Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans

BACKGROUND: All though the cause of alopecia areata is not known, many studies have recenty focused on the autoimmunity of alopecia areata. OBJECTIVES: The objectives of this study were to detect autoantibodies against hair follicular antigens and compare the autoantibody level before and after treatment of alopecia areata. METHODS: We collected serum from: (a) 7 alopecia areata patients with good therapeutic responses, (b) 5 alopecia areata patients with poor therapeutic responses (c) 5 normal control people. First, we detected the antigens of hair follicles with SDS-PAGE. Secondly we reacted the antigens with the patients' and normal control serums by Western blotting. RESULTS: The follicular antigens were seen in the range of 44kD-57kD. Autoantibodies obviously apparent in patients of alopecia areata but not in the normal control. High concentrations of were Autoantibodies against follicular antigens seemed to be present in the patients with good therapeutic responses and as they had been treated well, the level of autoantiboies has decreased. Autoantibodies, however, were present in small amounts and were almost an changed between before and after treatment in the patients with poor therapeutic responses except for one case. CONCLUSION: There are kinds of autoantibodies against hair follicles in the serums of alopecia areata patients, and the titers of antibodies may be correlated with therapeutic responses.
Alopecia Areata* ; Alopecia* ; Antibodies ; Autoantibodies* ; Autoimmunity ; Blotting, Western ; Electrophoresis, Polyacrylamide Gel ; Hair Follicle* ; Hair* ; Humans

We report a case of disseminated cutaneous metastatic carcinoma from stomach carcinoma in a 66-year-old male who complained chiefly of widespread cutaneous nodules. He had been admitted to the Department of Internal Medicine for stomach carcinoma. A radiological examination revealed a diffuse stomach wall thickening from the fundus to the antrum, and enlargement of paraaortic and pericaval lymph nodes during an abodominal CT scan. The clinical findings manifested above may suggest cutaneous metastasis from stomach carcinoma. A histological examination of the skin and stomach biopsies showed atypical cells with pleomorphic, hyperchromatic nuclei and bubble-like cytoplasm, which are consistent with poorly differentiated adenocarcinoma. Immunohistochemical stainings showed that these cells were positive for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and low molecular weight cytokeratin.
Adenocarcinoma ; Aged ; Biopsy ; Carcinoembryonic Antigen ; Cytoplasm ; Humans ; Internal Medicine ; Keratins ; Lymph Nodes ; Male ; Molecular Weight ; Mucin-1 ; Neoplasm Metastasis ; Skin ; Stomach* ; Tomography, X-Ray Computed

BACKGROUND: The association of androgenetic alopecia and coronary artery disease has not been well documented although many studies have tried to reveal this association. This relationship is still a controversial issue. OBJECTIVES: The aim of this study is to investigate the association between the androgenetic alopecia and lipid parameters for risk factors of coronary artery disease. METHODS: The subjects of this study were 102 patients with androgenetic alopecia who had visited the Department of Dermatology, Pil-dong Hospital, College of medicine, Chung-Ang University during 2 years (from January 2000 to December 2001). The subjects of control group were 40 male individuals who had no androgenetic alopecia, no risk factor of coronary artery disease and no coronary artery disease. RESULTS: 1. There were significant differences in the serum total lipid, phospholipid, triglyceride between the patients and the control group. But there were no significant differences in serum LDL-cholesterol, HDL-cholesterol, and total cholesterol between the two groups. 2. There were significant differences in the serum total lipid, phospholipid, triglyceride between frontal baldness patients and the control group (p<0.05). But there were no significant differences in the serum LDL-cholesterol, HDL-cholesterol, and total cholesterol between the two groups. 3. There were significant differences in the serum total lipid, phospholipid, triglyceride, LDL-cholesterol, and total cholesterol between vertex baldness patients and the control group (p<0.05). But there were no significant differences in serum HDL-cholesterol between two groups. 4. There were no significant differences in the serum total lipid, phospholipid, triglyceride, LDL-cholesterol, HDL-cholesterol and total cholesterol between androgenetic alopecia patients who were increased serum testosterone and the control group. CONCLUSION: These data suggest that androgenetic alopecia involving the vertex scalp is associated with significantly increased total cholesterol and LDL-cholesterol for risk factors of coronary artery disease. We recommend that dermatologists should investigate the lipid parameters, especially total cholesterol and LDL-cholesterol in vertex baldness patients.
Alopecia* ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Dermatology ; Humans ; Male ; Risk Factors* ; Scalp ; Testosterone ; Triglycerides

BACKGROUND: Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess.CASE PRESENTATION: A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions. CONCLUSION This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.

Dermatophytes usually do not invade beyond the epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state may allow penetration of the fungi into reticular dermis. We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 39-year-old male presented with 3.5x5 cm sized, erythematous, ulcerated lesion on the left heel for about 1 month. Histologic findings of the skin lesion showed granulomatous change and numerous hyphae in the dermis. Trichophyton rubrum was isolated on the fungus culture. The patient was treated with terbinafine (250 mg/day) for 10 weeks, resulting in the clearing of the skin lesion.
Adult ; Arthrodermataceae ; Dermis ; Epidermis ; Fungi ; Granuloma* ; Heel ; Humans ; Hyphae ; Male ; Skin ; Trichophyton* ; Ulcer

Dermatophytes usually do not invade beyond the epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state may allow penetration of the fungi into reticular dermis. We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 39-year-old male presented with 3.5x5 cm sized, erythematous, ulcerated lesion on the left heel for about 1 month. Histologic findings of the skin lesion showed granulomatous change and numerous hyphae in the dermis. Trichophyton rubrum was isolated on the fungus culture. The patient was treated with terbinafine (250 mg/day) for 10 weeks, resulting in the clearing of the skin lesion.
Adult ; Arthrodermataceae ; Dermis ; Epidermis ; Fungi ; Granuloma* ; Heel ; Humans ; Hyphae ; Male ; Skin ; Trichophyton* ; Ulcer

Fasciitis can occur very rarely with sclerotic-type chronic cutaneous graft-versus-host disease (GVHD). A 54-year-old woman presented with painful skin tightness on upper and lower limb with limited range of movement. She was diagnosed with chronic myelocytic leukemia 5 years ago and underwent allogeneic bone marrow transplantation. Histopathologically, the interlobular septum of subcutis and fascia were remarkably thickened with fibrosis and moderate inflammatory infiltrates accompanying the dilated lymphatic channels with considerable leakage of lymph fluids. Herein, we report a case of extensive fasciitis as a manifestation of chronic GVHD associated with poor prognosis.
Bone Marrow Transplantation ; Fascia ; Fasciitis ; Female ; Fibrosis ; Graft vs Host Disease ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Lower Extremity ; Prognosis ; Skin

Lichen nitidus(LN) is an uncommon chronic inflammatory disease of shiny, flat-topped, flesh-colored uniform papules most commonly located on the penis, forearms and wrists, lower abdomen, and thighs. LN almost has localized distribution, but in rare cases, it may become generalized. In Korea, three cases of generalized LN were reported. We report here three cases of generalized lichen nitidus in 31-year-old man, 8-year-old boy, and 6-year-old girl who had generalized numerous pinhead-sized, erythematous to flesh-colored, shiny papules. Microscopically, they had typical appearance of LN.
Abdomen ; Adult ; Child ; Female ; Forearm ; Humans ; Korea ; Lichen Nitidus* ; Lichens* ; Male ; Penis ; Thigh ; Wrist

OBJECTIVE: The cell-cell and cell-extracellular matrix interactions are critical to the embryogenesis, morphogenesis, maintenance of tissue integrity, and function of cells. This interactions are mediated by membrane glycoproteins called adhesion molecules. fil-integrins are heteredimeric transmembrane glycoproteins which play critical roles in the ability of cells to elaborate and maintain extracellular matrix. ICAM-1 is a sialylated glycoprotein and mediates various cell-cell interactions in immunity and inflammation. Articular cartilage consists of chondrocytes embedded in an extensive extracellular matirx. In normal tissue, the chondrocytes actively effect the stable equili-brium between the synthesis and degradation of matrix components, so that a constant concentration of these components is maintained. In osteoarthritis, the stable equilibrium is disrupted and the rate of loss of proteoglycan exceeds the rate of depositon of newly synthesized moleclues. This equilibrium is influenced by cytok{nes and growth factors such as IL-1, TNF-alpha, IGF-1 and TGF-beta. Integrins and their ligands may mediate some of the interactions of chondrocytes and cellular matrix, and the cytokines and local growth factors may affect the expression of integrins on chondrocytes. ICAM-1 may mediate interactions with other cells in osteoarthritic joint, and also may be modulated by cytokines and growth factors. The effect of IL-1, TNF-alpha, IGF-1 and TGF-beta in the expression of fil-integrin(CD29) and ICAM-l(CD54) on chondrocytes was investigated. METHODS: Cultured chondrocytes(3rd passages) from 2 osteoarthritc patient were used. Cells were incubated for 24hours with and without IL-lfi 25U/ml, IL-l 50U/ml, TNF-alpha lng/ml, TNF-alpha 10ng/ml, IFN-gamma 100U/ml, IGF-1 10ng/ml, IGF-1 50ng/ml, IGF-1 100ng/ml, TGF-beta 10ng/ml, and TGF-beta 30ng/ml. Chondrocytes were stained with monoclonal antibodies against beta1-integrin(CD29) and ICAM-1 (CD54), and positve cells were counted under the light microscpe. RESULTS: 1) Cultured chondrocytes readily expressed fi1-integrin(82. 9%). 2) filintegrin was down-regulated by IL-1beta(75.4%), TNF-alpha(61.2%), and TGF-beta (77.0%), and was slightly up-regulated by IFN-gamma(85.0%) and IGF-1 (88.9%). 3) ICAM-1 was presented in only 18.0% of cells. 4) Expression of ICAM-1 was readily up-regulated by IL-1beta(84.0%) and TNF-alpha(80.3%), and mildly up-regulated by IFN-gamma(33.0%), IGF-1 (35.0%), and TGF-beta(29.3%). CONCLUSIONS: The presence of fil-integrin and ICAM-1 on chondrocytes and the modulation of their expression by cytokines and local growth factors suggest that they have important roles in the interaction of chondrocytes with cartilage matrix and with other cells of osteoarthritic joints. Their roles should be elucidated by further researches.
Antibodies, Monoclonal ; Cartilage ; Cartilage, Articular ; Chondrocytes* ; Cytokines* ; Embryonic Development ; Extracellular Matrix ; Female ; Glycoproteins ; Humans ; Inflammation ; Insulin-Like Growth Factor I ; Integrins ; Intercellular Adhesion Molecule-1* ; Intercellular Signaling Peptides and Proteins* ; Interleukin-1 ; Joints ; Ligands ; Membrane Glycoproteins ; Morphogenesis ; Osteoarthritis ; Pregnancy ; Proteoglycans ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha