A patient with keratoma hereditaria mutians, 20 years old Korean girl, presented the following classic features of this rare disease, palmar and plantar hyperkeratosis beginning early in life, starfishlike keratosis of the dorsa of the hands, hyperkeratotic patches of dorsa of the feet with thickening of the toe nails, keloid-like keratoma of the elbows and knees, and constriction of the all fingers begining in early life and spontaneous amputation of theleft 5th finger. No family history was demonstrated in this patient.
Amputation ; Constriction ; Elbow ; Female ; Fingers ; Foot ; Hand ; Humans ; Keratosis* ; Knee ; Rare Diseases ; Toes ; Young Adult

We reported a case of follicular mucinosis which occurred in a 51 year old m;', . He had a firm grouped folliculopapular plaque above left eyebrow with ill-defined border, without any loss of eyebrow. But histopathologic findings showed charac- teristic changes in hair follicles and sebaceous glands with mucinous degeneration and no evidence of suggesting mycosis fungoides. Relatively rapid response to systemic corticosteroid suggested that this therapy had an actual effect.
Eyebrows ; Hair Follicle ; Humans ; Middle Aged ; Mucinosis, Follicular ; Mucins ; Mycosis Fungoides ; Sebaceous Glands

This study was performed with 31 cases of cutaneous tuberculosis among 18,846 cases of out-patients in Dermatologic Department of Busan National Universicy Hospital from 1967 to 1976. These 31 cases were consistent with skin tuberculosis in histological and clinical findings. The results were as follows. 1. The incidence of skin tuberculosis is 0.16%, among 18,846 cases of outpatients, 2. The localized tuberculosis of the skin, i.e. lupes vulgaris, tuberculosis verrucosa cutia and scrofuloderma was more common than disseminated type of tuberculosis of the skin. Among the disseminated types, papulonecrotic tuberculid is rather common than other types. 3. The ratio between male and female was l. 2: 1. 4. The age of onset varied according to types, but 70% of all cases occurred in the age group between 10-30 years. 5. Lung tuberculosis was associated in abaut 20 of skin tuberculosis. 6. Tubercle and tuberculoid structure were noticed in all biopsy specimens ancl in 55% the caseation necrosis was noticed.
Age of Onset ; Biopsy ; Busan ; Female ; Humans ; Incidence ; Lung ; Male ; Necrosis ; Outpatients ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous*

We presented a case of Reiters syndrome consisting of conjunctivitis, arthritis, and skin lesions, occurring in 20-year-o1d male. He had neither an episode of dysentery nor a history of sexual exposure before onset of syndrome. The skin lesions had begun with erythernatous scaly patches on the inguinal region and scalp, and later followed by generalized pustular, psoriasiform and/or hyperkeratotic crusted lesions on the erythematous base. Yellowish discoloration and onycholysis of nails and shallow ulcer of glans penis were observed. Arthritis of the knee and shoulder joints were developed, accompanied by pain, swelling, limited motion, wasting and weakness of both lower extremities. In laboratory investigation, urinalysis, stool examination for parasites and occult blood, renal function test, blood VDRL, and X-ray of chest, both knee. joints, shoulder joint and thoracolumbar spine were within normal limit or negative except for leukocytosis(24, 500/mm), increased ESR(90 mm/hr) and hypoalbuminemia(2.6 g/dl), and he was associated with HLA-A3, A 9, B5, and Rw 49 Histopathologically skin biopsy specimen showed extensive hyperkeratosis, paralceratosis, elongated rete ridges, spongiform macropustule of Kogoj. He was treated effectively with antibiotics, corticosteroid, and methotrexate for two months without recurrence till now.
Anti-Bacterial Agents ; Arthritis ; Biopsy ; Conjunctivitis ; Dysentery ; Hematologic Tests ; HLA-A3 Antigen ; Humans ; Joints ; Knee ; Lower Extremity ; Male ; Methotrexate ; Occult Blood ; Onycholysis ; Parasites ; Penis ; Recurrence ; Scalp ; Shoulder Joint ; Skin ; Spine ; Thorax ; Ulcer ; Urinalysis

The effect of 50 per cent potassium iodide (KI) ointment with occlusive dressing on onychomycosis of the fingers and toes was studiei in 54 patients with 176 diseased nails. The results obtained were as follows. 1. Of a total of 76 fingernails and 100 toenails in 54 patients, all fingernails and toenails showed an excellent response with easy removal of the diseased nails. 2. The duration that the occluded KI aintment remained in place before successful avulsion was 6. 6 (range, 3 to 18) days for fingernails, and 6. 8 (range, 3 to 20) days for toenails with onychomycosis. 8. Of 16 nails of control group which were treated with vaseline, none showed the significant improvement. 4. The problems during this treatment were; mild irritation and/or itching (9 cases), and pin-point bleeding on curettage of nail bed (18 cases). It is suggested that the KI treatment has many advantages and seemed to be an ideal method of treatment of onychomycosis.
Curettage ; Fingers ; Hemorrhage ; Humans ; Nails ; Occlusive Dressings ; Onychomycosis* ; Petrolatum ; Potassium Iodide* ; Potassium* ; Pruritus ; Toes

The idiopathic calcinosis of the scrotum which was first described by Shapiro et al. in 1970 is usually multiple, asymptomatic nodules of the scrotal skin and is easily misdiagnosed clinically as calcified epidermal inclusion cyst or pilar cyst. We present three cases of the idiopathic calcinosis of the scrotum. Clinically these three patients showed slightly yellowish papules or nodules in the scrotum without any other cutaneous disorders and subjective symptoms except mild itching sensation in one case. Histopathologically calcium deposits were found in the dermis without any evidence of residual cysts, and partial foreign body reaction was seen around the calcified area in one case. Laboratory findings including serum calcium, phosphorous and potassium level were within normal limits.
Calcinosis* ; Calcium ; Dermis ; Epidermal Cyst ; Foreign-Body Reaction ; Humans ; Potassium ; Pruritus ; Scrotum* ; Sensation ; Skin

Partial lipodystrophy is an uncommon disorder primarily affecting women, with onset usually in childhood, characterized by slowly progressive, symrnetrical loss of aubcutaneous fat from the upper half of the body. We present a case of partial lipodystrophy in a 43-year-old woman with multiple depressed lesion on the face and reticulated atrophic lesions on the upper trunk and u]pper extremities. Typically, her face was the first part of the body so affected, giving it a characteristic cadeverous appearance, and gradu ally spreaded to the upper half of t2e body. Sirnultaneously, there was an accumulation of fat over the lower part of the body. She was generally otherwise well, although there had been an association with hyperpigmentation, hirsutism, arthralgia, thyroid disoraer, and low serum CR(45mg/dl), Riopsy specimens of iace and back showed lack of subcutaneous fat, but in the other section of the face showed hydropic degeneration of basal cells and inflammatory infiltrate in the dermis.
Adult ; Arthralgia ; Dermis ; Extremities ; Female ; Hirsutism ; Humans ; Hyperpigmentation ; Lipodystrophy* ; Subcutaneous Fat ; Thyroid Gland

BACKGROUND: Trichloroacetic acid chemexfoliation has gained popularity and is widely used cosmetically. The depth of the wound caused by the various dilutions of TCA is paramount to the therapeutic efficacy. Therfore rational use of TCA chemexfoliation requires a clear understanding of the expected depth of destruction caused by a given dilution. OBJECTIVE: The purpose of this stuely is to quantitate the wound deptlw produced by varying concentrations of TCA. We have stirdied takie effects of consecutive applications, occlusion and tretinoin pretreatment on wound depth in TCA clinimical peeling. METHODS: Various concentrations of TCA and distilled water were aplied to two pairs of test sites of a guinea pigs back in a uniform fashion with cotton-tip applicators and then we have measured the mean depth of epidermal necrtsis mieroscopically by using Visual Imagc Data Analysis System. RESULTS: 1. Depths of wounds createdly threre consecutive applications of 20, 35% and 50% TCA were deeper than those of wounds by a single application of TCA. 2. Depths of wounds created by application of TCA with the occlusive method were deeper than those of the open method. Therefore the effect of occlusion is to enhance the penetration of TCA. 3. Depths of wounds pretreatwi with 0.05 % tretinoin daily for 7 days are deeper than those of the control in 50% TCA chemical peeling. Therefore the effect of 0.05% retinoin pretreatment is to enhance the penetration of TCA. CONCLUSION: This study showed that consecutive applications, oeclusion and tretinoin pretreatment in TCA chemexfoliation enhance the peietration of TCA.
Animals ; Chemexfoliation* ; Guinea Pigs ; Statistics as Topic ; Tretinoin ; Trichloroacetic Acid* ; Water ; Wounds and Injuries

BACKGROUND: The implementation of health care delivery system(HCDS) in 1989 affected the visit pattern of tertiary care hospital. In this study we analyzed the effect of implementation of HCDS in a university hospital. METHODS: We analyzed the yearbook of a university hospital from 1986 to 1992. The clinical departments were divided into three groups of medical departments, surgical departments with application of HCDS and clinical departments without application of HCDS. RESULTS: The total outpatient visits increased after implementation of HCDS. The new outpatient visits decreased after implementation in the medical departments and surgical departments but re-visit patients increased in all clinical departments. The number of emergent patients increased at year 1889, but decreased in 1990, then little changed. Admission rate via emergency room decreased in surgical departments and clinical departments without application of HCDS. The patient from Pusan in which hospital is located was little changed but patients that from other areas increased. So the proportion of patients from Pusan decreased, and from other regions increased. The visit of patients with self pay decreased, but patients with medical insurance increased. CONCLUSIONS: In spite of increased total outpatient visits, the new outpatient visits and patient visits from near place decreased through implementation of HCDS. The new outpatient visits decreased in the medical departments and surgical departments in clinical departments with application of HCDS, but the new outpatient visits increased in clinical departments without application of HCDS.
Busan ; Delivery of Health Care* ; Emergency Service, Hospital ; Humans ; Insurance ; Outpatients ; Tertiary Healthcare

We report a typical case of Hunters syndrr me in a 9 year old boy, who presented with firm skin colored nodules that coalesce to form a reticular pattern on a symmetrical rea between the angles of the scapulas, which is regarded as the pathognornonic cutaneous rnarker, for Hunters syndrome. He also showed growth retardation, clear corneas, hepatomegaly, attertich deficit and mild mental deterioration. The skin biopsy specimen taken frorn a typical nodule shows loosely arranged collagen fibers with massive mucinous material which stains positively with aliar blue at both pH 2.5 and 0.5, metachromatic granules within fibroblast stained with toluidine blue.
Biopsy ; Child ; Collagen ; Coloring Agents ; Cornea ; Fibroblasts ; Hepatomegaly ; Humans ; Hydrogen-Ion Concentration ; Male ; Mucins ; Mucopolysaccharidosis II* ; Scapula ; Skin* ; Tolonium Chloride