Lymphomatoid papulosis is a chronic disease of cutaneous atypical lymphoid infiltration characterized clinically by involuting and recurring papules, plaques, and sometimes nodules. A 51-year-old man presented with a single, coin sized, nontender, erythematous nodule on the left thigh of a 2-week duration. There was a history of recurrence and spontaneous healing of similar asymptomatic eruptions five to six times over 20 years. A biopsy specimen showed a dense, wedge-shaped dermal infiltrate that was patchy and perivascular. The cellular infiltrate was polymorphous and consisted of large atypical cells, small lymphocytes, eosinophils and neutrophils. The large atypical cells were strongly CD30(Ki-1) positive. We report a case of lymphomatoid papulosis unusually presenting as a single nodular eruption, in which the differential diagnosis between lymphomatoid papulosis and CD30(Ki-1)positive large cell lymphoma is exceedingly difficult.
Biopsy ; Chronic Disease ; Diagnosis, Differential ; Eosinophils ; Humans ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis* ; Middle Aged ; Neutrophils ; Numismatics ; Recurrence ; Thigh

BACKGROUND: The human homologue of mouse double minute 2(mdm-2) gene codes for a cellular protein that forms a complex with the mutant and wild type p53 protein and modulates its trans-activation activity. Overexpression of the mdm-2 protein is associated with the tumorigenic potential of mdm-2 gene and overcomes the growth suppressive activity of p53. OBJECTIVE & METHODS: In order to investigate the pattern of the mdm-2 and p53 expression in malignant skin tumors, we performed an immunohistochemical analysis using NCL-MDM-2p polyclonal antibody and DO7 monoclonal antibody, respectively, in 10 squamous cell carcinomas (SCCs), 8 basal cell carcinomas(BCCs), 5 malignant melanomas(MMs), and 6 fibrosarcomas (FSs). RESULTS: The expression of mdm-2 protein was detected in 40% of SCCs, 25% of BCCs, 40% of MMs and 33% of FSs, whereas 40% of SCCs, 25% of BCCs, 20% of MMs, and 17% of FSs showed p53 positivity. One case of SCCs and one case of BCCs showed immunoreactivity with both anti-mdm-2 and anti-p53 antibodies. Within the limitations of this small sample size, there was no relationship between the expression of mdm-2 and p53 protein, as overexpression of these two genes was not mutually exclusive. CONCLUSION: These findings suggest that interaction between the mdm-2 and p53 genes and products in these malignant tumors appears to be heterogenous and more complex than previously realized. Further studies on molecular basis are required to characterize the mechanism of mdm-2 overexpression and its relation to p53.
Animals ; Antibodies ; Carcinoma, Squamous Cell ; Fibrosarcoma ; Genes, p53 ; Humans ; Melanoma ; Mice ; Proto-Oncogene Proteins c-mdm2 ; Sample Size ; Skin*

We experienced a case of arteriovenous hemangioma showing Dariers sign on the forehead of a 43-year-old man. He presented with a single, 1 * 1.5cm sized, violaceous, asymptomatic nodule with a history of an intermittent wheal at the lesional site. This skin lesion showed Dariers sign clinically and proliferation of mast cells histopathologically with the punch biopsy specirnen suggesting urticaria pig- mentosa. Howerer, we could diagnose it as a arteriovenous hemangioma on complete excision, as the specimen showed arteriovenous proliferation with increased mast cells in a perivascular pattern. This case showed confusing clinical signs and showed the importance of complete excision for the diagnosis of a small skin tumor especially when a vascular proliferating tumor is suspected.
Adult ; Biopsy ; Diagnosis ; Forehead ; Hemangioma* ; Humans ; Mast Cells ; Skin ; Urticaria

BACKGROUND: Packs are viscous preparations that produce a film over the skin surface, thus preventing the evaporation of water and increasing the skin temperature. Because of this occlusive effect, packs can be used as the vehicle to which active pharmacologic agents produce a therapeutic effect. OBJECTIVE: This study aimed to explore the feasibility of pack formulation as a vehicle by comparing percutaneous absorption with ointment formulation. METHODS: After 0.5, 1, 2 and 6 hours of topical applications of 0.05% clobetasol 17-propionate ointment and pack on each forearm of 9 young, healthy male subjects, the amounts of the drug in tape-stripped stratum corneum were assessed using high performance liquid chromatography(HPLC). RESULTS: There was no significant difference with regard to the amount of the drug in tape-stripped stratum corneum between ointment and pack formulations of 0.05% clobetasol 17-propionate. CONCLUSION: Pack formulations delivered similar amount of drugs to the skin compared to ointment formulations, suggesting peel-off type pack can be used as a new vehicle of topical corticosteroids.
Adrenal Cortex Hormones* ; Clobetasol ; Forearm ; Humans ; Male ; Skin ; Skin Absorption* ; Skin Temperature

In cases of replantation, accurate closure of all structures, including bone, tendons, arteries, nerves, and veins is essential. Among these, the vein is a weaker structure and is damaged severely in most amputation cases. After fixation of bone, repair of tendons, nerves, and arteries, surgeons often experience difficulty in performing venous anastomoses. We found that in such cases, venous anastomosis is easy to perform using an additional incision after closure of the original wound. In a 33-year-old male patient with amputation of all four fingers at the metacarpophalangeal joint level, venous anastomoses were performed with dorsal veins using additional incisions after completion of the fixation of bones and repair of all other structures and closure of the skin due to surgical site tension.
Adult ; Amputation ; Arteries ; Fingers ; Humans ; Male ; Metacarpophalangeal Joint* ; Replantation* ; Skin ; Surgeons ; Tendons ; Veins* ; Wounds and Injuries*

BACKGROUND: The proper use of inhaler drugs is critical in the management of chronic asthma. In this study, we investigated the inhalation performance of asthmatic patients and effectiveness of the regular education of inhalation technique. METHODS: The 145 asthmatic patients who had been educated the inhaler technique for more than 3 times were enrolled. The inhalation performance of each patient was scored using a checklist form (9 items for metered dose inhaler [MDI], 4 items for dry powder inhaler [DPI]) whenever they visited the clinic. Clinical characteristics affecting inhalation performance were evaluated in the groups using each type of inhaler. RESULT: In MDI, the mean initial performance score was significantly low when the patients were female sex, aged patients (>65 years old), or had lower educational backgrounds. Some items of the checklist, which include tilting head back, placing the mouthpiece with a distance from lips, continuing deep inspiration, and holding breath after inhalation for 10 seconds, were improperly performed in about 25% of the MDI users. No significant change was observed in the final performance scores assessed after intensive repeated education for proper inhalation technique of MDI. In DPI, the mean initial performance score was significantly low in the patients with old age (>65 years old) or lower educational backgrounds. The final performance scores were significantly improved after the repeated education for proper use of DPI inhalation in contrast to MDI. CONCLUSION: For the effective management of asthma, it may be important to choose proper type of inhaler with consideration of individual characteristics of the patients. The evaluation of inhalation performance and regular education of inhalation technique could be useful to maintain and improve the effective use of inhaler, especially in DPI.
Asthma* ; Checklist ; Dry Powder Inhalers ; Education ; Female ; Head ; Humans ; Inhalation* ; Lip ; Metered Dose Inhalers ; Nebulizers and Vaporizers