BACKGROUND: Chicken Pox, a highly contagious exanthem that occurs most frequently in childhood, is the result of primary infection with varicella zoster virus. Although it is generally a benign, self-limiting disease, varicella zoster virus infection may be associated with serious complications, especially in older adults. OBJECTIVE: The aim of this study was to elucidate the epidemiological and clinical characteristics and histopathologic features of varicella in adolescents and adults. METHOD: 57 patients who were admitted with varicella as adolescents or adults during a 20-year period from 1985 to 2004 were evaluated in regard to age, sex, monthly incidence, prodromal symptoms, and cutaneous manifestations. Patients were further assessed over abnormalities of laboratory tests, associated diseases, or histopathologic features. RESULTS: The results were as follows: 1. Varicella was seen most frequently in the 20~29 year-old group (47%), followed by the 10~19 year-old group (30%). The ratio of males to females was 1.36: 1. As a result of calculating the average age in five-year peroids from 1985 to 2004, the average age in the last period (2000-2004) was 29.2 +/- 7.0 years. This was found to be higher than in the other 5-year periods. 2. With regard to monthly occurrence, varicella was found to be most prevalant in May (21%). 3. The most common prodromal symptom was fever (74%), followed by a sore throat (32%) and headache (30%). 4. Common cutaneous manifestations of varicella were papules (84%), vesicles (79%) and typical umbilicated vesicles (65%). Pruritus (96%) was an extremely common symptom. 5. The most common laboratory abnormality was an abnormal liver function (28%). 6. Associated diseases of varicella were observed in 6 patients (10%). These included hepatitis or the hepatitis B virus carrier (5%), diabetes mellitus (2%), pulmonary tuberculosis (2%), and ulcerative colitis (2%). 7. Complications of varicella were 1 case (2%) of keratitis and 1 case (2%) of secondary infection. 8. In 7 cases of varicella stained with hematoxylin-eosin, all cases showed necrosis of keratinocytes and ballooning degeneration, and 5 cases had severe inflammatory infiltrations. Intra-epithelial vesicles were found in 6 cases, and multinucleated giant cells were found in 2 cases. CONCLUSION: The mean age of varicella patients showed an increase in the last 5-year period. In adolescents and adults with varicella, we recommend that patients should be evaluated for abnormalities of liver function.
Adolescent* ; Adult* ; Chickenpox* ; Chickens* ; Coinfection ; Colitis, Ulcerative ; Diabetes Mellitus ; Exanthema ; Female ; Fever ; Giant Cells ; Headache ; Hepatitis ; Hepatitis B virus ; Herpesvirus 3, Human ; Humans ; Incidence ; Keratinocytes ; Keratitis ; Liver ; Male ; Necrosis ; Pharyngitis ; Prodromal Symptoms ; Pruritus ; Tuberculosis, Pulmonary

BACKGROUND: Pain and paresthesia often precede the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. OBJECTIVE: The aim of this study was to elucidate the clinical characteristics of herpes zoster and its nature of pain. METHODS: Three hundred and thirty three patients who were admitted with herpes zoster during a 10-year period from 1995 to 2004 were evaluated in regard to age, sex, dermatomal distribution, associated diseases, and complications. Patients were further assessed concerning the nature of the pain and its relationship to age, sex, dermatomal distribution, and postherpetic neuralgia. RESULTS: Herpes zoster was seen most frequently in the 70~79 year-old age group (30.9%), and the ratio of male to female patients was 1 : 2.2. The most common dermatomal distribution was thoracic dermatome (39.6%), followed by trigeminal (30.9%), cervical (11.7%), lumbar (7.2%), sacral (2.7%), and multiple dermatomal involvement (4.5%). Associated diseases to herpes zoster were observed in 180 patients (54.1%) which included hypertension (18.6%), diabetes mellitus (8.7%), gastritis and gastric ulcer (6.0%), fatty liver and hepatitis (5.1%), pulmonary tuberculosis (3.3%), malignancy (2.7%), rheumatoid arthritis (1.8%), and various other conditions (7.9%). The most common complication of herpes zoster was postherpetic neuralgia (15.6%), followed by ocular complications (6.9%), secondary infection (1.5%), scar formation (0.9%), Ramsay-Hunt syndrome (0.6%), and a neurogenic bladder (0.3%). The most common nature of pain associated with herpes zoster was pricking or stabbing (68%), followed by a dull ache (8.1%), tingling (7.2%), burning (4.2%), numbness (3.9%), throbbing (2.1%), a water trickling sensation (1.5%), itching (1.5%), formication (1.2%), soreness (0.9%), bursting (0.6%), sensation of being pulled down (0.3%), and sensation of cold water being poured on the skin (0.3%). Paresthesia was observed in 11 patients (3.3%), and 8 of these complained of this in the trigeminal dermatome (72.7%). CONCLUSION: Higher incidences of herpes zoster were observed in female and in the 70~79 year-old age group. The nature of pain associated with herpes zoster varied from a superficial itching to severe stabbing or bursting, and paresthesia occurred most frequently in the trigeminal dermatome.
Arthritis, Rheumatoid ; Burns ; Cicatrix ; Coinfection ; Diabetes Mellitus ; Diagnostic Errors ; Fatty Liver ; Female ; Gastritis ; Hepatitis ; Herpes Zoster* ; Humans ; Hypertension ; Hypesthesia ; Incidence ; Male ; Neuralgia, Postherpetic ; Paresthesia ; Pruritus ; Sensation ; Skin ; Stomach Ulcer ; Tuberculosis, Pulmonary ; Urinary Bladder, Neurogenic ; Water

The fungiform papillae are generally described as being pink or red in colour. Pigmented fungiform papillae of the tongue (PFPT) are characterized clinically by pigmentation confined to these papillae and histopathologically by melanophages in the lamina propriae. PFPT appears to be relatively common among the black population, whereas this entity has rarely been reported in Asians. We report a case of PFPT in a 35-year-old Korean woman who had black dots, exclusively involved with fungiform papillae, on the anterior dorsolateral side of the tongue. The patient also had iron deficiency anemia. Histopathologic findings revealed an increase of melanophages in the upper dermis within the fungiform papillae.
Adult ; Anemia, Iron-Deficiency ; Asian Continental Ancestry Group ; Dermis ; Female ; Humans ; Mucous Membrane ; Pigmentation ; Tongue*

Pseudofolliculitis is a chronic, inflammatory skin disorder seen mainly in individuals with curly hair. This condition is caused by hairs curling back into the skin and is seen most frequently in black men who shave their beards (pseudofolliculitis barbae), but may also be seen in all races who shave the axillary (pseudofolliculitis axillae) and pubic skin (pseudofolliculitis pubis). We report a case of pseudofolliculitis pubis in a 23-year-old black woman, who presented with multiple, dark, black-colored papules on both inner thighs, on the edge of the bikini line, which she regularly shaved. Histopathologically, foreign-body inflammatory reaction surrounding an ingrown hair was observed. We recommended her to stop shaving pubic hairs and to remove the hairs by laser.
Continental Population Groups ; Female ; Hair ; Humans ; Male ; Skin ; Thigh ; Young Adult

Eosinophilic pustular folliculitis(EPF) is characterized by recurrent crops of pruritic follicular papules and pustules that occur mainly on the face, trunk, and extremities. Histologically, the major distinguishing feature is abundant eosinophils that invade sebaceous glands and outer root sheaths of hair follicles. We herein report a typical case of eosinophilic pustular folliculitis for promoting research of this rare disease.
Eosinophils* ; Extremities ; Folliculitis* ; Hair Follicle ; Rare Diseases ; Sebaceous Glands

Mondor's disease, thrombophlebitis of the subcutaneous veins, is an uncommon condition. It has clinical features of sudden development of localized pain to be followed by a palpable and visible tender, linear, branching cutaneous groove. The patient was a 43-year-old man who showed two cord like tender subcutaneous grooves on the left lower quadrant of the abdomen. He had done vigorous weightlifting for one month prior to his visit. Histopathologic finding showed occlusion of vessels by organized thrombus.
Abdomen ; Adult ; Humans ; Thrombophlebitis ; Thrombosis ; Veins

A 40-year-old female patient, known angiocenteric T-cell lymphoma on nasal cavity, was transfered from the department of hemato-oncology for the evaluation of egg sized pinkish-yellow indurated mass with central necrotic tissue on the left medial elbow. Histopathologic findings revealed angiocentric, angioinvasive, and angiodestructive infiltrate containing atypical lymphocytes. The infiltrative cells were positivly stained with antibody to CD45RO, LCA, but not with antibody CD20. The atypical infiltrated perivascular lymphoid cells were positive to Epstein-Barr virus in situ polymerase chain reaction. She was treated with combined chemotherapy and radiation therapy, but she died due to sepsis. We herein report a rare case of angiocentric T-cell lymphoma on the nasal cavity and skin associated with Epstein-Barr virus.
Adult ; Drug Therapy ; Elbow ; Female ; Herpesvirus 4, Human ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Nasal Cavity ; Ovum ; Polymerase Chain Reaction ; Sepsis ; Skin ; T-Lymphocytes*

The rate of the relapse of leprosy differs from researcher to researcher, so it is thought that the exact decision on the termination of a treatment would play an important role in lowering the rate of the relapse of leprosy. This study attempts to lower the rate of the relapse of leprosy by the decision for termination of leprosy treatment by using reticulum stain of skin in leprosy which is one of granulomatous diseases, as granuloma can be easily observed in reticulum stain in sarcoidosis which is one of the common granulomatous diseases. The patients for this study consisted of five cases of lepromatous type leprosy, three cases of tuberculoid type leprosy, and one case of borderline tuberculoid leprosy. They were treated by a multidrug therapy, and its clinical lesions were observed every month. Also skin biopsy was performed every six months, and the changes of granuloma and acid-fast bacilli were observed in accordance with hematoxylin-eosin, Fite-Farraco, and reticulum stain which provides a better observation of granuloma lesion. Skin lesion of paucibacillary leprosy disappeared in 8 to 12 months, but seen from skin biopsy, epitheloid cell granuloma began to disappear after several months and after 12 months, it almost disappeared. But in some lesion, it remained until 21 months, and even after 33 months, perivascular inflammatory cell infiltrations were found. Skin lesions of multibacillary leprosy disappeared within 9 to 33 months, and bacilli checked by skin smear turned negative, but according to a skin biopsy, the number or the size of the foamy histiocytic granuloma became smaller. There was an example that it still remained after 84-month treatment. As a rule, reticulum stain in leprosy made reticulum fibers surround granuloma in various ways, so it helped us to observe distinctively granuloma. In a treatment of leprosy, it could prevent the relapse of leprosy that the already treated lesions should be checked with repeated skin biopsies at certain intervals, though skin lesions disappear and bacilli are not found in a skin smear. It is concluded that reticulum stain could be one of the useful methods in observing granulomatous lesions for determination of healing of leprosy.
Biopsy ; Granuloma ; Humans ; Leprosy* ; Leprosy, Multibacillary ; Leprosy, Paucibacillary ; Recurrence ; Reticulum* ; Sarcoidosis ; Skin*

Norwegian, or crusted scabies, is a fulminant and highly infectious form of scabies in which a large number of Sarcoptes scabiei mites infest the epidermis. This is often seen in senile or mentally retarded patients with poor cutaneous sensation, in subjects with severe systemic disease, or immunosuppressed patients. This form of scabies differs from ordinary scabies due to the hyperkeratotic, scaly, and crusted aspect of the lesions. We report a case of Norwegian scabies in 14-year-old boy with Down's syndrome. It is the first reported case in Korea.
Adolescent ; Down Syndrome* ; Epidermis ; Humans ; Korea ; Male ; Mentally Disabled Persons ; Mites ; Sarcoptes scabiei ; Scabies* ; Sensation

BACKGROUND: Vibrio (V.) vulnificus is a pathogenic marine bacterium that can cause rapid progression of a life-threatening infection. Although V. vulnificus sepsis is well-known to Koreans and was designated as a legal communicable disease in August 2000, many people still become infected each year. OBJECTIVE: The purpose of this study was to investigate the clinical features of V. vulnificus sepsis, in order to offer basic data for the treatment and prevention of this disease. METHODS: We reviewed the available data of 141 patients with V. vulnificus sepsis, which were obtained from 105 patients admitted to hospital and 36 case reports published in the Korean medical journals between 1982 and 2004. RESULTS: Eighty-five percent of patients were 40 to 60 years old. Men were affected 10.5 times more often than women. Patients with underlying chronic diseases (94%) such as alcohol abuse and liver diseases displayed primary sepsis starting with fever, chills, and/or diarrhea, often within 2.3 days of consumption of various kinds of raw seafood. Skin lesions appeared initially as a painful, localized swelling like a bee-sting, followed by edema, blisters, purpura, necrosis and, less commonly, maculopatch, cyanosis, papules, wheals, pustules or erythema multiforme-like lesions. The cutaneous lesions that were present in 91.5% of patients on admission, appeared on the lower extremities in 88.9% of the cases. Of the 141 patients, 88 patients (62.4%) died. The mortality rate increased as initiation of treatment was delayed. Laboratory findings revealed thrombocytopenia and elevated levels of liver enzymes in many tested cases. V. vulnificus was cultivated more easily from the skin lesion (95%) than blood (69%). There were significant differences in systolic blood pressure, leukocyte count and creatinine between survivors and nonsurvivors (p<0.05). V. vulnificus was highly susceptible to several kinds of antibiotics such as ampicillin, ciprofloxacin, and 3rd generation cephalosporins. Mortality rate increased as the delay from the onset of illness to the initiation of treatment was prolonged. CONCLUSION: Clinicians should promptly initiate appropriate therapy for patients with underlying chronic disease if they exhibit unexplained fever and diarrhea after ingesting raw seafood.
Alcoholism ; Ampicillin ; Anti-Bacterial Agents ; Blister ; Blood Pressure ; Cephalosporins ; Chills ; Chronic Disease ; Ciprofloxacin ; Communicable Diseases ; Creatinine ; Cyanosis ; Diarrhea ; Edema ; Erythema ; Female ; Fever ; Humans ; Leukocyte Count ; Liver ; Liver Diseases ; Lower Extremity ; Male ; Middle Aged ; Mortality ; Necrosis ; Purpura ; Seafood ; Sepsis* ; Skin ; Survivors ; Thrombocytopenia ; Vibrio vulnificus* ; Vibrio*