We report a 71 years old woman with transient periodic limb movement disorder and myoclonus that appeared after acute gastrointestinal bleeding. The abnormal movements dissolved as the blood loss was restored. The woman was later found to have an asymptomatic spine meningioma. Iron defi ciency due to acute bleeding may be the trigger resulting in the abnormal movements in this patient with subclinical spinal meningioma

BACKGROUND: Sleep disturbance (SD), parasomnia and excessive daytime sleepiness (EDS) are commonly reported in Parkinson disease (PD). But frequencies and etiological factors are not congruent in different studies. METHODS: We studied those patients who had visited our clinic and had been diagnosed as PD using a structured questionnaire. Disease severity was graded according to Hoehn and Yahr stage into 8 stages. Drug history of the patients is reviewed by medical records. SD is defined to be present when one complains of poor sleep regardless of sleep duration. We define sleep benefiter as those who are 'best' and 'on' in the morning. If one has 10 or more scores on the Epworth sleepiness scale, we regard him/her as having EDS. RESULTS: One hundred PD patients are recruited. Thirty-eight of them complain of sleep disturbance. The patients with SD need longer time to get into sleep, and have shorter sleep duration than those without SD. The average number of sleep fragmentation is higher in SD group. Vivid dreams are the most common parasomnia. Sleep benefiters are 61%. They have less amount of levodopa equivalent dose than non-sleep benefiter. Those with EDS have shorter sleep duration. And there are more snorers in them. CONCLUSIONS: We can confirm that SD, parasomnia and sleep benefit is commonly observed in PD patients.
Dreams ; Humans ; Levodopa ; Medical Records ; Parasomnias ; Parkinson Disease ; Surveys and Questionnaires ; Sleep Deprivation

We report a case of tuberculosis verrucosa cutis in a 33-year-old male patient who presented with mild itching verrucous plaque over the perineum. The Mantoux test revealed a positive reaction. The histophathologic picture consists of slight hyperkeratosis, irregular ac:anthosis overlying an inflammatory iafitrate in the dermis. Tuberculous granulomas with caseation necrosis were seen in the dermis. Tuber clebacillus was demonstrated. The patient was treated with Isoniazid, Rifampicin, and Pyrazine made for 6 months. To date, the skin lesions have markedly improved.
Adult ; Dermis ; Granuloma ; Humans ; Isoniazid ; Male ; Necrosis ; Perineum ; Pruritus ; Rifampin ; Skin ; Tuberculosis*

A case of circular eczematous dermatitis around seborrheic keratosis was presented. A 54-year-old man presented with two weeks history of a round pruritic eruption around a preexisting lesion of seborrheic keratosis. Microscopic findings showed central tumor nest composed mainly of basaloid cells with occasional spongtosis and exocytosis. A diffuse, dense, mononuclear cell infiltrate with increased contents of melanophages was seen beneath the tumor. The surrounding lesion of halo dermatitis showed mild dilatation of the capillaries and perivascular infiltration of mononuclear cells in the upper and mid-dermis. The lesion of halo dermatitis disappeared gradually over a three week period following excision of the central lesion. This peculiar phenomenon seemed to be different from that of Suttons halo nevus, and might be a manifestation of an eczematous condition which might have a dermatitis provoking factor.
Capillaries ; Dermatitis* ; Dilatation ; Eczema ; Exocytosis ; Humans ; Keratosis, Seborrheic* ; Middle Aged ; Nevus, Halo

Marjolins ulcer is a special type of skin malignancy arising from previous scar site. We report two cases of Marjolins ulcer arising from chronic deg enerating burn scar. A 65-year-old male had a 9 x 15cm sized ulcer on his right popliteal fossa. He had a history of burn when he was seventeen years old and an ulcerati 1g tumor developed at the site of burn scar about 1 year ago. The ulcer became progressively penlarged in size and also painful. Skin biopsy revealed squamous cell carcinoma and,subsequently Above-Knee amputation was done. Another 54-year-old male had a painful coin sized ulcer on his right popliteal fossa where he had burn at the age of thirty-four. The ulcer was developed at the site of burn scar about 2months ago. The pathologic diagnosis was squamous cell carcinoma. He was recommended to get his leg amputated, but it was refused.
Aged ; Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Diagnosis ; Humans ; Leg ; Male ; Middle Aged ; Numismatics ; Skin ; Ulcer*

We report two cases of Darier's disease improved with Etretmate in the 44-year-old father and his 18-year-old son. Clinically, multiple dirty brownish, verrucous, discrete or confluent papules and plaques were noted on their back, abdomen, and face. Histopathologically, both of them demonstrated hyperkeratosis, suprabasal acantholysis, acantholytic cells in the lacunae, corpsronds, grains, and dyskeratotic cells. Oral Etretinate 30mg daily was given in both cases with remakable improvement 3 weeks after treatment. Six months later, they showed almost total clearin, of their skin lesions. No specific adverse effect was noted. There has been no evidence of recurrence for 6 months follow up period.
Abdomen ; Acantholysis ; Acitretin* ; Adolescent ; Adult ; Edible Grain ; Darier Disease* ; Etretinate* ; Fathers ; Follow-Up Studies ; Humans ; Recurrence ; Skin

A 29-year-old woman had multiple, umbilicated papules on her fingers for 2 months. Skin biopsy specimen showed transepidermal perforation filled with plug of cellular debris, degenerated collagen and mucinous material. In the dermis, there were necrobiosis and peripheral palisading of mononuclear cells. Special stainings including masson's trichrome, alcian blue, acid orcein, and PAS showed necrobiotic collagen fibers and acid mucopolysaccharides on the necrobiotic zone and trasepidermal elimination canal. Topical application of 0.05% Clobetasol-17-propionate ointment improved her lesion.
Adult ; Alcian Blue ; Biopsy ; Collagen ; Dermis ; Female ; Fingers ; Glycosaminoglycans ; Granuloma Annulare* ; Granuloma* ; Humans ; Mucins ; Necrobiotic Disorders ; Skin

A 50-year-old female, who had been suffered from diabetes rielitus, showed typical cutaneous findinhs of dermatomyositis with only transient and mild proximal muscle weakness at sometime during the course of disease. She had Gottrons papules, Gottrons sign, heliotrope rash, macular violsceous erythema involving neck, anterior chest, back, extensor site of forearms and arms and dorsa of hands. However, he serum CPK, LDH and sGOP levels were within normal limits. Her fasting and 2 hours potprandial blood glucose levels were elevated. There were no histological abnormality in muscle biopsy. Histopathologic findigs of the skin lesion on her back were that of poikiloderma atrophicans vasculare. We diagnosed our patient as Rebeccas type 2 amyopathic dematomyositis which is chracterized by skin disease with subjective myalgias and musle weakness, but without laboratory evidence of muscle disease.
Arm ; Biopsy ; Blood Glucose ; Dermatomyositis* ; Erythema ; Exanthema ; Fasting ; Female ; Forearm ; Hand ; Humans ; Middle Aged ; Muscle Weakness ; Myalgia ; Neck ; Skin ; Skin Diseases ; Thorax

A 49-year-old male had erythematous to rusky red papules, indurated plaques and lichenified patches with hyperpigmentation on sun-exposed areas for 6 years. Phototest revealed the decreased rninimal erythemal dose to UVA(10J/cm. Photopatch test with 5% Trandate ointment, 5% hydrochlorthiazide ointment and vaselin. as a control were all negative. Two weeks after cessation of Trandate, an oral challenge of hydrochlorthiazide followed by phototest was perfrirmed resulting in exacerbation of skin lesions and photosensitivity with a decreased MED to UVA(10J/cm) again. After the cesation of Trandate containing hydrochlorthiazide, the skin lesions were improved with complete loss of photosensitivity. But, improvement of the infiltrated or licheified plaques were delayed. Presenile cataract previously noted in the patient seemed to be related to his longstanding intake of hydrochlorthiazide.
Cataract ; Humans ; Hyperpigmentation ; Labetalol ; Male ; Middle Aged ; Skin

We report a case of a phototoxic reaction in a 48-year-old female induced by griseofulvin ingestion. The patient hac! erythematous papules, vesicles and patches on the sun-exposed areas. Phototest revealed a decreased minimal erythemal dose to UVA (10J/cm). Photopatch tests with 1%, 5%, 10% Griseofulvin ointment and vaseline as a control and photoingestion tests with Griseofulvin (50mg b.i.d.) were all negative. After the cessation of Griseofulvin, her skin lesions were markedly improved with complete loss of photosensitivity.
Eating ; Female ; Griseofulvin ; Humans ; Middle Aged ; Petrolatum ; Skin