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Becker’s nevus (BN) is a benign hamartoma that may present as a distressing cosmetic problem. The treatment of BN poses a significant challenge as current therapeutic modalities are suboptimal and have an increased risk of adverse effects, such as scarring and dyspigmentation. We present the use of non-ablative fractional laser therapy combined with Q-switched Nd:YAG laser as a possible therapeutic option for BN treatment and review relevant literature to discuss its efficacy and limitations.
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Spider angioma (SA) may present as solitary or multiple lesions. Studies have shown that approximately 60% of pregnant women and 38% of healthy children have at least one spider telangiectasia. Hence, solitary SA in an otherwise healthy individual does not warrant further workup. However, multiple spider angiomas (MSAs) are usually suggestive of an underlying systemic disease. Physical examination for MSAs has been reported as the most reliable method to diagnose alcoholic liver cirrhosis; the presence of MSAs is more indicative of liver cirrhosis than just the history of alcohol use because a very low proportion of alcohol drinkers among the general population develop liver cirrhosis. We report a case of MSAs in a 42-year-old alcoholic woman suggesting that MSA is reliable indicator and a warning sign of liver cirrhosis, suggesting that further evaluation and management with the department of hepatology is necessary.
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BACKGROUND: A cream made from mucus secreted by snails contains 80% mucin, as well as glycosaminoglycan, allantoin for skin rejuvenation, glycolic acid for keratin removal, and collagen and elastin, which are components of dermis. OBJECTIVE: The goal of the present study was to evaluate the efficacy of using cream containing mucus secreted by snails to reduce wrinkles, improve skin elasticity, restore dermal density, and lift the skin. METHODS: Cream containing mucus secreted by snails was applied to the lateral epicanthal areas and the left cheek of 10 subjects for 4 weeks twice per day. Wrinkles, skin elasticity, dermal density, and skin tightening were evaluated at baseline and 2 and 4 weeks. A patient survey was conducted at 4 weeks. RESULTS: There were statistically significant differences between baseline and 4 weeks after applying the cream in terms of wrinkles, skin elasticity, dermal density, and skin tightening (p<0.05). CONCLUSION: Use of cream containing mucus secreted by snails seems to be effective for anti-aging of the skin. Long term follow up studies, such as 3 or 6 months, to confirm the efficacy of the cream should be conducted involving a larger number of patients.
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Humanos , Alantoína , Mejilla , Colágeno , Dermis , Elasticidad , Elastina , Mucinas , Moco , Rejuvenecimiento , Piel , CaracolesRESUMEN
BACKGROUND/AIMS: Some factors like stent wires, balloon dilatation and use of guide wires seems to increase perforation after self-expandable metal stent (SEMS) placement, but few studies mentioned about the relationship between angulation of malignant stricture and perforation. The present study aimed to confirm that more angular positioning of stents increases perforation. METHODS: This study was conducted with retrospectively evaluation at Digestive Disease Center, CHA Bundang Medical Center, CHA University. Between January 2002 and August 2011, SEMS was inserted in 130 patients with malignant colorectal obstruction. We studied the difference in the angle of stenosis between perforation and non-perforation groups using fluorography images. RESULTS: SEMS insertion was performed in 130 cases of obstruction due to colon cancer. Perforation occurred in eight patients (6.2%) of them. Thirteen cases were excluded from the analysis due to poor fluoroscopic images. Among the eight patients with perforation, the mean stenosis angle was 109.9degrees compared to 153.1degrees in the nonperforation group, indicating that the angle was more acute in the perforation group (p=0.016). CONCLUSIONS: This study shows that more angular positioning of stent increases bowel perforation after SEMS placement for malignant colorectal obstruction.
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Humanos , Neoplasias del Colon , Constricción Patológica , Dilatación , Perforación Intestinal , Estudios Retrospectivos , StentsRESUMEN
BACKGROUND: Spectacle contact allergy is not infrequent. The fine scratches on the spectacle frames which may play a role in the sensitization to the potential allergenic components have not been studied. OBJECTIVE: We sought the relationship between the scratches on the spectacle frames and the allergic contact dermatitis (ACD) in the Republic of Korea. METHODS: A total of 42 Korean patients with ACD at the spectacle contact sites were enrolled. Their spectacle frames were examined with the dimethylglyoxime (DMG) test and analyzed by the scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Patch tests (thin-layer rapid use epicutaneous test [TRUE tests]) were performed to identify the skin allergens. RESULTS: The DMG-positive spectacle frames were identified in 78.5% of the frames. The SEM results showed that there were more scratches on the skin-contacting parts of the spectacle frames than the non-skin-contacting parts of the same frames. In the EDS findings, the mean nickel content (weight, %) of the spectacle frames was 15.7+/-5.5, and the mean chromium content was 20.3+/-3.4 at the skin-contacting parts. In the TRUE tests, nickel sulphate was the most common allergen (31 cases, 73.8%), and potassium dichromate was the second (9 cases, 21.4%). Three patients presented simultaneous positive reactions with nickel sulphate and potassium dichromate. CONCLUSION: Minor visible and non-visible fine scratches on the spectacle frames may present the provocation factors of the ACD. Nickel sulphate was the most common allergen suspected of provoking the spectacle frame-induced ACD, followed by potassium dichromate.
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Humanos , Cromo , Dermatitis Alérgica por Contacto , Hipersensibilidad , Microscopía Electrónica de Rastreo , Níquel , Oximas , Pruebas del Parche , Potasio , Dicromato de Potasio , Piel , Análisis EspectralRESUMEN
The potential role of topical valproate (VPA) in hair regrowth has been recently suggested. However, safety reports of VPA as a topical formulation are lacking. Therefore, in the present study, we investigated whether VPA causes skin irritation in humans. We first performed a cell viability test and showed that VPA did not exhibit toxicity toward HaCaT keratinocytes, fibroblasts, and RBL-3H mast cells. We then performed clinical patch test and skin irritation test through transdermal drug delivery with the help of microneedle rollers. No significant findings were obtained in the clinical patch test. In the skin irritation test, only 1 patient showed erythema at 1 hr, but the irritation reaction faded away within a few hours. Erythema and edema were not observed at 24 hr. We concluded that VPA has minimal potential to elicit skin irritation. Therefore, we consider that VPA can safely be applied to human skin.
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Humanos , Supervivencia Celular , Edema , Eritema , Fibroblastos , Cabello , Queratinocitos , Mastocitos , Pruebas del Parche , Piel , Ácido ValproicoRESUMEN
BACKGROUND/AIMS: This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. METHODS: We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week. RESULTS: In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively. CONCLUSIONS: A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori.
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Humanos , 2-Piridinilmetilsulfinilbencimidazoles , Amoxicilina , Bismuto , Claritromicina , Helicobacter , Helicobacter pylori , Metronidazol , Ofloxacino , Rifamicinas , TetraciclinaRESUMEN
BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) occasionally fails due to surgically altered anatomy, difficult cannulation, or poor general condition. This study evaluated the safety and effectiveness of percutaneous transhepatic papillary balloon dilatation (PTPBD) for managing extrahepatic bile duct stones. METHODS: Between 2001 and 2010, 17 out of 509 patients with extrahepatic bile duct stones and acute cholangitis were enrolled retrospectively. After PTPBD of the sphincter, the stones were extracted using an occlusion balloon to push the stone over a guidewire into the duodenum. The procedure success was evaluated based on residual stones. In addition, the size and number of stones and complications were analyzed. RESULTS: Of the 17 patients, nine had a previous gastrectomy, four had poor general condition, and four had unsuccessful cannulation. The stone diameter ranged from 8 to 25 mm. Seven, five, and five patients had one, two, or three or more stones, respectively. The results were successful in 16 out of 17 patients, with no residual stones. Treatment failed in one patient, who was then treated with the rendezvous technique with endoscopy. No procedure-related major complication occurred. Three patients had mild transient elevations of the serum amylase levels. CONCLUSIONS: PTPBD was safe and effective for managing extrahepatic bile duct stones in patients with unsuccessful or contraindicated ERCP.
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Humanos , Amilasas , Conductos Biliares Extrahepáticos , Cateterismo , Colangiopancreatografia Retrógrada Endoscópica , Colangitis , Coledocolitiasis , Dilatación , Duodeno , Endoscopía , Gastrectomía , Estudios RetrospectivosRESUMEN
Linear focal elastosis (LFE) is characterized by several asymptomatic, yellow, palpable, irregularly indurated, striae-like lines extending horizontally across the middle and lower back. A focal increase in elastic fibers is a hallmark of the disease as seen from biopsy specimens. The pathogenesis of LFE is unclear, as is the association between LFE and striae distensae (SD). However, the prevailing opinion is that LFE represents an excessive regenerative process of elastic fibers and is analogous to keloidal repair of SD. Although the timing of onset of LFE and SD was not synchronous in our patient, the triggering factor was the same, which was the growth spurt. This case is supporting the putative association between LFE and SD.
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Humanos , Biopsia , Tejido Elástico , Queloide , Estrías de DistensiónRESUMEN
Obstructive jaundice is very rarely caused by impaction of a pancreatic stone in the papilla. We report here on a case of obstructive jaundice with acute cholangitis that was caused by an impacted pancreatic stone in the papilla in a patient with chronic pancreatitis. A 48-year-old man presented with acute obstructive cholangitis. Abdominal computed tomography with the reconstructed image revealed distal biliary obstruction that was caused by a pancreatic stone in the pancreatic head, and there was also pancreatic ductal dilatation and parenchymal atrophy of the pancreatic body and tail with multiple calcifications. Emergency duodenoscopy revealed an impacted pancreatic stone in the papilla. Precut papillotomy using a needle knife was performed, followed by removal of the pancreatic stone using grasping forceps. After additional sphincterotomy, a large amount of dark-greenish bile juice gushed out. The patient rapidly improved and he has remained well.
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Humanos , Persona de Mediana Edad , Atrofia , Bilis , Colangitis , Dilatación , Duodenoscopía , Urgencias Médicas , Fuerza de la Mano , Cabeza , Ictericia Obstructiva , Agujas , Conductos Pancreáticos , Pancreatitis Crónica , Esfinterotomía Endoscópica , Instrumentos QuirúrgicosRESUMEN
BACKGROUND/AIMS: Oxygen free radicals play an important role in acute pancreatitis. Pantoprazole as a proton pump inhibitor (PPI) has pancreatic anti-secretory effect and a pronounced inhibitory reactivity towards hydroxyl radicals. The objective of the study was to investigate the effect of pantoprazole on the course of acute pancreatitis. METHODS: We conducted a prospective randomized trial involving 40 patients with acute pancreatitis. Patients were divided into two groups. One group received PPI and the other group did not receive PPI. In the PPI group, patients received pantoprazole 40 mg intravenously twice a day for fasting time, and then 40 mg orally twice a day until discharge. RESULTS: There were no significant differences in baseline characteristics and laboratory markers between two groups. In the pantoprazole group, mean hospital stay was 7.4 days, time to start oral intake was 69.0 hours, and time to pain relief was 59.7 hours. Acute physiology and chronic health evaluation (APACHE) II score was 3.15 at admission day and 2.35 at discharge. On the other hand, in the non-pantoprazole group, mean hospital stay was 7.6 days, time taken to start oral intake was 71.4 hours, and time taken to pain relief was 61.8 hours. APACHE II score was 4.4 at admission and 2.85 at discharge. However, there were no significant differences between two groups. CONCLUSIONS: Treatment with pantoprazole did not have influence on the clinical course of acute pancreatitis. But, considering it was a pilot study, large scale prospective trials will be needed.
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Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , 2-Piridinilmetilsulfinilbencimidazoles/uso terapéutico , APACHE , Enfermedad Aguda , Consumo de Bebidas Alcohólicas , Ingestión de Alimentos , Tiempo de Internación , Manejo del Dolor , Pancreatitis/tratamiento farmacológico , Proyectos Piloto , Estudios Prospectivos , Inhibidores de la Bomba de Protones/uso terapéuticoRESUMEN
Idiopathic retroperitoneal fibrosis (IRF) is characterized by a fibrotic process and chronic inflammation of the retroperitoneal area and aorta. The development of retroperitoneal inflammation and fibrosis often results in periureteral encasement, ureteral obstruction, acute renal failure, and subsequent chronic renal failure and, rarely, mediastinal, pericardial, or pleural involvement. Our patient presented with left flank pain and abdominal computed tomography (CT) showed a retroperitoneal mass encompassing the aorta and both ureters. IRF was diagnosed after a biopsy of the retroperitoneal mass. A complicating left pleural effusion and acute renal failure developed and the patient underwent a percutaneous nephrostomy and was treated with prednisolone. After this, the patient's symptoms, renal failure, and pleural effusion improved and the retroperitoneal mass decreased in size. We report a case of IRF with a pleural effusion and acute renal failure that improved with steroid treatment, with a literature review.
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Humanos , Lesión Renal Aguda , Aorta , Biopsia , Fibrosis , Dolor en el Flanco , Inflamación , Fallo Renal Crónico , Nefrostomía Percutánea , Derrame Pleural , Prednisolona , Insuficiencia Renal , Fibrosis Retroperitoneal , Uréter , Obstrucción UreteralRESUMEN
Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. Linear hypopigmentation and atrophy after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect. A 30-year-old woman visited our dermatology department for a linear hypopigmented patch with atrophy from her left foot to the lower margin of the knee. The lesion developed after injection of an intralesional corticosteroid. The patient was diagnosed with linear hypopigmentation and atrophy secondary to the triamcinolone injection.
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Adulto , Femenino , Humanos , Alopecia , Atrofia , Dermatología , Pie , Hiperpigmentación , Hipopigmentación , Inyecciones Intralesiones , Rodilla , Triamcinolona , Triamcinolona AcetonidaRESUMEN
Electrical injuries can cause cardiac abnormalities, ranging from dysrhythmias to myocardial infarction. Atrial fibrillation after electrical injury is extremely rare. The mechanisms underlying electrical current-induced arrhythmias are unclear. However, due to differences in electrical resistance, current travels preferentially along blood vessels and nerves, making the heart the most susceptible organ to electrical injury. Cardiac arrhythmias may occur at the time of electrical injury or later, but most occur within the first day of injury. Almost all patients described in previous reports with atrial fibrillation developed the condition after high voltage injuries (> 1,000 V). In our case, however, atrial fibrillation developed after a low voltage injury (220 V). Atrial fibrillation was detected and the rate was controlled with intravenous digoxin infusion. A normal sinus rhythm was restored 21 h after the electrical injury.
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Humanos , Arritmias Cardíacas , Fibrilación Atrial , Vasos Sanguíneos , Digoxina , Impedancia Eléctrica , Traumatismos por Electricidad , Corazón , Infarto del MiocardioRESUMEN
HIV-associated eosinophilic folliculitis is characterized by recurrent crops of severely-pruritic follicular papules, pustules and plaques that occur mainly on the face, trunk and upper extremities of AIDS patients. This disease is distinguished from Ofuji's disease by severe pruritus, leukopenia, sparing of the palm and sole and a good response to phototherapy. Up to now, only three such cases have been reported in the Korean literature. A 55-year-old man, who was confirmed as being HIV positive 6 months previously, presented with severely-pruritic, erythematous pinhead to half pea sized papules and nodules on the face, neck and anterior chest. The skin biopsy from a nodular lesion on the face revealed perifolliculitis with a predominant eosinophilic infiltrate.
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Humanos , Persona de Mediana Edad , Biopsia , Eosinofilia , Eosinófilos , Foliculitis , VIH , Leucopenia , Cuello , Pisum sativum , Fototerapia , Prurito , Piel , Enfermedades Cutáneas Vesiculoampollosas , Tórax , Extremidad SuperiorRESUMEN
Gastritis cystica polyposa is an uncommon lesion that usually occurs at the gastroenterostomy site, but it may also develop in the non-operated stomach. This malady is characterized by polypoid mucosal changes with hyperplasia and cystic dilatation of glands that infiltrate into the submucosal layer. We report here on a case of gastritis cystica polyposa that presented as a mass impacted in the duodenum in a 63-year-old male, and this patient had been admitted for evaluation of progressive epigastric fullness and dyspepsia. Esophagogastroduodenoscopy revealed that the partial duodenal obstruction was caused by impaction of a huge polypoid mass with a stalk that originated from the lower body of the stomach. We fished out the impacted mass with a forceps catheter while holding the neck with a snare catheter. Thereafter, an endoloop was applied to the stalk of mass, and this was followed by polypectomy using a snare catheter.
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Humanos , Masculino , Persona de Mediana Edad , Catéteres , Dilatación , Obstrucción Duodenal , Duodeno , Dispepsia , Endoscopía del Sistema Digestivo , Gastritis , Gastroenterostomía , Hiperplasia , Cuello , Proteínas SNARE , Estómago , Instrumentos QuirúrgicosRESUMEN
Cutis verticis gyrata (CVG) is a descriptive term for a scalp condition that is convoluted folds and deep furrows that resemble the surface of the cerebral cortex. It is categorized by the underlying etiology, as primary essential, primary non-essential and secondary. Alopecia areata (AA) is a common, organ specific autoimmune disease, and most AA cases are sporadic. There is clearly a strong genetic component. There is no established relationship between CVG and AA. We report one case which was affected with essential primary CVG and alopecia areata, and suggest a possibility of genetic association between CVG and AA, possibly both being related to mutations in the fibroblast growth factor receptor 2 (FGFR2).
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Simple renal cysts are a common cystic disease of the kidneys, which is not symptomatic in most cases and is diagnosed by radiological examination. However, if the cyst is huge or symptomatic, it must be treated. Renal cyst aspiration and alcohol sclerotherapy is a safe and effective treatment for symptomatic simple renal cysts. Simple renal cysts have benign clinical features in the main and transformation of a simple renal cyst into renal cell carcinoma has rarely been reported. However, one case of renal cell carcinoma during renal cyst follow-up has been reported. We report a case of renal cell carcinoma that developed in a patient who was being treated with huge simple renal cyst sclerotherapy.
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Humanos , Carcinoma de Células Renales , Estudios de Seguimiento , Riñón , Enfermedades Renales Quísticas , EscleroterapiaRESUMEN
The skin lesion of herpes zoster is classically limited to a single dermatome, and most cases of multi-dermatomal herpes zoster have contiguous skin lesions. Noncontigous multi-dermatomal herpes zoster is very rare in both immunocompetent and immunosuppressed persons. The phenomenon of zoster occurring in two non-contiguous dermatomes has been referred to as zoster duplex unilateralis or bilateralis. We report here on a case of herpes zoster duplex bilateralis in a 49-year-old woman who had previously received chemotherapy for breast cancer treatment.
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Femenino , Humanos , Persona de Mediana Edad , Mama , Neoplasias de la Mama , Herpes Zóster , PielRESUMEN
Foreign body granuloma is a chronic, proliferative, inflammatory reaction caused by persistent poorly biodegradable tissue irritants. Currently, many injectable materials are being used extensively for soft tissue augmentation. Although considered biologically inert, these materials can evoke adverse reactions such as foreign body granuloma. Mainly these complications are a result of the use of unproven products injected by unlicensed or unqualified practitioners. Here we report a case of foreign body granuloma in the left lower eyelid secondary to injection of extracts from safflower seeds.