RESUMEN
Majocchi's granuloma is a well recognized but uncommon infection of dermal and subcutaneous layers that is caused by fungal organism. It often presents as plaques and papules on areas where trauma is common. Majocchi's granuloma appears usually in immunocompromised patient but can also appear in immunocompetent patient. Tinea incognito appears in various forms of skin diseases, but it is rarely presented as Majocchi's granuloma. We report a case of trichophytic granuloma of the knee caused by Trichophyton(T.) rubrum in a 70-year-old male, who showed a pruritic, 7.0 × 2.0 cm sized, erythematous scaly patches with multiple papules on the right knee for 2 months. Fungal culture of the biopsy specimen grew out typical white cottony colonies of T. rubrum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of T. rubrum strain ATCC 52013 (GenBank accession number KX092384.1). Histiologic examination showed chronic granulomatous inflammation and fungal elements in the dermis. After one month of itraconazole 200 mg/day and sertaconzole cream treatment, the lesion was completely cleared.
RESUMEN
Eccrine poroma is a common benign cutaneous tumor that originates in an intraepidermal eccrine duct. This tumor exhibits acral distribution (sole, palm), and is rarely encountered in the head and neck area. In fact eccrine poroma in the postauricular area has only been rarely reported. A 55-year-old female visited our hospital with a main complaint of a mass that first developed in the left postauricular area about a year previously. The mass was painless, soft, protruding, domed, and dark red in color, and had slowly enlarged (at presentation it measured 1×1 cm). Excisional biopsy was performed. Histological examination showed distinct features, and eccrine poroma was diagnosed. Follow-up at 6 months postoperatively showed no recurrence. The frequency of eccrine poroma is dependent on eccrine sweat glands density, and thus, usually occurs on the palms or soles. For eccrine poroma in the head and neck region, the differential diagnosis must rule out other masses, such as nevus, skin tag, pyogenic granuloma, cyst, basal cell carcinoma, and seborrheic keratosis. Importantly, 18% of poromas show malignant transformation, and can develop into porocarcinoma. For these reasons, an eccrine poroma in the facial area requires histological examination, complete excision, and follow-up.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Biopsia , Carcinoma Basocelular , Diagnóstico Diferencial , Oído , Estudios de Seguimiento , Granuloma Piogénico , Cabeza , Queratosis Seborreica , Cuello , Nevo , Poroma , Recurrencia , Piel , Glándulas SudoríparasRESUMEN
A giant cutaneous horn (GCH) is a morphological description of huge, conical, dense, hyperkeratotic protrusion. Because of its bizarre shape and associated risk of malignancy, GCH requires proper treatment. A 48-year-old male patient visited our department with a GCH on a burn scar of his right hand. It had started to develop about 8 months previously. At initial physical examination, the lesion presented as a hard, dark brown mass of basal area 4×3.5 cm², and height 3.5 cm. Preoperative biopsy confirmed the absence of malignancy. We performed excision of the entire GCH, and biopsy and repaired the resulting defect with full-thickness skin graft. Histopathologic results revealed that all surgical margin were negative for malignancy. Microscopically, the lesion exhibited marked regular acanthosis, parakeratosis and hyperkeratosis with granular layer loss. At 3 months postoperatively, no complication was observed. According to Mantese et al., 58.56% of GCHs originate from malignant or premalignant lesions. And thus, a histopathologic examination is mandatory, and if an accompanying malignant lesion is found, additional resection should be undertaken. In another study, it was concluded the risk of premalignancy or malignancy depends on development time. In our case, the GCH had grown from a burn scar, this has not been previously reported in Korea. Surgeons need to be aware cutaneous horn harbors risks of premalignancy or malignancy, and that histopathological evaluation is indispensable for treatment decision making.
Asunto(s)
Animales , Humanos , Masculino , Persona de Mediana Edad , Biopsia , Quemaduras , Cicatriz , Toma de Decisiones , Mano , Cuernos , Corea (Geográfico) , Paraqueratosis , Examen Físico , Piel , Cirujanos , TrasplantesRESUMEN
Kerion celsi is a severe inflammatory type of tinea capitis that presents as a boggy mass studded with broken hairs, oozing purulent material from follicular orifices. This infection is caused most commonly by zoophilic or geophilic pathogens. Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea unguium and tinea pedis. But, kerion celsi caused by T. rubrum is rare. Kerion celsi is uncommon in adult. We report a case of kerion celsi caused by T. rubrum in a 72-year-old woman. She presented with localized tender erythematous plaques with pustules with oozing purulent material on the frontal scalp. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. The nucleotide sequence of internal transcribed spacer region for clinical isolate was identical to that of T. rubrum strain UZ1588_14 (GenBank accession number KP326579.1). She was treated with 200 mg of oral itraconazole daily for 3 months. The skin lesions improved 1 month after treatment, and recurrence has not been observed.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Agar , Arthrodermataceae , Secuencia de Bases , Glucosa , Cabello , Itraconazol , Onicomicosis , Recurrencia , Cuero Cabelludo , Piel , Tiña del Cuero Cabelludo , Tiña del Pie , TrichophytonRESUMEN
Scedosporium apiospermum is an asexual state of Pseudallescheria boydii which has been isolated from soil, sewage, and decaying vegetation. It can cause cutaneous infections by traumatic implantation of the contaminant due to penetrating injury. This ubiquitous fungus cause not only mycetoma, but also infections of variety of body sites including the skin. The localized skin infection due to this organism is much rare than mycetoma. We report a case of cutaneous S. apiospermum infection occurred in 80-year-old male. The skin lesion was manifested by a 8.0 x 4.0 cm-sized erythematous plaque with pustules and crusts on the dorsum of right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored cottony colonies of S. apiospermum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of S. apiospermum strain IHEM 23829. The patient was treated with oral fluconazole for 3 months.
Asunto(s)
Anciano de 80 o más Años , Humanos , Masculino , Agar , Secuencia de Bases , Biopsia , Fluconazol , Hongos , Glucosa , Mano , Micetoma , Pseudallescheria , Scedosporium , Análisis de Secuencia de ADN , Aguas del Alcantarillado , Piel , SueloRESUMEN
Fusarium(F.) species are hyalohyphomycetes isolated from plants, soil and air. Fusarium species can cause disseminated infections with involvement of multiple organs and numerous skin lesions in immunocompromised patients. And they can also cause local skin infections of trauma site. We report a case of localized skin infection by F. oxysporum in a 63-year-old immunocompetent woman. She presented with multiple, mild pruritic, 1.5 x 1.5 cm-sized, erythematous maculopapules on the left cheek after cosmetic procedure 4 months ago. Histopathologically, suppurative granulomatous inflammation, fungal elements were observed in dermis. Fungal culture on Sabouraud's dextrose agar showed rapid growing, whitish, cottony colonies at 25degrees C for 1 week. Numerous fusoid macroconidia were observed in slide culture by light microscopy. The nucleotide sequences of the internal transcribed spacer (ITS) region of clinical sample identical to that of F. oxysporum CID 220 strain (GenBank accession number HQ829117.1). The patient had been treated with itraconazole for 6 months. The skin lesion was improved. There was no recurrence 6 months after treatment.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Agar , Secuencia de Bases , Mejilla , Dermis , Fusarium , Glucosa , Huésped Inmunocomprometido , Inflamación , Itraconazol , Microscopía , Recurrencia , Piel , Suelo , Heridas y LesionesRESUMEN
Accessory scrotum is a rare congenital anomaly that is often associated with perineal tumor or other developmental abnormalities. Because most cases are diagnosed and treated in early childhood, little is known about the natural biologic course of this entity and associated lesions through time. We present a case of accessory scrotum associated with lipomatous hamartoma in a 46-year-old man who was born with a perineal mass. We evaluate the clinicopathologic features and discuss the pathogenesis with a review of the literature.
Asunto(s)
Adulto , Humanos , Masculino , Persona de Mediana Edad , Hamartoma , Lipoma , Perineo , EscrotoRESUMEN
PURPOSE: This study was planned to evaluate that a lecture employing medical drama could motivate students to have an interest in the professionalism of healthcare personnel, which has currently become a critical subject in the field of medical education. METHODS: We analyzed subject headings, learning objectives, and further plans developed by students and their responses after two drama modules, 'car crash' and 'refusal of instruction', which were selected based on the conditions made by our faculty members, were given through video or paper to our 121 second-grade medical and nursing students in year 2012. RESULTS: Meaningful subject headings and learning objectives developed by students were 58.2%~60.0% and 36.8%~38.0% and significantly more in the 'refusal of instruction' than the 'car crash' (p=0.000). According to the students' major, medical students developed significantly more than nursing students (p=0.000). In the analysis of responses, 91.7% of students reported as impressive to the educational modules and 55.3% of them described their ideas associated with healthcare professionalism. CONCLUSION: Our study results suggest a possibility that the educational module employing selected medical drama could motivate students' healthcare professionalism.
Asunto(s)
Humanos , Atención a la Salud , Drama , Aprendizaje , Estudiantes de Medicina , Estudiantes de Enfermería , DescriptoresRESUMEN
BACKGROUND: The aim of this study was to examine the expression of CD10 and CD15 in tumor cells, stromal cells and infiltrating inflammatory cells during colorectal carcinoma (CRC) development and to investigate their expression levels between the tumor center and invasive front and compare them to clinicopathological parameters in invasive CRC. METHODS: We performed immunohistochemical staining for CD10, CD15, and E-cadherin in 42 cases of CRC, 49 of tubular adenoma, 15 of hyperplastic polyp, and 17 of non-neoplastic colon. RESULTS: CD10 was expressed in tumor cells (tCD10), stromal cells (sCD10) and infiltrating inflammatory cells (iCD10), and CD15 was expressed in tumor cells (tCD15) and infiltrating inflammatory cells (iCD15). Their expressions were progressively increased during CRC development and the iCD10 expression level was significantly correlated with the iCD15 expression level in invasive CRC. Invasive front revealed a higher expression level of iCD10 and iCD15 than the tumor center. Moreover, the iCD15 expression level of invasive front was significantly correlated with the degree of tumor budding and tCD15 in whole tissue sections was closely associated with tumor depth. CONCLUSIONS: The present study suggests that the expression of CD10 and CD15 is associated with the development and progression of CRC.
Asunto(s)
Adenoma , Antígeno Lewis X , Cadherinas , Neoplasias Colorrectales , Neprilisina , Pólipos , Células del EstromaRESUMEN
Kerion celsi is a severe inflammatory type of tinea capitis that presents as an inflammatory, boggy plaque studded with broken hairs. It usually occurrs in children between the age of 4 and 14 years which is caused by zoophilic pathogens such as Microsporum(M.) canis, Trichophyton(T.) mentagrophytes, and T. verrucosum. Recently various mammals have become a pet in Korea and there has been increase in reports of dermatophytosis transmitted from these pets sporadically. We report a case of kerion celsi caused by T. mentagrophytes probably transmitted from rabbit in a 34-year-old adult male patient. The patient had localized, tender to mild pruritic, erythematous plaque with pustular nodules and irregular hair loss on the right temporal scalp for 2 months. Culture from a scalp lesion of patient on Sabouraud's dextrose agar showed typical T. mentagrophytes. He was treated with 250 mg of terbinafine daily for 12 weeks and short term therapy of low dose of prednisolone. He was cured without recurrence.