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

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

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*

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

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

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

Mycobacterium massiliense, an emerging pathogen that is increasingly reported as a causative agent in infections occurring during medical procedures, is difficult to be identified using conventional methods. Here we report the case of a cutaneous M. massiliense infection that was associated with repeated surgical procedures and that was identified via a comparative sequence analysis of rpoB and hsp65. The patient showed a substantial response to treatment with a combination of antimicrobial therapies consisting of clarithromycin, amikacin, and cefoxitin for 6 months.
Amikacin ; Cefoxitin ; Clarithromycin ; Humans ; Mycobacterium ; Sequence Analysis

BACKGROUND: Hair constitutes an integral part of our self and our self-identity, which is why hair loss may cause a broad range of psychological problems related to our identity. However, the association between quality of life (QOL) in alopecia areata (AA) patients and their clinical characteristics has not yet been investigated in Korea. OBJECTIVE: The purpose of this study is to compare the QOL in patients with AA and healthy controls by using Hairdex scale. The relationship between their QOL and their clinical characteristics will be investigated. METHODS: 102 AA patients and 82 healthy controls were recruited in this study and compared by use of Hairdex. Correlation analysis was performed to examine the relationship between the QOL and the clinical characteristics of patients with AA. RESULTS: The total Hairdex scores and all domain scores, except those of the symptomatic domain, of the Hairdex scales in AA were higher than those of the healthy controls. Clinical characteristics, including the age, disease duration, AA type, AA area, treatment satisfaction, treatment history, anxiety and depression, showed significant correlation with QOL. Of these characteristics, the depression and treatment satisfaction showed strong association with QOL. CONCLUSION: AA can a impair patient's quality of life and has a significant psychological impact.
Alopecia ; Alopecia Areata ; Anxiety ; Depression ; Hair ; Humans ; Quality of Life ; Weights and Measures

BACKGROUND: Epigenetic modulation of gene expression occurs by various methods, including DNA methylation and histone modification. DNA methylation of specific genes may affect the chromatin structure, preventing access by the transcriptional machinery. Although gene expression is dramatically changed during keratinocyte differentiation, there is no evidence of epigenetic modulation during the process of epidermal stratification. OBJECTIVE: We investigated whether epigenetic modulation is involved in keratinocyte differentiation-specific gene regulation. METHODS: We used trypsin to produce epidermal fragmentation (named T1-T4) and performed a morphological analysis using hematoxylin-eosin stain and cytokeratin expression based on reverse transcription polymerase chain reaction. We then constructed a DNA methylation microarray. RESULTS: Each epidermal fragment showed morphological features of the epithelial layer. T1 represented the basal layer, T2 was the spinous layer, T3 was the granular layer, and T4 was the cornified layer. The level of the K14 proliferation marker was increased in the T1 fraction, and the level of K10 differentiation marker was increased in the T2-T4 fractions. Using a methylation microarray with the T1 and T4 fractions, we obtained many hypermethylated and hypomethylated genes from differentiated keratinocytes. CONCLUSION: The importance of epigenetic modulation in target gene expression during keratinocyte differentiation is identified.
Cell Differentiation ; Chromatin ; DNA Methylation ; Epigenomics ; Gene Expression ; Histones ; Keratinocytes ; Keratins ; Methylation ; Polymerase Chain Reaction ; Reverse Transcription ; Trypsin

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