BACKGROUND: Calcinosis cutis may occur when connective tissue is abnormal (dystrophic), or where calcium or phosphate levels in the blood are high(metastatic); alternatively, there may be no obvious underlying cause(idiopathic). The exact incidence of calcinosis cutis in dermatologic patients is not well-kniown and the pathomechanism of it remains to be elucidated. OBJECTIVE: This study was performed to analyze the incidence, clinical and histopathological features of calcinosis cutis. METHODS: We studied 72 patients with calcinosis cutis who visited our department between January 1985 and December 1996. The patients were classified into 3 types (dystrophic, metastatic, and idiopathic) and were analyzed clinically and histopathologically. Results : The results were summerized as follows; 1. There were 60 cases(83.3%) and 12 cases(16.7%) of the dystrophic and idiopathic types, respectively but the metastatic type was not observed. The frequency of dystrophic calcification in individual disorders was 88.2% in pseudoxanthoma elasticum, 66.7% in trichilemmal cyst and dermatomyositis, and 64.6% in pilomatrichoma. 2. In the idiopathic type, it was common in females aged over 50 years and the mean duration of lesions was 2.8+/-2.0 years. The predilection site was the flank(5 cases) and most of the lesions(7 cases) showed skin-colored nodules 3. Histopathologically, calcified material of the idiopathic type was located predominently in the dermis(10 cases) and was present as large masses surrounded by a foreign body reaction. 4. In the dystrophic type, calcified deposits were noted predominently within the shadow cells of pilomatricoma, in the degenerated elastic fibers of pseudoxanthoma elasticum, and in the keratinized area of basal cell carcinoma, squamous cell carcinoma, trichilemmal cyst, and epidermal cyst. Foreign body reactions with giant cells and mononuclear cell infiltrations were often found around large deposits of calcium. Conclusion : The incidence of calcinosis cutis in dermatologic patients is relatively low, but a variety of disorders can be associated with cutaneous calcification. Therefore, dermatologists should be familiar with the different forms of cutaneous calcification and the dermatoses that manifest them.
Calcinosis* ; Calcium ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Connective Tissue ; Dermatomyositis ; Elastic Tissue ; Epidermal Cyst ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Humans ; Incidence ; Pilomatrixoma ; Pseudoxanthoma Elasticum ; Skin Diseases

No abstract available.
Colitis, Ulcerative* ; Sweet Syndrome* ; Ulcer*

It has been generally assum d that eccrine poroma arises from acrosyringium, the epidermal sweat duct unit. Eccrine poroma mainly involves the non hairy surfaces of the skin, but it has also been found on hair-bearing areas. One of the characteristics of this structure is absence of melanocytes and melanin granules arnong its cells. However a complete absence of melanocytes and melanin granules in eccrine poroma is not invariable and a few reports of such an occurrence have been presented. The authors report herein a case of unusual and rare eccrine poroma. The eccrine poroma had melanin pigment and melanocytes, was pedunculated and occurred on the parietal scalp which was the unusual site of involvement. The eccrine poroma was also combined with a pedunculated congenital melanocytic nevus on the supraauricular scalp.
Melanins ; Melanocytes ; Nevus, Pigmented* ; Poroma* ; Rabeprazole ; Scalp* ; Skin ; Sweat

Necrolytic migratory erythema is a rare, distinctive, necrotizing cutaneous eruption usually associated with glucagonoma, an alpha-cell tumor of the pancreas. Other clinical features include ane- mia, diabetes mellitus and weight loss. However, it also occurrs without the pancreatic glucagonoma. So this rare condition is called pseudoglucagonoma syndrome, and has been described in association with chronic hepatic diseases, malabsorption with villous atrophy, chronic pancreatitis, celiac sprue, hypoproteinemia and odontogenic infection. We report a case of pseudoglucagonoma syndrome induced by malnutrition without glucagonoma. A 28-year-old Korean female was referred to our department complaining of multiple erythematous, desquamative, crusted and erosive patches on the extremities, and diffuse scalp alopecia for 5 years. She also had perianal erosion, angular cheilitis without glossitis, amenorrhea, axillary and pubic hair loss, and weight loss. Six years previously she had had Whipples operation for a pancreatic solid and papillary neoplasm. The laboratory data showed hypoalbuminemia, essential fatty acid deficiency, diabetes mellitus and slightly high levels of zinc and glucagon. A skin biopsy showed irregular acanthosis, epidermal edema and pallor, dyskeratosis, areas of superficial epidermal necrosis and vascular dilatation of the papillary dermis. The patient improved dramatically after intravenous hyperalimentation and oral intake of mediurn chain triglyceride. For 2.5 years she has taken medium-chain triglycerides without any other treatment, and no side effects on recurrence has been observed.
Adult ; Alopecia ; Amenorrhea ; Atrophy ; Biopsy ; Celiac Disease ; Cheilitis ; Dermis ; Diabetes Mellitus ; Dilatation ; Edema ; Extremities ; Female ; Glossitis ; Glucagon ; Glucagonoma ; Hair ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Malnutrition ; Necrolytic Migratory Erythema* ; Necrosis ; Pallor ; Pancreas ; Pancreatitis, Chronic ; Parenteral Nutrition, Total ; Recurrence ; Scalp ; Skin ; Triglycerides* ; Weight Loss ; Zinc

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

The N-terminal sequence of HIV1 gp41 (amino acid residues 584-623) was known to be the immundominant region of HIV1 gp41 protein. In order to determine epitope for gp41 protein of Korean anti-HIV1 positive sera, multiple antigenic peptides (MAPs) for the sequences corresponding to 584-604, 590-612, 604-623 and 584-618 of HIV1 gp41 were synthesized by solid phase method using Fmoc-Lys (Fmoc)-OH and used as coating antigens for ELISA. The reactivities of the synthetic peptides with Korean HIV1 positive (21 samples) and anti-HIV1 negative sera (22 samples) obtained from healthy blood doner were estimated by an indirect ELISA. MAPs for 584-604, 590-612 and 604-623 of gp41 reacted with 62 %, 100 % and 81 % of Korean anti-HIV1 positive sera tested, respectively. The results suggest that the epitope for HIV1 gp 41 for Korean anti-HIV1 positive sera is located in the region of amino acid 590-612 of gp41. MAP for gp41 (584-618) reacted with all (100 %) of anti-HIV1 positive sera tested, but did not react with anti-HlV1 negative sera. In addition, this MAP reacted stronger with seven samples of anti-HIV1 positive sera of anti-HIV1/2 combo performance panel than the mixture of 584-604, 590-612 and 604-623 of gp41, but did not react with anti-HIV negative serum. The high sensitivity and selectivity of MAP of gp41 (584-618) suggest that this peptide as a coating antigen in an ELISA system will be useful for antibody detection of HIV1.
Enzyme-Linked Immunosorbent Assay ; Epitope Mapping* ; Immune Sera* ; Peptides*

Cutaneous metastasis of the papillary thyroid carcinoma(PTC) is very rare. We report a case of PTC that metastasized to the left fourth fingertip. Its cutaneous appearance was similar to granuloma pyogenicum. A 65-year-old woman who has PTC with regional lymph nodes involvement and pulmonary metastasis complained of a protruding hemorrhagic subungual mass on the left fourth finger for two months. The histopathologic findings showed papillary projections of the tumor cells surrounding the axial fibrovascular stroma and mitotic cells. The tumor cells showed a positive reaction with antithyroglobulin antibody in immunoperoxidase stain. To the best of our knowledge, this is the first case report of PTC that metastasized to the fingertip, and that showed granuloma pyogenicum-like cutaneous lesion at the metastatic site.
Aged ; Female ; Fingers ; Granuloma* ; Granuloma, Pyogenic ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Thyroid Gland* ; Thyroid Neoplasms*

No Abstract Available.
Hyperpigmentation*

We attempted to identify parasite DNA in the biliary stones of humans via PCR and DNA sequencing. Genomic DNA was isolated from each of 15 common bile duct (CBD) stones and 5 gallbladder (GB) stones. The patients who had the CBD stones suffered from cholangitis, and the patients with GB stones showed acute cholecystitis, respectively. The 28S and 18S rDNA genes were amplified successfully from 3 and/or 1 common bile duct stone samples, and then cloned and sequenced. The 28S and 18S rDNA sequences were highly conserved among isolates. Identity of the obtained 28S D1 rDNA with that of Clonorchis sinensis was higher than 97.6%, and identity of the 18S rDNA with that of other Ascarididae was 97.9%. Almost no intra-specific variations were detected in the 28S and 18S rDNA with the exception of a few nucleotide variations, i.e., substitution and deletion. These findings suggest that C. sinensis and Ascaris lumbricoides may be related with the biliary stone formation and development.
Aged ; Aged, 80 and over ; Animals ; Ascaridida/genetics/isolation & purification ; Ascaris lumbricoides/genetics/isolation & purification ; Base Sequence ; Clonorchis sinensis/genetics/isolation & purification ; Common Bile Duct/*parasitology ; DNA, Helminth/*genetics ; DNA, Ribosomal/genetics ; Face/parasitology ; Female ; Gallbladder/parasitology ; Gallstones/*parasitology ; Helminths/genetics/*isolation & purification ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Polymerase Chain Reaction/*methods ; RNA, Ribosomal, 18S/genetics ; RNA, Ribosomal, 28S/genetics ; Sequence Alignment

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci