Scar sarcoidosis is a rarely encountering variant of cutaneous sarcoidosis and its pathogenesis is still unknown. When inactive scars that have been quiescent for years develop a red or purple hue with induration, we should doubt whether they become infiltrated with sarcoid granuloma or not. We report herein a 45-year-old patient with recurrent scar sarcoid, who shows indurated plaques on the right chin and raised serum level of angiotensin converting enzyme, although there was no evidence of systemic involvement. She was treated with oral doxycycline of moderate doses and skin lesions were cleared after 9 months of treatment.
Chin ; Cicatrix* ; Doxycycline ; Granuloma ; Humans ; Middle Aged ; Peptidyl-Dipeptidase A ; Sarcoidosis* ; Skin

PURPOSE: To introduce the modified Quickert suture for lower lid entropion, using nonabsorbable suture material. METHODS: From October, 2011 to June, 2012, a total of 11 patients (12 eyes) with lower lid entropion, in poor general condition or who did not want extensive surgery, were recruited for the present surgery. Three small skin incisions were made at the medial, central, and lateral areas, just below the lower cilia. With double armed 6-0 nylon, each needle was inserted in the inferior conjuctival fornix and the 2 ends of the suture were tied and buried at the point of the skin incision site. Sutures were made at the medial, central and lateral areas. RESULTS: The patients consisted of 4 males and 7 females with an average age of 71.3 +/- 8.4 years (54-82 years). The patients were followed up the patients for an average of 13.9 +/- 2.4 months postoperatively. All patients were satisfied with the outcome, and there were no recurrences. CONCLUSIONS: Quickert suture is a simple and effective method, for correcting lower lid entropion by inducing scar formation with absorbable suture materials, but the effect duration is limited. Because the modified Quickert suture utilizes its own tension with a nonabsorbable suture material, the effect lasts as long as the suture material remains. It is a useful and practicable method for patients, in poor general condition or not wanting extensive surgical procedures.
Arm ; Cicatrix ; Cilia ; Entropion* ; Female ; Humans ; Male ; Needles ; Nylons ; Recurrence ; Skin ; Sutures*

PURPOSE: To introduce the modified Quickert suture for lower lid entropion, using nonabsorbable suture material. METHODS: From October, 2011 to June, 2012, a total of 11 patients (12 eyes) with lower lid entropion, in poor general condition or who did not want extensive surgery, were recruited for the present surgery. Three small skin incisions were made at the medial, central, and lateral areas, just below the lower cilia. With double armed 6-0 nylon, each needle was inserted in the inferior conjuctival fornix and the 2 ends of the suture were tied and buried at the point of the skin incision site. Sutures were made at the medial, central and lateral areas. RESULTS: The patients consisted of 4 males and 7 females with an average age of 71.3 +/- 8.4 years (54-82 years). The patients were followed up the patients for an average of 13.9 +/- 2.4 months postoperatively. All patients were satisfied with the outcome, and there were no recurrences. CONCLUSIONS: Quickert suture is a simple and effective method, for correcting lower lid entropion by inducing scar formation with absorbable suture materials, but the effect duration is limited. Because the modified Quickert suture utilizes its own tension with a nonabsorbable suture material, the effect lasts as long as the suture material remains. It is a useful and practicable method for patients, in poor general condition or not wanting extensive surgical procedures.
Arm ; Cicatrix ; Cilia ; Entropion* ; Female ; Humans ; Male ; Needles ; Nylons ; Recurrence ; Skin ; Sutures*

PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

A drug eruption is any adverse skin reaction caused by a drug used in a normal dose. Celecoxib(Celebrex(R)), a cyclooxygenase(COX) 2 inhibitor, is a new generation non-steroidal anti- inflammatory drug, recently introduced in Korea. It is increasingly used because of significantly lower rate of gastrointestinal injury than typically seen with most other NSAIDs. Cutaneous reactions related to celecoxib are rare and there have been no previous reports in Korea. We report a case of drug eruption probably due to this drug with positive skin tests and wish to underline the possible cutaneous reactions with this new drug.
Anti-Inflammatory Agents, Non-Steroidal ; Drug Eruptions* ; Korea ; Skin ; Skin Tests ; Celecoxib

PURPOSE: To report a case of bilateral peripheral ulcerative keratitis after cataract extraction with a clear corneal incision in a patient with rheumatoid arthritis. CASE SUMMARY: A 67-year-old woman was referred to our clinic with bilateral ocular pain and visual disturbances, 10 days after a cataract extraction in her right eye. The patient had undergone a cataract extraction with clear corneal incision in the left eye and the same procedure was performed in the right eye after 1 week. During the surgery, hyphema occurred because of the iris damage by the phacoemulsification tip. Slit lamp examination showed bilateral peripheral ulcerative keratitis around the incision site and diffused corneal edema. Topical instillation and systemic administration of antibiotic agents were given as treatment but the patient showed no improvement. Corneal culture and smear were performed and showed a negative result. Because the patient was previously diagnosed with rheumatoid arthritis and showed the characteristic finger deformity, she was diagnosed with a sterile peripheral ulcerative keratitis and was treated with oral steroid, sulfasalazine, and steroid eye drop. After 1 month of treatment, epithelial thinning of the cornea and peripheral corneal ulcer stopped progressing and showed corneal re-epithelization. CONCLUSIONS: Because peripheral ulcerative keratitis after cataract extraction with clear corneal incision can occur in a patient with rheumatoid arthritis, caution is necessary to minimize damage by careful manipulation during the operation and requires special attention in preoperative and postoperative management.
Arthritis, Rheumatoid ; Cataract ; Cataract Extraction ; Congenital Abnormalities ; Cornea ; Corneal Edema ; Corneal Ulcer ; Eye ; Female ; Fingers ; Humans ; Hyphema ; Iris ; Phacoemulsification ; Sulfasalazine ; Ulcer

BACKGROUND: Although oral isotretinoin is an effective established therapy for acne, Korean data related with this therapy is very limited. Moreover, there is no published data available on the efficacy of this drug that uses a grading system suitable for Korean acne patients. OBJECTIVE: The purpose of this study is to evaluate the efficacy of oral isotretinoin (Roaccutane?) by using the Korean Acne Grading System (KAGS) and the general satisfaction of patients in treating acne. METHODS: In this multicenter and prospective clinical study, 499 patients with acne, who visited at 5 dermatologic clinics during 11 months, were enrolled. The drug dosage was 0.2~1.0 mg/kg/day over 4 months. The efficacy assessment was performed at baseline and monthly after, with an acne grading based on the KAGS and the patient satisfaction questionnaire. RESULTS: Out of the 499 patients, 435 and 371 have completed the 3-month and 4-month treatments, respectively. After the 4-month treatment, the mean acne grades significantly decreased from 2.71 to 0.68, thus showing a 75.9% reduction in pretreatment scores. The mean patient satisfaction scores improved at the end of 4-month treatment, showing a 4.42 out of 5. CONCLUSION: In this paper, we describe the efficacy of oral isotretinoin by using the KAGS, which has not been previously reported in the Korean literature. Our results show that oral isotretinoin is an effective and satisfactory treatment modality for acnes of all grades in Korean patients, regardless of the dosage.
Acne Vulgaris ; Humans ; Isotretinoin ; Patient Satisfaction ; Prospective Studies

When 6 or more Cafe-au-lait spots(CALS) tend to be randomly and widely distributed, we must rule out neurofibromatosis(NF). Nevus depigmentosus is a congenital nonprogressive hypopigmented patch that shows histologically decreased pigmentation while CALS shows increased pigmentation. We report a case of a 16-month-old girl showing generalized multiple cafe-au-lait spots with segmental nevus depigmentosus and capillary hemangioma on her right upper back. A possible explanation for the co-occurrence of CALS and nevus depigmentosus could be the concept of mosaicism.
Cafe-au-Lait Spots* ; Female ; Hemangioma* ; Hemangioma, Capillary ; Humans ; Infant ; Mosaicism ; Nevus* ; Pigmentation

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.
Biliary Tract ; Colonic Neoplasms ; Communicable Diseases ; Diabetes Mellitus ; Endophthalmitis ; Escherichia coli ; Hepatic Artery ; Klebsiella pneumoniae ; Liver Abscess* ; Liver Abscess, Pyogenic ; Neoplasm Metastasis ; Pneumonia ; Portal Vein ; Pulmonary Embolism ; Risk Factors ; Stomach Neoplasms*

BACKGROUND: Although the topical application of glycolic acid (GA) could possibly exert some effects on the normal epidermal permeability function, the exact effects and its mechanism of action have not been well documented. OBJECTIVE: This study was conducted to investigate the effects of GA on the expression of epidermal cytokines and to clarify its chelation effect on the epidermal calcium ions, which are known to control the secretion of lamellar bodies. METHODS: After topical application of 70% GA aqueous solution on the flank of hairless mice, the expression of epidermal IL-1alpha and TNF-alpha was assessed and the change of epidermal calcium ions was evaluated. RESULTS: The results could be summarized as the following: (1) real time reverse transcriptase polymerase chain reaction and immunohistochemical staining studies showed increases in mRNA and protein expression of epidermal IL-1alpha and TNF-alpha; (2) the GA reduced intracellular calcium ion concentrations in vitro and resulted in the loss of epidermal calcium gradient in vivo. CONCLUSION: These results suggest that, like iontophoresis or sonophoresis, GA could influence the skin's barrier homeostasis, possibly by lowering the epidermal calcium ions.
Animals ; Calcium* ; Cytokines* ; Homeostasis ; Ions ; Iontophoresis ; Mice ; Mice, Hairless* ; Permeability ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Tumor Necrosis Factor-alpha