Microscopic polyangiitis is a systemic small-vessel vasculitis, which may involve multiple organs, but cardiac involvement is relatively rare. We report a case of microscopic polyangiitis with multiple organ involvement, in which myocardial infarction was the early manifestation of the disease. A 53-year-old man presented with sudden papulovesicular eruptions and swellings on the face, posterior neck, dorsa of both hands and fingers, and with diffuse erythematous patches on the back. He had suffered from renal dysfunction, arthralgia, and hypertension for more than 8 years. He had been admitted to the department of cardiology for acute myocardial infarction and had suffered from recurrent gastrointestinal bleeding, renal failure, acute pancreatitis and sepsis during the admission. Histopathologically, small-vessel leukocytoclastic vasculitis with out granuloma was seen. Direct immunofluorescence showed no immune deposite. A high serum level of P-ANCA was detected by ELISA.
Acute Kidney Injury ; Antibodies, Antineutrophil Cytoplasmic ; Arthralgia ; Cardiology ; Enzyme-Linked Immunosorbent Assay ; Fingers ; Fluorescent Antibody Technique, Direct ; Granuloma ; Hand ; Hemorrhage ; Humans ; Hypertension ; Microscopic Polyangiitis* ; Middle Aged ; Myocardial Infarction* ; Neck ; Pancreatitis ; Sepsis ; Vasculitis

BACKGROUND: In eczematous skin it is expected that altered defense mechanisms are employed against an injury, which mechanisms include alterations in the stratum corneum barrier function and lipid contents. OBJECTIVE: To investigaten aspect of pathophysiology of hand eczema by comparing the water holding capacities and transepidermal water loss(TEWL) after injuries on the skin and by comparing the epidermal lipid contents between hand eczema and normal subjects. METHODS: The water holding capacities were checked by corneometer, and the TEWL were checked after epidermal barrie! destruction with acetone or adhesive tapes. The epidermal lipids were extracted with acetone, ther (1: 1 v/v) mixture solvent and analysed by HP- TLC. RESULTS: The water holdingapacities were decreased in eczema of the palm, but the recoveries of TEWL and the lipid content did not differ between hand eczema and normal subjects. CONCLUSION: The water holding capacities were decreased in the eczematous skin. But there were no significant differencies in the recovery of destructed epidermal barrier and the epidermal lipid contents.
Acetone ; Adhesives ; Defense Mechanisms ; Eczema* ; Hand* ; Skin ; Water

No abstract available.
Female ; Mammaplasty*

Sjogren's syndrome has been considered to be an autoimmune disease affecting various organs including salivary and lacrimal glands. It occurs most commonly in middle-aged women, and less than 20 cases with primary Sjogren's syndrome have been reported in children. An 11-yim-old boy presented with recurrent annular erythema on the face that had been present for 2 years. A schirmers test showed a positive result. ANA was detected at a dilution of 1:640. Anti-Ro/SSA and anti-La/SSB antibodies were also detected. On histological examination, lymphocytes were infiltrated in the periappendegeal areas as well as the papillary and reticular dernis. The skin findimg is uncommon in children, but has become a characteristic feature of childhood Sjogrens syndrome with anti-Ro and/or anti-La antibodies.
Antibodies ; Autoimmune Diseases ; Child ; Erythema* ; Female ; Humans ; Lacrimal Apparatus ; Lymphocytes ; Male ; Sjogren's Syndrome* ; Skin

A 26-year-old man presented with a 7-month history of hyperkeratotic skin lesions on both elbows and heels. He also had marked subungal hyperkeratosis and splinter hemorrhage on the finger and toe nails. A biopsy specimen from the elbow revealed lichenoid re-actions with areas of epidermal atrophy with alternating acanthosis and foci of parakeratosis. We made a diagnosis of keratosis lichenoides chronica based on the characteristic clinicopathologic findings. We have treated the patient with etretinate, but only the skin lesions on the elbows and heels responded to treatment.
Acitretin ; Adult ; Atrophy ; Biopsy ; Diagnosis ; Elbow ; Etretinate ; Fingers ; Heel ; Hemorrhage ; Humans ; Keratosis* ; Nails, Malformed* ; Parakeratosis ; Skin ; Toes

Intramuscular lipomas are benign soft-tissue mesenchymal tumors which rarely occur in the region of the head. These tumors present as slow-growing, generally painless masses and are easily misdiagnosed initially as epidermal inclusion cysts. We describe a 44-year-old woman who presented with an intramuscular lipoma of the frontalis muscle.
Adult ; Female ; Head ; Humans ; Lipoma*

Bullous pemphigoid(BP) and herpes gestationis(HG) are subepidermal bullous diseases which show clinical and immunological similarities. Both diseases show immune deposits along the basement membrane zone and their autoantibodies bind a common antigenic site within the non-collagenous stretch of the 180 kDa BPAG2 ectodomain. Besides its association with pregnancy, HG has some characteristic features that distinguish it from BP. The serum of patients with HG often contains an IgG that avidly fixes complement, and showes IgG1 subclass predominance. We report here two cases of non-pregnant young women presenting clinical and histological features of bullous pemphigoid or herpes gestationis. The immunopathology, IgG subtyping and immunoblotting studies showed that the autoantibodies in the patients were the characteristic ones of herpes gestationis. The patients might be a subtype of BP that have characteristics of autoantibodies of HG patients.
Autoantibodies* ; Basement Membrane ; Complement System Proteins ; Female ; Humans ; Immunoblotting ; Immunoglobulin G ; Pemphigoid Gestationis* ; Pemphigoid, Bullous* ; Pregnancy

Pachydermodactyly is a rare form of digital fibromatosis mostly affecting young men. It is characterized by asymptomatic, protracted, bulbous soft tissue swellings on proximal phalangeal and proximal interphalangeal joint areas of fingers. Histopathologic findings represent hyperkeratosis, acanthosis, and thickening of the dermis due to increased collagen bundles There is also mucin deposition in the dermis. Intralesional infection of steriods is helpful in relieving the skin lesions. We report a case of pacgydermodactyly manifested as soft tissue swellings unilaterally on the lateral aspects of fingers. The lesions showed a good response to triamcinolone intralesional infections.
Collagen ; Dermis ; Fibroma ; Fingers ; Humans ; Joints ; Male ; Mucins ; Skin ; Triamcinolone

BACKGROUND: Polymerase chain reaction(PCR) has brought an oppotunity for rapid detection of Mycobacterium leprae in clinical pecimens for the diagnosis of leprosy. Th DNA segment specific to M. leprae was detectable in a matteir of hours and DNA from one orgnisa appeared positive by PCR. However, the PCR tool has not been evaluated using elinical specimeriis from leprosy patients and controls. OBJECTIVE & METHODS: The primers amplifying 372bp segment of rebetitive sequence of M. leprae DNA were used in PCR. Skin biopsy specimens from 102 leprosy patient, and controls were examined for the presence of M. leprae by PCR and the results were aomared with microscopic and histopathologic findings. RESULTS: 1. As a result, of PCR after DNA preparation of M. leprae, six other mycobacteria, ten other bacteria, and skin from leprosy with five other skin biopsy tissues, 372bp DNA fragment was specifically amplified from M. leprae. 2. Dot blot, hybridization of PCR products showed that the 372bp DNA from skin biopsy specimens were derived from M. leprae. 3. As a result of PCR after DNA preparation of 10-fold diluted M. legrae from mouse footpad, PCR gave a positive result as low as one organism. 4. Of 87 specimens in which acid-fast bacilli were found under microcopic examinations 97% had positive PCR results. 5. Of 97 specimens which hadihistopathologic evidences of leprosy 95% had positive PCR results. 6. Of 15 specimens in which acid-fast bacilli were not found under n!icroscopic examinations 73% had positive PCR results. In three of five cases which had neither histopathologic nor microscopic evidences of leprosy had positive PCR results. CONCLUSION: PCR method amplifying 372bp fragment of repetitive seqi,ence was highly sensitive and specific in detecting M. leprae DNA in skin biopsy specimens, thus may be a useful tool as an additive diagnostic method, espcially for cases where microscopic antihystopathologic findings are not definite.
Animals ; Bacteria ; Biopsy* ; Diagnosis ; DNA ; Humans ; Leprosy* ; Mice ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Skin*

Jellyfish dermatitis was characterized by purpuric papules or tiny vesicles arranged linearly with a color ranging from pink to red to brown. A 24-year-old woman presented with multiple whiplash-like erythematous lesions of 5-hours duration on both legs after contact with a jellyfish at a Korean seashore.
Female ; Humans