ABSTRACT
The areola is a rare location for squamous cell carcinoma (SCC) because sunlight exposure, the main risk factor for SCC, is unusual on it. Acantholytic SCC (ASCC) is a rare histologic variant of SCC, characterized by pseudoglandular appearance with acantholytic tumor cells. A 59-year-old male presented a painful erythematous papule on his right areola. He had a history of psoralen ultraviolet A phototherapy for psoriasis in his 20s. Biopsy revealed an epithelial tumor and pseudoglandular structures with acantholytic tumor cells. In immunohistochemistry, cytokeratin 5/6, epithelial membrane antigen, and p63 were positive, while cytokeratin 7, carcinoembryonic antigen, S-100, and estrogen and progesterone receptors were negative. Periodic acid-Schiff stain was negative. Ki-67 labeling index was 79.7%. The final diagnosis was ASCC of the areola. After wide local excision, recurrence have not been reported. Here, we report a case of ASCC on the areola, focusing on its rare histologic variant and uncommon location.
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Syringocystadenoma papilliferum (SCAP) and apocrine hidrocystoma (AH) are benign apocrine neoplasms that usually occur separately. SCAP arises predominantly in head and neck, while AH typically develop in periorbital area. We report a case of a 68-year-old male with an asymptomatic erythematous papulonodule that occurred on his back 3 years ago. Histologic examination showed cystic invagination extending from the epidermis into the dermis with some papillary projections. The invaginated portion was lined by epithelial bilayer composed of cuboidal and columnar cells, and decapitation secretion was observed in the inner epithelial layer. In the deep dermis, multiple cystic spaces with variable sizes were observed, and these cysts also presented double layers of the epithelium and decapitation secretion.According to such histologic features, the coexistence of SCAP and AH within a single lesion was demonstrated. The patient was recommended to completely remove the remaining lesion after punch biopsy, but he refused further surgical management. Herein, we report an unusual case of complex apocrine tumor with a rare composition in an atypical site.
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Background@#Herpes zoster (HZ) is a neurocutaneous disease caused by reactivation of the varicella zoster virus after primary infection. In Korea, it is recommended that all adults aged ＞60 be vaccinated against HZ. However, breakthrough infection with HZ can occur infrequently in vaccinated individuals. @*Objective@#This study aimed to investigate the effects of the HZ vaccine on the clinical manifestations and courses of HZ in immunocompetent elderly individuals aged 60 years and older. @*Methods@#Among 848 immunocompetent HZ patients, 52 were vaccinated and 796 were unvaccinated. From this cohort, we chose 156 unvaccinated patients through a 1:3 propensity score matching analysis using three parameters;age, sex, and involved dermatome. We subsequently compared the clinical manifestations and courses between the vaccinated (n=52) and unvaccinated (n=156) groups. @*Results@#The vaccinated group had a lower peak numeric rating scale pain score and a lower rate of consultation with the pain control clinic than the opposite. Additionally, mild skin lesions without vesicles were more frequent in the vaccinated group than in the opposite. The vaccinated group had a shorter duration of total follow-up, shorter antiviral treatment period, lower admission rate, and shorter hospital stay than the opposite. Although postherpetic neuralgia occurred more frequently in the unvaccinated group than in the unvaccinated group, the incidences of other HZ-related complications showed no significant difference between the two groups. @*Conclusion@#Despite the possibility of breakthrough infection, the HZ vaccine should be recommended in the elderly as it can weaken the clinical features and course of the disease.
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no abstract available.
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Atypical fibroxanthoma (AFX) is a rare fibrohistiocytic tumor usually observed on ultraviolet light-exposed areas of the body, such as the face or scalp in elderly individuals. Despite its clinically benign course, AFX presents with malignant features on histopathological evaluation. A 12-year-old male adolescent presented with a 3-month history of an asymptomatic, skin-colored, oval-shaped nodule on his right thigh. Histopathological examination showed a dermal tumor adjacent to the epidermis, without epidermal invasion. The tumor was composed of numerous pleomorphic spindle cells and large atypical histiocytes with abundant vacuolated cytoplasm and pleomorphic nuclei. Immunohistochemical analysis revealed tumor cells, which were immunopositive for vimentin, CD68, CD10 and immunonegative for desmin, pan-cytokeratin antibody (AE1/AE3), and S-100. Therefore, the patient was diagnosed with AFX. We report a rare case of AFX that occurred on the thigh (an unusual site) in an adolescent (an uncommon age group). Immunohistochemical analysis is important in patients with suspected AFX, regardless of the patient’s age and site of lesion, for accurate diagnosis to differentiate this condition from other diseases with a similar presentation.
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Hand-foot-mouth disease (HFMD) is a viral infection that occurs commonly in children. It is characterized by vesicles with surrounding erythema on the extremities and mouth. Most common pathogens are Coxsackievirus A16 and Enterovirus 71. HFMD caused by Coxsackievirus A6 is uncommon and accompanied by more extensive and atypical eruptions. A 42-year-old man presented with erythematous papules and vesicles on the right hand which occurred 7 days prior to presentation. The rash spread extensively with high fever, chills, headache, and myalgia. He also had whitish ulcer-like lesions on the oral mucosa with swallowing difficulty. One day after hospitalization, he developed arthralgia on his shoulders, pelvis, knees, and fingers. The biopsy specimen showed an intraepidermal blister with reticular degeneration, epidermal necrosis, and neutrophilic infiltration. There were no inclusion cells or giant cells. The serum antibody titer of Coxsackievirus A6 showed a significant increase, at 64 times. He was diagnosed with HFMD caused by Coxsackievirus A6.
ABSTRACT
Atypical fibroxanthoma (AFX) is a rare fibrohistiocytic tumor usually observed on ultraviolet light-exposed areas of the body, such as the face or scalp in elderly individuals. Despite its clinically benign course, AFX presents with malignant features on histopathological evaluation. A 12-year-old male adolescent presented with a 3-month history of an asymptomatic, skin-colored, oval-shaped nodule on his right thigh. Histopathological examination showed a dermal tumor adjacent to the epidermis, without epidermal invasion. The tumor was composed of numerous pleomorphic spindle cells and large atypical histiocytes with abundant vacuolated cytoplasm and pleomorphic nuclei. Immunohistochemical analysis revealed tumor cells, which were immunopositive for vimentin, CD68, CD10 and immunonegative for desmin, pan-cytokeratin antibody (AE1/AE3), and S-100. Therefore, the patient was diagnosed with AFX. We report a rare case of AFX that occurred on the thigh (an unusual site) in an adolescent (an uncommon age group). Immunohistochemical analysis is important in patients with suspected AFX, regardless of the patient’s age and site of lesion, for accurate diagnosis to differentiate this condition from other diseases with a similar presentation.
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Kawasaki disease is an acute inflammatory syndrome affecting middle-sized arteries. It is diagnosed when a fever lasts longer than 5 days, and four out of the five diagnostic criteria are satisfied. Some skin lesions are not included in the criteria, but are associated with Kawasaki disease. They can be helpful when the patient has an incomplete presentation. Herein, we report a Kawasaki patient who presented with simultaneous orange-brown chromonychia on all 20 nails and black crusted lips.
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Bee pollen is a mixture made by worker bees and consists of pollen, nectar, and salivary secretions. Due to its abundant nutritional and medicinal effects, people are consuming bee pollen increasingly these days. By the way, some of the elements of bee pollen, such as pollen and fungus, can cause allergic reactions. Anaphylaxis is the most common symptom and other symptoms such as bronchospasm, abdominal pain and urticaria can occur. But localized cutaneous bee pollen allergy has never been reported. A 29-year-old man presented with erythematous vesicular patches on the lower abdomen 3 months ago. The skin biopsy specimen showed a subcorneal pustule filled with eosinophilic microabscess, perivascular eosinophilic infiltration, and epidermal spongiosis. He was diagnosed with skin allergy caused by bee pollen. He stopped ingesting bee pollen and was treated with oral antihistamines and a topical steroid. We report this case because of its unique clinical and histological appearance.
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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse drug reaction that is difficult to predict. It is characterized by fever, skin rash, and internal organ involvement that usually manifests 2∼6 weeks after use of the culprit drug. The antihyperglycemic agent sitagliptin is commonly used for treating diabetes mellitus, and sitagliptin-induced DRESS syndrome has not been previously reported in Korea. Herein, we report a case of DRESS syndrome after sitagliptin use; these observations may contribute to the timely diagnosis of sitagliptin induced DRESS syndrome and help reduce associated complications or morbidities.
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Cutaneous pseudolymphoma is a heterogeneous group of benign reactive T- or B-cell lymphoproliferative diseases of the skin that simulate cutaneous lymphomas histologically and, sometimes, clinically. Thus far, only a few cases of pseudolymphomas showing atypical clinical manifestations have been reported. A 10-month-old boy presented with multiple flesh-colored, yellowish erythematous disseminated papules on the face, abdomen, and arms. The cutaneous lesions morphologically resembled molluscum contagiosum, Langerhans cell histiocytosis, or juvenile xanthogranuloma. Punch biopsy and immunohistochemistry studies were performed, and the lesion was identified as a cutaneous B-cell pseudolymphoma. Most of the lesions were cleared within a month with systemic corticosteroids and oral antihistamine administration. In this report, we present an interesting rare case of infantile cutaneous B-cell pseudolymphoma mimicking many other dermatological diseases in addition to a cutaneous lymphoma.
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PURPOSE: 2003, Advances in medical-surgical technologies, histo-compatibility and immunosuppressive drugs, such as FK-506, MMF, have caused a dramatic increase in the rates of successful organ transplantation (TP). As the waiting list of patients requiring TP grows, there is a subtle donation. What is worse, its increased issues of ethics, for instance, definition of brain death, consent of living donation, paid organ donation, decreased altruism, living will, justice of sharing organ. Therefore, This study was done to develop on legal, ethical and philosophical for whole procedure of organ transplantation which is a life-saving treatment improvement the quality of life. METHODS: A survey questionnaire was used and received responses from TP doctors(59) and nursing coordinators(46) at 53 hospitals where TP were being done for this study. The basic data in TP were collected, 1) to identity the staffs in charge of TP and their jobs in the hospital, 2) committee of hospital ethics (CHE), 3) committee of brain death confirmation definition (CBDCD), 4) to research what consideration are appropriate donors and recipients, 5) the facility of hospital for TP, 6) to analyzed awaiting solution the problems for TP. The data were analyzed using SAS-program by descriptive statistics, t-test, ANOVA and Pearson correlation coefficient. RESULTS: The jobs of TP nursing coordinators were not only to give nursing information but also to take care of donors and recipients (62.8~84.4%). The job of TP has not been identified between CHE and CBDCD (62.8%). The mean score of CHE's members was 6.33 persons. The mean scores of the problems regarding the law of TP was 2.88 (full score:4). The high items of the problems regarding the law of TP were "the decreased TP, donation and brain death because of KONOS (Korea Network for Orgen Sharing) which operated TP". The mean score of the improvements regarding the law of TP was 2.97 (full score:4). The highest item of the improvements regarding the law of TP was "Compensation of loss should be paid by the KONOS. The procedure of confirm is a loose legal. Therefore that is concern about commercialization of human organ. Definition of brain death is rigid regulation. Sharing organs are a fair dealing. The problems were significantly correlated with the improvements (P<0.0001). CONCLUSION: The finding of the study suggested that a TP should manage donors and recipients in line with legal, ethical, philosophical, humanistic aspects. Various viewpoints, the CHE should be enacted from the principle of human dignity, conducted by CBDCD of professional members and the nursing coordinators played an important role. It is suggested that TP might meet the request of the time so that KONOS should be changed with the other organization of newly methods and responsibility.
Subject(s)
Humans , Altruism , Brain Death , Ethics , Ethics, Institutional , Jurisprudence , Living Wills , Nursing , Organ Transplantation , Personhood , Quality of Life , Surveys and Questionnaires , Social Justice , Tacrolimus , Tissue and Organ Procurement , Tissue Donors , Transplants , Waiting ListsABSTRACT
No abstract available.
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PURPOSE: The clinical outcome of a sling operation using a cadaveric fascia lata patch was evaluated to determine the efficacy and safety of the treatment for women with stress urinary incontinence (SUI). MATERIALS AND METHODS: Thirty one patients with SUI, who were treated with a sling operation using a cadaveric fascia lata patch from June 1999, were analyzed. The preoperative evaluation included the patients' history, a physical examination, urinalysis, a urodynamic test, a Q-tip test and incontinence staging with the Stamey grade. The follow-up ranged from 4-24 months (mean 14.5). All patients were assessed for the outcome of the procedure, subjective satisfaction and complications. RESULTS: Of the 31 women treated, 27 (87.1%) were satisfied with the treatment (16 dry, 11 improved). Mean operative time was 34.4 minutes and the mean hospital stay was 4.6 days. There were no complications related to the cadaveric fascia lata noted. De novo urgency developed in 4 (12.9%) patients. CONCLUSIONS: The mean operation time, hospital stay, catheter drainage, and post-operative complications were significantly lower when using a cadaveric fascia lata patch sling procedure compared to the traditional pubovaginal sling operation. However, when compared with the other sling procedures, the short-term success rate is unsatisfactory. A longer follow-up study is needed.
Subject(s)
Female , Humans , Cadaver , Catheters , Drainage , Fascia Lata , Fascia , Follow-Up Studies , Length of Stay , Operative Time , Physical Examination , Urinalysis , Urinary Incontinence , UrodynamicsABSTRACT
PURPOSE: The clinical outcome of a sling operation using a cadaveric fascia lata patch was evaluated to determine the efficacy and safety of the treatment for women with stress urinary incontinence (SUI). MATERIALS AND METHODS: Thirty one patients with SUI, who were treated with a sling operation using a cadaveric fascia lata patch from June 1999, were analyzed. The preoperative evaluation included the patients' history, a physical examination, urinalysis, a urodynamic test, a Q-tip test and incontinence staging with the Stamey grade. The follow-up ranged from 4-24 months (mean 14.5). All patients were assessed for the outcome of the procedure, subjective satisfaction and complications. RESULTS: Of the 31 women treated, 27 (87.1%) were satisfied with the treatment (16 dry, 11 improved). Mean operative time was 34.4 minutes and the mean hospital stay was 4.6 days. There were no complications related to the cadaveric fascia lata noted. De novo urgency developed in 4 (12.9%) patients. CONCLUSIONS: The mean operation time, hospital stay, catheter drainage, and post-operative complications were significantly lower when using a cadaveric fascia lata patch sling procedure compared to the traditional pubovaginal sling operation. However, when compared with the other sling procedures, the short-term success rate is unsatisfactory. A longer follow-up study is needed.
Subject(s)
Female , Humans , Cadaver , Catheters , Drainage , Fascia Lata , Fascia , Follow-Up Studies , Length of Stay , Operative Time , Physical Examination , Urinalysis , Urinary Incontinence , UrodynamicsABSTRACT
PURPOSE: Unilateral ureteral obstruction results in tubulointerstitial fibrosis of the affected kidney which is driven by increased levels of angiotensin II. In this study, we examed the fibrotic changes in un inephrectomized rats with incomplete urteral obstruction and explored the effect of an angiotensin converting enzyme(ACE)inhibitor, enalapril on the tubulointerstitial fibrosis of obstructive uropathy. MATERIALS AND METHODS: 130 Rats were sacrificed at 1, 2, 4 weeks after nephrectomy or obstruction. Collagen type I, II, and III were localized by immunohistochemical staining. And the distribution of each collagen type was analyzed using differences of their staining densities. RESULTS: There is no difference in total collagen amount and immunohistochemical staining between control and uninephrectomized group. After 2weeks in incomplete ureteral obstruction in uninephretomized rat, the total amount of collagen in affected kidney was significantly increased compared to control (p<0.05), and immunohistochemical staining for all type of collagen was gradually increased by increased duration of incomplete ureteral obstruction. Enalapril did not affect the total collagen amount and immunohistochemical staining in the kidney of uninephrectomized rat. Enalapril significantly decreased the collagen amount in affected kidneys of collagen was not significantly changed compaired to control group. CONCLUSIONS: the incomplete ureteral obstruction in uninephrectomized rat induces progressive increase of amount of collagen according to the duration of obstruction, especially 2 weeks, and enalapril administration after incomplete unilateral obstruction of tubulointerstitial fibrosis of obstructive uropathy.
Subject(s)
Animals , Rats , Angiotensin II , Angiotensins , Collagen Type I , Collagen , Enalapril , Fibrosis , Kidney , Nephrectomy , United Nations , Ureter , Ureteral ObstructionABSTRACT
No abstract available.
ABSTRACT
Hemangioma is the most common congenital anomaly in the human. It represents a proliferation of endothelial cells and has been characterized as a benign neoplasm. Hemangiomas involving the genitalia comprise 2% of all such masses. Arteriovenous hemangioma is a benign congenital lesion that rarely involves the scrotum or urethra and primarily presents during childhood. We report a case of subcutaneous scrotal and urethral hemangioma that has caused persistent urethral bleeding in a 14-year-old boy who was treated by en bloc excision.