We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

Lentigo maligna melanoma(LMM) is the least common type of melanoma and most commonly affects the sun-exposed skin of the elderly. We herein report a case of LMM evolved from lentigo maligna(LM). A 71-year-old female presented with a longstanding irregular brown patch containing two black papules on the left cheek which developed 8 months ago. Histopathologic findings were consistent with LM and LMM. We performed a wide excision and dufourmental flap for reconstruction with no recurrence for 30 months. Sun exposure has been known as the most important etiologic factor for the development of malignant melanoma including LMM and the incidence has an increasing tendency. Thus, skin biopsy is recommended in the evaluation of a longstanding irregular brown patch on the face to prevent LMM.
Aged ; Biopsy ; Cheek ; Female ; Humans ; Hutchinson's Melanotic Freckle* ; Incidence ; Lentigo* ; Melanoma* ; Recurrence ; Skin ; Solar System

BACKGROUND: Although rubella is a mild exanthematous viral infection and its incidence has been greatly decreased after effective vaccination, epidemics of rubella has been noted at 5- to 7-year intervals. But there has been few report about the clinical and histopathologic study of rubella in Korean literatures. OBJECTIVE: The purpose of this study was to review the clinical and histopathologic characteristics of rubella of 1996 outbreak. METHODS: We reviewed the clinical features and histopathologic findings in 50 patients diagnosed as rubella in Department of Dermatology, Presbyterian Medical Center from January 1996 through to May 1996. RESULTS: 1. The male-female ratio was 1: .17. The age distribution was 13-32 years and 72% of patients were aged 16-25 years. 2. Erythematous maculopapular rash on whole body was developed in all patients. Eighty two percent of the patients had fever and lymphadenopathy, and 36% of the patients had petechiae of soft palate. The main prodromal symptoms were sore throat(50%), headache(34%), and upper respiratory symptoms(22%), as order of frequency. 3. Positive serologic test for rubella IgM antibody was 79.5%. 4. The most common abnormal laboratory finding was leukopenia(58%), and followed by positive ASO(34%), the presence of atypical lymphocytes(21%), and thrombocytopenia(8%). 5. Histologically, epidermal changes were mild to moderate vacuolopathy(92.3%), the presence of dyskeratotic cells(30.8%), spongiosis(23.1%), and exocytosis(15.4%). Dermal findings were mild superficial perivascular lymphohistiocytic infiltration(100%), upper dermal edema(53.8%), perivascular edema(38.4%), pigmentary incontinence(30.8%), and the presence of extravasated RBC(23.1%). Eosinophil infiltration(15.4%) and the presence of large nucleated lymphocytes(92.3%) were also observed. Conclusions: According to the results of our study about rubella outbreak in 1996, clinical signs and symptoms were similar to those of previously described. Histologically, superficial perivascular dermatitis with mild to mederate vacuolar interface change was a main feature and large nucleated lymphocytes were frequently noted.
Age Distribution ; Dermatitis ; Dermatology ; Eosinophils ; Exanthema ; Fever ; Humans ; Immunoglobulin M ; Incidence ; Lymphatic Diseases ; Lymphocytes ; Palate, Soft ; Prodromal Symptoms ; Protestantism ; Purpura ; Rubella* ; Serologic Tests ; Vaccination

Occasionally, erythema multiforme has been reported to occur in association with allergic contact dermatitis to various substances including paraquat(Gramoxone(R)). In these cases the erythema multiforme has ranged from mild localized exanthem to life-threatening toxic epidermal necrolysis. We report a case of toxic epidermal necrolysis developed from erythema multiform due to contact of paraquat.
Dermatitis, Allergic Contact ; Erythema ; Erythema Multiforme ; Exanthema ; Paraquat ; Stevens-Johnson Syndrome*

BACKGROUND: Despite the fact that adolescent smokers are increasing in Korea, an effective smoking cessation program is not widely available. The purpose of the present study was to develop and evaluate a short term smoking cessation program. METHODS: The subjects involved in the smoking cessation program were 89 students from 9 different middle and high schools located in Seoul. They were referred to our program by their school teacher as a penalty for smoking in school. The duration of the program was a total of 270 minutes and the program was carried out in 3 sessions during a period of one week. The program included cigarette related experiments and life skills enhancement training, such as self-assertiveness, cigarette refusal skills and self esteem enhancement. The students considered to be smoke free at the end of the program were those who declared themselves to be smoke free and achieved an expiratory CO level of less than 8 ppm. The stage of smoking cessation was also assessed at the beginning to later evaluate if any progress in stage had occurred. Certification was given to those who succeeded in meeting the smoke free criteria. The students who were not able to meet the smoke free criteria were given the certification only under the condition that they achieve a level of expiratory CO measurement close th that of a nonsmoker's. RESULTS: Eighty seven students out of the 89 received the certification and 90.7% had attempted smoking cessation during the program. 39.1% Among, met the smoke free criteria used in this study. There was a significant difference between those who declared to be smoke free (54.1%) on the questionnaire and those who actually met the smoke free criteria. There was an average of a 0.75 stage advancement in terms of the stage of smoking cessation (P<0.005). CONCLUSIONS: The program yielded high smoking cessation attempt and cessation rate in spite of the short duration of the program.
Adolescent* ; Certification ; Disulfiram ; Humans ; Korea ; Self Concept ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Products ; Tobacco Use Cessation

Stereotactic vacuum-assisted breast biopsy (VAB) has been used to evaluate microcalcifications or non-palpable breast lesions on mammography. Although stereotactic VAB is usually performed in a prone or upright position, an expensive prone table is necessary and vasovagal reactions often occur during the procedure. For these reasons, the lateral decubitus position can be applied for stereotactic VAB, and true lateral mammography can be used to detect the lesion. We report on 15 cases of lateral decubitus positioning for stereotactic VAB with true lateral mammography for non-palpable breast lesions or microcalcifications. The mean procedure time was approximately 30.1 minutes, and no complications occurred during the procedures. Fourteen cases had benign breast lesions and one case had a ductal carcinoma in situ. The lateral decubitus stereotactic VAB with true lateral mammography can be applied for microcalcifications or non-palpable breast lesions and helps to minimize anxiety and vasovagal reactions in patients.
Anxiety ; Biopsy ; Breast ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mammography ; Stereotaxic Techniques

BACKGROUND: Fas and Fas ligand (FasL) are cell surface proteins that mediate apoptosis. Fas and FasL are expressed in normal epidermal cells, but are different in the expression patterns in epidermal layers. OBJECTIVE: The purpose of this study was to evaluate the expression of Fas and FasL in various skin diseases including non-tumorous diseases and tumors. METHOD: We performed immunohistochemical staining for Fas and FasL with monoclonal or polyclonal antibodies using frozen skin tissues from 29 patients. RESULTS: 1. In normal skin, Fas and FasL were expressed as intercellular and intracellular patterns. Fas was expressed in the basal and spinous layers, and FasL was expressed in the upper spinous and granular layers. 2. In psoriasis vulgaris and lichen planus, FasL expression was proportional to the degree of epidermal hyperplasia, such a relationship was not found in Fas expression. 3. In verruca vulgaris and herpes zoster, the upregulation of Fas and FasL expression was observed in lesional epidermis. 4. In skin tumors, Fas and FasL expression were observed in most tumor cells of Bowen's disease, keratoacanthoma, and squamous cell carcinoma. In basal cell carcinoma, FasL was expressed strongly and diffusely in the infiltrating tumor cells, but Fas was not expressed at all. CONCLUSION: Fas and FasL play an important role in the differentiating process of the epidermis by coordinate expression between them. In non-tumorous conditions and skin tumors, Fas and FasL might function as essential mediators of cellular turnover in pathogenesis of the skin diseases.
Antibodies ; Apoptosis ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epidermis ; Fas Ligand Protein* ; Herpes Zoster ; Humans ; Hyperplasia ; Keratoacanthoma ; Lichen Planus ; Membrane Proteins ; Psoriasis ; Skin Diseases* ; Skin* ; Up-Regulation ; Warts

BACKGROUND: Fas and Fas ligand (FasL) are cell surface proteins that mediate apoptosis. Fas and FasL are expressed in normal epidermal cells, but are different in the expression patterns in epidermal layers. OBJECTIVE: The purpose of this study was to evaluate the expression of Fas and FasL in various skin diseases including non-tumorous diseases and tumors. METHOD: We performed immunohistochemical staining for Fas and FasL with monoclonal or polyclonal antibodies using frozen skin tissues from 29 patients. RESULTS: 1. In normal skin, Fas and FasL were expressed as intercellular and intracellular patterns. Fas was expressed in the basal and spinous layers, and FasL was expressed in the upper spinous and granular layers. 2. In psoriasis vulgaris and lichen planus, FasL expression was proportional to the degree of epidermal hyperplasia, such a relationship was not found in Fas expression. 3. In verruca vulgaris and herpes zoster, the upregulation of Fas and FasL expression was observed in lesional epidermis. 4. In skin tumors, Fas and FasL expression were observed in most tumor cells of Bowen's disease, keratoacanthoma, and squamous cell carcinoma. In basal cell carcinoma, FasL was expressed strongly and diffusely in the infiltrating tumor cells, but Fas was not expressed at all. CONCLUSION: Fas and FasL play an important role in the differentiating process of the epidermis by coordinate expression between them. In non-tumorous conditions and skin tumors, Fas and FasL might function as essential mediators of cellular turnover in pathogenesis of the skin diseases.
Antibodies ; Apoptosis ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epidermis ; Fas Ligand Protein* ; Herpes Zoster ; Humans ; Hyperplasia ; Keratoacanthoma ; Lichen Planus ; Membrane Proteins ; Psoriasis ; Skin Diseases* ; Skin* ; Up-Regulation ; Warts

PURPOSE: In cases of overactive bladders, especially hyperreflexic neurogenic bladders, that arise in patients with spine disorder above sacral micturition center, current primary treatment modalities include the administration of anticholinergics and the intermittent catheterization. Because anticholinergics have many side effects including dry mouth, the demand for new agents has been rising. This study was designed to investigate the effects of ylang-ylang (YY) essential oil, which is currently used in aromatherapy, on the relaxation of urinary bladder muscle in vitro. MATERIALS AND METHODS: Isometric tension changes of isolated rat bladder muscle strips were recorded in an organ bath using a pressure transducer. Effects of YY oil were assessed on resting tension, electrical field stimulation(EFS)-, bethanechol-, ATP- and KCl-induced contraction. In order to determine the mechanism of YY oil, effects of YY oil on above all stimulations were assessed in the presence of methylene blue, L-NAME(N-nitro-L-arginine methyl ester) and N-ethylmaleimide. RESULTS: The contractility of strips pre-treated with YY oil was significantly decreased on all stimulation-induced contractions. There was no statistically significant difference between treated group only with YY oil and pre-treated group with YY oil and methylene blue. Similar findings were obtained when L-NAME(another NOS inhibitor) was used. When N-ethylmaleimide(c-AMP inhibitor) was employed, there was a statistically significant decrease in the rate of contraction induced by EFS, bethanechol, KCl and ATP applications. CONCLUSION: From the obtained data, the results of this study indicate that YY essential oil has relaxing effect on the bladder, and such mechanism is thought to be brought about by a pathway mediated by c-AMP.
Adenosine Triphosphate ; Animals ; Aromatherapy ; Baths ; Bethanechol ; Cananga* ; Catheterization ; Catheters ; Cholinergic Antagonists ; Ethylmaleimide ; Humans ; Methylene Blue ; Mouth ; Muscles* ; Rats* ; Relaxation* ; Spine ; Transducers, Pressure ; Urinary Bladder* ; Urination

We encountered a case of Sweet's syndrome associated with myelodysplastic syndrome in a 60-year-old woman. The clinical presentation strongly suggested Sweet's syndrome. A skin biopsy specimen taken from her skin lesion on the leg showed an infiltration of numerous neutrophils in the subcutis instead of the dermis which is the main area of neutrophilic infiltration in Sweet's syndrome. Among infiltrating cells, many neutrophils(8%) showed nuclear segmentation anomalies, that is, hyposegmentation(pseudo-Pelger-Huet anomaly) or hypersegmentation. Peripheral blood neutrophils had similar anomalies. This subcutaneous variant of Sweet's syndrome, Sweet's panniculitis, is rare and nuclear segmentation anomalies of neutrophils are probably a good clue to underlying myelodysplastic syndrome.
Biopsy ; Dermis ; Female ; Humans ; Leg ; Middle Aged ; Myelodysplastic Syndromes* ; Neutrophils* ; Panniculitis ; Skin ; Sweet Syndrome*