No abstract available.
Immunoglobulins*

The picosecond lasers have shown to effectively treat tattoo pigments that are intractable to previous multiple Q-switched (QS) laser treatments. Therefore we hypothesized that a picosecond laser would show better efficacy with minimal adverse events in the treatment of melasma and post-inflammatory hyperpigmentation (PIH) that are difficult to treat with conventional QS lasers. Two patients with melasma and one patient with PIH were treated with a Picosecond 755-nm Alexandrite Laser (Cyanosure, USA). All patients were Korean with skin type IV and no longer responding to QS laser treatments. Laser treatment was well tolerated in all the patients. Adverse events such as PIH were not reported during 8 weeks of follow up period. After the multiple treatment sessions, one patient reported fair improvement and two patients reported good improvement. Consistent with the clinical results, ex vivo skin model irradiated with a Picosecond 755-nm Alexandrite Laser also showed decreased epidermal keratinocyte necrosis compared with the 532-nm QS Neodymium-Doped Yttrium Aluminium Garnet Laser (Lutronic, Korea) yet decreased melanin content. In conclusion, the Picosecond 755-nm Alexandrite Laser may be useful for effective treatment of intractable melasma and PIH with fewer adverse events in dark Asian skin.
Asian Continental Ancestry Group* ; Follow-Up Studies ; Humans ; Hyperpigmentation* ; Keratinocytes ; Lasers, Solid-State* ; Melanins ; Melanosis* ; Necrosis ; Skin ; Yttrium

No abstract available.
Drug Eruptions* ; Rosuvastatin Calcium

No abstract available.
Humans ; Hyperlipoproteinemia Type III ; Male

PURPOSE: Langerhans cell histiocytosis (LCH) is a disorder characterized by the proliferation of activated Langerhans cells. Although current therapies are very effective at inducing remission, multiple recurrences and long-term sequelae are common for young patients. For this reason, more effective therapies based on the pathogenesis of LCH are needed. We investigated the use of 2-chlorodeoxyadenosine (2-CdA), a purine analogue with an antiproliferative effect on histiocytes and lymphocytes, in patients with recurrent or refractory LCH. METHODS: Four children with recurrent or refractory LCH received 2-CdA (5~7 mg/m2/day for 5 days, given as a 24-hr continuous infusion and repeated every 21~28 days for 5~7 courses). RESULTS: All four patients had multiorgan involvement, and were heavily pretreated. Of the two children with recurrent diseases, one had complete response and the other showed no active disease except for the remaining diabetes insipidus. Two infants who showed poor early response to previous combination chemotherapy also responded poorly: partial response in one, and progressive disease resulting in death in the other. Toxicity consisted mainly of myelosuppression, but significant infections did not occur. The peripheral neuropathy was not seen. CONCLUSION: 2-CdA, tolerable in children without significant side effects, might be effective for the treatment of recurrent LCH in children. However, the efficacy in infants with multi-system, refractory diseases needs further study. The feasibility of 2-CdA treatment as the first-line therapy for high-risk diseases, and the possibility of combination with other agents needs to be addressed in the future.
Child* ; Cladribine* ; Diabetes Insipidus ; Drug Therapy, Combination ; Histiocytes ; Histiocytosis, Langerhans-Cell* ; Humans ; Infant ; Langerhans Cells ; Lymphocytes ; Peripheral Nervous System Diseases ; Recurrence

Dermatofibroma is a common benign fibrohistiocytic tumor. It can occur anywhere on the body surface, but it has a propensity for the extremities. However, dermatofibroma may show a wide variety of clinicopathologic variants and so it is often misdiagnosed. Our case was a 13-year-old male who presented with a 1-year history of a solitary skin-colored hyperkeratotic nodule on the right sole. The nodule had recurred after topical therapy for viral wart. Histopathologic examination of the patient's lesion revealed a poorly circumscribed nodular tumor composed of collagen bundles, fibroblasts and histocytes, which was all consistent with plantar dermatofibroma.
Adolescent ; Collagen ; Extremities ; Fibroblasts ; Histiocytoma, Benign Fibrous ; Humans ; Male ; Warts

PURPOSE: Hepatic veno-occlusive disease (VOD) is a life-threatening complication occurring early after stem cell transplantation (SCT). Early diagnosis and effective treatment has not been established in severe VOD. Because there are few reports on VOD in Korean children, we evaluated the clinical characteristics of VOD following SCT in children. METHODS: We retrospectively reviewed the chart of all patients (n=116) receiving SCTs in CNUH Pediatric BMT center between May, 1991 and June, 2004. RESULTS: VOD developed in 11 patients (9.5%) (median age, 9.8 years; range, 2 to 13.9). Underlying diagnoses were ALL (n=3), severe aplastic anemia (n=3), AML (n=2), acute biphenotypic leukemia (n=1), neuroblastoma (n=1), and myelodysplastic syndrome (n=1). The median day of onset of VOD was D+9 (range, D-3 to D+19). VOD was classified as moderate in 5 and severe in 6 cases. Maximum level of serum total bilirubin was 2.9 mg/dL (range, 2.1 to 9.2) in moderate VOD and 7.3 mg/dL in severe VOD (range, 2.0 to 24.2) at D+18 (range, D-5 to D+59). We successfully treated VOD with various combinations including tPA and heparin (2/5, 40%), ursodeoxycholic acid (2/5, 40%), N-acetylcysteine (3/5, 60%), and defibrotide (1/2, 50%). All of 5 patients with moderate VOD survived at D+100 (range, 5.5+ to 66.6+ months). Five of 6 (83%) patients with severe VOD died within first 19 day from complications of VOD. CONCLUSION: This retrospective study showed that the incidence of VOD was 9.5%, and the mortality of severe VOD was still high which would necessitate early diagnosis, effective prevention and treatment.
Acetylcysteine ; Anemia, Aplastic ; Bilirubin ; Child ; Diagnosis ; Early Diagnosis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Heparin ; Hepatic Veno-Occlusive Disease* ; Humans ; Incidence ; Leukemia, Biphenotypic, Acute ; Mortality ; Myelodysplastic Syndromes ; Neuroblastoma ; Retrospective Studies* ; Stem Cell Transplantation ; Ursodeoxycholic Acid

There have been a small number of recent case reports of patients with erythematous patches around the joints, which histopathologically showed histiocytic aggregations in the dermal vessels. Intralymphatic histiocytosis (ILH) is a rare group of skin diseases that are characterized by the proliferation of histiocytes in a lymphatic vessel lumen, and this is thought to arise as a benign reaction to certain stimuli such as rheumatoid arthritis. The pathogenesis of this intralymphatic proliferation of histiocytes and the reasons they commonly present on the arms are still unknown. We report on a case of ILH with arthritis in a 68-year old female who had no underlying disease, and the ILH presented as irregular erythematous patches on the left antecubital area and these patches demonstrated the distinctive histopathological features of intralymphatic histiocytosis.
Arm ; Arthritis ; Arthritis, Rheumatoid ; Female ; Glycosaminoglycans ; Histiocytes ; Histiocytosis ; Humans ; Joints ; Lymphatic Vessels ; Skin Diseases

BACKGROUND: Dermatologic comorbidities can be the clue for the diagnosis and treatment of systemic conditions and a need for dermatological expert opinion is increased. OBJECTIVE: To analyze the patterns and to quantify the dermatologic consultations referred by the department of obstetrics and gynecology (OBGY). METHODS: We retrospectively studied the data from 479 cases referred by OBGY for a dermatologic consultation during a three-year period in a tertiary hospital. RESULTS: The most common skin disorder was pregnancy-related dermatoses (29.77%) in obstetric inpatients, while cutaneous infection (33.33%) was the most frequent in gynecologic inpatients. The distribution of the skin disorders in consulted OBGY inpatients was consistent with the previous reports. However, there were some differences, such as high proportion of infectious disease. Infectious skin diseases were significantly more frequent (p<0.001) in the chemotherapy group of gynecologic inpatients compared to that of the non-chemotherapy group, viral infection being the most common. In addition, superficial fungal infection accounted for the same proportion as the viral infection (37.50% each) among obstetrical inpatients. Maculopapular or urticarial eruption (51.52%) was the most common type of chemotherapy-related adverse drug reaction. CONCLUSION: This study revealed the distribution of skin disorders in patients referred by OBGY for dermatologic consultation. Furthermore, it could be helpful as an educational material to assist cooperation between dermatology and OBGY.
Communicable Diseases ; Comorbidity ; Dermatology ; Expert Testimony ; Gynecology ; Humans ; Inpatients ; Obstetrics ; Referral and Consultation ; Retrospective Studies ; Skin ; Skin Diseases ; Skin Diseases, Infectious

Granular parakeratosis is a recently recognized disorder of keratinization that is usually confined to intertriginous areas. The histopathologic features are distinctive and diagnostic. Rarely, histopathologic variants such as follicular granular parakeratosis and granular parakeratosis of eccrine ostia have been described. In this report, we describe a rare case of granular parakeratosis mostly confined to eccrine ostia.
Eccrine Glands ; Keratins ; Neck ; Parakeratosis