, nine patients were females and six patients were males. Most patients (80%) had lesions on the upper extremities. Fever and tenderness (60%) were the most commonly associated symptoms. Transient infections such as upper respiratory infection or gastroenteritis were the most common identifiable cause, observed in 40% of patients. Histopathologically, dermal neutrophilic infiltration was observed in all patients. All patients were treated with systemic corticosteroids and showed a good response, although 26.7% of the patients experienced symptom recurrence.During the follow-up period, there were no incidences of any complications or extracutaneous manifestations in the patients. Conclusion In contrast to previous reports of pediatric Sweet syndrome, female predominance was observed in this study. Transient infection was the most common factor. All patients responded well to systemic corticosteroid therapy without complications or extracutaneous manifestations during the follow-up period.

Background: Sweet syndrome is characterized by tender erythematous plaques and nodules with predominantly dermal neutrophilic infiltrates. Sweet syndrome is relatively rare in children and adolescents. To date, only a few cases have been reported in Korean literature. Objective: The aim of this study was to investigate the clinical and histopathological features of Sweet syndrome in Korean children and adolescents. Methods: A retrospective study was conducted on 15 pediatric patients (aged ＜18 years) who were diagnosed with Sweet syndrome between 1991 and 2019. We reviewed the clinical and histopathological features of Sweet syndrome. Results: The age of the 15 patients ranged from 4 months to 17 years. Among the 15 patients with Sweet syndrome, nine patients were females and six patients were males. Most patients (80%) had lesions on the upper extremities. Fever and tenderness (60%) were the most commonly associated symptoms. Transient infections such as upper respiratory infection or gastroenteritis were the most common identifiable cause, observed in 40% of patients. Histopathologically, dermal neutrophilic infiltration was observed in all patients. All patients were treated with systemic corticosteroids and showed a good response, although 26.7% of the patients experienced symptom recurrence.During the follow-up period, there were no incidences of any complications or extracutaneous manifestations in the patients. Conclusion In contrast to previous reports of pediatric Sweet syndrome, female predominance was observed in this study. Transient infection was the most common factor. All patients responded well to systemic corticosteroid therapy without complications or extracutaneous manifestations during the follow-up period.

PURPOSE: This study was undertaken to evaluate the long-term treatment of esophageal strictures in children with corrosive esophagitis and to determine the effect of self-bougienage on recurrent strictures. MATERIALS AND METHODS: We reviewed the medical records of nine children that were treated for corrosive esophageal strictures from May 2000 to May 2008. Six males and three females were included and their average age was 30 months. Six patients had ingested acids, two patents had ingested alkali, and one ingested an unknown agent. RESULTS: The interval between caustic ingestion and esophageal stricture ranged from one to eight weeks. The average length of the esophageal strictures was 3.8 cm (range, 1 to 9.2 cm). Four patients had a long segment stricture (longer than 5 cm) and one patient had multiple strictures. The most common site of involvement was the upper third followed by the mid third of the esophagus. Eight patients received repeated dilatation using a balloon catheter or bougie dilator. Among the eight patients, two patients had complete resolution of symptoms and six patients required surgery. Among five patients that developed restenosis of the esophageal anastomosis site, three patients had improved symptoms after self-bougienage and two patients had improved symptoms with repeated balloon dilatation or endoscopic bougienage. There were no complications in these patients. CONCLUSION: Although a small number of patients were studied, self-bougienage was safe, less invasive, and effective for the management of esophageal restenosis in patients who required frequent dilation after surgery.
Adult ; Aged ; Balloon Dilatation/adverse effects ; Esophageal Stenosis/*therapy ; Female ; Humans ; Male ; Middle Aged ; Self Care/*instrumentation ; Young Adult

The Overlap syndrome is characterized by a combination of the major hepatobiliary autoimmune diseases such as autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis. It is frequently accompanied by inflammatory bowel disease. Chronic lymphoplasmacellular osteomyelitis is characterized by recurrent episodes of bacterial osteomyelitis and is associated with autoimmune diseases (especially inflammatory bowel disease). We report the case of a girl who was diagnosed with ulcerative colitis and autoimmune hepatitis at 4 years of age and with the overlap syndrome with primary sclerosing cholangitis at 6 years. At 9 years, she was diagnosed with chronic lymphoplasmacellular osteomyelitis.
Autoimmune Diseases ; Child* ; Cholangitis, Sclerosing ; Colitis, Ulcerative ; Female ; Hepatitis, Autoimmune ; Humans ; Inflammatory Bowel Diseases ; Liver Cirrhosis, Biliary ; Osteomyelitis

BACKGROUND: Insulin resistance, decreased response of peripheral tissue to normal insulin levels, is known to be related to cardiometabolic diseases. Cardiopulmonary fitness is also considered to be related to these comorbidities. Therefore, we investigated the relationship between insulin resistance and cardiopulmonary fitness by performing a 3-minute step test in a Korean non-diabetes mellitus (DM) population. METHODS: A total of 118 non-DM subjects were enrolled during their routine health check-up. Insulin resistance was measured by calculating homeostatic model assessment-insulin resistance (HOMA-IR), and a 3-minute step test was performed to measure cardiopulmonary fitness. RESULTS: Post-60 seconds exercise heart rate after 3-minute test (R60 heart rate) was correlated with age (r = -0.21, P = 0.02), education (r = 0.17, P = 0.04), body mass index (r = 0.23, P = 0.01), waist circumference (r = 0.28, P < 0.01), fasting insulin (r = 0.28, P < 0.01), HOMA-IR (r = 0.25, P < 0.01), low density lipoprotein-cholesterol (r = 0.28, P < 0.01), high sensitivity C-reactive protein levels (r = 0.22, P = 0.02), and baseline heart rate (r = 0.56, P < 0.01). In a step-wise multiple regression analysis, baseline heart rate (beta = 0.79, P < 0.001), HOMA-IR (beta = 0.65, P = 0.02), and systolic blood pressure (beta = 0.15, P = 0.03) were identified as explanatory variables for R60 heart rates. CONCLUSION: Our results suggested that cardiopulmonary fitness was associated with insulin resistance in non-DM patients of a university hospital in Korea. Further studies are needed to elucidate the underlying mechanisms.
Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Comorbidity ; Exercise Test ; Fasting ; Heart ; Heart Rate ; Humans ; Insulin ; Insulin Resistance ; Korea ; Physical Fitness ; Waist Circumference

PURPOSE: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. METHODS: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. RESULTS: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. CONCLUSION: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.
Child* ; Endoscopy ; Esophagus ; Foreign Bodies* ; Humans ; Intestines ; Medical Records ; Numismatics ; Parents ; Retrospective Studies ; Stomach

PURPOSE: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. METHODS: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. RESULTS: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. CONCLUSION: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.
Child* ; Endoscopy ; Esophagus ; Foreign Bodies* ; Humans ; Intestines ; Medical Records ; Numismatics ; Parents ; Retrospective Studies ; Stomach

Hansens' disease is well known chronic inflammatory granulomatous disease by Macobacterium leprae., and occur rarely in these days. The wide range of clinical manifestations develop by status of the host resistant. These are from mild sensory change, erythematous macular patches, diffuse infiltrating plaque, and nodules to severe destruction of peripheral nerve and internal organ involvements. Vitilgo and xanthelasma rarely may occur in the lepromatous leprosy. The patient was a 60-year-old a farmer who complained erythematous diffuse ill defined infiltrative plaques or nodules on the face, trunk. He was diagnosed as lepromatous leprosy by skin biopsy and fite staining and had taken the standard 3 multidrug (dapsone, rifampicin, lamprene)therapy. About 3 months during the therapy, the existing skin lesions became erythematous and mild edematous, some of which show vitiligo like change, and severe general aching and neuralgia developed. Type 1 lepra reaction with upgrading was diagnosed by clinical symptoms and skin biopsy feature. The vitiligo lesions also appeared on the normal looking skin without previous lepromatous lesion. At that time, yellowish plaque appeared on both eyelid and diagnosed as xanthelasma without hypolipoproteinemia. The mutidrug therapy for lepsory continued and oral predinsolone was given for the general aching of neuralgia. The lepra skin lesions had been improved gradually and the vitiligo lesions also disappeared. Presenting case is very interesting in point of view that he had vitiligo related to type 1 lepra reaction, and simultaneously developed xanthelasma palpebrum.
Biopsy ; Eyelids ; Humans ; Hypolipoproteinemias ; Leprosy ; Leprosy, Lepromatous ; Middle Aged ; Neuralgia ; Peripheral Nerves ; Rifampin ; Skin ; Vitiligo