Laugier-Hunziker syndrone is a rare, pigmentary disorder of the lips, oral mucosa, and nails. The absence of intestinal polyposis differentiated it from Peutz-Jeghers syndrome. We describe a 16-year-old boy with multiple, brownish, lenticular macules on the lips, oral mucosa, perianal area and anal mucosa, and on the digits of his fingers and toes, in wham intestinal polyposis was not detectable.
Adolescent ; Fingers ; Humans ; Intestinal Polyposis ; Lip ; Male ; Mouth Mucosa ; Mucous Membrane ; Peutz-Jeghers Syndrome ; Toes

Intravascular fasciitis (IVF), a rare distinct variant of nodular fasciitis, possesses the same clinical and histologcal features of nodular fasciitis, but in addition, involves predominantly small to medium- sized veins and/or arteries intraluminally, intramurally and extramurally. Only 3 cases of intraoral IVF have been reported in the English literature. Herein we report a case of IVF developing on the inner lower lip and it was successfully treated with simple excision.
Arteries ; Fasciitis* ; Lip ; Veins

BACKGROUND: The hypereosinophilic syndrome(HES) represents a leukoproliferative process likely caused by a number of disorders, all of which are marked by sustained over-production of eosinophils. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of HES. METHODS: The medical records and hist opathological slides of patients with HES who had skin biopsies performed in our department were reviewed. Criteria for the diagnosis of HES include (1) peripheral blood eosinophilia with eosinophil counts greater than 1,500/L for at least 6 months; (2) no evidence of parasitic, allergic, or other known causes of eosinophilia; and (3) presumptive signs and symptoms of multiple organ involvement. RESULTS: Four male and three female patients were included. HES developed in adulthood or old age (mean, 43.4 years). Because only the patients with cutaneous involvement were included, all the patients showed skin lesions. Heart, liver, stomach, nervous system, lymph nodes, and lung were involved organs in decreasing order of frequency. At the onset of HES, 40 to 80% of white blood cells were eosinophils in peripheral blood. White blood cell count and serum IgE level were elevated in all the tested patients. In six patients (85.7%), the level of serum erythrocyte sedimentation rate was elevated. Persistent hypereosinophilia (>1,500/L) was present for longer than 6 months in all patients. Stool examination and skin test for parasitic infestation all gave negative results. All the patients were not taking any medication. Histopathological examinations revealed perivascular mixed inflammatory cell infiltration; predominantly eosinophils in the stomach, liver, and nerve as well as in the skin. Interestingly, two patients who were presented with skin lesions showed the findings of eosinophilic vasculitis. In these patients, the skin lesions were consisted of Raynaud's phenomenon, digital gangrene, and several erythematous plaques. The most common cutaneous manifestations were papules and nodules on the extremities. The main treatment modality was systemic steroid. Except for one patient presented with central nervous system involvement of HES, all the patients were in a well-controlled state. In one patient with the typical clinical and hematologic features of HES, Hodgkin's disease followed. After the complete remission of Hodgkin's disease with chemotherapy, HES subsided. CONCLUSIONS: HES is a heterogenous collection of disorders marked by hypereosinophilia and organ damage. Most common cutaneous manifestations were papules and nodules on the extremities. Raynaud's phenomenon and digital gangrene can be the primary manifestation of HES in which cases cutaneous lesions showed eosinophilic vasculitis. Five patients (71%) responded well to systemic steroids. HES may be a herald of malignancy such as Hodgkin's disease. Further investigation will be mandatory ro elucidate the etiology and pathogenesis of HES.
Biopsy ; Blood Sedimentation ; Central Nervous System ; Diagnosis ; Drug Therapy ; Eosinophilia ; Eosinophils ; Extremities ; Female ; Gangrene ; Heart ; Hodgkin Disease ; Humans ; Hypereosinophilic Syndrome* ; Immunoglobulin E ; Leukocyte Count ; Leukocytes ; Liver ; Lung ; Lymph Nodes ; Male ; Medical Records ; Nervous System ; Skin ; Skin Tests ; Steroids ; Stomach ; Vasculitis

BACKGROUND: Urticaria pigmentosa(UP) is primarily a disease of children. There have been no clinical studies of UP in Korea. OBJECTIVE: This study was performed to find the clinical characteristics of UP in Korean child-hood patients. METHOD: Twenty-nine cases of urticaria pigmentosa confirmed clinically and histopathologically were analyzed. RESULTS: The maculopapular type was the most common with the usual age of onset before the age of 6 months, and the lesions tended to be distributed in the central portion of the body. Darier sign was positive in 92% of the patients(24/26). No systemic involvements were detected in any of the patients with minimal associated symptoms. Seven patients of the maculopapular type and one patient of the multiple nodular type followed up for more than 2 years showed a tendency to improve or clear by the age of 6 years. CONCLUSION: Neonatal or infantile-onset patients of UP in Korean pediatric population were considered to have a benign clinical course and to require no aggressive therapy.
Age of Onset ; Child* ; Clinical Study* ; Humans ; Korea ; Methods ; Urticaria Pigmentosa* ; Urticaria*

OBJECTIVE: With improvement in endoscopic visualization and surgical tools, several minimally invasive procedures such as transpedicular fixation, interbody fusion, or decompression have advocated their respective advantages. But all these procedures are developed separately and are not related to other techniques. The authors utilize these procedures as organized procedure like comprehensive conventional procedure. This study is designed to study early results of minimally invasive decompression, interbody fusion, and endoscopic pedicle screw fixation. METHODS: We utilized minimally invasive decompression, interbody fusion, and endoscopic pedicle screw fixation on 12 consecutive patients(9 female, 3 male, mean age 54.8 years). For decompression, unilateral laminectomy and controlateral laminar undercutting was performed through tubular retractor, and interbody fusion(PLIF or TLIF) was done with one cage and bone packing. Pedicle screw fixation was done using expandable tubular retractor under endoscopic visualization and fluoroscopic guidance. Contralateral screw fixation was done with the same manner. RESULTS: There were five spinal stenosis and seven degenerative spondylolisthesis. All patients received one level (L4-5) decompression, interbody fusion, and fixation. Mean operating time was 245.8 minutes. There was dural tear in one patient. All patients were excellent or good with average follow up of 7.2 months. Bone fusion was not evident due to short-term follow-up, but there were no instability or screw loosening. CONCLUSION: Although it is small series and has short-term follow-up, this study demonstrates that minimally invasive decompression, interbody fusion, and pedicle screw fixation are feasible and effective.
Decompression* ; Female ; Follow-Up Studies ; Humans ; Laminectomy ; Male ; Spinal Fusion ; Spinal Stenosis ; Spondylolisthesis

The patient was a 34-year-old male who had the dorsum of his right foot burned with strong alkali. Subsequently, the wound changed to an ulcer 3 days after the accident, and it was resistant to conventional treatment. After seventeen days of a granulation tissue-forming period, we applied a suction blistered epidermal graft using an intrinsic heating system we had devised. Suction blistered epidermal grafting is a less painful method with minimal scarring that is applicable to various skin diseases and researches. However, currently used techniques require patients to be immobile for some time and it makes physicians and patients feel uneasy and uncomfortable. The time needed for the suction blister formation is dependent on many factors. Among them, the temperature and the suction pressure are the important factors that can be modified easily. So, we devised a suction device having the capability to heat itself and used a suction machine with a pressure meter. We applied this to the above patient. We present a case of a chemical burn wound treated with suction blistered epidermal grafting.
Adult ; Alkalies ; Blister* ; Burns ; Burns, Chemical* ; Cicatrix ; Foot ; Heating ; Hot Temperature ; Humans ; Male ; Methods ; Skin Diseases ; Suction* ; Transplants* ; Ulcer ; Wounds and Injuries*

BACKGROUND: Previous studies have suggested that pityrosporurr yeasts, normal resident flora of skin, may be important in the pathogenesis of dandruff seborrheic dermatitis and confluent and reticulated papillomatosis. OBJECTIVE: We investigated the incidence and distribution of pityiosorum yeasts on clinically normal skin as a more reasonable method for providing the basic data or proving the relationship of pityrosporum and pathogenesi, of the diseases. MEHTODS: A total of 350 subjects were studied. Skin scrapings were stained with 20% Parker ink-KOH(P-KOH) solution. The numbers of pityrosporum spores and hyphe per high power field( x 400) were counted and designated according to a new grading method using bacterial index(BI) of lepra bacilli. RESULTS: The incidence rates of pityrosporum orbiculare(p. orbiculare) and pityrosporum ovale(p. ovale) were 60-70% and 20-50% of subjects respectively on seborrheic area., The incidence of p. orbicilare was highter than that of p. ovale on all examined sites except for the iterior scalp. And pityrosporal hyphae was present on anteriand posterior scalp and earwax in 24-25% of subjects respectively. The incidence of pityrosporum was higher in summer than other seasons The incidence rate of p. orbiculare and hyphae in the group aged below 9 (except neonates) and above 60, were lower than that of other age groups. The inciderice rates and distribution of grades of pityrosporum of neonates were lower than those of older subjects. CONCLUSION: The results of this study showed that the incidence and distribution of pityrosporum spores were similar to previoureports and hyphal forms were found 25% approximately on clinically normal skin of the scalp and carwax. The significance of the presenet of pityosporal hyphae and the relationship between normal skin and pityrosporal hyphae are to be firther elucidated.
Dandruff ; Dermatitis, Seborrheic ; Humans ; Hyphae ; Incidence* ; Infant, Newborn ; Malassezia ; Papilloma ; Scalp ; Seasons ; Skin* ; Spores ; Yeasts

BACKGROUND: Warts are common virus-induced lesions that are troublesome to treat, especially in children. Recently, some trials have suggested that the pulsed dye laser may also be useful for the treatment of warts. OBJECTIVE: To determine the effectiveness and safety of 585nm flashlamp-pumped pulsed dye laser treatment of warts. METHODS: Fifty patients representing a total of 265 warts were recruited for the study. Patients were treated using the flashlamp-pumped pulsed dye laser with a pulse duration of 450 sec, a spot size of 5mm, and energy fluence ranging between 7 to 9 J/cm2. Patients in whom no visible evidence of warts remained before 5 treatment sessions were classified as 'cured'. RESULTS: The cure rates were 89% for hand warts, 21% for plantar warts, 58% for periungual or subungual warts, 98% for limb warts and 100% for facial warts. Significant difference in the clearance rate of warts was found according to the maximum diameter of warts (≤0.3cm, >0.3cm) (<0.05). CONCLUSION: The 585nm flashlamp-pumped pulsed dye laser had potential effectiveness for the treatment of small warts on the hands, face, and limbs, but it is less effective for plan-tar warts, or larger warts.
Child ; Extremities ; Hand ; Humans ; Lasers, Dye* ; Warts*

We present one case report of anterior urethral diverticulum in a male with giant calculi. The patient was a 56-year-old male with the complaints of base-ball sized palpable scrotal mass and post-void dribbling for 15-16 years. The diverticulum was filled with multiple whitish-yellow stones. The largest one was 8X7X6cm in size.
Calculi* ; Diverticulum* ; Humans ; Male* ; Middle Aged

BACKGROUND: The demographics of the stroke population consist mainly of elderly patients. Transcranial Doppler is an effective method for intracranial flow detection, but can be limited due to the poor temporal window (PTW), which is frequent in the elderly. Therefore, we investigated whether the low frequency 1.6-MHz probe can be useful to improve flow detection for PTW. METHODS: All 201 participants had a history of transient ischemic attack or minor ischemic stroke. Firstly, we analyzed the success rate of recording intracranial blood flow via temporal window by using 2.0-MHz (high frequency, HF) and 1.6-MHz (low frequency, LF) probes for a maximum of 10 minutes. Secondly, mean flow velocity (MFV) and pulsatile index (PI) of insonated spectrum of 25 patients with good temporal window were compared between the two probes. RESULTS: Seventy-eight patients were female and the mean age was 64.1+/-12.4 years. Among 402 windows, 125 (31.1%) were undetected when using the 2.0-MHz probe. Fifty-five patients were detected for the spectrum by the 1.6-MHz probe. However, 70 (17.4%) still remained as PTW. Between the two probes, there were no significant differences of variables from the middle cerebral arteries: MFVs (HF 61.0+/-14.1 vs. LF 61.3+/-14.8 cm/sec, p=0.403 in the right; HF 59.6+/-13.4 vs. LF 59.3+/-13.3 cm/sec, p=0.232 in the left) and PIs (HF 0.82+/-0.17 vs. LF 0.82+/-0.18, p=0.929 in the right; HF 0.82+/-0.20 vs. LF 0.83+/-0.17, p=0.605 in the left). CONCLUSIONS: Conventional 2.0-MHz probe had relatively high proportion of PTW but 1.6-MHz probe was feasible to improve flow detection for PTW.
Aged ; Cerebral Arteries ; Demography ; Female ; Humans ; Ischemic Attack, Transient ; Middle Cerebral Artery ; Stroke ; Temporal Bone ; Ultrasonography, Doppler, Transcranial