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

Supernunmerary nipple is a developmental anomaly occuring alon, the course of the embryological milk lines. This entity has receieved little attention in the dermatologic literature and has been confused with a pigmented nevus in some cases. We have experienced two ease of the more unusual form of supern umerary nipple. According to the Kajavas classification, our caes are classified as polithelia pilosa and complete breast with nipple.
Breast ; Classification ; Milk ; Nevus, Pigmented ; Nipples*

BACKGROUND: Although the histologic picture of epidermolytic hyperkeratosis is diagnostic for bullous congenital ichthyosiform erythrokerma (BCIE), it is not specific for it. It is found also in several other conditions, that is, linear epidermal nevus, epidermolytic keratisis palmaris et plantaris and epidermolytic acnthoma. Among these, BCIE is caused by mutations of the defferentiation s0pecific keratins K1 and K1-. These mutations produce a weakened cytoskeleton that is prone to collapse resulting I cell fragility and lysis. But the pathogenesis of epidermal nevus showing the similar histologic feature with BCIE is not known. OBJECTIVE: The purpose of our study is to conpare the electron microscopic picture and the immunohistochemical features, and to find the possible pathogenesis of both diseases. METHODS: We evaluated the clinical, histopathologic nd electron microscopic features of 5 BCIE cases and 14 epidermal nevus cases which were histologically diagnosed with epidermolytic hyperkeratosis at the department of dermatology at Wonju Christian Hospital, Shinchon Severance Hospital and Yongdong Severance Hospital, from January 1981 to June 1994. The immunohistochemical staining(PAP method) using monoclonal antibody against cytokeratin was performed on BCIE and epidermal nevus. RESULTS: Light microscopy of both BCIE and epidermal nevus showed the same histologic changes including hyperkeratosis, increased keratohyaline granules, acanthosis and perinuclear vacuolization of upper malpighia layer. Electron mioroscopic findings in both diseases were similar. Aggregation of tonofilaments is noted in the squamous cells, but is not evident in basal cells.In immunohistochemical study of both diseases, 34betaE12 is stained in the whole epidermis and is stuonger ex0ressed in the basal layer tan suprabasal layers. LP34 staining is evident in suprabasal cell layers up to the cornified cell layer. CONCLUSION: Electron microscopy and immunohistochemical study of both diseases showed the same finding. We thind that a defect in the differentiation specific keratins, K1 and K10 is perhaps involved in epidermal nevus histologically showing epidermolytic hyperkeratosis as in BCIE.
Cytoskeleton ; Dermatology ; Epidermis ; Gangwon-do ; Hyperkeratosis, Epidermolytic* ; Intermediate Filaments ; Keratins ; Microscopy ; Microscopy, Electron ; Nevus* ; Triacetoneamine-N-Oxyl

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

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*

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: The prevalence of skin diseases at a university hospital may not truly indicate their prevalence in the general population; nevertheless, it is the only available source of information. OBJECTIVE: This study aimed to investigate the prevalence of common dermatoses and compare this with previous reports. METHODS: We reviewed 29,477 new outpatients who visited the department of dermatology at Wonju Severance Christian Hospital from 2010 to 2014, and statistically analyzed the findings. RESULTS: Among the 29,477 outpatients, 14,501 (49.2%) were men and 14,976 (50.8%) were women. More patients were in their sixth decade (17.1%) or over 70 years (15.4%), in their seventh decade (13.5%) or in their fifth decade (13.0%), comprising 59% of the total outpatients. The 20 most common dermatoses were found to be urticaria, dermatophytosis, allergic contact dermatitis, other types of eczema, atopic dermatitis, pruritus, verruca, herpes zoster, alopecia, psoriasis, seborrheic dermatitis, drug eruptions, folliculitis, rosacea, benign epidermal tumor, melanocyte nevus, vitiligo, scabies, herpes simplex virus infection, and bacterial infection. In the distribution of dermatoses as disease groups, viral disease (11.2%), atopic dermatitis and eczema (10.7%); contact dermatitis and drug eruption (10.3%); erythema and urticaria (8.4%); fungal disease (7.6%); skin appendage disease (6.9%); seborrheic dermatitis, psoriasis, and pustular dermatoses (5.5%); epidermal nevi, neoplasms, and cysts (4.8%); pruritus and neurocutaneous dermatoses (4.6%); and acne (3.8%) constituted 73.8% of the total. CONCLUSION: Compared to the previous studies in the same area, the distribution of skin diseases was similar. The increasing tendency of older individuals with diseases in Gangwon province has persisted since 2000.
Acne Vulgaris ; Alopecia ; Bacterial Infections ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Dermatology ; Drug Eruptions ; Eczema ; Erythema ; Female ; Folliculitis ; Gangwon-do* ; Herpes Zoster ; Humans ; Male ; Melanocytes ; Nevus ; Outpatients ; Prevalence ; Pruritus ; Psoriasis ; Rosacea ; Scabies ; Simplexvirus ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Virus Diseases ; Vitiligo ; Warts

Pruritic folliculitis of pregnancy of pregnancy is a specific dermatoses of pregnancy which is characterized by erythematous follicular papules and pustules between the fourth and ninth month of pregnancy. It has usually resolved by 4 weeks of postpartum and has no adverse implications for mother and baby. We report a case of pruritic folliculitis of pregnancy in a 24-year-old primigravida woman who had had monomorphic erythematous follicular papules and pustules on her anterior chest wall and back. Histopathological findings of erythematous papules showed acute folliculitis and perifolliculitis. The skin lesions improved rapidly with 2 weeks of delivery without treatment.
Female ; Folliculitis* ; Humans ; Mothers ; Postpartum Period ; Pregnancy* ; Skin ; Skin Diseases ; Thoracic Wall ; Young Adult

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*