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

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

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*

Nicolau syndrome is defined as local cutaneous and sometimes muscular necrosis observed at the injection site of intramuscular preparations. It is characterized by severe pain immediately after the injection and variable degrees of skin necrosis. The only treatment is conservative. A 46-year-old man presented with painful skin necrosis on his buttock after the injection of diclofenac sodium. Histopathologic examination showed necrosis of the epidermis and upper 2/3 of the dermis. The lesion was treated conservatively with topical antibiotic ointment. We report a rare case of Nicolau syndrome due to diclofenac sodium.
Buttocks ; Dermis ; Diclofenac* ; Epidermis ; Humans ; Middle Aged ; Necrosis ; Skin

Herpes zoster classically occurs unilaterally within the area of skin innervated by a single sensory ganglion. Simultaneous involvement of two noncontiguous dermatomes is very rare and it has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 47-year-old woman presented with painful grouped vesicles on the right chest and the left lower back. The tzanck smear and the skin biopsy were consistent with herpetic infection. She was treated with intavenous acyclovir without any significant complications. We report a rare case of zoster duplex bilateralis.
Acyclovir ; Biopsy ; Female ; Ganglia, Sensory ; Herpes Zoster* ; Humans ; Middle Aged ; Skin ; Thorax

Mutiple cutaneous reticulohistiocytosis represent a unique pattern in the spectrum of reticulohistiocytoses, and are characterized by multiple granulomas confined to the skin without evidence of arthritis or underlying systemic illness. We report a case of multiple cutaneous reticulohistiocytosis in a 31-year-old male, who presented with multiple, asymptomatic reddish-brown or skin-colored papules on the whole body. Histopathologically, there were numerous mononuclear and multinucleated histiocytes with a ground glass appearance in the dermis. The histiocytes were diastase-resistant, and periodic acid-Schiff reagent and CD 68 positive. The patient was treated with narrow band UVB for 1 month and slightly improved slightly.
Adult ; Arthritis ; Dermis ; Glass ; Granuloma ; Histiocytes ; Humans ; Male ; Skin