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

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

Erythema multiforme can be induced by various causes, including infections like virus or fungus, drugs like sulfonamides and penicillins, internal malignences, connective tissue diseases, pregnancy, menstruation, and exoessive sun exposure ramoxone, one of the paraquat dichloride compounds, is the most commonly used weed-kiIler in Korea. It is sometimes used in suicides due to its fatal toxicity, and even weak transutaneous absorption can lead to death. Herein we report a case of erythema multiform in a 46-year-old man induced by accidental contact with the Gramoxone
Absorption ; Connective Tissue Diseases ; Erythema Multiforme* ; Erythema* ; Female ; Fungi ; Humans ; Korea ; Menstruation ; Middle Aged ; Paraquat ; Penicillins ; Pregnancy ; Solar System ; Suicide ; Sulfonamides

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

Twenty-nail dystrophy is a rare entity in which all 20 nail are uniformly and simultaneously affected with excess longitudinal ridging and loss of luster. This condition is thought to be idiopathic but, many cases are associated with alopecia areata, lichen planus, psoriasis, and ichthyosis. In such cases, it has been hypothesized that immunplogical disorders could play a role in pathogenesis. A 29-year-old male patient presented with dystrophic nail chatge on his all finger and toe nails for 3 years. On phisical examination, all nails were uniformly affected with longitudinal ridging and loss of luster and all body hairs were lost. Thyroid scan showed a finding of chronic thyroiditis. Herein we report a case of twenty-nail dystrophy associated with chronic thyroiditis and alopecia areata.
Adult ; Alopecia Areata ; Fingers ; Hair ; Humans ; Ichthyosis ; Lichen Planus ; Male ; Psoriasis ; Thyroid Gland* ; Thyroiditis* ; Toes

There are several methods for diagnosis of leprosy, including AFB stain, the measurement of PGL-1 (phenolic glycolipid - 1) antigen titer, and DNA-PCR. In this study, we have used the DNA-PCR amplifying the RLEP repetitive sequence. Our result showed that the RLEP primer offered the more sensitive detection and identification of M. leprae DNA in clinical specimens, compared with the other primer, for example, 18-kDa antigen gene. To screen the resistant M. leprae strain of MDT (Multi-Drug Therapy), we have used the TD (Touch-Down) PCR. We arranged and amplified sequences of the genes, folP, rpoB, gyr, 23S rRNA, in M. leprae involved in MDT-resistance, and could obtain the PCR product each gene, simultaneously. This method, based on annealing temperature, was useful to the detection for diagnosis and the screen of MDT-resistant strain of M. leprae, rapidly. Thus, we suggest that the RLEP primer and TD-PCR method are effective in assessing the diagnosis of leprosy and the identification of drug-resistant M. leprae.
Diagnosis* ; DNA ; Leprosy* ; Polymerase Chain Reaction* ; Repetitive Sequences, Nucleic Acid

Specific cutaneous infiltrates in chronic lymphocytic leukemia(CLL) presenting as tumor and large nodule on face, scalp and upper trunk and involvement of oral mucsa is extremly rare. In 7% of cases, leukemic infiltrates of the skin precede the diagnosis of Leuke. We report herein leukemic macrocheilia which occured 3 years before a diagnosis of CLL.
Diagnosis ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Scalp ; Skin

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*

The blue rubber bleb nevus syndrome(CRBNS) is a rare disorder characterized by distinctive vascular malformations of the skin and gastrointestinal tract. The syndrome is associated commonly with iron deficiency anemia due to gastrointestinal bleeding. Most cases are sporadic, although a few have been reported with autosomal dominant inheritance. We report a case with clinical characteristics of the blue rubber bleb nevus syndrome. The patient had typical skin manifestations of the BRBNS and chronic iron deficiency anemia. However, we could not find any gastrointestinal vascular malformations radiologically.
Anemia, Iron-Deficiency ; Blister* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Nevus* ; Rubber* ; Skin ; Skin Manifestations ; Vascular Malformations ; Wills

Upper gastrointestinal(UGI) bleeding was critical disease that was commonly found in emergency department and needed more early diagnosis and rapid treatment for decreasing mortality and morbidity. It's causes and frequencies here affected by many factors, but the majorities were caused by peptic ulcers and esophageal-gastric varices. With development of economy and medical services, new drugs and endoscopic interventions, the treatment of patients with UGI bleeding was more improved. So I would like to evaluate the change of causes and frequencies of UGI bleeding and the associated clinical findings. A total of 1,546 patients presented with UGI bleeding in emergency department of Yeungnam university hospital during the five years from Jan. 1991 to Dec. 1995 were clinically reviewed by charts and compared with previous seven years report from Jan. 1984 to Dec. 1990 in the same hospital. The ratio of male to female was 6.1:1 and slightly increased in comparison with previous seven years. The incidences in 6th and 5th decades were highest(54.4%) as like as previous seven years. Age distribution of duodenal ulcer bleeding, Mallory-Weiss tear and acute gastric mucosal lesion were developed in lower decades than the others. The causes of UGI bleeding were caused by esophageal varix(45.4%), peptic ulcer(38.8%), Mallory-Weiss tear(4.3%), gastric cancer(3.8%), others(3.1%), acute gastric mucosal lesion(2.7%), undetermined causes(1.8%) in defending order of frequencies. The proportion of esophageal varices was increased from 36.6% to 45.4%, but that of peptic ulcer was relatively decreased from 47.6% to 38.8%. And the annual distribution of varices was increased, however the annual distribution of peptic ulcers was increased. Although the ranking of annual distribution of gastric ulcers and duodenal ulcers were not changed compared to previous study and the frequency of gastric ulcers was increased since 1992, but additional follow-up was needed. Seasonal variations were found that upper gastrointestinal bleeding was increased in fall and peptic ulcer bleeding was increased significantly in summer and fall, however, varix bleeding was less frequent in summer time as like as previous seven years. Emergency endoscopic examination was performed within 6 hours far 54.5%, 24 hours for 90.8% and this reacts were to be like previous results, 57.5% and 90.7% respectively. Findings of emergency endoscopic examination were active bleeding focus(21.2%), blood clot(7.9%), exposed vessels(13.3%), flat blood spot(6.4%) and lesion without evidence of bleeding(51.3%). Endoscopic findings of active bleeding were easily seton when examination was perfomed within 24 hours. Blood transfusion was performed in 67.3% with average 2.1 units. When the causes of bleeding were due to varix and marginal ulcer, more amounts of blood were transfused than the others. In previous seven years, blood transfusions were performed in 71.2% with average 5 units and more amounts of blood were transfused in gastric cancer and varix bleeding.
Age Distribution ; Blood Transfusion ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Emergency Service, Hospital ; Esophageal and Gastric Varices ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Male ; Mallory-Weiss Syndrome ; Mortality ; Peptic Ulcer ; Seasons ; Stomach Neoplasms ; Stomach Ulcer ; Varicose Veins