Bisphosphonates have been approved for Paget's disease, cancer - related hypercalcemia, bone involvement in multiple myeloma or solid tumors and osteoporosis. Although, underlying pathophysiological mechanisms remain unclear, it seems that bisphosphonates inhibit osteoclast precursor cells, modulate migratory and adhesive characteristics and induce apoptosis of osteoclasts. Furthermore impacts on angiogenesis, microenvironment and signal transduction between osteoclasts and osteoblasts. In this report, we present a case of oral bisphosphonates induced osteonecrosis of the mandible in a 84-year-old patient who received for two years. Two tapered screw vent implants(Zimmer, USA) were placed in the area of first and second molar. Two weeks later after crowns restored, some inflammatory signs and symptoms were observed on the second molar area. Sequestrum was formed and the sequestrum was removed with the implant. Frequent follow-up checks and oral hygiene maintenances were done and the first molar implant was restored. There is insufficient evidence suggests that duration of oral bisphosphonate therapy correlates with the development and severity of osteonecrosis. Therefore, dentists should not overlook the possibility of development of bisphosphonate induced osteonecrosis in patients who have taken oral forms of medication for less than three years.
Adhesives ; Aged, 80 and over ; Apoptosis ; Crowns ; Dentists ; Diphosphonates ; DNA-Directed DNA Polymerase ; Follow-Up Studies ; Humans ; Hypercalcemia ; Mandible ; Molar ; Multiple Myeloma ; Oral Hygiene ; Osteoclasts ; Osteonecrosis ; Osteoporosis ; Signal Transduction

BACKGROUND: Topical diphenylcyclopropenone (DPCP) application on a daily or weekly basis has been used for the treatment of warts that affect different sites of the body. The concentration of DPCP for the treatment of warts needs to be determined according to the body site. In addition, the therapeutic response to DPCP application intervals needs to be evaluated for the treatment of warts. OBJECTIVE: The purpose of this study was to determine the minimal DPCP concentration required to induce an elicitation reaction in different body sites of patients with warts and to assess the therapeutic response of wart treatment with daily and weekly applications of DPCP. METHODS: Thirty patients with warts were divided into two groups. Each patient in the two groups was sensitized with 0.1% or 0.2% DPCP. After sensitization, in the first group of patients, DPCP was applied to warts daily. In the second group of patients, DPCP was applied to warts weekly. The initial concentration of DPCP was 0.01% for warts located on the palmoplantar area, periungual area and the dorsum of the hand, knee and upper arm. The initial concentration of DPCP was 0.004% for warts on the face. If no reaction was observed, the DPCP concentration (0.01%, 0.025%, 0.05%, 0.1%, 0.25%, 0.5%, 1% and 2%) was increased stepwise. The minimal concentration of DPCP to induce an elicitation reaction and treatment results were evaluated. RESULTS: The minimal concentrations of DPCP to induce an elicitation reaction were as follows: 0.004~0.01% for the face, 0.01~0.025% for the dorsum of the hand, 0.25~1% for the periungual area and 0.5~2% for the palmoplantar area. The results of weekly application of DPCP were similar as compared to the daily application of DPCP for the treatment of warts. CONCLUSION: Although further studies are needed, our study suggests that the DPCP concentration needs to be adjusted according to the body site and that the weekly use of DPCP may be a convenient alternative to daily use to treat warts.
Arm ; Cyclopropanes ; Hand ; Humans ; Knee ; Warts

Herpes zoster, involving noncontiguous dermatomes, is a rare disease. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending on whether one or both sides of the body are involved. A 76-year-old man, who had been treated for chronic obstructive pulmonary disease, presented with painful grouped vesicles on the right forehead and the right flank accompanied with generalized crusted papulovesicles. Tzanck smear showed multinucleated giant cells, and the histopathologic findings were consistent with herpes viral infection. We report a rare case of herpes zoster duplex unilateralis with herpes zoster generalisatus.
Aged ; Forehead ; Giant Cells ; Herpes Zoster* ; Humans ; Pulmonary Disease, Chronic Obstructive ; Rare Diseases

Actinomycosis is a chronic bacterial infection characterized by suppurative, fibrosing inflammation, and sinus tracts draining sulfur granules. It usually involves the head, neck, thorax and abdomen. Actinomycosis involving the inguinal area is extremely rare. A 55-year-old man presented with an asymptomatic, erythematous, hard, nontender nodule in his left inguinal area. A biopsy taken from the nodule showed an abscess and sulfur granules in the dermis. Gram staining and methenamine silver staining demonstrated a mesh of branching rods. Cultures of the pus and tissue specimens failed to grow any organisms. Based on the histopathologic findings, we diagnosed this case as actinomycosis of the inguinal area and treated it with a surgical method.
Abdomen ; Abscess ; Actinomycosis* ; Bacterial Infections ; Biopsy ; Dermis ; Head ; Humans ; Inflammation ; Methenamine ; Middle Aged ; Neck ; Sulfur ; Suppuration ; Thorax

BACKGROUND: Occurrence of dermatoses are influenced by various environmental factors in the area people live. Jeonbuk province, as well as other parts of Korea, has developed industrially for the past three decades. Until now, no statistical survey on dermatoses in Jeonbuk province has been made. OBJECTIVE: To compare the prevalence and trend of dermatoses by patients' age and time in Jeonbuk province over last 30 years. METHODS: The survey was conducted via the medical records of 55, 335 patients seen in Chonbuk National University Hospital from 1979 to 2002. RESULTS: The study results are summarized as follows: 1. Among the 55, 335 new patients (male 47.2%, female 52.8%), the 15 most common dermatoses were as follows (in order of frequency): dermatophytosis (7.8%), urticaria (7.7%), acne (5.2%), atopic dermatitis (4.9%), alopecia (4.4%), seborrheic dermatitis (4.3%), herpes zoster (4.0%), other eczema (3.9%), vitiligo (3.8%), psoriasis (2.6%), pruritus (2.5%), benign epidermal tumor (2.4%), verruca (2.2%), allergic contact dermatitis (1.7%), and irritant contact dermatitis (1.5%). These comprise 58.9% of the total outpatients. 2. The incidences of atopic dermatitis, alopecia, vitiligo and benign epidermal tumor had increase d (about 5 times), while dermatophytosis and urticaria had decreased (about 0.64 times) during the period. 3. The most frequent dermatoses during the summer season were dermatophytosis and vitiligo. In winter season, they were acne, atopic dermatitis, seborrheic dermatitis, psoriasis, pruritus, benign epidermal tumor and verruca. 4. The occurrence of scabies decreased rapidly from the early 90's and remained at a decreased level. Leprosy and tuberculosis had often occurred during the 80's and then became rare from the 90's. 5. The distribution of patients' age was as follows: The 3rd decade (22.0%), 2nd decade (15.8%), 1st decade (15.5%), 4th decade (14.7%), 5th decade (12.0%), 6th decade (10.3%), 7th decade (2.6%), 8th and above (0.4%). 6. Atopic dermatitis was found to be the most frequent dermatosis in the 1st decade. Vitiligo, benign epidermal tumor, and verruca were the most frequent in the 2nd decade, and urticaria, acne, alopecia, seborrheic dermatitis, psoriasis, allergic contact dermatitis and irritant contact dermatitis in the 3rd decade. Herpes zoster and pruritus were the most frequent in the 6th and 7th decade. CONCLUSION: From medical records between 1979 and 2002, we surveyed kinds, prevalence rates and trends of dermatoses in the Jeonbuk Province. During this period we observed changes in the incidence of the dermatoses with years and seasons. We also found that prevalence rates of the dermatoses were influenced by the time, environment and living conditions of the patients. To the best of our knowledge, this is the first survey on the occurrence of dermatoses Jeonbuk Province of Korea.
Acne Vulgaris ; Alopecia ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Eczema ; Epidemiology ; Female ; Herpes Zoster ; Humans ; Incidence ; Jeollabuk-do* ; Korea ; Leprosy ; Medical Records ; Outpatients ; Prevalence ; Pruritus ; Psoriasis ; Scabies ; Seasons ; Skin Diseases* ; Social Conditions ; Statistics as Topic* ; Tinea ; Tuberculosis ; Urticaria ; Vitiligo ; Warts

No abstract available.

Reiter's syndrome is a multisystemic disease characterized by a triad of urethritis, conjunctivitis and arthritis in association with skin lesions such as keratoderma blenorrhagica and balanitis circinata. Most cases of Reiter's syndrome are closely related to HLA-B27. We present a case of Reiter's syndrome that has typical clinicopathologic characteristics. A 37-year-old man had experienced weight loss and polyarthralgia for 7 months. He had painful swelling on the shoulders, elbows and knee joints, and hyperkeratotic plaques all over his body. He had no history of dysentry or sexual exposure, but was associated with the HLA-B27 antigen. Histopathology of the skin lesions on the back showed hyperkeratosis, rete ridge elongation and Munro microabscess. He was treated with corticosteroids, sulfasalazine, methotrexate, topical steroids and intra-articular corticosteroid injections. His skin lesions and urethritis were improved after 1 week, and his arthritis was improved after 6 months of therapy.
Adrenal Cortex Hormones ; Adult ; Arthralgia ; Arthritis ; Balanitis ; Conjunctivitis ; Elbow ; HLA-B27 Antigen ; Humans ; Knee Joint ; Male ; Methotrexate ; Shoulder ; Skin ; Steroids ; Sulfasalazine ; Urethritis ; Weight Loss

Papillary eccrine adenoma is a rare benign sweat gland neoplasm. It occurs most often as a solitary nodule in women and is located predominantly on the distal portion of the extremities. This tumor is similar to tubular apocrine adenoma in histological and clinical aspects, so distinction of these tumors is still controversial. We report a case of two papillary eccrine adenomas developed on the left popliteal and calf area of a 58-year-old-man, this is the first report of the multiple papillary eccrine adenomas in Korea.
Adenoma* ; Extremities ; Female ; Humans ; Korea ; Sweat Gland Neoplasms

Merkel cell carcinoma is an uncommon malignancy of the skin that was first described by Toker in 1972 and occasionally found concurrent with other malignancies such as squamous cell carcinoma, basal cell carcinoma or, as in the present study, with Bowen's disease. We report a unique case of Merkel cell carcinoma coexisting with Bowen's disease on the left forearm of a 42-year-old man who had a past history of multiple Bowen's disease. The tumor was excised and the specimen was examined histopathologically. The tumor cells exhibit trabecular, cord-like arrangement in the dermis, partly extending into subcutaneous tissue without involvement overlying epidermis, where Bowen's disease lesion was absent but the peripheral patch area exhibit Bowen's disease. The tumor cells in the dermis were positive for neuron-specific enolase and chromogranin. This is the first report of a case of Merkel cell carcinoma associated with Bowen's disease in Korea.
Adult ; Bowen's Disease* ; Carcinoma, Basal Cell ; Carcinoma, Merkel Cell* ; Carcinoma, Squamous Cell ; Dermis ; Epidermis ; Forearm ; Humans ; Korea ; Phosphopyruvate Hydratase ; Skin ; Subcutaneous Tissue

The purpose of this article is to present the clinical and laboratory procedures for single tooth restoration using "Combination Implant Crown". It is cemented on implant abutment and that abutment is screw-retained over implant body. This type of implant restorations has the advantages of cement-retained restoration while being antirotational and retrievable. And, more esthetic and functional result can be achieved by minimizing the size of access hole. The results were as follow : 1. Preparation of abutment below the cuffline should be avoided 2. Axial reduction of implant abutment should not be excessive because it may weaken the abutment 3. More esthetical and functional occlusal surface was achieved with a minimal access hole which is slightly larger than the diameter of hex driver to enable future total retrievability. 4. Combination Implant Crown has the advantages of both the cement-retained and screw-retained type implant restoration. 5. Cementation between implant crown and abutment reduces screw loosening through even force distribution.
Cementation ; Crowns* ; Tooth*