ABSTRACT
Background: Erythema nodosum and erythema induratum of Bazin are similar inflammatory diseases of the lower extremities. These are clinically distinguishable entities, though overlap can occur. Both diseases are reported to be related to Mycobacterium tuberculosis infection, but it is very difficult to identify Mycobacterium tuberculosis in skin lesions. Aim: This study aimed to develop a new nested polymerase chain reaction targeting the IS6110 insertion sequence of M. tuberculosis to improve the M. tuberculosis detection rate in skin lesions of erythema nodosum or erythema induratum of Bazin. Methods: From May 2016 to Jan 2018, 14 patients with clinically suspicious erythema nodosum or erythema induratum were enrolled in the study. Two cases were classified as erythema nodosum and 12 as erythema induratum. Individual patients were subjected to a 4-mm punch biopsy, and their venous whole blood was sampled immediately after diagnosis. Results: Eight patients were tested for M. tuberculosis using QuantiFERON, of which seven (87.5%) were positive. IS6110-nested polymerase chain reaction on all 14 patients identified 11 (78.6%) positive cases. Four of the eight (50%) individuals tested with QuantiFERON were also positive in the IS6110 nested polymerase chain reaction. The difference between the outcomes of the QuantiFERON and the IS6110-nested polymerase chain reaction tests was not statistically significant. There was also no significant agreement between the results of both assays. Sequencing the IS6110-nested polymerase chain reaction products showed a 97%–100% nucleotide sequence identity with the H37Rv genome. Conclusion: It is important to test for tuberculosis in patients with multiple tender subcutaneous nodules on their lower extremities in high-burden tuberculosis countries like Korea. Limitations: We need to register more suspicious patients to verify the association between erythema nodosum/erythema induratum of Bazin and M. tuberculosis. Furthermore, it is neces
ABSTRACT
BACKGROUND: There were many statistical studies about skin tumors. However, no articles have been reported which focus on the scalp tumors up to the present. OBJECTIVE: The purpose of our study was to analyze the epidemiologic aspect of scalp tumors, and compare them with other data related to skin tumors. METHODS: A statistical analysis was made using 251 cases of scalp tumors which were confirmed by histopathological study from January 1993 to December 2002 at Seoul National University Hospital. RESULT: 1. In the 251 cases of scalp tumors, 197 cases (78.5%) were benign scalp tumors, and 54 cases (21.5%) were malignant scalp tumors. 2. Among the 197 cases of benign scalp tumors, the most common tumor was nevus sebaceus (19.3%), followed by seborrheic keratosis (13.7%), epidermal cyst (10.2%), trichilemmal cyst (9.1%), lipoma (7.7%), intradermal nevus (7.1%), neurofibroma (6.1%). 3. Among the 54 cases of malignant scalp tumors, the most common tumor was metastatic cancer (31.5%), followed by basal cell carcinoma (18.5%), angiosarcoma (9.3%), squamous cell carcinoma (9.3%), lymphoma (7.4%), and so on. 4. Male to female ratio of benign scalp tumor was 1.3:1 and that of malignant scalp tumor was 1.1:1 5. The distribution of age of benign scalp tumor was relatively even from childhood to old age, but that of malignant scalp tumor showed that about 70% of cases were over 4th decade. 6. The distribution of each department which performed scalp biopsy was the following ; department of dermatology (49.2%), plastic surgery (21.8%), neurosurgery (17.3%), general surgery (11.2%), pediatrics (0.5%) at benign scalp tumor and department of dermatology (37%), neurosurgery (20.4%), plastic surgery (16.7%), general surgery (7.4%), internal medicine (7.4%), urology (5.6%), otolaryngology (3.7%) and emergency medicine (1.9%) at malignant scalp tumor.