Efficacy and Safety of Matrix Shave Biopsy Using a Razor Blade for the Diagnosis of Longitudinal Melanonychia / 대한피부과학회지

Background@#Longitudinal melanonychia (LM) can be caused by a variety of benign and malignant conditions. Nail matrix biopsy is necessary for the diagnosis of LM; however, physicians hesitate to perform the nail matrix biopsy due to the risk of postoperative complications like permanent matrix damage. Therefore, biopsy methods that minimize the risk of postoperative complications are necessary. @*Objective@#To investigate the efficacy and safety of the nail matrix shave biopsy using a razor blade. @*Methods@#We reviewed the medical records, clinical photographs, and histopathologic slides of patients who underwent shave biopsy for the diagnosis of LM from January 2018 to March 2020 at Wonkwang University Hospital. @*Results@#The entire pigmented lesion was removed completely by shaving only a partial thickness of the superficial matrix in all patients. The histopathologic diagnosis was melanocyte activation with no atypia in all cases. Eight patients were followed up for 7∼19 months. Resting pain after the shave biopsy improved in most cases (75%) within 1 week. One patient experienced numbness lasting for 3 months. Abnormal sensations, such as tingling and itching, were temporarily reported by two patients. One patient (12.5%) had temporary postoperative nail plate dystrophy, and three patients (37.5%) had recurrence of pigmentation. @*Conclusion@#Our protocol of shave biopsy showed a lower rate of postoperative nail dystrophy than the conventional shave biopsy. We suggest that the shave biopsy using a flexible stainless steel razor blade is a favorable alternative to the conventional shave biopsy.

Clinical Observations on Chief Complaints of Pediatric Patients

The following results were obtained from the clinicostatical observations on chief complaints of pediatric patients at National Medical Center in Seoul during the period from Jan. 1975 to Dec. 1979. 1. Total number of admission during the 5 year period were 3831 and male to female ratio was 1.73:1. 2. Annual incidence : a gradual increase was observed in number of admission. 3. Age incidence: the neonates and the infants less than 1year of age occupied 51.7% of total number of admission. 4. Seasonal incidence: the number of admission was significantly greater in autumn than in any other seasons in the age group above 4 weeks old age. 5. Frequency of chief complaints according to age was as following: i) In the early neonatal period, jaundice was the most frequent(40.7%) and low birth weight (22.2%), dyspnea(6.5%), vomiting(5.0%) etc. ii) In the age of 1 weeks, jaundice was the most frequent(26.0%) and poor sucking(9.5%), fever(8.1%_, cough(8.1%), skin lesion(7.7%) etc. iii) In the age of 4 weeks to 1 year, cough was the most frequent(18.9%) and diarrhea (14.4%), dyspnea(13.4%), fever(12.7%), vomiting(11.5%) etc. iv) In the age of 1 year to 2 years, fever was the most frequent(18.3%) and diarrhea (14.9%), vomiting(13.9%), cough(13.6%), dyspnea(9.9%) etc. v) In the age of 2 years, fever was the most frequent(18.7%) and cough(11.0%), dyspnea(8.5%), vomiting(6.4%), convulsion(6.0%) etc. vi) In the age of 6 years to 12 years, fever was the most frequent(18.7%) and cough(11.0%), dyspnea(8.5%), vomiting(6.4%), convulsion(6.0%) etc. vii) In the age of 12 years to 15 years, abdominal pain was themost frequent(10.3%) and fever(10.6%), dyspnea(9.0%), mental disturbance(8.4%), vomiting(7.5%) etc. 6. Frequency of chief complaints according to season: no significant variation was noted in each age groups, except that diarrhea was prominent in freauency in summer and autumn in the age of 4 weeks to 6 years. 7. The frequency of chief complaints all through the pediatric age is as following: fever(11.9%), cough(9.9%), dyspnea(9.3%), vomiting(8.6%), jaundice(8.1%), diarrhea(8.1%), convulsion(5.4%), low birth weight(3.9%), edema(3.3%), abdominal pain(2.9)\%), mental disturbance(2.8%), skin lesion(1.9%), etc

Observation of Social Back Ground and Disease Patterns of Children in an Institute for Foreign Adoption

A study was made to see the family back ground abandonment of mother's right, clinical and laboratory examination(urinalysis, blood examination, tuberculous skin test, VDRL, PKU screening test and chest X-ray) on 1,793 infants and children in an institure for foreign adoption. The results were as follows: 1) Gilrs were much more predominant than boys with male to female ratio of 1 : 2.3. 2) Most of them were Korean and only ten were mixed blood, Five were Korean-white, five were Korean-negro. 3) Most of them were under one year of age(70%). 4) Mid-wife delivery was the most common birth place among known ones. 5) Most of deliveries were normal full term delivery(46.9%). 6) There was no difference in monthly distribution. Duration of admission was 2~3 months usually. 7) concerning the family background, most of them were unknown, 432 of them(24.8%) were from unmarried mother, 397 from married mother, and founding, parents dead or left home, divorced and unmarried father in order of decreasing frequency. 8) Age of mothers, between 21~25 years was most frequent. Most of unmarried mothers were between 20~22 years of age. 9) In order of birth, most of them were between 3~5th children. 10) Disease pattern; Upper respiratory tract disease was the most common, and diarrhea was the next. Skin and mucous membrane disease were frequently seen. There were 12 cases of tuberculosis and 18 cases of congenital syphilis. There developed 15 cases of pneumocystis carinii pneumonia. 11) On routine laboratory examination, there noted 85 cases of positive TB sin test, 18 cases of positive VDRL reaction. No positive case in PKU screening test.

A case of Lupus Nephritis

Lupus nephritis is one of major complications of systemic lupus erythematosus, which determine the outcome of the disease. A case of lupus nephritis was admitted to our pediatric department and renal biopsy was done, which reveraled membranophroliferative type in electron-microscopy. He was treated with prednisone only and responded well in urinary findings. Now, he is maintained with low dose prednisone.