We report a case of follicular mucinosis which oecurred in a 28-year old female. She had an adult fist-sized erythemlatous indurated infiltrative plaque with an ill-defined border on the left cheek area. Histopatholcigical findings, including mucin stains, showed characteristic reticular degeneration and cystic spece formation in hair follicles and sebaceous glands with mucinous degeneration and infiltration of abundant eosinophiles. The present case should be differentiated from plaque type eosinophilic pustular folliculitis clinically and histologically.
Adult ; Cheek ; Coloring Agents ; Eosinophils ; Female ; Folliculitis ; Hair Follicle ; Humans ; Mucinosis, Follicular* ; Mucins ; Sebaceous Glands

Palisaded, encapsulated neuroma is characterized clinically by a solitary, slowly-growing and dome-shaped papule or nodule, usually accompanied by telangiectasia on the surface, and histopathologically by an encapsulated nodule in the dermis and the palisading arrangement of nuclei. A 57-year-old female patient presented with a 1cm-sized, solitary nodule on the right ala nasi which had been present for about 5 years. The nodule had a tendency to slow growth and it became a polypoid nodule. Telangiectasia was shown on the surface of the lesion. Histopathlogical findings showed a well-defined and encapsulated nodule in the dermis, composed of spindle cells with basophilic and plump nuclei in a palisading fashion. On immunohistochemical staining, the tumor cells of the nodule were positive for S-100 protein, while the capsule of the nodule was negative for S-100 protein. Epithelial membrane antigens were focally positive only on the capsule of the nodule. We report herein a case of palisaded, encapsulated neuroma, one case of which has been reported in Korea.
Basophils ; Dermis ; Female ; Humans ; Korea ; Middle Aged ; Mucin-1 ; Neuroma* ; S100 Proteins ; Telangiectasis

Pseudallescheria (P.) boydii is a true fungus that is ubiquitous in nature, and has a world-wide distribution. It has been isolated from soil, plant debris, polluted water and sewage. Infection may occur via direct inoculation or inhalation, and usually affects the extremities. It is a common cause of mycetoma characterized by tumefaction, draining sinuses and grains. It has polymorphism due to a complicated life cycle which undergoes teleomorph as well as anamorph stages. Cleistothecia, ascocarp and ascospore may be seen during the teleomorph stages, whereas scedosporium and graphium type may be seen during the anamorph stages. We report a case of P. boydii mycetoma occurring in a 69-year old male. He had multiple nodules with a discharging fistula on a dark red plaque at the dorsum of the right forearm. Cultural isolation for definitive diagnosis showed typical P. boydii. The lesion responded well to daily itraconazole.
Aged ; Edible Grain ; Diagnosis ; Extremities ; Fistula ; Forearm ; Fungi ; Humans ; Inhalation ; Itraconazole ; Life Cycle Stages ; Male ; Mycetoma* ; Plants ; Pseudallescheria* ; Scedosporium ; Sewage ; Soil

No abstract available.
Apoptosis

We report herein a case of Gianotti-Crosti syndrome showing unusual features. A 12-month-old male patient presented with papular skin lesions on his face and papulovesicular skin lesions on the trunk, upper and lower extremities, which were distributed symmetrically. Three days before the skin eruptions, he had been immunized with a measles vaccination. Serologically, antigens of the type B hepatitis virus and antibodies to coxsackie virus B-4, Epstein-Barr virus, and varicella-zoster virus were all negative and antibodies to the measles virus (IgG, IgM) and the type B hepatitis virus were positive. After conservative treatment the skin lesions subsided with exfoliation within 4 weeks. An association with the measles vaccination and the initial papulovesicular skin lesions are considered as peculiar features of this case.
Acrodermatitis* ; Antibodies ; Hepatitis Viruses ; Herpesvirus 3, Human ; Herpesvirus 4, Human ; Humans ; Infant ; Lower Extremity ; Male ; Measles ; Measles virus ; Skin ; Vaccination

We report three cases of unusual eosinophilic pustular folliculit is whose initial manifestation is indurated plaque rather than papule and pustule and one case of eosinophilic pustular folliculitis was found in an infant. None of the adult patients in these cases complained of any suhjective syrnptoms other than the skin lesion, but an itching sensation might be present in the case of the infant. In laborat ory test, eos nophilia was observed in only one case and any other abnormal results were not observed. In all cases, histopathologic study revealed numerous eosinophilic infil tration around the follicles exttending to the periappendageal and perivacscular area, that is consistent with the finfings of eosinophilic pustuar folliculitis. All adult patients relatively responded well to dapsone and topical stroid and the infant patient resporided well to topical steroids, But they had a chronic course with remission and exacerhation.
Adult ; Dapsone ; Eosinophils* ; Folliculitis ; Humans ; Infant ; Pruritus ; Sensation ; Skin ; Steroids

OBJECTIVE: New antidepressant, nefazodone is classified as a serotonin -2 antagonist/reuptake inhibitor like old antidepressant, trazodone. Nefazodone, however, differs from trazodone in that it lacks anti-histaminergic properties and in that it has some norepinephrine reuptake inhibitory properties. These differences may account for the differences between the two drugs in the side effect profiles. This study was conducted to compare the acute effects of nefazodone on the psychomotor performance with those of trazodone. METHODS: The subjects were 12 healthy male volunteers aged between 20-40 years. A single, oral starting dose of nefazodone or trazodone was administered in a double-blind, randomized latin-square design with a 1-week interval between each drug switch. Psychomotor performances were assessed at 1 hour before and at 2 hours after administration of nefazodone 50 mg, nefazodone 100 mg or trazodone 50 mg. The measures of psychomotor performance included Vienna Determination Unit for complex choice reaction time, Critical Flicker Fusion Test, and Grooved Pegboard Test. RESULTS: In the Vienna Determination Unit, when 'within drug effect' (pre- vs. post-medication) was analyzed, nefazodone 100 mg decreased complex choice reaction time in both subtest 2 and subtest 3. Nefazodone 50 mg also decreased the reaction time in subtest 3 but not in subtest 2 which was more difficult and demanding task than subtest 3. On the other hand, no significant changes in the reaction time were observed with trazodone 50 mg in either subtest 2 or subtest 3. When 'between drug effect' was analyzed, however, the differences between drugs were not found to reach statistically significant level. No significant 'between drug effect' or 'within drug effect' was observed in Critical Flicker Fusion Test and Grooved Pegboard Test. CONCLUSION: Although the differences between nefazodone and trazodone did not reach statistically significant level, the results on the complex choice reaction time suggest that al least a single starting dose of nefazodone up to 100 mg does not impair psychomotor performances and it might have a less detrimental effect than trazodone on the psychomotor performance.
Administration, Oral* ; Flicker Fusion ; Hand ; Healthy Volunteers* ; Humans ; Male ; Norepinephrine ; Psychomotor Performance* ; Reaction Time ; Serotonin ; Trazodone* ; Volunteers

Background: A recent concern in breast reconstruction procedures is skin color mismatch of the pedicled transverse rectus abdominis myocutaneous (TRAM) flap. With the goal of objectively quantifying the skin tone of the TRAM flap donor site, contralateral breast, and flap, a comparative study was conducted. Methods: This study was conducted in July 2021, included 17 patients who received delayed breast reconstruction via TRAM flaps from January 2016 to December 2020 with at least 12 months of follow-up. Melanin levels and redness values of the flap, abdomen, and contralateral breast were measured in patients using a skin pigmentation analyzer. Furthermore, in 20 healthy women in their 40s to 60s, measurements were made of the abdomen, as well as breast. Results: The contralateral breast had lower mean melanin and redness than the abdomen. The flaps had slightly higher melanin levels than the contralateral breasts. The flaps tended to have higher redness values, but the difference was not significant. The difference between the flap and abdomen was significant for melanin, but not redness. Preoperative radiotherapy did not affect skin tone. The upper abdomen showed lower melanin and redness than the lower abdomen. Conclusions The breast had a brighter skin tone than the abdomen. The upper abdomen showed brighter skin tone than the lower abdomen, and the area used as the donor site of the TRAM flap presented the same tendency. In the process of TRAM flap engrafting, the melanin level of the tissue decreases, and the redness value tends to increase slightly compared to the contralateral breast.

Primary cutaneous marginal zone B-cell lymphoma (PCMZL) is an uncommon type of malignant lymphoma that mainly occurs in the trunk and upper extremity, with less frequent incidence observed on the head. Herein, we report the early diagnosis and treatment of a rare case of facial PCMZL in an Asian patient. A 51-year-old man presented with masses on the forehead and nose tip, which he had incidentally discovered 2 months previously. The masses appeared as a papule on the forehead and a patch on the nose. There were no signs of infection or bleeding, and the patient reported no other symptoms. After complete surgical excision, PCMZL was diagnosed based on the permanent biopsy. The histopathological findings revealed lymphoid aggregations with multifocal granulomas. Further treatment and follow-up were conducted at the hematology and oncology department. Despite its rarity in Asian populations, cutaneous lymphoma should be included in the differential diagnosis of facial masses. Early diagnosis and treatment based on a physical examination, imaging study, and excisional biopsy are important for a favorable prognosis.

Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.