Callus is a nonpenetrating circumscribed hyperkeratosis produced by repeated friction or pressure. It occurs on parts subjected to intermittent pressure, particularly on the palms and soles, and particularly over the bony prominences of the joints. In painful callosities of the feet, ill-fitting shoes and orthopedic problems of the foot (bunions, exostoses) are some of the etiological factors to be considered. Gout is a condition of inborn metabolic and/or acquired form of the disease characterized by hyperuricemia, tophaceous deposits of sodium urate and recurrent attacks of arthritis. We present a case of callus caused by tophi. The patient was a 45-year-old man who had complained of a painful, well-demarcated, hyperkeratotic plaque on the heel of the left foot for 18 months. After the tophi beneath overlying whitish thickened skin had been removed, the skin lesion disappeared and to date has not recurred.
Arthritis ; Bony Callus* ; Callosities ; Foot ; Friction ; Gout ; Heel ; Humans ; Hyperuricemia ; Joints ; Middle Aged ; Orthopedics ; Shoes ; Skin ; Uric Acid

Darier disease is a rare genodermatosis clinically characterized by multiple hyperkeratotic papules and plaques predominantly on seborrheic areas. It has characteristic histopathological features; corps-ronds, grains, suprabasal clefts or lacunae, villi projections etc. We present a case of Darier disease in a 36-year-old woman. She had suffered from skin lesions which bore a great resemblance to those of verruca plana or eruptive syringoma. We could confirm the diagnosis as Darier disease because she had the characteristic nail changes.
Adult ; Edible Grain ; Darier Disease* ; Diagnosis ; Female ; Humans ; Skin ; Syringoma ; Warts

Blue nevus is a benign melanocytic neoplasm and represents itself usually as a solitary blue or blue-black papule. It rarely occurs as multiple lesions grouped in a circumscribed area. How-ever, non-grouped disseminated blue nevi are exceedingly rare. We report a patient with acquired multiple blue nevi that was distributed over the entire body discretely and showed an increase in the number of the nevi without any causal factors.
Humans ; Nevus ; Nevus, Blue*

BACKGROUND: Monocytes and T helper cells play major roles in the immunologic dysfunction of atopic dermatitis (AD). Many studies have been done on the cytokine pattern to evaluate abnormalities or differences of immune cells in AD, but the results were conflicting among studies and most of these previous reports were performed with various kinds of mitogen-stimulation. OBJECTIVE: The purpose of this study was to investigate spontaneous cytokine pattern in peripheral blood mononuclear cells (PBMC) from patients with AD. We focused on the expression of monokines that had effects on monocytes and T cells. METHODS: We measured mRNA expression of IL-10, GM-CSF and TNF-alpha in freshly isolated PBMC with semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). The intensity of cytokine cDNA was normalized to that of beta-actin product as a standard marker. RESULTS: IL-10 mRNA expression was significantly enhanced in AD compared:with control subjects (p<0.05). Spontaneous mRNA expression of TNF-alpha was significantly lower in AD patients (p <0.01). The level of GM-CSF mRNA expression was heterogeneous and spontaneous mRNA expression was slightly increased in AD although the difference did not reach the level of statistical significance. CONCLUSION: Our data was able to represent in vivo cytokine expression state of PBMC in atopic dermatitis. Increased expression of IL-10 and GM-CSF may have been associated with monocyte dysfunction in AD although increase in the expression of GM-CSF mRNA was not statistically significant. TNF-alpha mRNA expression was decreased in AD and increased IL-10 was suggested to exert an inhibitory effect on the expression of TNF-alpha mRNA.
Actins ; Dermatitis, Atopic* ; DNA, Complementary ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Interleukin-10 ; Monocytes ; Monokines ; RNA, Messenger* ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Tumor Necrosis Factor-alpha

Trichoblastoma includes all benign follicular germinative cell tumors in skin. We presented a case of trichoblastoma which occurred on the scalp as a large pedunculated tumor. The tumor was composed of lobular aggregations of basaloid epithelial cells and numerous primitive papillary mesenchymal bodies. Stromal retraction was observed between the stroma adjacent to epithelial nests and surrounding normal dermis. Focal connection to the overlying epidermis was observed. The classification and terminology for the benign neoplasms with follicular differentiation was discussed.
Classification ; Dermis ; Epidermis ; Epithelial Cells ; Scalp ; Skin

Myofibroma and myofibromaiosis are uncommon, benign, mostly self-limiting, probably hamartomatous proliferation of myofibroblasts. These tumors are most often present at birth or before the age of 2 years with multiple ot solitary lesion. Adult cases are rare and most,ly showed as a solitary lesion. We present a case of solitary myofibroma that developed on the vertex of scalp in a 51-year-old man. The lesion was a mild tender and intermittent pruritic firm, pedunclated 1 1cm sized tumor. The iumor was diagnosed as myofibroma by light microscopy and immunohistochemistry.
Adult* ; Humans ; Immunohistochemistry ; Microscopy ; Middle Aged ; Myofibroblasts ; Myofibroma* ; Parturition ; Scalp

BACKGROUND: Such screening tools for alcoholism as MAST, NAST, CAGE focused on the alcohol-related psyhosocial problems. But some men can be exduded in a study using these tools whereas they might be at risk for alcohol related physical problems. From this perspective the new tools focusing under quantity and frequency of intake for detection of early-stage drinkers not yet manifesting evident psychosocial problems but having alcohol- related potential harms, are being developed. With focus on these aspects, 10 itemed AUDIT was developed by WHO and this study was developed to provide standard points for screening alcohol problems in Korea with cultural difference through AUDIT. METHOD: The subjects were 85 drinking men and 11 male alcohol dependents who visited Kangmung hospital af Asan foundation from July until August 1998. The team composed of 2 family physicians and 1 psychiatrist, who delivered structured interviews based on DSM-IV criteria in terms of psychosocial problems, and examined them and reviewed the patient records in terms of alcohol-related physical problems. Accordingly the subjects were classified into 'normal', 'physical problems-related drinkers' without psychosocial problems, and 'alcohol abuser' and 'alcohol dependent' according to DSM-IV criteria. Aside from physicians diagnostic procedures, they were again made to complete a questionnaire induding all the items of AUDIT, MAST, NAST and CAGE. RESULTS: As regards physicians' diagnostic results, 31 were normal, 8 had physical problems without psychosocial problems, 36 abused alcohol, and 21 were alcohol-dependent. The mean AUD1T scores of all the sub were 17.5(+/-9.5) and the mean AUDIT scores of each group were 7.1(+/-4.3), 16.6(+/-3.4), 19.9(+/-5.0), 29.3(+/-5.1), respectively and revealed significant difference among them AUDlT scores were significantly correlated with those marked from physicians' diagnostic results and also significantly correlated with MAST, NAST and CAGE, respectively. After consideration of mean AUDIT scores and standard deviations of each group according to diagnostic results, the preliminary standard AUDIT scores for detection of a broader sense of 'problem drinker' including physical as well as psychosocial problems were most possibly 12, 13, 14 points. Their sensitivity and specificity were 96.9% and 87.1% in 12 points, 92.3% and 90.8% and 90.3% in 14 points, respectively. The preliminary standard AUDIT scores concerning alcohol use disorders hased on DSM IV criteria were most possibly 14, 15, 16 with its sensitivity and specificity of 91.2% and 74.4% in 14 points, 89.5% and 79.5% in 15 points, and 84.2% and 84.6% in 16 points. The preliminary standard AUDIT scores for 'alcohol dependence' were most possibly 25, 26, 27 with its sensitivity and specificity of 85.7% and 90.7% in 25 points, 85.7% and 93.3 in 26 points, and 71.4% and 94.7% in 27 points. CONCLUSIONS: The authors recommend AUDIT cut-off scores of 12 points as the standard value for a broader sense of problem drinking including physical as well as psychasocial problems, 15 for 'alcohol use disorders' based on DSM IV criteria, and 26 for 'alcohol dependence' in Korea.
Alcoholism* ; Chungcheongnam-do ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Humans ; Korea* ; Male ; Mass Screening* ; Physicians, Family ; Psychiatry ; Sensitivity and Specificity ; Surveys and Questionnaires

Myelodysplastic syndrome (MDS) may show various kinds of skin lesions including leukemia cutis. Frequently MDS may progress into blast transformation accompanied with the skin lesions. We present a case of MDS with multiple painful subcutaneous nodules on both extremities in a 52-year-old man. He had been suffered from MDS (RA type) for 18 months. These subcutaneous nodules showed the findings of erythema nodosum histopathologically, but obvious evidence of blast transformation was not observed.
Erythema Nodosum ; Erythema* ; Extremities ; Humans ; Leukemia* ; Lymphocyte Activation ; Middle Aged ; Myelodysplastic Syndromes* ; Skin

Isotopic response describes the occurrence of a new skin disorder at the site of another one, already healed and unrelated. The preceding diseases are mostly herpes zosters. Reactive perforating collagenosis is rare dermatosis that has characteristic histopathologic features; transepidermal elimination of degenerated dermal collagen fibers. There has been only one report of an reactive perforating collagenosis occurring on the healed site of herpes zoster. We present a case of acquired reactive perforating collagenosis that was developed on the site previously affected by herpes zoster in a 67-year-old woman, which is thought to be an isotopic response.
Aged ; Collagen ; Female ; Herpes Zoster* ; Humans ; Skin ; Skin Diseases

Herpes gestationis is a rare pregnancy-associated autoimmune bullous disease resembling bullous pemphigoid in both clinical and immunohistopathological aspects. Generally it may be improved spontaneously or easily controlled by topical or low-dose corticosteroid. Very rarely, however, severe and long-standing cases that did not respond to high-dose corticosteoid therapy were reported. We present a case of an unusual severe herpes gestationis in a 26-year-old woman that was resistant to high-dose corticosteroid and/or dapsone therapy. But the lesions responded dramatically to low-dose cyclosporine.
Adult ; Cyclosporine* ; Dapsone ; Female ; Humans ; Pemphigoid Gestationis* ; Pemphigoid, Bullous