Sneddon's syndrome consists of widespread livedo reticularis and ischemic cerebral manifestations. We report a case of a 70-year-old Korean woman with extensive livedo reticularis, hypertension, positive laboratory results for antinuclear antibodies and the lupus anticoagulant test, and idiopathic Parkinson's disease.
Aged ; Antibodies, Antinuclear ; Female ; Humans ; Hypertension ; Livedo Reticularis ; Lupus Coagulation Inhibitor ; Parkinson Disease

According to the size of nevus, a congenital pigmented nevus may be classified as small, medium, and giant. Among these, giant congenital pigmented nevus is known to have high potential for malignant transformation. The rate of malignant transformation is different according to lesional anatomical sites. We describ a case of a 48-year-old man who had a maignant melanoma arising from giant congenital pigmented nevus on the left thigh. Wide excision and inguinal lymph node dissection were performed but distant metastases were found four months later.
Humans ; Lymph Node Excision ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Nevus ; Nevus, Pigmented* ; Thigh

Five cases of coronary arteriovenous fistula(CAVF) were diagnosed with coronary arteriography during recent 3 years in Seoul National University Hospital. In one patients, the CAVF was from right coronary artery to left ventricle at posterior aspect. In another, the CAVF was from left circumflex to left atrium. In the remaining three, it was from conal branch of left anterior descending to pulmonary artery. The correct diagnosis for the appropriate treatment of CAVF is important since the incicence of the ischemic coronary heart disease is increasing recently.
Adult* ; Angiography ; Arteriovenous Fistula* ; Coronary Disease ; Coronary Vessels ; Diagnosis ; Heart Atria ; Heart Ventricles ; Humans ; Pulmonary Artery ; Seoul

Organ transplantation has become a' widely accepted treatment modality for end-stage organ disease. The shortage of allogenic donors for organ transplantation has brought about the necessity of xenotransplantation as an unlimited source of organ donation. However, organ transplantation between different species have never been successful because of hyperacute rejection. Although the mechanism of this phenomenon is not fully understood, many researchers believe that the natural antibodies present in the recipient's serum may bind to the graft and induce the activation of complement cascade triggering the process of hyperacute rejection. ...continue...
Antibodies ; Complement System Proteins ; Heterografts ; Humans ; Organ Transplantation ; Tissue and Organ Procurement ; Tissue Donors ; Transplantation, Heterologous ; Transplants

An atypical form of scabies is crusted or Norwegian sacbies, which is often seen in the physically or mentally handicapped, immunocompromised, and institutionalized persons. The characteristic skin lesions in this form are gross scaling and hyperkeratotic plaque, especially on the hands, feet, scalp, face, and pressure bearing areas with varying degrees of pruritus. We report a case of Norwegian scabies in a 81 year old patient with a chronic obstructive pulmonary disease using systemic steroid.
Aged, 80 and over ; Foot ; Hand ; Humans ; Institutionalization ; Mentally Disabled Persons ; Pruritus ; Pulmonary Disease, Chronic Obstructive ; Scabies* ; Scalp ; Skin

BACKGROUND: Toxic epidermal necrolysis(TEN) is the most dramatic and life-threatening cutaneous drug reaction. However, specific and effective treatment for TEN have not yet been identified. Recently several reports suggested that high dose intravenous immunoglobulin(IV Ig) treatment has produced good results in patients with TEN. OBJECTIVE: To analyze the efficacy and side effects of IV Ig in treatement of TEN. METHODS: Ten patients with clinicopathological diagnosis of TEN were treated with IV Ig(1.6-3.4g/kg), and clinical efficacy and side effects were observed. RESULTS: Nine patients were healed and one died of sepsis. Interruption of further epidermal detachment occurred after an average 3 days from the onset of IV Ig therapy. Complete wound healing occurred after an average of 14.3 days. The side effects of IV Ig including headache, myalgia, nausea, transient neutropenia, and coombs positive hemolytic anemia were observed in 4 patients but normalized after cessation of IV Ig therapy. Three of them showed complete healing of detached skin but died with aggravation of underlying disease. CONCLUSION: IV Ig therapy represents a safe and very effective treatment for TEN. Furthermore, intensive care for underlying diseases is also very important for reducing the mortality rate in patients with TEN.
Anemia, Hemolytic ; Diagnosis ; Headache ; Humans ; Immunoglobulins* ; Critical Care ; Mortality ; Myalgia ; Nausea ; Neutropenia ; Sepsis ; Skin ; Stevens-Johnson Syndrome* ; Wound Healing

BACKGROUND: Onychomycosis is a common superficial fungal infection. Causative organisms in onychomycosis have been extensively studied, but the role of non-dermatophytes is controversial. Trichosporon beigelii are soil and water inhabiting yeasts, occasionally found in flora normally associated with human skin, mouth, and nails. Several reports in the literature have suggested that T. beigelii is one of the pathogens in onychomycosis. OBJECTIVE: We performed mycologic studies to investigate the causative organisms of onychomycosis and to confirm the pathogenic role of T. beigeliis in onychomycosis. METHODS: We performed a survey of the mycologic labaratory records of patients clinically suspected of onychomycosis from July 1996 to December 1998. RESULTS: 1) Out of a total of 1934 nail samples examined, 928(48.0%) of these were culture positive, including 192(10.8%)cases with T. beigelii. 2) The overall positive rate for the KOH mount examination was 59% and in the cases with T. beigelii was 89.1%. 3) Among the age groups, the incidence rate was highest in the fifth decade(26.6%). 4) The monthly prevalence of onychomycosis was highest in July(10.6%), the distribution of T. beigelii was high in July and August. 5) The most common causative organism of onychomycosis was Trichophyton rubrum(62.0%), and the others in decreasing frequency were T. beigelii(20.7%), Candida spp.(7.2%), Trichophyton mentagrophytes(4.0%) and mixed infection(2.2%). 6) T. beigelii was repeatedly isolated in the successive nail cultures from 10 out of 20 patients with T. beigelii nail infection. CONCLUSION: T. beigelii was the second commonly isolated fungus in onychomycosis had the high positive rate of the which KOH mount examination on nails and successive repeated cultures. We suggest that T. beigelii might be a pathogen of onychomycosis.
Candida ; Fungi ; Humans ; Incidence ; Mouth ; Onychomycosis* ; Prevalence ; Skin ; Soil ; Trichophyton ; Trichosporon* ; Yeasts

Cheilitis granulomatosa as a monosymtomatic form of the Melkersson-Rosenthal sydrome, was charaterized by reccurrent or persistent edema in the orofacial lesion that could not be explained on the basis of infections, systemic, malignant, or connective tissue disorders. Herein we report two cases of cheilitis granulomatosa which have been treated with triamcinolone acetonide intralesional injection, hydroxychloroquine 400mg per day. After a short course of systemic steroids the swelling of the lip improved.
Cheilitis* ; Connective Tissue ; Edema ; Hydroxychloroquine ; Injections, Intralesional ; Lip ; Melkersson-Rosenthal Syndrome* ; Steroids ; Triamcinolone Acetonide

Toxic epidermal necrolysis(TEN) is the most dramatic, life-threatening cutaneous drug reaction. TEN is characterized by extensive detachment of the epidermis undergoing full-thickness necrosis. The pathogenetic pathway and specific treatments of TEN have not yet been identified. Recently, several reports suggested that apoptosis in TEN is promoted by proteins such as Fas antigen and high dose intravenous immunoglobulin(IVIG) inhibits Fas-mediated cell death by blocking the Fas receptor. We report a case of TEN in a 26-year-old woman who had been treated with prednisolone due to iritis. She was treated with high dose IVIG(0.4g/Kg/day for 4 days one day and 0.7g/Kg/day for consecutive). In our case, the progression of skin lesion was interrupted after IVIG infusion and favorable vital outcome was achieved with mild adverse effects.
Adult ; Antigens, CD95 ; Apoptosis ; Cell Death ; Epidermis ; Female ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Iritis ; Necrosis ; Prednisolone ; Skin ; Stevens-Johnson Syndrome*

Toxic epidermal necrolysis(TEN) is the most dramatic, life-threatening cutaneous drug reaction. TEN is characterized by extensive detachment of the epidermis undergoing full-thickness necrosis. The pathogenetic pathway and specific treatments of TEN have not yet been identified. Recently, several reports suggested that apoptosis in TEN is promoted by proteins such as Fas antigen and high dose intravenous immunoglobulin(IVIG) inhibits Fas-mediated cell death by blocking the Fas receptor. We report a case of TEN in a 26-year-old woman who had been treated with prednisolone due to iritis. She was treated with high dose IVIG(0.4g/Kg/day for 4 days one day and 0.7g/Kg/day for consecutive). In our case, the progression of skin lesion was interrupted after IVIG infusion and favorable vital outcome was achieved with mild adverse effects.
Adult ; Antigens, CD95 ; Apoptosis ; Cell Death ; Epidermis ; Female ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Iritis ; Necrosis ; Prednisolone ; Skin ; Stevens-Johnson Syndrome*