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

The antiphospholipid antibody syndrome is an acquired multisystemic disorder characterized by persistent elevated antiphospholipid antibodies and/or hypercoagulation in veins or arteries, or both. The clinical manifestations of the antiphospholipid antibody syodrome are recurrent thrombosis, fetal loss, thrcenbocytopenia, and various cutaneous lesions. Skin lesions are the first sign of this syndrome in 41% of patients and systemic thrombosis develops in 40% of them. Livedo reticularis is the most common cutaneous finding of the antiphosphotipid antibody syndrome. Although vasculitis has not been frequently noted in antiphospholipid antibody syndrome, some vasculitis such as polyarteritis nodosa, giant cell arteritis, and other nonspecific vasculitides have been found in association with antiphospholipid antibody syndrome. We present a male patient with typical manifestations of leukocytoclastic vasculitis with deep vein thrombosis and positive antiphospholipid antibodies. It suggests that a case of antiphospholipid antibody syndorme was accompanied with cutaneous leukocytoclastic vasculitis.
Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome ; Arteries ; Giant Cell Arteritis ; Humans ; Livedo Reticularis ; Male ; Polyarteritis Nodosa ; Skin ; Thrombosis ; Vasculitis* ; Vasculitis, Leukocytoclastic, Cutaneous ; Veins ; Venous Thrombosis

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

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: 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

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

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: 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: 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*