Two imported cases of cutaneous larva migrans

Cutaneous larva migrans (CLM) is a rare serpiginous cutaneous eruption caused by accidental penetration and migration in the skin with infective larvae of nematode that normally do not have the human as their host. Although CLM has a worldwide distribution, the infection is most frequent in warmer climates. More recently, they have been increasingly imported from the tropics or subtropics by travelers. We experienced two patients who had pruritic serpiginous linear eruption in their skin for a few weeks after traveling to the endemic areas (Brazil and Thailand, respectively). After the treatment with albendazole, the skin lesions resolved with post-inflammatory hyperpigmentation. We report herein two cases of cutaneous larva migrans successfully treated with albendazole.

A Case of Necrobiosis Lipoidica Diabeticorum with Koebner Phenomenon / 대한피부과학회지

The isomorphic response of Koebner is a well-known phenomenon commonly associated with psoriasis, but it has been also described in conjuction with a host of other disorders. However it has seldom been associated with necrobiosis lipoidica diabeticorum, a rare skin manifestation of diabetes mellicuts. In this report, we describe a 59-year-old woman who developed necrobiosis lipoidica diabeticorum on the left shin where a mosquito had bitten her 2 months ago. Four months ago, she was diagnosed as necrobiosis lipoidica diabeticorum on the right forearm and shin by biopsy and the lesions were improved with corticosteroids intralesional injection. The lesions were asymptomatic and had grown slowly. Histopathological findings showed a large palisading granulomas composed of histiocytes, epithelioid cells and areas of necrobiosis of collagen with multinucleated giant cells. Van Gieson stain showed decreased and fragmented elastic fibers and there were no deposits of mucin in the necrobiotic areas. The lesions were improved with triamcinolone acetonide intralesional injection and there was no recurrence during 4 months.

A Case of Aplasia Cutis Congenita / 대한피부과학회지

Aplasia cutis congenita(ACC) is a rare congenital anomaly characterized by a well-demarcated skin defect. In the majority of cases it is limited to the scalp especially on the vertex although other areas of the body may also be involved. We report a case of aplasia cutis congenita, in a month-old female infant born with a round shaped hairless transparent menbrane on the left temporal area of the scalp. No associated other congenital anomalies were in this case.

Comparison the Growth Rate between the Affected and the Unaffected Great Toenail in the Same Patients with Onychomycosis / 대한의진균학회지

BACKGROUND: Onychomycosis is a common manifestation of fungal disease, accounting for 50% of all nail problems and a recent rise in the prevalence of onychomycosis has been noted. Despite enormous advances in the treatment of onychomycosis in recent years, treatment frequently fails and recurrences of infection following successful therapy are not uncommon. In order to understand the pathogenesis of onychomycosis, it is crucial to know the factors affecting the nail growth (individual health, age, sex, familial tendency and seasonal factor, etc) and the growth rate of nails. OBJECTIVE: The purpose of this study was to find any difference of growth rate between affected and unaffected toe nails in the same individual. METHODS: During a 2-year-period from February, 1998 to February, 2000, 49 patients who had attended our department with distal subungal onychomycosis affecting only one sided toe nail were recruited. A reference mark (lunula or 3 mm from the border of the proximal nail fold) by CO2 laser was etched on the nail plate of their both great toe nail. Patients were seen at intervals of 1-2 weeks. At each visit the vertical distance was measured between the lunula or the proximal nail fold and the mark on the nail plate. The growth rate of affected and unaffected toe nails in the same patients was measured. All data are reported as mean+/-SD and statistical analysis was performed using the paired t-test. RESULTS: The growth rate of the affected great toe nails showed a decrease against that of the unaffected. The affected toe nails were divided to above 50% and under 50% according to the size of invasion of the nail plate by fungi and compared with unaffected toe nails respectively. In under 50% we did not find any statistically significant difference of the growth rate. CONCLUSION: our study did not support slow linear nail growth as a predisposing factor for onychomycosis. Other factors such as local abnormality of nails which are more common in older patients may be responsible for the increased incidence of onychomycosis in this group.

A Comparison of Direct Immunofluorescence Method and Tzanck Test for the Diagnosis of Varicella-Zoster Virus and Herpes Simplex Virus Infections / 대한피부과학회지

BACKGROUND: Optimal management of cutaneous varicella-zoster virus(VZV) and herpes simplex virus(HSV) infections requires rapid and accurate diagnostic method. The Tzanck test is a simple, inexpensive and rapid method, but it shows relatively low sensitivity and cannot distinguish VZV and HSV. The viral culture is the reference method, but it is time-consuming and needs cell culture facilities. Direct immunofluorescence(DIF) method has been known to be rapid and sensitive, but it has not been widely used in Korea. OBJECTIVE: We compared the usefulness of DIF method to Tzanck smear in patients with VZV and HSV infections. METHODS: Smears were collected from the base of fresh vesicular lesions, from a total of 134 patients clinically suspected of having VZV or HSV infections. The two wells of IF slide were stained with FITC-conjugated VZV-specific and HSV-specific monoclonal antibody each. Apple-green fluorescence of cytoplasm was considered positive for VZV or HSV. Glass slide smears were made for Tzanck test and stained with Wright stain. Giant cells with enlarged nucleus were considered positive. RESULTS: Among the 107 patients suspected of having VZV infection, positive rates of DIF method and Tzanck test were 91.6% and 76.6%, respectively. The positive rates of HSV in 27 patients suspected of having HSV infection, were 92.6% and 74.1%, respectively. The positive rates of DIF method were higher than that of the Tzanck test in both VZV and HSV infections. CONCLUSION: The DIF method is a more sensitive and relatively rapid method for the diagnosis of cutaneous VZV and HSV infections.

A Case of Pityriasis Lichenoides et Varioliformis Acuta in children: Treatment with roxithromycin / 대한피부과학회지

Pityriasis lichenoides et varioliformis acuta is a cutaneous disease of unknown origin characterized by an acute polymorphous eruption which heals with superficial scarring and pigmentation. It occurs mainly in young adults and less commonly in children. Although various types of therapy have been proposed for pityriasis lichenoides, including systemic steroids, tetracycline, methotrexate, sulfones, an UV radiation, there is no definitive treatment and there is few studies of appropriate, efficacious therapy in children. We report a case of pityriasis lichenoides et varioliformis acuta in children treated with roxithromycin.

A Case of Pityriasis Lichenoides et Varioliformis Acuta in children: Treatment with roxithromycin / 대한피부과학회지

Pityriasis lichenoides et varioliformis acuta is a cutaneous disease of unknown origin characterized by an acute polymorphous eruption which heals with superficial scarring and pigmentation. It occurs mainly in young adults and less commonly in children. Although various types of therapy have been proposed for pityriasis lichenoides, including systemic steroids, tetracycline, methotrexate, sulfones, an UV radiation, there is no definitive treatment and there is few studies of appropriate, efficacious therapy in children. We report a case of pityriasis lichenoides et varioliformis acuta in children treated with roxithromycin.

A Case of Actinic Granuloma / 대한피부과학회지

Actinic granuloma presents in chronically sun-damaged skin as normally colored to erythematous papules that coalesce to form centrifugally enlarging annular patterns. Histologically, a granulomatous infiltrate of giant cells and histiocytes is seen to be intimately related to the presence of elastotic fibers in the upper dermis. We report a typical case of actinic granuloma that developed on the V-area of anterior chest in a 59-year-old male.

A Case of Actinic Granuloma / 대한피부과학회지

Actinic granuloma presents in chronically sun-damaged skin as normally colored to erythematous papules that coalesce to form centrifugally enlarging annular patterns. Histologically, a granulomatous infiltrate of giant cells and histiocytes is seen to be intimately related to the presence of elastotic fibers in the upper dermis. We report a typical case of actinic granuloma that developed on the V-area of anterior chest in a 59-year-old male.

A Case of Segmental Lichen Aureus / 대한피부과학회지

Lichen aureus is a variant of pigmented purpuric lichenoid dermatitis. The skin lesions usually appear asymptomatic rusty, copper, or orange colored roundish lichenoid erythematous-purpuric papules and patches on the lower extremities. Histologically, the epidermis shows minimal changes, with a dense lymphohistiocytic infiltrate observed in the superficial derrnis, typically distributed in a band-like fashion. The typical lesion is a single patch localized on the lower extremity. We report a rare case of segmental lichen aureus localized on the right lower extremity.

A Comparison of Direct Immunofluorescence Method and Tzanck Test for the Diagnosis of Varicella-Zoster Virus and Herpes Simplex Virus Infections / 대한피부과학회지

BACKGROUND: Optimal management of cutaneous varicella-zoster virus(VZV) and herpes simplex virus(HSV) infections requires rapid and accurate diagnostic method. The Tzanck test is a simple, inexpensive and rapid method, but it shows relatively low sensitivity and cannot distinguish VZV and HSV. The viral culture is the reference method, but it is time-consuming and needs cell culture facilities. Direct immunofluorescence(DIF) method has been known to be rapid and sensitive, but it has not been widely used in Korea. OBJECTIVE: We compared the usefulness of DIF method to Tzanck smear in patients with VZV and HSV infections. METHODS: Smears were collected from the base of fresh vesicular lesions, from a total of 134 patients clinically suspected of having VZV or HSV infections. The two wells of IF slide were stained with FITC-conjugated VZV-specific and HSV-specific monoclonal antibody each. Apple-green fluorescence of cytoplasm was considered positive for VZV or HSV. Glass slide smears were made for Tzanck test and stained with Wright stain. Giant cells with enlarged nucleus were considered positive. RESULTS: Among the 107 patients suspected of having VZV infection, positive rates of DIF method and Tzanck test were 91.6% and 76.6%, respectively. The positive rates of HSV in 27 patients suspected of having HSV infection, were 92.6% and 74.1%, respectively. The positive rates of DIF method were higher than that of the Tzanck test in both VZV and HSV infections. CONCLUSION: The DIF method is a more sensitive and relatively rapid method for the diagnosis of cutaneous VZV and HSV infections.

A Case of Calcinosis Cutis due to Intravenous Administration of Calcium Gluconate / 대한피부과학회지

We report a case of calcinosis cutis following administration of 10% calcium gluconate, used for the treatment of a hypocalcemic seizure in a 5-week-old neonate. After administration of 10% calcium gluconate, subcutaneous induration developed at the infusion site. The histopathological findings taken from the dorsum of the left foot showed multiple foci of calcium deposits with infiltration of epitheloid histiocytes between collagen bundles and foreign body giant cells phagocyting calcific granules throughout the reticular dermis and subcutis.

A Case of Angiomatoid Fibrous Histiocytoma / 대한피부과학회지

No abstract available.

Skin Ulcers Possibly Induced by Morganella Morganii / 대한피부과학회지

Morganella morganii, a gram, negative rod is often regarded as an opportunistic, secondary invader rather than a primary pathogen on the skin. It has been isolated from blood, sputa, and pus from patients with respiratory tract and wound infections or with bacteremia. A 2-year-old boy presented with erythematous ulcerative lesions on the cheeks and left knee which had a tendency to superficial scarring. The organism isolated from the ulcer displayed a biochemical char acteristics typical of Morganella morganii. The lesions responded well to systemic antibiotic therapy with amikacin and carbenicillin, which were recognized as effective drugs in in vitro sensitivity testing.

A Case of Arteriovenous Hemangioma showing Darier's Sign / 대한피부과학회지

We experienced a case of arteriovenous hemangioma showing Dariers sign on the forehead of a 43-year-old man. He presented with a single, 1 * 1.5cm sized, violaceous, asymptomatic nodule with a history of an intermittent wheal at the lesional site. This skin lesion showed Dariers sign clinically and proliferation of mast cells histopathologically with the punch biopsy specirnen suggesting urticaria pig- mentosa. Howerer, we could diagnose it as a arteriovenous hemangioma on complete excision, as the specimen showed arteriovenous proliferation with increased mast cells in a perivascular pattern. This case showed confusing clinical signs and showed the importance of complete excision for the diagnosis of a small skin tumor especially when a vascular proliferating tumor is suspected.