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

BACKGROUND: Several different kinds of drugs have been used to treat chronic oral lichen planus (OLP). During the last decade, there have been several reports demonstrating success with levamisole and low dose prednisolone therapy for treating OLP. However, some OLP patients who have underlying diseases such as diabetes, hypertension and malignancy are unable to take steroids. OBJECTIVE: The aim of this study was to evaluate levamisole monotherapy for treating OLP. METHODS: Eleven patients who had OLP were treated with levamisole between 2005 and 2007. The levamisole was administered at a dose 50 mg thrice daily for three consecutive days, but then it was not administered on the following four days. RESULTS: After 2 weeks of treatment, 8 patients reported a partial response, 3 patients reported no response and no patients reported clearance of lesion. After 4 weeks of treatment, 6 patients reported a partial response, 3 patients reported no response and 2 patients reported clearance of lesion. Furthermore, after 3 months of treatment, 3 patients reported a partial response, 3 patients reported no response and 5 patients reported complete clearance of lesion. Clinical improvement was shown in 2 weeks, whilst the mean duration to achieve clearance of lesion was 6.2 weeks. Although 1 patient had mild itching, there were no significant adverse effects. CONCLUSION: Levamisole monotherapy could be a successful and safe treatment option for patients with chronic OLP and who cannot take steroids.
Humans ; Hypertension ; Levamisole ; Lichen Planus, Oral ; Prednisolone ; Pruritus ; Steroids

Mucoepidermoid carcinoma is a rare disease that usually occurs in the salivary gland. In extremely rare cases, it can originate from the skin. These cases are more aggressive than the usual mucoepidermoid carcinoma, so they have high mortality and high recurrence rates. Herein we report a case of primary cutaneous mucoepidermoid carcinoma on the cheek. A 34-year-old man had a 1.0x1.0 cm sized cystic lesion. This lesion displayed central erosion and oily discharge. He had been operated on 4 times at a private hospital, but the lesion had recurred. Histopathologically, there were many tumor islands that consisted of mucoid cells, epidermoid cells, intermediate cells and clear cells. The tumor islets showed mild positivity for Alcian blue (pH 2.5), PAS, and d-PAS stain. There was no parotid tumor on the neck-CT scan, nor on positron emission tomography. We therefore diagnosed this cheek lesion as primary cutaneous mucoepidermoid carcinoma, and it was removed completely.
Adult ; Alcian Blue ; Carcinoma, Mucoepidermoid ; Cheek ; Hospitals, Private ; Humans ; Islands ; Positron-Emission Tomography ; Rare Diseases ; Recurrence ; Salivary Glands ; Skin

BACKGROUND: Systemic contact dermatitis (SCD) due to the ingestion of Japanese lacquer tree (Rhus verniciflua) is pretty common in Korea, and it is on a trend of increment. It is thought that the increase in ingestion of chickens boiled with the lacquer tree has been caused by the regard of the lacquer tree as a health food or herbal medicine for gastrointestinal disease. OBJECTIVE: To review the clinical findings and laboratory findings, and to make people aware of the harmful effects of the lacquer tree. METHODS: We retrospectively reviewed the medical records of 147 patients who had SCD due to chicken boiled with lacquer tree, 98 patients in Wonkwang University Hospital over the last 20 years (1998`2007) and 49 patients in Areumdaun Dermatology Clinic over the past 5 months (August~December, 2007). RESULTS: The sex ratio of patients (male to female) was 1.3:1 and the average age was 44.0 years old (range: 11~76). They ate chicken boiled with lacquer tree as a health food (42.9%) and for the treatment of gastrointestinal disease (22.4%). The mean incubation period was 47.7 hours (range: 30 min~16 days). The first symptoms they had were erythematous maculopapules (42.9%), itching without rash (33.7%), and edematous change (16.3%). The skin lesions developed as maculopapules (50.6%), erythroderma (40.9%), and erythema multiforme-like lesion (8.4%), vesicles, wheals, purpura, and pustules. On laboratory findings, some people had leukocytosis (61.2%), increment of Ig E (26.4%), abnormalities of liver function test (ALT: 16.3%, AST: 4.1%). Sixty percent of patients had a history of contact dermititous contracted via chicken boiled with rhus lacquer ingestion (36.7%) or contact with the lacquer tree. Clinical symptoms were developed by 29.5% who ate chicken boiled with lacquer. Mainly they had been treated with corticosteroids, antihistamines. The mean period needed for treatment was 8+/-2.4 days. CONCLUSION: Systemic contact dermatitis due to ingestion of the lacquer tree was developed in either sensitized or non-sensitized persons. It is suggested that SCD is caused by the highly allergic and toxic effects of lacquer. Physicians need to make people aware of the harmful effects of the lacquer tree and educate people not to ingest it.
Adrenal Cortex Hormones ; Asian Continental Ancestry Group ; Chickens ; Contracts ; Dermatitis, Contact ; Dermatitis, Exfoliative ; Dermatology ; Eating ; Erythema ; Exanthema ; Gastrointestinal Diseases ; Food, Organic ; Herbal Medicine ; Histamine Antagonists ; Humans ; Korea ; Lacquer ; Leukocytosis ; Liver Function Tests ; Medical Records ; Pruritus ; Purpura ; Retrospective Studies ; Rhus ; Sex Ratio ; Skin ; Trees

Skin metastasis from internal malignancy is relatively rare. Skin metastasis from biliary tract cancer is known to be extremely uncommon (around 0.4~0.7%). In most cases, biliary tract cancer metastasizes into neighboring organs or other internal organs, but rarely into the skin. The authors have experienced a case of skin metastasis into a finger of a patient with carcinoma of Ampulla of Vater. This is thought to be the first case reported in Korea.
Ampulla of Vater* ; Biliary Tract Neoplasms ; Fingers* ; Humans ; Korea ; Neoplasm Metastasis ; Skin

BACKGROUND: Vibrio vulnificus is an estuarine bacterium which is capable of causing rapidly fatal infections in humans following either ingestion of raw seafoods or entry from seawater into wounds. Although V. vulnificus sepsis (called as Vibrio sepsis) has been well known in Korea since 1982 and was designated as a legal communicable disease (group III) since August 2000, many patients occurr annually. OBJECTIVE: We investigated the epidemiological features of Vibrio sepsis to offer basic data such as correlation among disease occurrence, seawater temperature, salinity and pH, amount of rainfall, incidence rate and consumed seafoods, in order to further prevent this disease. METHODS: We reviewed the epidemiologic data on monthly disease occurrence, history of raw seafood consumption and kinds of consumed seafoods in 141 patients with Vibrio sepsis obtained from 105 admitted patients in hospitals and 36 case reports published in the Korean medical journals between 1982 and 2004. Environmental data on seawater temperature, salinity and pH were obtained from the National Fisheries Research & Development Institute. The monthly amount of rainfall was obtained from the Korea Meteorological Administration. The yearly occurrence of Vibrio vulnificus regional areas was obtained from the Korea Center for Disease Control & Prevention. Population data were obtained from the Korea National Statistical Office. RESULTS: Patients began to develop in June when mean seawater temperature was over 18.9degrees C, and with a peak from July to September when seawater temperature was over 22degrees C. The majority of the patients were found in the southern and western coastal areas of Korea, especially, estuaries, where sea mud is abundant. Also disease occurrence was positively correlated with the amount of rainfall which can lower the salt concentration of seawater. Yearly occurrence of patients by regional area was the highest in the Jellanam-do during the 5 years since August 2000. The incidence rates per 100,000 population were highest in the Jellanam-do (0.69), lowest in the Jeju-do (0.01) and 0.10 in the whole areas. Seventy two percent of patients ingested 38 kinds of seafoods raw such as blue crab, goby, blood ark shell and many kinds of fishes and shellfishes. 9% of patients had not eaten seafood and 17% had either no records or unknown. 2% developed sepsis resulted from exposure of wounds to seawater. CONCLUSION: Vibrio sepsis develops in summer months with much rain and mostly in the estuaries. These results suggest that Vibrio vulnificus multiply well in the warm and in relatively low salt seawater. We think that weather, environmental and geographic factors are important for the outbreak of Vibrio sepsis.
Arcidae ; Brachyura ; Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Eating ; Epidemiologic Studies ; Estuaries ; Fisheries ; Fishes ; Geography ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Korea ; Rain ; Salinity ; Seafood ; Seawater ; Sepsis ; Shellfish ; Vibrio ; Vibrio vulnificus ; Weather

Chrome may have a corrosive, necrotizing effect on tissue, so repeated skin contact to chromate might induce perforations or ulcers on the skin. This condition is called a "chrome ulcer" or "chrome hole". It appears as a small, punched-out mark with a rolled-out border. It is rarely associated with pain, but a severe itching sensation is common. We report a case of a 33-year-old man who presented with a 3 month history of several ulcers on his abdomen. He was employed at a chromate alloying process. He had several hole-like atrophic scars and unbearable pruritus. After changing his occupation, plus treatment with oral corticosteroids and antihistamines, the lesions were healed and the itching sensation faded away. However, atrophic scarring remained.
Abdomen ; Adrenal Cortex Hormones ; Adult ; Cicatrix ; Histamine Antagonists ; Humans ; Occupations ; Pruritus ; Sensation ; Skin ; Ulcer*

Chronic exogenous steroid therapy can result in hypothalamic-pituitary-adrenal axis dysfunction; this usually results from systemic steroid therapy, and is rarely associated with topical steroid therapy. We report a case of suspected iatrogenic Cushing syndrome that developed after the treatment of annular pustular psoriasis. The patient applied clobetasol-17-propionate cream (Betabate(R)) 15~30 g daily, for 4 months, without a dermatologist's prescription. After 4 months of application, the following symptoms developed; a moon face; facial flushing; hypertrichosis; central obesity; purple striae; and multiple erythematous scaly annular patches. The development of Cushing syndrome from exogenous corticosteroid treatment was supported by the typical clinical manifestations and the low basal state of the blood cortisol level, which was perhaps due to secondary suppression of the hypothalamic pituitary-adrenal axis. Steroid-containing drugs, especially during childhood, should be used with caution and monitored carefully.
Axis, Cervical Vertebra ; Cushing Syndrome* ; Flushing ; Humans ; Hydrocortisone ; Hypertrichosis ; Obesity, Abdominal ; Prescriptions ; Psoriasis