BACKGROUND: Nevus sebaceus of Jadassohn is a complex anomaly involving the epidermis, dermis, apocrine glands and hair follicles, as well as the sebaceous glands, and a variety of benign and malignant tumors and neurologic abnormalities may be associated with it; however, only a few studies on it have been reported in the Korean literature. OBJECTIVE: The objectives of this study was to document clinical and histopathologic features of nevus sebaceus in Koreans and compare them to those in the previously reported studies. METHOD: Clinical records and histopathology of 53 cases of nevus sebaceus diagnosed at Ewha Womans University Tongdaemun Hospital during a period of 18 years were reviewed and analyzed. RESULTS: The average incidence rate of nevus sebaceus among new patients was 0.03%. The male-to-female ratio was 1.04 and the average age at visit, 16.5 years. The lesions had been present since birth or had developed before age 10 in 85% of the cases. A11 lesions were situated on the head, and the most common site was the scalp. Linear 1esions (20.8%) were mostly facial lesions. Histopathologically, the incidence of sebaceous and apocrine glandular hyperplasia was most notable in the 13-18 and over-18 age groups. The sebaceous glands showed small punched out defects or "holes" in 24.5%; ectopic apocrine glands were found in 24.5 %. Mature hair follicles were absent or greatly reduced in number in 75.5%. Acanthosis nigricanslike pattern of acanthosis and mild papillomatosis were the dominant changes in the epidermis. Hyperplasias and neoplasms were associated in 15.1%, which included 5 cases of primitive follicular induction and 1 trichoblastoma. CONCLUSION: In this series, no examples of malignant neoplasms were identified; however, an early total excision before age 13 is recommended since a variable "deficit malformation" of the follicles with hyperplasia of the epidermis and sebaceous glands becomes more prominent after that age.
Apocrine Glands ; Dermis ; Epidermis ; Female ; Hair Follicle ; Head ; Humans ; Hyperplasia ; Incidence ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Papilloma ; Parturition ; Scalp ; Sebaceous Glands

A 22-year-old woman with no history of trauma or other diseases presented with a slowly enlarging firm nodule with a central pointed opening on the right chest. An excisional biopsy revealed a pilomatricoma associated with an epidermoid cyst. Histopathologically, an epidermoid cyst located in the deep dermis was lined mostly by keratin-forming stratified squamous epithelium but focally had columns of shadow cells that projected from the epithelial lining of the cyst into the lumen. The lumen also contained masses of shadow cells, unattached to the epithelial lining. In the stroma surrounding the cyst, numerous masses of shadow cells with giant cell reaction and focal calcification were seen, which were in turn surrounded by a connective tissue capsule. These features are similar to those seen in infundibular cysts associated with Gardner's syndrome. Since epidermoid cysts and pilomatricomas originate in common from the pilosebaceous unit and pilomatricomas begin as infundibular matrix cysts, we suggest that they can occur simultaneously, although rarely, in a healthy person.
Biopsy ; Connective Tissue ; Dermis ; Epidermal Cyst* ; Epithelium ; Female ; Gardner Syndrome ; Giant Cells ; Humans ; Pilomatrixoma* ; Thorax ; Young Adult

No abstract available.
Acupuncture* ; Dermatitis, Allergic Contact* ; Nickel*

BACKGROUND: Pilomatricoma is a rare benign follicular tumor in Asians OBJECTIVE: purpose of this study was to assess the clinical and histopathological features of the tumor. METHODS: The hospital charts and slides of 13 patients with pilomatricoma over a 12-year period at Ewha Womans University Tongdaemun Hospital were retrospectively reviewed. RESULTS: The age of patients ranged from 5 to 76 years with a mean of 21.5 years. The maleto-female ratio was 1:3.3. Seventy-seven percent of the tumors were located on the upper and lower extremities, followed by the face and neck. Most tumors appeared as a pea-sized hard movable skin-colored nodule. At histopathologic level, the most common morphological stage was the early regressive stage (stage 3), followed by late regressive (stage 4), fully developed (stage 2), and early (stage 1) stages. Foreign body giant cells, calci6cation, ossification were seen in 69.2%, 84.6%, and 7.7%, respectively; giant cells and inflammatory infiltrate were mostly seen in stage 3 tumors, calcification in stage 3 and 4 tumors, and ossification, only in the sole stage 4 tumor. Anetodermic changes of overlying dermis were seen in 2 cases (15.4%). CONCLUSION: The various histopathologic features of pilomatricoma can be explained by its chronological, morphological stages.Most pilomatricomas present for longer than 6 months are already in stage 3, and one can expect the histopathological features accordingly.
Asian Continental Ancestry Group ; Dermis ; Female ; Giant Cells ; Giant Cells, Foreign-Body ; Humans ; Lower Extremity ; Neck ; Pilomatrixoma* ; Retrospective Studies

Purpose: The purpose of this study was to examine the effects of a multidisciplinary program for relapse prevention on abstinence self-efficacy, impulsivity and suicidal ideation among patients with substance use disorder Methods: A nonequivalent control group non-synchronized design was used. The participants were 42 substance addicted patients admitted to the addiction ward. The study variables of abstinence self-efficacy, impulsivity, and suicidal ideation were evaluated by the x2 test, Kolmogorov-Smirnov test, Shapiro-Wilk test, Mann-Whitney U test using the SPSS program. Results: The experimental group showed a significant difference in abstinence self-efficacy (U=54.50, p<.001), impulsivity (U=88.00, p<.001) and suicidal ideation (U=77.50, p<.001) compare to the control group. Conclusion The multidisciplinary relapse prevention program was effective in improving abstinence self-efficacy, impulsivity, and suicidal ideation. It is essential to develop optimal nursing interventions for patients with substance use disorders to prevent relapse.

No abstract available.
Granuloma, Foreign-Body*

No abstract available.
Exostoses* ; Toes*

No abstract available.
Exostoses* ; Toes*

Given that Kawasaki disease (KD) can cause cardiac complications, it is crucial to diagnose and treat the disease in the emergency department. We report a case of a 10-year-old girl who presented to the emergency department with cervical lymphadenopathy and fever. The initial diagnosis was retropharyngeal abscess based on computed tomography findings, but antibiotic therapy failed and she was subsequently diagnosed with KD. After 3 doses of intravenous immunoglobulin along with methylprednisolone and methotrexate, she was discharged on hospital day 21. The cervical lymphadenopathy suggesting retropharyngeal abscess might be an early sign of incomplete or intravenous immunoglobulin-resistant KD.
Child* ; Diagnosis* ; Emergency Service, Hospital ; Female* ; Fever* ; Humans ; Immunoglobulins ; Lymphatic Diseases* ; Methotrexate ; Methylprednisolone ; Mucocutaneous Lymph Node Syndrome* ; Neck Pain ; Retropharyngeal Abscess* ; Vasculitis

BACKGROUND: Scoring of atopic dermatitis has been a rather controversial issue in recent years, with scoring systems of varying complexity being advocated by different investigators. OBJECTIVE: It was the aim of this study to compare two of the most commonly used scoring methods in a clinical setting. METHODS: Fifty-eight patients diagnosed as having atopic dermatitis were evaluated using the Rajka & Langeland grade and the SCORAD, and the two scoring systems were compared with respect to the presence or absence of clinical and laboratory parameters of atopic dermatitis. RESULTS: The patients were composed of 22 males and 36 females, with an average age of 7.1 years. The average Rajka & Langeland grade was 6.1 (maximum, 9) and the SCORAD, 42.6 (maximum, 103). In both systems, the majority of the patients belonged to the moderate group; however, there was a relatively poor agreement between the two scoring systems in the assessment of overall severity of atopic dermatitis (kappa = 0.267). The SCORAD was better cor- related with the clinical and laboratory parameters, such as associated diseases, family history, smoking of the mother, contact with animal and high IgE level. CONCLUSION: The two scoring systems cannot be used interchangeably. The Rajka & Langeland grade is more ideal for quick, large surveys, and the SCORAD, for drug-effect studies or follow-up of progression of the disease. The SCORAD is the more useful system in relation to other clinical and laboratory aspects of atopic dermatitis.
Animals ; Dermatitis, Atopic* ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Male ; Mothers ; Research Design* ; Research Personnel ; Smoke ; Smoking