Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonograpl'hy and hyperdense mass lesion on early-phase IV bolus CF and isodense mass, lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.
Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis ; Focal Nodular Hyperplasia ; Hepatocytes ; Humans ; Hypertrophy ; Korea ; Kupffer Cells ; Liver* ; Ultrasonography

An etiologic agent in seborrheic dermatitis is now considered to be due to Pityrosporum ovale. The connection between the yeast and the disease has been clearly dernonstrated in a number of patients treatd with antifungal agents. However, the fact, that Pityrosporum ovale (Pityrosporum orbiculare) belongs to the normal human cutaneou. flora makes it difficult, to explain the role of the organism in seborrheic dermatitis. In this clinical study, twenty eight subjects were divided into two group by treatment regimen of topical 2% ketoconazole shampoo(TKS)and 0.3% prednisolone valerate solution (PVS). Before and during the four weeks treatment periods, the number of Pityrosporum ovale on the scalp were evaluated by scrub Giemsa staining method, which estimat,ed by score scale, under direct. microscopic examination. Also clinical symptoms including erythema, scales and itching were recorded by scores every week and compared between two treatment group. Topical application of 2% ketoconazole shampoo(TKS) is a very effective treatment regimen to reduce the yeasr cell score(from 5.8+1.3 to 1.8+1.4) than PVS(from 6.4+1.3 to 3.5+1.5), significantly(p<0.05). So the results of this study acconsistent with the view that density of Pityrosgourum ovale plays a role in the cause and course of seborcheic derrnatitis on the scalp. And antifungal agent(TKS) shows favorable effects ori tnis disease clinically and mycologically.
Antifungal Agents ; Azure Stains ; Dermatitis, Seborrheic* ; Erythema ; Humans ; Ketoconazole* ; Malassezia ; Prednisolone ; Pruritus ; Scalp* ; Weights and Measures ; Yeasts

A 20-year-old female, who had been treated with topical PUVA therapy for her vitiligo, developed characteristic skin lesions of disseminated superficial artiric porokeratosis(DSAP). All of her three sisters had vitiligo and had been treated with topica PUVA, hut only one developed DSAP lesion. Her mother had had DSAP lesions on expcsec areas for 20 years. DSAP shows an autosomal dominant mode of inheritance, and is charaterized by multiple ciark brownish keratotic papaules surrounded by slightly elevatied order. The exacerbation of the lesion by exposure t.o UV lignt indicates that the regulatingene for DSAP is related to sunlight. 1-lerein we reported a case of DSAP induced by topica] PUVA therapy in one patient during management of familial vitiligo in 3 sisters.
Female ; Humans ; Mothers ; Porokeratosis* ; PUVA Therapy ; Siblings ; Skin ; Sunlight ; Vitiligo* ; Wills ; Young Adult

Mycetoma is a clinical syndrome of localized, indolent, deforming, swollen lesions and sinuses, involving cutaneous and subcutaneous tissues, fascia, and bone. Its lesions. are composed of suppurat.ing abscesses, granulomata, and dra ning sinuses and the etiologic agents are wide variety of bacteria (actinomycotic mycetoma) and fungi(eumcotic mycetoma) from plant and soil. The patient was a 65-year-old female and a farnier. She was referred by the skin lesion loalized on the dorsum of her lefther left hand and wrist for three months. It showed multiple subcutaneclis nodules, abscesses, and discharging fitula based on the erythematous plaque. The skin biopsy frorn the lesion revealed the PAS positive hyphae in the granulocytic infiltration. Fungus cult,ure with a piece of tissue on sabouraud media shows hin, floccose, white colonies. Slide culture and biochemical idcrtification of pathogen led to the final diagnosis as Mycetoma caused by Pseudallescheria boydii(Monosporium apiospermum). The lesions disappeared gradualy following systemic oral administratior of Itraconazole 200mg daily for six weeks.
Abscess ; Aged ; Bacteria ; Biopsy ; Diagnosis ; Fascia ; Female ; Fungi ; Hand ; Humans ; Hyphae ; Itraconazole ; Mycetoma* ; Plants ; Pseudallescheria* ; Skin ; Soil ; Subcutaneous Tissue ; Wrist

A 50-year-old female, who had been suffered from diabetes rielitus, showed typical cutaneous findinhs of dermatomyositis with only transient and mild proximal muscle weakness at sometime during the course of disease. She had Gottrons papules, Gottrons sign, heliotrope rash, macular violsceous erythema involving neck, anterior chest, back, extensor site of forearms and arms and dorsa of hands. However, he serum CPK, LDH and sGOP levels were within normal limits. Her fasting and 2 hours potprandial blood glucose levels were elevated. There were no histological abnormality in muscle biopsy. Histopathologic findigs of the skin lesion on her back were that of poikiloderma atrophicans vasculare. We diagnosed our patient as Rebeccas type 2 amyopathic dematomyositis which is chracterized by skin disease with subjective myalgias and musle weakness, but without laboratory evidence of muscle disease.
Arm ; Biopsy ; Blood Glucose ; Dermatomyositis* ; Erythema ; Exanthema ; Fasting ; Female ; Forearm ; Hand ; Humans ; Middle Aged ; Muscle Weakness ; Myalgia ; Neck ; Skin ; Skin Diseases ; Thorax

A case of circular eczematous dermatitis around seborrheic keratosis was presented. A 54-year-old man presented with two weeks history of a round pruritic eruption around a preexisting lesion of seborrheic keratosis. Microscopic findings showed central tumor nest composed mainly of basaloid cells with occasional spongtosis and exocytosis. A diffuse, dense, mononuclear cell infiltrate with increased contents of melanophages was seen beneath the tumor. The surrounding lesion of halo dermatitis showed mild dilatation of the capillaries and perivascular infiltration of mononuclear cells in the upper and mid-dermis. The lesion of halo dermatitis disappeared gradually over a three week period following excision of the central lesion. This peculiar phenomenon seemed to be different from that of Suttons halo nevus, and might be a manifestation of an eczematous condition which might have a dermatitis provoking factor.
Capillaries ; Dermatitis* ; Dilatation ; Eczema ; Exocytosis ; Humans ; Keratosis, Seborrheic* ; Middle Aged ; Nevus, Halo

Erythema multiforme can be induced by various causes, including infections like virus or fungus, drugs like sulfonamides and penicillins, internal malignences, connective tissue diseases, pregnancy, menstruation, and exoessive sun exposure ramoxone, one of the paraquat dichloride compounds, is the most commonly used weed-kiIler in Korea. It is sometimes used in suicides due to its fatal toxicity, and even weak transutaneous absorption can lead to death. Herein we report a case of erythema multiform in a 46-year-old man induced by accidental contact with the Gramoxone
Absorption ; Connective Tissue Diseases ; Erythema Multiforme* ; Erythema* ; Female ; Fungi ; Humans ; Korea ; Menstruation ; Middle Aged ; Paraquat ; Penicillins ; Pregnancy ; Solar System ; Suicide ; Sulfonamides

Twenty-nail dystrophy is a rare entity in which all 20 nail are uniformly and simultaneously affected with excess longitudinal ridging and loss of luster. This condition is thought to be idiopathic but, many cases are associated with alopecia areata, lichen planus, psoriasis, and ichthyosis. In such cases, it has been hypothesized that immunplogical disorders could play a role in pathogenesis. A 29-year-old male patient presented with dystrophic nail chatge on his all finger and toe nails for 3 years. On phisical examination, all nails were uniformly affected with longitudinal ridging and loss of luster and all body hairs were lost. Thyroid scan showed a finding of chronic thyroiditis. Herein we report a case of twenty-nail dystrophy associated with chronic thyroiditis and alopecia areata.
Adult ; Alopecia Areata ; Fingers ; Hair ; Humans ; Ichthyosis ; Lichen Planus ; Male ; Psoriasis ; Thyroid Gland* ; Thyroiditis* ; Toes

Acromelanosis progressiva is a peculiar progressive pigmentary disorder characterized by intensely dark and sharply demarcated hyperpigmentation over the dorsa of fingers and toes, and the pigmentation rapidly spread proximally. A 19-year-old female had sharply demarcated symmetric dark aroarn macules on the dorsa of her hands and feet, forearms, lower legs, face and neck. These pigmentations at first appeared at the age of 5 on the dorsa of her fingers and toes, thereafter these pigmertatons spread progressively to the proximal portion of her body. Histologically, a proliferation of mela biocyte at the epidermal-dermal junction was seen, associated with mild hyperkeratosis. She was othervise normal on physical examination and had no family historv of consanguinity.
Consanguinity ; Female ; Fingers ; Foot ; Forearm ; Hand ; Humans ; Hyperpigmentation ; Leg ; Neck ; Physical Examination ; Pigmentation ; Toes ; Young Adult

Pleomorphic xanthoastrocytoma is histologically characterized by marked cellular pleomorphism of lipid-laden neoplastic astrocytes and bizarre giant cells showing mitotic figures and high cellularity. Inspite of its ominous-looking microscopic features, howerver, the prognosis is usually favorable. This tumor develops mainly in the supratentorial area of young people and frequently involves the leptomeninges. We experienced a case of pleomorphic xanthoastrocytoma in 18 year-old-male. In addition to the cellular pleomophism, the prominent reticulin fibers surround the individual tumor cells or the tumor cells nests. Immunohistochemical staining and electron microscopy revealed glial fibrillary acidic protein(GFAP) expression and pericytoplasmic basal lamina in the tumor cells.