Two Cases of Mushroom Intolerance / 대한피부과학회지

Shiitake (Lentinus edodes) is nowadays the second most commonly produced edible mushroom in the world. Two patients complained of severe itching and showed widespread disseminated very small erythematous papule and characteristic linear grouped erythematous papules after scratching (Kobner phenomenon). Here we report two cases of mushroom intolerance which developed after ingestion of boiled or cooked shiitake mushrooms.

A Case of Cutaneous Metastasis of Male Breast Cancer / 대한피부과학회지

Male breast cancer is a rare disease, accounting for approximately 1% of all breast cancer. We report a case of cutaneous, osteolytic, pulmonary, and hepatic metastases of male breast cancer in a 40-year-old male who presented 4x2.5 cm erythematous plaque with ulceration and bloody discharge on the areolar area of the left anterior chest. The histopathologic findings of the lesion showed nests and strands of invasive carcinoma forming ductlike structures and cellular arrangement in single-row line, referred to as Indian filing, between collagen bundles. The tumor cell showed positive reaction for estrogen receptor, but negative reaction for progesterone receptor. He was treated with tamoxifen, 5-fluouracil, adriamycin, and cyclophosphamide. Six months after initiation of the treatment, skin lesion was improved. Also, number and size of the metastatic cancer nodules decreased in the computer tomographic imaging.

A Case of Aspirin Intolerance in Chronic Urticaria / 대한피부과학회지

Aspirin intolerance is defined as acute urticaria-angioedema, bronchospasm, severe rhinitis, or shock occuring within three hours of aspirin ingestion. Aspirin intolerance occurs most frequently in individuals with chronic urticaria, asthma, chronic rhinitis, and normal individual in order of decreasing frequency. NSAIDs frequently cross-react with aspirin in intolerant individuals. We report a case of aspirin intolerance, which cross-reacts with naproxen, in a 42-year-old male with chronic urticaria. He experienced angioedema within 20 minutes after ingesting aspirin (700mg) and within 2 hours after ingesting naproxen (125mg). He has also experienced itching, wheal, chest tightness, and nausea during oral challenge test with aspirin.

A Case of Fungal Granuloma Caused by Trichophyton rubrum / 대한피부과학회지

We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 75-year-old male presented an erythematous patch with painless crusted and non-crusted nodules on the left elbow which had persisted for 5 weeks. Histologic findings of the erythematous nodule showed epidermal hyperplasia and granulomatous change in the lower dermis. Trichophyton rubrum was isolated on the fungus culture of the biopsy specimen. The patient was treated with itraconazole (100mg/day) for 8 weeks, resulting in the clearing of the skin lesion and there has been no recurrence of any skin lesion over a 3-month' follow-up period.

A Case of Desmoplastic Trichoepithelioma / 대한피부과학회지

Desmoplastic trichoepithelioma is a rare benign adnexal tumor with female preponderance, most commonly located on the face. Clinically, the tumor measures from 3 to 8mm in diameter, and has a raised, annular border and a depressed nonulcerated center. The three characteristic histologic features are narrow strands of tumor cells, horn cysts, and a desmoplastic stroma. We report herein a case of desmoplastic trichoepithelioma in a 25-year-old woman who had an asymptomatic hard annular nodule with a raised border and depressed center on the left cheek.

Study of Results of Bacterial Culture and Antibiotic Sensitivity in Burn Patients / 대한피부과학회지

BACKGROUND: As a result of the extensive changes in burn care over the last few decades, including prevention of infection, burn survival has greatly increased. However, infection is still one of the main causes of death in severe burn cases, despite the progression in intensive care. But no recent comprehensive survey of infection has been carried out. OBJECTIVES: This retrospective study of bacteriological profile and antibiotic sensitivity patterns of isolates from a burn unit was carried out to provide burn care to plan future steps to reduce further the incidence of sepsis. METHODS: A retrospective review of burn wound infection in 623 patients treated in the burn center at the Hangang Sacred Heart Hospital, over a 2-year period (1998 - 2000) was carried out. RESULTS AND CONCLUSIONS: From wound cultures, Pseudomonas aeruginosa was most commonly isolated (24.7%) followed by Staphylococcus aureus (15.8%), Acinetobacter baumannii (14.5%), Enterococcus faecium (10.4%), Enterococcus faecalis (9.1%), coagulase negative staphylococcus (7.7%), Escherichia coli (6.6%), alpha-hemolytic streptococcus (5.3%), Klebsiella spp. (3.9%), Candida (3.2%), Serratia marcescens (2.9%), and Proteus spp. (2.1%). The most common isolate from blood cultures was Staphylococcus aureus (39.9%) followed by Enterococcus faecium (17.2%), coagulase negative staphylococcus (8.7%), Pseudomonas aeruginosa (7.5%), Enterococcus faecalis (4.7%), Candida (3.7%), Acinetobacter baumannii (3.7%), Serratia marcescens (3.5%), Enterobacter aerogens (2.8%), and Enterobacter cloaca (2.8%). The concordance rate of the results of the wound culture and blood culture was 96.0% in the Pseudomonas aeruginosa, 51.3% in the Staphylococcus aureus, 16.7% in the Enterococcus faecalis, 10.5% in the coagulase negative staphylococcus. Vancomycin and teicoplanin were effective in 100% of gram-positive organism. The drugs effective in gram-negative organism were cefepime, aztreonam, imipenem, piperacillin+tazobactam, ticarcillin+clavulanic acid, and amikacin.