An 80-year-old woman was admitted because of ag avation of preexisting dyspnea and was refened to the dermatology deparbnent for evaluation of three tender nodules on her extremitiom. A chest X-ray and CT scan suggested pulrnonaxy tuberculosis wikh an endobromchial sprtad, Her past medical histary showed congeative heart failure, treated pulmonery tuberculosis and corticstertoid medication for arthralgia. Acid-fast bacilli were observed in tissue smears and a biopsy specimen. Mycobacterium tubereulosis was recovered from cultures. We suggest that this case was a tuberculous gumma following pulmonary tuberculosis and that a tissue or pus smear for acid-fast bacilli is a very useful diagnostic toal in tuberculous gumma because tubercle bacilli are copious in numbcr.
Aged, 80 and over ; Arthralgia ; Biopsy ; Dermatology ; Dyspnea ; Female ; Heart Failure ; Humans ; Mycobacterium ; Suppuration ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

In this report we will highlight an interesting 3 year case of a halo nevus on the back of a 13-year-old Korean girl. This was a single halo nevus with a central pinkish mole and a depigmented patch, 20 mm in diameter. The patient underwent an autologous suction blister graft on the lesion. The halo nevus was completely repigmented except for the marginal rim. At a 4 month follow-up, a new whitish halo was observed around the central pinkish mole. At this point the central nevus was excised and examined with a H & E stain and an immunohistochemical stain with an anti-Ig G antibody. After the excision of the central mole, repigmentation was completed and this condition persisted at a 3-year-follow-up.
Adolescent ; Blister* ; Female ; Follow-Up Studies ; Humans ; Nevus ; Nevus, Halo* ; Recurrence* ; Suction* ; Transplants*

BACKGROUND: Hormones influence various normal biological processes in the skin and hairs. OBJECTIVE: This study was undertaken to investigate the presence of estrogen receptors(ER) and progesterone receptors (PR) in the skin and to assess differences in sex and age. METHODS: We examined seven normal volunteers' skin. The mouse monoclonal antibodies against human ER and PR were used to identify the localization of ER and PR in the frozen tissue sections by using a standard two stage indirect immunoperoxidase technique. RESULTS: The granular layer of epidermis and infundibulum of hair follicle in all the samples showed strong positivity of PR. Although each skin section did not contain all skin appendages, most of the samples showed that eccrine gland duct, inner root sheath of hair follicle stained weakly positive of PR. ER was not demonstrate in all samples epidermis. CONCLUSION: PR was presented in the granular layer of epidermis, infundibulum of hair follicle, eccrine gland duct, and inner root sheath of hair follicle. Therefore, we might suspect that the progesterone probably contributes to the keratinization of the skin because these positively staining sites are prior to complete keratinization layers.
Animals ; Antibodies, Monoclonal ; Biological Processes ; Eccrine Glands ; Epidermis* ; Estrogens* ; Hair ; Hair Follicle ; Humans ; Immunoenzyme Techniques ; Mice ; Pituitary Gland ; Progesterone* ; Receptors, Progesterone* ; Skin

BACKGROUND: Ivory colored hypopigmentation has been frequently observed in morphea and lichen sclerosus et atrophicus, and also seen after phenol peels, dermabrasion, cryosurgery and post-laser resurfacing. OBJECTIVE: This study was undertaken to investigate the cause of hypopigmentation following autologous suction blister graft (ASBG) in vitiligo patients. METHODS: The ivory lesion and contralateral normal skin were collected by punch biopsies. And the tissues were stained with hematoxylin-eosin, Fontana-Masson, Masson's trichrome, Verhoeff-van Gieson, and S-100 protein to compare the differences between two specimens. RESULTS: H-E and Masson's Trichrome stains showed that compacted hyalinized sclerotic collagens and collapsed, small sized capillaries in the upper dermis were definite in the hypopigmented lesion, whereas norma1 control sites were unremarkable. Elastic fibers were markedly decreased or fragmented in upper dermis of the hypopigmented lesion. Fontanna-Masson stain identified that the lesional epidermis was more hyperpigmented rather than hypopigmented. S-100 stain showed no differences between hypopigmented and contro1 sites. CONCLUSION: The results suggest that the ivory colored hypopigmentation is not caused by the failure of procedure, but by scar formation due to deep freeze; therefore, this kind of complication may be prevented by carefully performing the cryotherapy.
Biopsy ; Blister* ; Capillaries ; Cicatrix ; Collagen ; Coloring Agents ; Cryosurgery ; Cryotherapy ; Dermabrasion ; Dermis ; Elastic Tissue ; Epidermis ; Humans ; Hyalin ; Hypopigmentation* ; Lichen Sclerosus et Atrophicus ; Phenol ; S100 Proteins ; Scleroderma, Localized ; Skin ; Suction* ; Transplants* ; Vitiligo*

A 37-year-old female was presented with an epidermal cyst on her lower back. Histopathologic examination was consistent with an epidermoid cyst with seborrheic verrucalike cyst wall and acantholytic change was also found in the cyst wall. Human papillomavirus(HPV)-specific DNA sequences in paraffin-embedded tissue section were not detected by polymerase chain reaction using HPV consensus primers.
Acantholysis* ; Adult ; Base Sequence ; Consensus ; Epidermal Cyst* ; Female ; Humans ; Polymerase Chain Reaction

A 35-year-old housewife was diagnosed with onychomycosis and treated by oral terbinafine, 250mg/day, for 4 months. Clinically all infected nails improved gradually. However, her left great toe-nail was not improved thereafter. At that time the proximal end of the onychomycotic lesion was marked with surgical blade, and terbinafine therapy was continued for four weeks. However, the onychomycotic nail was not improved, and the scratch mark passed by the proximal end of the infected nail. Therefore, we detected the resistance to the therapy and switched the medication to itraconazole 100 mg/day and then another scratch mark was done at the proximal end of the onychomycotic lesion. After another 2 weeks the infected nail went along with the scratch mark distally, and showed clinical improvement. After 8 weeks therapy of itraconazole, she was cured clinically and mycologically. The fungal culture was identified as Aspergillus sydowii.
Adult ; Aspergillus* ; Humans ; Itraconazole ; Onychomycosis*

The authors analyzed 38 consecutive cases with an occipital arteriovenous malformation(AVM) in regard to visual field defect. The incidence of occipital AVM was 10.4% among 367 patients with a cerebral AVM treated between 1975 and 1994 in our institute. Bleeding rate of occipital AVM in this series was 86.8%(EE cases) and it was significantly higher than that of AVM in other locations. Of 38cases, 15 patients(39.5%) had a visual field defect on admission and all of them were accompanied by intracerebral hematomas caused by the rupture of AVMs. The presence of visual field defect did not correlate with angioarchitecture in reference to pattern of nidus, feeding artery, and draining vein. Of 15 patients with visual field defect. 10 patients showed homonymous hemianopsia and five patients, homonymous quadrantanopsia. The size and location of intracerebral hematoma correlated well with hemispheric approach : 11, parietooccipital approach : 10, with six preoperative embolization and 1 postoperative gamma knife surgery. Fifteen patients underwent gamma knife surgery with five preoperative embolization. One patient underwent embolization only. The results of treatment were as follows : There were no mortality and morbidity except for visual field defect. We confirmed complete resection or obliteration of malformed vessels in 25 patients and reduction of the nidus size in eight patients. Five patients were not followed. After gamma knife surgery, two patients showed rebleeding during the follow up period. Among 23 patients who had no visual field defect before treatment, three patients showed visual field defect after treatment(one after microsurgical resection using occipital interhemispheric approach, two after preoperative embolization). In 15 patients with visual field defect before treatment, four patients showed improvement in their visual field defect after treatment(three after microsurgical resection using occipital interhemispheric approach, one after gamma knife surgery). The parietooccipital approach did not change the status of visual field in any of the ten parients. In occipital AVM, visual field defect was the most srious morbidity. Ruptured occipital AVM had a higher incidence of hemorrhage causing a visual field defect and had a higher indication of direct surgical approach than AVM of other location. In planning surgery of occipital AVM, one has to count microsurgical anatomy based on the visual pathway as well as clinical findings such as the angioarchitecture, location of intracerebral hematoma, and preopeative visual field.
Arteries ; Arteriovenous Malformations* ; Follow-Up Studies ; Hematoma ; Hemianopsia ; Hemorrhage ; Humans ; Incidence ; Mortality ; Occipital Lobe ; Rupture ; Veins ; Visual Fields* ; Visual Pathways

Congenital constricting band of the trunk is a rare malformation with a wide spectrum of associated congenital anomalies. A 3-year-old boy with a congenital constricting band around the waist and anterior thigh and clubfoot deformity is reported. Laboratory test and chest and abdominal X-ray examination were within normal limits and unremarkable. Histopathologic examination revealed compact fibrocollagenous bundles in deep dermis. The compact fibrocollagenous bundles are parallel to the skin surface and have thin wavy nuclei. We think these bundles caused annular constriction on the trunk. We follow up the patient regularly without specific treatment because the constricting band caused no functional impairment and hypertrophic scar had developed at the biopsy site.
Biopsy ; Child, Preschool ; Cicatrix, Hypertrophic ; Clubfoot ; Congenital Abnormalities ; Constriction ; Dermis ; Follow-Up Studies ; Humans ; Male ; Skin ; Thigh ; Thorax

A total of 748 newborns delivered at the Fatima Hospital, Taegu, Korea, over period of 8 months were examined for the presence of skin lesions within 48 hours of birth. The frequencies of the type of birthmarks were: salmon patch, 61.8%; portwine stain, 0.7%; mongolian spot, 99.1%; cafe-au-lait spot, 0.5%; congenital nevomelanocytic nevus, 0.5%; milia, 44.5%; sebaceous hyperplasia, 76.9%; nevus sebaceus, 0.9%; erythema toxicum neonatorum, 29.3%; genital hyperpigmentation, 49.7%. Erythema toxicum neonatorum was less common in premature infants and more frequent on the second day of life than first one. Genital hyperpigmentation was observed predominantly in the male neonate. There was positive relationship between genital hyperpigmentation and birthweight.
Cafe-au-Lait Spots ; Daegu ; Erythema ; Humans ; Hyperpigmentation ; Hyperplasia ; Infant, Newborn* ; Infant, Premature ; Korea ; Male ; Mongolian Spot ; Nevus ; Parturition ; Salmon ; Skin*

BACKGROUND: There have been few clinical studies of halo nevi. OBJECTIVE: The purpose of this study was aimed at evaluating the clinical and histopathologic features of halo nevi and correlation between halo nevi and vitiligo. METHODS: The medical records of 40 patients with halo nevi and biopsy specimens of 30 patients with halo nevi were reviewed. RESULTS AND CONCLUSION: 1.The ratio of male to female patients was 1:1.5. 2.The mean age of the onset was 20.1 years (male : 11.5, female : 25.9). 3.Multiple halo nevi were present in 32.5%(male : 25%, female : 37.5%). 4.The areas in which the lesions developed were head and neck(39.1%), back(32.8%), anterior chest(12.5%), abdomen(10.9%), groin(3.1%), and lower extremity(1.6%) in descending order. 5.The mean duration of each color in central nevus was as follows: black(2.7 years), pink(3.5 years), gray(4.9 years) 6.The most common pathology of the central nevus was intradermal(80%). 7.The halo nevi associated with vitiligo were 21 cases(52.5%) out of 40 patients. Among them, the cases with non-segmental vitiligo were 13(61.9%), the cases with segmental vitiligo were 8(38.1%). 8.Out of the 21 cases with halo nevi associated with vitiligo, the cases with halo nevi prior to vitiligo were 4(19.1%), concurrent onset 12(57.1%) and the cases with halo nevi after vitiligo were 5(23.8%).
Biopsy ; Female ; Head ; Humans ; Male ; Medical Records ; Nevus ; Nevus, Halo* ; Pathology ; Vitiligo