A 69-year-old man presented with annular lichen planus involving both forearms, hand dorsa, wrists, inner sides of the thighs, knees and ankles. He was treated initially with systemic corticosteroids and etretinate, but rernission and recurr ence of the skin lesions were observed. During the follow-up, we found erythrasma on all his toewebs and both soles. After administration of erythromycin for the treatment of erythrasma, lesions of the lichen planus rapidly improved. Five months later, some lesions of lihen planus and erythrasma had recurred. After administration of erythromycin, the lesions of lichen planus improved again. No recurrence was observed for the following 8 months. We suspect that eradication of the chronic focus of infection and the anti-inflammatory effect, of erythromycin may lead to supression of abnormal immunological reactions and resolution of lichen planus.
Acitretin ; Adrenal Cortex Hormones ; Aged ; Ankle ; Erythrasma ; Erythromycin* ; Etretinate ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Knee ; Lichen Planus* ; Lichens* ; Recurrence ; Skin ; Thigh ; Wrist

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

BACKGROUND: Mycosis fungoides(MF) is a form of cutaneous T cell lymphoma with clonal differentiation of helpr' T cell. It has a patch, plaque, and tumor stage. But pathogenetic factors controlling the development and progression of MF are still unclear. Apoptosis plays a major role in developmental biology and homeostasis. The bcl-2 oncogene prolongs ce11 life by inhibiting apoptosis. The mutant pS3 gene induces apoptosis indirectly. Ki-67 antigen is the cell proliferation marker. Recently, it has been shown that the relationships among them are important in the tumorigenesis of the various tumors. OBJECTIVE: The aim of this study was to examine the expression of these genes and apoptotic rate and clarify the relationship among them in the development and progression of MF. METHODS: The eighteen specimens from 8 patients with MF and 10 specimens from benign lymphocytic infiltrating diseases including 5 lichen planus, 3 lupus erythematosus, and 2 contact dermatitis were included. We performed immunoperoxidase staining(LSAB technique) using monoclonal antibodies including bc1-2, p~53, and Ki-67(MIB1). We used ApoptaqTM(Oncor) in situ labelling kit for detecting apoptotic cell.
Antibodies, Monoclonal ; Apoptosis* ; Carcinogenesis ; Cell Proliferation ; Dermatitis, Contact ; Developmental Biology ; Homeostasis ; Humans ; Ki-67 Antigen ; Lichen Planus ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides* ; Oncogenes

Chromosomal abnormalities are higher in twin gestations than in the singleton population. Turner's syndrome(gonadal dysgenesis) variety may result from chromosome loss during gametogenesis in either parent or a mitotic error during one of the early cleavage divisions of the fertilized zygote. The vast majority of 45, XO conceptions result in first or second-trimester miscarriage. Fetuses with Tumer's syndrome commonly exhibit posterior nuchal cystic hygromas and generalized edema. Recently we experienced one fetal demise in twin pregnancy. The affected fetus was associated with Turner's syndrome which was diagnosed by amniocentesis and karyotyping. The fetus was associated with cystic hygroma which was antenatally diagnosed by ultrasonogram. The unaffected fetus had normal karyotype and was delivered through cesarean section without any abnormalities. we report this case with brief review of literatures.
Abortion, Spontaneous ; Amniocentesis ; Cesarean Section ; Chromosome Aberrations ; Edema ; Female ; Fertilization ; Fetus ; Gametogenesis ; Humans ; Karyotype ; Karyotyping ; Lymphangioma, Cystic ; Parents ; Pregnancy ; Pregnancy, Twin* ; Turner Syndrome ; Ultrasonography ; Zygote

No abstract available.
Cell Count* ; HIV* ; Humans ; Panax*

BACKGROUND AND OBJECTIVES: Since allergic fungal sinusitis (AFS) has been described in 1983, only a few cases have been reported in the domestic scientific journals. This leads to alleviate the strict criteria because many patients with allergic mucin and fungal hyphae reveal negative results of allergic skin test or serologic tests for fungal antigens. To classify these patients, the term `eosinophilic fungal rhinosinusitis (EFS)' was first coined in 1999. The objective of this study was to evaluate the clinicopathological features of EFS. SUBJECTS AND METHOD: The authors retrospectively reviewed medical records of 21 patients who had been diagnosed as EFS between June 2002 and November 2003 at the department of otolaryngology, Asan medical center. RESULTS: Chief complaints at first visits were in the order of nasal obstruction, postnasal drip, headache, foul odor, and rhinorrhea. Nasal endoscopic findings showed nasal polyp, purulent discharge, and fungal debris. 14.2% of patients revealed no abnormal findings. All patients had increased intrasinus attenuation at non-contrast media-enhanced CT. 47.6% of patients had complete opacification of maxillary sinus predominantly. No patients had the evidence of type I hypersensitivity for fungal antigens. Twenty patients had undergone endoscopic sinus surgery and surgical specimens proved to have allergic mucin with fungal hyphae. Postoperatively, four patients (20%) had recurrent symptoms and polypoid mucosal changes, which showed responses to short term oral steroid therapy. CONCLUSION: EFS is a frequent type of fungal sinusitis if surgical specimens are carefully examined histologically. Out of patients who received endoscopic sinus surgery, bi-meatal approach for the maxillary sinus lesions, and local steroid therapy, 80% were cured with no sign of relapse. The existence of eosinophilic infiltration and allergic mucin leads us to believe that focal allergic reaction occurs inside the sinus.
Antigens, Fungal ; Chungcheongnam-do ; Eosinophilia ; Eosinophils* ; Headache ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Hyphae ; Maxillary Sinus ; Medical Records ; Mucins ; Nasal Obstruction ; Nasal Polyps ; Numismatics ; Odors ; Otolaryngology ; Paranasal Sinus Diseases ; Recurrence ; Retrospective Studies ; Serologic Tests ; Sinusitis ; Skin Tests

Kerion celsi is an inflammatory type of tinea capitis, which occurs chiefly in children between the ages of 4 and 14 years. We report a case of kerion celsi caused by Trichophyton(T.) mentagrophytes in 69 year-old man, who showed a 8x8 cm sized, erythematous boggy mass with pustules and crusts on the right occipital scalp. Cultures from scalp lesion and infected hair on Sabouraud dextrose agar media showed T. mentagrophytes. Histopathologic findings showed inflammatory cell infiltration in entire dermis and many spores around the hair shaft. The skin lesion was successfully treated with terbinafine (250 mg/ day) for 8 weeks. This case is reported with three interesting facts: Kerion celsi caused by T. mentagrophytes has been rarely reported in Korean literatures; Kerion celsi is occuring in an aged man with decreased cellular immunity after chemotherapy; Kerion celsi caused by T. mentagrophytes responded well to oral terbinafine.
Agar ; Aged ; Child ; Dermis ; Drug Therapy ; Glucose ; Hair ; Humans ; Immunity, Cellular ; Scalp ; Skin ; Spores ; Tinea Capitis* ; Trichophyton*

BACKGROUND: The skin over the lower one third of the nose is less mobile and cannot be easily recruited for the closure of even small defects. In addition, the texture and color of the nose are so unique that neither distant nor nearby skin can always provide a good match. Therefore, when we reconstruct the surgical defect of lower one third of the nose, we must consider the reconstruction method, defect site or size, recurrence of the lesion such as basal cell carcinoma, patient age, general health state, and functional and cosmetic aspects. The bilobed flap is a useful tool for reconstruction of the nose but is occasionally complicated by pincushioning effect or trapdoor deformity. OBJECTIVE: The propose of this study was to evaluate the usefulness of a geometric design of bilobed flap for use in reconstructing defect on the lower one third of the nose. METHODS: From Februrary 1999 to March 2001, we reconstructed defects on the lower one third of the nose after Mohs surgery of basal cell carcinoma in 6 patients using the geometrical design of bilobed flap. Patients were reviewed for complications and cosmetic results. RESULTS: Cosmetically acceptable results were seen in all patients. Significant pincushioning and trapdoor deformity were not presented postoperatively in any patients. CONCLUSION: The geometrical design of bilobed flap is an excellent choice for reconstruction of defects of the lower one third of the nose, particularly around the nasal tip, because of the good skin match and low incidence of complication.
Carcinoma, Basal Cell* ; Congenital Abnormalities ; Humans ; Incidence ; Mohs Surgery* ; Nose* ; Recurrence ; Skin

Subcutaneous island pedicle flap is based on the basic principle of V-Y advancement and closure. This advancement flap involves the isolation of a segment of skin as an island disconnected from the peripheral epidermal-dermal attachment. Subcutaneous island pedicle flap offers several distinct advantages over various transposition flap and skin graft. Moreover its design and execution are straightforward, being a conceptual extension of the elliptical excision technique. Four cases of malignant tumors on the face were removed by Mohs surgery, followed by reconstruction of defects with subcutaneous island pedicle flap. In our cases, there were no significant complications and the results were cosmetically acceptable. Subcutaneous island pedicle flap is a simple and satisfactory alternative for the reconstruction of medium-sized defects in the face.
Mohs Surgery ; Skin ; Transplants

BACKGROUND: Many factors have been implicated in the etiology of varicose veins. Among them, the most widely advanced are weakness of the vascular wall due to defective smooth muscle and connective tissue metabolism, dysfunction of the endothelium, valvular incompetence, and hemodynamic stress. However, the etiology remains unclear. OBJECTIVE: This study was performed to analyze the wall structure and composition changes of primary varicose veins of the legs. METHODS: Varicose vein samples were collected from 13 patients having primary varicose veins who underwent ambulatory phlebectomy. Control veins(below the age of 50 years) were collected from 2 patients with no history or clinical evidence of varicose vein. Samples were stained with hematoxylin and eosin, Masson's Trichrome, Van Gieson stains and immunohistochemical stains for collagen type IV, alpha-smooth muscle actin antigen were performed. Tissue samples were examined by light microscopy for comparative histological changes and different components of the varicose vein wall as compared to control veins. RESULTS: In the varicose vein, there was intimal hypertrophy in almost all the sections examined. The thickness of intima varied at different places. There were hyperplasia of smooth muscle cell and collagen in the varicose vein. Collagen type IV exhibited an accumulation especially in the subendothelial region of varicose vein. CONCLUSION: Dilatation and varicosities are not due to deficiency in the vein wall components, but rather to hemodynamic response. Modulation in the extracellular proteins may be the cause for the development of varices.
Actins ; Collagen ; Collagen Type IV ; Coloring Agents ; Connective Tissue ; Dilatation ; Endothelium ; Eosine Yellowish-(YS) ; Hematoxylin ; Hemodynamics ; Humans ; Hyperplasia ; Hypertrophy ; Leg* ; Metabolism ; Microscopy ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Varicose Veins* ; Veins