A Case of Ant Sting by Crematogaster Matsumurai Vagala

Reactions from stinging insects are significant to dermatologists because of the wide variety of clinical presentations from mild local reaction to severe anaphylactic reaction. Although ant sting commonly occurs, it has been rarely reported in the literatures. We experienced a unique case with allergic reactions by the ant of the Cremawgaster iw6w urai vagala, subfamily Myrmicinae, family Formicidea, order Hymenoptera that has not been previously reported.

A Case of Subungual Exostosis of the Finger / 대한피부과학회지

Subungual exostosis is a benign osteochondral tumor usually involving the distal phalanx of the great toe. It rarely occurs on other toes or the fingers. We report a case of a 26-year-old male who presented with a growing painful nodule on his right 4th finger. Diagnosis was confirmed by radiologic and histopathologic studies, followed by complete excision of the lesion. At the 13-month follow-up, there was no sign of recurrence. We think that subungual exostosis should be considered in the differential diagnosis of any digital mass.

Reclassification of Staphylococcal Scalded Skin Syndrome by Clinical Analysis of 25 Cases / 대한피부과학회지

BACKGROUND: Staphylococcal scalded skin syndrome (SSSS) is defined as a spectrum of superficial blistering skin disease caused by the exfoliative toxins of Staphylococcus (S.) aureus. The spectrum of the disease includes generalized, localized (bullous impetigo), abortive and intermediate forms. OBJECTIVE: The purpose of this study is to reclassify clinical types of SSSS by reviewing the clinical and microbiologic features of SSSS and to redefine the clinical types exactly. METHODS: We retrospectively reviewed medical records, clinical photographs and the microbiologic results of 25 patients with SSSS and studied them according to the new classification. We defined the 3 clinical types as follows: i) The Generalized type is defined as a case where tender erythroderma and large thin bullae occur on the whole body excluding the mucous membrane, palms and soles. The nikolsky sign is positive. ii) The intermediate type is defined as a case where tender erythroderma and vesicles or pustules occur in the regionally limited area. The Nikolsky sign is positive. iii) The abortive type is defined as a case where tender erythema occurs only on the whole body or in regionally limited areas. The nikolsky sign is negative. All patients of SSSS have periorificial, radial crusting and fissuring. RESULTS: We could reclassify the clinical types of SSSS into 3 types (generalized, intermediate, abortive) according to this retrospective clinical study. Of the 25 patients, 3 patients were of the generalized type, 13 patients were of the intermediate type and 9 patients were of the abortive type. All the types have the acute eczematous lesion on the periorbital and perioral areas. The male to female sex ratio was 1: 1.3. The mean age of onset was 2.9 years. Cultures from the suspected site of the primary infection were positive in 14 out of 21 patients, and colonized sites were the throat (29%), conjunctiva (21%), nasal cavity (21%), ear (21%) and skin (8%) in 14 patients. Methicillin-sensitive S. aureus and methicillin-resistant S. aureus were 8 cases and 6 cases, respectively. In all clinical types, the most common complication was conjunctivitis (54.5%). Four cases were accompanied by atopic dermatitis. All the patients were cured with first generation cephalosporin without significant sequelae. CONCLUSION: We reclassified SSSS into generalized, intermediate and abortive types with reference to our 25 cases and previously existing papers, and offered a correct definition for the 3 types.

A Case of Herpes Zoster Duplex Bilateralis / 대한피부과학회지

Herpes zoster classically occurs unilaterally within the area of skin innervated by a single sensory ganglion. Simultaneous involvement of two noncontiguous dermatomes is very rare and it has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 47-year-old woman presented with painful grouped vesicles on the right chest and the left lower back. The tzanck smear and the skin biopsy were consistent with herpetic infection. She was treated with intavenous acyclovir without any significant complications. We report a rare case of zoster duplex bilateralis.

A Case of Nicolau Syndrome Due to Diclofenac Sodium / 대한피부과학회지

Nicolau syndrome is defined as local cutaneous and sometimes muscular necrosis observed at the injection site of intramuscular preparations. It is characterized by severe pain immediately after the injection and variable degrees of skin necrosis. The only treatment is conservative. A 46-year-old man presented with painful skin necrosis on his buttock after the injection of diclofenac sodium. Histopathologic examination showed necrosis of the epidermis and upper 2/3 of the dermis. The lesion was treated conservatively with topical antibiotic ointment. We report a rare case of Nicolau syndrome due to diclofenac sodium.

A Case of Silicone Granuloma of the Face After Liquid Silicone Injections / 대한피부과학회지

Silicone has become one of the most extensively applied biomaterials in moderm medicine. But, silicone-related diseases are being observed with increasing frequency. We report a case of silicone granuloma of the face in a 44-year-old female patient who had been injected with liquid silicone for cosmetic purpose 20 years prior to visit. The patient presented with erythematous sclerotic plaque and large round brownish patch on the chin and left cheek, respectively. Histopathologically, there were many variable sized ovoid or round cavities surrounded by multinucleated giant cells and lymphohistiocytes. After 6 weeks of oral steroid treatment, mild improvement was noted.

Therapeutic Effect of Silatranes on Mouse Skin Ulcers / 대한피부과학회지

BACKGROUND: Silicon compounds, especially silatranes, are known to stimulate the regeneration of connective tissue, especially collagen. This has led to a great deal of research on the effects that new silatranes have on wound healing. OBJECTIVE: The purpose of this study is to compare efficacies of new silatrane ointments, an ointment-base (vaseline-lanoline), and a mupirocin ointment (Bactroban(R)) on ulcer healing. METHODS: Two groups of mice, composed of 10 mice each, were included in this study. Three ulcers were made on the back of each mouse and ointments were applied twice daily. For each mouse of Group I, silatrane ointment (-vinyl) was applied to the first ulcer, the ointment-base (vaseline-lanoline) to the second, and the mupirocin ointment (Bactroban(R)) to the third. Ointments were applied to the mouse of Group II in the same manner using silatranes ointment (-allyl), the ointment-base, and the mupirocin ointment. We compared the time it took for each ulcer to heal, the percent change over time of the wound area from baseline (as a reduction of percentage area), and mean healing rate. RESULTS: The results are as follows: 1. Two silatrane ointments (-vinyl, -allyl) brought about a faster healing time than either the ointment-base or the mupirocin ointment did. 2. Two silatrane ointments led to a greater reduction in the percentage area from baseline over time than the ointment-base and the mupirocin ointment. 3. Two silatrane ointments provided better results in terms of total area healed per day during the first 7 days than the ointment-base and mupirocin ointment did. CONCLUSION: Two Silatrane ointments (-vinyl, -allyl) are effective in the treatment of mouse skin ulcers.

A Case of Multiple Myeloma First Presenting as Cutaneous Plasmacytoma / 대한피부과학회지

Cutaneous extramedullary plasmacytomas are rare in patients with multiple myeloma, they usually indicate a large tumor cell burden and fatal outcome. A 55-year-old man presented with multiple cutaneous tender nodules or masses on whole body. A biopsy specimen of cutaneous nodule showed dermal infiltration by well differentiated plasma cells. Many atypical and immature plasma cells were found in a bone marrow smear and biopsy. A serum protein electrophoresis revealed elevated quantities of Ig G-globulin with type lambda light chain. The patient was treated with VAD(vincristine, adriamycin, dexamethasone) chemotherapy, but died with pulmonary edema and acute respiratory distress syndrome. We report a fatal case of multiple myeloma first presenting as multiple extramedullary cutaneous plasmacytomas.

A Case of Transient Acrodermatitis Enteropathica / 대한피부과학회지

Acrodermatitis enteropathica is a rare autosomal recessive disorder affecting early infancy. This syndrome is characterized by acral and periorificial dermatitis, alopecia and intractable diarrhea. Whereas hereditary acrodermatitis enteropathica is caused by mutation affecting intestinal zinc absorption, transient acrodermatitis enteropathica is caused by inadequate supply or malabsorption of zinc in the premature infant. We report a case of transient acrodermatitis enteropathica in a 5-month-old, breast-fed premature infant.

Primary Cutaneous Aspergillosis Complicating the Grafted Skin after Burn / 대한피부과학회지

A 60-year-old healthy man was consulted with dark brown eschars and purulent discharges on the grafted skin of a burn scar on the posterior aspect of both lower extremities which had developed two weeks after the skin graft. Aspergillus fumigatus was isolated by repeated fungal cultures from pus and tissue pieces. Also septate hyphae branching at an acute angle are seen in the dermis in PAS-stained section. After two weeks therapy with fluconazole and itraconazole, the patient accepted skin graft again. The skin lesion was improved after prophylactic itraconazole treatment for three weeks.

A Case of Primary Cutaneous Infection of the Burn Scar by Aspergillus niger / 대한의진균학회지

A 61-year-old healthy breeder presented with three punched out, purulent ulcers surrounded by erythematous indurated plaque on the burn scars of the dorsum of the right upper arm and hand which were developed at six months prior to visit. Aspergillus niger was isolated from the pus and tissue pieces in three consecutive cultures. After eight weeks therapy with oral itraconazole, purulent ulcers were healed leaving fibrotic scars. We report a rare case of primary cutaneous aspergillosis by A. niger in a healthy man.

Multiple Pilomatricomas Associated with Myotonic Muscular Dystrophy in Brother and Sister / 대한피부과학회지

Pilomatricoma is a tumor with differentiation toward hair cortex cells. There have been a few cases of multiple familial pilomatricomas in association with myotonic muscular dystrophy. We report two members of the family(brother and sister) with association of multiple pilomatricomas and myotonic muscular dystrophy. Multiple familial pilomatricomas may be a cutaneous manifestation of the myotonic syndrome.

A Case of Creeping Eruption / 대한피부과학회지

Creeping eruption is a syndrome characterized by the penetration in human skin of larvae from hookworms of various animals, mainly cats and dogs. A 26-year-old male presents with pruritic erythematous serpiginous linear skin lesion on the left lower leg for 2 weeks. The skin lesion was developed after walking in bare feet along the beach of an island in Philippines. Histopathologic finding showed a burrow containing numerous eosinophils and a few mononuclear cells in the epidermis. No parasite was found in multiple histologic section.