BACKGROUND: A number of factors can cause dark circles around the eyes including excessive pigmentation, thin and translucent lower eyelid skin overlying the orbicularis oculi muscle, and shadowing due to skin laxity and tear trough. Autologous fat graft is an effective method for the treatment of lower lid dark circles, but irregularities caused by leaving visible lumps of the fat can occur. Tonnard et al. suggested 'nanofat' grafting and introduced its characteristics and clinical applications. The authors used their nanofat grafting to correct lower eyelid dark circles. METHODS: Nanofat grafting was performed in 19 patients for dark lower eyelids. The grafts were injected into subdermal layer using blunt cannula. Microfat grafting with nasojugal fold was performed to all the patients. Among them, 18 patients received transconjunctival fat removal at the same time. RESULTS: All the patients showed much improvement from preoperative dark coloration. There were no visible lumps of fat, contour irregularities, or fat necrosis. Postoperative edema and ecchymosis were minimal. CONCLUSIONS: Nanofat grafting methods provide a good alternative for correcting dark circles by augmenting thin skin with lower complications. This simple, cost effective procedure is suitable for correction of dark circles and various skin rejuvenation purposes.
Catheters ; Ecchymosis ; Edema ; Eyelids* ; Fat Necrosis ; Humans ; Hyperpigmentation ; Pigmentation ; Rejuvenation ; Shadowing (Histology) ; Skin* ; Transplantation ; Transplants*

No abstract available.
Angiofibroma*

Caudal analgesia is a widely accepted technique for providing pain relief. However, both permanent and transient neurologic complications, including paraplegia, have been reported. We report on a patient who developed paraplegia following a caudal block for an epidural mass. The cause of the paraplegia was unknown, but possibly spinal angioma may have taken part in the onset and progression of the paralysis. A mechanism is proposed by which the caudal injection may have caused a change in blood flow through the spinal angioma resulting in cord ischemia.
Analgesia* ; Hemangioma ; Humans ; Ischemia ; Paralysis ; Paraplegia*

No abstract available.
Epidermal Cyst

BACKGROUND: Skin cancer is divided into two categories, melanoma and nonmelanoma skin cancer, by its malignant potential. The former is prone to be metastatic and it often requires regional lymph node dissection and chemotherapy, while the latter is rarely metastatic with no need for such further treatment. We report here on the reconstruction methods after surgical removal of skin cancers, with excluding melanoma. OBJECTIVE: Our purpose was to analyze the reconstruction methods according to the location and size of the lesions after surgical removal of nonmelanoma skin cancers and we report on the clinical findings. METHODS: We analyzed 186 cases of nonmelanoma skin cancers that were treated Between January, 2000 and December, 2006 at the Department of Dermatology, Chonbuk University Hospital. The cases were analyzed according to the reconstruction methods for the defects after surgery, the gender ratio, the age range, the lesion site and the lesion size. RESULTS: The mean age of onset was 67.7 years old. The ratio of men to women was 1:1.02. The most common nonmelanoma skin cancer was basal cell carcinoma (66.7%), followed by squamous cell carcinoma (22.1%), and Bowen's disease (4.3%). The most common site of all the nonmelanoma skin cancers was the face (68.8%), followed by the trunk (7.5%) and scalp (6.5%). The most common reconstruction method was local flap (40.3%), followed by primary closure (38.7%), skin graft (18.8%) and secondary intention (2.2%). In terms of location, the most commonly used method was local flap for the face (50.0%) and primary closure for the trunk (53.3%), scalp (83.3%) and the upper (44.4%) and lower extremities (63.6%). According to the lesions' size, the most common method was flap for tumor between 10 mm and 30 mm in diameter (95.1%), primary closure for tumor less than 10 mm in diameter (66.7%) and graft for tumor greater than 30 mm in diameter (66.7%). CONCLUSION: We offer this data for the reconstruction methods of nonmelanoma skin cancers and their clinical findings in Korea.
Age of Onset ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Female ; Humans ; Intention ; Korea ; Lower Extremity ; Lymph Node Excision ; Male ; Melanoma ; Scalp ; Skin ; Skin Neoplasms ; Transplants

No abstract available.

Background: Clear cell acanthoma is a rare benign epidermal tumor that is considered a nonspecific reactive dermatosis. To date, no reports have described systematic analyses of clear cell acanthoma in Koreans. Objective: We investigated the clinical, histopathological, and dermoscopic features of clear cell acanthoma. Methods: In this study, we evaluated 14 lesions of clear cell acanthoma. Results: We observed female predominance (male:female ratio 1:1.3), and the mean patient age was 55.8±18.0 years (range 15∼76 years), with the peak incidence observed in patients in their 60s. Notably, 57.1% of lesions developed on the lower extremities. The lesion was most commonly misdiagnosed as seborrheic keratosis. Histopathological examination revealed a well-demarcated area of keratinocytes with pale-staining cytoplasm and psoriasiform epidermal hyperplasia and mild spongiosis, exocytosis of neutrophils, and thinned suprapapillary plates. Dermoscopic examination showed a clear cell acanthoma with characteristic vascular findings, including pinpoint red dots, globular red dots, and glomeruloid structures with linear or reticular patterns. Conclusion Clear cell acanthoma commonly presents as a small solitary lesion measuring <1 cm in diameter that occurs on the lower extremities in women in their 60s. Histopathological characteristics of this lesion include Periodic acid Schiff-positive with pale cytoplasm, and dotted, globular, and glomeruloid vessels with a linear or reticular pattern on dermoscopy. This was a single-center, small-sized retrospective study; however, in our view, the results of this study would contribute to the literature by providing a better understanding of clear cell acanthoma in Koreans.

No abstract available.
Nevus, Blue*

Neuromas are hyperplasia of axons and associated nerve sheath cells. Cutaneous neuromas are uncommon. Three kinds of true neuromas exist in the skin and mucous membranes: traumatic neuromas, solitary palisaded encapsulated neuromas, and multiple mucosal neuromas. Traumatic neuromas are usually solitary, skin-colored or pink, firm papules or nodules at the sites of scars following local trauma. A 2-year-old male patient presented a solitary rice grain sized, skin-colored painful and tender polypoid papule on the left 2nd finger. The lesion was superimposed on a small linear scar. The patient had taken a trauma by a broken piece of glass about one month before the development of the neuroma. We report a case of traumatic neuroma with a review of the literature.
Axons ; Edible Grain ; Cicatrix ; Fingers ; Glass ; Humans ; Hyperplasia ; Male ; Neuroma ; Preschool Child ; Skin

BACKGROUND: Epidural narcotics are now widely used for postoperative pain relief, but their side effects are problematic. Thus, this study was undertaken to evaluate the analgesic effects and to minimize the side effects of the combination of epidural morphine and ketamine versus epidural morphine alone in pateints with postoperative pain. METHODS: The value of using a combined infusion of morphine with a variable dose of ketamine for postoperative analgesia following subtotal gastrectomy was assessed in a double-blind randomised study of 30 patients. Three groups of 10 patients received an infusion of morphine at 2 mg/day, either alone, or combined with ketamine at a rate of 0.4 or 0.6 mg/kg/day. RESULTS: Postoperative anlagesia, sedation, and side effects were not statistically significantly different between groups I and II. Postoperative sedation, and side effects were not statistically significantly different between groups I and III. VAS of group III at 1-2 h was lower than in group I. CONCLUSION: The addition of ketamine to a continuous infusion of morphine dose not significantly improve postoperative analgesia. In addition, increasing the dose of ketamine does not significantly improve postoperative analgesia, Nor does it increase sedation, or side effects.
Analgesia ; Gastrectomy* ; Humans ; Ketamine ; Morphine* ; Narcotics ; Pain, Postoperative*