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

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.
Dialysis* ; Peritonitis* ; Salmonella*

No abstract available.
Dialysis* ; Peritonitis* ; Salmonella*

Drug eruptions are common problems in hospital inpatients and outpatients. Cutaneous drug reactions range from mild to severe and from those localized only to skin to those associated with systemic disease. Cutaneous drug reactions are also a challenging diagnostic problem since they can mimic a large variety of skin diseases, including viral exanthem, collagen vascular disease, neoplasia, bacterial infection, psoriasis, and autoimmune blistering disease, among others. Furthermore, determining a particular medication which caused an eruption is often difficult when the patient is taking multiple drugs. In this review, clinical manifestations of adverse cutaneous drug reactions are described. A morphologic approach to drug eruption includes those that are classified as exanthematous eruption, urticaria, pustular eruption, bullous eruption, fixed drug eruption, photosensitive eruption, skin necrosis, lichenoid eruption, cutaneous pseudolymphoma, lupus erythematosus, and hand-foot syndrome. And also, recently reported cutaneous adverse reactions associated with newly developed drugs, such as epidermal growth factor receptor inhibitors, low molecular weight tyrosine kinase inhibitors, tumor necrosis factor-alpha antagonists, sirolimus and granulocyte colony-stimulating factor, are discussed.
Bacterial Infections ; Blister ; Collagen ; Drug Eruptions ; Exanthema ; Granulocyte Colony-Stimulating Factor ; Hand-Foot Syndrome ; Humans ; Hydrazines ; Inpatients ; Lichenoid Eruptions ; Molecular Weight ; Necrosis ; Outpatients ; Protein-Tyrosine Kinases ; Pseudolymphoma ; Psoriasis ; Receptor, Epidermal Growth Factor ; Sirolimus ; Skin ; Skin Diseases ; Tumor Necrosis Factor-alpha ; Urticaria ; Vascular Diseases

BACKGROUND: It is well-known that the giant congenital nevi prcgress to malignant, melanama more frequently than other benign melanocytic nevi but to date the laor tory methods for early detection of such progression were not avsilable. The proliferating cell uncleai antigen(PCNA) staining has been regsrded as an useful marker in determining prognosis of some maignant diseases. OBJECTIVE: The PCNA taining was performed as a predictive value of malignant transformation from benign meanocytic skin lesions. We investigated the differcnces between malignant melanoma and the benign lesions. MATERIAL AND METHODS: Immunohistochemical study was employee using anti-PCNA, anti-S-100, and anti-CD45RO antibody in 6 giant congenital nevi, 8 small and medium sized congenital nevi, 10 acquired nevi, and 10 malignant meanomas. Only cells positive for both PCNA and S-100, and negative for CD45RO on the serial sections were identified as melanocyts. RESULTS: The number of PCNA-posit,ive cells per 1000 melanocy,es averaged 6.0+7.5 in giant, congenital nevi, 2.9+1,9 in small and medium sized congenital novi, 3.1+2.7 in acquired nevi, and 61.5+ 39.4 in malignant, melanomas. Malignant melanomas showed onger intensity of PCNA staining than the other melanocytir nevi. CONCLUSION: There was not significant difference of the numter of PCNA-positive cells among the groups of congenital neviind PCNA staining can't be used in prditive measure of malignant. progression and studying mechansm of malignancy in giant congenital nevi. But, PCNA staining is considered as an useful method in differentiat,ing malignant melanoma from mllanocytic nevi.
Melanoma ; Nevus ; Nevus, Pigmented ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Skin*

BACKGROUND: Desmogleins are transmembrane glycoproteins of the desmosome which provide mechanical strength to epithelial tissue. Desmogleins have so far, been implicated in several diseases such as pemphigus, striate palmoplantar keratoderma, 4S and squamous cell carcinomas. Skin cancer usually occurs in old age. And there are reports that the expression of desmogleins are increased in squamous cell carcinoma. However the role of desmogleins in skin aging has not yet been reported. OBJECTIVE: The purpose of this study was to investigate the expression of desmoglein 1 and 3 according to chronologic skin aging. METHODS: A total of 6 normal tissue samples from sun-protected skin of different age groups (from 34-year-old to an 84-year-old) and 1 squamous cell carcinoma tissue from a 72-year-old patient were taken. Western blotting and immunohistochemical staining were performed with anti desmoglein 1 and 3 antibodies. The expression of desmoglein 1 and 3 by Western blotting were calculated semiquantitatively by a densitometer. RESULTS: The expression of desmoglein 1 was 0.382 in the 34-year-old, 0.450 in the 45-year-old, 0.369 in the 56-year-old, 0.761 in the 65-year-old, 1.035 in the 77-year-old and 1.329 ODu/mm2 in the 84-year-old. The expression of desmoglein 3 was 0.830 in the 34-year-old, 0.984 in the 45-year-old, 1.029 in the 56-year-old, 1.534 in the 65-year-old, 1.714 in the 77-year-old and 1.878 ODu/mm2 in the 84-year-old. In immunohistochemical staining, the expression of Dsg1 increased from the basal layer to the granular layer and Dsg3 was expressed in the basal and suprabasal layers. CONCLUSION: The expression of desmoglein 1 and 3 were increased according to chronologic skin aging.
Adult ; Aged ; Aged, 80 and over ; Antibodies ; Blotting, Western ; Carcinoma, Squamous Cell ; Desmoglein 1* ; Desmoglein 3 ; Desmogleins* ; Desmosomes ; Glycoproteins ; Humans ; Keratoderma, Palmoplantar ; Middle Aged ; Pemphigus ; Skin Aging* ; Skin Neoplasms ; Skin*

BACKGROUND: In diabetes mellitus patient with general anesthesia can be especially quite fatal if autonomic neuropathy were involved in the autonomic nervous system of cardiovascular system. This research was designed to study for incidence of diabetic autonomic neuropathy(DAN) in diabetic patients and to check the effects of the cardiovascular system by general anesthesia in DAN patients. METHODS: DAN was diagnosed by 5 different diagnostic criterias and that criterias were suggested by Ewing and Clarke. For evaluation of the effects between autonomic neuropathy and general anesthesia in diabetes patients with DAN, systolic blood pressure, diastolic blood pressure, heart rates were measured on 5 points from start of anesthesia to 5 minutes prior to completion of operation, and was checked about incidence of dysrhythmias and using of vasopressor drugs during anesthesia. RESULTS: Incidence of DAN were 11 cases within 33 diabetes patients. Among the 11 cases, 10 cases developed neuropathy in parasympathetic nervous system and 3 cases developed neuropathy in sympathetic nervous system. There were no statistical significance of the changes of systolic blood pressure, diastolic blood pressure and heart rate between control group and DAN patients under general anesthesia except just after intubation. Also, the incidence of dysrhythmias and using vasopressors during anesthesia were checked and compared. CONCLUSIONS: We concluded as follow. 1) It is essential to the safe anesthetic managements that diabetes patients are anesthetized after having diabetic autonomic function test before anesthesia. 2) If we are going to do general anesthesia for DAN patient, anesthesiologist have to pay more vigilance on the change of blood pressure and pulse rate, especially on just after intubation period.
Anesthesia ; Anesthesia, General* ; Autonomic Nervous System ; Blood Pressure* ; Cardiovascular System ; Diabetes Mellitus ; Diabetic Neuropathies* ; Heart Rate* ; Heart* ; Humans ; Incidence ; Intubation ; Parasympathetic Nervous System ; Sympathetic Nervous System

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

Aplasia cutis congenita (ACC) is an uncommon condition which is characterized by congenital, localized or widespread absence of skin or scar formation. Lesions can be multiple and may occur on any body surface, although they are mostly seen on the scalp as a solitary lesion. ACC is most often a benign isolated defect; but it can be associated with other physical anomalies or malformation syndromes. Adams-Oliver syndrome is a distinct subtype in which distal limb reduction is found in association with a solitary scalp defect. There is no single underlying cause of ACC; it may reflect a disruption of intrauterine skin development. A 25 day-old boy was referred to our clinic with a thick hemorrhagic crust, and a surrounding hairless atrophic scar on the midline over the skull vertex. He also had hypoplasia of the left 2nd to 5th toes since birth. The rest of the physical examination as well as an ultrasound examination of the brain were normal. Herein we report a rare case of ACC of the scalp accompanied by distal limb hypoplasia, Adamson-Oliver syndrome.
Brain ; Cicatrix ; Ectodermal Dysplasia ; Extremities ; Limb Deformities, Congenital ; Parturition ; Physical Examination ; Scalp ; Scalp Dermatoses ; Skin ; Skull ; Toes