We report a case of tuberculosis verrucosa cutis in a 33-year-old male patient who presented with mild itching verrucous plaque over the perineum. The Mantoux test revealed a positive reaction. The histophathologic picture consists of slight hyperkeratosis, irregular ac:anthosis overlying an inflammatory iafitrate in the dermis. Tuberculous granulomas with caseation necrosis were seen in the dermis. Tuber clebacillus was demonstrated. The patient was treated with Isoniazid, Rifampicin, and Pyrazine made for 6 months. To date, the skin lesions have markedly improved.
Adult ; Dermis ; Granuloma ; Humans ; Isoniazid ; Male ; Necrosis ; Perineum ; Pruritus ; Rifampin ; Skin ; Tuberculosis*

Xeroderma pigmentosum is a hereditary disorder characterized by the ear1y development of pigmentary changes, atrophy, keratoses, and carcinoma, predorninantly light exposed area skin. Two cases of xeroderma pigmentosum complicated. by basal cell Ca. were presented. The one was 15 years old male who had been suffered frorn pea to walnut sized multiple tumors and ulcers on the face with scattered brownish macuIes on the sun exposed area since about 9 years old of his age. The other was 22 years old maIe who had been suffered from the same skin lesions as the former on the face, neck and dorsum of hands. In both cases skin lesions aggravated during each summer seasons and there were on history of convulsions and other neurological symptoms Histopathological findings of tumors on both cases revealed typical findings of basal cell Ca.
Adolescent ; Atrophy ; Child ; Hand ; Humans ; Juglans ; Keratosis ; Male ; Neck ; Peas ; Seasons ; Seizures ; Skin ; Solar System ; Ulcer ; Xeroderma Pigmentosum ; Young Adult

The pathogenicity of Demodex folliculorum (DF) is not well established, becausc this cutaneous parasite can be found very often not only from acneic skin lesions but also on healthy human skin, surface, particularly on sebaceous gland-rich and functionaIly active areas of the skin, i.e. on face, and therefore, the mite has been generally considered as normal inhabitant of human skin. However, as is the case with candidiasis, the parasite could also be pathogenic in the state of disturbed host-para-site relationship. To find out the pathogenicity of the mite, the authors studied the incidence of finding DF from different sites of face in several groups of 60 acneic patients (various types of acne vulgaris and rosacea) and 30 normal subjects as control. And the results obtained were as follows: the mite was found in 33 cases out of the acnei patients (55%), in male patients 67% (12 out of l8) were positive and in fernales 50% (21 out of 42). In the control group of 3O (15 each sex), 17 cases (9 males and 8 females) had thc mite, the incidence rate being 57%, The incidence rate of DF in various types of acneic skin lesions were: 85% in rosacea. 80% in pustular acne 71% in cvstic acne and 32% in papular acne. The distribution of the mite in various sites of the face differed markedly in the acneic and normal groups. In the control group 17 (57 %) were positive on nose, 3 (10%) on cheek, 2 (7%) on chin, and none on the forehead. Among 60 acneic patients, however, 18 (30%) were positive on cheek, 17 (28%) on nose, 15 (25%) on chin 12 (20 %) on forehead. In addition, the acuthors observed two cases of demodicidosis in the dogs. These two dogs were siblings and lived together with other dogs of the same lineage, but the other dogs were not affected. In spite of vigorous treatment with 15 % benzyl benzoate aqueous emulsion and 10 % crotamiton ointment applied topically for two to three weeks, the dogs died within one to two months. Slight improvement only was noted in the first week of the treatment, but the dogs were gradually emaciated, leading to death. At the onset of the disease, both dogs were two to three months old. Histopathological studies of the affected skin revealed dense patchy lymphocytic infiltration predominantly in perifollicular area, follicular keratotic plugging and egg-like materials in the Iumen of hair follicle. Histopathology of the affected canine skin appeared similar to that of human demodicidosis except that the mitelike material was observed lodged in the lumen of hair follicle. The morphology of demodex folliculorum canis seemed slightly different from that of the human strain (DF hominis). It is generally smaller in size and has narrower and shorter stunted abdomen than human strain, otherwise it is almost alike. The human demo3icrdosis can be effectively treated with 15% benzyl benzoate aqueous emulsion, 1% gamma benzene hexachlrode cream and 10 % crotamiton ointment, and it seems to be most effective agent being crotamiton ointment among them. It is suggested that demodex folliculorum, which has been hitherto thought to be harmless, can be pathogenic in certain individuals and that some immunologic factors might be implicated in the process of the demodicidosis.
Abdomen ; Acne Vulgaris ; Animals ; Benzene ; Benzoates ; Candidiasis ; Cheek ; Chin ; Dogs ; Dronabinol ; Forehead ; Hair Follicle ; Humans ; Immunologic Factors ; Incidence ; Male ; Mites ; Nose ; Parasites ; Rosacea ; Siblings ; Skin ; Virulence*

We report a case of subcutaneous panniculitic T-cell lymphoma (SPTCL) which occurred in a 10-year-old Korean girl. Her disease presented as multiple erythematous subcutaneous nodules on the right cheek, left chest, abdomen, left flank, both calves, and left shin with systemic symptoms. She had a protracted course of multiple erythematous subcutaneous nodules for 2 months often with spiking fever. Histopathologic findings for the subcutaneous nodules revealed lobular panniculitis-like findings composed of atypical small, bland lymphocytes and histiocytes. Characteristically, atypical lymphocytes rimmed individual fat cells in a lace-like pattern and some histiocytes occasionally phagocytosed WBCs. Bone marrow findings revealed increased phagocytic histiocytes with engulfed hematopoietic cell. The immunophenotypic studies showed CD45RO (UCHLl)+, CD20-, CD4-, CD8+ and CD56+ (focal), lysozyme+, CD45 (LCA)+ and EBV-. She received three cycles of high-dose cyclophosphamide, adriamycin, vincristine, prednisolone (CHOP) and methotrexate, intrathecal methotrexate and one cycle of fludarabine, mitoxantrone and dexamethasone (FND) chemotherapy. She died of acute renal failure during multiple chemotherapy.
Abdomen ; Acute Kidney Injury ; Adipocytes ; Bone Marrow ; Cheek ; Child* ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Glycogen Storage Disease Type VI ; Histiocytes ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Methotrexate ; Mitoxantrone ; Prednisolone ; T-Lymphocytes* ; Thorax ; Vincristine

An etiologic agent in seborrheic dermatitis is now considered to be due to Pityrosporum ovale. The connection between the yeast and the disease has been clearly dernonstrated in a number of patients treatd with antifungal agents. However, the fact, that Pityrosporum ovale (Pityrosporum orbiculare) belongs to the normal human cutaneou. flora makes it difficult, to explain the role of the organism in seborrheic dermatitis. In this clinical study, twenty eight subjects were divided into two group by treatment regimen of topical 2% ketoconazole shampoo(TKS)and 0.3% prednisolone valerate solution (PVS). Before and during the four weeks treatment periods, the number of Pityrosporum ovale on the scalp were evaluated by scrub Giemsa staining method, which estimat,ed by score scale, under direct. microscopic examination. Also clinical symptoms including erythema, scales and itching were recorded by scores every week and compared between two treatment group. Topical application of 2% ketoconazole shampoo(TKS) is a very effective treatment regimen to reduce the yeasr cell score(from 5.8+1.3 to 1.8+1.4) than PVS(from 6.4+1.3 to 3.5+1.5), significantly(p<0.05). So the results of this study acconsistent with the view that density of Pityrosgourum ovale plays a role in the cause and course of seborcheic derrnatitis on the scalp. And antifungal agent(TKS) shows favorable effects ori tnis disease clinically and mycologically.
Antifungal Agents ; Azure Stains ; Dermatitis, Seborrheic* ; Erythema ; Humans ; Ketoconazole* ; Malassezia ; Prednisolone ; Pruritus ; Scalp* ; Weights and Measures ; Yeasts

No abstract available.
Anus Neoplasms* ; DNA* ; Ploidies*

No abstract available.
Anus Neoplasms* ; DNA* ; Ploidies*

Mycetoma is a clinical syndrome of localized, indolent, deforming, swollen lesions and sinuses, involving cutaneous and subcutaneous tissues, fascia, and bone. Its lesions. are composed of suppurat.ing abscesses, granulomata, and dra ning sinuses and the etiologic agents are wide variety of bacteria (actinomycotic mycetoma) and fungi(eumcotic mycetoma) from plant and soil. The patient was a 65-year-old female and a farnier. She was referred by the skin lesion loalized on the dorsum of her lefther left hand and wrist for three months. It showed multiple subcutaneclis nodules, abscesses, and discharging fitula based on the erythematous plaque. The skin biopsy frorn the lesion revealed the PAS positive hyphae in the granulocytic infiltration. Fungus cult,ure with a piece of tissue on sabouraud media shows hin, floccose, white colonies. Slide culture and biochemical idcrtification of pathogen led to the final diagnosis as Mycetoma caused by Pseudallescheria boydii(Monosporium apiospermum). The lesions disappeared gradualy following systemic oral administratior of Itraconazole 200mg daily for six weeks.
Abscess ; Aged ; Bacteria ; Biopsy ; Diagnosis ; Fascia ; Female ; Fungi ; Hand ; Humans ; Hyphae ; Itraconazole ; Mycetoma* ; Plants ; Pseudallescheria* ; Skin ; Soil ; Subcutaneous Tissue ; Wrist

No abstract available.
Humans ; Infant, Newborn*

BACKGROUND: This study was performed to compare the effectiveness of cholesterol-lowering diet therapy instructed by physicians with that instructed by dieticians using techniques that remove regression to the mean. METHODS: 118 patients who visited the office of Family Medicine department in Pusan Paik Hospital from February to November, 1996 and had serum total cholesterol(TC) concentrations greater or equal to 200mg/dL from two measurements were enrolled. The patients were divided into two groups randomly according to the cholesterol-lowering dietary education methods : the one was educated by physicians(Group I), and the other by dieticians(Group II). We evaluated the differences of lipid levels after education in consideration of regression to the mean. RESULTS: The mean reduction in TC concentrations achieved by dietary therapy was 10.7 % and 7.3%(without and with adjustment for regression to the mean) in Group I, and 9.8 and 6.5%(without and with adjustment, for regression to the mean) in Group II. The baseline TC concentrations and TC concentrations after dietary therapy were significantly different in individual group regardless of adjustment for regression to the mean. However, the reduction degrees of TC concentrations were not significantly different between two groups. CONCLUSIONS: The results indicate that even after adjustment for regression to the mean, dietary therapy will achieve the expected reduction. And it seems that the diet education by physicians will be effective as much as that by dieticians.
Busan ; Diet Therapy ; Diet* ; Education ; Humans ; Nutritionists*