A 45 year-old Korean woman presented with multiple pruritic umbilicated papules on both ankles of 3 months duration. Histopathologic findings showed calcium deposits in the upper dermis and the transepidermal elimination of calcium. This is a very rare presentation of calcinosis cutis.
Ankle ; Calcinosis* ; Calcium ; Dermis ; Female ; Humans

A 37-year-old man was diagnosed as having chronic renal failure received hemodialysis, Five months after starting hemodialysis developed rice to pea sized erythematous follicular papvles on the posterior neck and trunk which was accompanied by mild pruritus. Histopathologically the lesion showed typical finding of perforating folliculitis and Pickers nodule like changes in the adjacent epidermis.
Adult ; Epidermis ; Folliculitis* ; Humans ; Kidney Failure, Chronic ; Neck ; Peas ; Pruritus ; Renal Dialysis*

Occult syringoma means a clinically inapparent tumor of the swea gland that are histologically similar but not identical with the common syringoma. They may occur in a variety of inflammatory skin lesions and cutaneous neoplaams as a reactive process. We report herein a case of diffuse alopecia areata associated with occult syringoma in the scalp of a 57-year-old man. Our patient developed progressive, fairly well circ amscribed patches of alopecia and diffuse hair loss over a 1 month period. Histopathological examinaiion revealed non-scaring alopecia and a proliferation of eccrine ductal structures in the upper dermis. These ductal structures resembled syringoma. Only minimal focal fibrosis was occasionally observed arcund the hair follicles. We believe that occult syringona is a reactive process and is secondary to active inflarnmation or dermal fibrosis. It has been most commonly observed in scarring alobiecias but plays no significant role in the etiology of hair loss.
Alopecia Areata ; Alopecia* ; Cicatrix ; Dermis ; Fibrosis ; Hair ; Hair Follicle ; Humans ; Middle Aged ; Scalp ; Skin ; Syringoma*

Phakomatosis pigmentovascularis is characterized by the coexistence of pigmentary nevus and hemangioma. Since the term was first described by Ota et al in 1947, about 80 cases have been reported in the literature. In 1979, Hasegawa et al subclsssified the disorder into eight types : type I, nevus flammeus and nevus pigmentosus et verrucosus, type II, nevus flamme is and dermal melanocytosis, type III nevus flammeus and nev.us spilus, type IV, nevus flammeus, dermal melanocytosis and nevus spilus. Each type is subdivided into localized(a) and systemic(b) types, A 25-year-old male had brown papules on the left knee and thigh and purple patches on the left leg that had been present for approximately 7 years. He had no concon ittant systemic disease. The histopathologic findings on brown papules and purple patches are compatible with epidermal nevus and nevus flammeus respectively. We herein report a case of phakomatosis pigmentovascularis type I a.
Adult ; Down Syndrome ; Hemangioma ; Humans ; Knee ; Leg ; Male ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Thigh

BACKGROUND: Primary targit injured from the immunologic mechanism of alopecia areata is not definitely confirmed although alopecia areata is regarded as a disease occuring from certain im munologic process. Recently, par ticular interest has been focused on the follicular keratinocytes which show morphologic and anigenic alterations in active lesions. Another important point is the subclinical state hypothesi. It is based upon the observation that the patterns of T lymphocytes infiltration and ultrastructural changes of dermal papilla cells are nearly identical in active lesions and in non-lesional areas of alopecia areata. OBJECTIVE: The purpose of this study is to determine and to compare the aberrant expression of HLA-DR, CD1 and ICAM-1 on the follicular keratinocytes from the active alopecia areata lesion, stationary lesion and non-lesional scalp. METHODS: We performed a n immunohistochemical study, using the streptavidin system to compare the patterns of HLA-DR, CD1 and ICAM-1 immunoreactivity in the follicular keratinocytes in five active alopecia lesions two stationary lesions and non-lesional scalp specimens among four active and two stationary patients, and two normal control scalp specimens. RESULTS: In the active aloecia lesions, the HLA-DR and ICAM-1 immunoreactivity was observed in some patients while CD1 immunoreactivity was observed in all the patients. In the sta tionary alopecia lesions, none of the HLA-DR or CD1 or ICAM-1 immunoreactivity was observed as was the case in the norrial control scalp specimens. In the non-lesional normal scalp specimens, the HLA-DR, CD1 and ICAM-1 immunoreactivity showed nearly the same patterns as those in the acute alopecia leions. CONCLUSION: The aberrant antigenic alterations, especially CD1 expression of follicular keratinocytes are likely to be asociated with the active progress of alopecia areata lesions. These antigenic alterations were also observed in non-lesional scalp as well as alopecia areata lesions in the very similar patterns.
Alopecia Areata* ; Alopecia* ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Scalp* ; Streptavidin ; T-Lymphocytes

Telangiectasia is characterized by permanently dilated small vessels usually arising from the suprapapillary plexus of venule capillaries, or arterioles. It may be etvlogically divided into the primary and secondary types. Rosacea, varicose vein, prolonged sun xvsure, radiation, and physical trauma may be the causes of secondary telangiectasia. We report herein a case of secondary telangiectasia associated which operation for a femur fracture.
Arterioles ; Capillaries ; Femur ; Rosacea ; Solar System ; Telangiectasis* ; Varicose Veins ; Venules

Aplasia cutie congenita is a rare congenital disease showing focal abscence of skin. In the msjority of instances it is limited ta the scalp especially on the vertex although other areas of the body may also be involved. Other congenital malformation have been reported to ccur with ACC odcasionally. Diagnosis depends on primarily clinical findings. The histologic finding virious from an absence of appendages to the involvement of varying layers of skin, occasionally extending to the bane or dura. Healed lesions often demonstrate a flattened epidermis, a proliferation of fibrobasts in a loose connective tissue stroma, newly formed capillaries, and a complete absence of adnexa stuctures. We observed a newborn infant with aplssia cutis congenita. The akir, defect was found on the posterior fontanelle. No associating cangenital anomalies were found in this case.
Capillaries ; Connective Tissue ; Cranial Fontanelles ; Diagnosis ; Ectodermal Dysplasia* ; Epidermis ; Humans ; Infant, Newborn ; Scalp ; Skin

BACKGROUND: Pemphigus are chronic autoimmune blistering disorcers characterized by acantholysis. In addition to pemphigus vulgaris(PV), the major clinical variarts are pemphigus foliaceus(PF), paraneoplastic pemphigus(PNP) and drug-induced pemphigus(DP). Detection of pemphigus antigen is important for differential diagnosis as well as research work. Most investigators have identified pemphigus antigens by means of immunoprecipitation using metabolically radiolabeled cultured keratinocytes. However, immunorepitation is generally more expensive, hazardous and time-consuming than immunoblotting. Therefore, establishment of the immunoblotting as a standard technique for the detection of the pemphig us antigens is desirable. OBJECTIVE: To characterized pemphigus antigens by an immunobloting analysis of human epidermal extract and by indirect itnmunofluroscence study using human of cultured keratinocytes as a substraie. METHOD: We performed imrnunoblotting analysis af sera from patieiits with PV, PF, PNP and DP with human epidermal extract as a source of antigen. Indirect immunof uorescence study was also performed using human keratinocytes cultured in high or low calcium media for detection of pemphigus antigens. RESULTS: In an immunoblotting analysis, all(9/9) PV sera showed secific reactivities with a 130-KD protein and all(5/5) FF sera showed reactivities with a 150-KK protein, which is most likely desmoglein 1. Furthermore, one of nine PV serum also reacted with a 150-KD protein, which seems to be the identical antigen detected in PF. All PNP(3/3) sera showed reactivities with two protein bands, 210KD and 190KD. In our indirect imrnunofluorescence study using culltured human keratinocytes as a substrate, when keratinocytes were grown in low calcium media, no pimphigus antigens could be detected. However, when grown in high calciurn media, pemphigus vulga ris and paraneoplastic pernphigus antigens were present t the cell-cell contact areas with a puncta;e pattern, whereas pemphigus foliaceus antigen was not, presint in keratinocytes even when cultured in high calcium media. CONCLUSION: Our results suggests (1) immunoblotting analysis is a reliable technique for defining pemphigus antigen and could be a valuable tool for the differentiation of PV, PF and PNP and(2) PF antigen rnay not be expresseden cultured keratinocytes.
Acantholysis ; Blister ; Calcium ; Desmoglein 1 ; Diagnosis, Differential ; Fluorescent Antibody Technique, Indirect* ; Humans ; Immunoblotting ; Immunoprecipitation ; Keratinocytes* ; Pemphigus* ; Research Personnel

No abstract available.
Anterior Cruciate Ligament*

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*