Livedo reticularis is a mottled bluish discoloration of the skin which occurs in a netlike pattern and is not a diagnosis in itself, but is a nonspecific reaction pattern. It may be classified as idiopathic and secondary livedo reticularis. Decompression sickness can occur during decompression after diving into deep sea water or during a rapiid ascent from sea level, and is one of the many causes of the secondary livedo reticularis. We report a case of livedo reticulris which developed in a patient with decompression sickness. A biopsy from the purpuric patch revealed an unusual histopathologic finding that resembles those of bullae and sweat gland necrosis in drug induced coma.
Biopsy ; Coma ; Decompression Sickness* ; Decompression* ; Diagnosis ; Diving ; Humans ; Livedo Reticularis* ; Necrosis ; Seawater ; Skin ; Sweat Glands

Astasia-abasia refers to the inability to stand or walk despite possessing good motor strength and conserved voluntary coordination. Although it is usually regarded as a psychogenic disorder, organic causes have been reported. Herein we describe a patient who presented with alcohol-induced episodic astasia-abasia. Interestingly, SPECT performed during an episode showed hyperperfusion in the dorsal brainstem and subthalamic region. These areas roughly coincide with the mesencephalic locomotor region and subthalamic locomotor region, respectively, and it is conceivable that abnormal neural activity in these areas is related to the symptoms in our patient.

We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

Lentigo maligna melanoma(LMM) is the least common type of melanoma and most commonly affects the sun-exposed skin of the elderly. We herein report a case of LMM evolved from lentigo maligna(LM). A 71-year-old female presented with a longstanding irregular brown patch containing two black papules on the left cheek which developed 8 months ago. Histopathologic findings were consistent with LM and LMM. We performed a wide excision and dufourmental flap for reconstruction with no recurrence for 30 months. Sun exposure has been known as the most important etiologic factor for the development of malignant melanoma including LMM and the incidence has an increasing tendency. Thus, skin biopsy is recommended in the evaluation of a longstanding irregular brown patch on the face to prevent LMM.
Aged ; Biopsy ; Cheek ; Female ; Humans ; Hutchinson's Melanotic Freckle* ; Incidence ; Lentigo* ; Melanoma* ; Recurrence ; Skin ; Solar System

BACKGROUND: Although rubella is a mild exanthematous viral infection and its incidence has been greatly decreased after effective vaccination, epidemics of rubella has been noted at 5- to 7-year intervals. But there has been few report about the clinical and histopathologic study of rubella in Korean literatures. OBJECTIVE: The purpose of this study was to review the clinical and histopathologic characteristics of rubella of 1996 outbreak. METHODS: We reviewed the clinical features and histopathologic findings in 50 patients diagnosed as rubella in Department of Dermatology, Presbyterian Medical Center from January 1996 through to May 1996. RESULTS: 1. The male-female ratio was 1: .17. The age distribution was 13-32 years and 72% of patients were aged 16-25 years. 2. Erythematous maculopapular rash on whole body was developed in all patients. Eighty two percent of the patients had fever and lymphadenopathy, and 36% of the patients had petechiae of soft palate. The main prodromal symptoms were sore throat(50%), headache(34%), and upper respiratory symptoms(22%), as order of frequency. 3. Positive serologic test for rubella IgM antibody was 79.5%. 4. The most common abnormal laboratory finding was leukopenia(58%), and followed by positive ASO(34%), the presence of atypical lymphocytes(21%), and thrombocytopenia(8%). 5. Histologically, epidermal changes were mild to moderate vacuolopathy(92.3%), the presence of dyskeratotic cells(30.8%), spongiosis(23.1%), and exocytosis(15.4%). Dermal findings were mild superficial perivascular lymphohistiocytic infiltration(100%), upper dermal edema(53.8%), perivascular edema(38.4%), pigmentary incontinence(30.8%), and the presence of extravasated RBC(23.1%). Eosinophil infiltration(15.4%) and the presence of large nucleated lymphocytes(92.3%) were also observed. Conclusions: According to the results of our study about rubella outbreak in 1996, clinical signs and symptoms were similar to those of previously described. Histologically, superficial perivascular dermatitis with mild to mederate vacuolar interface change was a main feature and large nucleated lymphocytes were frequently noted.
Age Distribution ; Dermatitis ; Dermatology ; Eosinophils ; Exanthema ; Fever ; Humans ; Immunoglobulin M ; Incidence ; Lymphatic Diseases ; Lymphocytes ; Palate, Soft ; Prodromal Symptoms ; Protestantism ; Purpura ; Rubella* ; Serologic Tests ; Vaccination

BACKGROUND: Pigmented basal cell carcinoma(PBCC) is a clinical and histological variant of BCC, which is known to show better prognosis than non-PBCC. There has been no report about the PBCC among Korean patients. OBJECTIVE: Our purpose was to identify the clinical and histologic characteristics of PBCC and to determine whether this correlated with prognosis. METHODS: A clinical and histological survey was done with 62 lesions of 56 cases of PBCC that visited the Department of Dermatology, Presbyterian Medical Center during the last 10 years(1988 - 1998). Some results were then compared with results of non-PBCC. RESULTS: 1. The frequency of BCC in the total number of new outpatients was 0.34%, and 83.6% of BCC contained pigment histologically. 2. The male-female ratio was 1.24:1, and 92.9% of the patients with PBCC were older than the age of 40 years with the mean age of 62.9 years. 3. 88.7% of the PBCC occurred on the face, especially on the nose(38.7%), cheek(19.4%), and eyelid(17.7%). Clinically, most of the tumors were noduloulcerative(77.4%) and diffuse pigmentation was more common than dotted. 4. The most frequent histologic types were nodulocystic(43.6%) and mixed(43.6%) type followed by superficial(6.4%), micronodular(1.6%), adenoid (1.6%), infiltrative(1.6%), basosquamous(1.6%) types. Histologically 51.6% of the tumors were associated with ulceration, and 71% of the tumors were associated with infiltration of inflammatory cells. 5. Fontana-Masson stains showed pigment is melanin and it was found in both tumor nests and surrounding dermis in most cases(95.0%). Hypertrophic melanocytes with prominent dendrites were seen in the tumor nodule(77.8%) and in the normal epidermis overlying tumor(22.2%). 6. Margins were examined for evidence of residual tumor in 48 lesions that were excised. In 4 lesions(8.3%) were the margin positive for tumor. This was statistically not significant (p>0.05) compared with 10 excisions of non-PBCC in which 2(20%) showed positive margins. CONCLUSION: High incidence of PBCC is a characteristic feature in Korean patients, and PBCC showed better prognosis than non-PBCC because it is more frequently excised with adequate margins.
Adenoids ; Carcinoma, Basal Cell* ; Coloring Agents ; Dendrites ; Dermatology ; Dermis ; Epidermis ; Humans ; Incidence ; Melanins ; Melanocytes ; Neoplasm, Residual ; Outpatients ; Pigmentation ; Prognosis ; Protestantism ; Ulcer

Background & Objective: The MAPT H1 haplotype and SNCA single nucleotide polymorphism (SNP) rs356219 have been reported to have a synergistic effect on the risk of Parkinson’s disease (PD). Because the H1/H1 genotype has been reported to predominate in Korean population, we investigated the polymorphism of rs356219 in 878 PD patients and 559 controls. Methods: The SNCA SNP rs356219 was analyzed in 878 PD patients and in 559 healthy Korean subjects. Results: The G allele of SNCA SNP rs356219 was found to contribute to PD susceptibility with odds ratios (ORs) similar to those reported previously. However, the ORs were not as large as that of the SNCA rs356219 plus MAPT H1/H1 combination reported in the literature, which cast doubt on the existence of a synergistic effect between the two genotypes in our population. Conclusions: This study supports that the G allele of the SNCA SNP rs356219 contributes to PD susceptibility as reported previously, but it does not support the presence of a synergistic interaction between SNCA and MAPT.

Occasionally, erythema multiforme has been reported to occur in association with allergic contact dermatitis to various substances including paraquat(Gramoxone(R)). In these cases the erythema multiforme has ranged from mild localized exanthem to life-threatening toxic epidermal necrolysis. We report a case of toxic epidermal necrolysis developed from erythema multiform due to contact of paraquat.
Dermatitis, Allergic Contact ; Erythema ; Erythema Multiforme ; Exanthema ; Paraquat ; Stevens-Johnson Syndrome*

Background and Objectives: This study aimed to examine factors of poor outcome by analyzing the outcomes of bilateral subthalamic deep brain stimulation in Parkinson’s disease after 3 years. Methods: We assumed that patients who could not manage independent life in their best stimulationon/medication-on condition after a defi ned period might not have been a good surgical candidate. A poor outcome is defi ned as a failure to maintain functional independence at three years during a stimulation-on/medication-on state. Results: A total of 84 patients underwent bilateral subthalamic deep brain stimulation and all were followed up for 3 years. We excluded one patient who had intracranial hemorrhage. Twenty-one patients of the 83 patients could not keep up independent life even during their best condition for the following reasons: freezing in 15 patients, dementia in 5, depression in 3, musculoskeletal problems in 7, and cancer in one patient. Conclusions: Many patients could not keep up independent life during their best condition as early as three years after deep brain stimulation. Musculoskeletal problems were one major cause of disabilities, as were freezing and dementia. We emphasize that musculoskeletal problems need more attention in the preoperative screening of deep brain stimulation candidates and during the follow up.

PURPOSE: The purpose of this qualitative research is to explore the background of occurrence of perceived incivility by nursing students in clinical practice.METHOD: Data were collected through focus interviews and individual interviews were analysed using qualitative content analysis.RESULT: The results showed that three categories that represented the background of occurrence of incivility were scheme which is not cleared, position which is not settled and unequal relationship.CONCLUSION: Since the background of occurrence of perceived incivility is complex, So it is required to macroscopic approach to reduce the perceived incivility of the students in the clinical practice.
Humans ; Methods ; Nursing ; Qualitative Research ; Students, Nursing