BACKGROUND: The efficacy of tumescent liposuction in the treatment of axillary osmidrosis has been widely established. But there have been few studies that have conducted a comparative analysis according to the level of dermal curettage with respect to the efficacy and safety. OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and complications of tumescent liposuction according to the degree of dermal curettage. METHODS: From September 2004 through August 2009, a total of 33 patients with axillary osmidrosis (66 axillae) were included in this study. Twelve patients (24 axillae) were treated by tumescent liposuction with dermal curettage at the level of the mid-dermis (the classical technique group), and the other 21 patients (42 axillae) were treated by tumescent liposuction with dermal curettage at the level of the dermo-subcutis junction (the modified technique group). The preoperative and postoperative disease severity was measured as 0, 1, 2 and 3. The improvement of symptoms was graded by the patient as excellent, good, fair and poor. We also evaluated the postoperative complications, including skin necrosis, scar, hematoma, sensory disturbance and infection. Biopsies of the axillary skin were performed in 7 patients to confirm the level of dermal curettage and the reduction of apocrine glands after treatment. RESULTS: The follow-up ranged from 6 to 60 months. Six months after treatment, 95.8% (23/24) of the axillae in the classical technique group and 95.2% (40/42) of the axillae in the modified technique group had reduced disease severity below 1. Among the 12 patients treated with the classical technique, 11 (91.7%) had excellent to good results, while 95.2% (20/21) of the patients treated with the modified technique had excellent to good results by the patients' own grading. The complications included skin necrosis, scar and hematoma. In the classical technique group and the modified technique group, the incidence of skin necrosis was 12.5% (3/24) and 2.4% (1/42), respectively, the incidence of scar formation was 4.2% (1/24) and 0%, respectively, and the incidence of hematoma was 8.3% (2/24) and 0%, respectively. The postoperative histologic examinations confirmed that the dermal curettage level was at the mid-dermis in the classical technique and at the dermo-subcutis junction in the modified technique. Interestingly, the histologic examination from the classical technique group revealed vacuolar alteration of keratinocytes and partial separation of the dermo-epidermal junction. CONCLUSION: The efficacy of the modified technique is compatible with that of the classical technique, but the modified technique offers fewer complications. So, the modified technique may improve the cosmetic outcome without reducing the treatment efficacy for the patient with axillary osmidrosis.
Apocrine Glands ; Axilla ; Biopsy ; Cicatrix ; Cosmetics ; Curettage ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Keratinocytes ; Lipectomy ; Necrosis ; Postoperative Complications ; Skin ; Treatment Outcome

No abstract available.
Bowen's Disease ; Fingers

A retrospective analysis of clinical findings in 23 patients with Y. pseudotuberculosis infection who visited Department of Pediatrics of Han Il Hospital from May. 1990 to June, 1992 was performed. 1) The most prevalent age group was 7 to 12 years (16 case: 69.6)and male-to-female ratio was 1.1:1. 2) Monthly distribution showed a high frequency in April, May and June (22 cases:95.7%) 3) The common symptoms were fever(23 cases:100%), abdominal pain (18 cases: 78.3%) vomiting(16 cases: 69.6%), diarrhea (13 cases: 56.7%), rash (13 cases: 56.5%)and acute renal failure (6 cases: 26.1%) in order of frequency, respectively. 4) The laboratory findings were anemia (17.4%), WBC>1(10E4/mm((73.9%), ESR>20mm/hr (91.3%), CRP>3+(91.3%), Positive Widal test (13.0%), BUN>20mg/dl (26.1%) and creatinine> 1.2mg/dl (26.1%). 5) The most common serotype was 4a (30.4%), followed by 4b, 5b, 2b, 2c, 5a, 1b, 1a, 6 in order of frequency. The results suggest that Yersinia pseudotuberculosis infection is one of the important causes of the important causes of fever, eruptive skin diseases and acute renal failure in Korean children and further studies including epidemiology, pathogenesis, etc, are needed.
Abdominal Pain ; Acute Kidney Injury ; Anemia ; Child ; Diarrhea ; Epidemiology ; Exanthema ; Fever ; Humans ; Pediatrics ; Retrospective Studies ; Skin Diseases ; Yersinia pseudotuberculosis* ; Yersinia*

The importance of tick-borne diseases is increasing because of climate change, with a lack of long-term studies on tick-borne pathogens in South Korea. To understand the epidemiological characteristics of tick-borne diseases, the monthly distribution of field ticks throughout the year was studied in South Korea between May 2014 and April 2018 in a cross sectional study.

Melanotrichoblastoma is a variant of pigmented trichoblastoma that shows highly pigmented epithelial lobules and differentiation toward the hair bulb. Histologically, the tumor presents features of trichoblastoma, and the histological findings are remarkable by virtue of the heavy melanin deposits found within and around the tumor cell nests. For the immunohistochemistry, abundant dendritic melanocytes (with the expressions of S100 protein, tyrosinase and most importantly, gp100/HMB45) are found within the tumor masses. We report here on a rare case of melanotrichoblastoma in a 57 year-old female patient.
Female ; Hair ; Humans ; Immunohistochemistry ; Melanins ; Melanocytes ; Monophenol Monooxygenase ; Virtues

Pleomorphic adenomas are the most common neoplasms of the salivary glands. A long-lasting pleomorphic adenoma can develop into a malignant tumor. Malignant mixed tumor of the salivary gland includes carcinoma ex pleomorphic adenoma, carcinosarcoma, and metastasizing pleomorphic adenoma. The metastasizing pleomorphic adenoma is to be distinct from the true malignant mixed tumor, because it remains histologically benign and can metastasize. We report the case of a 64-year-old female with a long-standing goose egg-sized neck mass and multiple small firm nodules on the trunk and extremities, which showed histological features metastasizing pleomorphic adenoma of the salivary gland.
Adenoma, Pleomorphic ; Carcinosarcoma ; Extremities ; Female ; Humans ; Middle Aged ; Mixed Tumor, Malignant ; Neck ; Neoplasm Metastasis* ; Salivary Glands ; Submandibular Gland*

Late-onset focal dermal elastosis is a recently described disorder afflicting elderly patients with yellow papules on the neck and flexural areas. Although there are similar clinical findings to pseudoxanthoma elasticum, no stigmata of pseudoxanthoma elastimum are not evident. Histologically the papules are characterized by increased elastic fibers of normal appearance in the mid and deep dermis and no evidence of solar elastosis. Late-onset focal dermal elastosis may be caused by focal accumulation of normal appearing elastic tissue due to loss of age related homeostatic growth regulating gene control mechanism. We report a case of pseudoxanthoma elasticum-like late-onset focal dermal elastosis and suggest that this condition may be more common than has been reported.
Aged ; Christianity ; Dermis ; Elastic Tissue ; Humans ; Neck ; Pseudoxanthoma Elasticum

BACKGROUND: Uremic pruritus is a common disabling problem in patients with end-stage renal disease (ESRD). Not many studies have focused on evaluating the clinical characteristics of uremic pruritus. OBJECTIVE: The aim of this study was to identify the prevalence and clinical characteristics of uremic pruritus in hemodialysis patients. METHODS: A detailed questionnaire was used to evaluate the pruritus of 75 patients who were treated at the hemodialysis unit in Maryknoll Medical Center. We examined the relationship of the quality of dialysis and various factors and medical parameters with uremic pruritus. RESULTS: Pruritus was a common symptom in the study population. Twenty two point seven percent of the patients had severe pruritus in the past, and 36% were affected by it at the time of the study. There was no correlation between the occurrence of pruritus and the demographic or medical parameters of the patients (gender, age, the cause of ESRD, the duration of ESRD and hemodialysis, previous treatment of ESRD, the dialysis efficacy as expressed by Kt/V, and the transfusion and laboratory parameters such as blood urea nitrogen, creatinine, calcium, phosphorus, parathyroid hormone and uric acid). Skin dryness was found in 14 (18.7%) patients. It was assessed as slightly dry skin in 9 (12.0%) patients and as rough skin in 5 (6.7%) patients. A significant relationship was demonstrated between the intensity of xerosis and the frequency of uremic pruritus (p=0.042). The intensity of xerosis was greater in the severe pruritic patients, but any statistically significant correlation was not found. The major factors found to exacerbate pruritus included sleep disturbance, heat, dry skin and dialysis. The major factors found to reduce pruritus included taking a shower or bath, sleeping, dialysis and physical activity. CONCLUSION: There was a significant relationship between the intensity of xerosis and the frequency of uremic pruritus. A better understanding of the clinical characteristics of uremic pruritus will afford clinicians the necessary elementary tools to discover its origin and the possible effective treatments.
Baths ; Blood Urea Nitrogen ; Calcium ; Creatinine ; Dialysis ; Hot Temperature ; Humans ; Kidney Failure, Chronic ; Motor Activity ; Parathyroid Hormone ; Phosphorus ; Prevalence ; Pruritus ; Renal Dialysis ; Skin ; Surveys and Questionnaires

BACKGROUND: The impaired barrier function on the skin lesion of herpes zoster can contribute to the development of secondary bacterial infection. Although bacterial infection may delay wound healing and cause scarring, there is no available data about secondary bacterial infection of patients with herpes zoster. OBJECTIVE: We investigated the relationship between the result of bacterial studies and several clinical manifestations of herpes zoster including age, dermatomal distribution, duration of the skin lesion, severity of acute pain, incidence of postherpetic neuralgia, and diabetes mellitus. METHODS: We classified 377 patients with herpes zoster, according to the results of bacterial studies of the wound, conducted by means of bacterial culture and Gram stain. We compared them by age group, dermatomal distribution, duration of the skin lesion, severity of acute pain, and the presence of postherpetic neuralgia and diabetes mellitus. RESULTS: The positive rate of bacterial culture study of the skin lesion was 613% and that of Gram stain was 48.0%. The most common identified pathogen was Staphylococcus epidermidis (83 cases, 35.9%). 61.3% (73/119) of the male patients were positive and 41.9% (108/258) of the female patients were positive in the Gram stain and the difference was significant (p=0.0004). In the relationship with dermatomal distribution, the positive rate in the Gram stain of patients with a distribution of the trigeminal nerve was 62.1% (59/95) and was significantly higher than in other patients (p=0.0276). The positive rate in the bacterial culture of the posthepetic neuralgia group was 71.2% (84/118) and that of the non-postherpetic neuralgia group was 28.8% (34/118). The difference was statistically significant (p=0.008). However the positive rate in the Gram stain of the posthepetic neuralgia group was 55.1% (65/118) and was still higher than that of the non-postherpetic neuralgia group, 44.9% (53/118). But the difference was not statistically significant (p=0.063). 64.4% (38/59) of diabetic patients were positive and 35.6% (21/59) of non-diabetic patients were positive in Gram stain study. The difference was statistically significant (p=0.006). CONCLUSION: The incidence of positive result of the bacterial study in patients with herpes zoster was significantly higher in male patients, patients with a dermatomal distribution of the trigeminal nerve, patients with postherpetic neuralgia, and diabetic patients. But the rate of positive result of the bacterial study was not related to age, duration of the skin lesion, severity of acute pain and postherpetic neuralgia.
Acute Pain ; Bacterial Infections ; Cicatrix ; Diabetes Mellitus ; Female ; Herpes Zoster* ; Humans ; Incidence ; Male ; Neuralgia ; Neuralgia, Postherpetic ; Skin* ; Staphylococcus epidermidis ; Trigeminal Nerve ; Wound Healing ; Wounds and Injuries

Neonatal meningitis caused by the Group B beta-hemolytic streptococcus was first reported in 1958. In recent years this organism has assumed major importance in the etiology of neonatal infection. In Korea, this organism is likely to play an increasing role in neonatal infection. So this investigation was designed to report the 9 cases of Group Bbeta-hemolytic streptococcus infected neonates admitted to the NICU, department of Pediatrics, Hanil Hospital from January 1990 to June 1993. The results were as followings. 1) Onset of disease was between 12days and 32 days of age and male to female ratio is 1:2. 2) Two cases were delivered by c-section, seven cases were by NFSD and all of the infants had normal birth weight with full term at delivery. Maternal obstetric and neonatal complications were not detected in all cases. 3) The common presenting symptoms were fever in all cases, seizure in 6 cases, feeding difficulty, lethargy, vomiting, etc. 4) Group Bbeta-hemolytic streptococcus was isolated in CSF of all cases and in blood of 6 cases. 5) There were abnormal brain CT findings in 4 cases of group Bbeta-hemolytic streptococcal meningitis. 6) The sensitive antibiotics were Cefotaxime, Cefazoline, Erythromycin, Ampicillin, Chloramphenicol, Clindamyucin and Penicillin. 7) All cases were reconvered except one case that expired on the 1st day of admission and 6 cases were followed up for the period of 2months to 33months without neurologic sequelae, of which 1 case revealed decreased wave on Lt. hemisphere in ABR.
Ampicillin ; Anti-Bacterial Agents ; Birth Weight ; Brain ; Cefazolin ; Cefotaxime ; Chloramphenicol ; Erythromycin ; Female ; Fever ; Humans ; Infant ; Infant, Newborn ; Korea ; Lethargy ; Male ; Meningitis* ; Pediatrics ; Penicillins ; Seizures ; Streptococcus ; Vomiting