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

OBJECTIVE: The objectives are to deliver clinicians and researchers in academia the history, ethics, current principles, guidelines and issues of research in child and adolescent psychopharmacology and to identify challenges facing professionals in the field. METHODS: Children as research subjects were exploited and abused until the middle of 20th century. The response to the conduct of unethical research lead to the overprotection of human subjects in biomedical and behavioral research. In the 1990s, increased spending and the introduction of pediatric exclusivity lead to a large increase in pediatric psychopharmacologic research. Despite the increased number of research, concerns exist about methods and bioethics for making new medications available for use in child and adolescent psychiatric disorders. Through literature review and personal experience, concerns and issues surrounding the research in child and adolescent psychopharmacology were discussed. CONCLUSION: To ensure early access of new drugs for treating psychiatric disorders in children and adolescents, we must strengthen our ability to self-assess in the field of research, be familiar with bioethics and be able to address the challenges posed by the restrictive environment governing child and adolescent psychopharmacology research.
Adolescent* ; Behavioral Research ; Bioethics ; Child* ; Ethics ; Humans ; Psychopharmacology* ; Research Subjects

No Abstract Available.
Rosacea*

BACKGROUND: Allergic reactions are known to be associated with symptomatic aggravation of atopic dermatitis. Skin prick tests were used as a routine in vivo screening test for the evaluation of allergic patients. Many tests to detect specific IgE antibody including RAST, FAST and MAST chemilu-minescent assay (MAST-C~LA) were also used. Previous studies revealed that the results of skin prick tests and MAST-CLA were well correlated in patients with asthma, allergic rhinitis and urticaria. OBJECTIVES: The purpose of this study was to evaluate the effectiveness of MAST-CLA compared with skin prick tests in patients with atopic dermatitis. METHODS: We performed the chemiluminescent assay with 35 allergens and skin prick tests with 23 allergens common with allergens used in MAST-CLA in 34 patients with atopic dermatitis. The positive reaction rate of allergens in each test and sensitivity, specificity, efficiency, positive predictive value and negative predictive value of MAST-CLA to the skin prick test were evaluated and MAST net volts of serum total IgE was compared with PRIST.
Allergens ; Asthma ; Dermatitis, Atopic* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Luminescent Measurements ; Mass Screening ; Rhinitis ; Sensitivity and Specificity ; Skin* ; Urticaria

On histological examination, an epidermolytic hyperkeratosis was observed adjacent to follicular papules on the back of a 53-year-old man. It has been reported that incidental epidermolytic hyperkeratosis occur either within various lesion (epidermal neoplasm, melanocytic neoplasm, scars, and inflammatory conditions) or in the normal skin adjacent to the lesion. This patient participated in the Vietnam War for 2 years, and had had contact with defoliants. He was treated for multiple peripheral neuropathies and cerebral infarcts. In keratinocytes, 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD; Agent Orange) contained in defoliating agents is associated with altered patterns of keratinocyte differentiation. So, as a cause of incidental epidermolytic hyperkeratosis, defoliant contact could be suspected.
Cicatrix ; Humans ; Hyperkeratosis, Epidermolytic* ; Keratinocytes ; Middle Aged ; Peripheral Nervous System Diseases ; Skin* ; Tetrachlorodibenzodioxin ; Veterans* ; Vietnam*

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

Plexiform neurofibroma is considered a pathognomic of Von Recklinghousen's disease, which involves the deep and large nerve trunk. These are large irregular nerve fascicles which result from an increase in endoneural matrix within individual nerve facicles, without an increased number of nerve fibers. We experenced a case of Von Recklinghausen's disease in a 24 year-old male who had variable cutaneous skeletal, and CNS lesions. He presented multiple neurofibromas, cafe-au-lait spots, and axillary freckles as common cutaneous lesions of NF-I and giant pigmentation, sacral hypertrichosis, and plexiform neurofibroma as unusual cutaneous lesions. Also he had a scoliosis, bowing deformity of the humerous and wedging deformity of the body of the 5th cervical spine as a skeletal manifestation and cortical calcification in the occipital area as a CNS manifestation.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Humans ; Hypertrichosis ; Male ; Melanosis ; Nerve Fibers ; Neurofibroma, Plexiform* ; Neurofibromatoses ; Neurofibromatosis 1 ; Pigmentation* ; Scoliosis ; Spine ; Young Adult

We present herein a case of pyoderma gangrenosum, which showed good response to cyclosporine therapy. The patient, a 47-year-old man, had suffered from a skin defect on the left anterior chest 2 months before the rapidly spreading pustules and ulcer with an inflammed, irregular undermined border appeared together with a hemorrhagic base which developed on his left anterior chest and upper abdomen. Cyclosporine was given orally in a dose of 150mg three times daily for 2 weeks, and tapering to 100mg three times daily for the next 3 weeks. Clinical improvement was observed after 14 day's treatment and all the skin lesions were replaced by granulation tissue with epithelialization after 35 day's treatment. After the 5-week period of treatment, blood urea nitrogen and creatinine rose to 29 and 1.8 mg/dl. Cyclosporine was stopped and then the patient was given prednisolone (10mg/day) in addition to dapsone(50mg/day) for 1 month. Recurrence has not been observed.
Abdomen ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Granulation Tissue ; Humans ; Middle Aged ; Prednisolone ; Pyoderma Gangrenosum* ; Pyoderma* ; Recurrence ; Skin ; Thorax ; Ulcer

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*

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