We rep a case of vulvar syringoma in a 32-year-old woman who had pruritus vulvae for 2 years. An examination of both the labia major revealed slightly thickened hyperpigmented or hypopigmented patches without yellow papules. A skin punch biopsy revealed characteristic histological findings of syringoma. Syringoma of the vulva is a rare disorder and is usually asymptomatic. Five cases of vulvar syringoma preriously reported in the Korean literature all had asymptomatic yellow or brown colored papules, but this case presented here was clinically considered as pruritus vulvae.
Adult ; Biopsy ; Female ; Humans ; Pruritus Vulvae* ; Pruritus* ; Skin ; Syringoma* ; Vulva

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

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

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*

We treated a case of extramammary Paget's disease that affected the scalp of a 45-year-old female. It is extremely rare that the disease arises in areas other than the anogenital region and the axillae. The lesion was a round erythematous oozing crusted hairless patch. Histopathologically, many pagetoid cells were found within the epidermis and dermis. The cytoplasms of these cells stained with alcian blue at pH 2.5, CEA, EMA and low-molecular-weight-cytokeratin. The patient underwent a wide local excision. We used a mapping technique to reveal the distribution of microscopically involved lesions.
Alcian Blue ; Axilla ; Cytoplasm ; Dermis ; Epidermis ; Female ; Humans ; Hydrogen-Ion Concentration ; Middle Aged ; Paget Disease, Extramammary* ; Scalp*

Dermatofibroma with granular cells is composed mainly of spindle shaped cells mixed with in-conspicuous foamy cells that contain granular cytoplasm. We present a case of dermatofibroma with granular cells in a 36-year-old male who visited our clinic to evaluate a slow-growing nodule on the medial side of the left lawer leg. He have had the nodule for five years and sometimes felt an itching sensation. Biopsy of the nodule identified a dermal nodular tumor showing cellular spindle cell proliferation admixed with peripheral foamy histiocytes. With the immunohistochemical staining, the granular cell was positive for alpha-1-antitrypsin and CD68, and negative for S-100. A few electron-dense granules were seen in the cytoplasm on the electronmicroscopic study. These results suggested that the granular cells originated from histiocytes.
Adult ; Biopsy ; Cell Proliferation ; Cytoplasm ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Leg ; Male ; Pruritus ; Sensation

Objective: This study was conducted to investigate the prevalence, status, severity, frequency, and impact on life of drooling in children with cerebral palsy. Methods: A total of 74 children with cerebral palsy, aged 2-6 years (53.68±17.33 months), who exhibited drooling symptoms were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Drooling Impact Scale (DIS) to determine the status, severity, frequency, and impact of drooling in drooling group and control group. The study also examined differences in drooling-related factors based on gender, age, and prematurity status. Results: The overall prevalence of drooling was 60.8%, 35.6% in those with spastic quadriplegia, and 77.8% in children at Gross Motor Function Classification System (GMFCS) level III-V. Significant differences were found in drooling severity based on gender, prematurity, and age. Higher scores were observed for drooling severity and frequency, frequency of wiping the mouth, and the impact of drooling on the child’s life compare to control group.Although a few had undergone drooling-related treatments, many parents expressed a desire to receive treatment. It was reported that treatment for drooling was primarily provided by occupational therapists through referrals to rehabilitation medicine, with dysphagia rehabilitation and oral motor therapy being the main interventions. Conclusion By utilizing standardized assessment tools, the severity of drooling according to the specific conditions of children with disabilities was assessed. It is believed that the necessary steps to be taken include identifying the cause of drooling and setting appropriate treatment goals, followed by the provision for a suitable intervention.

Objective: This study was conducted to investigate the prevalence, status, severity, frequency, and impact on life of drooling in children with cerebral palsy. Methods: A total of 74 children with cerebral palsy, aged 2-6 years (53.68±17.33 months), who exhibited drooling symptoms were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Drooling Impact Scale (DIS) to determine the status, severity, frequency, and impact of drooling in drooling group and control group. The study also examined differences in drooling-related factors based on gender, age, and prematurity status. Results: The overall prevalence of drooling was 60.8%, 35.6% in those with spastic quadriplegia, and 77.8% in children at Gross Motor Function Classification System (GMFCS) level III-V. Significant differences were found in drooling severity based on gender, prematurity, and age. Higher scores were observed for drooling severity and frequency, frequency of wiping the mouth, and the impact of drooling on the child’s life compare to control group.Although a few had undergone drooling-related treatments, many parents expressed a desire to receive treatment. It was reported that treatment for drooling was primarily provided by occupational therapists through referrals to rehabilitation medicine, with dysphagia rehabilitation and oral motor therapy being the main interventions. Conclusion By utilizing standardized assessment tools, the severity of drooling according to the specific conditions of children with disabilities was assessed. It is believed that the necessary steps to be taken include identifying the cause of drooling and setting appropriate treatment goals, followed by the provision for a suitable intervention.

Objective: This study was conducted to investigate the prevalence, status, severity, frequency, and impact on life of drooling in children with cerebral palsy. Methods: A total of 74 children with cerebral palsy, aged 2-6 years (53.68±17.33 months), who exhibited drooling symptoms were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Drooling Impact Scale (DIS) to determine the status, severity, frequency, and impact of drooling in drooling group and control group. The study also examined differences in drooling-related factors based on gender, age, and prematurity status. Results: The overall prevalence of drooling was 60.8%, 35.6% in those with spastic quadriplegia, and 77.8% in children at Gross Motor Function Classification System (GMFCS) level III-V. Significant differences were found in drooling severity based on gender, prematurity, and age. Higher scores were observed for drooling severity and frequency, frequency of wiping the mouth, and the impact of drooling on the child’s life compare to control group.Although a few had undergone drooling-related treatments, many parents expressed a desire to receive treatment. It was reported that treatment for drooling was primarily provided by occupational therapists through referrals to rehabilitation medicine, with dysphagia rehabilitation and oral motor therapy being the main interventions. Conclusion By utilizing standardized assessment tools, the severity of drooling according to the specific conditions of children with disabilities was assessed. It is believed that the necessary steps to be taken include identifying the cause of drooling and setting appropriate treatment goals, followed by the provision for a suitable intervention.