Dermal melanocytosis is histologically characterized by the presence of ectopic melanocytes in the dermis. Mongolian spots, nevus of Ota, nevus of Ito and blue nevus are the most common types and these are usually present at birth or in early childhood. However, it has been reported that several types of dermal melanocytosis could appear in adult life. We report here on an unusual case of acquired dermal melanocytosis occurring in a 51 year-old female. She had bilaterall brownish or slate-bluish pigmented patches on the face and the posterior auricular, supraclavicular, scapular and back areas. The skin biopsy specimen taken from the upper back revealed scattered, darkly pigmented, spindle-shaped cells and dendritic cells containing abundant golden brown pigment in the dermis.
Adult ; Biopsy ; Dendritic Cells ; Dermis ; Female ; Humans ; Melanocytes ; Mongolian Spot ; Nevus ; Nevus of Ota ; Nevus, Blue ; Parturition ; Skin

Trichoblastoma is a benign cutaneous neoplasm that consists of follicular germinative cells. There have only been a few case reports describing the malignant counterpart of trichoblastoma. We report trichoblastic neoplasms that show histological features of malignancy. The histological sections revealed locally aggressive neoplasms showing prominent differentiation towards hair germ and follicular sheath with formation of papillary mesenchymal bodies and follicular bulb-like structures. The tumor was widely excised with a clear margin. No sign of recurrence has been noted 1 year later.
Hair ; Recurrence

PURPOSE: Lead toxicity affects every organ system, most importantly, the central and periphral nervous systems, kidney, and blood. Not yet, there are not so many data about blood lead levels of children in Korea. The children residing in Ulsan have some risk exposured to lead because of air pollution resulted from rapid industrialization and some lead-using industries. So we estimated the blood lead levels of children in Ulsan and tried to abtain the predict values of them. METHODS: Venous blood specimens were obtained for lead levels from two groups of 60 primary school children(30 residing in suburb, near-industry, and 30 in inner-city), aged 11-12 years. We also determined serum iron, ferritin, and hemoglobin. We compared blool lead levels between two groups according to nature of housing, age of housing, using the paint, condition of paint, parent's occupation. RESULTS: 1) The mean blood lead levels of 60 chiddren was 6.20+/-2.29 g/dl. 2) The children residing in inner-city had the higher blood lead levels(7.02+/-2.29 g/dl) than near-industry, suburban children (5.38+/-1.99 g/dl) with statistical significance (p<0.01). 3) Four children had the blood lead level over 10 g/dl, but all of them below 15 g/dl, and no intellectual deficit. 4) Air lead in classroom of 2 schools was not detected. 5) The serum iron, ferritin and hemoglobin level were all within the normal range. 6) There were no significant difference of blood lead levels between two groups according to nature of husing, age of housing, using the paint, condition of paint, parent's occupations. CONCLUSIONS: The mean blood lead levels of some primary school children in Ulsan was 6.20+/-2.29 g/dl, within the acceptable ranges. Children residing in inner-city had slightly higher blood lead levels than near-industry, suburban children.
Air Pollution ; Child* ; Ferritins ; Housing ; Humans ; Iron ; Kidney ; Korea ; Nervous System ; Occupations ; Paint ; Reference Values ; Ulsan*

Skin lesions can sometimes be the presenting sign of metastatic cancers. We report a case of skin metastasis resembling pyogenic granuloma from hepatocellular carcinoma, which is a common malignancy in Korea. A 79-year-old male presented with a 1 month history of a dark-reddish nodule on his left cheek, which was thought to be pyogenic granuloma. On histopathologic examination, it was composed of tumor cells and intervening sinusoids and therefore showed characteristics of hepatocellular carcinoma. We confirmed hepatocellular carcinoma upon abdomen computer tomography. We present this case along with a review of previous reports of cutaneous metastasis from hepatocellular carcinoma.
Abdomen ; Aged ; Carcinoma, Hepatocellular* ; Cheek ; Granuloma, Pyogenic* ; Humans ; Korea ; Male ; Neoplasm Metastasis* ; Skin

BACKGROUND: Acute diffuse alopecia areata (AA) was described as a unique AA which mimics anagen effluvium, or in which the initial hair loss is diffuse and followed by total denudation of scalp within several weeks or months. In spite of its peculiar clinical feature, there was neither further characterization nor known effective treatment for this form of AA. OBJECTIVE: To evaluate the characteristic clinical findings of acute diffuse AA and confirm the effect of high dose methyl prednisolone therapy. METHODS: The medical records of 13 patients with acute diffuse AA between January 2002 and April 2006 at the Department of Dermatology, Chungnam National University Hospital were reviewed. All patients were treated with high dose methylprednisolone therapy. RESULTS: Of the 13 patients who completed the study, 8 patients (61.5%) were male and 5 patients (38.5%) were female. The mean age was 29.6 years old. The progress of hair loss stopped 2.4 weeks on average after initial treatment and newly emerging hairs were recognized 4.1 weeks on average after initial treatment. 84.6% (11/13) of patients showed terminal hair growth, and 46.2% (6/13) of patients completely responded to this therapy. CONCLUSION: Acute diffuse alopecia areata can occur in male as well as in female patients. High dose methylprednisolone therapy appears to be effective in patients with rapidly progressing acute diffuse alopecia areata to prevent the progression of the disease.
Alopecia Areata* ; Alopecia* ; Chungcheongnam-do ; Dermatology ; Female ; Hair ; Humans ; Male ; Medical Records ; Methylprednisolone ; Prednisolone ; Scalp

Verrucous hyperplasia appears as multiple, warty, coalescent papules arising on the distal portion of amputation stump skin, yet it displays no histological evidence of viral warts. It occurs when the chronic pressure of a poor prosthetic fit disrupts vascular and lymphatic channels, subsequently causing chronic tissue edema. We report a case of 30 year old male, with 15 year history of wearing below-the-knee prosthesis, who presented with a verrucous papule that arose at his amputation site. Histopathological findings showed hyperkeratosis, acanthosis, superficial dermal edema and dilated thick vessles oriented vertical to the skin surface. Verrucous hyperplasia with lymphedema was diagnosed on the basis of clinical and histological findings.
Adult ; Amputation Stumps* ; Amputation* ; Edema ; Humans ; Hyperplasia* ; Leg* ; Lymphedema* ; Male ; Prostheses and Implants ; Skin ; Warts

PURPOSE: Popular use of fetal ultrasonography has increased to detect congenital hydronephrosis(CH) which is the most common anomaly prenatally detected. We'd like to determine the frequency and clinical characteristics of prenatally diagnosed CH and outcome of ureteropelvic junction stenosis(UPJS). METHODS: The records of births between January 1994 and June 2003 in Chonnam National University Hospital(CNUH), and the records of children who were diagnosed with CH in the Department of Pediatrics of CNUH during the above period, were retrospectively analyzed. In the patients with UPJS, the initial anterior posterior diameters of renal pelvis(APD) were compared between the spontaneous regression (SR) and operation group(OP). In the SR group, sequential regression rates of APD were estimated. RESULTS: Among a total 9,076 births, 231(2.54 percent) patients with 293 renal units were diagnosed as CH and 19(6.78 percent) renal units spontaneously regressed 3 days after birth. In 228 children(56 bilateral; 172 unilateral; total 284 renal units) diagnosed with CH in the department of pediatrics of CNUH, male(71.9 percent) and left kidney(69.2 percent) predilection were found and 78.1 percent of CH were caused by UPJS. The initial APD of the SR group(121 units) in UPJS was 7.8+/-6.28 mm, which was significantly smaller than the APD(26.8+/-12.14 mm) of the OP group(25 unit)(P<0.05). In the SR group, 81 percent spontaneously regressed within one year. CONCLUSIONS: In CH, male and left kidney predilection were found. UPJS was the most common cause of CH and initial APD in UPJS at 3 days of age was a good prognostic indicator. Close monitoring should be done for at least one year because most SR in UPJS regressed spontaneously within one year.
Child ; Constriction, Pathologic* ; Humans ; Hydronephrosis* ; Jeollanam-do ; Kidney ; Male ; Parturition ; Pediatrics ; Retrospective Studies ; Ultrasonography, Prenatal

The amniotic band syndrome is a collection of fetal malformations associated with fibrous band that appears to entangle or entrap various fetal part, in utero, leading to deformation, malformation or disruption. Its pathogenesis has been debated in the literature for many years. The associated anomalies vary from minor limb anomalies to major craniofacial defects and visceral defects. We experienced a case of limb anomalies due to amniotic band and present the findings with a brief review of literature.
Amniotic Band Syndrome ; Extremities ; Infant, Newborn

We report a case of an isolated plexiform neurofibroma occurring in a patient with myasthenia gravis. A 48-year-old man presented with asymptomatic skin-colored nodules on the tip of his 4th finger. Microscopically, a plexiform neurofibroma was identified located in the dermis that appeared to originate from small superficial nerves. He had a 20-year history of treated myasthenia gravis; otherwise, his personal and family histories were unremarkable. Given that myasthenia gravis is a disorder of the peripheral nerves, plexiform neurofibromas could be associated with myasthenia gravis. However, the development of an isolated plexiform neurofibroma in a case of myasthenia gravis has not yet been reported. The occurrence of a neurofibromas in a patient with myasthenia gravis suggests a link in the pathogenesis of these two diseases.
Aluminum Hydroxide ; Carbonates ; Dermis ; Fingers ; Humans ; Middle Aged ; Myasthenia Gravis ; Neurofibroma ; Neurofibroma, Plexiform ; Peripheral Nerves

BACKGROUND: Leukoderma punctata is a peculiar disorder with punctiform, hypopigmented and achromic spots. Histopathologically, a focal reduction of melanocytes and melanin granules are found in the depigmented macule. The phototoxic effect of phototherapy on melanocytes has been suggested as the most likely cause. This occurs mostly after application of systemic or topical psolaren on photochemotherapy. However, a case following narrowband UVB therapy is very rare. OBJECTIVE: The purpose of our study was to investigate the characteristics of leukoderma punctata patients and find the cause of leukoderma punctata. METHODS: We reviewed the medical records of leukoderma punctata patients, and a skin biopsy was taken from punctiform hypopigmented macules. The tissues were stained with hematoxyline and eosin, Fontana-Masson, and dopa-oxidase. RESULTS: The average age of patients was 51 years old. There was no difference between results of male and female patients. Involvement sites of patients were mostly the arms and legs. 76% of patients did not have preceding subjective symptoms. In eight of nine patients, a marked reduction of melanin and melanocytes was noted with both Fontana-Masson staining and dopa-oxidase staining. The average total period of PUVA therapy was 26 months and average total dose of PUVA irradiation was 351.2 J/cm2 in leukoderma punctata patients. Before leukoderma punctata developed, the average total period of narrowband UVB therapy was 6.9 months and average total dose of narrowband UVB was 22.45 J/cm2. The results suggest that leukoderma punctata developed in very small dose of narrowband UVB, although it did not develop with large doses of PUVA. CONCLUSION: Narrowband UVB (311 nm) is the most likely spectrum for development of leukoderma punctata.
Arm ; Biopsy ; Eosine Yellowish-(YS) ; Female ; Hematoxylin ; Humans ; Leg ; Male ; Medical Records ; Melanins ; Melanocytes ; Middle Aged ; Photochemotherapy ; Phototherapy ; PUVA Therapy ; Skin ; Vitiligo*