A Case of Dermatomyositis Associated with Small Cell Lung Cancer: Changes in Naifold Capillary Morphology / 대한피부과학회지

We present a case of dermatomyositis associated with small cell lung cancer. This 45-year-old male patient who had been diagnosed as small cell lung cancer presented multiple itchy violaceous patches, muscle weakness, myalgia and abnormal laboratory data. The skin lesions and myalgia were improved after treatment with dexamethasone 10mg/day under the diagnosis of dermatomyositis. The skin symptoms and myalgia were wax-and-waned despite of the improvement of lung cancer. Interestingly, telangiectasias observed on the proximal nail folds were wax-and-waned according to the skin and muscle symptoms, too. Further evaluation on the finding would be beneficial in the prognosis evaluation for the patients.

First Coital Age and Risky Sexual Begavior Assiciated with Sexually Transmitted Diseases / 대한피부과학회지

BACKGROUND: Early age at first sexual intercourse in women is associated with an increased number of sex partners, a greater risk for sexually transmitted diseases(STD), and an increased risk for cervical neoplasia. OBJECTIVE: The purpose of this study was to find risky sexual behavior for STD and to examine the correlation between the behavior and age of first sexual intercourse. Therefore we investigate whether early initiation of sexual intercourse is a risk factor for risky sexual behavior and STD. METHODS: Responses to a self-administered questionniare and interview from 1132 recruit men in a Korean army recruit training center were analysed. RESULTS: The rate of previously affected STD by first coitus were 40.6% in men who were sexually active before 15 years, 25.8% between 16 and 18 years, and 14.2% after 19 years. The men who had more sex partners tend to have higher rate of STD. The rate of STD is higher in men who experienced hallucinogens. In men who had sexual intercourse with risky sexual partners the rate of STD was higher. The experience rate of extravaginal sex had no effect on the rate of STD. Men who became sexually active before 15 years were more likely to report having 5 or more sexual partners, having coitus with risky partners, using hallucinogens, and having more prevalence of STD than other first coital age group. CONCLUSION: Risky sexual behavior is sexual intercourse with risky sexual partner, use of hallucinogens, more sexual partner, and early age of first sexual intercourse. In this study, our data provide evidence that early age of first intercoutse is a useful marker for risky sexual behavior and STD.

A Case of Follicular Mucinosis / 대한피부과학회지

We report a case of follicular mucinosis in a 12-year-old girl. She had an erythematous indurated plaque with an ill-defined border on the chin. A biopsy specimen showed reticular degeneration, cystic space formation, and abundant mucin deposition in pilosebaceous follicles. She had been treated with topical corticosteroid for 3 months. The skin lesion was completely resolved.

A Case of Nodular Fat Necrosis Associated with Pancreatitis / 대한피부과학회지

Nodular fat necrosis is a rare and often overlooked sign of pancreatic disease. It is manifested as painful subcutaneous erythematous nodules, often found on the legs. We report a case of nodular fat necrosis associated with pancreatitis. The patient was a 14-year-old girl who presented with erythema nodosum-like tender subcutaneous nodules on both her lower extremities. The serum amylase and lipase levels were markedly elevated. The change of serum calcium and eosinophils were not so remarkable. Histopathological findings showed diffuse subcutaneous fat necrosis and ghost-like cells with thick shadowy walls and no nuclei. The lesions involuted gradually without any specific treatment and the underlying pancreatitis was followed up in the department of medicine.

A Case of Acquired Tufted Angioma / 대한피부과학회지

Acquired tufted angioma is a benign, slowly progressive angioma with a typical histological pattern that was first described by Wilson-Jones in 1976. We report a case of acquired tufted angioma in a 19 year old female who had erythematous papules and plaques on the right thigh. Histopathological findings showed multiple capillary lobules in a cannonball arrangement scattered throughout dermis, which was diagnostic of acquired tufted angioma.

A Case of Arrhythmogenic Right Ventricular Dysplasia

Arrhythmogenic right ventricular dysplasia is a rare heart muscle disorder of unknown cause that primarily involves the right ventricle. It is characterized pathologically by fibrofatty replacement of the right ventricular myocardium. Clinical manifestations include structural and functional abnormalities of the right ventricle, electrocardiographic depolarization/repolarization changes, and presentation with sudden death or ventricular arrhythmias of right ventricular origin. It is one of the important causes of the ventricular arrhythmia or sudden death among apparently healthy young people. We report a case of arrhythmogenic right ventricular dysplasia with the review of the literature.

Diagnosis of the Malfunctioning Bioprosthetic Mitral Valve in Patient with Congestive Heart Failure after Remote Implantation. The Characteristics of Transthoracic and Transesophageal Echocardiography in Comparison with Operative Findings

BACKGROUND: Early diagnosis and proper therapy of malfunctioning prosthetic heart valves remain a challange. Transthoracic echocardiography(TTE) is the diagnostic procedure of choice for the evaluation of malfunctioning prosthetic heart valves. Howerver, TTE may be limited owing to poor acoustic windows. Some of these limitations can be overcome by transesophageal echocardiography(TTE). METHODS: The study comprised 33 consecutive patients(20 male and 13 famale patients, age range 20 to 59) in congestive heart failure after remote mitral valve replacement with bioprosthesis. The patients were examined between 1987 and 1994. All the 33 patients were studied by TTE and 19 patients among these patients furthermore by TEE. The morphology of the explanted bioprosthesis was confirmed by surgery in all cases. RESULTS: The abnormalities of the bioprosthesis were diagnosed correctly by TTE in 32 cases. The more detailed morphology of the valves could be observed by TEE(19 cases). Only in one case a small thrombus in left atrium was overlooked in TTE examination, on the otherhand it was detectedd by TEE. The severity grade of mitral regurgitation was estimatedca. I' severer by TEE in 8 cases. In all TEE examination spontaneous echocontrast was observed in left atrium. The bioprostheses from CE(Carpentier-Edwards) showed higher tendency to cuspal tearing and perforation. CONCLUSION: TTE is the diagnostic procedure of choice on patients with bioprosthetic mitral valve replacement. TTE examination confirms immediately clinical diagnosis of bioprosthetic failure. The transesophageal approach promises more detailed informations about lesions of the degenerated bioprosthetic valves and left atrium.