BACKGROUND: At least 30 per cent of diabetics, which is said to comprise over 3% of general population in Korea, have one or more cutaneous complications during the course of the disease. These skin changes may be the consequences of microangiopathy, arteriosclerosis, direct metabolic disturbances and/or the sequelae of chronic therapy. OBJECTIVE: We tried to observe certain cutaneous and nail changes in diabetics and to relate them with systemic complications, blood sugar level and duration of diabetes. METHODS: During the period of 12 months from March, 1992 to February, 1993, a total of 1858 outpatients diagnosed as diabetes mellitus at Eulji General Hospital were examined. RESULTS: The cutaneous manifestations are observed in 79.5% of diabetics examined and cutaneous infections are the most prevalent(52.3%). Pruritus(p<0.01), anogenital pruritus(p<0.01), peripheral dedema(p<0.05) are more common in females and infections, shin spots, finger pebbles(p<0.01) are more common in males. Systemic complications are observed in 50.7% and the cutaneous manifestations are observed more frequently in patients with systemic complications(p<0.05). Shin spots, diabetic foot, peripneral edema diabetic bullosis are observed frequently associated with systemic microangiopathic complications such as retinopathy, nephropathy and neuropathy(p<0.01). There is a significant correlation between blood sugar level and fungal infections and anogenital pruritus(p<0.01). The frequencies of shin spots, diabetic foot and diabetic bullosis increase with the length of time diabetes has been present. Nail changes are observed in 39.6% of diabetics and onychomycosis is the most frequent(34.5%). CONCLUSION: It is suggested that cutaneous shgns especially fungal infections in diabetics are on the increase in Korea. A variety of skin conditions are encountered with diabetes mellitus and the dermatologist may be able to make a significant contribution in the control of diabetes mellitus by identifying skin signs and conditions as diabetic complications.
Arteriosclerosis ; Blood Glucose ; Diabetes Complications ; Diabetes Mellitus* ; Diabetic Foot ; Edema ; Female ; Fingers ; Hospitals, General ; Humans ; Korea ; Male ; Onychomycosis ; Outpatients ; Skin

Romberg syndrome is a rare disease and characterized by unilaeril atrophy of the skin, subcutaneous tissue and the underlying structure of half the face. The lesion does not usually cross the midline of the scalp. Roriberg syndrome is sometimes mildsnosed as linear scleroderma, although they differ widely in their clinical and histological apperance. A 13-year-old boy was present with a one year history of idefined atrophic patch on the left side of face and neck. We involved skin was not bound down to the underlying structure. The history revealed no prcvious trauma or disease, He had no abnormal neurologic finding. Computerized tomography demonstrated a diminished subcutaneouat volume and also decreased thickness of back muscle is the left side face from cheek to neck.
Adolescent ; Atrophy ; Back Muscles ; Cheek ; Humans ; Male ; Neck ; Neurologic Manifestations ; Rare Diseases ; Scalp ; Scleroderma, Localized ; Skin ; Subcutaneous Tissue

Pseudocyst of the auricle presents as a non-inflammatory, fluctuant swelling on the upper half or third section of the ear, due to intracartilaginous accumulation of fluid. Histological examination shows an intracartilaginous cavity without an epithelial lining. The etilogy and pathogenesis of this disorder remains unknown, but the lesion is likely to be due to localized de-generation of cartilage. The degenerated cartilage is replaced by a vascular fibrous tissue from which there is serious exudation, and a clinical cystic swelling is formed. We describe in this report three cases of pseudocyst of the auricle, of which one was treated successfully by surgical excision and a pressure dressing, and the others by aspiration and steroid injection therapy. In all cases, the skin lesions had not recurred, and the patients were left with an excellent cosmetic result.
Bandages ; Cartilage ; Ear ; Humans ; Skin

Agminated lentigines may be defind as a circumscribed grouping of small pigmented macules arranged in a small or large group, often in a segmental pattern, each macule consisting of a lentiginous epidermal proliferation of melanocytes. We report five cases of agminated lentigines in otherwise healthy persons. Histologic exarnination of the pigmented lesion revealed findings consistent with lentigo simplex.
Humans ; Lentigo* ; Melanocytes

Favre-Racouchot syndrome is a disease of senile or actinic processes and another name is nodular elastosis with cysts and comedones. Clinically, facial skin shows, especially lateral to the eyes, multiple open and cystically dilatated comedones and can be defined as cutaneous disturbances characterized by a degenerative process of the dermis associated with cysts and comedones. Sunlight is a strong causative factor and dermal degenerative processes result in this condition. We report the case of a 78-year-old man who showed multiple yellowish papules on both sides of cheeks, the periorbital and, malar areas. He had had this condition for 25-years. His job used to involve physical labor and much exposure to sunlight. An excisional biopsy specimen from the facial malar lesion showed cystically dilated comedones with basophilically degenerated dermal tissue. We performed a therapeutic excision on the two large nodular lesions on both malar areas and applied topical tretinoin. The Patients clinical appearance was much improved 2 months later.
Actins ; Aged ; Basophils ; Biopsy ; Cheek ; Dermis ; Facial Dermatoses* ; Humans ; Skin ; Sunlight ; Tretinoin*

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

Acoustics ; Child ; Cleft Palate ; Humans ; Korea

Generalized plane xanthoma is less common and usually involves the eyelids, lateral side of the neck, upper trunk, and extremities. Lesions, however, may appear on any portion of the body. Cutaneous xanthomas may occur in hyperlipidemic and in normolipidemic states. Generalized normolipidemic plane xanthoma is often associated with multiple myeloma, other reticulo-endothelial malignancies and monoclonal gammopathy with unknown significance(MGUS). We wish to report two eases of generalized plane xanthoma associated with IgG monoclonal gammopathy of unknown significance.
Extremities ; Eyelids ; Immunoglobulin G ; Multiple Myeloma ; Neck ; Paraproteinemias* ; Xanthomatosis*

BACKGROUND: The effectiveness for vagal stimulation by ice water aplication to face during metronome-controlled respiration of 15 breaths/minute was examed. The importance of basal vagal tone and sympathovagal interaction in the individual variability of responsiveness to the vagal stimulation was investigated. METHOD: Fifty three 12~13 year old healthy volunteers were included. Vagal tone and sympathovagal interaction before and after application of ice water to the face were assessed by power spectral analysis of RR interval(heart rate) variability. RESULT: Basal heart rate, high frequency power, and low to high frequency power ratio were 81+/-13(58~110 beats/min), 791+/-1061(56~4161 msec2) and 1.08+/-1.22(0.04~4.85) during controlled respiration. After ice water application twenty three children developed 5 more nodal escape beats due to severe bradycardia. Minimum heart rate, high frequency power and low to high power ratio changed to 42+/-12(19~72/min), 1890+/-1882(221~7258msec2) and 0.64+/-0.43(0.12~1.46). The increased ratio of high frequency power, maximum heart rate decrement and its percent after stimulation were 5.44+/-5.62(0.63~24.26), 39+/-14(10~81/min) and 47+/-15(16~81%) respectively. The increased ratio of high frequency power was correlated with basal logarithmic high frequency power(r=-0.60, p=0.0004). Maximum heart rate decrement was correlated with basal logarithmic high frequency power(r=-0.41, p=0.0018) and low to high frequency power ratio(r=0.27, p=0.04). CONCLUSION: Application of ice water to the face during controlled respiration produces powerful vagal stimulation and bradycardia, however, there is a wide individual variability of responsiveness to it. The absolute basal vagal tone contribute to this individual variability.
Bradycardia ; Child ; Healthy Volunteers ; Heart Rate* ; Heart* ; Humans ; Ice* ; Respiration* ; United Nations ; Water*

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases