BACKGROUND: Periungual warts are a therapeutic challenge. Many studies have revealed that intralesional interferon α-2b therapy and pulsed dye laser therapy have numerous advantages over other modalities of theratment. OBJECTIVE: The purpose of this study was to determine if combination therapy with intralesional interferon α-2b and pulsed dye laser might offer an effective treatment for periungual warts. METHODS: Thirty-three patients were randomly assigned to one of three study groups. In group A, the patients received both intralesional interferon α-2b treatment and pulsed dye laser(PDL) therapy (n=13). Group B patients were treated wit intralesional interferon α-2b alone (n=10) and group C was done with PDL therapy only (n=10). RESULTS: The clearance rate was 92.3% for the patients treated with the combination therapy of intralesional interferon α-2b treatment and pulsed dye laser (PDL) therapy. It was 50% for the patients with the intralesional interferon α-2b treatment alone, and 0% for the group with the PDL therpy only. No significant side effects were observed. At 6 months after cessation of the therapy, total 2 cases (one from group A and the other from group B) were recurred. CONCLUSION: The combination therapy with intralesional interferon α-2b treatment and pulsed dye laser therapy was highly effective for the treatment of recalcitrant periungual warts.
Humans ; Interferons* ; Lasers, Dye* ; Warts*

BACKGROUND: The endothelial expresson and upregulation of ICAM-1 and epidermal keratinocyte expression of ICAM-1 are well documented in psoriasis. ICAM-1 mediates the adhesion and trafficking of circulating activated skin-seeking CD45RO+ memory CD4+ T lymphocytes from the vessel into the dermis and epidermis of psoriatic skin by binding to its ligand LFA-1(lymphocyte function-associated antigen-1) expressed on lymphocyte membranes. OBJECTIVE: The purpose of this study was to investigate the expression of ICAM-1 in vascular endothelium and keratinocyte of psoriatic skin and the difference of ICAM-1 expression between early and fully developed psoriatic lesions. METHODS: We have studied the expression of ICAM-1 in twelve psoriatic patients who had not been treated for psoriatic lesions for 1 month and three normal human skin samples by immunohistochemical staining using monoclonal antibody against ICAM-1. RESULTS: Immunohistochemical staining revealed anti-ICAM-1 antibody positively stained only in the subpapillary endothelial cells of normal skin. But in all psoriatic lesions studied, anti- ICAM-1 antibody was stained positively in the endothelium of papillary and subpapillary plexus, and in fully developed psoriatic lesions, anti-ICAM-1 antibody was stained focally in epidermal keratinocytes. CONCLUSION: The results suggest that ICAM-1 expression on papillary microvessels and keratinocytes may play an important role in the transendothelial and transepidermal migration of lymphocytes from the vessel into the dermis and epidermis of psoriatic skin.
Dermis ; Endothelial Cells ; Endothelium ; Endothelium, Vascular* ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Lymphocytes ; Membranes ; Memory ; Microvessels ; Psoriasis ; Skin* ; T-Lymphocytes ; Up-Regulation

Targetoid hemosiderotic hemangioma is a benign vascular tumor with a peculiar clinical presentation and histologic features sometimes difficult to differentiate from the patch stage of Kaposi's sarcoma, progressive lymphangioma, eosinophilic hemangioma, retiform hemangioendothelioma. We report a case of targetoid hemosiderotic hemangioma on upper back and right upper arm of a 28-year-old male. He has a 5mm × 5mm sized slightly raised violaceous papule surrounded by an ecchymotic halo on upper back and right upper arm. We took a biopsy of the lesion and identified it as targetoid hemosiderotic hemangioma. This is a case of targetoid hemosiderotic hemangioma with typical clinical and histopathological findings.
Adult ; Arm ; Biopsy ; Eosinophils ; Hemangioendothelioma ; Hemangioma* ; Humans ; Lymphangioma ; Male ; Sarcoma, Kaposi

Once splinter hemorrhage can be considered as a pathognomonic sign of subacute bacterial endocarditis. But it can also be associated with a variety of systemic disorders that increase capillary fragility or primary nail bed involvement in dermatologic disorders. The cause of splinter hemorrhage can usually be established by careful history and physical examination. We report a case of 33-year-old man with splinter hemorrhages, who had polycythemia vera.
Adult ; Capillary Fragility ; Endocarditis, Subacute Bacterial ; Hemorrhage* ; Humans ; Physical Examination ; Polycythemia Vera* ; Polycythemia*

Sjogren-Larsson syndrome is a rare autosomal recessive neurocutaneous disorder due to a deficiency of the fatty aldehyde dehydrogenase. It consists of ichthyosis, spastic di- or quardriplegia and mental retardation. We report a case of a 9-year-old boy who was suspected to have Sjogren-Larsson syndrome. He had congenital ichthyosis, spastic diplegia and mental retardation. In addition, there was macular degeneration on the fundus. His neurological symptoms were improved after selective posterior rhizotomy and rehabilitation therapy. However, the dermatological problem did not subside with conservative treatment.
Aldehyde Dehydrogenase ; Cerebral Palsy ; Child ; Humans ; Ichthyosis ; Intellectual Disability ; Macular Degeneration ; Male ; Muscle Spasticity ; Neurocutaneous Syndromes ; Rehabilitation ; Rhizotomy ; Sjogren-Larsson Syndrome*

We report a case of an intraparenchymal schwannoma of the left parietal lobe. A 51-year-old woman was admitted to our hospital with complaints of intermittent headaches. Computed tomography and magnetic resonance images revealed a 1.3 cm sized intra-axial homogeneous enhancing mass in the left parietal lobe. The lesion was pathologically confirmed to be a schwannoma.
Brain Neoplasms ; Female ; Headache ; Humans ; Magnetic Resonance Spectroscopy ; Middle Aged ; Neurilemmoma ; Parietal Lobe

Bullous pemphigoid(BP) is a bullous disease in elderly people characterized by subepidermal bullae on erythematous and normal skin. Peripheral blood easinophilia have been reported in the patients with BP, and blood eosinophilia may be related to disease activity and severity in BP. We report a 70-year old man BP. He showed peripheral blood eosinophilia, and was treated successfully with a combination of low dose steroids & tetracycline-niacinamide(T-N) therapy. The eosinophil counts fell to normal levels as the skin lesion cleared.
Aged ; Eosinophilia ; Eosinophils ; Humans ; Pemphigoid, Bullous* ; Skin ; Steroids

BACKGROUND: The earlier laser treatment of patients with nevus flammeus or Ota nevus prevent psychologic dysfunction due to unwanted cutaneous lesion and the increasing size of lesion. OBJECTIVE: Our purpose was to assess the safety and side effect of general anesthesia in the laser treatment of nevus flammeus or Ota nevus in children. METHODS: 25 children treated with laser for nevus flammeus or Ota nevus and underwent general anesthetic modality were included in this study. The age of patients, the size and the location of cutaneous lesions were noted. Most of children, after induction of anesthesia with thiopental and succinycholine, were maintained airway with intratracheal intubation. Some of children was done with intravenous anesthesia, propofol or ketamine. The results of laser treatment were assessed by photograph and clinical observation, based on a scale: excellent for 75-100% improvement, good for 50-75% improvement, fair for 25-50% improvement, poor for 0-25% improvement. RESULTS: 25 children treated with laser for nevus flammeus or Ota nevus were below 10 years old, eight of them were below 3 years old. The laser treatment was more effective in proportion with the number of laser treatment. After general anesthesia, all patients with laser treatment didn't appear the side effect of laryngeal spasm or apnea etc. Our data showed minimal risk and sequale of general anesthesia in the treatment of nevus flammeus or Ota nevus in children. CONCLUSION: The use of general anesthesia in the treatment of nevus flammeus or Ota nevus in children does not appear to be accompanied by increased risk.
Anesthesia ; Anesthesia, General* ; Anesthesia, Intravenous ; Apnea ; Child* ; Child, Preschool ; Humans ; Intubation, Intratracheal ; Ketamine ; Laryngismus ; Nevus of Ota ; Port-Wine Stain ; Propofol ; Thiopental

BACKGROUND: Previous studies have demonstrated the pathogenetic role and expression of TGF-beta in psoriatic lesion. Transforming growth factor s are a family of growth factors with inhibitory effects on epithelial cell proliferation. Their effects are mediated by two interacting receptors, of which type I receptor mediates signal transduction after interaction with type II receptor carrying the TGF ligand. OBJECTIVE: The purpose of this study was to investigate the relationship between development of psoriasis and expression of TGF-beta receptors in psoriatic lesion. METHODS: We have studied the expression of TGF-beta type I and type II receptors in psoriatic lesions of 30 psoriatic patients who had not been treated for 1 month, 5 non-lesional psoriatic skin, and 3 normal human skin by immunohistochemical staining using polyclonal rabit antisera. RESULTS: 1. Immunohistochemical analysis revealed an intense immunoreactivity for TGF-beta type I and type II receptors in the basal and also suprabasal layer of normal epidermis and non-lesional psoriatic skin. 2. Almost all psoriatic lesions studied lacked detectable immunoreactivity of either receptor in the epidermis. CONCLUSION: We suggest the lack of TGF-beta - mediated growth inhibition by down regulation of TGF-beta receptor expression may play an important role in the pathogenesis of psoriasis.
Down-Regulation ; Epidermis* ; Epithelial Cells ; Humans ; Immune Sera ; Intercellular Signaling Peptides and Proteins ; Psoriasis ; Receptors, Transforming Growth Factor beta ; Signal Transduction ; Skin ; Transforming Growth Factor beta ; Transforming Growth Factors

Sclerosing panniculitis refers to the skin induration and hyperpigmentation of the legs that often occurs in patients who have venous insufficiency. Sclerosing panniculitis is similar to those described under the designations hypodermitis sclerodermiformis or lipodermatosclerosis. Histologically the septa of the subcutis become thickening by inflammation and fibrosis. Adipocytes coalesce to form small and large pseudocysts. Some of these are lined by refractile, amphophilic crenulated membranes. This alteration was referred to as lipomembranous change. We report a case of sclerosing panniculitis in a 40-year-old female patient presented as induration and depression of the skin and subcutaneous tissues of the lower third of the leg.
Adipocytes ; Adult ; Depression ; Female ; Fibrosis ; Humans ; Hyperpigmentation ; Inflammation ; Leg ; Membranes ; Panniculitis* ; Skin ; Subcutaneous Tissue ; Venous Insufficiency