Syringoma is not a uncommon tumor of the skin. It is a benign adenoma, of intraepidermal eccrine ducts. It occurs predominantly in women at puberty or adolescence. The lesions usually are multiple and small, skin colored or slightly yellowish payules, usually only 1 or 3mm in size. The lesions usually are limited to the lower eyelids but may occur on cheek, axilla, abdomen, neck, anterior chest and vulva. Rarely these are generalized in distributior. A 23 years old healthy man has had widespread lesions over the face, anterior chest and abdomen. The lesions appeared at the age of 13 on the anterior chest and abdomen. These increased in number and extended slowly to the face On visiting our department, there were numerous, angular or round, skin colored papules on his face and anterior chest as well as yellowish brown colored papules on his abdomen. Diagnosis was confirmed by clinical and histopathological findings as generalized syringoma.
Abdomen ; Adenoma ; Adolescent ; Axilla ; Cheek ; Diagnosis ; Eyelids ; Female ; Humans ; Neck ; Puberty ; Skin ; Syringoma* ; Thorax ; Vulva ; Young Adult

PURPOSE: Nowadays laparoscopic appendectomy is widely practiced in developed countries. The purpose of this study was to evaluate laparoscopic appendectomy in comparison with open appendectomy. METHODS: On hundred cases each of laparoscopic appendectomy and open appendectomy, performed between February 2001 and June 2002, were reviewed for age, sex, operative time, hospital days, time for first meal, number of used parenteral analgesia, number of OPD visits, etc. RESULTS: Operative time was longer in the laparoscopic appendectomy group (P>0.05) and the number of used parenteral analgesia was slightly higher in the laparoscopic group (P>0.05). However, recovery time for diet was slightly shorter in the laparoscopic group (P>0.05). None of these trends were statistically significant. The times of OPD visit after discharge was less in the laparoscopic group (P<0.05). The hospital days of pathological simple appendicitis were shorter in the laparoscopic appendectomy group (P<0.05). In the laparoscopic group, intraabdominal abscess was developed in 2 cases, wound infection in 4, and intestinal obstruction in 2. The conversion rate to open appendectomy was 7% (7/100) in the laparoscopic group. CONCLUSION: Laparoscopic appendectomy can shorten overall OPD follow up days and in case of simple appendicitis, laparoscopic appendectomy can also shorten hospital days.
Abscess ; Analgesia ; Appendectomy* ; Appendicitis ; Developed Countries ; Diet ; Follow-Up Studies ; Intestinal Obstruction ; Meals ; Operative Time ; Wound Infection

BACKGROUND: The major limitations of the current therapeutic treatments for onychomycosis are the recurrence of the infection and the duration of the treatment. Recently, photodynamic therapy (PDT) is thought to be a novel alternative method for treatment of onychomycosis. OBJECTIVE: The aim of this study is to investigate the efficacy and safety of PDT with methyl 5-aminolevulinic acid (MAL) for the treatment of onychomycosis. METHODS: We performed MAL-PDT in eight patients with distal subungual onychomycosis on at least one great toenail. After the total three treatments, we observed the clinical and mycological courses for twelve months. RESULTS: For the twelve months of follow-up period, three patients (37.5%) showed continuous clinical improvement, two patients (25%) aggravation after transient improvement, and the rest, three patients (37.5%) resistance to treatment. All subjects complained of quite severe burning pain during irradiation of light source. CONCLUSION: In this study, we observed the highly variable clinical and mycological results of PDT in onychomycosis. We concluded that it is too difficult to consistently achieve the best fungicidal effect by PDT without strictly selected conditions.
Burns ; Follow-Up Studies ; Humans ; Light ; Nails ; Onychomycosis ; Photochemotherapy ; Recurrence ; Triazenes

Fibroepithelioma of Pinkus is generally accepted as a low-risk variant of basal cell carcinoma. A 66-year-old man was presented with a solitary dark red nodule with superficial erosion on his right groin. It tended to bleed, but was otherwise asymptomatic. Histopathologically, the tumor was composed of long, thin, branching and anastomosing strands of basaloid cells, which extends from the epidermis into the fibromucinous stroma. Basaloid tumor cells were palisaded at the periphery of the strands, and small buds were seen projecting from the epithelial strands. Significant amounts of melanin pigment were deposited in the papillary and reticular dermis, and the stroma between the tumor cords and also inside the tumor cells. The lesion was completely excised with clear margin. We report a case of pigmented fibroepithelioma of Pinkus with review of the literature in this communication.
Aged ; Carcinoma, Basal Cell ; Dermis ; Epidermis ; Groin ; Humans ; Melanins

Confluent and reticulated papillomatosis (CRP) was first described as a relatively rare dermatosis. CRP is characterized by slightly hyperkeratotic pigmented papules that are confluent in the center and reticulated at the periphery, located on the neck, abdomen, intermammary, and interscapular regions. Histopathologically, lesions typically reveal orthohyperkeratosis, papillomatosis, and focal acanthosis. A 20-year-old man presented with a 2-year history of slightly pruritic lesions on the chest, abdomen, back, and upper extremities. The lesions were brownish papules and plaques in a reticulated and coalescing pattern. Histologically, a basket-weave pattern of orthohyperkeratosis and mild acanthosis were seen. However, there was no significant papillomatosis, even in multiple sections. Periodic acid Schiff stain was negative for fungi. The patient was treated with doxycycline, 200 mg daily, for 4 weeks. The lesions completely resolved and did not recur during 12 months of follow-up. We report a rare case of CRP without papillomatosis.
Abdomen ; Doxycycline ; Follow-Up Studies ; Fungi ; Humans ; Neck ; Papilloma ; Periodic Acid ; Skin Diseases ; Thorax ; Upper Extremity ; Young Adult

We present a case of accessory tragus (AT) which developed at an unusual site, the nasal vestibule, of a 1-day-old girl. To our knowledge, this is the first report of an accessory tragus that appears on the nasal vestibule.

Malignant syphilis (also known as lues maligna) is a rare dermatologic manifestation of syphilis and this is more commonly seen in patients with human immunodeficiency virus (HIV) infection. A 40-year-old man presented with general malaise and widespread cutaneous noduloulcerative lesions covered with lamellar crusts for 15 days. He had been diagnosed with HIV infection 6 years earlier, but had not regularly taken antiretroviral drugs. The syphilis serology showed a VDRL (venereal disease research laboratory) titer of 1 : 256 and a positive TPPA (treponema pallidum particle agglutination test) at presentation. Histologic exam showed the dense perivascular inflammatory infiltrates composed of lymphocytes, histiocysts and neurophils with some plasma cells in the underlying upper and reticular dermis. Obliterated blood vessels with eosinophilic materials were observed as an unusual histologic feature of syphilis. Based on the clinical, histological and serological findings, a diagnosis of malignant syphilis accompanied by acquired immune deficiency syndrome (AIDS) was made. The patient was treated with intramuscular benzathine penicillin G at 2.4 million units per week for 3 weeks, and the skin lesions completely healed with post-inflammatory hyperpigmentation. It is necessary to take into account this entity among the possible diagnoses in HIV-infected patients with cutaneous noduloulcerative lesions.
Acquired Immunodeficiency Syndrome ; Adult ; Agglutination ; Blood Vessels ; Dermis ; Eosinophils ; Ethylenediamines ; HIV ; HIV Infections ; Humans ; Hyperpigmentation ; Lymphocytes ; Penicillin G Benzathine ; Plasma Cells ; Skin ; Syphilis

We report here on a 71-year-old female who had well-demarcated erythematous patches, along with some pearly papules, on the right cheek. Histopathological examination of the lesions revealed a basaloid cell mass, which appeared to be a superficial basal cell carcinoma, and a small keratin-filled cyst that appeared to be a milium. A part of the milium was surrounded by the basaloid cells of tumor islands and milia later developed on the lesion of basal cell carcinoma. We suggest that basal cell carcinoma may be one of the causes of secondary milia.
Aged ; Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Islands

Spindle cell squamous cell carcinoma (SCSCC) is relatively uncommon, but may be encountered. It poses a challenge in the differential diagnosis in that it includes other spindle cell neoplasms. An 81-year-old female with a raised and exophytic plaque with central ulceration surrounding erythematous patches of the left lower extremities, which was gradually and very slowly increasing in size was admitted to our hospital. After resection, conventional histopathological investigation showed spindle-shaped cells showing hyperchromatic nuclei and mitosis, infiltrating the dermis in a storiform pattern. Immunohistochemical analysis revealed that SCSCC was positive for cytokeratins (AE1/AE3, CAM 5.2, 34betaE12) and mesenchymal markers (vimentin, SMA), but was negative for p63, CD34, CD68, melan A and S-100.
Carcinoma, Squamous Cell ; Dermis ; Diagnosis, Differential ; Female ; Humans ; Keratins ; Leg ; Lower Extremity ; MART-1 Antigen ; Mitosis ; Ulcer

Trichilemmoma is a benign, solitary, small tumor that might often be misdiagnosed as a basal cell carcinoma or verruca. It is usually seen on the face, and especially on the nose and cheeks. A 79-year-old Korean man presented with a 2.0x2.0 cm-sized nodular mass on his right shoulder and the lesion was histopathologically diagnosed as a trichilemmoma. The atypical clinical appearance and localization of his neoplasm did not help us diagnose the lesion, and the histological findings were the only clues for making the diagnosis of trichilemmoma.
Aged ; Carcinoma, Basal Cell ; Cheek ; Humans ; Nose ; Shoulder ; Warts