Basal cell carcinoma (BCC) is one of the most commonly diagnosed malignant skin tumors and develops characteristically on sun-exposed areas, such as the head and neck. Ultraviolet light exposure is an important etiologic factor in BCCs, and BCCs arising from non-sun- exposed areas are, therefore, very rare. In particular, the axilla, nipple, the genital and perianal areas are not likely to be exposed to ultraviolet light; thus, if BCC develops in these areas, other predisposing factors should be considered. Herein, we report a case of BCC arising on the pubic area in a 70-year-old man. We also performed a survey of the literature and discussed the 19 cases of BCC from non-sun-exposed areas reported to date in Korea.
Aged ; Axilla ; Carcinoma, Basal Cell ; Head ; Humans ; Korea ; Neck ; Nipples ; Skin ; Ultraviolet Rays

Immobilization of skin grafts on the recipient bed is essential for graft survival. There are several methods of securing skin grafts to the recipient wound bed. Classically, nylon basting sutures and a tie-over bolster dressing are commonly used. This method is currently recognized to ensure that the full thickness skin grafts "take"; however, this method is complicated and time-consuming. Moreover, suturing in this manner may also pull the edges of the skin with too much tension, cause elevation and crater-like deformity and suture marks. We experienced two cases of sutureless Burow's graft using skin tapes to reconstruct a skin defect after Moh's micrographic surgery. Instead of the conventional method, the Steri-strip(R) was used to fix the graft and a light compressive dressing with dry gauze and Tegaderm(R) was applied over the graft. This method has the advantage of being convenient to apply and remove, time-saving and inexpensive. Therefore, we recommend the use of the sutureless method using skin tape as an alternative to suturing small skin grafts, and particularly for the relatively immobile areas on the face.
Adhesives ; Bandages ; Congenital Abnormalities ; Dietary Sucrose ; Graft Survival ; Imidazoles ; Immobilization ; Light ; Mohs Surgery ; Nitro Compounds ; Nylons ; Skin ; Surgical Tape ; Sutures ; Transplants

Malignant skin tumors, including squamous cell carcinoma and malignant melanoma, have occurred in tattoos. Seven documented cases of basal cell carcinoma associated with tattoos have also been reported in the medical literature. We encountered a patient with basal cell carcinoma in a tattooed eyebrow. We report on this case as the eighth reported case of a patient with basal cell carcinoma arising in a tattooed area.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Eyebrows ; Humans ; Melanoma ; Skin

BACKGROUND: Nalbuphine is one of the opioid agonist-antagonists and is used frequently in the anesthetic field. Usage is focused on potent analgesic action and the adjuvant of narcotics because of less complications with preserved analgesia. The most common routes of administration for postoperative pain control are epidural and intravenous, so we compared both pharmacokinetic profiles. METHODS: Twelve patients were randomly divided into two groups. All patients were given a spinal anesthesia with tetracaine hydrochloride. One group (n = 6) received nalbuphine 10 mg via epidural route and another group (n = 6) received the same dose via intravenous route. Venous blood was drawn at 0, 0.25, 0.5, 1, 2, 4, 6 and 8 hours to measure plasma nalbuphine concentrations. Analysis was performed by high performance liquid chromatography with an electrochemical detector. RESULTS: At 0.25 hour, the plasma concentration of nalbuphine was significantly higher in the epidural administration group (49.48 +/- 4.98 ng/ml) than in the intravenous administration group (40.44 +/- 1.64 ng/ml). At 6 and 8 hours, the plasma concentration of nalbuphine was significantly higher in the epidural administration group (5.98 +/- 1.86 ng/ml, 3.85 +/- 0.94 ng/ml) than in the intravenous administration group (3.80 +/- 0.33 ng/ml, 2.43 +/- 0.32 ng/ml). Clearance, elimination half life, volume of distribution and AUC were not significantly different between the two groups. CONCLUSIONS: The plasma concentrations of nalbuphine via epidural route and intravenous route were similar in both groups after 0.25 hour to 6 hours. At 0.25 hour and after 6 hours, the epidural administration group had a higher plasma concentration of nalbuphine than the intravenous administration group.
Administration, Intravenous* ; Analgesia ; Anesthesia, Spinal ; Area Under Curve ; Chromatography, Liquid ; Half-Life ; Humans ; Nalbuphine* ; Narcotics ; Pain, Postoperative ; Plasma* ; Tetracaine

BACKGROUND: Basal cell carcinoma in Korea is the most common skin cancer and its incidence is increasing at a steady rate. It is not unusual for dermatologists to experience the recurrence of tumor after surgery but there is no data on recurrent basal cell carcinoma in Korea. OBJECTIVE: The aim of this retrospective survey was to determine the clinical and histopathological characteristics of recurrent basal cell carcinoma after surgical excision in Korean patients. METHODS: We analyzed clinical findings and histopathologic subtypes of 21 cases of recurrent basal cell carcinoma after surgical excision among 480 cases diagnosed between January of 1980 and December of 2006 at the Department of Dermatology, Chonbuk National University Hospital. RESULTS: Overall recurrence rate was 4.38%. The average interval between the surgical excision of the primary tumor and recurrence was 40.8 months. The mean age of the patients was 65.1 years old and the ratio of men to women was 1 : 2. The most frequent location of the tumor recurrence was the nose and the mean size was 1.2 cm. There were no immunocompromised patients with underlying disorders, but two patients had taken corticosteroid for an extended period of time. The most common histological subtype of the primary and the recurrent basal cell carcinoma was nodular type. Six cases of primary basal cell carcinomas of nodular type transformed to aggressive subtype when they recurred. Perineural involvement of the primary basal cell carcinoma was found in 5 cases. CONCLUSION: This study demonstrates the clinicopathological features of recurrent basal cell carcinoma in the Korean population and we hope this data would be of help to dermatologists when treating Korean patients with basal cell carcinoma.
Carcinoma, Basal Cell ; Dermatology ; Female ; Humans ; Immunocompromised Host ; Incidence ; Korea ; Male ; Nose ; Recurrence ; Retrospective Studies ; Skin Neoplasms

Primary cutaneous cryptococcosis is isolated cutaneous cryptococcosis without evidence of systemic involvement. It usually presents as a solitary nodule in an exposed area, such as head and neck or extremities, and the occurrence of primary cutaneous cryptococcosis in the covered area has been rarely reported in the literature. A healthy 81-year-old immunocompetent woman presented with a solitary reddish scaly plaque on her abdomen without clinical evidence of systemic cryptococcal infection. Histopathologic examination showed numerous encapsulated spores, and the organism was identified as Cryptococcus neoformans in a series of fungal studies. We diagnosed this case as a primary cutaneous cryptococcosis by the findings mentioned above. The patient was successfully treated with surgical excision and oral fluconazole without any side effects.
Abdomen* ; Aged, 80 and over ; Cryptococcosis* ; Cryptococcus neoformans ; Extremities ; Female ; Fluconazole ; Head ; Humans ; Neck ; Spores

OBJECTIVES: This study aimed to estimate the completeness of cancer registration with Capture-recapture method. METHODS: The study was conducted in the population based cancer registry of Kwangju, Korea, for which there are three main sources of notification: reports by Korean Central Cancer Registry, reports by pathology data, and the others reports by radiology data, death certificates, etc. The defined cases in three sources were matched by 13 digits Resident Register Number. To derive an estimates, log-linear models were applicated. RESULTS: Overall completeness was estimated to be around 93%. There was some variation with age(consistently high levels below age group 60-74 years, a minimum of 88.6% above 75 years). Among the most common cancer sites, estimates of completeness were highest for thyroid cancer(97.1%), while lower estimates of completeness were derived for stomach cancer(92.3%), liver cancer(92.6%). CONCLUSIONS: Careful application of Capture-recapture method may provide an alternative to traditional approaches for estimating the completeness of cancer registration in Kwangju city.
Death Certificates ; Gwangju ; Humans ; Korea ; Linear Models ; Liver ; Pathology ; Stomach ; Thyroid Gland

OBJECTIVES: This 3-year longitudinal study was conducted to evaluate the influence of self-rating health perception on health care utilization and all cause-death risk. METHODS: The hypothesis was tested using a community-based samples, among which subjects 3,414 were interviewed in 1995. Self-rating health perception was assessed by single-item question. Three components of health care utilization amount(number of visits, number of medications, yearly health care expenses) per year were measured using medical insurance data during 3-year follow-up period among subjects in district health care insurance. There were 123 deaths from all causes among 3,085 subjects interviewed. RESULTS: The results showed that those who had poor health perception revealed more increases in the amount of health care utilization than good health perception group (p<0.05). After adjusting for age and sex, the poor health perception group had higher death risk over 3 years than good health perception group(hazard ratio=1.88). but, after adjusting health care utility, supplementary, was not significant. CONCLUSION: These results suggest that self-rating health percep-tion was associated with difference in health care utilization and all cause-death risk.
Delivery of Health Care* ; Follow-Up Studies ; Insurance ; Longitudinal Studies

Halo nevus is a pigmented nevus surrounded by a round or oval depigmentation. Of patients with halo nevus, 18 to 26% patients have vitiligo, either involving the nevus or at a distant site. While the exact etiology of halo formation and vitiligo is unknown, several theories suggest that common immunologic mechanisms are involved in the destruction of melanocytes of both phenomena. Unlike common melanocytic nevus, congenital nevus associated with both halo formation and concurrent extralesional vitiligo is very uncommon and only one case has been reported in the Korean dermatological literature. A 19-year-old female presented with surrounding depigmentation around a congenital hairy nevus on the left forearm. Simultaneously, vitiligo appeared on the lowerabdomen and surrounding regions of both areola. The halo depigmented lesion around congenital nevus and the periareolar vitiliginous lesion shared some histological and immunohistochemical features. These findings further support common immunological mechanisms of pigment destruction in both phenomena.
Female ; Forearm ; Humans ; Melanocytes ; Nevus ; Nevus, Halo ; Nevus, Pigmented ; Vitiligo ; Young Adult

BACKGROUND: There are various methods of reconstruction of cutaneous surgical defect after removal of skin tumor, and skin graft is frequently used. Classically, in full-thickness skin graft (FTSG), nylon basting sutures with a tie-over bolster dressing are used in securing skin graft to the recipient wound bed, but this method is complicated, time-consuming, and may cause complications. OBJECTIVE: The aim of this study was to evaluate the usefulness of an adhesive skin tape (Steri-strip(R)) for securing a graft without suture when performing a Burow's skin graft, one of the types of FTSG. METHODS: We conducted a case-controlled retrospective study. A total of 45 patients (total 46 cases) treated with Burow's skin graft after removal of skin tumor between May 2006 and August 2010 were enrolled in this study, and grafts were secured with Steri-strip(R) (case, n=26) or conventional tie-over bolster dressings (control, n=20). The cosmetic results were scored at 1, 3, and 6 months after the operation. Also, the size and depth of the defect were measured and the run-time of the operation for the skin graft was checked. RESULTS: The operation time for the Steri-strip(R) group was significantly less than for the conventional tie-over bolster dressing group (p<0.001). No significant differences were observed between the groups with regards to age, sex, location, size, depth of the defect, prevalence of complications, and scored cosmetic results at 6 months after operation (p>0.05). CONCLUSION: Sutureless Burow's graft with skin tape required less time than the conventional method with a similar cosmetic result. Thus we suggest that sutureless Burow's graft with skin tape may be an easy and useful method to reconstruct the defect after skin surgery.
Adhesives ; Bandages ; Case-Control Studies ; Cosmetics ; Dermatologic Surgical Procedures ; Humans ; Nylons ; Prevalence ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Surgical Tape ; Sutures ; Transplants