No abstract available.
Amnion* ; Hydrocortisone* ; Pregnancy*

Lichen planus is a chronic papulosquamous disease that affects the skin and mucous membranes. It is characterized by pruritic violaceous papules that are most commonly seen on the extremities of middle aged adults, but the elderly are rarely affected. Hypertrophic lichen planus usually occurs on the extremities and especially on the shins, and it tends to be the most pruritic variant. An 82-year-old female presented with severe pruritic multiple papules and plaques on the both the upper and lower extremities for 1 year. At first, the lesions began as small, polygonal papules that formed verrucous plaques over several months. Histopathologic examination showed marked hyperkeratosis, irregular acanthosis and wedge-shaped hypergranulosis. The vacuolar alteration and the lymphocytic inflammatory infiltrate were accentuated at the base of the rete ridge. From these findings, we diagnosed these lesions as hypertrophic lichen planus. The lesions were treated with topical steroid and intralesional injection of steroid, and they were slightly improved after 2 months of therapy.
Adult ; Aged ; Aged, 80 and over ; Extremities ; Female ; Humans ; Injections, Intralesional ; Lichen Planus ; Lichens ; Lower Extremity ; Middle Aged ; Mucous Membrane ; Skin

No abstract available.
Anetoderma* ; Granuloma Annulare* ; Humans ; Infant*

BACKGROUND: Acute pain can severely interfere with the activities of daily living (ADL) of patients with herpes zoster, but until now, little has been published in the Korean medical literature about the impact of herpes zoster on the ADL. OBJECTIVE: The objective of this study was to identify the nature and severity of the acute pain of herpes zoster patients and its relationship to the patients' ADL. METHODS: 86 patients with herpes zoster and who visited our hospital from August 2009 to June 2010 were evaluated in regard to age, gender, the dermatomal distribution, the associated diseases, the severity and nature of the pain and the ADL. The nature of the pain was measured by the Short Form McGill Pain Questionnaire. To access interference of pain with the ADL, we used the Zoster Brief Pain Inventory (ZBPI) and the Zoster Impact Questionnaire (ZIQ). RESULTS: The mean onset of pain was 5.6+/-3.2 days before the visit, and the mean onset of skin lesion was 4.2+/-2.2 days before the visit. The most common nature of the pain of herpes zoster was shooting pain (55.8%), followed by stabbing pain (54.7%). But there was no significant difference of gender, age, the dermatomal distribution, the clinical severity and the associated disease according to the severity and nature of the pain. For every 1.0 point increase in the pain score, there was a 0.257 and 0.105 point increase in the ZBPI and ZIQ scores, respectively, on the multivariate linear regression model. CONCLUSION: This study will help to choose appropriate treatments to reduce the pain of patients who suffer with herpes zoster.
Activities of Daily Living ; Acute Pain ; Herpes Zoster ; Humans ; Linear Models ; Pain Measurement ; Quality of Life ; Skin

BACKGROUND: Acute pain can severely interfere with the activities of daily living (ADL) of patients with herpes zoster, but until now, little has been published in the Korean medical literature about the impact of herpes zoster on the ADL. OBJECTIVE: The objective of this study was to identify the nature and severity of the acute pain of herpes zoster patients and its relationship to the patients' ADL. METHODS: 86 patients with herpes zoster and who visited our hospital from August 2009 to June 2010 were evaluated in regard to age, gender, the dermatomal distribution, the associated diseases, the severity and nature of the pain and the ADL. The nature of the pain was measured by the Short Form McGill Pain Questionnaire. To access interference of pain with the ADL, we used the Zoster Brief Pain Inventory (ZBPI) and the Zoster Impact Questionnaire (ZIQ). RESULTS: The mean onset of pain was 5.6+/-3.2 days before the visit, and the mean onset of skin lesion was 4.2+/-2.2 days before the visit. The most common nature of the pain of herpes zoster was shooting pain (55.8%), followed by stabbing pain (54.7%). But there was no significant difference of gender, age, the dermatomal distribution, the clinical severity and the associated disease according to the severity and nature of the pain. For every 1.0 point increase in the pain score, there was a 0.257 and 0.105 point increase in the ZBPI and ZIQ scores, respectively, on the multivariate linear regression model. CONCLUSION: This study will help to choose appropriate treatments to reduce the pain of patients who suffer with herpes zoster.
Activities of Daily Living ; Acute Pain ; Herpes Zoster ; Humans ; Linear Models ; Pain Measurement ; Quality of Life ; Skin

Glomus tumors are benign cutaneous neoplasm, occurring in the vascular hamartomatous tubercles of the glomus body, which is a myoarterial apparatus typically found in the reticular dermis of the skin. Histopathologically, glomus tumors are composed of neoplastic cells that resemble normal glomus cells, arranged around a varying number of thin-walled, sometimes branching capillaries. Immunohistochemically, neoplastic cells in glomus tumors clearly exhibit smooth muscle characteristics with expression of muscle-specific actin and alpha-smooth muscle actin; whereas, the expression of CD34 is rare. In this report, we present two cases of benign glomus tumors on the subungual area and palm. Tumor cells of glomus tumor in two patients were both positive for smooth muscle actin (SMA) and CD34 immunohistochemical staining. We thought that coexpression of SMA and CD34 adds support to the interpretation of these lesions as a family of perivascular neoplasms.
Actins ; Capillaries ; Dermis ; Glomus Tumor ; Humans ; Muscle, Smooth ; Muscles ; Skin

OBJECTIVE: This study evaluated the prognostic factors that influence the surgical outcomes of elderly patients older than 65 years old with an aneurysmal subarachnoid hemorrhage. METHODS: Ninety-two patients older than 65 years old, who were operated in our hospital between 1998 and 2005, were reviewed retrospectively. The clinical outcomes were evaluated using the modified Rankin Scale three months after surgery. RESULTS: The preoperative neurological status, such as the Hunt-Hess grade (p<0.001), World Federation of Neurological Surgeons (WFNS) grade (p<0.001), and the Fisher grade (p=0.001), was significantly associated with the surgical outcomes in this series. The vasospasm (0.016) and ventriculostomy (0.039) are factors influencing the surgical outcomes. However, the other factors including hypertension (0.831), smoking (0.228), accompanying disorder (0.706), size of aneurysms (0.177), location of aneurysms (0.755), shunt operation (0.356), and timing of surgery (0.194) had no influence on the surgical outcome. CONCLUSION: In elderly patients with intracranial aneurysms, the preoperative neurological status, vasospasm, and ventriculostomy are the most significant prognostic factors.
Aged* ; Aneurysm* ; Humans ; Hypertension ; Intracranial Aneurysm ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage* ; Ventriculostomy

A calcifying aponeurotic fibroma is a rare benign fibrous tumor with well-characterized histopathological features. Calcifying aponeurotic fibromas are generally slowly-growing lesions related to tendons and aponeuroses in the distal extremities of children and adolescents. While the neoplasm is usually asymptomatic, cases of progressive local discomfort have been reported. The exact etiology of this neoplasm is unknown, and there is frequently no history of trauma or local irritating factors. A 10-year-old female presented with a 2.5x2.0 cm, subcutaneous mass on the right sole 4 years after she bumped against a table. The histopathologic examination showed a poorly circumscribed fibrotic mass with foci of chondroid differentiation and calcification. These findings were consistent with the diagnosis of a calcifying aponeurotic fibroma. After total excision of the mass, there has been no recurrence of the lesion in 8 months of follow-up.
Adolescent ; Child ; Extremities ; Female ; Fibroma ; Follow-Up Studies ; Gait ; Humans ; Recurrence ; Tendons

Dowling-Degos disease (DDD) is an autosomal dominant genodermatosis and this disease is a genetically determined disturbance of epidermal proliferation. It is characterized by acquired, slowly progressive pigmented lesions that primarily involve the great skin folds and flexural areas such as the axilla, neck, limb flexures, the inframammary area and the inguinal folds. The vulva is an unusual location for DDD. A 41-year-old woman presented with a 10-year history of multiple, small, reticulated and brownish macules distributed symmetrically on the bilateral external genital regions. We found no other similarly pigmented skin lesions on her body, including the flexural areas. There was no known family history of similar eruptions or pigmentary changes. The histologic examination showed irregular rete ridge elongation with a filiform or antler-like pattern and basilar hyperpigmentation on the tips. Fontana-Masson staining showed increased pigmentation of the rete ridges and the S100 protein staining did not reveal an increased number of melanocytes in the epidermis. From these findings, we diagnosed this lesion as DDD.
Adult ; Axilla ; Dichlorodiphenyldichloroethane ; Epidermis ; Extremities ; Female ; Humans ; Hyperpigmentation ; Melanocytes ; Neck ; Pigmentation ; Skin ; Skin Diseases, Genetic ; Skin Diseases, Papulosquamous ; Vulva

Myopericytoma (MP) is a benign tumor composed of cells that show apparent differentiation towards putative perivascular myoid cells called myopericytes. It arises most commonly in the dermis or subcutaneous tissue of the extremities in adults. The most common presentation is a well-circumscribed, slow-growing painless firm mass. A 45-year-old woman presented with a 2-year history of a painless, slowly growing 0.9x0.7 cm sized firm mass in the subcutaneous tissue of the posterior side of the right lower leg. We presumed this lesion to be an epidermal cyst, pilomatricoma or calcinosis cutis and performed an excisional biopsy. The histologic examination showed that it was composed of spindle-shaped myoid-appearing cells in a concentric arrangement, intimately associated with thin-walled vascular channels. Lesional spindle cells were diffusely positive for smooth muscle actin and were negative for CD34, desmin and S100 protein. From these findings, we diagnosed this lesion as a myopericytoma.
Actins ; Adult ; Biopsy ; Calcinosis ; Dermis ; Desmin ; Epidermal Cyst ; Extremities ; Female ; Humans ; Leg ; Middle Aged ; Muscle, Smooth ; Pilomatrixoma ; Subcutaneous Tissue