A Case of Neonatal Purpura Fulminans Due to Homozygous Protein C Deficiency

Homozygous Protein C deficiency is a rare genetic disease with catastrophic and fatal purpura fulminans like or thrombotic complication occurring during the neonatal period. Purpura fulminans is characterized by microvascular thrombosis in the dermis followed by perivascular hemorrhage, necrosis, and minimal inflammation. Laboratory findings are consistent with disseminated intravascular coagulopathy: We report a case of purpura fulminans in a neonate with the findings of disseminated intravascular coagulopathy and an undetectable level of protein C activity, whose parents proved to be heterozygous protein C deficiency.

Mycobacterium Fortuitum Infection of Acupuncture Sites

We report a case of Mycobacterium(M.) fortuitum infection in a 65-year-old female who presented with erythematous to purplish colored tender nodules and plaques with curst and purulent discharge on both upper and lower extremities along the sites of acupuncture. The culture of surgically excised specimen in 3% Ogawa media yielded slightly yellowish colored colonies within 2 days. Several tests for identification of the species were performed and growth on 5% NaCl, negative niacin test, positive results in nitrate reduction, catalase, urease and iron uptake tests were noted. Excision of the lesions followed by administration of minocycline and ciprofloxacin showed no sign of relapse to data a year after treatment.

Three Cases of Letterer - Siwe Disease / 대한피부과학회지

Letterer-Siwe disease is one of Langerhans cell histiocytosis, with Hand-Schuller-Christian disease and eosinophilic granuloma, characterized by proliferation of Langevha is cell. The clinical course of Letterer-Siwe disease is acute fulmunant of casionally fatal, involving skin and many other internal organs, such as the lymph node, liver, spleen, ung and bone. We present 3 cases of Letterer-Siwe disease with characteristic cutaneous findings and revealed Langerhans granules by imrriunohistochemical stain and electronmicrc scopic examination. All patients died in spite of combined chernotherapy.

Detection of human papillomavirus DNA using the polymerase chain reaction in paraffin-embedded biopsy specimens of condylomata acuminata / 대한피부과학회지

BACKGROUND: Condylomata acuminata is a sexually transmitted cisease which is caused by the human papillomavirus(HPV). The types of HPV causing condylomata acuminata are HPV 6,11,16,18. HPV 16 and 18 are related to anogenital carcinoma. OBJECTIVE: The goals of this study were to determine the types cif HPV in condylomata acuminata, and to investigate the relationship between condylomata acuminata and anogenital carcinoma. MEHTODS: Polymerase chain reaction and restriction fragment le igth polymorphisms were performed in the paraffin-embedded tissues of 17 cases of condylomata acciminata. RESULTS: HPV DNA was detected in all of 17 cases of condylomata accuminata tested. HPV 6 and 11 were found in 53% (9/17) and 41% (7/17) of the samples, respectiiely. HPV 16 and/or 18, which are related to anogenital carcinovia, were not detected, except in one case in which HPV 16 was found to be superimposed with HPV 6 and 11. CONCLUSION: These results suggest that most of condylomata acumirata are caused by HPV 16 and 11, and there is not so much risk of this disease transforming into the aiogenital carcinoma.

The study of incidence and distribution of pityrospoum on clinically normal skin / 대한피부과학회지

BACKGROUND: Previous studies have suggested that pityrosporurr yeasts, normal resident flora of skin, may be important in the pathogenesis of dandruff seborrheic dermatitis and confluent and reticulated papillomatosis. OBJECTIVE: We investigated the incidence and distribution of pityiosorum yeasts on clinically normal skin as a more reasonable method for providing the basic data or proving the relationship of pityrosporum and pathogenesi, of the diseases. MEHTODS: A total of 350 subjects were studied. Skin scrapings were stained with 20% Parker ink-KOH(P-KOH) solution. The numbers of pityrosporum spores and hyphe per high power field( x 400) were counted and designated according to a new grading method using bacterial index(BI) of lepra bacilli. RESULTS: The incidence rates of pityrosporum orbiculare(p. orbiculare) and pityrosporum ovale(p. ovale) were 60-70% and 20-50% of subjects respectively on seborrheic area., The incidence of p. orbicilare was highter than that of p. ovale on all examined sites except for the iterior scalp. And pityrosporal hyphae was present on anteriand posterior scalp and earwax in 24-25% of subjects respectively. The incidence of pityrosporum was higher in summer than other seasons The incidence rate of p. orbiculare and hyphae in the group aged below 9 (except neonates) and above 60, were lower than that of other age groups. The inciderice rates and distribution of grades of pityrosporum of neonates were lower than those of older subjects. CONCLUSION: The results of this study showed that the incidence and distribution of pityrosporum spores were similar to previoureports and hyphal forms were found 25% approximately on clinically normal skin of the scalp and carwax. The significance of the presenet of pityosporal hyphae and the relationship between normal skin and pityrosporal hyphae are to be firther elucidated.

Cyclosporine in the treatment of psoriasis / 대한피부과학회지

BACKGROUND: Psoriasis is belived to be a disorder of keratinocyte hyperproliferation mediated by T helper cells. Cyclosproine is one of the immunosuppressants and there have been several studies showing the benefcial effects of cyclosporine on psoriasis. OBJECTIVE: To evaluate the clinical efficacy, tolerability, and adverse effects of cyclosporine, a randomized open uncontrolled multicenter study was conducted in 15 university hospitals in Korea. METHOD: There were 68 total trial cases and among them 16 patients dropped out from the study. The reported reasons for stopping the use of the medication under study prematurely were lack of cooperation(seven cases), adverse effects(six cases), the ineffectiveness of the medication(two cases), and another(one case). The drug was administered for 18 weeks to 52 patients. The initial dosage of the drug was 2.5mg/kg/day which was maintained or increased to 4mg/kg/day or 5mg/kg/day according to the PASI score reduction rate at the 6th and 12th week. The PASI score was measured and Iaboratory tests and observation of adverse events were done. RESULTS: At the end of therapy PASI score reduction rate of more than 66% occured in 40 patients (76.9%). The PASI score was significantly reduced from 20.0 to 5.4 after treatment for 18 weeks. The social disability score was significantly decreased. Pruritus and nail involvement were also significantly decreased. The change of systolic and diastolic blood pressure were statistically not significant. The 30% increase of serum creatinine level compared to the baseline was observed in six patients(11.5%) at the 6th week, three patients(5.8%) at the 12th week, five patients(9.6%) at the 18th week, but no patients showed an increase above the normal range.The increase of serum total bilirubin and SGOT was observed in six patients(11.5%) and one patient(1.9%0, respectively. The clinical adverse events reported during the study were gastrointestinal trouble(seven cases, 13.5%), hypertrichosis(two cases, 3.8%), generalized weakness(two cases, 3.8%0, paresthesia(one case, 1.9%), hypertension(one case, 1.9%), disturbance of erection(one case, 1.9%). The overall assessment of efficacy and tolerability by investigator and patients were mostly good or very good. CONCLUSION: Generally cyclosporine was well accepted and tolerated and low dose cyclosporine therapy-2.5mg/kg/day to 5mg/kg/day-is an effective therapeutic modality for the treatment of psoriasis.

The significance of lectins in the differentiation between lichen sclerosus et atrophicus(LSA)and scleroderma / 대한피부과학회지

BACKGROUND: Differential diagnosis of lichen sclerosus et atrophicus( SA) and scleroderma is occasionally difficult. OBJECTIVE: The purpose of this study was to attempt differentiation between the two diseases using imrnunohistochemical stain and lectins. MEHTODS: Paraffin-embeddred sections of 4 cases of LSA and 11 cases of scleroderma were evaluated for this study. Using lectins, such as peanut agglutinin(PNA), siybean agglutinin(SBA), Ulex europaeus agglutinin-I(UEA-I) and Dolichos biflorus agglutinin(DBA) and the avidin-biotin-peroxi-dase complex(ABC) technique, differential lectin binding patterns betv een the two diseases were examined. RESULTS: In the case of LSA, PNA and SBA stained the upper and lower spinous layer of the epidermis, and UEA I also stained the spinous layer of the epidermis weakly, but no DBA was stained. In the case of scleroderma, PNA stained not only the spinous layer but also the basal layer, SBA stained the upper half of the spinous layer but not the lower half of the pinous layer of epidermis. But UEA-I stained the vascular endothelial cells of dermis instead of epidermis, and DBA stained only the basal layer of epidermis. CONCLUSION: Staining of these 4 lectins on paraffin-embedded sectians using ABC teehnique could be helpful in differenting LSA and scleroderma.

A Case of Generalized Acrodermatitis Continua of Hallopeau

Acrodermatitis continua (AC) of Hallopeau is one of the chronic relapsing pustular eruptions of the extremities. Generalization of AC sometimes occurred spontaneously, or induced by withdrawl of drugs such as corticosteroid, or pregnancy. We report a case of generalized AC in a 50-year-old woman who has been treated intermittently with various medications other than systemic retinoids. The histopathologic findings of the pustules on the fingertips and trunk revealed subcomeal abscesses and/or spongiform pustules. The patient was treated with etretinate in the dose of 50mg/day, and UVB exposure. Two months after treatment, skin lesions were markedly improved.

A case of mycobacterium fortuitum infection at the site for antibiotics susceptibility test / 대한피부과학회지

Cutaneous mycobacterial infection can occur with Mycobacterium tube culosis or other mycobacterial agents. The commonest of the group IV rapidly growing mycobacteia Mycobacterium fortuitum, has widespread distribution in natur, and is an uncommon causative agent of human mycobacterial infection. We report herein a case of Mycobacterium fortuitum infection follcwiiig an antibiotics susceptibility test. This 24-year-old man suffered fram ulcerative itchy nodules on the left forearm where the antibiotics susceptibility test was don. The skin biopsy specimen revealedly. iphohistiocytic granulomatous infiltration in the dermis. Culture of the tissue specimen revealed rapicly growing yellowish colonies, which was isolated to Mycobacoterium fortuitum. Among 3 biovariants of M. fortuitum, our case was revealed to he biovariant fortuiiam: Surgical excision was performed followed by the administration of antiliiiitics, and no sign of relapse was noted until now, 1 year since.

A case of eccrine angiomatous hamartoma / 대한피부과학회지

Eccrine angiomatous hamartoma, eccrine-pilar angiomatous hamartoma and sudoriparous angioma represent the same disease entity, a hamartoma showing hyperplasia of the eccrine sweat apparatus and of vascular elements in the same lesion histologically. We present a case of eccrine angiomatous hamartoma on the medial side of the right thigh in a 3-year-old male patient and review 16 cases reported in Korea.

An experimental study of the effect of the polyurethane film dressing on wound healing / 대한피부과학회지

We have studied the effects on wound healing of moist conditions in rabbit, achieved by covering excised wounds with the polyurethane film dressings, and dry conditions, by exposure to air during the period from day 1 to day 21 after injury. We have quantified the rate of dermal repair by means of differenetial cell counts of neutrophils, macrophages, fibroblasts, and endothelial cells. The rate of re-epithelialization was also examined. The resuts were as follows: 1. There was an acceleration of the inflammatory phase of repair in the moist wounds. The late phase of inflammation began more rapidly. On day 3 after injury there were 150% more macrophages (p<0.01) and 70% fewer neutrophils (p<0.01) in moist wounds. It was also observed the presence of significantly more fibroblasts (p<0.01) in the moist wounds than the dry wounds. 2. There was also more rapid increase in the number of proliferative phase cells-fibroblasts (p<0.01) and endothelial cells (p<0.01) in moist wounds. the lower content of neutrophils (p<0.05) and the higher number of fibroblasts (p<0.01) which were observed in moist wounds on day 7 after injury suggested that healing was by then well advanced into the proliferative phase. 3. On day 14 after injury, the decrease in the number of fibroblasts in moist wounds suggested that this group entered the remodeling phase of repainr. The lower total cell count in moist wounds than in dry on day 21 after injruy suggested a more rapid progress through the remodeling phase. 4. The reepithelialization of moist wounds was faster than that of dry wounds. These findings suggested that moist wounds occluded with polyurethane film dressing healed more rapidly and in a more orderly manner than did dry wounds, both epidermal and dermal repair being accelerated.

Pustulosis palmaris et plantaris associated with sternocostoclavicular hyperostosis: report of 3 cases of pustulotic arthro-osteitis / 대한피부과학회지

Pustulotic arthro-osteitis is a rheumatic syndrome of unknovn cause, characterised by an inflammatory osteitis of the sternocostoclavicular region and pustuosis palmaris et plantaris. Although many ases of the disease have been reported in Japan, it, has not been reported in Korea so far. Three cases of pustulosis palmaris et plantaris associated i rith sternocostoclavicular hyperostosis or pustulotic arthro-osteitis are presented.

Phakomatosis Pigmentovascularis

Phakomatosis pigmentovascularis was first described in 1947 as a distinctive association of cutaneous hemangioma and pigmentary nevi by Ota et al. We describe a 7-year-old boy who, since birth, had three kinds of discolored patches over the various parts of the body: blue spots (dermal melanocytic nevi), reticulated reddish patches (nevus flammeus), and hypopigmented macules (nevus anemicus). No systemic disease was found.

Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is an unusual primary cutaneous tumor, occasionally found con-current with other malignancies. A case of MCC with coexisting squamous cell carcinoma (SCC) was studied histologically, immunohistochemically and ultrastructurally. The MCC and SCC occured at the same site, but each preserved its identity and transition between the two was not identified.

Clinical and histopathological observation of confluent and reticulated papillomatosis / 대한피부과학회지

No abstract available.

A case of acute febrile neutrophilic dermatosis associated with ulcerative colitis / 대한피부과학회지

No abstract available.

Experimental study on granulomatous reaction to tattoo pigment / 대한피부과학회지

No abstract available.

Pyogenic Granuloma (Granuloma Pyogenicum) with Multiple Satellites

Granuloma pyogenicum is a benign vascular tumor and usually occurs as a single lesion. But in a few instances, the development of multiple satellite lesions has been observed following excision or irritation of the primary lesion. Multiple satellite granuloma pyogenicum is a very rare variant of granuloma pyogenicum and occurs most commonly on the back, chest, or trunk, particularly in the interscapular region during childhood. We report a case of multiple granuloma pyogenicum which occurred on the unusual site of the scalp in a 70-year-old woman. The patient presented with a reddish pedunculated nodule with multiple satellite lesions on the right temporal area. The histopathologic findings of the primary and satellite lesions showed many newly formed capillaries and characteristic epidermal collarettes. The lesions were treated by surgical excision and electrodesiccation.

A Case of Rhinocerebral Mucormycosis in a Diabetic Woman

We report a case of rhinocerebral mucormycosis in a 63-year-old female with a 1-year history of poorly controlled diabetes mellitus. She had black necrotic ulcers on the hard palate, bloody nasal discharge, swelling of the left side of her face, left blepharoptosis, proptosis, and conjunctival injection. Histopathological examination of the palatal lesion showed large, nonseptate, right-angled branching fungal hyphae in the dermis, and Rhizopus species was isolated on Sabouraud's agar media. The patient was treated with a combination of amphotericin B and surgical debridements but died of asphyxia one month after admission. This is a relatively uncommon, opportunistic infection occurring in a diabetic woman, and only several cases are reported in the Korean literature up to date.

Neurilemmoma Occurring in the Skin and Lung

A 27-year-old man had subcutaneous nodules on his left scapula and right upper arm at the site of a prior excision. On chest roentgenogram, a circumscribed mass was seen in the left up-per lung field; chest computed tomography showed an elliptical tumor around the left main bronchus. Histopathologic examination of the subcutaneous nodule and the pulmonary mass showed characteristic findings of a neurilemmoma.