A Case of the Sign of Leser-Trelat / 대한피부과학회지

The sign of Leser-Trelat refers to the sudden appearance and rapid increase in size and number of freckles and seborrheic keratoses, It is considered to be a sign of internal malignant tumors, most probable of the gastrointestinal tract. We report a case of adenocarcinoma of the stomach associated with the sign of Leser-Trelat and the literatures were reviewed. This 62-year-old man, over a period of 5 months, developed multiple seborrheic keratoses over his trunk and extremities. He came to our department in August 1981, because of sudden increse in their number and size during the several preceding months. He had never complained of the symptoms of gastrointestinal tract such as gastric pain, vomiting, indigestion, and weight loss. On examination of the skin, hundreds of brown or brown-black, more or less greasy verrucous papules were found almoat exclusively on the extensor aspects of forearms and lower legs. These lesions were variable in size and were consistent clinically with seborrheic keratoses. The findings of both fiberoptic biopsy and upper gastrointestinal tract series of roentgenographic studies were compatible with ulcer and adenocarcinoma of the stomach. Based on our experience, it is again suggested that though seborrheic keratoses are very common in the elderly, the rapid increase in size and number should arouse suspicion of an internal malignancy.

A Case of Acrodermatitis Enteropathica / 대한피부과학회지

Diiodohydroxyquin introduced by Dillaha et al in 1953, had been the mainstay for the treatment of acrodermatitis enteropathica (A.E.). However, following the report by Moynahan and Barnes in 1973 of successful treatment with the oral administration of zinc sulfate, the clinical response to this treatment has been confirmed by different investigators in many countries. In Korean literature, Rhim et al reported two cases of A,E. in siblings successfully treated with oral zinc sulfate in 1980. In our case of cow's milk-fed, 7 month-old male infant, typical claasical features of total alopecia, diarrhea and periorificial dermatitis developed at about 3 months. of age and the zinc level in serum was 101 ug/dl at the first visit. Treatment first with diiodohydroxyquin was initiated at a dose of 315 mg/day by mouth for the first week and 630 mg/day for the second week, but this therapeutic regimen brought about little or no effect. Because of no definite improvement even with increasing dose of 1260 mg/day for another week, treatment was. changed to oral zinc sulfate. The patient began to receive zinc sulfate 50mg at first day by mouth and the dosage was immediately increased to l00mg daily from the next day. Within 72 hrs there found dramatic improvement in the skin lesions and diharrhea stopped. Twenty days after the start of zinc therapy, nearly all the skin lesions disappeared and the patient was discharged in satisfactory condition with only mild residual erythema. (countinued..)

A Case of Atrophie Blanche / 대한피부과학회지

Atrophie blanche which was first described by Milian in 1929 is a sistinct entity and not a variation of stasis dermatitis. We reported a case of atrophie blanche which occurred in 21 year-old female. She had erythematous patches, telangiectaic purpuric areas, small 1 to 2mm ectasias suggestive of small angiomas with central ulcer, pustules and crusts on both lower legs and dorsa of feet without severe painful sensation. Histopathologic findings showed endothelial proliferation of the capillary blood vessele of dermis, presence of fibrinoid material on the superficial blood vessels and storma, and infarction of the epidermis and superficial corium. Response to treatment was not satisfactory with antibiotics and corticosteroid.

A Clinical Study on Lichen Planus / 대한피부과학회지

Clinicalstudies on thirty patients with lichen planus seen during the past 9 years from 1968 to 1976 at the Department of Dermatology, Busan National University Hospital were ma,de;particularly, varied clinical types of the disease and significance of histological findings were emphasized. The results obtained were as follows; 1. The incidence of lichen planus was 0.17% patients to total number of dermatologic 2. There were 19 males and 11 females in this series. The age at the first visit varied from 16 years to 71 years, and the pitients between 21 and 50 years occupied 76.7% of all. 3. The most common site of the initial lesion was extremities(66.7%), and flexor surface was rather common than extensor surface. And lesions of trunk, oral mucosa, extemal genitalia were also noticed. 4. The most common clinical type was chronic localized type(11), and hypertrophic type(4), Iichen planus of mucous membrane(4), annular type(4), acute widesprearead type(3), vesicobulIous type(2), linear type(2), follicular type(l) were also noticed. 5. Pruritus developed in 22 patints(73.3%) an@d Koebners phenomenon was noticed only in R cases(10%). 6. Histopathological examination of 25 biopsy specimens showed epidermal changes of hyperkeratosis(24), acanthosis(22), hypergranulosis(21), elongation of rete ridge(8) and liquefaction degeneration of hasal cells(25). Dermal changes include bandlike infiltration of infIammatory cells(24), melanophages in upper dermis(18), colloid or eosinophilic body(9), and dermo-epidermal separation(3).

A Case of GEneralized Pustular Psoriasis / 대한피부과학회지

We have presented a case of generalized pustular psoriasis appearing in a 18 year-old femaIe patient wbo suddenly developed annular lesions on the lower abdomen and crural areas with erythematous, scaly and pustular margin, following mild febrile attack. Histopathological findings showed typical spongiform pustule of Kogoj and Munro macroabscess. All the skin lesions were almost cleared with systemic corticosteroid and methotrexate in 3 weeks.

A Case of Reiter's Syndrome / 대한피부과학회지

We presented a case of Reiters syndrome consisting of conjunctivitis, arthritis and mucocutaneous lesions, occurring in 49 year-old Korean male. He had an pisode of dysentery 18 months before the onset of the syndrome and later followed by transient conjunctivitis but no history of venereal disease was revealed. He had the relatively well demarcated erythematous scaly patches on the scalp, face and back, and also the solitary or confluent thickened hyperkeratotic plaques on the dorsum of the feet and hands and lower extremities. Balanitis circinata as .a lesion of the mucous membrane, was seen but there were no lesions on the oral mucosa and palate. Arthritis of the knee and elbow joints were very scvere, accompanied by severe pain and limited motion, and severe wasting and weakness of the muscles of both lower extremities were noticed. He was treated with penicillin and corticosteroids systemically combined witb physiotherapy with some improvement of both skin lesions and joint pain but he died 3 months later probably of the far advanced pulmonary tuberculosis, gastrointestinal bleeding and cachexia.

A Clinical Study on Myltiple Neurofibromatosis / 대한피부과학회지

No abstract available.

Porphytia Cutanea Tarda: Report of a Case / 대한피부과학회지

A case of porphyria cutanca tarda is reported, in which the photosensitive cutaneous symptoms developed in association with impaired hepatic function possibly related to chronic consumption of alcohol. Wood's light examination of the urine revealed coral red fluorescence, and qualitative chemical urinalysis was strong positive for uroporphyrin and coproporphyrin. Biopsy of the skin showed subepidermal bulla with festooning arrangement of the naked papillae and basophilic degeneration of the dermis. The patient's favorable response to alkalinization therapy by sodium bicarbonate per os is encouraging, even for a short period's observation. Clinical, histopathological, and biochemical features of this disease are also discussed.

Behcet's Syndrome: Clinical Studies of Thirteen Cases / 대한피부과학회지

Clinical studies on thirteen patients with Behcet's syndrome who had visited during the period from Jan. 1970 to Sep. 1973, to the Department of Dermatology & Ophthahnology, Busan National University Hospital, were made and the following results obtained. 1) The ratio of male vs. female was l. 0: l. 6 with no definite sexual differences. The ages ranged from 17 to 56 years with the peak incidence in third decade of life. 2) The "complete" form consisting of oculo- oro-genital and cutaneous lesions appeared in . 4 patients (30. 8%) and the "incomplet" in 9 patients (69. 2%). 3) Aphthous stomatitis was most predominant, being observed in 12 out of all 13 cases (92.3%), the next was cutaneous manifestations such as erythema nodosum, pyodermas, acneiform & pustular lesions and erythema multiforme in 10 cases (76. 1%) and genital ulcers in 9 cascs (69.2%). Ocular lesions and articular involvements came fourth, each being found in 8 cases (61. 5%). 4) The commonest feature of ocular involvement was relapsing iridocyclitis, being observed in 57. 7% and the disease led to a bilateral loss of vision in 38. 4% 5) Single or combined therapy including corticosteroids and antimicrobials gave transient conservative effects and was of no value to prevent recurrent attacks.