Incontinentia pigmenti is an uncommon neurocutaneous genodermatosis characterized by three stages; vesicular lesions, verrucous lesions and hyperpigmentation. A two-week-old female infant showed grouped erythema-based vesiculopustules on the whole body since birth. One month later, vesiculopustular lesions began to disappear gradually. At this time, she developed linear verrucous plaques on the dorsum of the feet and hands and reticulated hyperpigmented patches on the lower extremities. At 2 months of age, vesicular lesions completely disappeared and the pigmented patches spread to the abdomen which became darker with time. The verrucous lesions diminished at 3 months of age. There were no neurological or ocular defects. We describe a case of incontinentia pigmenti with typical clinical and pathological features at each stage.
Abdomen ; Female ; Foot ; Hand ; Humans ; Hyperpigmentation ; Incontinentia Pigmenti* ; Infant ; Lower Extremity ; Parturition

BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

The CD8(+)CD28(+) T cells have known to mediate major histocompatibility complex class I-restricted cytolysis and to secret an HIV-1 inhibitory factor. As HIV infection lead to dramatic changes within the cellular immune system, the cellular cytotoxicities decrease in the duration of the HIV infection. To determine the importance of the cellular cytotoxicities in long-term nonprogression, we tried to compare CD28 expression on total T, CD4(+) T, and CD8(+) T cells as one of methods for cellular cytotoxicity measurements between long-term nonprogressor and normal person or between long-term nonprogressor and rapid progressor. The median percentages and counts of CD4(+) T cells of the norrnal, the long-term nonprogressor, and the rapid progressor groups were 39.9 and 0.96 * 10(9) cells/L, 24.6 and 0.58 * 10(9) cells/L, 9.9 and 0.15 * 10 cells/L, respectively. As a result of comparison of the cells having CD28 surface molecules on CD8(+) T cells in the long-term nonprogressor and the rapid progressor group, they showed over 5 times lower than that in the normal group. Especially, the long-term nonprogressor regarded to the healthy HIV-infected patient showed much lower CD28 expression on total T, CD4(+) T, and CD8(+) T cells than those of the normal person. The proportions of CD4'CD28 T and CD3CD28 T cell subsets showed the significant difference between the LTNP and the RP group. In conclusion, although HIV-infected patients were LTNPs having the steady CD4(+) T cell counts and no clinical symptoms, we suggested that HIV led to abnormality within the lymphocyte subsets such as the altered expression of CD28 molecules on various T cell subsets and this result would cause deficiency of host immune function and failure of control of HIV replication by anergy in T cell subsets.
Cell Count ; HIV ; HIV Infections ; HIV-1 ; Humans ; Immune System ; Lymphocyte Subsets ; Major Histocompatibility Complex ; T-Lymphocyte Subsets* ; T-Lymphocytes

Stevens-Johnson syndrome (SJS) and acute generalized exanthematous pustulosis (AGEP) are 2 distinct entities that can overlap within the spectrum of severe cutaneous adverse reaction (SCAR). AGEP is a self-limiting and drug-induced eruption characterized by sudden onset of sterile pustules, erythema, and sometimes fever. SJS, in contrast, is a severe form of SCAR that causes blistering and necrosis of the skin and mucosal membranes, often leading to significant morbidity and mortality. However, there are cases where patients may present with symptoms that overlap between AGEP and SJS, making it challenging to differentiate the 2 conditions. This report describes a 70-year-old male with nontuberculous mycobacterium tenosynovitis in the left hand, coinfected with methicillin-resistant coagulase-negative Staphylococcus and Klebsiella oxytoca. After administration of additional antibiotics, the patient developed fever and erythematous macules with purpuric centers on the trunk and the extremities. Further examination revealed marked leukocytosis and elevated C-reactive protein levels. Skin biopsy histopathology showed subcorneal intraepidermal pustule formation with neutrophil infiltration. The patient’s clinical course improved after cessation of the culprit drugs and treatment with a high-dose systemic steroid. This case highlights the rare occurrence of SJS/AGEP overlap and underscores the importance of prompt diagnosis and appropriate management of these SCAR.

Stevens-Johnson syndrome (SJS) and acute generalized exanthematous pustulosis (AGEP) are 2 distinct entities that can overlap within the spectrum of severe cutaneous adverse reaction (SCAR). AGEP is a self-limiting and drug-induced eruption characterized by sudden onset of sterile pustules, erythema, and sometimes fever. SJS, in contrast, is a severe form of SCAR that causes blistering and necrosis of the skin and mucosal membranes, often leading to significant morbidity and mortality. However, there are cases where patients may present with symptoms that overlap between AGEP and SJS, making it challenging to differentiate the 2 conditions. This report describes a 70-year-old male with nontuberculous mycobacterium tenosynovitis in the left hand, coinfected with methicillin-resistant coagulase-negative Staphylococcus and Klebsiella oxytoca. After administration of additional antibiotics, the patient developed fever and erythematous macules with purpuric centers on the trunk and the extremities. Further examination revealed marked leukocytosis and elevated C-reactive protein levels. Skin biopsy histopathology showed subcorneal intraepidermal pustule formation with neutrophil infiltration. The patient’s clinical course improved after cessation of the culprit drugs and treatment with a high-dose systemic steroid. This case highlights the rare occurrence of SJS/AGEP overlap and underscores the importance of prompt diagnosis and appropriate management of these SCAR.

Stevens-Johnson syndrome (SJS) and acute generalized exanthematous pustulosis (AGEP) are 2 distinct entities that can overlap within the spectrum of severe cutaneous adverse reaction (SCAR). AGEP is a self-limiting and drug-induced eruption characterized by sudden onset of sterile pustules, erythema, and sometimes fever. SJS, in contrast, is a severe form of SCAR that causes blistering and necrosis of the skin and mucosal membranes, often leading to significant morbidity and mortality. However, there are cases where patients may present with symptoms that overlap between AGEP and SJS, making it challenging to differentiate the 2 conditions. This report describes a 70-year-old male with nontuberculous mycobacterium tenosynovitis in the left hand, coinfected with methicillin-resistant coagulase-negative Staphylococcus and Klebsiella oxytoca. After administration of additional antibiotics, the patient developed fever and erythematous macules with purpuric centers on the trunk and the extremities. Further examination revealed marked leukocytosis and elevated C-reactive protein levels. Skin biopsy histopathology showed subcorneal intraepidermal pustule formation with neutrophil infiltration. The patient’s clinical course improved after cessation of the culprit drugs and treatment with a high-dose systemic steroid. This case highlights the rare occurrence of SJS/AGEP overlap and underscores the importance of prompt diagnosis and appropriate management of these SCAR.

Stevens-Johnson syndrome (SJS) and acute generalized exanthematous pustulosis (AGEP) are 2 distinct entities that can overlap within the spectrum of severe cutaneous adverse reaction (SCAR). AGEP is a self-limiting and drug-induced eruption characterized by sudden onset of sterile pustules, erythema, and sometimes fever. SJS, in contrast, is a severe form of SCAR that causes blistering and necrosis of the skin and mucosal membranes, often leading to significant morbidity and mortality. However, there are cases where patients may present with symptoms that overlap between AGEP and SJS, making it challenging to differentiate the 2 conditions. This report describes a 70-year-old male with nontuberculous mycobacterium tenosynovitis in the left hand, coinfected with methicillin-resistant coagulase-negative Staphylococcus and Klebsiella oxytoca. After administration of additional antibiotics, the patient developed fever and erythematous macules with purpuric centers on the trunk and the extremities. Further examination revealed marked leukocytosis and elevated C-reactive protein levels. Skin biopsy histopathology showed subcorneal intraepidermal pustule formation with neutrophil infiltration. The patient’s clinical course improved after cessation of the culprit drugs and treatment with a high-dose systemic steroid. This case highlights the rare occurrence of SJS/AGEP overlap and underscores the importance of prompt diagnosis and appropriate management of these SCAR.

Stevens-Johnson syndrome (SJS) and acute generalized exanthematous pustulosis (AGEP) are 2 distinct entities that can overlap within the spectrum of severe cutaneous adverse reaction (SCAR). AGEP is a self-limiting and drug-induced eruption characterized by sudden onset of sterile pustules, erythema, and sometimes fever. SJS, in contrast, is a severe form of SCAR that causes blistering and necrosis of the skin and mucosal membranes, often leading to significant morbidity and mortality. However, there are cases where patients may present with symptoms that overlap between AGEP and SJS, making it challenging to differentiate the 2 conditions. This report describes a 70-year-old male with nontuberculous mycobacterium tenosynovitis in the left hand, coinfected with methicillin-resistant coagulase-negative Staphylococcus and Klebsiella oxytoca. After administration of additional antibiotics, the patient developed fever and erythematous macules with purpuric centers on the trunk and the extremities. Further examination revealed marked leukocytosis and elevated C-reactive protein levels. Skin biopsy histopathology showed subcorneal intraepidermal pustule formation with neutrophil infiltration. The patient’s clinical course improved after cessation of the culprit drugs and treatment with a high-dose systemic steroid. This case highlights the rare occurrence of SJS/AGEP overlap and underscores the importance of prompt diagnosis and appropriate management of these SCAR.

PURPOSE: In Korea, vivax malaria re-emerged in 1993 and the outbreak continued in several areas near the DMZ until now. This study was conducted to define the epidemiologic pattern of malaria in Korea and to examine the changes comparing to the one in 1999. METHODS: We collected information about civilian, veteran patients through the National malaria surveillance system and soldier from the Ministry of National Defense. We analyze epidemiological characteristics of malaria by groups (civilian, veteran, soldier). RESULTS: The reported cases of malaria in 2000 were 4,142 that number is an increase of 14% in numbers compared with those of 1999's. Most of cases occured in 17 counties nearby DMZ and from May to October(98.7%) seasonally. The incidence rates (per 100,000) in 2000 by residence were 17.0 in Gangwon-Do, 15.5 in Incheon Metropolitan city, 10.3 in Gyeonggi-Do was dereased. The risk area in 2000 were 17 counties located nearly DMZ and the high risk area were 5 counties where the incidence rate greater than 100. In case of civilian and veteran, the time required to diagnosis from onset of symptom was 8.1 days on the average. CONCLUSION: Epidemiologic pattern of malaria in 2000 did not differ from the one in 1999. Et showed regional spread (increasing risk area) but incidence rate was lowered in the high risk area of 1999. And it is necessary that we pay more attention to Gangwon-Do and Incheon metrocity to reduce the incidence rate in 2001.
Diagnosis ; Epidemiology* ; Gangwon-do ; Gyeonggi-do ; Humans ; Incheon ; Incidence ; Korea* ; Malaria* ; Malaria, Vivax ; Military Personnel ; Seasons ; Veterans

PURPOSE: To evaluate the usefulness of transperineal sonography of the prostate in patients with previousabdominoperineal resection. MATERIALS AND METHODS: Transperineal prostatic sonograms were obtained from ninepatients with abdominoperineal resection. The shortest distance between the probe and the prostate gland, itsvolume, and its internal and external structures were evaluated for image quality, shape, border, and the degreeof distortion in internal echo. Because the number of patients was small, statistical analysis was not performed. RESULTS: Transperineal sonography of the prostate in eight patient was obtained at ease, except that one of ninepatients was not able to continue the procedure because of severe tenderness of the perineum and poor cooperation.Acceptable images of the prostate gland and their adjacent structures were obtained in one patient with less than1cm between the probe and prastate gland, three of four with between 1cm and 1.5cm, and one of three with morethan 1.5cm. CONCLUSION: In patients with previous abdominoperineal resection, transperineal sonography of theprostate may be a good imaging modality.
Humans ; Perineum ; Prostate*