No abstract available.
Child* ; Humans ; Humerus*

Phakomatosis pigmentovascularis is characterized by the coexistence of pigmentary nevus and hemangioma. Since the term was first described by Ota et al in 1947, about 80 cases have been reported in the literature. In 1979, Hasegawa et al subclsssified the disorder into eight types : type I, nevus flammeus and nevus pigmentosus et verrucosus, type II, nevus flamme is and dermal melanocytosis, type III nevus flammeus and nev.us spilus, type IV, nevus flammeus, dermal melanocytosis and nevus spilus. Each type is subdivided into localized(a) and systemic(b) types, A 25-year-old male had brown papules on the left knee and thigh and purple patches on the left leg that had been present for approximately 7 years. He had no concon ittant systemic disease. The histopathologic findings on brown papules and purple patches are compatible with epidermal nevus and nevus flammeus respectively. We herein report a case of phakomatosis pigmentovascularis type I a.
Adult ; Down Syndrome ; Hemangioma ; Humans ; Knee ; Leg ; Male ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Thigh

A statistical observations were made on total 79 In-Patients in the departments of dermatology, Dongsan Presbyterian Hospital, Kyungpook National University and Fatima Hospital, Taegu, Korea during the period from Sept. 1, 1975 to August 31, 1976.
Daegu* ; Dermatology* ; Gyeongsangbuk-do* ; Korea* ; Protestantism*

Aplasia cutie congenita is a rare congenital disease showing focal abscence of skin. In the msjority of instances it is limited ta the scalp especially on the vertex although other areas of the body may also be involved. Other congenital malformation have been reported to ccur with ACC odcasionally. Diagnosis depends on primarily clinical findings. The histologic finding virious from an absence of appendages to the involvement of varying layers of skin, occasionally extending to the bane or dura. Healed lesions often demonstrate a flattened epidermis, a proliferation of fibrobasts in a loose connective tissue stroma, newly formed capillaries, and a complete absence of adnexa stuctures. We observed a newborn infant with aplssia cutis congenita. The akir, defect was found on the posterior fontanelle. No associating cangenital anomalies were found in this case.
Capillaries ; Connective Tissue ; Cranial Fontanelles ; Diagnosis ; Ectodermal Dysplasia* ; Epidermis ; Humans ; Infant, Newborn ; Scalp ; Skin

Subacute osteomylitis is far less common than acute osteomyelitis, characterized by insidious onset of the symptoms of mild local pain or discomfort without any acute systemic illness. Radiographic findings are not infrequently confused with benign or malignant bone tumors. From Jan, 1983 to Dec. 1991, we experienced twelve patients with subacute osteomylitis of long bones. Our clinical observations were as follows. 1. There were 11 boys and one girl with an average age of 9.7 years(range, 30months-16years). 2. The involved sites were proximal in 1, distal radius in 3, midshaft of femur in 3, distal femur in 2, proximal tibia in 1, and distal tibia in 2 cases. 3. All patients had insidious onset of mild to moderate pain. ESR was increased in 9 cases(75%) with a mean value of 44 mm/hr, but leukocytosis was not found. 4. According to the Green and Edwards' classification, there were type 1 in 1, type 2 in 3, type 3 in 3, and type 6 in 5 cases. 5. Eleven patients had operative treatment. The remaining one patient was treated by antibiotic treatment. 6. Primary treatment was successful in 11 patients who were followed for and average 9.5 months. One patients was lost to follow-up.
Child ; Classification ; Clinical Study ; Female ; Femur ; Humans ; Leukocytosis ; Lost to Follow-Up ; Osteomyelitis ; Radius ; Tibia

The imbalance between paralyzed orbicularis oculi and normally functioning its antagonists such as the levator of the upper lid and the capsulopalpebral fascia of the lower lid in patients with leprosy causes ectropion, eyelid retraction and lagophthalmos. There are a lot of surgical methods to manage the ectropion and retraction of the lower lid including lateral canthoplasty, lateral canthopexy, spacer graft, canthal sling, medial tarsorraphy as well as temporal fascia transfer. In this study, we applied the lateral tarsal strip combined with Kuhnt- Szymanowski procedure to thirty-two patients with paralytic ectropion and this method was proven to be very effective in correcting the abnormal conditions.
Ectropion ; Eyelids ; Fascia ; Humans ; Leprosy ; Transplants

Lepra bacilli invade the nasal mucosa from early stage. The infiltrated mucous membrane breaks down and ulcerates easily. Irritating crusts and ulcers occur, creating in perforation of the septum. When most of the septum and inner mucosal lining of the nose is destroyed, the nose is deprived of its support and it collapses. The nasal bones are typically intact, and the collapsed nose adheres to the facial skeleton, giving the characteristic 'sunken and short nose' deformities. We have operated on 25 patients with deformities such as short nose, sunken nose, collumela deformity and ala collapse since 1992. In short nose we operated with a paramedian forehead flap and rib cartilage graft in a cantilever pattern. In ala collapse we used a conchal cartilage graft. Lastly, in collumela deformity we used the local flap and a composite graft.
Cartilage ; Congenital Abnormalities* ; Forehead ; Humans ; Leprosy* ; Mucous Membrane ; Nasal Bone ; Nasal Mucosa ; Nose ; Ribs ; Skeleton ; Transplants ; Ulcer

Since 1992, We have treated nearly nine hundreds cases with paralytic ectropion and lagophthalmos as a sequela of Hansen's disease. Treatment to correct paralytic ectropion was performed by already established conventional surgical methods or their minor modifications. Although most of patients quite improved postoperatively, lagophthalmos frequently remained partially. Involutional orbital changes superimposed on decreased tone of the paralyzed orbicularis muscle make the corrective effect short-lived, which in turn brings about recurrence of ectropion and lagophthalmos. Of the surgical techniques, dynamic Gillies' temporalis muscle transfer was used mostly in the early stage. After that, various static methods such as gold plate insertion, transsection of levator muscle and spacer graft in the upper eyelid, and medial tarsorrhaphy, medial canthoplasty, horizontal wedge resection, spacer graft, lateral tarsal strip and lateral canthoplasty in the lower eyelid were applied. Sometimes canthal sling with Alloderm or autologous fascia to pull upward the lower eyelid or Kuhnt-Szymanowsky flap to tighten eyelid skin was added to the surgical procedures. In future, the more sophisticated techniques must be exploited to fulfill complete eyelids closure and to lower the recurrence rate. Upgrade of canthal sling method or return to Gillies' method may be an alternative at present.
Collagen ; Ectropion ; Eyelids ; Fascia ; Humans ; Leprosy ; Muscles ; Orbit ; Recurrence ; Skin ; Transplants

BACKGROUND: Damage of the facial nerve, especially buccal and marginal mandibular branches, causes facial palsy and paralytic deformity of the lips such as lower lip ectropion, lip drooping, deviation of the mouth, inability of closing mouth, and the loss of the nasolabial folds. OBJECTIVE: To find out the best surgical method to correct paralytic deformity of the lips. METHODS: We reviewed retrospectively the various surgical treatment modalities of the paralytic deformity of the lips performed in The Institute for Leprosy Research for 13 years. RESULTS: One hundred and twenty five surgical procedures were performed in 80 patients with Hansen's disease. Of these, the static method, dermal suspension flap, was done in 15 cases, the dynamic methods were done in 64 cases, and others were done in 46 cases. All patients showed postoperatively clinical improvement above the average. Two patients received reoperation or additional procedures due to relapse of the condition. CONCLUSIONS: The dynamic method using tensor fascia lata was superior to other treatment modalities.
Congenital Abnormalities ; Ectropion ; Facial Nerve ; Facial Paralysis ; Fascia Lata ; Humans ; Leprosy ; Lip ; Mouth ; Recurrence ; Reoperation ; Retrospective Studies

Facial nerve paralysis in leprosy adversely affects facial regions from the forehead to the lip. In particular, lagophthalmos in patients with leprosy causes exposure keratitis, corneal and conjunctival dryness which can progress blindness and disfigurement. The function of the eyelids is controlled by the oculomotor nerve and the facial nerve. In leprosy patients the oculomotor nerve continues to function causing the levator muscle to lift the eyelids. However, paralysis of the facial nerve prevents the orbicularis oculi muscle from closing the eyelids, resulting in lagophthalmos. Various methods were developed to correct lagophthalmos, one of which was temporal muscle transfer(TMT) reported in 1934 by Gillies. Since we noted relatively high occurrence of ptosis as a complication in patients treated previously with the TMT, we performed other surgical procedures for laglphthalmos over 15 years, not to make the ptosis. Although most of the patients quite improved post-operatively, partial lid-gap frequently persisted. It may be related to involutional changes and paralyzed orbicularis muscle. Recently, we conducted 4 different TMT methods for last 4 years to reduce ptosis. The methods used included Brown & McDowell, McCord & Codner, modified Gillies & Anderson, and modified Gillies. Seventy-five TMT operations in 60 patients(26 males and 34 females) were done between 2011 and 2014. The age range of the patients was 54~87 years(the mean was 70.1). Fifteen patients had bilateral TMT procedures. As a result, ptosis appeared in 14(18.7%) out of 75 TMT procedures for 4 years. Four technical points should be considered for the initial assessment to prevent or reduce the incidence of ptosis. The first is the increase of the length of temporalis muscle flap to approximately 8cm with a parallel course to the lateral canthus, which will reduce the oblique pull. Second, the width of the fascia sling in the upper eyelid is narrow(3~4mm) to reduce weight on the eyelid. Third, the fascia sling in the upper lid is not tied with that of the lower lid at the medial canthal tendon to reduce tension. Lastly, the fascia sling in the upper eyelid is shallow(subdermal level) in location and as near as possible to the lid margin.
Aged ; Blindness ; Eyelids ; Facial Nerve ; Fascia ; Forehead ; Humans ; Incidence ; Keratitis ; Leprosy* ; Lip ; Male ; Oculomotor Nerve ; Paralysis ; Temporal Muscle* ; Tendons