ABSTRACT
Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Subject(s)
Humans , Middle Aged , Bowen's Disease , Follow-Up Studies , Hematoporphyrin Derivative , Lasers, Gas , Light , Oxygen , Palliative Care , Photochemotherapy , SkinABSTRACT
Nodular fasciitis is an uncommon nonneoplastic swelling consisting of reactive fibroblastic proliferation occurring in the subcutaneous tissue of the extremities. It is characterized by benign clinical course and aggressive histologic features mimicking soft tissue sarcoma, Herein we report a 33-year-old man with a solitary, tender, 1.2 X 1.5cm sized hard nodule on the right forearm which clinically and histologically shows a typical nodular fasciitis.
Subject(s)
Adult , Humans , Extremities , Fasciitis , Fibroblasts , Forearm , Sarcoma , Subcutaneous TissueABSTRACT
BACKGROUND: An important constituent of normal human oral microflora has long been recognized. The increase in the incidence of candidal infections has been associated with the increase in the number of patients at risk. Especially, diabetic patients have been increased susceptibility to general and local infections, but it is often equivocal whether or not risk factors such as oral-ambient conditions are related to candidal colonization. OBJECTIVE: The isolates of candidal species were evaluated in the oral cavity of diabetic patients in comparison with non-diabetic, non-immunocompromized subjects. Risk factors that could influence candidal colonization in diabetic patients were also studied. METHOD: Candidal species were isolated from the oral mucosa of 205 diabetics and 62 non-diabetics, using oral swab and smear technique. They were identified by germ tube test, Cornmeal-Tween agar and API 20C system. RESULTS: The frequency of oral candidal isolates was more common in 130 isolates (63.4%) in diabetic patients compared with 23 (37.1%) isolates in controls (p0.05). Germ tubes were formed in the 102 species and chlamydospores in the 105 species in diabetic patients. Candida(C) albicans among the species was the most frequent isolates in both groups (80.8% vs 69.6%). The isolated 130 candidal species, identified by API 20C system, in diabetic patients, showed C. albicans (104), C. tropicalis (16), C. parapsilosis (6), C. krusei (1), C. kefyr (1) and unidentified species (2) compared with C. albicans (16), C. tropicalis (2), C. parapsilosis (2), C. krusei (3), C. kefyr (3) in 23 of controls. These results were almost same in both groups except for the relative high frequency of C. kefyr in controls. As for the risk factors, the isolates were increased in diabetic patients who were smokers (p0.05). Candidal culture rate and diabetic duration were not correlated (p>0.05). The number of colonies in SDA plate was significantly increased in smokers and denture-wearers (p<0.05). CONCLUSION: The frequency of oral candidal isolates in diabetic patients is higher than in that of controls. Oral-ambient factors such as smoking, probably involve in the development of oral candidal colonization, but not being the result of a single factor.
Subject(s)
Humans , Agar , Candida , Colon , Dentures , Glycated Hemoglobin , Incidence , Mouth , Mouth Mucosa , Risk Factors , Sex Distribution , Smoke , SmokingABSTRACT
BACKGROUND: An important constituent of normal human oral microflora has long been recognized. The increase in the incidence of candidal infections has been associated with the increase in the number of patients at risk. Especially, diabetic patients have been increased susceptibility to general and local infections, but it is often equivocal whether or not risk factors such as oral-ambient conditions are related to candidal colonization. OBJECTIVE: The isolates of candidal species were evaluated in the oral cavity of diabetic patients in comparison with non-diabetic, non-immunocompromized subjects. Risk factors that could influence candidal colonization in diabetic patients were also studied. METHOD: Candidal species were isolated from the oral mucosa of 205 diabetics and 62 non-diabetics, using oral swab and smear technique. They were identified by germ tube test, Cornmeal-Tween agar and API 20C system. RESULTS: The frequency of oral candidal isolates was more common in 130 isolates (63.4%) in diabetic patients compared with 23 (37.1%) isolates in controls (p0.05). Germ tubes were formed in the 102 species and chlamydospores in the 105 species in diabetic patients. Candida(C) albicans among the species was the most frequent isolates in both groups (80.8% vs 69.6%). The isolated 130 candidal species, identified by API 20C system, in diabetic patients, showed C. albicans (104), C. tropicalis (16), C. parapsilosis (6), C. krusei (1), C. kefyr (1) and unidentified species (2) compared with C. albicans (16), C. tropicalis (2), C. parapsilosis (2), C. krusei (3), C. kefyr (3) in 23 of controls. These results were almost same in both groups except for the relative high frequency of C. kefyr in controls. As for the risk factors, the isolates were increased in diabetic patients who were smokers (p0.05). Candidal culture rate and diabetic duration were not correlated (p>0.05). The number of colonies in SDA plate was significantly increased in smokers and denture-wearers (p<0.05). CONCLUSION: The frequency of oral candidal isolates in diabetic patients is higher than in that of controls. Oral-ambient factors such as smoking, probably involve in the development of oral candidal colonization, but not being the result of a single factor.
Subject(s)
Humans , Agar , Candida , Colon , Dentures , Glycated Hemoglobin , Incidence , Mouth , Mouth Mucosa , Risk Factors , Sex Distribution , Smoke , SmokingABSTRACT
BACKGROUND: Onychomycosis is a common disease and has a tendency to increase in its incidence. Although there have been many reports about onychomycosis, very few studies about onychomycosis in the elderly have yet been conducted. OBJECTIVE: The purpose of this study was to investigate the clinical and mycological features of onychomycosis in the elderly, and to evaluate the concept and attitude of the elder patients towards onychomycosis, which would affect the treatment and further infections of onychomycosis. METHOD: Sixty eight onychomycosis patients over 60 years old were examined clinically and surveyed by questionnaire to evaluate their concern about the onychomycosis. All the patients were confirmed by potassium hydroxide (KOH) examinations and underwent cultures on the both cornmeal potato agar with and without cycloheximide. An additional culture was done a week later when the initial culture showed contamination or no growth. RESULTS: Among 648 patients with onychomycosis, 68 patients (10.5%) were over 60 years old. Fifty (73.5%) were female and 18 (26.5%) were male. Twenty six (38.2%) had systemic illness. The average duration of onychomycosis was 13 years and the average number of onychomycosis involving nails was 4.7. Sixty three patients (92.6%) had toe nail onychomycosis. Sixty six patients (97.1%) showed distal subungal onychomycosis. Trichophyton rubrum was the main causative organism in 38 patients (55.9%). Forty one patients (60.3%) discontinued the medication in 4 weeks, and 11 (16.2%) were treated over 12 weeks. From the questionnaire, only 10 patients reported previous treatment for this problem, but with duration of treatment no longer than one month. Fifty three patients had mere understanding atypical alternation in their nails before the visit. The main reasons of the discontinuing the medication were the cost of the treatment, physical discomfort due to age, and extended duration of the therapy. CONCLUSION: From this study, we noticed that the elder onychomycosis patients could be long time carriers of fungi because of their lack of the knowledge of onychomycosis and insufficient treatment. Therefore, it is necessary to educate and support to treat the elder patients effectively.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Agar , Cycloheximide , Fungi , Incidence , Onychomycosis , Potassium , Solanum tuberosum , Toes , Trichophyton , Surveys and QuestionnairesABSTRACT
Herpes Zoster duplex -zoster affecting 2 separate dermatome simultaneously- is a rare disease. A 65 year old man, healthy in the past, presented with severely painful grouped papulovesicles and hemorrhagic crusts on the erythematous base on the right forehead and nasal bridge(V-I dermatome) and left chest(T4 dermatome) with nearly simultaneous occurrence. Tzanck smear revealed multinucleated giant cells and biopsy taken from the chest lesion showed the features consistent with herpetic viral blister. He was treated with intravenous administration of acyclovir for 5 days and both lesions were markedly improved.
Subject(s)
Aged , Humans , Acyclovir , Administration, Intravenous , Biopsy , Blister , Forehead , Giant Cells , Herpes Zoster , Rare Diseases , ThoraxABSTRACT
A rare case of perforating pilomatricoma is reported. A rice grain-sized lesion occurred on the 23-year-old man's left upper arm about 3 years ago. It has developed into a 0.5X0.8cm sized well-defined scaly hard tumor during recent 1 year. Excised tumor showed small islands of shadow cells in the mid-dermis and calcified materials, extruded from the dermis into the deeply invaginated epidermis, by transepidermal elimination.
Subject(s)
Humans , Young Adult , Arm , Dermis , Epidermis , Islands , PilomatrixomaABSTRACT
A rare case of perforating pilomatricoma is reported. A rice grain-sized lesion occurred on the 23-year-old man's left upper arm about 3 years ago. It has developed into a 0.5X0.8cm sized well-defined scaly hard tumor during recent 1 year. Excised tumor showed small islands of shadow cells in the mid-dermis and calcified materials, extruded from the dermis into the deeply invaginated epidermis, by transepidermal elimination.
Subject(s)
Humans , Young Adult , Arm , Dermis , Epidermis , Islands , PilomatrixomaABSTRACT
A 27-year-old man presented with a 6-month history of a dark-reddish nodule on the dorsal aspect of the right fifth finger. The lesion was a smooth-surfaced asymptomatic polypoid feature, measuring 0.4x0.9x0.5cm. Past and personal history were unremarkable. The excisional biopsy specimen showed numerous nests of spindle cells with some epithelioid cells in the entire dermis. The junctional activity was not present. On immunohistochemical staining, nest cells were strong positive for S-100 protein, but weak positive for HMB-45. No relapse was noted during a period of 6-month follow-up.
Subject(s)
Adult , Humans , Biopsy , Dermis , Epithelioid Cells , Fingers , Follow-Up Studies , Nevus, Epithelioid and Spindle Cell , Recurrence , S100 ProteinsABSTRACT
We report herein two cases of collodion baby in dizygotic twins, one boy and one girl. The babies were presented with general involvement of enclosement in a constricting parchment-like or collodion-like membrane, followed by its shedding and revealing red skin underneath. Histologically, compact dense hyperkeratosis and mild cellular infilterate in the upper dermis were seen, without parakeratosis or prominent granular layer. The babies markedly improved about 1 month later. The mild ichthyotic skin remained in the lower legs.
Subject(s)
Female , Humans , Male , Collodion , Dermis , Leg , Membranes , Parakeratosis , Skin , Twins, DizygoticABSTRACT
Reactive perforating collagenosis(RPC) is a kind of perforating disorder characterized by the transepidermal elimination of altered dermal collagen. Two types have been recognized; the childhood or inherited form and the adult or acquired form. Acquired RPC is frequently associated with diabetes, chronic renal failure with nephropathy and liver disease. We describe a case of RPC in a 41-year-old woman of about 2 months' duration. She has had a problem of tricuspid regurgitation for 3 years. Skin lesions showed scattered umbilicated papules with central keratotic plugs, 0.3-0.8cm sized, located on the proximal extremities.
Subject(s)
Adult , Female , Humans , Collagen , Extremities , Kidney Failure, Chronic , Liver Diseases , Skin , Tricuspid Valve InsufficiencyABSTRACT
We report a case of pemphigus vulgaris localized on the scalp in a 48-year-old woman who presented with several oozing crusted plaques for about 4 months. Scalp biopsy specimen showed suprabasal bulla and acantholysis in the epithelium and intercellular IgG deposition by the direct immunofluorescence. Circulating pemphigus antibodies were not detected. Treatment with systemic corticosteroids resulted in a remission, and there was no relapse for the following 7 months.