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

Hair shaft breakage is a common condition frequently caused by physical or chemical trauma as well as intrinsic diseases. The hair can be modified both externally and internally through the cosmetically-used chemicals. Use of these products causes a decrease in the hair shaft's elastic properties, allowing increased hair breakage. Herein we report four cases of hair shaft breakage presented with features of alopecia caused by hair care cosmetics. Microscopic examination revealed abnormal hair shaft endings such as weathering, trichoptilosis and trichoclasis. Through these cases, we remind the fact that the dermatologist can better aid the patient with hair difficulties if he or she has an understanding of the formulation and the effects of products designed to modify the hair.
Alopecia ; Hair* ; Humans ; Weather

BACKGROUND: There are numerous therapeutic options for molluscum contagiosum (MC) and these may be broadly subdivided into surgical procedures (curettage, squezzing), chemical application (silver nitrate, cantharidin) and immunological therapies (imiquimod). However, in young children it is quite difficult to treat the condition due to pain associated with these procedures. Therefore, physicians need to consider more tolerable treatment options in pediatric patients. OBJECTIVE: We evaluated 20 children with MC for clinical effectiveness and side effects of imiquimod application. METHODS: Twenty children with MC were asked to apply 5% imiquimod cream three times per week at nights every other day for between 8~12 weeks. RESULTS: Nine of the 20 patients (45%) achieved complete clearance after a mean treatment period of 6.9 weeks. Partial clearance was observed in 10 patients (50%) and no response in 1 patient (5%). No patients dropped out due to adverse effects. Twelve children (60%) reported erythema and five children (25%) reported itching. CONCLUSION: Therapy with imiquimod cream was found to be effective, safe and painless in the treatment of MC in children. However, large-scale, double-blind, controlled prospective studies are needed to confirm the effectivenss of Imiquimod cream.
Child* ; Erythema ; Humans ; Molluscum Contagiosum* ; Pruritus

Lichen planus is an inflammatory disorder that affects the skin, mucous membrane, nails and hair. According to the literature, lichen planus on the palms and/or soles occurs rarely and does not usually have classical clinical features. We report a case of lichen planus in a 26-year-old man, who presented with papules on his palms and soles.
Adult ; Hair ; Humans ; Lichen Planus* ; Lichens* ; Mucous Membrane ; Skin

Lichen planus is an inflammatory disorder that affects the skin, mucous membrane, nails and hair. According to the literature, lichen planus on the palms and/or soles occurs rarely and does not usually have classical clinical features. We report a case of lichen planus in a 26-year-old man, who presented with papules on his palms and soles.
Adult ; Hair ; Humans ; Lichen Planus* ; Lichens* ; Mucous Membrane ; Skin

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

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