A 6-year-old male patient had been suffering from angular cheilitis and paronychia with fragmentation and dystrophic change of the finger nails. Laboratory findings showed low serum iron level and anemia. Immunologic studies revealed defects in cell mediated immunity. KOH examination and culture of specimens from the lesions showed hyphal elements and growth of Candida albicans respectively. Concomitantly itraconazole and iron sulfate were administered. Four months after treatment he was free of any clinical evidence of the disease.
Anemia ; Candida albicans ; Candidiasis, Chronic Mucocutaneous* ; Cheilitis ; Child ; Fingers ; Humans ; Immunity, Cellular ; Iron ; Itraconazole ; Male ; Paronychia

Torsion of a mucocele of the vermiform appendix is an extremely rare condition and also a rare cause of an acute abdomen with a clinical presentation that is indistinguishable from acute appendicitis, and thus, the condition is diagnosed during operation. Here, the authors describe the case of a 78-year-old female, who presented with intermittent abdominal pain. The appendix had a pelvic position and the torsion was counterclockwise. In addition, the torsion was associated with mucocele of the appendix, which was considered a secondary factor of torsion. Appendectomy and drainage were performed.
Abdomen, Acute ; Abdominal Pain ; Aged ; Appendectomy ; Appendicitis ; Appendix ; Drainage ; Female ; Humans ; Mucocele ; Torsion Abnormality

Ultrasonographic localizations were performed by methylene blue injection in 35 cases of nonpalpable breast lesion. The lesions were sized 0.3cm-1.3cm and biopsied just after localization with 100% success rate. All the patients tolerated well the procedure and had not any complications. Ultrasonoguided dye injection is an accurate, comfortable and simple method for prebiopsy localization of nonpalpable breast lesion.
Breast* ; Humans ; Methylene Blue

BACKGROUND: The regular use of soaps and synthetic detergents has been associated with skin dryness and aggravation of dermatological conditions. OBJECTIVE: Our purpose was to investigate the irritancy of 10 hand dishwashing liquids on normal skin. METHODS: The skin changes, responding to repeat patch testing with 10 hand dishwashing liquids, were measured by visual scoring. RESULTS: The results are summarized as follows; 1. Of the 16 healthy volunteers 8 had reactions. 5 women and 3 men, but there was no significant difference in irritancy between men and women. 2. The mean irritancy scores of the 10 hand dishwashing liquids ranged from 0.06 to 0.88. 3. A prominent increase in the degree of erythema in the first 24 hour patch test did not persist beyond exposure day 5, but after day 5, augmented responses of the erythema and scales, even fissuring occurred. 4. The pH of the test solutions of the hand dishwashing liquids ranged from 5.0 to 6.0, but there appeared to be no correlation between pH and irritancy in the dishwashing liquids tested. CONCLUSION: Our data suggests that regular exposure to hand dishwashing liquids may cause disturbances of the skin in a substantial proportion of individuals, and workers should use hand dishwashing liquids in lower concentrations than recommended and only for short periods with protective measures.
Detergents ; Erythema ; Female ; Hand* ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Male ; Patch Tests ; Skin* ; Soaps ; Weights and Measures

Pretibial myxedema, which consists of localized cutaneous accumulations of acid mucopolysaccharides, oceurs in a few patients with hyperthyroidi';m after its correction by surgery or radioactive iodine therapy. We report a case of pretibial myxedema with exophthalmos in a 36 year old male. He has suffered from hyperthyroidism with bilateral pretibial myxedema for a period of 4 years. He was treated with a subtotal thyroidectomy and excision of both pletibia lesions 1 year ago. The lesions recurred on t,he left pretibial area, as a 11 X 16cm sized, non pitting, non tender, swollen, brownish plaque. The histopathologic findings showed epidermal hyperkeratosis and a considerable arnount of mucin in the mid-dermis. We treat.ed him with intralesional injection of triamcinolone acetonide with marked improvement.
Adult ; Exophthalmos ; Glycosaminoglycans ; Humans ; Hyperthyroidism ; Injections, Intralesional ; Iodine ; Male ; Mucins ; Myxedema* ; Thyroidectomy ; Triamcinolone Acetonide

We report a case of disseminated cutaneous metastatic carcinoma from stomach carcinoma in a 66-year-old male who complained chiefly of widespread cutaneous nodules. He had been admitted to the Department of Internal Medicine for stomach carcinoma. A radiological examination revealed a diffuse stomach wall thickening from the fundus to the antrum, and enlargement of paraaortic and pericaval lymph nodes during an abodominal CT scan. The clinical findings manifested above may suggest cutaneous metastasis from stomach carcinoma. A histological examination of the skin and stomach biopsies showed atypical cells with pleomorphic, hyperchromatic nuclei and bubble-like cytoplasm, which are consistent with poorly differentiated adenocarcinoma. Immunohistochemical stainings showed that these cells were positive for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and low molecular weight cytokeratin.
Adenocarcinoma ; Aged ; Biopsy ; Carcinoembryonic Antigen ; Cytoplasm ; Humans ; Internal Medicine ; Keratins ; Lymph Nodes ; Male ; Molecular Weight ; Mucin-1 ; Neoplasm Metastasis ; Skin ; Stomach* ; Tomography, X-Ray Computed

We report a case of infantile digital fibromatosis in a 34 month-old boy, who presented with a painless subcutaneous tumor on the medial aspect of the left third toe. A histological examination showed scattered small, round eosinophilic inclusion bodies in the cytoplasm of the tumor cells, which was consistent with infantile digital fibromatosis. A'immunohistochemical study revealed that desmin, a-smooth muscle actin, and vimentin were clearly positive in the cytoplasm of the tumor cells, but the inclusions themselves showed negative staining, thus indicating a hollow-like staining pattern. Electron microscopy showed either well-defined or ill-demarcated dense bodies in the cytoplasm of the tumor cells. In some areas, small vesicles and intracellular organells were observed' in the inclusions. In the course of conservative treatment, a new lesion developed on the lateral aspect of the left third toe, seven months after the appearance of the initial lesion.
Actins ; Cytoplasm ; Desmin ; Eosinophils ; Fibroma* ; Humans ; Inclusion Bodies ; Male ; Microscopy, Electron ; Negative Staining ; Toes ; Vimentin

BACKGROUND: Skin cancers arc the most common malignancies in human. The increasing incidence of skin cancer has been attributed to increasing exposure of the papulation to sunlight and other factors, such as chemicals or. viruses. OBJECTIVE: The purpose of this study is to investigate a recent 10 year period(1984-1993) of clinical observation of cutaneous malignant tumors. METHODS: A statistical study was made with 60 cases of malignant tumors that visited the Departrnent of Dermatology, Chung Ang University during a 10 year period(1984-1993). RESULTS: 1. The mean incidence of cutlneous malignant tumors in the total number of outpatients was 0.16%(60/36,416). The incidence of malignant turnors has tended to increase in the last 4 years. 2. The age of onset was quite varied but the majority of cases, 51 cases(85.0%), were over 40 years old. The ratio of rnen to women was 1.3: 1.3. Among the 60 cases of malignant cutaneous tumors, the most frequently observed tumor was basal cell carcinoma, 20 cases(33.3% ). The next most frequent tumors were squamous cell carcinoma, 9 cases(15.0%), metastatic carcinoma, 9 cases(15.0%) and malignant melanoma, 6 cases(10.0%). 4. Among the 20 cases of basal cell carcinoma, 19 cases(95.0%) were over 40 years old. The most frequent age was the 7th decade(30.0%). The most common predilection sites were the nose (30.0%), the cheek(20.0%) and the eyelid(10.0%). 5. Among the 9 cases of squamous cell carcinoma, 8 cases(88.9% ) were over 40 years old. The ratio of men to women was 1: 2. The most frequent age was the 8th decade(44.4% ). The most common predilection sites were the head(55.6%), lower extremity(22.2%), upper extremity (11.1%) and trunk(11.1%). 6. All patients with malignant melanoma were over 40 years old. The most frequent age was the 5th decade(50.0%). The most cornmon predilection sites were the upper and lower extremities (66.7% ). 7. Among the 9 cases of metastatic carcinoma, 7 cases(77.8%) were over 40 years old. The ratio of men to women was 1: 1.25. The most frequent primary tumor was stomach cancer in men and lung cancer in women. 8. Cutaneous malignant tumor. usually had no detectable metastasis but there were 2 cases of extramammary Pagets disease with metastasis in the regional lymph nodes. CONCLUSIONS : This study revealed that the incidence of malignant tumors has tended to increase over the last few years, the most frequent age was over 40 years old, the most observed turnor was basal cell carcinoma and any type of cutaneous malignant tumors was rarely metastasis.
Adult ; Age of Onset ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Female ; Humans ; Incidence ; Lower Extremity ; Lung Neoplasms ; Lymph Nodes ; Male ; Melanoma ; Neoplasm Metastasis ; Nose ; Outpatients ; Paget Disease, Extramammary ; Skin Neoplasms ; Statistics as Topic ; Stomach Neoplasms ; Sunlight ; Upper Extremity

Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans

BACKGROUND: Superficial fungal infections are common diseases acid the prevalence of superficial fungal diseases are not static but change under the influence of various forces such as climate, migration of peoples and development in prophylaxis and therapy. OBJECTIVE: To investigate the present status of superficial dermatiphytoses and some changes on the frequency of the diseases, sex distributions and varieties of the casiative organisms. MEHTODS: The clinical and rnycological aspects of superficial fungal diseases of 3,222 patients from July 1989 to June 1992 were analyzed. Results : 1) The incidence of superficial fungal diseases was 25.4% of total out-patients. 2) The superficial fungal diseases showed a higt incidence in the third(26.4%) and the fourth decade(24.3%). 3) The ratio of male to female was 2.11:1(2,188:1,034). 4) The monthly prevalence of super ficial fungal diseases was high inhuly(17.8%), August(15.2%) and June(1.7%). 5) The incidence of superficial fungal diseases in order of frequency were tinea pedis ,28.1%, tinea cruris(19.5%), onychomycosis(15.6%), tinen orporis(11.5%), tinea manus(7.8%), tinea versicolar(7.8%), candidiasis(7.4%) and tinea capitis(2.3%), 6) Coexisting fungal infections were found in 644 patients(19.9%) and the case of tinea pedis with onychomycosis was the most common. 7) The positive rate of KOH scraping was 54.0% and the positive rate of culture on ordinary Salourauds dextrose agar media was 42.7%. 8) Trichophyton rubr,im was the most common causative orantism of superficial dermatophytes(38.4%), and other in decreasing frequency were Candida albicans(36.9%), Trichophyton mentagrophytes(23.6%) Microsporum canis(0.7%), Trichophyton ferrvgiteum(0.3%) and Epidermophyton floccosum(0.1%). CONCLUSION: These results are not significantly different from those iif previous studies. But the incidence rate of the superficial pungal diseases(25.4%) were higher thar, previous studies and showed a high incidence in young male patients and in the summer. The positiv rate of KOH scraping(54.0%) was lower than previous studies. The most common causative organism was Trichophyton rubrum(38.4 %).
Agar ; Candida ; Climate ; Epidermophyton ; Female ; Glucose ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Prevalence ; Sex Distribution ; Tinea ; Tinea Pedis ; Trichophyton