The blue rubber bleb nevus syndrome(CRBNS) is a rare disorder characterized by distinctive vascular malformations of the skin and gastrointestinal tract. The syndrome is associated commonly with iron deficiency anemia due to gastrointestinal bleeding. Most cases are sporadic, although a few have been reported with autosomal dominant inheritance. We report a case with clinical characteristics of the blue rubber bleb nevus syndrome. The patient had typical skin manifestations of the BRBNS and chronic iron deficiency anemia. However, we could not find any gastrointestinal vascular malformations radiologically.
Anemia, Iron-Deficiency ; Blister* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Nevus* ; Rubber* ; Skin ; Skin Manifestations ; Vascular Malformations ; Wills

BACKGROUND: Vitiligo is an acquired depigmentary disorder characterized by loss of melanocytes from the epidermis. Autografting using the suction blistered epidermis technique is one of the surgical modalities of vitiligo treatment, and has been successfully used by several authots. OBJECTIVE: The purpose of this study was to evaluate the effect of the autografting using the suction blistered epidermis technique for the treatment of vitiligo. METHODS: 142 sites from 39 patients with vitiligo were treated with autografting using the suction blistered epidermis technique. The recipient sites were prepared by freezing with liquid nitrogen of the sites 48 hours prior to grafting. RESULTS: Better results were seen in cases with the following Factors: a) cases where the disease had been present for more than 3 years b) the post-operative period had been Longer than a year c) the Lesional sites of the vitiligo were on the trunk and neck rather than the neck and extremities d) the vitiligo had affected the grabous rather than the hairy areas on the face. However, there were no differences between the clinical types(such as generalized, localized, and segmental) in the success rate of treatment. Preopera'tive PUVA or post operative PUVA also did not affect the statistical results. CONCLUSION: On autografting using the suction blistered epidermis, it is better to select the patients who have had the disease for more than 3 years, and graft the epidermis which has increased melanocytes by preoperative PUVA for good treatment results and even pigmentation.
Autografts* ; Blister* ; Epidermis* ; Extremities ; Freezing ; Humans ; Melanocytes ; Neck ; Nitrogen ; Pigmentation ; Suction* ; Transplantation, Autologous* ; Transplants ; Vitiligo*

PURPOSE: Therapeutic hypothermia (TH) has been a standard treatment for ventricular fibrillation (VF) cardiac arrest survivors to improve neurological outcomes. However, there is a lack of evidence that TH has a neuroprotective effect to asphyxial cardiac arrest, which is one of the most prevalent causes of sudden death besides VF cardiac arrest. We studied whether TH improves the neurological outcomes after resuscitation from asphyxial cardiac arrest. METHODS: We included asphyxial cardiac arrest survivors from January 2002 to December 2010. Clinical and neurological outcome data of 24 consecutive patients undergoing TH were compared with 18 patients who did not undergo TH (11 historical controls and seven refusal of TH by patient's next-of-kin). Neurological outcome was assessed at discharge according to the Cerebral Performance Category scale. The incidence of complications after asphyxial cardiac arrest was compared between the two groups. RESULTS: Baseline characteristics except arterial pH after recovery of spontaneous circulation were not different between the TH group and the non-hypothermic group. Good neurological outcome was similar between the TH group and the non-hypothermic group (8.3% vs 0.0%, p=0.498). The TH group included 18 hypokalemic patients, while non-hypothermic group included eight hypokalemic patients (p=0.044). The rate of other complication did not differ significantly between the two groups. CONCLUSION: Therapeutic hypothermia was not associated with good neurological outcome in asphyxial cardiac arrest survivors and was not associated significantly with the incidence of complications after asphyxial cardiac arrest. However, the findings are not conclusive because of a lack of patients, lack of randomization, and uncertainty of appropriateness of therapeutic hypothermia method to asphyxial cardiac arrest.
Asphyxia ; Coma ; Death, Sudden ; Disulfiram ; Heart Arrest ; Humans ; Hydrogen-Ion Concentration ; Hypothermia ; Hypothermia, Induced ; Incidence ; Neuroprotective Agents ; Random Allocation ; Resuscitation ; Survivors ; Uncertainty ; Ventricular Fibrillation

BACKGROUND: Becker's nevus is a relatively common pigmented smooth muscle harmatoma that develops during adolescence and occurs primarily in young men. The nevus, characterized by hypertrichosis and hyperpigmentation, is usually located unilaterally over the shoulder, upper arm, and scapula. These nevi are not only cosmetically undesirable but also psychologically distressing, as traditional surgical therapies have been either unsuccessful or have resulted in scarring. OBJECTIVE: We evaluated the clinical improvement of 14 patients with a becker's nevus who were treated with a Q-switched (QS) frequency doubled ND: YAG laser in order to decrease pigmentation. METHODS: Our study was designed by analyzing the clinical improvement of outpatients with becker's nevus via clinical examination and photography. RESULTS: The results were as follows; Male to female ratio of 2.5: 1. The mean age was 19.7 years old and the subjects in most of the studies were young adult. The mean age of onset was 5.7 years old (below 5 years old: n=8, 57%). We treated 14 patients with a QS ND: YAG laser. The patients' response to treatment was; excellent; 14%, good; 36%, fair; 21%, and poor; 29%. Conparison, was made, of the positive clinical improvement in patients who received treatment once (n=10) and those who received treatment more than twice (n=4). Multiple treatments (75%) showed superior improvement compared with single treatment (40%). The clinical improvement, the according to the area of lesions, was the best in the neck (100%) and the worst in the trunk (25%). The lesions were accompanied by hair in 6 cases. Among these, the excellent or good cases were 33%. The other patients (8 cases) without hairs had more positive results (63%). Treatment effects according to laser fluence were not shown to be significant. During the study, the most common complication was hyperpigmentation (36%), followed by transient erythema (14%). Scarring or hypopigmenatation had resulted in none. CONCLUSION: Our data suggested that QS ND: YAG laser irradiation is an effective and safe method to treat the hyperpigmentation characteristic of a becker's nevus. Long-term further evaluation will be necessary to determine whether the favorable results observed in these patient will be permanent.
Adolescent ; Age of Onset ; Arm ; Child, Preschool ; Cicatrix ; Erythema ; Female ; Hair ; Humans ; Hyperpigmentation ; Hypertrichosis ; Lasers, Solid-State* ; Male ; Muscle, Smooth ; Neck ; Nevus* ; Outpatients ; Photography ; Pigmentation ; Scapula ; Shoulder ; Young Adult

BACKGROUND: It is mandatory to measure the minimal phototoxic dose(MPD) in order to determine adequate irradiation of UV-A in photochemotherapy. However, the measurement of MPD is not easy in some cases due to inadequte size and site of lesions, time and manpower. OBJECTIVE: The purspose of this study was to standardize the minimal phototoxic dose for a vitiliginous lesion. METHODS: The minimal phototoxic dose of UV-A was measured in 82 vitiligo patients. Then we analyzed the MPD according to the sex, age, site of the vitiliginous lesions, duration of disease, and administration route of the photosensitizer. RESULTS: 1. There were no significant differences between exposed and unexposed areas in MPD in both cases of topical and systemic administration of the photosensitiser. 2. There was no significant correlation between disease duration and MPD in both cases of topical and systemic administration of the photosensitiser. 3. In the group of topical application of 8-methoxypsoralen cream, MPD for males and females were 0.53+0.38J/cm2 and 0.48+0.32J/cm2 respectively without significant difference in sex. 4. In the group of systemic administration of 8-methoxypsoralen, there was a significant difference between males and females in MPD. The MPD in males and females were 1.38+0.72J/cm2 and 2.51 + 1.40J/cm2, respectively. 5. In the group of topical application of 8-methoxypsoralen cream, the MPD in 2nd decade patients was the highest(0.80+0.55J/cm2). The MPD had a tendency to decrease gradually as age receded from the 2nd decade. 6. In the group of systemic administration of 8-methoxypsoralen, there was a tendency for the MPD to be increased according to age without statistical significance. 7. MPD in the group systemically administrated with 8-methoxypsoaralen was four-fold to that of the topical application group. CONCLUSION: It may be valuable to keep in mind that there was a statistical differrence in MPD between sexes in systemic administration of the photosensitizer, and that MPD was different according to patients age in the topical application group.
Female ; Humans ; Male ; Methoxsalen ; Photochemotherapy ; Skin* ; Vitiligo

Scedosporium(S). apiospermum is the asexual stage of Pseudallescheria boydii. This ubiquitous fungus causes not only mycetoma but also infection of a variety of body sites including the skin. Localized skin infection without grain production due to this organism is much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection which occured in a 75-year old female. She had multiple suppurative nodules with pustules on a dark red plaque at the dorsum of the right forearm. Cultural isolation for definitive diagnosis showed typical S. apiospermum. The patient was treated successfully with oral terbinafine 250mg daily for 1 week and oral itraconazole 200mg daily for 3 weeks.
Aged ; Edible Grain ; Diagnosis ; Female ; Forearm ; Fungi ; Humans ; Itraconazole ; Mycetoma ; Pseudallescheria ; Scedosporium* ; Skin*

The presence of facial wrinkles can have a significant effect on a person's self image relating to physical appearance and social acceptance. Many treatment modalities for wrinkle reduction, such as surgical method, injection of Botulinum toxin, chemical peeling, and laser peeling have been developed. The resurfacing carbon dioxide laser has recently proved to be a useful and safe tool in the treatment of facial wrinkles. We have attempted to treat pecular perioral wrinkles using a combination of laser and chemical peeling techniques. This combination treatment has resulted in a good cosmetic appearance. We report and encourage use of this method for wrinkle reduction.
Botulinum Toxins ; Lasers, Gas ; Social Distance

Keratolytic winter erythema is an autosomal dominant skin disorder of unknown etiology. It is charaterised by cyclical erythema, hyperkeratosis, and peeling of the skin of the palms and soles, arresting at major skin creases. The symptoms are noticeable during winter. We present clinical and histological data of a 22-year-old male with the attributes of keratolytic winter erythema.
Erythema* ; Humans ; Male ; Skin ; Young Adult

In our country the ICD-10(International classification of disease) is used to classify disease. But it has many problems in classifying and managing statistics in the field of dermatology. For instance, there are many diseases that are not included in the ICD-10, and the classification is not organized. Also, in many cases the classification of ICD-10 has problems in computerizing. Even though we need a classification overcoming these problems, National health insurance corporation is using the ICD-10. In this study, we corrected the problems of the ICD-10 to make an improved ICD-10 to use in dermatologic fields. To do this, we had to search all the dermatologic disease code contained in the ICD-10, and find all the disease listed in the book of domestic and foreign. We had to compare and analyse these. Subsequently, we add the diseases that are not contained in the ICD-10, organized the classification and improved the dermatologic disease code of ICD-10. This classification would be useful for the management of disease in the dermatologic field.
Classification* ; Dermatology ; International Classification of Diseases ; National Health Programs

We report a case of multiple Bowen's disease in a 36-year-old female patient who had multiple erythematous, scaly patches and plaques distributed diffusely on her trunk, upper and lower extremities. Histopathologic studies showed hyperkeratosis, parakeratosis, acanthosis, and thickening of the rete ridges in the epidermis. The cellular architecture is disorganized, and individually keratinizing cells and atypical cells were seen at all levels of the epidermis. The skin lesions were improved with treatment with oral isotretinoin, 0.5mg/kg per day in combination with interferon alpha-2a administrated subcutaneously at 3 million units once a week.
Adult ; Bowen's Disease* ; Epidermis ; Female ; Humans ; Interferon-alpha ; Interferons* ; Isotretinoin* ; Lower Extremity ; Parakeratosis ; Skin