Acrokeratoelastoidosis of Costa is a rare palmoplantar keratoderma with autosomal dominant inheritance. It is clinically charaeterized by small, firm, yellowish, shiny, translucent papules occumng over the dorsal hands, the knuckles, and the lateral margine of the palms and soles. Histologically, the characteristic features are hyperkeratosis, aeanthosis, and most strikingly, fragmentation of coarse elastic fibers within the dermis. The lesions usually begin in early childhood and progress slowly. We herein report two familial cases of acrokeratoelastoidosis of Costa showing typical clinic1 and histopathological features.
Dermis ; Elastic Tissue ; Hand ; Keratoderma, Palmoplantar ; Wills*

No abstract available.
Animals ; Clone Cells* ; Cloning, Organism* ; Mast Cells* ; Mice*

Tegafur is a fluoropyrimidine structurally similar to 5-fluorouracil, used in the treatment of advanced gastrointestinal neoplasms. Mucocutaneous side reactions induced by this agent are rare and include photosensitivity of lichenoid and eczematous types, acral erythema, hyperpigmentation and palmoplantar keratoderma. However, to our knowledge, there has been no report of concurrent development of eruptions of two types in a patient. We describe a female patient with breast cancer, presented with combined features of acral erythema and hyperpigmentation due to oral tegafur.
Breast Neoplasms ; Erythema* ; Female ; Fluorouracil ; Gastrointestinal Neoplasms ; Humans ; Hyperpigmentation* ; Keratoderma, Palmoplantar ; Tegafur*

Anetoderma is loose and wrinkled skin lesions that show the characteristic histopathological feature of focal loss of elastic fibers in the dermis. The primary type of anetoderma arises in clinically normal skin and the secondary type replaces the lesions of associated disorders including various infections, infiammatory diseases and tumors. However, anetoderma due to pilomatricoma is very rare. Our patient, a 21-year-old female, presented with a soft and wrinkled skin overlying a firm, pedunculated tumor on her left upper arm. The histopathological examination showed anetodermic cutaneous changes which were associated with the underlying pilomatricoma.
Anetoderma* ; Arm ; Dermis ; Elastic Tissue ; Female ; Humans ; Pilomatrixoma* ; Skin ; Young Adult

Linear IgA bullous dermatosis (LABD) is an autoimmune subepidermal blistering disease characterized on direct immunofluorescence of perilesional skin by the linear deposition of IgA at the basement membrane zone. The pathogenesis of LABD is not known, but rar ely some cases of LABD have been reported in association with drug exposure. We report a case of drug-induced LABD showing linear deposits of IgA and IgG at the basement membrane zone on direct immunofluorescence of perilesional skin as well as typical clinical and histologic characteristics, although the causative agent could not be specified.
Basement Membrane ; Blister ; Fluorescent Antibody Technique, Direct ; Immunoglobulin A ; Immunoglobulin G ; Linear IgA Bullous Dermatosis* ; Skin

Traumatic fat necrosis is a localized reaction of panniculus resulting from blunt trauma occurring predominantly on large pendulous breasts in elderly females and on the face in children. The facial lesions in children need no treatment and therapeutic excision is not indicated because a reasonable cosmetic result comes from spontaneous healing in a year or more. The clinicians unfamiliar with this problem may have confusion in diagnosis and management. Herein we report a case of a three-year-old girl who presented with a 3 cm sized erythematous and bullous plaque on her right cheek. The diagnosis of traumatic fat necrosis was made following clinical and pathological findings.
Aged ; Breast ; Cheek ; Child* ; Diagnosis ; Fat Necrosis* ; Female ; Humans

BACKGROUND/AIMS: Rebleeding after endoscopic therapy for non-variceal upper gastrointestinal hemorrhage (NGIH) is the most important predictive factor of mortality. We evaluated the risk factors of rebleeding in patients undergoing endoscopic therapy for the NGIH. METHODS: Between January 2003 and January 2007, 554 bleeding events in 487 patients who underwent endoscopic therapy for NGIH were retrospectively enrolled. We reviewed the clinicoendoscopical characteristics of patients with rebleeding and compared them with those of patients without rebleeding. RESULTS: The incidence of rebleeding was 21.7% (n=120). In the multivariate analysis, initial hemoglobin level < or =9 g/dL (p=0.002; odds ratio [OR], 2.433), inexperienced endoscopist with less than 2 years of experience in therapeutic endoscopy (p=0.001; OR, 2.418), the need for more 15 cc of epinephrine (p=0.001; OR, 2.570), injection therapy compared to thermal and injection therapy (p=0.001; OR, 2.840), and comorbidity with chronic renal disease (p=0.004; OR, 2.908) or liver cirrhosis (p=0.010; OR, 2.870) were risk factors for rebleeding following endoscopic therapy. CONCLUSIONS: Together with patients with low hemoglobin level at presentation, chronic renal disease, liver cirrhosis, the need for more 15 cc of epinephrine, or therapy done by inexperienced endoscopist were risk factors for the development of rebleeding.
Comorbidity ; Endoscopy ; Epinephrine ; Gastrointestinal Hemorrhage ; Hemoglobins ; Hemorrhage ; Humans ; Incidence ; Liver Cirrhosis ; Multivariate Analysis ; Odds Ratio ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors

Background/Aims: Enzymatic analysis of aspartate/alanine aminotransferase (AST/ALT) does not exactly represent the progression of liver fibrosis or inflammation. Immunoassay for AST (cytoplasmic [c] AST/mitochondrial [m] AST) and ALT (ALT1/ALT2) has been suggested as one alternatives for enzymatic analysis. The objective of this study was to evaluate the efficacy of immunoassay in predicting liver fibrosis and inflammation. Methods: A total of 219 patients with chronic hepatitis B (CHB) who underwent hepatic venous pressure gradient (HVPG) and liver biopsy before antiviral therapy were recruited. Serum samples were prepared from blood during HVPG. Results of biochemical parameters including enzymatic AST/ALT and immunological assays of cAST, mAST, ALT1, and ALT2 through sandwich enzyme-linked immunosorbent assay (ELISA) immunoassay with fluorescence labeled monoclonal antibodies were compared with the results of METAVIR stage of live fibrosis and the Knodell grade of inflammation. Results: METAVIR fibrosis stages were as follows: F0, six (3%); F1, 52 (24%); F2, 88 (40%); F3, 45 (20%); and F4, 28 patients (13%). Mean levels of AST and ALT were 121 ± 157 and 210 ± 279 IU/L, respectively. Mean HVPG score of all patients was 4.7 ± 2.5 mmHg. According to the stage of liver fibrosis, HVPG score (p < 0.001, r = 0.439) and ALT1 level (p < 0.001, r = 0.283) were significantly increased in all samples from patients with CHB. ALT (p < 0.001, r = 0.310), ALT1 (p < 0.001, r = 0.369), and AST (p < 0.001, r = 0.374) levels were positively correlated with Knodell grade of inflammation. Conclusions ALT1 measurement by utilizing sandwich ELISA immunoassay can be useful method for predicting inf lammation grade and fibrosis stage in patients with CHB.