Purpura fulminans may be seen in three different clinical settings: (1) in the neonatal period from protein C and S deficiencies, (2) during severe bacterial infections such as “sepsis-associated” purpura fulminans, and (3) during the convalescence of an otherwise benign “preparatory” infectious disease most commonly involving the skin. We report a case of a 20-month-old male child with purpura fulminans as a presenting sign of disseminated intravascular coagulopathy (DIC). He had suffered from fever of unknown origin for a month. Although purpura fulminans is not a common disorder to dermatologists, the awareness of this disorder may be the clue to diagnose and treat underlying diseases.
Bacterial Infections ; Child ; Communicable Diseases ; Convalescence ; Fever of Unknown Origin ; Humans ; Infant ; Male ; Protein C ; Purpura Fulminans* ; Purpura* ; Skin

We report a case of histiocytoid hemangioma (angiolymphoid hyperplasia with eosinophilia) in a 60 year-old female patient who was effectively treated with dapsone. The therapeutic effect of dapsone may support the hypothesis that immunologically mediated reactive process plays a role in the pathogenesis of histiocytoid hemangioma.
Dapsone* ; Female ; Hemangioma* ; Humans ; Hyperplasia* ; Middle Aged

Infection-induced panniculitis develops either through direct inoculation or as a manifestation of sepsis. However, it has rarely been considered as a disease entity within broader context of panniculitis. Moreover, panniculitis associated with a cardiac abscess without the evidence of sepsis has not been reported. We describe a case of infection-induced panniculitis associated with a cardiac abscess. We suggest that infection should be considered as a potentially important etiology of panniculitis, especially in the case of immunosuppression, and in such a case, meticulous efforts should be done to find the focus of infection.
Abscess* ; Immunosuppression ; Panniculitis* ; Sepsis

BACKGROUND: Actinic granuloma is an annular inflammatory reaction that develops in skin that has had long-term sun-exposure. OBJECTIVES: The purposes of this study were aimed to characterize the clinical and histopathologic features of actinic granuloma. METHODS: Examinations were performed on eight patients with actinic granuloma regarding the age, sex, duration, clinical morphology, distribution, associated diseases, and treatment and course. Histo-pathologic studies of ten specimens obtained from eight patients were performed with special stains, such as Verhoeff-van Gieson, Gomori-Methenamin silver and alcian blue.
Actins* ; Alcian Blue ; Coloring Agents ; Granuloma* ; Humans ; Silver ; Skin

We report a case of Winkelmann granuloma in a 63-year-old man. nstopathological findings of the biopsy specimens from the lesions of the ear, finger and iliac crest area were compatible with Winkelmann granuloma. Winkelmann granuloma is a rare disorder showing an association with systemic immunoreactive disorders. Although our patient did not have any definite systemic disease, he had characteristic clinical and histopathological findings of Winkelmann granuloma, arthralgia, an elevated erythrocyte sedimentation rate, positivity to the rheumatoid factor and antinuclear antibodies. Therefore, we believed that he was strongly suspected to have an unclassifiable systemic immunoreactive disease.
Antibodies, Antinuclear ; Arthralgia ; Biopsy ; Blood Sedimentation ; Ear ; Fingers ; Granuloma* ; Humans ; Middle Aged ; Rheumatoid Factor

Cancer incidence has been increasing steadily and is the leading cause of mortality worldwide. Gastric cancer is still most common malignancy in Korea. Cancer initiation and progression are multistep processes involving various growth factors and their ligands. Among these growth factors, we have studied hepatocyte growth factor (HGF), which is associated with cell proliferation and invasion, leading to cancer and metastasis, especially in gastric cancer. We explored the intercellular communication between HGF and other surface membrane receptors in gastric cancer cell lines. Using complimentary deoxyribonucleic acid microarray technology, we found new genes associated with HGF in the stomach cancer cell lines, NUGC-3 and MKN-28, and identified their function within the HGF pathway. The HGF/N-methyl-N’-nitroso-guanidine human osteosarcoma transforming gene (c-MET) axis interacts with several molecules including E-cadherin, urokinase plasminogen activator, KiSS-1, Jun B, and lipocalin-2. This pathway may affect cell invasion and metastasis or cell apoptosis and is therefore associated with tumorigenesis and metastasis in gastric cancer.

Each eyelid contains two to three rows of lashes with a total of 100 to 150 lashes. The eyelashes form a first strong link in the protective chain of the eyelids, The partial loss of eyelashes is namely encountered by dermatologists. We describe a 31-year-old man with partial alopecia on the left upper eyelid due to chronic rubbing. We would like to call it "friction alopecia".
Adult ; Alopecia* ; Eyelashes ; Eyelids* ; Humans

PURPOSE: We analyzed the therapeutic results of 703 cases of urinary calculi treated using an EDAP-Sonolith Praktis, an electroconductive lithotriptor (ECL). MATERIALS AND METHODS: Between January 2000 and June 2004, 703 patients meeting the study inclusion criteria were treated with an EDAP-Sonolith Praktis. The site and size of the stones, session, auxiliary procedure, success rate, causes of failure, complication, efficiency quotient (EQ) and retreatment were analyzed. RESULTS: The records of 703 patients, in whom urinary calculi were treated by extracorporeal shock wave lithotripsy, using an EDAP-Sonolith Praktis, were retrospectively reviewed. The success rates were 99.3, 92.5, 66.7 and 12.5% for stone sizes < or=9, 10-19, 20-29 and > or=30mm, respectively, with an overall success rate of 95.3%. The EQ, mean number of session and retreatment rate were 0.71, 1.7 and 30.6%, respectively. As auxiliary procedures, double-J stenting, ureteroscopic stone removal and open surgery were performed in 6, 15 and 1, respectively. The complications were gross hematuria, flank pain, steinstrasse, nausea and fever, which were successfully controlled by conservative treatment. CONCLUSIONS: EDAP-Sonolith Praktis, an ECL, is an efficient and safe outpatient procedure for initial urinary calculi treatment.
Fever ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Nausea ; Outpatients ; Retreatment ; Retrospective Studies ; Shock* ; Stents ; Urinary Calculi*

Patients with idiopathic erythroderma have often been regarded to have a pre-Sezary syndrome because some of them have developed a cutaneous T-cell lymphoma during follow-up. Sezary syndrome is a form of leukemia-lymphoma characterized clinically by erythroderma, pruritus, adenopathy, and circulating atypical cells with cerebriform nuclei. We describe a case of Sezary syndrome in a 40-year-old man, who suffered from idiopathic erythroderma for 3 years. We suggest that close and long-term follow-up should be performed on patients with idiopathic erythroderma.
Adult ; Dermatitis, Exfoliative ; Follow-Up Studies ; Humans ; Lymphoma, T-Cell, Cutaneous ; Pruritus ; Sezary Syndrome*

BACKGROUND: The hypereosinophilic syndrome(HES) represents a leukoproliferative process likely caused by a number of disorders, all of which are marked by sustained over-production of eosinophils. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of HES. METHODS: The medical records and hist opathological slides of patients with HES who had skin biopsies performed in our department were reviewed. Criteria for the diagnosis of HES include (1) peripheral blood eosinophilia with eosinophil counts greater than 1,500/L for at least 6 months; (2) no evidence of parasitic, allergic, or other known causes of eosinophilia; and (3) presumptive signs and symptoms of multiple organ involvement. RESULTS: Four male and three female patients were included. HES developed in adulthood or old age (mean, 43.4 years). Because only the patients with cutaneous involvement were included, all the patients showed skin lesions. Heart, liver, stomach, nervous system, lymph nodes, and lung were involved organs in decreasing order of frequency. At the onset of HES, 40 to 80% of white blood cells were eosinophils in peripheral blood. White blood cell count and serum IgE level were elevated in all the tested patients. In six patients (85.7%), the level of serum erythrocyte sedimentation rate was elevated. Persistent hypereosinophilia (>1,500/L) was present for longer than 6 months in all patients. Stool examination and skin test for parasitic infestation all gave negative results. All the patients were not taking any medication. Histopathological examinations revealed perivascular mixed inflammatory cell infiltration; predominantly eosinophils in the stomach, liver, and nerve as well as in the skin. Interestingly, two patients who were presented with skin lesions showed the findings of eosinophilic vasculitis. In these patients, the skin lesions were consisted of Raynaud's phenomenon, digital gangrene, and several erythematous plaques. The most common cutaneous manifestations were papules and nodules on the extremities. The main treatment modality was systemic steroid. Except for one patient presented with central nervous system involvement of HES, all the patients were in a well-controlled state. In one patient with the typical clinical and hematologic features of HES, Hodgkin's disease followed. After the complete remission of Hodgkin's disease with chemotherapy, HES subsided. CONCLUSIONS: HES is a heterogenous collection of disorders marked by hypereosinophilia and organ damage. Most common cutaneous manifestations were papules and nodules on the extremities. Raynaud's phenomenon and digital gangrene can be the primary manifestation of HES in which cases cutaneous lesions showed eosinophilic vasculitis. Five patients (71%) responded well to systemic steroids. HES may be a herald of malignancy such as Hodgkin's disease. Further investigation will be mandatory ro elucidate the etiology and pathogenesis of HES.
Biopsy ; Blood Sedimentation ; Central Nervous System ; Diagnosis ; Drug Therapy ; Eosinophilia ; Eosinophils ; Extremities ; Female ; Gangrene ; Heart ; Hodgkin Disease ; Humans ; Hypereosinophilic Syndrome* ; Immunoglobulin E ; Leukocyte Count ; Leukocytes ; Liver ; Lung ; Lymph Nodes ; Male ; Medical Records ; Nervous System ; Skin ; Skin Tests ; Steroids ; Stomach ; Vasculitis