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

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

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

Eccrine angiomatous hamartoma, eccrine-pilar angiomatous hamartoma and sudoriparous angioma represent the same disease entity, a hamartoma showing hyperplasia of the eccrine sweat apparatus and of vascular elements in the same lesion histologically. We present a case of eccrine angiomatous hamartoma on the medial side of the right thigh in a 3-year-old male patient and review 16 cases reported in Korea.
Child, Preschool ; Hamartoma* ; Hemangioma ; Humans ; Hyperplasia ; Korea ; Male ; Sweat ; Thigh

BACKGROUND: The multicomponent cognitive-behavioral group treatment program is an effective treatment for fear of flying (FOF). In Korea, the effect of this treatment has not yet been studied. This is a preliminary study to assess the program's effect for Koreans with FOF. METHODS: Among 11 patients who participated in the treatment program, 10 completed the program, and data of 9 patients were obtained. Patients participated in individual treatment phase by diagnosis and symptoms, and in the group treatment phase for 2 days, composed of education on flight and anxiety, relaxation technique, cognitive reconstruction, imaginary exposure, mock-up treatment, real flight, etc. Flying history, Visual Analogue Flight Anxiety Scale (VAFAS), Flight Anxiety Situation Questionnaire (FAS) with 3 subscales (generalized, anticipatory, in-flight), Flight anxiety Modality Questionnaire (FAM) with 2 subscale (somatic, cognitive) were assessed before treatment and at 3 months after completion of the program. RESULTS: 8 patients made flights within 3 months after treatment. VAFAS, FAS total, 3 FAS subscales, FAM, and 2 FAM subscales were all decreased significantly after treatment. CONCLUSION: This results suggest that the multicomponent cognitive-behavioral group treatment program is effective for Koreans with FOF.
Anxiety ; Diagnosis ; Diptera* ; Education ; Humans ; Korea ; Relaxation ; Surveys and Questionnaires

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

We have studied the effects on wound healing of moist conditions in rabbit, achieved by covering excised wounds with the polyurethane film dressings, and dry conditions, by exposure to air during the period from day 1 to day 21 after injury. We have quantified the rate of dermal repair by means of differenetial cell counts of neutrophils, macrophages, fibroblasts, and endothelial cells. The rate of re-epithelialization was also examined. The resuts were as follows: 1. There was an acceleration of the inflammatory phase of repair in the moist wounds. The late phase of inflammation began more rapidly. On day 3 after injury there were 150% more macrophages (p<0.01) and 70% fewer neutrophils (p<0.01) in moist wounds. It was also observed the presence of significantly more fibroblasts (p<0.01) in the moist wounds than the dry wounds. 2. There was also more rapid increase in the number of proliferative phase cells-fibroblasts (p<0.01) and endothelial cells (p<0.01) in moist wounds. the lower content of neutrophils (p<0.05) and the higher number of fibroblasts (p<0.01) which were observed in moist wounds on day 7 after injury suggested that healing was by then well advanced into the proliferative phase. 3. On day 14 after injury, the decrease in the number of fibroblasts in moist wounds suggested that this group entered the remodeling phase of repainr. The lower total cell count in moist wounds than in dry on day 21 after injruy suggested a more rapid progress through the remodeling phase. 4. The reepithelialization of moist wounds was faster than that of dry wounds. These findings suggested that moist wounds occluded with polyurethane film dressing healed more rapidly and in a more orderly manner than did dry wounds, both epidermal and dermal repair being accelerated.
Acceleration ; Bandages* ; Cell Count ; Endothelial Cells ; Fibroblasts ; Inflammation ; Macrophages ; Neutrophils ; Polyurethanes* ; Re-Epithelialization ; Wound Healing* ; Wounds and Injuries*

Nevus sebaceus of Jadassohn has been referred to as a organoid nevus that classically evolves through three stages and may be associated with a range of skin tumors, and of these, syringocystadenoma papilliferum and basal cell carcinoma have been commonly reported to occur. The occurrence of keratoacanthoma is a very rare event in nevus sebaceus. Herein we report on a 23-year-old man with nevus sebaceus of the cheek. He represents a keratoacanthoma arising within nevus sebaceus.
Carcinoma, Basal Cell ; Cheek ; Humans ; Keratoacanthoma* ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Organoids ; Skin ; Young Adult

Acute colonic pseudoobstruction was first reported in 1948 by Sir H. Ogilvie. It is characterized by an acute, abrupt right-sided colonic distention in the absence of physical reasons for obstruction. If untreated, it may progress to cecal perforation, peritonitis, and death. Although primary cases have been reported, 87 percent of cases were secondary results of medical or surgical conditions. The most common medical conditions were infections, cardiac disease, and neurologic problems. In surgical conditions, cesarean section has been reported as the most common cause of Ogilvie's syndrome. In 1995, the first case of Ogilvie's syndrome complicated after a cosmetic surgical procedure(abdominoplasty) was reported by Bradley et al. We report a case of Ogilvie's syndrome complicated after breast reconstruction with TRAM flap that developed in the postoperative third day in 35-year old woman. The complications are primarily related to decreased flap perfusion. No reference of intestinal pseudoobstruction was found in the literature conducted in regard to complications of TRAM flap breast reconstruction.
Adult ; Breast* ; Cesarean Section ; Colon ; Colonic Pseudo-Obstruction ; Female ; Heart Diseases ; Humans ; Intestinal Pseudo-Obstruction ; Mammaplasty* ; Perfusion ; Peritonitis ; Pregnancy