• Title/Summary/Keyword: Skin infection

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Successful Treatment of Lupoid Cutaneous Leishmaniasis with Glucantime and Topical Trichloroacetic Acid (A Case Report)

  • Nilforoushzadeh, Mohamad Ali;Sadeghian, Giti;Jaffary, Fariba;Ziaei, Hengameh;Shirani-Bidabad, Liela;Mahzoni, Parvin
    • Parasites, Hosts and Diseases
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    • v.46 no.3
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    • pp.175-177
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    • 2008
  • Lupoid leishmaniasis is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and a chronic relapsing course, mostly caused by infection with Leishmania tropica. In this clinical form, 1-2 yr after healing of the acute lesion, new papules and nodules appear at the margin of the remaining scar. Herein, we describe a case of this clinical form that was resistant to 2 courses of treatments: systemic glucantime and then a combination therapy with allopurinol and systemic glucantime. However, marked improvement was seen after a combination therapy with topical trichloroacetic acid solution (50%) and systemic glucantime, and there were no signs of recurrence after 1 yr of follow-up.

Skin Test for Paragonimiasis among Schoolchildren and Villagers in Namback District, Luangprabang Province, Lao PDR

  • Song, Hyun-Ouk;Min, Duk-Young;Rim, Han-Jong;Youthanavanh, Vonghachack;Daluny, Bouakhasith;Sengdara, Vongsouvan;Virasack, Banouvong;Bounlay, Phommasak
    • Parasites, Hosts and Diseases
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    • v.46 no.3
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    • pp.179-182
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    • 2008
  • As a part of a broader effort to determine the status of Paragonimus species infection in Lao PDR, an epidemiological survey was conducted on villagers and schoolchildren in Namback District between 2003 and 2005. Among 308 villagers and 633 primary and secondary schoolchildren, 156 villagers and 92 children evidenced a positive reaction on a Paragonimus skin test. Only 4 schoolchildren out of 128 skin test-positive cases had Paragonimus sp. eggs in their sputum, all of which was collected on 1 day. Several types of crabs, which were identified as the second intermediate host of the Paragonimus species, were collected from markets and streams in a paragonimiasis endemic area for the inspection of metacercariae. Among the examined crabs, only "rock crabs" (Indochinamon au) harbored Paragonimus sp. metacercariae, and it is speculated that the life cycle of Paragonimus sp. was maintained via rock crabs in Namback District, Lao PDR.

Utilizing Pedicled Muscle Flap for Defect Coverage after External Auditory Canal Cancer Resection (외이도에 발생한 악성종양에서 유경근육피판을 이용한 결손 재건)

  • Lee, Kangwoo Nathan;Kim, Eun Key
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.37-42
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    • 2011
  • Purpose: Cancer arising from the external auditory canal is a rare disease. A lesion that seems harmless in someway, can be lethal when inadequately excised, the tumor may infiltrate nerves, the parotid and auditory tissues before re-invading the skin. Wide resection of the lesion surrounding the structure and reconstruction with an adequate plan is crucial for the treatment of this disease. Methods: Two patients with external auditory canal cancer were treated with muscle flaps and skin grafts. Lateral temporal bone resection (LTBR) was performed for complete resection of the cancer. The defect cavity was obliterated with highly vascularized tissue using pedicled sternocleidomastoid muscle, and temporalis muscle individually, combined with full thickness skin graft for covering the skin defect of the ear. Results: Clear resection margin was obtained, and both patients showed disease free survival during the follow up. There was no complications of hematoma, infection, flap loss, or wound problem in both patients. Both patient received radiation therapy, there was no osteoradionecrosis or any other complication related to radiation therapy. Conclusion: Utilizing pedicled muscle flaps for managing defects after wide resection of the external auditory canal cancer is an effective method for managing this difficult disease.

Solitary Keratoacanthoma at the Recipient Site of a Full-Thickness Skin Graft: A Case Report and Review of the Literature

  • Jeong Ho Kim;Sang-Hoon Lee;Seung-Phil Hong;Jiye Kim;Sug Won Kim
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.59-62
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    • 2023
  • A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative. Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

A Nematode Infection in the Epithelial Tissue of Cultured Rockfish Sebastes schlegeli in Cheonsu Bay, Western Korea (서해안 천수만 일대 양식 조피볼락(Sebastes schlegeli)의 상피 선충 감염현황)

  • Seo, Han-Gill;Seo, Jung Soo;Ryu, Min-Kyung;Lee, Eun Hye;Kwon, Se Ryun;Kang, Jong Soon;No, Yun-San;Choi, Hye-Sung;Jung, Sung Hee;Han, Hyun-Ja
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.47 no.5
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    • pp.603-610
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    • 2014
  • We investigated a nematode infection in the epithelial tissue of rockfish Sebastes schlegeli cultured in Cheonsu Bay, western Korea, from May 2013 to April 2014. Nematodes infected the epithelial tissues of various external organs, including the fins, operculum, nares, mouth, and head. Over a 1-year period, the overall nematode infection rate in rockfish was 55% (n=89/163): 56.7% (n=17/30) in May 2013, 88% (n=29/33) in August 2013, 0% (n=0/30) in October 2013, 70% (n=21/30) in January 2014, and 55% (n=22/40) in April 2014. During this study, the only mass mortality of cultured rockfish in Cheonsu Bay was in August 2013, when we identified skin wounds on the rockfish caused by the nematodes escaping from their hosts. During this period, the accumulated mortality for 2 weeks was 1.4-22.4% in different farms. In addition, several pathogenic bacteria (Photobacterium damselae, Vibrio spp., and Streptococcus iniae) were isolated from the moribund rockfish; these were thought to be transmitted through the skin wounds caused by the nematodes.

Usefulness of interferon-γ release assay for the diagnosis of latent tuberculosis infection in young children

  • Yun, Ki Wook;Kim, Young Kwang;Kim, Hae Ryun;Lee, Mi Kyung;Lim, In Seok
    • Clinical and Experimental Pediatrics
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    • v.59 no.6
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    • pp.256-261
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    • 2016
  • Purpose: Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-${\gamma}$ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI. Methods: We performed a tuberculin skin test (TST) and IGRA on children who were younger than 18 years and were admitted to Chung-Ang University Hospital during May 2011-June 2015. Blood samples for IGRA were collected, processed, and interpreted according to manufacturer protocol. Results: Among 149 children, 31 (20.8%) and 10 (6.7%) were diagnosed with LTBI and active pulmonary TB, respectively. In subjects lacking contact history with active TB patients, TST and IGRA results were positive in 41.4% (29 of 70) and 12.9% (9 of 70) subjects, respectively. The agreement (kappa) of TST and IGRA was 0.123. The control group, consisting of non-TB-infected subjects, showed no correlation between age and changes in interferon-${\gamma}$ concentration after nil antigen, TB-specific antigen, or mitogen stimulation in IGRAs (P=0.384, P=0.176, and P=0.077, respectively). In serial IGRAs, interferon-${\gamma}$ response to TB antigen increased in IGRA-positive LTBI subjects, but did not change considerably in initially IGRA-negative LTBI or control subjects. Conclusion: The lack of decrease in interferon-${\gamma}$ response in young children indicates that IGRA could be considered for this age group. Serial IGRA tests might accurately diagnose LTBI in children lacking contact history with active TB patients.

Necrotizing Fasciitis in a Patient with Systemic Lupus Erythematosus (전신성 홍반성 루푸스 환자에서 발생한 괴사성 근막염의 치험례)

  • Cho, Hye-In;Chang, Hak
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.309-314
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    • 2011
  • Purpose: Necrotizing fasciitis is a life-threatening, destructive soft tissue infection with a very high rate of mortality that needs early diagnosis and aggressive treatment. Systemic Lupus Erythematosus (SLE) is a systemic, autoimmune disease and it's major cause of mortality is an infection. But necrotizing fasciitis in SLE is very rare and there have been only 22 cases reported in the literatures. We reported a patient of necrotizing fasciitis with SLE and reviewed 22 others from literature research. Methods: A 40-year-old female patient with a history of SLE for 6 years came to the emergency room. The patient complained of severe pain and swelling on her right leg. She was diagnosed as necrotizing fasciitis and underwent emergency fasciotomy. As wound cultures showed variable organisms, she was treated with broad-spectrum antibiotics and underwent several surgical debridements. Then, the wound was treated with the V.A.C (Vacuum Assisted Closure) device and split thickness skin grafting was performed two times. Results: Skin graft was well taken within 2 weeks after operations and the patient was discharged to outpatient follow up. There was no complication related with surgery and she could walk without cane after 3 months. Conclusion: We treated a necrotizing fasciitis in a patient with SLE and reviewed 22 others from literature research. The case presented here suggests that necrotizing fasciitis is a rare disease in SLE patients, but should be considered in the differential diagnosis of soft tissue infection in SLE patients. A high index of suspicion is needed for early diagnosis and proper management in these patients.

Herpes Zoster Ophthalmicus in Minor Facial Burn (눈대상포진이 병발된 경미한 얼굴의 화상)

  • Han, Jung Kyu;Kim, Sun Goo;Kim, Yu Jin
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.803-805
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    • 2009
  • Purpose: Many conditions can mimic the presentation of burns. Herpes zoster is one of them. The characteristic features of herpes zoster such as vesicles, pustular lesions and crusts can also be found in burns. Herpes zoster ophthalmicus is a disease caused by recurrent infection of varicella - zoster virus in the ophthalmic division of the trigeminal nerve. This virus frequently affects nasociliary branch and serious ocular complications can occur. Thus, early diagnosis and proper treatment of this disease is important to prevent further ocular manifestations. We report a man who sustained minor facial burn injury that was complicated with herpes zoster ophthalmicus. Methods: A 66 - year - old man visited emergency room with multiple whitish vesicles with serous discharge on right forehead, right medial canthal area and nose. At first he was thought to have a secondary infection of facial burn injury. The vesicles on his face began to form crusts on the next day. Since his skin lesion was located on the ophthalmic division of trigeminal nerve, we also suspected herpes zoster ophthalmicus. He was referred to dermatologist and ophthalmologist. Results: We used antiviral agent (Acyclovir) and NSAIDs for treatment. The patient had no ocular complications. His skin lesion was almost healed after 1 month and remained scars. We treated a patient with minor facial burn complicated with herpes zoster ophthalmicus with antiviral agent. Conclusion: In this work, we describe a case of old patient with herpetic infection and emphasize the need for careful examination to diagnose accurately.

Surgical Treatment of Ahilles Tendon Rupture Using Modified Lynn Method (변형 Lynn씨 방법에 의한 아킬레스건 파열의 수술적 치료)

  • Kang, Jae-Do;Kim, Kwang-Yul;Kim, Hyung-Chun;Kim, Jin-Hyung;Choi, Shin-Kwon
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.223-231
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    • 2003
  • Purpose: Achilles tendon rupture has become more common in the recent years. As suture with foreign material has been blamed for impaired healing, better results should be expected from the use of autogenous material such as plantaris tendon. We have evaluated the surgical results of end-to-end anastomosis using the plantaris tendon as suture material. Materials and Methods: Between Jan 1997 and Jan 2002, the 60 patients were included this study during one year follow-up. We performed the operations with end-to-end suture technique using modified Lynn's method. The plantaris tendon has been used as a autogenous suture material and can be utilized in the end-to-end anastomosis of ruptured Achilles tendon with modifed Bunnel suture technique. We used a clinical scoring system reported by Leppilahti to evaluate the results. Results: The overall results were excellent in thirty eight(63.3%), good in sixteen(26.6%), fair in five(8.3%) cases, and poor in only one (1.6%) case. Fifty four cases(90%) had the score more than good. We had no deep infection, rerupture, deep vein thrombosis, and skin necrosis as major complication. In just 2 cases, although there were superficial skin infection, the wounds did not proceed necrosis due to using antibiotics. Conclusion: End-to-end anastomosis using the plantaris tendon as suture material was good treatment option that had low infection rate and no foreign body reaction because of using autogenous material, and therefore we can get rapid healing of ruptured tendon due to early ragne of motion and accerlerated rehabilitation.

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A Study on Nursing Diagnoses and Nursing Intervention Classification -focused on Home Health Care Clients- (간호진단과 중재분류에 관한 조사연구 -가정 간호 대상자를 중심으로-)

  • 김조자;최애규;김기란;송희영
    • Journal of Korean Academy of Nursing
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    • v.29 no.1
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    • pp.72-83
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    • 1999
  • The purpose of this study was to classify, from collected home health care records data, nursing diagnoses according to the NANDA system and nursing interventions according to the NIC system, and to link nursing interventions to nursing diagnoses. For this study, 101 home health care records of clients seen between September, 1994 and November, 1996 at Yonsei Medical Center, Seoul, were analyzed. The results of this study are summarized as follows : 1. The most frequent nursing diagnoses were ‘Risk for infection’ and ‘Altered nutrition : Less than body requirements’, then ‘Impaired skin intergrity’ and ‘Ineffective airway clearance’ in the Exchange pattern of NANDA nine human response patterns. 2. The most frequent nursing interventions were the interventions in the Physiological : Complex domain, there were 690(50.7%) interventions among a total 1347 interventions. This results corresponds to Yom, Young Hee(1995)’s research, both Korean and U.S. nurses used the interventions in the Physiological : Complex do main most often on a daily basis. And respiratory nursing interventions were most frequent because 32.7% of the subjects were respiratory patients. 3. The next step was to link the nursing interventions to nursing diagnoses. The most frequent nursing diagnosis was ‘Risk for infection’ and 19 interventions for ‘Risk for infection’ were used 267 times. Then 14 interventions for ‘Impaired skin integrity’ were used 258 times, 12 interventions for ‘Ineffrective airway clearance’ were used 193 times, 12 interventions for ‘Altered nutrition : Less than body requirements’ were used 122 times, 10 interventions for ‘Activity intolerance’ were used 75 times, and 11 interventions for ‘Knowledge deficit’ were used 52 times. 4. The use of standardized classification in the areas of nursing diagnoses and nursing interventions facilitates clinical decision making and prompt nursing activity, and so enhances the effectiveness of nursing care.

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