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

STATEMENT OF PROBLEM: Over the past two decades, implant supported fixed prosthesis have been widely used. However, there are few studies conducted systematically and intensively on the splinting effect of implant systems in mandible. PURPOSE: The purpose of this study was to investigate the changes in stress distributions in the mandibular implants with splinting or nonsplinting crowns by performing finite element analysis. MATERIALS AND METHODS: Cortical and cancellous bone were modeled as homogeneous, transversely isotropic, linearly elastic. Perfect bonding was assumed at all interfaces. Implant models were classified as follows. Group 1: Branemark length 8.5mm 13mm splinting type Group 2: Branemark length 8.5mm 13mm Nonsplinting type Group 3: ITI length 8.5mm 13mm splinting type Group 4: ITI length 8.5mm 13mm Non-splinting type An load of 100N was applied vertically and horizontally. Stress levels were calculated using von Mises stresses values. RESULTS: 1. The stress distribution and maximum von Mises stress of two-length implants (8.5mm, 13mm) was similar. 2. The stress of vertical load concentrated on mesial side of implant while the stress of horizontal load was distributed on both side of implant. 3. Stress of internal connection type was spreading through abutment screw but the stress of external connection type was concentrated on cortical bone level. 4. Degree of stress reduction was higher in the external connection type than in the internal connection type.
Crowns ; Finite Element Analysis ; Mandible ; Prostheses and Implants ; Splints

Lupus panniculitis is an uncommon clinical variant of cutaneous lupus erythematosus. The cutaneous lesions of lupus panniculitis are characterized by subcutaneous nodules or plaques. The overlying skin can often appear unchanged, but may also be associated with discoid lupus erythematosus and appear erythematous, atrophic, telangiectatic or poikilodermatous. The mean age of incidence is between 30~40 years, and children are rarely affected. Furthermore, a linear distributions of the lesions has rarely been reported. We herein describe a case of 8-year-old girl with linear lupus panniculitis on the face, and propose that the possibility of this disease be considered in cases where linear subcutaneous nodular lesions occur in children or young adults.
Child* ; Female ; Humans ; Incidence ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Discoid ; Panniculitis, Lupus Erythematosus* ; Skin ; Young Adult

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

Acute hemorrhagic edema of childhood or infancy (AHE) is a benign form of leukocytoclastic vasculitis with many similarities to Henoch-schonlein purpura (HSP). It occurs in children younger than 2 years and is characterized by abrupt onset of inflammatory edema and ecchymotic purpura in a target or cockade pattern, that resolve spontaneously within 3 weeks. AHE had been considered by some as a variant of HSP which shares certain clinicopathologic features. But most authors have regarded it as an entity distinct from HSP in view of the younger age of patients, lack of visceral involvement, distinctiveness of cutaneous lesions, absence of perivascular IgA on immunofluorescence, and excellent prognosis. We report a typical case of AHE presenting with a cockade or target-like purpura and edema on the face and acral areas with excellent prognosis in a 13-month-old boy.
Child ; Edema* ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin A ; Infant ; Male ; Prognosis ; Purpura ; Purpura, Schoenlein-Henoch ; Vasculitis

X-linked dominant chondrodysplasia punctata is a rare congenital disorder characterized by transient punctate epiphyseal calcifications and ichthyotic skin changes, usually resolving during early infancy. We experienced a baby girl born with a thickened and diffusely red integument with adherent scales following the lines of Blaschko and punctata calcification, flat nose. We report a case of condrodysplasia punctata, X-linked dominant type which was confirmed with gene study.
Chondrodysplasia Punctata* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Female ; Humans ; Ichthyosis ; Nose ; Skin ; Weights and Measures

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

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