A case of toxic epidermal necrolysis (TEN) was presented in 46 year-old male patient. The characteristic skin lesions of TEN were developed after some medictions and tetanus anti-toxin (TAT) injection due to trauma. Probably, the cause of the disease was drugs, TAT injection or trauma inself. On the pathologic findings, lower epidermis and dermo-epidermal cleavage were noticed. He was treated with massive antibiotics and steroid. About 7 days after therapy, much improvement achived. However foul odorous yellowish discharge was noticed since 20 days of hospitalization. Wide debridement of necrotic tissue was carried without improvement. Patient expired on 48th hospital day due to sepsis and impending hepatic coma.
Anti-Bacterial Agents ; Debridement ; Epidermis ; Hepatic Encephalopathy ; Hospitalization ; Humans ; Male ; Middle Aged ; Odors ; Sepsis ; Skin ; Stevens-Johnson Syndrome* ; Tetanus

Histoid leproma usually occur in pat.ients with lepromatous leproy who have had relapsed after being undcr treatment(usually sulfones) for a long time and who have shown variable improvement. A 56 year old female patient who had been suffering from lepromatous leprosy and had been treated which clapsone relatively regularly for approximately 28 years had a history of several shiny rice grain t.o peanut sized nodules on the face and right flank. Histopathologic examination of a specimen taken from a nodular lesian revealed a well circirmscrihed nodule composed mainly of spindle-shaped cells and epithe:ioi 1 cells on the upper and mid-levmis, and granuloma composed of epithelioid cells, multinucleated wait cells and foamy histiocytes on the lower dermis. In AFB stain, numerous acid-fast bacilli were scatt red dermis and epidermis, especially stratum corneum. This study opplied a polymease chain reaction(PCR) on sections of biopsy tissues and peripheral blood of pat.ient. Positive amplification of a 530 bp fragment was deteated not only in the lesion tissues but also in the per ipher al blood.
Biopsy ; Edible Grain ; Dermis ; Epidermis ; Epithelioid Cells ; Female ; Granuloma ; Histiocytes ; Humans ; Leprosy, Lepromatous ; Middle Aged ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction*

Leukemia cutis is defined as infiltration of the skin by malignant leukocytes that have originated from the bone marrow. The cutaneous eruption of leukcmia may be divided into the specific and non-specific lesion (leukemid). These may occur separately or in combination. True leukemia infiltrations of the skin consist of nodular, diffuse, or plaque-like infiltrations with swelling, macules, papules, ecchymoses, palpable purpura, erythroderma, and ulceration. A 55-year-old man presented with multiple as mptomatic dark-brown nodules on the whole body with recurrent gingival bleeding. The patient developed seoticemia and died 6 months after the onset of the disease.
Bone Marrow ; Dermatitis, Exfoliative ; Ecchymosis ; Hemorrhage ; Humans ; Leukemia* ; Leukocytes ; Middle Aged ; Purpura ; Skin ; Ulcer

No abstract available.
Carbon Monoxide* ; Carbon*

We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematous painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematoas painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are'observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. Treatment with INH, myambutol and rifampin resulted in some improvment on the chest and considerable improvement on the skin and intestine within 6 months.
Anal Canal ; Barium ; Dermis ; Enema ; Ethambutol ; Granuloma ; Humans ; Intestines ; Middle Aged ; Ovum ; Parasites ; Proteus ; Rifampin ; Skin ; Skin Tests ; Sputum ; Subcutaneous Tissue ; Thorax ; Tuberculin ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer ; Urinalysis ; Wounds and Injuries

Melanoma is relatvely uncommon malignant tumor arising in the skin from epidermal melanocytes, from the junctional component of a cellular nevus or, rarely within a blue nevus and frequently metastasizes to regional lymph nodes first, followed by hematogenous spread to lungs, liver, gastrointestinal tract, pancreas, adrenal, heart and brain. All melanoma patients are carefully evaluated according to several parameters. A complete history and physical examination are carried out, with particular attention being devoted to other pigmented tumors that the patient may have. The patient should be further evaluated to determine the presence or absence of metastases by chest X-ray examination, metastatic series or bone scan, liver function studies, liver scan, EKG, etc. Special factors such as age, sex, and race, as well as site, size, and growth rate of lesions are also evaluated. We had a case of 59 year-old male patient with disseminated malignant melanoma. Upon his first visit, we did not find any abnormality in his physical examination and routine laboratory findings except skin tumors on left heel and left leg.
Brain ; Continental Population Groups ; Electrocardiography ; Gastrointestinal Tract ; Heart ; Heel ; Humans ; Leg ; Liver ; Lung ; Lymph Nodes ; Male ; Melanocytes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Nevus ; Nevus, Blue ; Pancreas ; Physical Examination ; Skin ; Thorax

No abstract available.
Herpes Zoster* ; Humans ; Immunosuppressive Agents*

A 17-year-old woman had an extensive nevus comedonicus affecting the left sides of the breast, trunk, axilla, and upper extremity. Her condition was complicated by episodes of re-current cyst formation, secondary infection, and atrophic scars. We performed various therapeutic approaches include topical keratolytic agents, manual extraction of comedones, excision of smaller lesions, and systemic antibiotics but the response was unsatisfactory. We tried systemic isotretinoin and minocycline and the pustulation of the lesions was reduced. Herein we report a rare case of linearly arranged extensive nevus comedonicus.
Adolescent ; Anti-Bacterial Agents ; Axilla ; Breast ; Cicatrix ; Coinfection ; Female ; Humans ; Isotretinoin ; Keratolytic Agents ; Minocycline ; Nevus* ; Upper Extremity

Serum zinc is an essential element in men and animals. Recently on the dermatologic fields, the serum and the skin levels and the roles of zinc have been studied especially in acne vulgaris, but the results were controversial. So to confirm the previous reports and for evaluation of the relationship between the various aspects of acne vulgaris and the serum levels of zinc, the serum levels of zinc were measured by atomic absorption spectrophotometer in 13 healthy controls and 46 patients with acne vulgaris. In the healthy controls, their mean values of zinc were 0.843+0.251 ppm in total, 0.920+0.219 ppm, in females and 0.777+0.260 ppm in males. There was no statistical difference attributable to sex. In the 46 patients with acne vulgaris, their mean value of zinc was 0.741+0.195 ppm. There was no significant difference in the mean serum zinc level compared with the controls. In the males with acne, the mean va1ue of zinc was 0.727+0.166 ppm, and 0.748+0.208 ppm in females with acne. There was no significant statistical difference between males and females with acne. And females, but not males, with acne had significantly lower serum zinc levelss than controls of the corresponding sex. (p<0.1) By clinical severity, classifying the 46 patients with acne vulgaris into three groups: mild type (only comedones), moderate type (comedones with pa.pules) and severe type (includes pustules, comedones, and papules, etc.), the serum zinc levels of each group were 0.774+0.185 ppm, 0.7880. 200 ppm and 0.666+0.176 ppm. The significant statistical difference was found only in the severe type of acne compared with the healthy controls (p<0.05). Also classifying the patients into three groups (acute, moderate and chronic types of acne) by duration of acne, the serum values of zinc were 0.738+0.158 ppm, 0.692+0.283 ppm and 0.769+0.241 ppm, respectively. Only in the moderate type of acne, the mean serum level of zinc was significantly reduced compared with the control group (p<0.1)
Absorption ; Acne Vulgaris* ; Animals ; Female ; Humans ; Male ; Skin ; Zinc*

Squamous cell carcinoma of the lower lip can be developec by a number of underlying etiologic factors, the most outstanding of which is solar irracdiation, and is considerably more aggresive and has a much higher incidence of metastatic spread. Its early detection and effective treatment afford a high cure rate. Cryosurgery is a simple, efficient and effective method of treatment of skin cancer and is now a widely accepted modality for the treatment of these lesions. Two patients(67-year-old male and 57-year-old female) were presented with solitary or two masses on the lower lip without regional lymphadenopathy. These two cases showed clinical and histopathologic findings of squamous cell carcinoma. They were successfully treated by cryotherapy with liquid nitrogen without any significant side effects.
Carcinoma, Squamous Cell ; Cryosurgery ; Cryotherapy ; Humans ; Incidence ; Lip* ; Lymphatic Diseases ; Male ; Middle Aged ; Nitrogen* ; Skin Neoplasms