Congenital triangular alopecia is an uncommon nonscarring form of alopecia. It presents with isolated alopecic patch at the frontotemporal area of the scalp. Although previously considered congenital, this condition usually is discovered after 2 years of age and, more recently, is thought to be acquired. We report a case of congenital triangular alopecia in a 12 month old female who had the lesion since birth.
Female ; Humans

Acantholytic dyskeratosis is a regular histologic feature in Darier's disease, transient acantholytic dermatosis and warty dyskeratoma. It is also occasionally observed as an incidental histological finding in linear epidermal nevus. We report a case of acantholytic dyskeratotic epidermal nevus in an 11-month-old boy. The patient showed unilateral, brown colored verrucous plaque on the right shin. Histological finding showed hyperkeratosis, irregular acanthosis & focal acantholytic dyskeratosis.

Transient acantholytic dermatosis was first described by Grover in 1970. It is characterized by pruritic, discrete papules and papulovesicles distributed mainly on the trunk. The histologic hallmark of the disorder is focal acantholysis, several patterns of which have been described. The etiologic factors and pathogenesis remain unclear. We report a 45-year-old male patient with multiple severely pruritic, discrete papules and papulovesicles on the trunk. There were no oral cavity, palm and sole involvement. Histopathologic findings revealed epidermal acanthosis, acantholysis and hyperkeratosis with suprabasal splits. He showed good response to topical steroid and oral antihistamine.
Acantholysis ; Humans ; Male ; Middle Aged ; Mouth ; Skin Diseases*

The authors report a rare case of air gunshot wound to the thoracic spinal cord in Korea. A case of 17 year-old girl with a air-gunshot wound to the thoracic spine was presented with paraplegia. Radiologic studies revealed a bullet in the fifth thoracic spinal canal. The cerebrospinal fluid leaked through the entry point of the bullet was noted. After laminectomy and dural opening, a intramedullary hematoma with lodged bullet in the contused cord was found. They are removed successfully with any postoperative complications. The bullet was composed of lead. We report this case focusing on the pathophysiology and surgical treatment with review of literatures.
Adolescent ; Cerebrospinal Fluid ; Female ; Hematoma ; Humans ; Korea ; Laminectomy ; Paraplegia ; Postoperative Complications ; Spinal Canal ; Spinal Cord ; Spinal Cord Injuries ; Spine* ; Wounds and Injuries* ; Wounds, Gunshot

BACKGROUND: The factors that regulate hair follicle growth are still poorly understood. In vitro models may be useful in elucidating some aspects of hair follicle biology. TNF-alpha is potent inhibitor of hair follicle growth. TNF-alpha induces the formation of a club-like hair follicle, similar to catagen morphology of the hair bulb. Minoxidil induces generalized hypertrichosis when administered systemically, or localized hair regrowth when applied topically to sites of alopecia. OBJECTIVE: The purpose of this study is to investigate the effect of TNF-alpha and minoxidil on human hair growth using in vitro model. METHODS: Healthy human hair follicles without any visible damage were collected, they were cultured in Williams E medium with several combinations of supplements and TNF-alpha and/or minoxidil were added to the media. The results were evaluated by measuring linear hair fiber growth and hair follicle morphology on light microsocopy and by measuring radioisotope uptake of (methyl-3H)thymidine of hair follicle. RESULTS: The following results were obtained from this study. TNF-alpha have inhibitory effect on the rate of linear hair growth in cultured hair follicles. Minoxidil has no stimulatory effect on the rate of linear hair growth and no protective effect on the TNF-alpha induced growth inhibition in cultured hair follicles. CONCLUSION: TNF-alpha has growth-inhibitory effect and minoxidil has no protective effect on the TNF-alpha induced hair change.
Alopecia ; Biology ; Hair Follicle ; Hair* ; Humans* ; Hypertrichosis ; Minoxidil* ; Tumor Necrosis Factor-alpha*

Between March 1995 and March 1996, we used a newly-designed neurosurgical procedure, based on 'keyhole surgery', to operate on 20 patients diagnosed as suffering from lumbar spinal stenosis without instability. The unique surgical steps involved in this procedure are: 1) three-quarter prone position of the patient; 2) small paramedian skin incision; 3) half-way incision of the spinous process; 4) small turnover funnel shaped unilateral laminectomy and wide forminotomy using high speed drills; 5) extensive ligament flavectomy; 6) microsurgical decompression without using nerve root retractor; 7) cosmetic wound closure. In some cases, if bilateral radicular symptom was present, the contralateral nerve root was explored through the unilateral laminectomy opening; this was achieved by changing the inclination of the base of the spinous process and extensively removing of the ligamentum flavum. Compared with conventional procedures, these technical innovations offer both procedural adventages and a better clinical outcome. Because of the small patient populations and short follow-up period, this technique requires further investigation, but we hope it will provide another option for future lumbar stenosis surgery. Further technical refinements and long-term follow-up results will be reported elsewhere.
Constriction, Pathologic* ; Decompression* ; Follow-Up Studies ; Hope ; Humans ; Laminectomy ; Ligaments ; Ligamentum Flavum ; Neurosurgical Procedures ; Prone Position ; Skin ; Spinal Stenosis ; Wounds and Injuries

Sclerosing panniculitis refers to the skin induration and hyperpigmentation of the legs that often occurs in patients who have venous insufficiency. Sclerosing panniculitis is similar to those described under the designations hypodermitis sclerodermiformis or lipodermatosclerosis. Histologically the septa of the subcutis become thickening by inflammation and fibrosis. Adipocytes coalesce to form small and large pseudocysts. Some of these are lined by refractile, amphophilic crenulated membranes. This alteration was referred to as lipomembranous change. We report a case of sclerosing panniculitis in a 40-year-old female patient presented as induration and depression of the skin and subcutaneous tissues of the lower third of the leg.
Adipocytes ; Adult ; Depression ; Female ; Fibrosis ; Humans ; Hyperpigmentation ; Inflammation ; Leg ; Membranes ; Panniculitis* ; Skin ; Subcutaneous Tissue ; Venous Insufficiency

In order to identify the correlations between clinical results and quantitative data of gait analysis, we analyzed the results of 20 cases of total knee joint replacement arthroplasty in 15 patients with degenerative arthritis. We also evaluated the gait analysis of ten age-matched healthy candidates as a control group. Mean follow-up periods were 30 months. Clinical results included post-operative HSS (Hospital for Special Surgery) knee rating scores and the changes of the tibiofemoral angles. The three dimensional gait analysis included clinical assessment, video-taping, three dimensional kinematics and kinetics. The three dimensional kinematics were obtained using a 5 camera VICON system, and the three dimensional kinetic data was collected using two AMTI force plates. There was no statistical difference in linear parameters between the patient and control group. In patients group, however, double support time decreased as the HSS score increased, and range of knee motion and maximum knee flexion increased in accordance with the increase of pain score. Kinematic data of the patients group revealed that some parameters, such as knee flexion during loading response, knee flexion in swing phase, and knee varus during swing phase, were decreased. On the other hand, internal rotation of the knee from initial contact to initial swing was increased when compared with that of control group. There was no significant correlation between the degrees of tibiofemoral angle and coronal plane moment in the patients group. In three cases which showed mild varus instability post-operatively, knee flexion during loading response decreased and valgus moment in midstance increased as compared with the cases without instability. We believe that three dimensional gait analysis will be a good modality for evaluation of the results after total knee arthroplasty. With further accumulation of long term. follow-up data of gait analysis, we might be able to predict the long term results of total knee arthroplasty including possibility of loosening.
Arthroplasty* ; Arthroplasty, Replacement ; Biomechanical Phenomena ; Follow-Up Studies ; Gait* ; Hand ; Humans ; Kinetics ; Knee Joint ; Knee* ; Osteoarthritis

Pityriasis rubra pilaris is a rare papulosquamous and keratotic disease. The orange hue to the erythema, the thickening of the palms and soles and so called 'islands of normal skin' contribute to establish the diagnosis based on morphologic features. We present a 6-month-old male patient with multiple scaly erythematous patches and 'island of normal skin' on the face. There is no palmoplantar keratoderma, nor onychopathy. Histopathologic findings revealed alternating parakeratosis and hypergranulosis in the epidermis and mild perivascular lymphocytic infiltration in the dermis. Unlike to Griffiths classification, he showed good responses to topical steroid and UV phototherapy.
Citrus sinensis ; Classification ; Dermis ; Diagnosis ; Epidermis ; Erythema ; Humans ; Infant* ; Keratoderma, Palmoplantar ; Male ; Parakeratosis ; Phototherapy ; Pityriasis Rubra Pilaris* ; Pityriasis*

Sneddon's syndrome is an infrequent neurocutaneous disorder of unknown origin. It is characterized by the combination of livedo reticularis and cerebrovascular accident. We present a 57-year-old male patient with livedo reticularis and cerebrovascular accident. Magnetic resonance imaging of the head showed a sign of acute focal infarctions in the right cerebellar hemisphere and right vermis. He had netlike patterned, mottled bluish discoloration on both legs. Histopathologic finding revealed elongation and fusion of rete ridges and mild thickening of dermal capillaries.
Capillaries ; Head ; Humans ; Infarction ; Leg ; Livedo Reticularis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurocutaneous Syndromes ; Stroke