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

Iterative decomposition of water and fat with echo asymmetry and the least-squares estimation (IDEAL) is a recently developed method for robust separation of fat and water with very high signal-to-noise-ratio (SNR) efficiency. In contrast to conventional fat-saturation methods, IDEAL is insensitive to magnetic field (B0 and B1) inhomogeneity. The aim of this study was to illustrate the practical application of the IDEAL technique in reducing metallic artifacts in postoperative patients with metallic hardware. The IDEAL technique can help musculoskeletal radiologists make an accurate diagnosis particularly in musculoskeletal imaging by reducing metallic artifacts, enabling the use of contrast enhancement, improving SNR performance, and providing various modes of MR images with one scan parameter.
Adipose Tissue ; Adult ; Aged ; *Artifacts ; Body Water ; Cartilage, Articular/pathology ; Contrast Media/diagnostic use ; Humans ; Least-Squares Analysis ; Magnetic Resonance Imaging/*methods ; Male ; Metals ; Middle Aged ; Phantoms, Imaging ; *Prostheses and Implants ; Signal-To-Noise Ratio

BACKGROUDN: Telemedicine has the potential to reform the delivery system of dermatologic health care. OBJECTIVE: The purpose of this study was to investigate the concordance and accuracy of diagnosis and the management plan of dermatologist's teleconsultation and traditional clinic-based consultation. METHODS: Eighty-eight lesions of 77 patients were examined by digital image and clinic-based consultation by one dermatologist. The reliability and accuracy of the dermatologist's diagnoses and the reliability of the management recommendations were compared. RESULTS: The concordance of diagnosis between telemedicine and clinic-based consultation showed high levels(complete agreement, 92.05%; complete + partial agreement, 97.73%). The agreement on management recommendations was variable. The diagnostic confidence and the image quality affected the agreement. CONCLUSION: The digital image consultations result in reliable diagnostic outcomes when compared with the traditional clinic-based consultaion. And it is necessary to investigate the accuracy of teledermatology and to identify clinical conditions inappropriate for teleconsultation.
Delivery of Health Care ; Dermatology* ; Diagnosis ; Humans ; Referral and Consultation ; Remote Consultation* ; Telemedicine

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

Nevus comedonicus(NC) is an uncommon skin disorder, which appears as linear groups of open comedones clinically. A 56-year-old male patient presented a painful walnut-sized erythematous nodule with pus-like discharge on the right posterior aspect of the neck. He has extensive comedone like lesions on the right side of the body after his birth and has suffered from recurrent infections. Histopathologic finding showed the typical features of nevus comedonicus, wide and deep invagination of the epidermis filled with keratin plugs. He was treated with incision, pus drainage and systemic antibiotics. We report a case of extensive nevus comedonicus.
Anti-Bacterial Agents ; Drainage ; Epidermis ; Humans ; Male ; Middle Aged ; Neck ; Nevus* ; Parturition ; Skin ; Suppuration

Cephalic brain-like heterotopias, so called nasal gliomas, are masses of mature glial tissue resulted from an error in embryonic development and are frequently located on the bridge of the nose. They often give rise to the clinical suspicion of dermoid cyst, hemangioma, or lipoma. Histologically, they are composed of fibrillary neuroglial cells, mainly large astrocytes, which are interlaced with a variable amount of fibrous and vascular connective tissue. Mitoses are rare. The possible tumor stalk is usually fibrous without glial elements. Due to the occasional presence of connection to the intracranial space it deserves a careful preoperative evaluation including imaging studies. We report a case of cephalic brain-like heterotopia. A sixteen day-old infant presented a mass which was suspended to the forehead by a fibrous stalk. Th excised lesion showed characteristic pathologic features of cephalic brain-like heterotopia.
Astrocytes ; Connective Tissue ; Dermoid Cyst ; Embryonic Development ; Female ; Forehead ; Glioma ; Hemangioma ; Humans ; Infant ; Lipoma ; Mitosis ; Neuroglia ; Nose ; Pregnancy

Generalized lymphangiomatosis is a rare congenital malformation of the lymphatics. CT and MR scan have been used to evaluate lymphangiomas, which appear as large multicystic fluid-filled masses. CT and MR Imaging findings are often helpful in distinguishing lymphangiomas from various vascular disorders. We report the findings of CT, MRI and bone scan in a patient with generalized cystic lymphangiomatosis. Whole body 3.0-T MR scan using STIR sequence with a larger FOV could detect the additional lesions that were not seen at other imaging modalities. We believe that whole body 3.0 T MR imaging is a good modality to evaluate the extent of the disease and following up the patients with the generalized cystic lymphangiomatosis.
Humans ; Lymphangioma

BACKGROUND: Lichen planus is a chronic papulosquamous disease characterized by various clinical manifestations of the skin, mucosa, hair, and nails. Various drugs or physical treatments for lichen planus have been proposed, but the efficacies are often disappointing and controversial. Linear lichen planus is a rare variant of lichen planus, which accounts for 0.2~0.6% of all patients with lichen planus. Systemic corticosteroids remain the most widely used treatment for lichen planus. However, there have been no clinical studies on the effectiveness of this therapy on linear lichen planus despite the fact that linear lichen planus usually lasts for more than 1 year and occasionally results in cosmetic problems. OBJECTIVE: This study evaluated the efficacy and safety of oral methylprednisolone therapy for linear lichen planus. METHODS: Retrospective study was performed by reviewing the medical records and clinical photographs of 12 linear lichen planus patients treated with oral methylprednisolone. The analyses of treatment response to oral methylprednisolone therapy, adverse effects, and recurrence were performed. RESULTS: All the 12 patients who completed the oral methylprednisolone therapy achieved complete response. Most patients showed a marked improvement 1 to 2 weeks after starting oral methylprednisolone therapy. Three of the 12 patients showed recurrence at 9 to 14 weeks after cessation of the treatment. Oral methylprednisolone therapy was generally well-tolerated and no serious adverse effects were observed. CONCLUSION: Oral methylprednisolone therapy is an efficacious, safe, and tolerable treatment modality for linear lichen planus.
Adrenal Cortex Hormones ; Cosmetics ; Hair ; Humans ; Lichen Planus ; Lichens ; Medical Records ; Methylprednisolone ; Mucous Membrane ; Nails ; Recurrence ; Retrospective Studies ; Skin