A Case of Pigmented Spindle Cell Nevus / 대한피부과학회지

Pigmented spindle cell nevus (PSCN) is often interpreted as a Spitz nevus or misdiagnosed as a malignant melanoma. Some authors consider PSCN as a pigmented variant of Spitz nevus, but many dermatologists classify it as a separate disease. We report a case of pigmented spindle cell nevus which occurred in a 4-year-old boy. The lesion was a well-demarcated, 3x3mm sized, black macule on the dorswn part of the 4th finger, left hand. The histopathologic findings of the excisional biopsy specimen revealed the proliferation of uniform, spindle shaped, pigmented melanocytes at the dermoepidermal junction and sharply defined lateral margins. The pathologic features were consistent with PSCN.

A Case of Ecthyma Gangrenosum Associated with Liver Abscess and Renal Abscess / 대한피부과학회지

Ecthyma gangrenosum is usually seen in the immunocompromised patients or in the patients with underlying malignancy. Ecthyma gangrenosum is a rapidly progressing skin infection characterized by edema, hemorrhage, bullae and necrosis. We experienced the case of a 13-month-old male who had ecthyma gangrenosum associated with liver absess and renal abscess. The patient initially presented with skin lesions of multiple well defined central necrotic black colored large erythematous bullae. The multiple liver abscess with hepatomegaly and multifocal pyelonephritis with focal renal abscess revealed by abdominal ultrasonogram and computed tomogram. In the bacterial cultures of skin, urine and liver aspiration fluid, Pseudomonas aeruginosa was grown. The patient had no immune deficiency disease. We report this case with a review of related literatures.

Ureteral Stone in an Infant / 대한비뇨기과학회지

Pediatric urolithiasis is a rare disease. Although the causes of pediatric urolithiasis are unknown, the metabolic conditions account for more than 50% of diagnoses. Because pain originating from stones may mimic a colic in infants, it is difficult to diagnose a stone in pediatrics. To our knowledge there is no case of urolithiasis reported in Korean infants. Here we report a case of a calcium-uric acid urolithiasis in an infant.

Purple Urine Bag Syndrome / 대한비뇨기과학회지

Purple urine bag syndrome (PUBS) is a rare phenomenon where the urinary catheter and bag turns purple following catheterization. The colors are formed from the substrate indoxyl sulfate (indican). PUBS is associated with urinary tract infections induced by the reaction of some species of bacteria with indoxyl sulfatase. We report here in a case of purple urine bag syndrome.

Grades IV and V Renal Injury: How to Treat? / 대한비뇨기과학회지

PURPOSE: Management of major renal injury caused by blunt trauma is still somewhat controversial. We investigated the characteristics of grades IV and V blunt renal injury patients who underwent conservative or operative treatment, and determined the feasibility of conservative treatment of such injury. MATERIALS AND METHODS: We retrospectively reviewed the records of 25 patients who presented our hospital with grades IV or V blunt renal injury. The 10 patients treated conservatively were assigned to group 1, and the 15 patients treated surgically to group 2. Each group was compared with respect to initial evaluation, radiologic findings, associated injuries, duration of hospital and intensive care unit stay, transfusion requirements, complications and follow-up imaging. RESULTS: We found that shock was the only characteristic sign of the surgical treatment group and that the degree of hematuria did not correlate with treatment options. Radiologic findings which differed significantly between the 2 groups were the proportion of devitalized segments to total renal parenchyma and the presence of ureteral opacification despite urinary extravasation. Patients in group 1 had lower transfusion requirements but longer hospitalization, both significantly. Follow-up imaging of group 1 patients revealed functioning renal parenchyma with resolution of retroperitoneal hematoma in 8 of the 10 cases (80%). CONCLUSIONS: This study shows that conservative treatment of blunt grades IV and V renal injury should be considered for patients with hemodynamic stability, no significant associated intra-abdominal organ injuries, devitalized segments less than 25% of renal parenchyma and ureteral opacification despite urinary extravasation on radiologic finding.

Epidemiologic Study about Inguinal Hernia and Hydrocele Performed in Young Men in Daejeon City and Chung-nam Area / 대한비뇨기과학회지

PURPOSE: We investigated the incidence and risk factors of contralateral inguinal hernia or hydrocele in men dwelling in community with initially unilateral disease. MATERIALS AND METHODS: A total of 2,700 men aged 20 years dwelling in the community were randomly selected at a 10.0% sampling fraction after a sampling process by census district and 2,080 of these men agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. They completed a self-administered questionnaire providing detailed information on any previous history. To evaluate risk factors for contralateral occurrence of inguinal hernia or hydrocele, we compared 3 possible variables (initial side, type and history of repair) between total patients with and those without contralateral inguinal hernia or hydrocele. For patients who underwent repair, 4 variables were compared (initial side, type, ipsilateral recurrence and age at repair) between the 2 groups. RESULTS: Of the participants, 48 men (2.3%) were observed to either have inguinal hernia or hydrocele on physical examination (n=14) or had a history of inguinal hernia or hydrocele repair (n=34). Six (12.5%) patients experienced contralateral inguinal hernia or hydrocele. Contralateral diseases occurred in 2 of 28 (7.1%) patients with initial right inguinal hernia or hydrocele, and 4 of 20 (20.0%) patients with initial left inguinal hernia or hydrocele. There were no significant differences between the 2 groups in any of the variables. CONCLUSIONS: We did not identify subgroups at sufficiently increased risk to warrant contralateral exploration. Our findings suggest that routine contralateral exploration cannot be justified in these patients since the incidence of contralateral clinical inguinal hernia or hydrocele is low.

A Case of Frey Syndrome / 대한피부과학회지

Frey syndrome is characterized by sweating and flushing on the auriculotemporal region in respense to gustatory stimuli following surgery, trauma or irfection of the parotid areas. A 22-year-old man had received a surgery for sclerosis and hypertrophy of the left mandible. Two months after operation gustatory sweating occurred, whenever he eats, on the malar area without any detectable flushing or sensory impairment. Sweating starts in 30 seconds during food intake and is clearly visible with naked eyes within 2 minutes. This syndrome is encountered uncommonly to the dermatologic practitioners but more cases might be discovered if more attention could be given to this condition.

Two Case of Verrcous Hemangioma / 대한피부과학회지

Verrucous hemangioma is a variant of a capillary, cavernous, or mixed hemangioma which undergoes a reactive proliferative epidermal change. Most verrucous hemangiomas appear on the lower extremities, and most are present at birth or appear during childhood. We observed two patients who showed typical clinical and histopathological findings of verrucous hemangioma. Treatment was done by wide surgical excision and skin graft. The first rnale patient had a good therapeutic result but the second female patient had a recurrence at one month post-operative.

Confluent and Reticulate Papillomatosis: Treated with an Aromatic Analog of Vitamin A Acid (Ro 10 - 9359) / 대한피부과학회지

Confluent and reticulate papillomatosis is a rare but clinically distinct dermatosis first described by Gougerot and Carteaud in 1927. It consists of dark brown pigmented papules which coalesce to reticulate and confluent patches. It usually begins shortly after puberty mainly in females and is most often localized to the intermammary and interscapular regions. Histological examination shows hyperkeratosis and papillomatosis, and there may be decreased granular cell layer, focal acanthosis, or hypermelanosis of the basal cell layer. We recently observed a 20-year-old male patient who showed typical clinical and histopathological findings of confluent and reticuIate papillomatosis. Treatment with an aromatic analog of vitamin A acid(Ro 10-9359) resulted in dramatic effectivenese.

The Therapeutic Effect of Oral Retinoid (Ro - 10 - 9359) on Psoriasis Vulgaris / 대한피부과학회지

Retinoid, Ro l0-9359 is an aromatic analog of vitamin A acid or retinoic acid. The orally administrable retinoid has a therapeutic effect on the treatment of psoriasis, ichthyosis, Darier's disease, pustulosis palmoplantaris and skin cancer. However, some results have been reported previously, indicating that oral retinoid alone does not clear psoriatic lesions although some improvement may he noted. Morcover, promising results of combination treatment of psoriasis with the retinoid and local dithranol or PUVA have been reported. In the present study we report the clinical results obtained in 16 psoriatics after oral retinoid treatment, with and without the addition of topical cotricosteroid. We employed a new retinoid regimen orally in 16 adults with widcspread psoriatic lesions, Most of them bad been treated earlier with topical corticosteroids without beneficial effect. Of 16 cases 8 were treated with retinoid alone and the other 8 patients with topical corticosteroids in addition to the oral regimen, The results are summarized as follows: 1. Complete to good clearing of the lesions was seen in 5 of 8 patient with retinoid alone and in 7 of 8 patients using the combination treatment. 2. Side-effects appeared in all patients, the most prominent being dryness of the mouth or cheilitis in cases and pruritus in 10 cases. However, there were no abnormalities shown in liver function tests during or after treatment. From the above results the combination treatment with topical corticosteroids seems to be more effective than retinoid alone in the treatment of psoriasis. It is considered that the oral retinoid could be an alternative on the treatment of psoriasis.

Pseudozanthoma Elasticum: Report of 5 Case / 대한피부과학회지

Pseudoxanthoma. elasticum is a rare, heritable, systemic disease of connective tissue characterized by degeneration of elastic tissue and mainly affecting the skin, eyes and blood vessels. Recently, according to Pope (1974), it can be inherited as an autosomal dominant or recessive trait. We presented a study of 5 cases of pseudoxanthoma elasticum of autosomal recessive inheritance, which showed typical peau d'orange skin lesions. Two among the 5 cases were associated with angioid streaks, a case with myopia and broderline mental retardation, and 2 cases without any other systemic disturbances.

Stevens-Johnson Syndrome Associated with Toxic Hepatitis / 대한피부과학회지

Pseudoxanthoma. elasticum is a rare, heritable, systemic disease of connective tissue characterized by degeneration of elastic tissue and mainly affecting the skin, eyes and blood vessels. Recently, according to Pope (1974), it can be inherited as an autosomal dominant or recessive trait. We presented a study of 5 cases of pseudoxanthoma elasticum of autosomal recessive inheritance, which showed typical peau d'orange skin lesions. Two among the 5 cases were associated with angioid streaks, a case with myopia and broderline mental retardation, and 2 cases without any other systemic disturbances.

The Bacteriological Study of Impetige Contagiosa / 대한피부과학회지

Our present knowledge of impetigo contagiosa extends from its first description as a separate clinical entity by Fox in I864, and the proof of its bacterial etiology by Radcliffe-Crocker in 1881. Both staphylococci and streptococci have been discovered from the lesions, but the relative preponderance of each varies greatly, and reports are contradictory. Seventy-eight patients with impetigo contagiosa were studied bacteriologically in order to ascertain the primary etiologic agent. Also, a susceptibility test (Bauer- Kirby method) was done on the isolated organisms with 7 antibiotics which are used frequently in the clinical field. Specimens obtained from the skin lesions were cultured and organisms were isolated. They were identified by various biochemical and serological tests. A DN ase test, a carbohydrate fermentation test, and a coagulase test were done for the isolated staphylococci. A bacitracin disc method and a precipitin test(Lancefield method) were done for the isolated B-hemolytic streptococci. The results were as follows: Fifty-six cases(71.8%) were infected by staphylococcus only. Twenty cases(25.6%) were infected by a mixture of staphylococcus and p-hemo- lytic streptococcus. Only 2 cases(2.6%) were infected by B-hemolytic streptococcus alone. All 76 strains of staphylococci were identified as coagulase positive staphylococci. Among the 22 strains of B-hemolytic streptococci, 15 strains were identified as group A and remaining 7 strains were identified as group B. Coagulnse negative sta,phylococcus was not found. In the susceptibility test to 7 antibiotics, staphylococci showed susceptibility to lincomycin, erythromycin, cloxacillin, and chloramphenicol, and resistance to tetra-cycline, penicillin, and ampicillin. Streptococci showed susc.ptibility to all of the above antibiotics except tetracycline. From the results of this experiment, it was concluded that the primary etiologic agent of impetigo contagiosa was coagulase positive staphylococcus and streptococcus for the most part can be considered as a secondarily infecting agent. Coagulase negative staphylococcus apparently is not implicated as an etiologic agent of impetigo contagiosa. The results of the antibiotic susceptibility tests would seem to indicate that the use of such antibiotics as tetracycline, penicillin, and ampicillin is not indicated in the treatment of impetigo contagiosa.

Erythema ANnulare Centrifugm: Report of one Case / 대한피부과학회지

Erythema Annulare Centrifugum is characterized by migratory annular, arcuate or polycyclic erythemas with central clearing. Its etiology is not conclusive but there are many reports about the etiology, i.e." due to dermatophytid"," the drugs",' intemal diseases", or" unknown etiology" etc. A case of Erythema Annulare Centrifugum with "unkown etiology" was reported. The patient revealed slightly elevated, migratory annular erythemas with central clearing on the both posterior portions of thighs. Histopathologically, there was no abnormality in the epidermis. In the dermis, cellular infiltrates sbowing fairly well demarcated perivascular coat-sleeve like arrangement and endothelial prolifera01

Poikilodermatomyositis / 대한피부과학회지

The authors observed 2 cases of poikilcdermatomyositis who were 16 and l0 years old female. The former visited our dept. due to rashes on the anterior portion of right thigh with 3 months duration. The skin lesion revealed mottled skin pigmentation, telangiectasia, atrophy, and cigarrette paper like wrinklings. On the palpation, hardness and tenderness in the lesion were felt. The latter visited our dept. due to weakness of the right lower extremity for 3years. The skin lesion revealed the same feature as the former but more prominent. Histophthologically, P.V.A. patterns are seen in the both skin lesions. The epidermis shows moderate atrophy of St. malphigi and flattening of reteridges. The dermis is edematous, vascular dilatations, and cellular infiltrations, most of lymphocytes, around the blood vessels. The muscle biopsies for the Quardriceps Femoris sbow Dermatomyositis patterns which the muscle bundles are degenerative changes and many cellular infiltrations, chiefly of lymphocytes, are seen between the muscle bundles. Diagnosis was confirmed by the clinical and histological pictures. These patients were markedly improved by the prednisolone therapy.