Adult-onset Still's disease (AOSD) is an uncommon disorder characterized by fever, polyarthralgia, elevated white blood cell count, and maculopapular rash, the histologic features of which have not been well known. A 54-year-old woman presented with fever, arthritis, and persistent pruritic lichenified rash. These cutaneous lesions showed unique histological features such as dyskeratosis with a peculiar, distinctive distribution in the upper epidermis and cornified layers with hyperkeratosis. In addition, dermal mucin deposition was increased, with inflammation and minimal fibroblast proliferation. The patient was diagnosed with AOSD according to the diagnostic criteria of Yamaguchi. Herein, we present an atypical form of AOSD showing distinctive clinical and pathological manifestations.
Arthralgia ; Arthritis ; Epidermis ; Exanthema ; Female ; Fever ; Fibroblasts ; Humans ; Inflammation ; Leukocyte Count ; Middle Aged ; Mucins ; Still's Disease, Adult-Onset*

No abstract available.
Neoplasm Metastasis* ; Pancreatic Neoplasms* ; Scalp* ; Thorax*

BACKGROUND: The need for dermatological consultations for hospitalized patients has gradually increased and there are a number of dermatoses caused by underlying psychological conditions. However, the data regarding the analyses of these consultations for psychiatric inpatients are limited. OBJECTIVE: To analyze the demographics and the type of dermatoses among inpatients with primary psychiatric diseases. METHODS: We retrospectively reviewed 581 consultation reports for inpatients referred by the Department of Psychiatry between January 1, 2009 and December 31, 2014. RESULTS: The proportion of the consulted patients from the Department of Psychiatry was 25.9% (331 consulted inpatients/1279 psychiatric inpatients). The most common age group was the 40~49 year-old group (19.3%) and the male to female ratio was 1:1.14. There were no remarkable findings regarding the annual or seasonal distribution. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the most common underlying psychiatric disorders were mood disorders (41.0%), followed by schizophrenia and other psychotic disorders (25.0%), and substance-related disorders (12.1%). The most frequent skin disorders were eczematous dermatoses (34.6%) and infectious dermatoses (32.2%); dermatomycosis (20.8%) was especially common. The most common reasons for consultation were new-onset dermatologic problems (68.5%), followed by persistence or aggravation of pre-existing dermatologic disorders (28.7%). CONCLUSION: This study reports the dermatologic characteristics of psychiatric inpatients. We conclude that dermatologists and psychiatrists need to be concerned about the education and continuous management of various skin diseases in psychiatric patients.
Demography ; Dermatomycoses ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Female ; Humans ; Inpatients* ; Male ; Mood Disorders ; Psychiatry ; Psychotic Disorders ; Referral and Consultation* ; Retrospective Studies ; Schizophrenia ; Seasons ; Skin ; Skin Diseases ; Substance-Related Disorders

No abstract available.
Child* ; Humans ; Syringoma* ; Vulva

No abstract available.
Child* ; Humans ; Nevus, Epithelioid and Spindle Cell*

Poroid hidradenoma is a benign tumor that is classified as a poroid neoplasm, and is so called because of its morphology, which is intermediate between the cytological features of a poroid neoplasm (poroid and cuticular cells) and the architectural features of a hidradenoma (solid and cystic areas, and tumor cells restricted to the dermis). As these tumors are cystic and superficially located, fine needle aspiration cytology has been useful, but the diagnosis relies on the histological examination. A 79-year-old woman presented with a solitary walnut-sized, soft, tender, reddish-to-bluish nodular lesion that had been enlarging steadily over a period of two years. Histopathologic examination of the cutaneous lesion showed a well-demarcated tumor composed of poroid and cuticular cells in the dermis not connected to the overlying epidermis, consistent with poroid hidradenoma. Herein, we present a rare case of poroid hidradenoma arising in an unusual location.
Acrospiroma* ; Aged ; Biopsy, Fine-Needle ; Dermis ; Diagnosis ; Epidermis ; Female ; Humans ; Poroma

Leser-Trelat sign is a rare paraneoplastic dermatosis that is characterized by the eruptive and rapid development of multiple seborrheic keratosis that coincides with an internal malignancy. Eruptive seborrheic keratosis can be pruritic and appear in a "Christmas-tree pattern." This sign occurs in association with a number of cancers, such as adenocarcinoma of the gastrointestinal tract and various lymphoproliferative disorders. However, Leser-Trelat sign associated with a malignant melanoma is very rare. A 58-year-old male patient presented with an asymptomatic black mass on the penile orifice and patch on the glans penis. He complained of gross hematuria. At the same time, he developed asymptomatic multiple brown papules and plaques on the back. The histopathologic findings of the glans and back lesions were consistent with malignant melanoma and seborrheic keratosis, respectively. Here, we describe a rare case of Leser-Trelat sign associated with malignant melanoma.
Adenocarcinoma ; Gastrointestinal Tract ; Hematuria ; Humans ; Keratosis, Seborrheic ; Lymphoproliferative Disorders ; Male ; Melanoma* ; Middle Aged ; Penis ; Skin Diseases

Crohn's disease is a systemic inflammatory and granulomatous disease, mainly involving the gastrointestinal tract with extraintestinal manifestations such as the skin, liver and bone. Cutaneous manifestations of Crohn's disease are relatively common; however, the groin is an unusual site for cutaneous Crohn's disease. A 36-year-old male presented with mild pruritic nodules on the left groin for 2 months. Nine years ago, he was diagnosed with intestinal Crohn's disease by endoscopic biopsy. Histopathologic examination of the cutaneous lesion showed non-caseating granulomatous reactions composed of multinucleated giant cells with lymphohistiocytic infiltration in the dermis. Staining for periodic acid-Schiff and acid-fast bacilli was negative. From these findings, we diagnosed these lesions as cutaneous Crohn's disease. The lesions were markedly improved with three rounds of intralesional steroid injection.
Adult ; Biopsy ; Crohn Disease* ; Dermis ; Gastrointestinal Tract ; Giant Cells ; Groin* ; Humans ; Liver ; Male ; Skin

Erythema annulare centrifugum is an inflammatory skin disorder of unknown etiology characterized by erythematous urticarial papules that enlarge in a centrifugal pattern to form annular appearance. These lesions are usually asymptomatic. Erythema annulare centrifugum generally tends to be a chronic condition. It develops most frequently in adults between 30 and 50 years of life, and only a few infantile cases have been reported in the English literature. Herein, we present an additional case of infantile erythema annulare centrifugum with a review of the literature.
Adult ; Erythema* ; Humans ; Infant ; Skin

OBJECTIVE: Interspinous devices for dynamic stabilization of lumbar spine are undergoing development and clinical trials. A few short-term outcomes of interspinous devices have been reported but little has been mentioned about longterm outcomes. We reviewed 19 cases of interspinous implantation (Coflex Paradigm spine, Germany) to evaluate clinical long-term outcome and radiologic features. METHODS: From January 2003 to March 2004, 19 patients (13 female and 6 male) who underwent interspinous implantation were included and follow-up data on clinical and radiologic outcomes were obtained at last clinic visit (mean follow-up: 38 months). Clinical outcomes were assessed by Visual analogue scale (VAS) score and Odom..s criteria. RESULTS: Preoperative VAS score for low back pain and leg pain was improved from 4.9+/-2.4 and 7.5+/-2.4 to 2.6+/-1.2 and 3.0+/-1.8 respectively at postoperative last clinic visit (p<0.01). Using Odom..s criteria, 7 and 9 patients showed excellent (36.8%) and good (47.3%) results for low back pain and 7 and 11 showed excellent (36.8%) and good (57.9%) results for leg pain. Anterior and posterior disc height were decreased significantly on postoperative follow-up radiologic data due to discectomy at the level of instrumentation (p<0.01). There were no complications such as infection or device failure. CONCLUSIONS: In this long-term follow-up study, clinical outcome was good but disc degeneration after discectomy at instumented level resulting in decrease of disc height was observed.
Ambulatory Care ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Leg ; Low Back Pain ; Spine