With the recent increase in reported cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), fears of breast implants have increased. In particular, some patients now desire expander removal without implant insertion. In the case described herein, a 41-year-old female patient who had undergone a skin-sparing mastectomy with expander insertion due to breast cancer requested expander removal due to fear of BIA-ALCL during expansion. The authors modified the Goldilocks technique to prevent a chest wall deformity due to expansion. The expanded skin was sufficiently thick, as it was engrafted with acellular dermal matrix, and some of it was de-epithelized and rolled in. The patient’s chest wall depression was completely corrected and an acceptable breast mound was created. To summarize, this technique was used to correct a chest wall deformity and to form a breast mound in a patient who underwent expander removal without implant insertion.

Background: Although rarely used at present in South Korea, saline implants accounted for most of the implants used from 1992 to 2007. However, few studies have reported on the long-term outcomes of saline implants, especially in breast reconstruction. We analyzed the long-term outcomes of patients who underwent direct-to-saline implant reconstruction. Methods: This retrospective study included patients who underwent saline implant-based immediate breast reconstruction between 2003 and 2007. The patients’ demographic information, medical history, operative/implant details, and oncologic data were collected. Early and late complications, reoperations, and final outcomes of the implant (maintenance, explantation, exchange, and autologous conversion) were analyzed to determine the long-term results and to identify factors affecting the outcomes. Results: Early complications (within 90 days) were noted in 19.5% of patients and late complications (after 90 days) occurred in 29.3% of patients. The most common early complications were skin necrosis and delayed healing, whereas the most common late complications were rippling or visibility and capsular contracture. Of the implants, 22% were replaced (12%) or converted to autologous tissue (10%). The factors that influenced the final outcomes were patient age, nipple-areola-sparing procedure, breast size, implant fill volume, and implant manufacturer. Conclusions Patients who previously received saline implants still visit the clinic for consultations. This long-term follow-up study with few dropouts reflects the real needs of reconstruction patients. Our results provide useful information for consulting with patients who already have saline implants or those who request for as much information about available implant options as possible.

BACKGROUND: Dermatophytoses in children are commonly seen but relatively infrequent than adults. Dermatophytoses in children can be different clinically and mycologically from those in adults in that children experience rapid physical changes and they have different skin features and environments from those of adults. OBJECTIVE: The goal of this research is to understand the clinical and mycological characteristics of dermatophytoses in children. METHODS: This clinical and mycological investigation was made with 15,684 patients under age 18 who were diagnosed with dermatophytoses from April, 1976 to March, 2005. RESULTS: The results can be summarized as follows: 1. The incidence of dermatophytoses in children to total number of pediatric outpatients was 6.4%. Male patients were 9,475 and female patients were 6,209 leaving male to female ratio of 1.5:1. Dermatophytoses showed high incidence in the age group between 13 and 18 (7,009). 2. Tinea pedis was 4,020 cases and the most common, followed by tinea cruris, tinea capitis, tinea corporis, tinea unguium, tinea faciale. Tinea capitis largely increased in 1980s and is falling off through 1990s, tinea pedis tends to increase since 1990s. The onsets in summer were the most eminent. 3. Among 15,684 cases, 9,395 cases (59.9%) yielded isolated strains on fungal culture. Trichophyton (T.) rubrum was 5,049 strains (53.7%) and the most common among the total isolated 9,395 strains followed by Microsporum (M.) canis, and T. mentagrophytes. M. canis was the most commonly isolated organism in tinea capitis and tinea manus but in other cases T. rubrum was. CONCLUSIONS: Dermatophytoses in children are different clinically and mycologically from those in adults and vary with the change of the times.
Adult ; Child ; Female ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Skin ; Tinea ; Tinea Capitis ; Tinea Pedis ; Trichophyton

A 36 year-old man and his 6 month-old daughter presented with multiple, slightly depressed, skin-colored, hard nodules and plaques on the abdomen, back, and both extremities. They also showed abnormal physical appearance, including short stature and neck, round face, and short digits, which suggested Albright's hereditary osteodystrophy (AHO). Histopathologically, various sized bony spicules were present in the dermis. The laboratory results showed normal serum calcium, phosphorus and parathyroid hormone levels. On the basis of clinical, laboratory and histologic findings, we diagnosed these cases as Albright's hereditary osteodystrophy with cutaneous ossification occurring in pseudopseudohypoparathyroidism.
Abdomen ; Calcium ; Dermis ; Extremities ; Fibrous Dysplasia, Polyostotic ; Neck ; Nuclear Family ; Parathyroid Hormone ; Phosphorus ; Pseudopseudohypoparathyroidism

A 36 year-old man and his 6 month-old daughter presented with multiple, slightly depressed, skin-colored, hard nodules and plaques on the abdomen, back, and both extremities. They also showed abnormal physical appearance, including short stature and neck, round face, and short digits, which suggested Albright's hereditary osteodystrophy (AHO). Histopathologically, various sized bony spicules were present in the dermis. The laboratory results showed normal serum calcium, phosphorus and parathyroid hormone levels. On the basis of clinical, laboratory and histologic findings, we diagnosed these cases as Albright's hereditary osteodystrophy with cutaneous ossification occurring in pseudopseudohypoparathyroidism.
Abdomen ; Calcium ; Dermis ; Extremities ; Fibrous Dysplasia, Polyostotic ; Neck ; Nuclear Family ; Parathyroid Hormone ; Phosphorus ; Pseudopseudohypoparathyroidism

Sporotrichosis is a chronic cutaneous fungal infection caused by Sporothrix (S.) schenckii. It is subdivided into three groups by clinical manifestation: lymphocutaneous, fixed cutaneous, disseminated sporotrichosis. Lymphocutaneous sporotrichosis is most common type and involves upper extremities usually. The incidence of lymphocutaneous sporotrichosis on the face is very low, especially in children. We report a case of lymphocutaneous sporotrichosis on face in a 10-month-old girl. The lesions represented linear three small erythematous papules on the right cheek. The fungal culture on Sabouraud's dextrose agar showed dark brown to black colored wrinkled colonies. The microscopic examination showed septated, branched mycelia and clustered conidia in slide culture of S. schenckii. The patient was treated with oral administration of potassium iodide and the lesions were cured completely.
Administration, Oral ; Agar ; Cheek ; Child ; Glucose ; Humans ; Incidence ; Infant ; Potassium Iodide ; Spores, Fungal ; Sporothrix ; Sporotrichosis ; Upper Extremity

Angiokeratoma of Fordyce is a relatively common type of angiokeratoma that is characterized by small, multiple, purplish to dark red papules on the scrotum. Pathogenesis is unknown, but it has been suggested that increased venous pressure caused by varicocele, hernia or tumor of the epididymis can induce angiokeratoma of Fordyce. We report a case of unilateral angiokeratoma of Fordyce with varicocele in a 30 year-old man. He presented with approximatly 2 mm sized, purplish to dark red, and multiple hyperkeratotic papules on the left scrotum. The lesions were strictly limited to the left side of the scrotum and associated with varicocele on the same side. Histopathologically, hyperkeratosis, acanthosis with elongation of rete ridges and dilated papillary vessels are presented. Based on this clinical and histologic finding, we diagnosed this case as unilateral angiokeratoma of Fordyce with varicocele. The patient was treated with varicocelectomy for left varicocele and then cryotherapy for skin lesions.
Angiokeratoma ; Cryotherapy ; Epididymis ; Hernia ; Humans ; Male ; Scrotum ; Skin ; Varicocele ; Venous Pressure

Onychomycosis is caused by dermatophytes usually, but some species of non-dermatophytic molds and yeasts are also associated with invasion of nails. Fusarium (F.) verticillioides is a non-dermatophytic mold, which are common soil saprophytes. Onychomycosis due to Fusarium species almost always involves great toe nails and occurs infection easily in the presence of trauma, onychodystrophy and prior onychomycosis. We report a first case of onychomycosis caused by Fusarium verticillioides in a 48-year-old man. He presented with proximal white superficial onychomycosis for 3 months. Fungal culture showed whitish cottony colonies and microscopic examination of colonies showed microconidia in a chain from monophialide. We diagnosed onychomycosis caused by Fusarium verticillioides and treated by itraconazole 200 mg daily and 5% amorolfine nail lacquer for 3 months.
Arthrodermataceae ; European Continental Ancestry Group ; Fungi ; Fusarium ; Humans ; Itraconazole ; Lacquer ; Middle Aged ; Morpholines ; Nails ; Onychomycosis ; Soil ; Toes ; Yeasts

Steatocystoma is a benign adnexal tumor originating from the pilosebaceous duct junction which can be classified into two groups (steatocystoma simplex and steatocystoma multiplex). Steatocystoma simplex, which presents as a solitary lesion, is very rare. Steatocystoma simplex occurs most commonly on the face and the case reported herein involving the scalp is extremely rare. A 49-year-old man presented for evaluation and treatment of a solitary papule on the right parietal scalp which had persisted for a period of 1 year. The histopathologic examination revealed a thin-walled cyst consisting of stratified squamous epithelium with hyaline cuticle that lacked a stratum granulosum. Based on clinical and histologic findings, we diagnosed this case as steatocystoma simplex of the scalp and report this rare case.
Epithelium ; Humans ; Hyalin ; Methylmethacrylates ; Middle Aged ; Polystyrenes ; Scalp

Pthiriasis is a sexually transmitted disease, and in most cases this is caused by Pthirus pubis (pubic or crab lice) that mainly infest the pubic hair of adults. Eyebrows, eyelashes and axillary hair are also relatively common sites of infestation, but the scalp is an uncommon site of manifestation, and especially in adults. We report here on a case of pthiriasis that was confined to the scalp, without involving any other parts of the body of a 55-year-old woman.
Adult ; Eyebrows ; Eyelashes ; Female ; Hair ; Humans ; Middle Aged ; Scalp ; Sexually Transmitted Diseases