Kasabach-Merritt syndrome is the association of thrombocytopenia, disorder of coagulation, spontaneous bleeding and enlargement of a hemangima or extensive hemangiomatosis, which can be often life threatening. We experienced a three years-old girl with suddenly enlarging hemangioma of right cheek, complicated by severe thrombocytopenia, consumptive coagulopathy and hemorrhagic cystitis. Generalized petechia and ecchymosis were noted on the overlying skin of hemangioma, trunk and extremities. But the study of MRI and angiography, hypevascular was located within the right masseter muscle extending to temporalis muscle and anterior to parotid gland. So selective embolization with PVA (polyvinyl alcohol) was performed through the distal branch of internal maxillary artery and facial artery. She was medicated with oral corticosterioid for 3 weeks. After embolizationn, blood flow to hemangioma and facial swelling were markedly decreased. Patient was followed up for 7 years and she showed normal contour of face and no bleeding diathesis.
Angiography ; Arteries ; Cheek ; Cystitis ; Disease Susceptibility ; Ecchymosis ; Extremities ; Female ; Hemangioma ; Hemorrhage ; Hemorrhagic Disorders* ; Humans ; Kasabach-Merritt Syndrome* ; Magnetic Resonance Imaging ; Masseter Muscle ; Maxillary Artery ; Parotid Gland ; Skin ; Thrombocytopenia

No abstract available.
Humans ; Plasma* ; Tranexamic Acid* ; Urticaria*

No abstract available.
Animals ; Lordosis*

BACKGORUND: A tourniquet is commonly used to achieve bloodless field in surgery of the extremities. However, use of tourniquet occasionally has been associated with intraoperative hypertension, but the mechanism of this tourniquet-induced hypertension is unknown. We investigated the effect of preoperative ketamine on tourniquet-induced changes of arterial blood pressure (BP), heart rate (HR), cardiac index (Ci), and systemic vascular resistance index (SVRi). METHODS: Twenty-two patients of ASA physical status class 1 and 2, scheduled for lower extremity surgery using a tourniquet, were randomly assigned into two groups. Anesthesia was maintained with 1.5-2.0 vol% enflurane and 50% N2O in O2 with endotracheal intubation. The changes of BP, HR, Ci, and SVRi were measured (1) at 10 minutes after induction, (2) at 10 minutes after injection of normal saline (control group) or ketamine 0.25 mg/kg, i.v. (ketamine group) before skin incision and tourniquet inflation, (3) at immediately and 5, 10, 15, 20, 30, and 40 minutes after inflation of tourniquet, and (4) immediately after deflation of tourniquet. RESULTS: During tourniquet inflation, BP and HR were not significantly changed in each group and there was no significant differences between the two groups. However, Ci decreased during inflation of the tourniquet in both groups, and it significantly decreased in the control group at the time of 5 and 40 minutes after inflation of tourniquet. SVRi significantly increased during inflation of the tourniquet, and decreased immediately after deflation of the tourniquet in the control group. CONCLUSiONS: We concluded that preoperative iV ketamine, 0.25 mg/kg can prevent tourniquet-induced hemodynamic changes in patients under general anesthesia.
Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Enflurane ; Extremities ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Inflation, Economic ; Intubation, Intratracheal ; Ketamine* ; Lower Extremity* ; Skin ; Tourniquets* ; Vascular Resistance

OBJECTIVES: Recent studies have suggested that the personality and communication style of the mother can affect the progress of disease in children with chronic illnesses. The current study assessed the characteristics, attachment type and communication skill of mothers who have children with alopecia areata that may concern their children. METHODS: The subjects of this study were 46 mothers of children with alopecia areata (alopecia children: mean age 7.52+/-3.41yrs ; 27 males, 19 females), who visited the alopecia clinic at the Dermatology Department of Chung-Ang University Hospital, and 42 mothers of normal children (control children : mean age 6.85+/-0.46 yrs; 20 males, 22 females). The Minnesota Multiphasic Personality Inventory (MMPI) subscale, the Revised Adult Attachment Scale (RAAS), the Parent Adolescent Communication Inventory (PACI), and the Campbell Index of Well-Being were administered to all the subjects for the purpose of comparing the mothers of the alopecia group with those of the normal controls. RESULTS: There were no differences in socio-demographic characteristics between the alopecia and control group mothers. The MMPI scores of both groups were within the normal profile ranges, but the scores of the mothers in the alopecia areata group were significantly lower than those in the control group mothers on the Pd(4), Mf(5), and Ma(9) subscales (p=0.028, p=0.001, p=0.005 respectively). There were significant differences in communication style between the two groups. Alopecia group mothers showed less open family communication (p=0.034) and more problems in family communication (p=0.000) than the control group mothers. The scores on problems in family communication were positively correlated with Pd(4) scores (r=0.48, p=0.03). An insecure attachment style was more common in the alopecia group mothers than in control group mothers (p=0.023). There was no difference between the two groups of mothers on the Index of Well-Being. CONCLUSION: Compared with the mothers of control group children, the mothers of children with alopecia areata had more depressed and suppressed personality characteristics not expressing their psychological conflicts directly (low Pd, Mf, and Ma scores), more problems in family communication with their children and more insecure attachment type. We suggest that these results should be considered in the treatment of children with alopecia, and that psychological intervention for their mothers is needed.
Adolescent ; Adult ; Alopecia ; Alopecia Areata ; Child ; Chronic Disease ; Dermatology ; Humans ; Male ; MMPI ; Mothers ; Object Attachment ; Parents

Among various soft tissue tumors, extraskeletal chondroma is a rare benign cartilaginous tumor most frequently found in the hands, adjacent to periarticular tissue. We recently experienced a case of extraskeletal chondroma in a 47-year-old woman. The skin lesion showed a slowly-growing, solitary nodule on the dorsal aspect of her foot, causing pain and tenderness. An excisional biopsy was undertaken, revealing a well-encapsulated subcutaneous nodule which was mainly composed of mature hyaline cartilage.
Biopsy ; Chondroma* ; Female ; Foot* ; Hand ; Humans ; Hyaline Cartilage ; Middle Aged ; Skin

BACKGROUND: Basal cell carcinoma (BCC) is a slow-growing, locally invasive malignant epidermal skin tumor. Several studies of differences in age, site distribution and male to female ratio have been conducted among different histological subtypes of BCC. OBJECTIVE: We analyzed the five major subtypes of BCC with regard to gender, age, and anatomical distribution. METHODS: We retrospectively included 246 cases of BCC diagnosed from January 2000 to March 2011. The diagnoses and classifications of histopathological subtypes (nodular, superficial, micronodular, infiltrative, or morphemic) of BCC were confirmed by three dermatologists. Gender, age at diagnosis, and location were recorded and analyzed by histopathological subtypes. RESULTS: We recorded 246 cases (M : F=11.08) with a mean age of 64.0 years. Of the BCCs, 61.0% were nodular, 15.4% were superficial, 11.4% were micronodular, 10.2% were infiltrative, and 2.0% were morpheic. The nodular subtype was diagnosed at a mean age of 64.9 years, whereas the superficial subtype was diagnosed at an earlier age (60.3 years) and more frequently occurred in women (M : F=1 : 1.5) than the nodular subtype. Compared with the nodular subtype (4%), the superficial subtype (26.3%) occurred more frequently in the trunk (p-value<0.0001). CONCLUSION: The results showed differences in anatomical distribution, gender, and mean age according to histological subtypes. Superficial BCC occurred more commonly on the trunk, more often in women, and was seen in younger patients than that of the nodular subtype.
Carcinoma, Basal Cell ; Female ; Humans ; Male ; Retrospective Studies ; Skin

BACKGROUND: Zinc is one of the most widely studied metals in childhood diseases and dermatological conditions, and low serum zinc levels have been reported in children with atopic dermatitis (AD). As a recent experiment has shown that a zinc deficient diet results in AD-like eruptions in mice, there is a positive relationship between AD and decreased zinc level. OBJECTIVE: The purposes of this study were to investigate the prevalence of zinc deficiency in patients with AD and to compare the levels with those in non-AD patients. We also compared the prevalence of zinc deficiency in each patient with AD who had acute and chronic lesions. Furthermore, we investigated the relationship between low serum zinc levels and skin Staphylococcus aureus colonization rate. METHODS: We collected blood samples to check serum zinc level and performed skin swabs for bacterial cultures from 388 patients with AD and 234 control patients with urticaria who visited Samsung Medical Center, Department of Dermatology from February 2010 to November 2010. RESULTS: Approximately 52% of the patients with AD had low serum zinc levels. In patients older than 20 years old, the prevalence of zinc deficiency was 42.5% in patients with AD and 52.6% in patients with urticaria (p=0.084). The percentages of patients with a low serum zinc level were 42.9% and 42.4% respectively in patients with AD and acute lesions and in patients with AD and chronic lesions. However, we found no significant significance in the skin S. aureus colonization rates between the low serum zinc level group and the normal serum zinc level group. CONCLUSION: It was confirmed that >50% of patients with AD had low serum zinc levels. However, no significant differences in serum zinc levels were found between the AD and urticaria groups >20 years old or between the acute skin lesion and chronic skin lesion groups. Furthermore, serum zinc level did not affect S. aureus colonization in the skin in patients with AD or non-AD patients.
Affect ; Animals ; Child ; Colon ; Dermatitis, Atopic ; Dermatology ; Diet ; Humans ; Metals ; Mice ; Prevalence ; Skin ; Staphylococcus aureus ; Urticaria ; Zinc

Pachyonychia congenita is an uncommon genodermatosis of abnormal keratinization characterized by dystrophic nails and hyperkeratosis of the palms, soles, oral mucosa, and hair follicles. Mutations in keratin 6, 16, and 17 have been identified in a number of families. The 4 major features of the syndrome are onychogryphosis, palmoplantar keratoderma, follicular hyperkeratosis, and oral leukokeratosis. Treatment is only palliative, however, with attempts directed at improving symptoms that cause significant disability. We report a case of pachyonychia congenita in a 5-day-newborn with characteristic changes of nail, palms, soles, and oral mucosa.
Hair Follicle ; Humans ; Keratin-6 ; Keratoderma, Palmoplantar ; Leukoplakia, Oral ; Mouth Mucosa ; Nails, Malformed* ; Pachyonychia Congenita*

BACKGROUND: Reactive perforating collagenosis is one of the perforating disorders that are characterized by transepidermal elimination of dermal materials. It can be associated with systemic disease such as chronic renal disease and/or diabetes mellitus. OBJECTIVE: We wanted to investigate the clinical and histopathological features of reactive perforating collagenosis. METHODS: We reviewed the medical records, clinical photographs and histopathologic slides of 14 cases of reactive perforating collagenosis that were seen in our department. RESULTS: The most common clinical features were flesh-colored, dome-shaped papules with a keratinous plug. Residual scarring was seen from the previously healed lesions. Half of the patients had skin lesions on the whole body except the face, palm and sole. Most of the patients (79%) had at least one systemic disease. Chronic renal failure (21%) and diabetes mellitus (29%) were the most commonly associated conditions. The other associated conditions were hypertension, acute pyelonephritis, non-small cell lung cancer, herpes zoster, transplantation and non-Hodgkin lymphoma. Three of the cases (21%) were otherwise healthy. Most patients benefited from topical steroid and oral antihistamine when their disease was regressing. CONCLUSION: This study demonstrated the clinicopathologic features of reactive perforating collagenosis. It is frequently associated with diabetes mellitus and chronic renal failure, but this may also develop in patients with other systemic disorders, and also in those patients who are without any medical problems.
Carcinoma, Non-Small-Cell Lung ; Cicatrix ; Diabetes Mellitus ; Herpes Zoster ; Humans ; Hypertension ; Keratins ; Kidney Failure, Chronic ; Lymphoma, Non-Hodgkin ; Medical Records ; Pyelonephritis ; Renal Insufficiency, Chronic ; Skin ; Transplants