A 24-year old woman presented with hemorrhagic vesicles on her legs. She had taken sibutramine (Reductil(R), Abbott Labs., Seoul, South Korea) for 3 months and developed skin lesions the week before. A skin biopsy showed leukocytoclastic vasculitis with conspicuous eosinophilic infiltration of the tissue. These lesions showed improvement after discontinuation of sibutramine. However, 3 months later the skin lesions recurred on other sites on the lower extremities when the patient was rechallenged with the same drug for 2 weeks. Herein, we report the first case of necrotizing vasculitis induced by sibutramine.
Biopsy ; Cyclobutanes ; Eosinophils ; Female ; Humans ; Leg ; Lower Extremity ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

No abstract available.
Child ; Histiocytoma, Benign Fibrous ; Humans

BACKGROUND/AIMS: Fecal calprotectin (FC) is a marker of intraluminal intestinal inflammation. Intestinal inflammation may contribute to the pathophysiology of irritable bowel syndrome (IBS). This study evaluated FC levels in children with IBS and differences in FC levels in children stratified by IBS subtype and healthy controls (HCs).METHODS: A total of 157 children with IBS and 56 HCs aged 4–16 years (119 boys, 94 girls, mean age of 9.48 years) were included in this prospective study. Children with IBS were diagnosed using the Rome III criteria and classified into 4 subtypes: IBS with constipation (IBS-C, n=37), IBS with diarrhea (IBS-D, n=54), IBS with alternating constipation and diarrhea (IBS-M, n=49), and IBS unsubtyped (IBS-U, n=17); postinfectious IBS (PI-IBS) was also considered. The FC concentration in stool samples was analyzed using an enzyme-linked immunosorbent assay. All participants answered a questionnaire regarding several demographic and clinical characteristics.RESULTS: Children with IBS had significantly higher levels of FC than the HCs (88.71 μg/g vs. 17.77 μg/g). Among the 4 IBS subtypes, the FC concentration was highest in children with IBS-D, followed by those with IBS-M, IBS-C, and IBS-U (169.94 μg/g vs. 45.04, 31.22, and 33.52 μg/g, respectively), and these differences were statistically significant. For PI-IBS, 90% of cases were in the IBS-D group.CONCLUSIONS: The FC level was significantly higher in children with IBS than in HCs and differed depending on the IBS subtype, supporting the notion that IBS is a type of low-grade bowel inflammation.
Child ; Constipation ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Inflammation ; Irritable Bowel Syndrome ; Leukocyte L1 Antigen Complex ; Prospective Studies

No abstract available.

The displacement of an entire tooth into the adjacent anatomical area is an uncommon complication of a tooth extraction. We encountered a 23-year-old woman who had previously undergone surgery under local anesthesia to remove the lower third molar about 12 weeks prior and the upper third molar was extracted 2 days prior to visiting this hospital. Upon admission, she complained of a swallowing discomfort and a mouth opening limitation. Panoramic radiograph and a CT scan revealed a displacement of the entire tooth into the lateral pharyngeal space. The tooth was retrieved via the transoral approach under general anesthesia. The removed tooth had an indentation formed by a dental bur. Therefore, it was concluded that the tooth displaced into the lateral pharyngeal space was the lower third molar. This report describes an unusual case of a third molar that was displaced into the lateral pharyngeal space with a review of the relevant literature.
Anesthesia, General ; Anesthesia, Local ; Deglutition ; Female ; Humans ; Molar, Third* ; Mouth ; Tomography, X-Ray Computed ; Tooth ; Tooth Extraction ; Young Adult

No abstract available.
Thyroid Gland* ; Thyroiditis*

We report here on a 63-year-old woman who presented with recurrent bruise-like infiltrative plaques on the left leg without systemic symptoms or laboratory abnormalities. The histopathologic findings showed an infiltration of panniculus by small to medium-sized atypical lymphocytes. But the prominent lymphoid atypia, fat necrosis, vascular thrombosis, erythrophagocytosis and striking dominance of CD8+ lymphocytes seen in subcutaneous panniculitis-like T-cell lymphoma (SPTCL) were not detected. The diagnosis of atypical lymphocytic lobular panniculitis (ALLP) was made based on these histopathologic and clinical features. The lesions responded well to systemic steroid treatment. But the CD4/CD8 ratio in the later lesion was more decreased than that of the initial lesion, and the patient is under clinical follow up.
Fat Necrosis ; Female ; Follow-Up Studies ; Humans ; Leg ; Lymphocytes ; Lymphoma, T-Cell ; Middle Aged ; Panniculitis ; Strikes, Employee ; Thrombosis

A 6-day-old infant presented with a deeply bluish cystic mass below the right medial canthus. She had been born healthy. Under the impression of a hemangioma brain computed tomography was conducted. As a result, a diagnosis of congenital dacryocystocele was made. We present this case to show that it is important for a dermatologist to correctly identify congenital dacryocystoceles and appropriately refer the infant to a pediatric ophthalmologist prior to performing invasive measures.
Brain ; Hemangioma ; Humans ; Infant

We report a case of cutaneous Mycobacterium (M.) abscessus infection in a 32-year-old woman who presented with a red infiltrated plaque on her left shin. No history of prior trauma was reported, but she had a history of habitual leg shaving. Skin biopsy specimen showed neutrophilic abscesses with poorly defined granulomas in the lower dermis and subcutaneous tissue, as well as some acid-fast bacilli. The microorganism was identified as M. abscessus by tissue culture and PCR-restriction fragment length polymorphism (PCR-RFLP) analysis. The patient was treated with clarithromycin and cefaclor for 4 months, and there was no evidence of recurrence at 6 month follow-up.
Abscess ; Adult ; Biopsy ; Cefaclor ; Clarithromycin ; Dermis ; Female ; Follow-Up Studies ; Granuloma ; Humans ; Leg ; Mycobacterium ; Neutrophils ; Recurrence ; Skin ; Subcutaneous Tissue

Dermatitis neglecta (unwashed dermatosis) presents as pigmented hyperkeratotic plaques with adherent scales which clinically resembles psoriasis. This condition is the result of avoiding washing the affected areas, so the lesions are characteristically resolved with normal washing or with gentle wiping from an alcohol swab. We report a 29-year-old man who presented with an asymptomatic hyperkeratotic scaly plaque on umbilicus. A skin biopsy was done under the clinical impression of psoriasis. During skin biopsy, gentle swabbing with H2O2 and saline gauze was done. The patient revisited our clinic 10 days after the skin biopsy and the hyperkeratotic lesion had cleared. Histologic examination showed orthokeratotic hyperkeratosis and anastomosing rete ridges. There has been no previous report of dermatitis neglecta with histologic confirmation, and so this case could be the first report to provide the histologic characteristics of dermatitis neglecta. Because this condition might be overlooked and underdiagnosed, recognizing its existence and cause are important to avoid unnecessary biopsies and potentially aggressive therapeutic measures.
Adult ; Biopsy ; Dermatitis ; Humans ; Psoriasis ; Skin ; Umbilicus ; Weights and Measures