BACKGROUND: Punch grafts and punch elevation can be useful for the correction of deep pitting or round atrophic acne scars. The traditional punch elevation technique gives inadequete results. Even round scars leave a retraction space and do not always heal well. OBJECTIVES & METHODS: To improve the cosmetic results of traditional punch elevation and thus promote the use of punch elevation instead of punch grafting, we performed punch elevation with purse-string sutures on 10 patients with acne, pox & atrophic scars. We performed dermabrasion or CO2 laserbrasion after 8 weks. RESULTS: Nicely fit margins of the punch elevation site with purse-string suture left no retraction spaces and enhanced the aesthetic results. CONCLUSION: Punch elevation is a simple, satisfactory method of improving cosmetic results in scars. The Purse-string suture technique can make it a more valuable tool for surgery of facial scars, because it overcomes of disadvantages the punch elevation.
Acne Vulgaris* ; Cicatrix* ; Dermabrasion ; Humans ; Suture Techniques ; Sutures* ; Transplants

Giant congenital melanocytic nevi may lead to severe cosmetic and psychosocial problems. Another important problem is the relatively high potential to undergo malignant transformation. The management of congenital melanocytic nevi remains controversial as there is no universal agreement. We report two cases of giant congenital melanocytic nevi which were removed by curettage and dermatomes. There is relatively less intra and postoperative morbidity using these methods than with other treatment modalities. They were also considered as acceptable surgical methods and there are potentially more pleasing cosmetic results.
Curettage* ; Nevus, Pigmented*

The complement system is known to be involved in the pathogenesis of the skin lesions in pernphigus vulgaris, bullous pemphigoid, dermatitis herpetiformis, epidermolysis bullosa acquisita, and systemic lupus erythematosus. Authors examined the skin specimens of each disease cases, who did not show any evidence of complement deficiency, to determine the deposition of complement components(C4, C3, Chb-9) and their inhibitors(C4bp, Factor H, S-protein) by modified direct immunofluorescence. We also looked at the staining pattern and localization, for further insights of their pathobiologic contributions in each disease. The findings of deposits of complement components up to C9, as well as inhibitor proteins at the primary histopathologic sites, in the majority of those cases, may indicate that the complement system, to certain extent, involves the inflamrnatory reactions in these diseases. The co-localization of C5b-9 and S-protein could be regarded as the consequence of in situ formation of SC5b-9 complexs or as the result of non-lytic adsorbed complexes of fluid phase SC5b-9. The pathologic role of the complement seems to depend mostly on the complement-fixing biologic property and the amount of the tissue bound immune complexes, which are often heterogeneous to different diseases and among different patients.
Antigen-Antibody Complex ; Complement Factor H ; Complement Membrane Attack Complex ; Complement System Proteins* ; Dermatitis Herpetiformis ; Epidermolysis Bullosa Acquisita ; Fluorescent Antibody Technique, Direct ; Humans ; Lupus Erythematosus, Systemic ; Pemphigoid, Bullous ; Skin ; Skin Diseases*

BACKGROUND: A majority of patients undergoing chemical peeling complain of pain severe enough to disturb the process of the peeling. However, there has been few controlled studies on pain control during chemical peeling. OBJECTIVES: We evaluated the efficacy and safety of pretreatment with intramuscular ketorolac (Tarasyn, 30 mg) and oral diazepam(Valium, 5 mg) in comparison with control and diazepam groups, and compared the sensitivity of pain between two sexes. METHODS: The patients were randomly assigned to one of three groups; control, diazepam, and ketorolac plus diazepam groups. Pain intensity was assessed 5 times at every ten minutes from the beginning of the peeling using visual analog scale(VAS). RESULTS: At every 10 minutes of pain assessment, ketorolac plus diazepam group recorded the lowest VAS among the three groups. Except at the first 10 minutes, nificant. There was no significant difference in the pain intensity between the sexes at all five times. After application of Jessner`s solution, there was significant increase of VAS in all groups. CONCLUSION: The ketorolac pretreatment is a safe and effective modality of pain relief prior to chemical peeling without the adverse reactions.
Diazepam ; Humans ; Ketorolac* ; Pain Measurement ; Premedication*

A 19 month old girl with trisomy 18 is described. She showed loose folds of skin about the neck, a prominent occiput, a simian crease on both palms, epicanthal folds, acrocephaly, micrognathia, and unusual dermatologic features including total alopecia and no finger prints on either hands. Because of the simian crease on both palms, dermatoglyphics of both hands and total alopecia, a skin biopsy from the scalp and a chromosomal study were established at age 19-months, and an absence of hair follicles was observed, while peripheral blood lymphocytes demonstrated 47, XX, 4-18. To our knowledge, this would be the first recorded report on the dermatoglyphic pattern of Edwards syndrome in a Korean journal of dermatology.
Alopecia ; Biopsy ; Craniosynostoses ; Dermatoglyphics* ; Dermatology ; Female ; Fingers ; Hair Follicle ; Hand ; Humans ; Lymphocytes ; Micrognathism ; Neck ; Scalp ; Skin ; Trisomy*

A 19 month old girl with trisomy 18 is described. She showed loose folds of skin about the neck, a prominent occiput, a simian crease on both palms, epicanthal folds, acrocephaly, micrognathia, and unusual dermatologic features including total alopecia and no finger prints on either hands. Because of the simian crease on both palms, dermatoglyphics of both hands and total alopecia, a skin biopsy from the scalp and a chromosomal study were established at age 19-months, and an absence of hair follicles was observed, while peripheral blood lymphocytes demonstrated 47, XX, 4-18. To our knowledge, this would be the first recorded report on the dermatoglyphic pattern of Edwards syndrome in a Korean journal of dermatology.
Alopecia ; Biopsy ; Craniosynostoses ; Dermatoglyphics* ; Dermatology ; Female ; Fingers ; Hair Follicle ; Hand ; Humans ; Lymphocytes ; Micrognathism ; Neck ; Scalp ; Skin ; Trisomy*

Squamous cell carcinoma(SCC) is a recognized late complication of chronic discoid lupus erythematosus(CDLE). There are many case reports of SCC in white patients with chronic DLE. However, it is uncommon in blacks and Asians. The etiology of squamous cell carcinoma is multifactorial. The predisposing factors for the development of SCC in these patients include actinic keratosis, Bowen's disease, burn scars, arsenic keratosis, and chronic discoid lupus erythematosus. Of these causes, SCC developing in the lesions of CDLE is very rare. We report a patient who has been evaluated for ten years with a diagnosis of discoid lupus erythematosus and has squamous cell carcinoma.
African Continental Ancestry Group ; Arsenic ; Asian Continental Ancestry Group ; Bowen's Disease ; Burns ; Carcinoma, Squamous Cell* ; Causality ; Cicatrix ; Diagnosis ; Humans ; Keratosis ; Keratosis, Actinic ; Lupus Erythematosus, Discoid*

Epithelioid hemangioendothelioma(EH) is a low-grade tumor of vascular endothelial cell origin, which most commonly occur in the lower extremities of middle-aged patients with an equal gender distribution. It may occur on internal organs such as the liver or lung or bones. A 54-year-old woman who had a history of metastatic adenocarcinoma of unknown origin on the right inguinal lymph node, was presented to us because of a 1.0 x 1.0cm-sized and 2 x 2cm-sized two subcutaneous nodule on her right shin. On H & E stain, there were nests of round nucleated, polygonal, vacuolated cells, some of which contained fragmented erythrocytes. Factor VIII related antigen, CD31 was positive. A diagnosis of epithelioid hemangioendothelioma was established based on histologic, immunohistochemical studies. Wide excision was performed. There was no recurrence nor the development of new lesions so far.
Adenocarcinoma ; Diagnosis ; Endothelial Cells ; Erythrocytes ; Female ; Hemangioendothelioma, Epithelioid* ; Humans ; Liver ; Lower Extremity ; Lung ; Lymph Nodes ; Middle Aged ; Recurrence ; von Willebrand Factor

BACKGROUND: Scoring of atopic dermatitis has been a rather controversial issue in recent years, with scoring systems of varying complexity being advocated by different investigators. OBJECTIVE: It was the aim of this study to compare two of the most commonly used scoring methods in a clinical setting. METHODS: Fifty-eight patients diagnosed as having atopic dermatitis were evaluated using the Rajka & Langeland grade and the SCORAD, and the two scoring systems were compared with respect to the presence or absence of clinical and laboratory parameters of atopic dermatitis. RESULTS: The patients were composed of 22 males and 36 females, with an average age of 7.1 years. The average Rajka & Langeland grade was 6.1 (maximum, 9) and the SCORAD, 42.6 (maximum, 103). In both systems, the majority of the patients belonged to the moderate group; however, there was a relatively poor agreement between the two scoring systems in the assessment of overall severity of atopic dermatitis (kappa = 0.267). The SCORAD was better cor- related with the clinical and laboratory parameters, such as associated diseases, family history, smoking of the mother, contact with animal and high IgE level. CONCLUSION: The two scoring systems cannot be used interchangeably. The Rajka & Langeland grade is more ideal for quick, large surveys, and the SCORAD, for drug-effect studies or follow-up of progression of the disease. The SCORAD is the more useful system in relation to other clinical and laboratory aspects of atopic dermatitis.
Animals ; Dermatitis, Atopic* ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Male ; Mothers ; Research Design* ; Research Personnel ; Smoke ; Smoking

BACKGROUND: Indomethacin is a potent inhibitor of prostaglandins biosysnthesis. Sunburn erythema is mainly mediated by prostaglandins. OBJECTIVE: Our purpose was to compare objectively the effectiveness of topical indomethacin with topical corticosteroid on the suppression of UVB erythema METHODS: Sixteen male medical students who had not exposed their back skin during the last year were included in this study. According to the individual´s MED, 1,2, and 3 MED of UVB were irradiated on each back in triplicate lines. Immediately after UVB irradiation, 2.5% indomethacin solution and 0.25% desoximethasone were applied to each row with one row left for control. 24 hours after the initial application the intensity of each erythema was measured by the naked eye and by colorimeter. RESULTS: The suppressive effectiveness of 2.5% indomethacin solution on UVB induced erythema was superior to that of 0.25% desoximethasone. The L* and a* value of colorimeter were significantly correlated to the differencies of UVB induced erythema among the experimental and control groups is a useful and rapid method to evaluate the UVB induced erythema, and can give a numerical expression to eye perception. CONCLUSION: Our data confirm that topical indomethacin has a stronger suggestive effect on UVB erythema than that of topical corticosteroid.. We suggest that the suppressive effect of indomethacin is mainly due to the inhibition of prostaglandins biosynthesis. The colorimeter CR-200(MINOLTA) is well correlated with the naked eye score and is a useful instrument for objective measurement of the degree of erythema.
Erythema* ; Humans ; Indomethacin* ; Male ; Methods ; Prostaglandins ; Skin ; Students, Medical ; Sunburn