Cerebral Venous Sinus Thrombosis with Meningitis and Septicemia due to Haemophilus influenzae Type f in an Immunocompetent Child

Since the implementation of conjugate Haemophilus influenzae serotype b (Hib) vaccine, the rate of infections caused by Hib has dramatically decreased, and the proportion of infections caused by non-type b H. influenzae has increased. Cerebral venous sinus thrombosis (CVST) is rare; however, it should be considered as a potential complication of bacterial meningitis. Herein, we report about a child who developed CVST after being diagnosed with H. influenzae serotype f meningitis.

Epidemiology and Identification of Organisms Causing Superficial Dermatomycoses at Tertiary Hospitals in Korea: A Prospective Multicenter Study / 대한의진균학회지

BACKGROUND@#Superficial dermatomycoses are fungal infections of the skin, hair, or nails and are most commonly caused by dermatophytes. Superficial dermatomycoses are very common diseases in the field of dermatology; however, their prevalence and clinical characteristics vary with geographical areas and populations. Moreover, pathogenic species change constantly over time.@*OBJECTIVE@#This multicenter study aimed to investigate the epidemiologic and clinical findings of tinea corporis, tinea faciale, and tinea capitis in Korea during 2016-2017. In addition, we sought to identify the pathogenic organism causing these three different types of fungal infections.@*METHODS@#Total 453 patients from the dermatology clinics of 13 tertiary hospitals in Korea were enrolled in this study. Information regarding demographic characteristics, comorbidities, occupation, family history of superficial dermatomycoses, suspected routes of infection, and treatment was collected. Fungal cultures and molecular analyses were performed for patients with tinea corporis, tinea faciale, and tinea capitis.@*RESULTS@#Of the 453 patients, 275 were men and 178 were women. With respect to past history, 214 patients (53.4%) had at least one comorbidity. Tinea corporis (27.3%) was the most common form of superficial dermatomycosis, followed by tinea pedis (23.2%) and tinea unguium (16.6%). Overall, the fungal culture positivity was 77.8% (126/162). Trichophyton rubrum was the most common causative organism for tinea corporis (66.7%, 68/80) and tinea faciale (43.8%, 14/23), while Microsporum canis was the most common causative organism for tinea capitis (36.7%, 11/23).@*CONCLUSION@#Trichophyton rubrum was consistently the most common causative organism of superficial dermatomycoses, except for tinea capitis in Korea.

Using Array-Based Comparative Genomic Hybridization to Diagnose Pallister-Killian Syndrome

Pallister-Killian syndrome (PKS) is a rare multisystem disorder characterized by isochromosome 12p and tissue-limited mosaic tetrasomy 12p. In this study, we diagnosed three pediatric patients who were suspicious of having PKS using array-based comparative genomic hybridization (array CGH) and FISH analyses performed on peripheral lymphocytes. Patients 1 and 2 presented with craniofacial dysmorphic features, hypotonia, and a developmental delay. Array CGH revealed two to three copies of 12p in patient 1 and three copies in patient 2. FISH analysis showed trisomy or tetrasomy 12p. Patient 3, who had clinical features comparable to those of patients 1 and 2, was diagnosed by using FISH analysis alone. Here, we report three patients with mosaic tetrasomy 12p. There have been only reported cases diagnosed by chromosome analysis and FISH analysis on skin fibroblast or amniotic fluid. To our knowledge, patient 1 was the first case diagnosed by using array CGH performed on peripheral lymphocytes in Korea.

A Case of Juvenile Pityriasis Rubra Pilaris Clinically Improved with Cyclosporine / 대한피부과학회지

No abstract available.

Tufted Angioma Presenting with Polycyclic Features Mimicking Tinea Faciale / 대한피부과학회지

Tufted angioma is a rare benign vascular neoplasm that usually occurs in children. It appears as an erythematous, purplish, indurated papule or plaque on the trunk or neck. Although it can have variable clinical manifestations, the annular or serpiginous configuration of lesions resembling tinea infections has rarely been reported. A 47-year-old woman presented with an erythematous plaque enlarging by peripheral extension to form polycyclic or serpiginous figures on her left chin and buccal cheek for 7 months without any subjective symptoms. Tinea faciale was considered as the initial clinical diagnosis, but repeated KOH tests were all negative; therefore, skin biopsy was performed. Histopathology revealed discrete circumscribed foci of capillaries scattered throughout the dermis showing a cannon ball appearance, compatible with tufted angioma. Clinical features showed considerable improvement after 2 sessions of intense pulsed light and pulsed-dye laser (5 repetitions) without any complications. Herein, we report a rare case of polycyclic variant of tufted angioma, which developed in a woman in her 5th decade.

Clinical Manifestations and Genotypes of Human Papillomavirus in Korean Patients with Condyloma Acuminatum / 대한피부과학회지

BACKGROUND: Condyloma acuminatum is a sexually transmitted disease (STD) associated with the human papillomavirus (HPV). Although it is a relatively common disease, there has been no epidemiological and clinical study of condyloma acuminatum performed in Korea since 1978. OBJECTIVE: We aimed to evaluate the clinical features of condyloma acuminatum in Korean patients, to identify the genotypes of HPV, as well as determine factors associated with recurrence of condyloma acuminatum. METHODS: We studied 80 patients (60 men and 20 women) diagnosed with condyloma acuminatum. We analyzed age, sex, duration of the disease, number and locations of lesions, underlying diseases and co-infection with STDs, treatment modalities, and number of relapses. Additionally, 26 patients were analyzed for HPV subtypes. We also evaluated factors affecting recurrence of condyloma. RESULTS: Mean age at the time of diagnosis was 36.9±17.7 years and mean duration of disease was 7.2±16.5 months. The most common sites of involvement were found to be the penile shaft in men and the labia majora in women. We observed that 28 patients showed relapse with a mean duration of 1.5±4.5 months. HPV genotyping revealed that type 6, 11, and 44 genotypes that are associated with a low risk of malignancy were detected in 76.9% of cases, and type 16, 18, 51, 52, and 66 genotypes associated with a high risk of malignancy were detected in 15.3% cases. A significant relationship was observed between the recurrence rates of condyloma acuminatum and the rates of co-infection with STDs and the number of lesions. CONCLUSION: We report a recent epidemiological and clinical review analyzing genotypes of HPV in Korean patients presenting with condyloma acuminatum.

Candida famata Infection Presenting as an Erosive Patch on the Sole of an Immunocompetent Patient / 대한피부과학회지

Candida famata previously called Torulopsis famata or Debaryomyces hansenii, is usually found in natural substrates. It was earlier considered nonpathogenic in humans; however, a number of clinical cases of human infection have been reported showing isolation of this yeast. Dermatologic literature contains only a few reports regarding cutaneous infection caused by Candida famata. An 18-year old woman presented with a 4-month history of a 4.0×3.0 cm sized erythematous erosive patch on her left sole. A skin biopsy revealed numerous spores and hyphae in the epidermis. Histopathological specimens showed positive findings using the Periodic acid-Schiff and Gomori methenamine silver stains but negative findings using acid-fast bacilli stain. Cultures from skin scrapings yielded numerous colonies. Identification of the fungus was processed up to species level using VITEK 2 (bioMérieux, Inc. Hazelwood, MO, USA), and Candida famata was isolated. She was administered itraconazole at a dose of 200 mg once daily, and following 5 weeks of therapy, the erosive lesion was noted to have completely healed with postinflammatory hyperpigmentation.

Trichoblastoma and Compound Nevus Arising from Nevus Sebaceus / 대한피부과학회지

Nevus sebaceous is a common congenital cutaneous hamartoma occurring mainly on the face and scalp. It is well known that secondary neoplasms can be easily observed in the primary lesion. However, a case of trichoblastoma and compound nevus concurrently arising from nevus sebaceous has not been previously reported. A 26-year-old woman presented with a well-demarcated atrophic skin-colored plaque on her scalp from birth. On the plaque, a black dome-shaped round nodule and a brownish nodule with irregular margins were found one week previously without subjective symptoms. Histopathological examination of the central plaque lesion revealed epidermal hyperplasia and hyperplasia of the sebaceous glands and eccrine glands. In addition, ectopic, dilated apocrine glands were revealed in the lower dermis, and the hair follicles remained small and primordial, consistent with nevus sebaceous. A section of the black nodule showed palisading basaloid cells surrounded by abundant fibrous stroma. Nests of nevus cells were found at the dermo-epidermal junction and dermis in the brownish nodule. Based on these findings, the black nodule and brownish nodule were diagnosed as trichoblastoma and compound nevus, respectively. Herein, we report an interesting case of trichoblastoma and compound nevus concurrently arising from nevus sebaceous, which is, to our knowledge, the first such report in the dermatologic literature.

Annular Erythema of Infancy / 대한피부과학회지

No abstract available.

Histiocytic Sarcoma of the Cervical Spinal Cord with Secondary Involvement of the Skin / 대한피부과학회지

Histiocytic sarcoma is a rare, lymphohematopoietic malignant tumor comprised of tumor cells with the morphological and immunophenotypic features of mature histiocytes. A 35-year-old man presented with a disseminated histiocytic sarcoma that first occurred in the spinal cord and metastasized to the skin and lymph nodes. The tumor cells of the primary histiocytic sarcoma of the spinal cord were very large epithelioid cells with abundant eosinophilic cytoplasms and large, round-to-oval nuclei. In contrast, the metastatic histiocytic sarcoma of the skin was composed of relatively small polygonal cells with well-defined cell borders and high N/C (nucleus/cytoplasm) ratios. Immunohistochemically, both tumors were diffusely positive for histiocyte-associated antigens; but negative for epithelial, melanocyte, lymphoid, and dendritic cell antigens. It is important to recognize the morphological features and immunohistochemical characteristics of metastatic cells in order to ensure accurate diagnoses.

Comparison of Cervical-lymph-node-first Presentation of Kawasaki Disease and Typical Kawasaki Disease

PURPOSE: The diagnosis of Kawasaki disease depends on clinical symptoms, which makes it difficult to diagnose early in patients with only cervical lymphadenopathy. The purpose of this study is to understand the clinical characteristics of cervical-lymph-node-first presentation of Kawasaki disease and compare them with those of typical Kawasaki disease. METHODS: We surveyed 283 patients who were admitted to Hallym Sacred Heart Hospital and were diagnosed with Kawasaki disease from January 2012 to December 2014. The patients were divided into two groups: cervical-lymph-node-first presentation of Kawasaki disease (LKD, N=24) and typical Kawasaki disease (KD, N=259). The medical records were retrospectively reviewed. RESULTS: The mean age of the LKD group was higher than that of the KD group (P=0.04). At admission, the LKD patients had on average 1.62 out of 5 symptoms, whereas the KD patients had 3.47. The time from fever to diagnosis and administration of IV immunoglobulin was longer in the LKD group than in the KD group (P<0.001). The mean C-reactive protein of the LKD group was higher than that of the KD group (P=0.01). There were no statistical differences in the presence of coronary artery complications between the two groups at two weeks or at two months after diagnosis (P=0.52, P=0.08). CONCLUSIONS: The Kawasaki disease patients with fever and cervical lymphadenopathy usually do not present obvious clinical symptoms, which makes it hard to diagnose in the early phase of disease. Clinician must pay attention when examining these patients.

Leukocytoclastic Vasculitis Associated with Orientia tsutsugamushi Infection: A Report of Two Cases / 대한피부과학회지

No abstract available.

Accidental ingestion of E-cigarette liquid nicotine in a 15-month-old child: an infant mortality case of nicotine intoxication / 소아과

Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents.

Linear Scleroderma Clinically Improved with Cyclosporine / 대한피부과학회지

No abstract available.

Linear Scleroderma Clinically Improved with Cyclosporine / 대한피부과학회지

No abstract available.

Kaposi's Varicelliform Eruption due to Varicella Zoster Virus in a Patient with Atopic Dermatitis / 대한피부과학회지

No abstract available.

A Case of Solitary Trichoepithelioma on the Toe / 대한피부과학회지

Trichoepithelioma (TE) is a benign lesion that arises from hair follicles. Solitary TE occurs mainly on the face in young adults. Various previous reports have described the localization of this disorder, but there have been no reported cases with presentation on the toe. Histopathologically, TE shares characteristic features with basal cell carcinoma (BCC), so immunohistochemical stains are required for the differential diagnosis. Therefore, we report the first case of TE occurring on the toe, confirmed with immunohistochemial differentiation.

Clinical Significance of Serum Varicella Zoster Virus Immunoglobulin M and G in Varicella and Herpes Zoster / 대한피부과학회지

BACKGROUND: The presence of serum varicella zoster virus (VZV) immunoglobulin M and G (IgM and IgG) aid diagnosis of and confirmation of immunization against varicella and herpes zoster. However, the relationship between serum VZV IgM and IgG and the clinical characteristics of VZV infection remains unclear. OBJECTIVE: We evaluated quantitative changes in serum VZV IgM and IgG in accordance with the clinical features of varicella, herpes zoster, and disseminated herpes zoster compared with a normal control group. METHODS: A total of 922 patients were classified into 3 groups: varicella, herpes zoster, and disseminated herpes zoster. We assessed serum VZV IgM and IgG titers in association with age, severity of skin lesions, duration of skin lesions, immune status, and neurologic complications. RESULTS: In patients with varicella and herpes zoster, serum antibody titer varied significantly depending on age and the duration of skin lesions. A high serum VZV IgM titer was related to varicella or disseminated herpes zoster viremia. In herpes zoster, elevated antibody titers, especially VZV IgM, were associated with severe skin lesions and the presence of neurologic complications. CONCLUSION: Serologic data for varicella and herpes zoster varied according to clinical features. A high serum VZV IgM titer was associated with an unfavorable clinical course of herpes zoster.

Anetoderma Developing in Generalized Granuloma Annulare in an Infant

No abstract available.

Pachydermoperiostosis Associated with Peptic Ulcer and Hyperplastic Polyp of Stomach / 대한피부과학회지

No abstract available.