A 4-year-old boy has had a solitary sclerotic depressed plaque on the right anterior chest since birth. The histopathologic findings are consistent with morphea profunda: thickening, hyalinization, and homogenization of collagen bundles in the dermis and subcutaneous tissues, admixture with a prominent lymphocytic and plasma cell infiltrate, and sweat glands en-trapped between the thickened collagen bundles. We report a case of congenital solitary morphea profunda.
Child, Preschool ; Collagen ; Dermis ; Humans ; Hyalin ; Male ; Parturition ; Plasma Cells ; Scleroderma, Localized* ; Subcutaneous Tissue ; Sweat Glands ; Thorax

Isolated pulmonary stenosis, a relatively common congenital anomaly that accounts for about 10 percent of all congenital heart disease, is characterized by stenosis of pulmonary valve itself, infundibulum or both of them. Since cardiac catherterization was applied to man by Cournand and Ranges, pulmonary stenosis had been easily diagnosed and many clinical studies had been investigated. It has a wide clinical spectrum depending on the degree of stenosis. The electrocardiogram, phonocardiogram and chest X-ray have proved useful in estimating the severity of hemodynamic facotrs in individual cases. This series comprises 47 cases in whom the clinical diagnosis of isolated pulmonary stenosis was confirmed by right heart catheterization with cardiac cineangiography at Severance Hospital, Yonsei University. An attempt was made to correlate the electrocardiographic, phonocardiographic, chest X-ray findings, and types of stenosis with the hemodynamic data in these cases. 1. Of 47 patients, 33 were male and 14 female. Their ages ranged from 2 to 42 years: the mean age was 19.1 years. 2. The incidence was 5.9 percent of all 797 catheterized congenital heart disease cases. The pulmonary valvular stenosis was 30 (68.3%), infundibular 7 (14.6%) and combined 10 (21.6%) cases. 3. The correlation between electrocardiogram and hemodynamic data were as follows. i) The regression equation between right ventricular sysytolic pressure (RVSP) and height of R wave in V1 lead (RV1) was RVSP=3.32 RV1+48.2: its correlation coefficient was 0.818 and it was very significant (p=0.000). ii) The higher the RVSP, the more the frontal axis of QRS complex shifted to the right side (r=0.55. p=0.001). iii) The RVSP of the groups with positive ECG findings such as p-pulmonale, right ventricular hypertrophy or right ventricular strain were much higher than the RVSP of the groups without such findings (p=0.032.0.000, 0.000). iv) The group with RV1 higher than 20 mm showed much more elevated mean of RVSP than the group with lower RV1 (p=0.000). v) The groups with the above mentioned positive ECG findings showed good correlation with the severity of RVSP which was arbitrarily classified as 49 or less, 50~100, and 100 mmHg or more (chi-square=8.96, 26.69, 19.06; p=0.011, 0.000, 0.000). 4. The group with late occurrence of the maximum intensity of the ejection systolic murmur showed higher mean of RVSP than the group with early peak of the murmur (p=0.014). 5. The means of RVSP of the groups with chest X-ray findings such as decreased pulmonary vascularity, were much higher than the means of RVSP of the groups without such findings (p=0.000, 0.005, 0.015). The groups with above mentioned positive chest X-ray findings showed good corelations with the severity of RVSP which was classified as above limits (chi-square=7.55, 10.94, 13.36; p=0.022, 0.004, 0.001). 6. Combined pulmonary valvular and infundibular stenosis showed more severe systolic pressure gradient and higher mean of RVSP than the isolated types (p=0.000).
Axis, Cervical Vertebra ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Electrocardiography ; Female ; Heart Defects, Congenital ; Hemodynamics* ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pulmonary Valve ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Thorax

No abstract available.
Skin*

BACKGROUND: Acne is a relatively common disorder, especially in the adolescent. The condition is characterizecl by comedones, papules and pusi:ules. Acne patients frequently wash their face. Cleansing with an effective agent is therapeutic and preventive for patients suffering from acne vulgaris. OBJECTIVE: The study was designed to compare thc efficacy and safety of a facial clemser consisting of 1% triclosan and 0.5% Ku Shen and a in in the treatment of facial acne vulgaris. METHODS: The study was camed out on two groups of people: a treatment and a control group. Efficacy and safety were assessed at baseline and at weeks 1, 2, 3, 4, 6, 8, 10 and 12. Efficacy was determined by investigating counts of non-inflamatory open and closed comedones, and inflamatory papules and pustules. Global improvement was also assessed. RESULTS: At week 12, the mean counts in the differe,nt lesions were as follows; 11.2 versus 17.2 for total lesions (p<0.05); 9.4 versus 11.3 for non-inflammatory lesions (p<0.05); 1.8 versus 5.9 for inflammatory lesions (p<0.05) in the treatment and control group, respectively. A Statistically significant difference was observed in patients overall self-assessment (p<0.05). The Group applying the facial cleanser with 1% triclosan and 0.5% Ku Shen felt significantly better than the one applying the control facial cleanser. Some patients developed mild and transient local side effects. CONCLUSION: Cleansing three times a day with a facial cleanser consisting of l% triclosan and 0.5% Ku Shen was found to be effective ancl safe for patients suffering from acne vulgaris.
Acne Vulgaris* ; Adolescent ; Dronabinol ; Humans ; Self-Assessment ; Triclosan*

BACKGROUND: Topical irritants disrupt the cutaneous permeability barrier through the removal of stratum comeum lipids. This perturbation of barrier integrity stimulates a variety of homeostatic repair responses that ultimately result in the normalization of bamer function. Object To measure the effect of desoxymethasone ointment, vaseline and hydrobase on the barrier recovery of benzalkonium chloride (BKC) imtated skin. MATERIALS AND METHODS: The left flank skin of 2-3 monthold hairless mice was treated with BKC and then desoxymethasone ointment, vaseline and hydrobase were applied. Transepidermal water loss (TEWL) was checked after 0, 3, 6, 9, 12, 15, 18, 21 and 24 hours. Electron microscopic examination was performed after 3 and 24 hours after desoxymethasone, vaseline and hydrobase had been applied. RESULTS: The recovery of TEWL was most prominantly observed in the desoxymethasone ointment treated group followed by vaseline and hydrobase. Electron microscopic examination using ruthenium tetroxide fixation revealed that secretion and numbers of lamellar bodies and complete formatice of lipid bilayers were most prominent at desoxymethasone ointment and vaseline treated group. CONCLUSION: Desoxymethasone ointment, vaseline and hydrobase can be good agents in improving bamer recovery after exposure to irritant material.
Animals ; Benzalkonium Compounds* ; Desoximetasone* ; Irritants ; Lipid Bilayers ; Mice ; Mice, Hairless* ; Permeability ; Petrolatum* ; Ruthenium ; Skin*

We report a interesting case of acral lentigenous malignant melanoma associated with pseudocarcinomatous hyperplasia in a 65-year-old women A skin lesion showed a 5 x 5cm sized, black colored protruding mass with ulcerative surface on the right great toe for the last 10 years. Histopathological findings reveled hyperplasia of epidermis and the epithelium of the upper protion of the adnexa admixed with a proliferation of atypical epitheloid melanocytes that involved the mid and lower portion of the epidermis and the papillary dermis. There were dyskeratotic cells and pseudohorn cysts between the aggregates of atypical melanocytes. Immunhistochemical staining revealed that the nucleus and cytoplasm of the atypical epitheloid cells were strongly positive for S-100 protein and negative for keratin. Keratin staining revealed aggregates of positively stained kertinocytes with dyskeratosis and pseudohorn cysts admixed and trapped among negatively stained atypical melnocytes. A unusual case of malignant melanorna associated with pseudocarcinomatous hyperplasia in which conventional hematoxylin and eosin stained sections were difficult to differentiation between malignat melanoma and squamous cell carcinoma. Immunohistochemical staining for S-100 protein and keratin were essential in establesging the correct diagnosis.
Aged ; Carcinoma, Squamous Cell ; Cytoplasm ; Dermis ; Diagnosis ; Eosine Yellowish-(YS) ; Epidermis ; Epithelium ; Female ; Hematoxylin ; Humans ; Hyperplasia* ; Melanocytes ; Melanoma* ; S100 Proteins ; Skin ; Toes ; Ulcer

BACKGROUND: Xerosis is a relatively common disorder, especially in the elderly. The condition is characterized by fine scaling and is associated with generalized pruritus. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy, safety and tolerability of Zalsming cream in patients with xerosis and pruritus. METHODS: Thirty patients were treated with Zalsming cream. Clinical efficacy, as measured by the score of subjective symptom and objective signs, transepidermal water loss(TEWL) and electron microscopic finding, were asessed at 2, 4, and 6 weeks after topical application of the cream. RESULTS: The scores of clinical signs and TEWL showed statistically significant improvements. No one developed any local or systemic side effects. CONCLUSION: Topical application of Zalsming cream was found to be effective and safe for patients suffering from xerosis and pruritus.
Aged ; Humans ; Pruritus*

BACKGROUND: Bentonite clay, which is a major component of mud pack, has been used for various purposes in cosmetics. Glycolic acid is known to be effective in the treatment of acne. Al-though those products are used widely, information on the mode of action and effects on the skin are little and controversial till now. OBJECTIVE: To investigate whether bentonite alone, or bentonite with glycolic acid in mixed formulation affect the stratum corneum leading to alteration on cutaneous barrier function and whether those products alter the lipid lamellae and desmosomes of corneocytes. MATERIALS AND METHODS: Mud pack-type ointment of bentonite, bentonite and 5% glycolic acid formulation, bentonite and 10% glycolic acid formulation were applied on the volar fore-arm of the five healthy men and flank skin of five 6-8 week old hairless mice. Transepidermal water loss and capacitance were measured. Electron microscopic examination after ruthenium tetroxide postfixation was performed on the flank skin of the mice. RESULTS: Transepidermal water loss(TEWL) increased immediately and normalized 4 to 6 hours later after removal of vapor permeable membrane in both mouse and human. Capacitance did not show any evidence of change in the water content of the stratum corneum. Electron microscopic examination revealed that lipid lamellae and desmosome of corneocytes were not de-graded, but lamellar body secretion and partially electron-lucent material was-increased in 10% glycolic acid and bentonite mixture-treated area. CONCLUSION: Barrier function of stratum corneum is not disturbed by bentonite and glycolic acid formulations at the concentration used. Barrier structures are not disrupted, but lamellar body secretion and partially electron-lucent material was increased by bentonite and glycolic acid formulations at higher concentration.
Acne Vulgaris ; Animals ; Bentonite* ; Desmosomes ; Humans ; Male ; Membranes ; Mice ; Mice, Hairless ; Mud Therapy ; Ruthenium ; Skin ; Water

We report a case of herpes zoster with generalized varicelliform eruption. A 56-year-old male presented with rice-sized erythematous grouped ruptured or crusted vesicles with a band-like distribution on the left chest and back and generalized rice-to-pea-sized erythematous vesicles on his whole body. Histologic examination revealed ballooning degeneration and multi-nucleated giant cells in the epidermis and leukocytoclastic vasculitis in the dermis.
Dermis ; Epidermis ; Giant Cells ; Herpes Zoster* ; Humans ; Male ; Middle Aged ; Thorax ; Vasculitis

A case of multiple trichilemmal cysts (TC) is presented. TC is known to be a kind of keratinous cyst with lining cells showing trichilemmal keratiniration. A 63-year-old female patient presented with a 30 year duration of increasing in size and number of twenty five nodular lesions on the scalp. All twenty five TC on the scalp were totally excised and examined microscopically. However, the evidence of proliferation or malignant change like the previous case reports was not found in our case.
Female ; Humans ; Middle Aged ; Scalp