A Case of Pyogenic Granuloma on the Buccal Mucosa / 대한피부과학회지

Pyogenic granuloma is not an uncommon oral cavity lesion and is a benign soft tissue tumor arising from the connective tissue of the skin or mucous membrane. We have reported a pedunculated tumor on the junctional area of the left side of upper lip and buccal mucosa which was developed without any history of trauma and clinically it was composed with condyloma acuminatum. Histopathological findings showed many newly formed blood vessels with marked endothelial swelling and collarette formation of rete ridges of epidermis. The lesion was completely subsided after surgical excision.

Photochemotherapy for Psoriasis / 대한피부과학회지

The beneficial effects of sunlight and ultraviolet light for the treatment, of psoriasis vulgaris has long been recognized. Parrish et al were the first to introduce a controlled light source, which allowed the delivery of a known quantity of light energy to the patients skin after the patient had ingested a photosensitizer, 8-methoxypsoralen (methoxsalen) two hours previous to UVA exposure. This successful treatment has become known as PUVA (psoralen and UVA). PUVA photochernotherapy denotes a systemic approach that is based on the interaction of light and a photoactive drug. Parrish et al have described successful treatment of psoriasis with PUVA and other investigators alI over the world have confirmed their beneficial results. The rationale of photochemotherapy in psoriasis is the inhibition of the increased DNA synthesis within the psoriatic lesions by the interaction of psoralen molecule and light energy in the UVA range(320-400nm). The present study was undertaken to evaluate the therapeutic effectiveness of PUVA photochernotherapy combining orally administered methoxsalen and UAA exposure using Dermatron UVA phototherapy system in patients with wi5espread psoriasis. A total of 15 patients with psoriasis over more than 30% of their bodies were selected at the department of dermatology, National Medical Center through March 1978 to September 1978. Oral administration of methoxsalen, 20 to 50 mg doses according to body weight, was followed by exposure to a high-intensity longwave ultraviolet light emitting a continuous spectrum between 320 and 400nm (peak emission, 350 - 365nm). Initial UVA exposure times were based on each patients minimal phototoxicity dose (MPD) and exposure times were increased at each treatment by 1 - 2 minutes to maintain minimal erythema. Frequency of treatment was two to three times weekly. Once the psoriatic lesions had, cleared completely the patient was placed on a maintenance schedule. If psoriasis recurred the frequency of treatment was increased. The results were as follows: l. 5 patients were dropped out due to unknown reasons. 2. 7 cases showed clearing of over 95, of the lesions (Response 5'). Mean number of PU VA therapy was 16. 7. During 1 4 months follow-up period, 4 cases remained free of psoriasis but 3 cases couldn't be followed. 3. Immediate side effects of PUVA were temporary and generally mild. No significant changes in laboratory screenings were noted. Side effects of therapy included transient nausea(33.3%), dizziness(26.7%), erythema.(66.7%), pruritus (60%), increased pigrnentation(100 %). 4. Comparison of pre-and post-PUVA therapy in biopsy specimens by light microscopy revealed histologic improvement evidenced by diminished acanthosis and parakeratosis, and regeneration of granular layers in all of 8 cases. Glycogen accumulation in the affected epiderrnis was significantly decreased or absent after PUVA therapy in all cases.

A Case of Darier's Disease / 대한피부과학회지

A case of Dariers disease was presented and the literatures were reviewed. The patient was 20 year old male whose skin lesions revealed normal skin colored, dirty, scaly, keratotic papules with mild itching on face, anterior chest, back, abdomen, axillae, groins and flexural surfaces of extremities. They had a tendency to aggrevate in summer and improve in winter. Histopathologically, suprabasal lacunae, hyperkeratosis, papiIIomatosis, moderate degree of acanthosis and corps ronds in Iacuna were demonstrated in the epidermis. Dermal papillae surrounded with single layer of basal cells proliferated inta the lacunae. Upper dermis revealed mild nonspecific inflammatory cell infiltrates.

A Clinical Study for Topical Vitamin A Acid Derivative in Acne Vulgaris / 대한피부과학회지

Many modalities for the treatment of acne vulgaris have been introduced, but the results of the treatment were variable and unsatisfactory. In 1969, Kligman ct al reported that vitamin A acid was one of the mot effective raembers of the topical therapeutics for ance than any other topical remedies. But the undesirable side effects of vitamin A acid limit its use, and so we us instead of vitamin A acid for minimizing of possible side effects The results are as follows: 1. The total number of skin eruption progressively diminished after treatment with topical vitamin A acid derivatives and we found significant diminution on fourth week, and the effectiveness of the total patients was 73.7%. 2. The number of papules and closed comedories progressively diminished after treatment, but that of open corzelones slightly increased on first week of the treatment and diminished thereafter. 3. The number of pustules too few to evaluate with statistical analysis, but newly developed pustules noted speciaelly in first and second weeks wit.h unpredictable courses 4. The frequent, undesirable side effects were scale, buming & stinging and erythemas in order of frequeny, but other side effeccs auch as itching, tightness, pain, and pigmentation also noted in a few patients but the side effect.s were mild. So we considered the effectiveness of vitamin A acid derivatives were as good as those of vit,amin A acid, but the undesirable side effects of vitamin A acid. derivatives were less severe than those of vitamin A acirl.

A Study of Effect on Topical Clocortolone ( Purantix ) in Psoriasis and Eczema / 대한피부과학회지

Clocortolone pivalate (Purantix') is a new dihalogenated corticosteroid for topical use, posessing powerful anti-inflammatory, anti-pruriginous, anti-allergic, anti-exudative and anti-proliferative activity. We are clinical trial to evaluate its efficacy and tolerance when used at a concentration of 0.1% in an oil-in-water base, in several dermatoses normally responsive to topical corticosteroids. In a study of 30 cases, Purantix' was shown to be highly effective in the treatment of various forms of eczema and dermatitis. It was also shown to be highly effective in most cases of atopic dermatitis, and outstanding benefit was obtained in the relief of pruritus in all conditions and highly significant for erythema, weeping, scaling and lichenification. Among these 30 cases, we observed excellent effects in 13 pts(48.3%), good effects in 11 pts (36.6%) and fair effects in 5 pts(16.6%). Namely among these 30 pts, 24 pts(80%) revealed excellent to good therapeutic effects on their skin conditions with Purantix'. No untoward side effect was noted in all subjects treated with Purantix'.

A Study on Delayed Cutaneous Hypersensitivity Reaction to Various Skin Test Antifgens in Patients with Leprosy / 대한피부과학회지

Several investigators have attempted to clarify th well-known phenomenon of anergy in lepromatous leprosy during past two decades, utilizing various methods of immunologic assessrvent, including response to skin test antigens, active skin sensitization with strong allergens, skin homograft survival rate, imrnunopathology of lymphnodes, in vitro blastogenic response by antigens or mitogens of lymphocytes, lymphokine production in vitro and measurement of peripheral T and B cell ratio. Howcver, there is no general agreement as to the cellular irnmunologic status of leprosy patients b tween various investigators. The present study was undertaken to evaluate the ability to mount cutaneous hypersensitivity reactions to various skin test antigens and to investigate active sensitization with DViCB in patients with leprosy. Ten polar lepromatous (LL) and 12 polar tuberculoid (TT) p-tients who have been treated at Department of Dermatology, National Iviedical Center and Seoul Nationa,l University Hospital were the subjects. The subjects have rcceived regular antileprosy chemotherapy with DDS and the average duration of treatment in LL and TT groups was 6. 2 and 4. 7 years, respectively. The control group included 10 healthy physicians and nurs-s. Skin test antigens includ=d lepromin (1 x10' bacilli,ml'), PPD (Parke-Davis 5ppJ/0.1ml), SK-SD (Lederle, 40 u SK and 10 u SD/0.1 ml), Candidin (Hollister stier Lab 1: 1000 dilution) and DNCB aceton solution in the concentrations of 1000ug,/0.1ml for sensitization and 100ug/0.1ml for challenge, respcctively. Skin reactions were read 48 hours after intraderrnal injection of 0.1 rnl of each antigen anci th.' metho4 of DNCB sensitization was same as described elsewhere. The result showed that in polar lepromatous leprosy patients, the skin reactivity to various antigens were generally decroased, as cornpared to both th healthy control group and polar tuberculoicl patients, especially to lepromin, PPD and I')NCB sensitization (p<0.05, respectively). We concluded thxt lepromatous leprosy patients were especially unresponsive to mycobacterial antigcns(lepromin and PPD) and to newly administered antigen (DNCB) and tbe possible mechanism was discussed.