Postoperative (pressure) alopecia is the temporary or permanent loss of hair that occurs following a prolonged immobilization during and/or after general anesthesia and intubation. The cause is considered to be pressure-induced ischemia. Although not an uncommon condition, it is frequently overlooked as a minor complication relative to a causative surgical procedure. We report a 22-year-old woman who was presented with focal hair loss of two weeks' duration after a 9-hour operation for a left brachial plexus injury. Histopathologic examination showed that nearly all terminal follicles were in catagen phase with marked atrophic change of subcutaneous fat.
Alopecia* ; Anesthesia, General ; Brachial Plexus ; Female ; Hair ; Humans ; Immobilization ; Intubation ; Ischemia ; Subcutaneous Fat ; Young Adult

BACKGROUND: Herpes zoster is a common dermatologic disorder. However, there has been no reported study of herpes zoster in children exclusively in the Korean literature. OBJECTIVE: The purpose of this study was to analyze epidemiological features and clinical characteristics of herpes zoster in children. METHODS: A retrospective study was performed by reviewing the medical records of 64 patients who were under 12 years old and who had herpes zoster. We searched for cases occurring during a 10-year-period from January 2000 to December 2009. We analyzed for age, gender, accompanying symptoms, dermatomal distribution, underlying disease, treatment and complications. RESULTS: Children under 12 years old account for 2.48% of all herpes zoster patients. The ratio of males to females is 1:1. The number of enrolled patients was increasing according to age (p=0.0004). The number (p=0.0009) and the proportion (p=0.0187) of pediatric patients has been increasing year by year. Underlying diseases were observed in 17.2%, and included asthma, atopic dermatitis, chronic sinusitis, epilepsy and tic disorder. There was no patient with immunocompression. Lesions of herpes zoster were most frequently found in the trigeminal dermatome (35.9%), followed by the thoracic (34.4%), cervical (14.1%), lumbar (9.4%), and sacral (4.7%) dermatomes, and multiple involvement (1.16%). Pain accompanying herpes zoster was reported in 54.7% and pruritus in 71.9%. Complications were observed in 14.1%; the most common one was eye involvement. CONCLUSION: The incidence of accompanying pain in children with herpes zoster is lower than in adults with this disease. However, the incidence of accompanying pruritus was higher in children than in adults. Postherpetic neuralgia did not developed in children.
Adult ; Asthma ; Child ; Dermatitis, Atopic ; Epilepsy ; Eye ; Female ; Herpes Zoster ; Humans ; Incidence ; Male ; Medical Records ; Neuralgia, Postherpetic ; Pruritus ; Retrospective Studies ; Sinusitis ; Tic Disorders

BACKGROUND: Pyogenic granuloma is a common vascular neoplasm of the skin and mucous membranes. However, few comprehensive studies are available on the clinical and histopathological characteristics of pyogenic granuloma. OBJECTIVE: To analyze the clinical and histopathological characteristics of pyogenic granuloma. METHODS: Patients with pyogenic granuloma diagnosed clinically and histopathologically were reviewed retrospectively. RESULTS: Fifty patients (17 males and 33 females) were enrolled, and the mean age of onset was 33.6 years old. The mean lesion size was 6.7 mm. Forty-eight patients had a solitary lesion, whereas two patients had multiple lesions on the skin and mucosa. The most common area for lesions was the head and neck followed by the hands, trunk, and lower extremities. Patient complained of easy bleeding, pain, tenderness, and pruritus. Dermoscopic findings of nine lesions showed patterns of a reddish homogenous area, white scaly collarette, white rail lines, and a hemorrhagic crust. Histopathological findings of all biopsy cases showed a lobular pattern of angiomatous tissue with numerous congested capillaries, a flattened epidermis, a well-formed epidermal collarette, and CD34-positive endothelial cells. Various treatment modalities including surgery and laser have been used, but lesions recurred following a single laser treatment with a pulsed dye laser or long-pulsed Nd:YAG laser. CONCLUSION: A correlation between clinicopathological and dermoscopic findings was useful for the differential diagnosis of other diseases mimicking pyogenic granuloma and to detect recurrence after treatment. Laser treatments were less invasive therapy, but the recurrence rate was higher than that of other surgical modalities when used alone. Additional prospective studies are needed to determine the effectiveness of the various treatment modalities.
Age of Onset ; Biopsy ; Capillaries ; Dermoscopy ; Diagnosis, Differential ; Endothelial Cells ; Epidermis ; Estrogens, Conjugated (USP) ; Granuloma, Pyogenic ; Hand ; Head ; Hemorrhage ; Humans ; Lasers, Dye ; Lower Extremity ; Male ; Mucous Membrane ; Neck ; Pruritus ; Recurrence ; Skin ; Vascular Neoplasms

A 52-year-old male had presented with painful swelling on the left shoulder. The lesion had progressed to involve the left chest, neck, and arm, and 3 months later, evolved into brown to light purplish hard plaque mimicking the feature of scleroderma. A skin biopsy findings were consistent with metastatic carcinoma, and neck MRI and thyroid sonogram revealed primary thyroid cancer of left lobe. The patient's condition was carcinoma en cuirasse, an uncommon clinical feature of metastatic skin cancer. Skin metastasis of thyroid cancer is rare, and to our knowledge, there is not any documented case of carcinoma en cuirasse from thyroid cancer. We present a case of carcinoma en cuirasse from thyroid cancer.
Arm ; Biopsy ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Shoulder ; Skin ; Skin Neoplasms ; Thorax ; Thyroid Gland* ; Thyroid Neoplasms*

Angiomyxolipoma is a rare variant of lipoma and seven cases have been reported in the English literature. The reported cases mostly presented with a well-demarcated, asymptomatic, solitary, subcutaneous mass on the scalp or extremities. Histopathologic features of this tumor are characteristic and consist of the paucicellular myxoid areas and the mature fat tissue, with numerous thin, dilated blood vessels. The important histopathological differential diagnoses include myxoid spindle cell lipoma, myxoid lipoma, angiolipoma, angiomyolipoma, superficial angiomyxoma, myxoid liposarcoma and low-grade myxofibrosarcoma. We describe a 38-year-old man with multiple angiomyxolipoma on the gluteal area and the upper and lower extremities.
Adult ; Angiolipoma ; Angiomyolipoma ; Blood Vessels ; Diagnosis, Differential ; Extremities ; Humans ; Lipoma ; Liposarcoma, Myxoid ; Lower Extremity ; Myxoma ; Scalp

BACKGROUND: Generalized lichen nitidus is a rare subtype of lichen nitidus characterized by multiple, flesh-colored, shiny papules occurring over the entire body. OBJECTIVE: We investigated the clinical features of generalized lichen nitidus in patients followed up at our institution. METHODS: The patients with generalized lichen nitidus diagnosed clinically and histopathologically between 1998 and 2007 were reviewed. RESULTS: Twelve patients (9 males and 3 females) were enrolled in this study and the mean age at onset was 10.3 (range: 4~27) years. Of the 12 patients, 5 (41.7%) experienced pruritus and 4 (33.3%) had atopic dermatitis. None of the patients had a family history of lichen nitidus. Nine patients were treated with topical steroids, systemic steroids, oral antihistamines, or narrow-band UVB. We propose that narrow band UVB is an effective treatment modality for generalized lichen nitidus. The mean duration to clearance was 37.7 (range: 7~120) months and the disease was relapsing in 2 patients. The duration to clearance was correlated to the age at onset (p=0.0005) and to the duration at the first visit (p=0.0000), whereas it was not related to the sex of the patient, pruritus or the accompanying atopic dermatitis. CONCLUSION: Generalized lichen nitidus is often associated with varying degrees of pruritus and the clinical course of the disease tends to be chronic. We propose that onset at an early age and the short duration of disease at the first visit are good prognostic factors, and that narrow band UVB is an effective treatment modality for generalized lichen nitidus.
Dermatitis, Atopic ; Histamine Antagonists ; Humans ; Lichen Nitidus ; Lichens ; Male ; Pruritus ; Steroids

Erythromelalgia(EM) is a rare clinical syndrome characterized by the triad of redness, increased temperature, and pain of the extremities. The patient was a 69-year-old woman presented erythematous tender patches on both palms and soles. Laboratory and clinical investigations revealed an underlying myeloproliferative disorder. Histologic examination of the erythema on her foot showed some vessels with thickened endothelial walls and partially obstructed lumens by organized thrombi. Hydroxyurea used for the treatment of polycythemia vera eliminated the skin lesions and symptoms of erythromelalgia. We report a case of secondary erythromelalgia associated with polycythemia vera.
Aged ; Erythema ; Erythromelalgia* ; Extremities ; Female ; Foot ; Humans ; Hydroxyurea ; Myeloproliferative Disorders ; Polycythemia Vera* ; Polycythemia* ; Skin

Piebaldism is an uncommon autosomal dominant genetic disorder. It is characterized by amelanotic macules or patches, usually containing some hyperpigmented or normopigmented macules, of the central portion of the forehead, the chin, and the ventral aspect of the trunk and the limbs. A 10 year-old female patient had depigmented lesions on the abdomen and both legs, discovered one month after her birth. On the history taking, she had family history of four generations. We report a case of piebaldism showing typical autosomal dominant pattern.
Abdomen ; Child ; Chin ; Extremities ; Family Characteristics* ; Female ; Forehead ; Humans ; Leg ; Parturition ; Piebaldism*

The adverse effects of BCG vaccination span diversely from systemic to local reactions. However, the adverse effects of BCG vaccination on the skin are rare and these can appear as non-specific or specific skin reactions. We experienced two cases of non-specific skin reaction, which occurred on a vaccine-injected site. Eczematous lesions with the clinical and pathological findings have not previously been report in the English dermatologic literature. Herein, we present two interesting cases of non-specific skin reactions from dermatological complications of BCG vaccination.
Mycobacterium bovis* ; Skin ; Vaccination*

Sezary syndrome is a variant of cutaneous T-cell lymphoma (CTCL) featuring erythroderma, pruritus, adenopathy and circulating atypical T-lymphocytes. Recent studies suggest that patients with prolonged idiopathic erythroderma, possibility of Sezary syndrome should be considered because in a certain proportion of these patients, they may develop CTCL. We report a case of a 35-year-old man with a prolonged erythroderma for three years. On physical examination, multiple swellings of lymph nodes were noted. Presence of Sezary cells in the peripheral blood, skin and lymph nodes supported the diagnosis of Sezary syndrome.
Adult ; Dermatitis, Exfoliative ; Diagnosis ; Humans ; Lymph Nodes ; Lymphoma, T-Cell, Cutaneous ; Physical Examination ; Pruritus ; Sezary Syndrome* ; Skin ; T-Lymphocytes