Trichilemmal carcinoma is a rare tumor that is located predominantly on sun-exposed skin of the elderly. It is thought to be related to the external root sheath of the hair follicle and the malignant counterpart of a trichilemmoma. We report a case of trichilemmal carcinoma in a 88-year-old woman who had a 10 year history of a single, dark brown tumor on the right preauricular region. In her past medical history, it had been excised twice at a private clinic without a histopathological evaluation and recurred 2 years later. Histopathological findings showed atypical clear cells resembling those of the outer root sheath. Tumor cells showed PAS-positive cytoplasm. Immunohistochemistry revealed positive high molecular weight cytokeratin expression. To our knowledge, this is the second case of trichilemmal carcinoma in the Korean literature. (Ann Dermatol 100) 175178, 1998).
Aged ; Aged, 80 and over ; Cytoplasm ; Female ; Hair Follicle ; Humans ; Immunohistochemistry ; Keratins ; Molecular Weight ; Skin

BACKGROUND: Becker's mealanosis is not an uncommon entity, and many cases are probably not reported because the diagnosis is usually made clinically and the condition is benign with cosmetic significance only. the etiology remains obscure. OBJECTIVE: The purpose of this study is to establish the clinicopathologic characteristics of Becker's melanosis in Korean. METHODS: Thirty-six patients with Becker's melanosis were retrospectively studied. RESULTS: The clinical and histopathologic findings observed in our cases were similar to previous reports except for the following. Nine patients(25%) had abnormal findings in their hair follicles : dilatation of the infundibular portion filled with abnormal keratin, Pityrosporum orbiculare and bacteria(19.4%); formation of intrafollicular cyst(5.6%). Three patients(8.3%) had granulomatous infiltration. Twenty-two patients(61.1%) had increased smooth muscle bundles. CONCLUSION: The findings associated with dermal hair follicles may be related to the pathogenesis of Becker's melanosis.
Diagnosis ; Dilatation ; Hair Follicle ; Humans ; Malassezia ; Melanosis* ; Muscle, Smooth ; Retrospective Studies

We report two cases of linear focal elastosis. They are a 16-year-old girl and a 14-year-old boy who had had asymptomatic, several, yellow-red, slightly elevated, palpable, striae-like lesions on their middle and lower back since their early childhood. Light microscopic examinations of skin biopsy specimens demonstrated dermal thickening and focal increases of thin wavy fibers in the upper and mid-dermis but no changes in the epidermis. Verhoeff-van Gieson stains for elastic fiber revealed aggregated, clumped, curled, or fragmented elastic fibers.
Adolescent ; Biopsy ; Coloring Agents ; Elastic Tissue ; Epidermis ; Female ; Humans ; Male ; Skin

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

No abstract available.

Merkel cell carcinoma (MCC) is an unusual primary cutaneous tumor, occasionally found con-current with other malignancies. A case of MCC with coexisting squamous cell carcinoma (SCC) was studied histologically, immunohistochemically and ultrastructurally. The MCC and SCC occured at the same site, but each preserved its identity and transition between the two was not identified.
Carcinoma, Merkel Cell* ; Carcinoma, Squamous Cell

Phakomatosis pigmentovascularis was first described in 1947 as a distinctive association of cutaneous hemangioma and pigmentary nevi by Ota et al. We describe a 7-year-old boy who, since birth, had three kinds of discolored patches over the various parts of the body: blue spots (dermal melanocytic nevi), reticulated reddish patches (nevus flammeus), and hypopigmented macules (nevus anemicus). No systemic disease was found.
Child ; Hemangioma ; Humans ; Male ; Neurocutaneous Syndromes* ; Nevus ; Parturition ; Port-Wine Stain

OBJECTIVES: The purposes of this clinical study were 1) to assess 5-year survival rates in 195 patients with locally invasive cervical cancer(stage Ia-IIb) treated by surgery, neoadjuvant chemotherapy+surgery and postoperative radiation in selected cases, 2) to evaluate the prognostic factors affecting the survival rate, and 3) to get helpful information for the better treatment. METHODS: A retrospective analysis was conducted of 195 patients. They were diagnosed and operated on during the period of Jan. 1988 - Dec. 1993 in Dept. of OB/Gyn, Pusan Paik Hospital, Inje Medical School. The 5-year survival rates were estimated using the Kaplan-Meier method, and prognostic factors were assessed using Wilcoxon test. RESULTS: The 5-year survival rates for FIGO stages Ia, Ib, IIa, and IIb were 100, 86.1, 76.9, and 81.1%, respectively. Factors that affect the 5-year survival rates were clinical stage(P=0.0001), cell type(small cell vs other, P=0.0001), depth of invasion(< or = 5 mm vs >5 mm, P=0.0013), tumor size(< or = 3 cm vs >3cm, P=0.0035), and lymph node metastasis(0 vs 1 vs more than 2, P=0.0001). There was no difference in 5-year survival rates between without neoadjuvant chemotherapy group and with neoadjuvant chemotherapy group which had poor prognostic factors. The predicted recurrence rate of the postoperative radiation group showed a lower 5-year survival rate than the no postoperative radiation group(P=0.0001). CONCLUSIONS: We conclude that the factors affecting the prognosis were FIGO stage, cell type, depth of invasion, tumor size, and lymph node metastasis, and speculated that the survival rates could be improved by using neoadjuvant chemotherapy for more advanced locally invasive cases properly.
Busan ; Drug Therapy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Schools, Medical ; Survival Rate ; Uterine Cervical Neoplasms

BACKGROUND: Intra-aortic balloon pump (IABP)is well known for its hemodynamic benefit but still has its own complications.Proper use of IABP is the best way t o obt ai n maximum benefit with low complication rate. MATERIALS AND METHOD: Twenty one(men 10,female 11) patients were included in this study among the 100 consecutive adult cardiac surgery patients in our hospital.Eighteen(85.7%)were ischemic heart disease patients.They all received IABP therapy due to postcardiotomy cardiogenic shock according to the well-known indications.Their preoperative conditions,intraoperative factors including hemodynamics, postoperative conditions and IABP-related complications were analyzed. RESULT: Nineteen patients(90.5%)were successfully weaned from IABP.There were 2 patients of operative death and the mortality rate was 9.5%.Duration of IABP use was 40.7+/-24.3 hours.There were 2 cases(9.5%)of IABP-related vascular complications that required surgical intervention. CONCLUSION: We concluded that IABP could be used effectively and safely for postcardiotomy cardiogenic shock patients with low complication rate.
Adult ; Hemodynamics ; Humans ; Mortality ; Myocardial Ischemia ; Shock, Cardiogenic* ; Thoracic Surgery

Multiple endocrine neoplasi~a type 3 is a rare, heritable or sporadic, multiple neoplastic disorder that is charracterized by thyroid medullary careinoma, pheochromocytoma, multiple mucosal neuroma, and marfanoid habitus. The most important disorder of the syndrome is mucosal neuroma that is an early diagnostic sign of multiple endocrine neoplasia type 3. Early diagnosis of MEN type 3 determines prognosis of the disease. We present a case of multiple endocrine neoplasia type 3 of the sporadic pattern in a 27-year-old man who had typical medullary thyroid carcinoma, mucosal neuroma, marfanoid habitus, and megacolon.
Adult ; Early Diagnosis ; Humans ; Male ; Megacolon ; Multiple Endocrine Neoplasia* ; Neuroma* ; Pheochromocytoma ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms