BACKGROUND: Reticulum fibers represent a special type of thin collagen fiber that measures from 0.2 to 1.0 micrometer in diameter. A reticulum stain is currently used for diagnosing liver cirrhosis, chemodectoma, differentials of lymphoid tissue tumors and vascular tumors. In particular, it has been used for diagnosing sarcoidosis in the field of dermatology. OBJECTIVE: This study was conducted to ascertain whether reticulum fibers appeared when diseases showing granulomatous reaction were stained with a reticulum stain. METHODS: Patients who had been clinically or histopathologically diagnosed as having a granulomatous disease were used in this study. Granulomatous diseases included: sarcoidosis, leprosy, skin tuberculosis, lupus miliaris disseminatus faciei, granuloma annulare, paraffinoma, silicon granuloma or foreign body granuloma. A patient without a graunlomatous disease was used as the control. Hematoxylin-eosin staining and reticulum staining using Gomori's silver impregnation method were performed in all cases. RESULTS: A reticulum stain revealed a network of reticulum fibers surrounding and permeating the granulomas of various forms in patients with a granulomatous disease, although it was less abundant in sarcoidosis. CONCLUSION: We concluded that reticulum fibers appear in all granulomatous diseases.
Collagen ; Dermatology ; Granuloma ; Granuloma Annulare ; Granuloma, Foreign-Body ; Humans ; Leprosy ; Liver Cirrhosis ; Lymphoid Tissue ; Paraganglioma, Extra-Adrenal ; Reticulum* ; Sarcoidosis ; Silicones ; Silver ; Tuberculosis, Cutaneous

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

Parry-Romberg syndrome is an extremely rare connective tissue disorder. It might be a form of linear scleroderma, and it manifests as progressive hemifacial atrophy, epilepsy, exophthalmos or alopecia. Herein we report a case of Parry-Romberg syndrome. A 68-year-old woman had left hemifacial atrophy, shortening and deformity of the left leg, and deformities to her side fingers that occurred from her 1st decade to 2nd decade. Sclerotic change had stopped spontaneously when she was 20 years old. Histopathologically, there were a few signs of skin appendages, but no sclerotic change. On autoimmune antibody test, no positivity was shown. X-ray showed shrinkage of the lung field, elevation of the left diaphragm, shortening of length and reduction of bone mass in the left femur, tibia, and fibula. And there were multiple melorheostasis. Neck CT showed left facial sclerotic change, bone mass loss, and multiple melorheostasis. Because the progression of sclerosis had stopped the patient did not receive any treatment.
Aged ; Alopecia ; Congenital Abnormalities ; Connective Tissue ; Diaphragm ; Epilepsy ; Exophthalmos ; Facial Hemiatrophy ; Female ; Femur ; Fibula ; Fingers ; Humans ; Leg ; Lower Extremity ; Lung ; Neck ; Scleroderma, Localized ; Sclerosis ; Skin ; Tibia

A 32-year-old woman had a brownish hard plaque with localized hypertrichosis. She had fallen down some stairs 1 year previously, and the injury had left a scar on her right shin. Even though pain and the scar had gone, the brown patch had remained. During that time hair had been grown on the site. Histologic examination showed lobular panniculitis, fat necrosis, fibrotic change and lipomembranous change. We diagnosed the patient as a traumatic panniculitis with localized hypertrichosis, based on the trauma history, skin lesion and histologic findings. We report a case of traumatic panniculitis with localized hypertrichosis.
Adult ; Cicatrix ; Fat Necrosis ; Female ; Hair ; Humans ; Hypertrichosis ; Panniculitis ; Skin

BACKGROUND: Exposure to Rhus (Japanese lacquer) can cause many adverse effects such as contact dermatitis, pruritus, rash and even hepatitis in human, and these effects can be caused by contact or ingestion of Japanese lacquer. Many Koreans currently eat Japanese lacquer boiled with chicken although it has many side effects. Koreans believe that Rhus will improve their health. However, they don't known its adverse effects, and there is no experimental report on this topic. OBJECTIVE: The principle objective of this study was to gather evidence on the toxicity and negative effects of Japanese lacquer through an experimental study with rats. METHODS: A total of 60 Sprague-Dawley rats were included in the study; 30 rats (experimental group) were given 0.1 ml of Japanese lacquer sap extract, water and food, and 30 rats (control group) were given only food and water. The WBC, the Hgb, ALT, AST, BUN and creatinine levels, the presence of pruritis and skin eruption, the skin biopsy findings and the liver biopsy findings were all checked at 5, 10, and 15 days. RESULTS: The rats that were given Japanese lacquer sap showed a higher WBC and higher ALT and AST levels and only these rats demonstrated erythroderma (5th day: 30%, 10th day: 40%, 15th day: 70%). In addition, they exhibited frequently scratching behavior. On histological examination of the skin of the rats given Rhus, dermal edema and mild inflammatory cell infiltration were found. On histological examination of the liver of the rats given Rhus, there was no significant change as compared with the rats that weren't given lacquer. CONCLUSION: In this experimental study, it was proven that Rhus could induce pruritis, erythroderma, skin inflammation and hepatotoxicity.
Animals ; Asian Continental Ancestry Group ; Biopsy ; Chickens ; Creatinine ; Dermatitis, Contact ; Dermatitis, Exfoliative ; Eating ; Edema ; Exanthema ; Hepatitis ; Humans ; Inflammation ; Lacquer ; Liver ; Pruritus ; Rats ; Rats, Sprague-Dawley ; Rhus ; Skin ; 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: Reduced lipid content in the stratum corneum is a major cause of skin-barrier dysfunction in various pathological conditions. Promoting lipid production is a potential strategy to improve skin-barrier function. Recent evidence supports the beneficial effects of adiponectin on lipid metabolism and senescence in keratinocytes. Objective: This study aimed to investigate whether plant extracts can enhance skin-barrier function. Methods: We screened fruit and herb extracts that enhance the lipid synthesis of keratinocytes via AMP-activated protein kinase (AMPK) activation and SIRT1 signaling in the adiponectin pathway. The levels of major lipid synthesis enzymes and transcription factors as well as epidermal barrier lipids involved in adiponectin-associated epidermal barrier formation were evaluated in the herbal extracts- or adiponectin-treated human epidermal keratinocyte and equivalent models. The mRNA expression of major lipid synthesis enzymes increased following treatment with Lycii Fructus, Prunus tomentosa, and Melia toosendan extracts. Results: The expression of transcription factors SIRT1, liver X receptor α, peroxisome proliferator-activated receptors (PPARs), and sterol regulatory element-binding proteins (SREBPs) were upregulated. Levels of free fatty acids, cholesterol, and ceramides were elevated. The expression of keratinocyte differentiation markers increased. In particular, among fruit extracts with a detectable effect, Melia toosendan induced the highest expression of lipid synthase. Conclusion These results indicate that Melia toosendan is a promising candidate for improving skin-barrier function.

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*

Reed's syndrome is a rare, autosomal dominant disease with incomplete penetrance that is characterized by uterine and cutaneous leiomyomas. We report a case of Reed's syndrome in a 50-year-old woman. The patient underwent removal of the uterine leiomyoma at the age of 36. Following this the patient noticed development of multiple, cutaneous nodules on both arms at the age of 45. These nodules progressively increased in both number and size, while appearing in other sites. The histopathologic finding of an isolated, single skin lesion showed typical leiomyoma arising from arrector pilorum muscle. Familial history revealed that her father had been affected with similar cutaneous lesions.
Arm ; Fathers ; Female ; Humans ; Leiomyoma ; Leiomyomatosis* ; Middle Aged ; Penetrance ; Skin