Highly transient population, multiple sexual partners and high prevalence of unprotected sex behaviors suggest a potential rapid spread of sexually transmitted diseases (STD) in China. However, there are some 200 non-sexually transmitted diseases involving the genitalia, etiologically falling into 23 types. To avoid unnecessary medical disputes, enough attention should be paid to the differential diagnosis of non-sexually transmitted diseases in the genitalia.
Female ; Genital Diseases, Female ; diagnosis ; etiology ; Genital Diseases, Male ; diagnosis ; etiology ; Genital Neoplasms, Male ; diagnosis ; Humans ; Male ; Skin Diseases, Infectious ; diagnosis ; etiology ; Skin Neoplasms ; diagnosis

Adult ; Cardiomyopathies ; diagnosis ; etiology ; Electrocardiography ; Heart Block ; diagnosis ; etiology ; Humans ; Male ; Sarcoidosis ; complications ; diagnosis ; pathology ; Skin Diseases ; diagnosis ; etiology ; pathology

We present here a case of acrodermatitis enteropathica-like eruption associated with essential free fatty acid and protein deficiencies as well as borderline zinc deficiency that occurred after Whipple's operation in a 31-yr-old woman. Her eruptions were improved not by zinc supplements alone, but her condition was improved by total parenteral nutrition including amino acids, albumin, lipid and zinc. Although we could not exactly decide which of the nutrients contributed the most to her manifestations, we inferred that all three elements in concert caused her dermatoses. This case shows that even though the patient's skin manifestations and laboratory results are suggestive of acrodermatitis enteropathica, the physicians should keep in mind the possibility that this disease can be associated with other nutritional deficiencies such as free fatty acid or protein deficiency.
Acrodermatitis/*diagnosis/*etiology ; Adult ; Fatty Acids, Essential/deficiency ; Female ; Humans ; Malnutrition/*diagnosis/*etiology ; Pancreatectomy/*adverse effects ; Protein-Losing Enteropathies/diagnosis/etiology ; Skin Diseases/*diagnosis/*etiology ; Zinc/deficiency

Sjogren's syndrome (SS) describes xeropthalmia and xerostomia due to lymphocytic infiltrates of lacrimal and salivary glands. SS may occur alone (primary SS) or in association with several other autoimmune diseases (secondary SS). The clinical features involve a wide variety of organs, including skin, eyes, oral cavity and salivary glands, and systems, including nervous, musculoskeletal, genitourinary and vascular. Sicca symptoms can be found in a number of other disorders including rheumatoid arthritis, systemic lupus erythematosus, scleroderma, primary biliary cirrhosis, and other rheumatic disorders.
Eye Diseases/etiology ; History of Medicine, 20th Cent. ; Human ; Mouth Diseases/etiology ; *Sjogren's Syndrome/complications/diagnosis/history/physiopathology/therapy ; Skin Diseases/etiology ; Sweden

OBJECTIVETo describe the etiology, clinical features and treatment of childhood acute generalized exanthematous pustulosis (AGEP).

METHODSClinical data from 20 cases of childhood acute generalized exanthematous pustulosis from 1990 to 2008 were retrospectively reviewed.

RESULTSEighteen cases had a history of medication, including the use of penicillin (n=6), cephalosporins (n=3), sulphonamides (n=2), algopyrin (n=2), vaccines (n=2 ) and anti-cold drugs (n=3). Fever and generalized erythematous pustules were observed in all 20 cases. Histopathologic examination revealed spongiform superficial pustules and papillary edema. The patients were asked to stop taking suspected sensitizing drugs and received glucocorticoid treatment (1-2 mg/kg daily). After 3-5 days of the treatment, symptoms were improved and the dosage of glucocorticoid was gradually reduced. All patients were healed within 20 days after treatment.

CONCLUSIONSThe cause of AGEP is mainly attributed to the use of antibiotics, sulphonamides, antipyretic analgesics and vaccines in children. AGEP is characterized by fever and widespread pustular eruption of the skin. Removal of sensitizing factors and glucocorticoid administration is important in the treatment of AGEP in children.

Child ; Child, Preschool ; Drug Eruptions ; diagnosis ; etiology ; therapy ; Exanthema ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies ; Skin Diseases, Vesiculobullous ; diagnosis ; etiology ; therapy

A 32-year-old woman with a long-standing systemic lupus erythematosus had multiple subcutaneous nodules on her axillae, iliac crests and limbs. Three years ago, these nodules began to appear and slowly became larger. Some of them amassed to form a large, fungating, lobulated mass on her right iliac crest. Roentgenographic and histological examination showed that they were calcium deposits. She was initially treated with aluminum hydroxide administration for nine months, which resulted in moderate decrease in size and softening in consistency, but not complete resolution. Then, the mass on the right iliac crest was excised, with an excellent early result.
Administration, Oral ; Adult ; Aluminum Hydroxide/therapeutic use* ; Biopsy ; Calcinosis/therapy* ; Calcinosis/etiology ; Calcinosis/diagnosis ; Case Report ; Female ; Human ; Lupus Erythematosus, Systemic/complications* ; Skin Diseases/therapy* ; Skin Diseases/etiology ; Skin Diseases/diagnosis

A 32-year-old woman with a long-standing systemic lupus erythematosus had multiple subcutaneous nodules on her axillae, iliac crests and limbs. Three years ago, these nodules began to appear and slowly became larger. Some of them amassed to form a large, fungating, lobulated mass on her right iliac crest. Roentgenographic and histological examination showed that they were calcium deposits. She was initially treated with aluminum hydroxide administration for nine months, which resulted in moderate decrease in size and softening in consistency, but not complete resolution. Then, the mass on the right iliac crest was excised, with an excellent early result.
Administration, Oral ; Adult ; Aluminum Hydroxide/therapeutic use* ; Biopsy ; Calcinosis/therapy* ; Calcinosis/etiology ; Calcinosis/diagnosis ; Case Report ; Female ; Human ; Lupus Erythematosus, Systemic/complications* ; Skin Diseases/therapy* ; Skin Diseases/etiology ; Skin Diseases/diagnosis

Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder that has three major features: multiple neural tumors, cafe-au-lait spots, and pigmented iris hamartomas (Lisch nodules). The purpose of this case report is to advise physicians of the danger associated with the progression of fast-onset massive hemorrhage to hemodynamic instability, which mandates rapid treatment to prevent the development of a life-threatening condition. A 64-yr-old woman with NF-1 was admitted to the Emergency Department (ED) because of a rapidly growing, 10x5x3 cm-sized mass on the left back area. She had previously undergone surgery for a large subcutaneous hematoma, which had developed on her right back area 30 yr before. She became hemodynamically unstable with hypotension during the next 3 hr after admission to ED. Resuscitation and blood transfusion were done, and the hematoma was surgically removed. The mass presented as a subcutaneous, massive hematoma with pathologic findings of neurofibroma. We report a case of NF-1 that presented as recurrent, massive, subcutaneous hemorrhage on the back region combined with hypovolemic shock.
Diagnosis, Differential ; Female ; Hematoma/etiology/pathology ; Hemorrhage/*etiology/pathology ; Humans ; Middle Aged ; Neurofibromatosis 1/*complications/pathology ; Recurrence ; Skin Diseases/*etiology/pathology ; Tomography, X-Ray Computed

We report here a case with hypereosinophilia and peripheral artery occlusion. A 32-yr-old Korean woman presented to us with lower extremity swelling and pain. Angiography revealed that multiple lower extremity arteries were occlusive. The biopsy specimen showed perivascular and periadnexal dense eosinophilic infiltration in dermis and subcutaneous adipose tissue. Laboratory investigations revealed a persistent hypereosinophilia. She was prescribed prednisolone 60 mg daily. Her skin lesion and pain were improved and the eosinophil count was dramatically decreased. After discharge, eosinophil count gradually increased again. Cyanosis and pain of her fingers recurred. She had been treated with cyclophosphamide pulse therapy. Her eosinophilia was decreased, but the cyanosis and tingling sense were progressive. The extremity arterial stenoses were slightly progressed. Skin biopsy showed perivascular eosinophilic infiltration in the dermis and CD40 ligand (CD40L) positive eosinophilic infiltration. The serum TNF-alpha was markedly increased. These results suggest that CD40L (a member of TNF-alpha superfamily) could play a role in the inflammatory processes when eosinophil infiltration and activation are observed. We prescribed prednisolone, cyclophosphamide, clopidogrel, cilostazol, beraprost and nifedipine, and she was discharged.
Adult ; Arterial Occlusive Diseases/*diagnosis/etiology ; CD40 Ligand/analysis ; Cyanosis/etiology ; Diagnosis, Differential ; Eosinophilia/*diagnosis/etiology ; Female ; Gangrene/etiology ; Humans ; Hypereosinophilic Syndrome/blood/complications/*diagnosis ; Immunohistochemistry ; Peripheral Vascular Diseases/*diagnosis/etiology ; Skin/chemistry/pathology ; Tumor Necrosis Factor-alpha/metabolism ; Vasculitis/*diagnosis/etiology

Porcine pancreatic extracts (PPE), which are widely used as a digestive drug in Korea, are composed of alpha-amylase and lipase. Such enzymes are commonly described as occupational allergens. This is the first report of occupational rhinitis caused by PPE developing into occupational asthma in a hospital nurse. She showed strong positive response in the skin prick test (SPT) (5+, wheal ratio of allergen to histamine) and had a high serum-specific IgE level to PPE, but showed a negative response in the methacholine bronchial challenge test (MBT). She had been exposed to PPE intermittently with intermittent medications for rhinitis. Two years later, she presented with rhinitis and additional asthmatic symptoms. In contrast to her first visit, she showed a positive response in the MBT, and developed bronchoconstriction in the PPE-bronchial provocation test (BPT). These findings suggest that inhalation of PPE powder can induce IgE-mediated occupational rhinitis in a hospital setting, which will develop into occupational asthma if avoidance is not complete.
Adult ; Animals ; Asthma/*diagnosis/etiology ; Bronchial Provocation Tests ; Female ; Gastrointestinal Agents/adverse effects ; Humans ; Immunoglobulin E/metabolism ; Methacholine Chloride/pharmacology ; Occupational Diseases/*diagnosis/etiology ; Pancreatic Extracts/*adverse effects ; Powders ; Rhinitis/*diagnosis/etiology ; Skin Tests ; Swine