A Case of Linear IgA Bullous Dermatosis of Childhood / 대한피부과학회지

Linear IgA bullous dermatoses(LABD) occurring in childhood is considered to be a childhood counterpart of LABD,rather than chronic bullous dermatosis of childhood. This disease characteristically involves the perioral area,lower trunk,pelvic region and the lower extremities. Immunopathologically,it is characterized by the linear deposits of IgA at the dermoepidermal junction of the perilesional skin. A 20-month-old female infant presented with multiple pruritic tense bullae on the face, lower trunk, both extremities and pelvic region of 2 weeks duration. She had no oral lesions or any specific signs or symptoms referable to the disease of the gastrointestinal tract. A skin biopsy revealed subepidermal blisters infiltrated with many neutrophils and a few eosinophils. Direct immunofluorescence demonstrated linear deposition of IgA at the dermoepidermal junction. An indirect immunofluorescence study using NaC1-split skin as the substrate revealed fluorescence for IgA in a linear pattern on the roof of the split at a titer of 1:40. The clinical diagnosis of LABD of childhood was confirmed and we started with a combined remedy of dapsone and corticosteroids; 10 weeks later almost all of the lesions had disappeared.

Primary Cutaneous Cryptococcosis Treated with Itraconazole / 대한의진균학회지

In most instances, Cryptococcosis is a systemic disease caused by the yeast-like fungus Cryptococcus neoformans through respiratory tract. The organism is worldwide in its distribution, is saprophytic, and is found in soil and in pigeon excretion. Primary cutaneous cryptococcosis is rare; skin lesion is the sole manifestation of the disease without preceding generalized or cerebrospinal involvement. We report a case of primary cutaneous crytococcosis. The patient was a 53-year-old female, who had had an erythematous ulcerated lesion with swollen border on the dorsum of right wrist. Histopathologic examination showed typical spores with capsules. Other physical examinations and laboratory findings were within normal limit. The lesion was successfully treated with oral itraconazole (200mg/dayx7weeks).

Pigmented Photoallergic Contact Dermatitis Due to Musk Ambrette / 대한피부과학회지

Pigmented photoallergic contact dermatitis is a disease usually resulting from recurrent cutaneous exposure to cosmetic photoallergens which produce bizarre dark brown hyperpigmentation. Histologicnl examination of this condition reveals liquefaction of the basal cells of the epidmis and melanophages in the upper dermis. A 50-year-female developed dark brownish mottled hyperpigmented patches on her face after using a soap named O.E. and taking a nap every afternoon for 4 years. The histological fmding on the lesion site was consistent with pigmented photoallergic contact dermatitis. The cosmetic photopatch test with, O.E. soap, and the Scandinavian scries resulted in a positive reaction only on one side where 5 J/cm2 lights were applied by using Waldman 800UV machine. The other side howed a negative finding. We fmally diagnosed pigmented photoallergic contact dermatitis based on the patients histoty of using the soap containing musk ambrette, a histological examination of a biopsy and the results of photopatch tests. We report rare case of pigmented photoallergic contact dermatitis.

The Survey of Occupational Dermatoses in a Semiconductor Industry for 3 years / 대한피부과학회지

BACKGROUND: Occupational dermatoses are increasing tendency in Korea. But there were only a few reports about occupational dermatoses in Korean dermatologic literatures. OBJECT: For the effective preventive method and having interest in occupational dermatoses, we have done wide ranged basic study about the occupational dermatoses for 3 years in a semiconductor industry. METHODS: The number of workers of the semiconductor industry was 10,500(male 5,000, female 5,500) and finally the number of analysed patients in this survey was 2,736. A dermatologist attended regularly at the clinic in a semiconductor industry once a week for the duration of 3 years from June 1992 to May 1995. Diagnosis was made by clinical findings and investigation about the working environment. RESULTS: 1. The most common dermatoses are contact dermatitis(14.3%), acne(14.0%), seborrheic dermatitis(7.1%) and tinea pedis(6.9%). Urticaria, hand eczerna, abscess, onychomycosis, t.inea versicol or and chemical burn were also observed frequently. 2. Chemical burn(2.0%), contact dermatitis(1.4%) and acne(0.8%) were the most important occupation related dermatoses in this survey. Hydrofluoric acid(1.4%) was the main cause of chemical burn. The occupationa contact dermatitis and acne in this survey were mainly came from the mask, hood and dust preventing clothes which the workers must wear for 8 hours a day at working place. 3. The other dermatoses related to occupation were hand eczema, trauma, nummular eczema, atopic dermatitis, etc.. CONCLUSION: This study regardless of insufficient inspection equipment was done for a relatively long period in the semiconductor industry. In the future, many studies like this will be reported and the studies will give a model of management of occupational dermatoses in Korea.

Histopathologic Observation on Hydrofluoric Acid Burn Using Guinea Pigs / 대한피부과학회지

BACKGROUND: Hydrofluoric acid(HF) is one of the strong stirritating, corrosive and poisonous inorganic acid, The HF burns are occuring with ever-increa firifrequency due to the wide use of this acid in industrial fields, such as electronics and semicor tor industries. OBJECTIVE: The purpie of this study is to quantiate theound depths produced by varying concentrations of HF aiud to suggest the treatment guideline. METHODS: Uarious cinicentrations of HF(5%, 25%, 50%),were applied to two pairs of test sites on a guinea pig's back in a uniform fashion with cotton-tip applicators and then the histopathologic changes of guinea pig skin were observed. RESULTS: 1, In the 5% HF applied group, intracellular edema vaobserved in the epidermis after 12 hours. After 3days, epidermal cell necrosis was observed. 2. In the 25% HF applied group, intraepidermal vesice was observed after 6hours. After 12hours, inflammatory cell infiltrations were observed in the apper dermis and then after 3days, dermal necrosis was oberved. 3. In the 50% HF applied group, epidermal cell necros After 6hours, liquefaction degeneration in the epidermis an was observed focally after 3hours. iflhmmatory cell infiltrations in the upper dermis were observed. After 2days, dermalar.ecrosis was observed and then after days, the reaction was at its peak and subcutaneous tissuc. necrosis was observed. CONCLUSION: This study showed that a higher concentrator HF exposure enhances The penetration of HF. For treatmi not alcohloic solution of a quarternary ammonium for avintralesional injection of calcium gluconate within 24 hours of HF and a longer period after we suggest wet dressing with an concentration of HF burn and high concentration of HF burn.

Clinical study of hydrofluoric acid burn / 대한피부과학회지

BACKGROUND: Hydrofluoric acid burns are occuring with ever-increiisir g frequency due to the wide use of this acid in industrial fields, such as electronics and semiconductor i idustries. OBJECTIVE: The purpose of thie study was to evaluate the clinical charateristics of hydrofluoric acid burn. This study will give basic information of hydrofluoric acid burn to the dermatologists who are not familiar with hydrofluoric acid. METHOD: Twenty-two patient who were diagnosed as having hydroiluiiric acid burns at koryo General Hospital(1986-1993) were irraluated clinical)y. Forteen were malc ar d eight were female, most of them were in their third decade. RESULTS: The results are sumrnurised as follows 1. Latent periods were variabie from 30 min. to 3 days. Most patients recognized their chemical burn several hours after exposure. 2. Foot & sole (9 cases) and fingers (7 cases) were most frequently in olved. In 7 cases, nails were also involved. 3. Pain was the most. commori iuobjective symptom. 4. Skin lesions showed erytherna, erythematous swelling, erosion, bulla., necrosis, pigmentation and crust, formation, progressii ely. 5. Treatment Wet dressing with Hyami-solution and topical application of ai tibiotics or steroidointment were sufficient in mild case. In severe cases, intralesional injection of calcium glucoante was perfirmed. Debridement was also performed after the progn ssion of tissue damage stopped. Nails were extracted in cases involving nails. CONCLUSION: Hydrofluoric acid burn is characterized clinically by severc progessive tissue destruction and excruciating pain. Dermatologists need to be aware of the clinical features of hydroclucric acid burn and its proper treatment.

Clinical study and skin tests of patients with drug eruptions / 대한피부과학회지

BACKGROUND: Althogh drug euption refers to a common dermatological condition, there are numerous holdbacks on the diagnosis. OBJECTIVE: This study atternpts to define the clinical features and causavite drug of the patients with drug eruptions, and to evalarate the diagnostic value of various skin tests. METHOD: 130 patients with drug eruptions were reviewed clinically. In 54 patients, intradermal test, patch test, and scratch patch test were performed using suspected drugs. Result : The exanthematous eruption(53.0%), fixed drug eruptior.(29.2%), and urticaria(6.2%) were the common types of the drug eruption. The common causative agenst of drug eruptions were antibiotics/antimicrobials, antipyretics/NSAIDs, and CNS depressants. 28 paitients out of the 54 patients on skin tests with suspected drugs had positive results in at least one slinest. CONCLUSION: In our study, we were able to obtain somewhat meaningfi 1 results based on data from the combination of various skin tests.

Hyperkeratosis of the nipple and areola surgical excision and skin graft / 대한피부과학회지

Hyperkeratosis of the nipple and areola is a rare skin disordr characterized clinically by thickening and discoloration of the skin of the areola and/or nipple and pathoiog cally by papillomaosis or acanthosis-nigricans like changes. We report a case of hyperkeratosis of the nipple and areola occuring in a woman with no underlying endocrinopathy and no other additional hyperkeratotic conditions. Ttie iresent case seems to be the nevoid form by the Levy-Franckel classification. Treatment with topical medications including steroids and keratolytic agents produced no improvement. Therefore we recommeneded surgical excision because the paient was greatly disturbed by the appearance of the lesions. Surgical excision and full thickness skin graft were performed sucessfully.

A study of garlic sensitivity in patients with hand eczema / 대한피부과학회지

The importance of garlic as a cause of hand eczema has been a matter of debate. Diallyldisulfide is considered as the main allergen in garlic. Twentv two antigens of the modified European standard series and diallyldisulfide of 5%, 2%, 1%, 0.5%, 0.1% in petrolatum were patch tested in 44 patients with hand eczema. Diallylclisi.!lfide was also tested in 13 women as a control. The results were summerized as follows. l. In patch testing with the European standard series, nickel sulfate (22.7%), cobalt chloride (18.2%), fragrance mix (13.6%), balsam of Peru (9.1%) and termerosal (6.8%) were the cornmon allergens which showed positive reactions. The overal positive rate was 59.1 % (26/44). 2.5% diallyldisulfide showed an irritant reaction in 6 (46.2%) out of 13 controls and in 16 (36.4% ) out of 44 patients. 2% diallyldisulfide showed an irritant reaction in 2/13 (15.4 %) in the control group and 6/44 (13.6%) in the patient group. All 13 controls and 44 patients were negative iin tests with diallyldisulfide of 1%, 0.5%, 0.1%. Our results indicate that patch testing with diallyldisulfide of 1% petrolatum is reommended in order to avoid an irritant reaction when contact allergy to garlic is suspetel. 3. Garlic is suspected as an irritant in provoking hand eczema. True contact allergy to garlic in hand eczema seems to be rare.

A case of pemphigus erythematosus / 대한피부과학회지

We present here, a case of pemphigus erythematosus developed in a 31-year-old woman, who had been suffering from repeated episode, of remission and exacerbation with several erythematous, and somewhat oozing patche accompanying a mild pruritus or her face, upper part of the back and anterior chest. In serological studies, she had antinuclear antiboc@lies at. a titer of 1:160. Histopathological finding showed subcorneal bullae. Immunofluorescent study revealed IgG and C, deposition in the intercellular space of the epidermis and along the de rmoepidermal junction.

Occupational Contact Dermatitis in Patch Test Clinics of General Hospitals / 대한산업의학회지

Occupational allergic contact dermatitis cases who had visited the patch test clinics of Seoul National University Hospital(1984-1988) and Koryo General Hospital(1982-1988) were analyzed in this study. Patch test was performed with either Hollister-Stier standard battery or European standard battery in addition to the patients own materials and other commercially available antigens. Patch test was peformed according to the recommendation of International Contact Dermatitis Research Group. The result is summarized as follows. 1. Out of 946 cases 65 (6.9%) were suspected as having occupational dermatoses clinically and 35 (3.7%) were diagnosed as occupational allergic contact dermtitis after patch test. 2. Sixteen (45.7%) out of the 35 patients were male and 19 (54.3%) were female. Twenty one (60.0%) patients were in the age of 20 to 40 years. 3. The occupational distribution of 35 patients were medical personnels (8), cement workers (7), industrial workers (5), hair dressers (5), farmers (3), merchants (3), cooks (2) and painters (2). 4. Potassium dichromate, nickel sulfate and rubber chemicals were the most common occupational allergens. We also reviewed the Korean literatures related to the occupational dermatoses.

Occupational Rediodermatitis: Report of 4 Cases / 대한피부과학회지

Recently radiation and radioisotope are being used widely in many fields such as medicine and industry. But only a few papers were reported about the radio dermatitis due to industrial use of radiation. Authors experienced 4 cases of occupational radiodermatitis due to Ir-192 occur red during the radioisotope traspierce test. All 4 patients noticed painful swelling, erythema, and bullae on their fingers or palms 1-2 weeks after exposure. All laboratory tests to detect ystemic effects of radiation were normal. Three patients recovered after treatment with systemic and topical corticosteroid and emollient cream for 2-4 weeks. But one patient suffered from complication of fibrosis and recurrent cellulitis on his fingers. We discussed about the working situation of our patients and reviewed the literatures about the radiodermatitis.

Clinical Features of Early Lesions in Pemphigus / 대한피부과학회지

Among 13 patients with pemphigus : 8 of pemphigus vulgaris(PV), 4 of pemphigus foliaceus(PF), l of pemphigus erythematosus(PE), we have examined the sites of early lesions and the clinical appearances of the skin lesions. The most common site of the early lesions in PV was the oral mucosa, however, in PF and PE the face was affected first. The clinical appearances of the early lesions were flaccid bullae, erythematous papules and eczematoid patches. Clinicians should be aware of these clinical features of pemphigus for a more precise diagnosis and better management.

Pemphigus Foliaceus: Report of 5 Cases / 대한피부과학회지

Pemphigua foliaceus is a rare, relatively mild and chronic variety of pemphigus which is characterized by superficial flaccid bullae which show acantholytic changes in the upper part of the epidermis histopathologically. We report herein five cases of pemphigus foliaceus. The patients had erythematous and crusted patches chiefly on face, chest and back areas, except for case 2 who had flaccid bullae on the upper extrimities. The diagnosis of all these patients were confirmed by immunofluorescence studies. Among these five patients, one was recognized as a rifampicin induced pemphigus foliaceus, and the other one revealed concurrent lesions of psoriasis.

Sources of Formalin: III. Formalin Concentration in Adhesives / 대한피부과학회지

Formaldehyde in adhesives is used as preseratives as well as adhesives themeseles such as phenol-formaldehyde, carbamide-formaldehyde and melarnine-forma 1dehyde. Formaldehyde content in 43 kinds of adhesives used at present in Korea was determined by lutidine method. The study result was as follows. 1. The The distribution of formaldehyde concentrations of 43 different kinds of adhesives was in the 0 to 333. 9 ppm ranges. 2. High concentration of formaldehyde was observed in 3 kinds of wall paper adhesives and 1 kind of stationary adhesive, which has an important clinical significance because of their frequent contact sources of domestic uses.

Herpes Zoster Treated with Vidarabine-5-Monophosphate / 대한피부과학회지

We present four cases of herpes zoster treated successfully with vidarabine-5-monophosphate, two patients receiving chernotherapy and radiation therapy due to Hodgkins lymphoma or colon cancer, a patient combined with viral meningitis, and a patient with herpes zoster ophthalmicus. Viclarabine can be used to treat herpes zoster in immunosuppressed patients or patients with malignancy or patients with severe complications.

A Case of Subcutaneous Granuloma Annulare / 대한피부과학회지

No abstract available.

A Case of Kimura's Disease / 대한피부과학회지

A case of Kimuras disease was presented. It seemed that this is the first reported case in Korean literature. The patient was 26 years old male having painless slowly growing tumor-like swelling on his left cheek for 5 months. Mild leukocytosis and marked eosinophilia (27%) were noted in routine laboratory tests. Histopathologically numerous well developed lymphoid follicular structures composed of closely packed lymphocytes and histiocytes were seen in the deep dermis and subcutaneous fat tissue. Dense eosinophilic infiltrations in and around the follicles were peculiar picture. The literature was reviewed. Its relation to the similar descriptions in western literature under various diffe'rent headings was discussed;

The Comparative Studies on the Antigenicity of Antidog Spleen, Lymphnode and Thymus Sera in Rabbit / 대한피부과학회지

The present study was undertaken to evaluate and compare the in vitro leucoagglutination titers and in vivo lymphopenic eftect of three different antilymphocytic sera. Rabbits were immunized against adult dog and pup lymphoid tissue with multiple intramuscular injections of pooled spleen, mesenteric lymphnode and thymus cells. The number of lymphoid cells per each immunization was 1.8 * 107 of spleen cells, 1.68*108 of mesenteric lymphnode cells and 4.4*107 of thymus cells and immunization was done once per 10 days for 2 months. After completion of immunization and one booster injection, the rabbits were bled and total of 11 antidog spleen sera(RADSS), 4 antidog lymphnode sera(RADLS)and 3 antidog thymus sera (RADTS) were prepared and stored at-20C until used. With in vitro agglutination technique, each serum was serially diluted with buffered saline and tested with freshly prepared dog spleen, lymphnode,thymus cells and peripheral blood buffy coat leucocytes. With in vivo test, the antilymphocytic sera were intramuscularly injected in a dose of 1 ml/kg into adult dogs and after 12 hours peripheral blood pictures were evaluated and compared with those before antisera administration. The results were as follows. 1. The range of in vitro leucoagglutination titers of RADSS for spleen cells, tymphnode cells, thymus cells and peripheral leucocytes was 1: 4 to 1: 128, 1: 4 to 1: 128, 1: 4 to 1: 64 and 1: 4 to 1: 128, respectively. 2. The range of in vitro leucoagglutination titers of RADLS for sp]een cells, lymphnode cells, thymus cells and peripheral leucocytes was 1: 32 to 1: 64. 1: 32 to 1: 256, 1: 32 to 1: 128 and 1: 16 to 1: 256, respectively. 3. The range of in vitro leucoagglutination titers of RADTS for spleen cells, lymphnode cells, thymus cells and peripheral leucocytes was 1: 16 to l: 128, 1: 16 to 1: 64, 1: 8 to 1: 64 and 1: 8 to 1: 64, respectively. 4. After a singIe intramuscular injection of the antisera, the total R.B,C. counts were not significantly changed in RADSS, RADLS and RADTS. However, the percentage of neutrophils increased bv a mean value of 35.3% 34.8% and 21.7%p in RADSS,RADI.S and RADTS, respectively and the percentage of lymphocytes decreased by a mean value of 47.8%, 51.8% and 30.6% in RADSS, RADLS and RADTS, respectiveIy. The eosinophils showed a tendency of decrease in RADSS, RADLS and RADTS, respectively. The monocyes and basophis were not significantly changed after injection of the antisera. The author found that there was no significant difference between the in vitro leucoagglutination titers of three kind of antisera and that with in vitro leucoagglutination test, the peripheral blood leucocytes may serve as an useful antigen because of simp]icity of preparation. Also, the author found that there was no direct correlation between the in vitro leucoagglutination titers and in vivo Iymphopenic effect, but generally the antisera with strong lymphopenic effect had higher in vitro titers than those with weak lymphopenic effcct, In this experiment, the lymphopenic effect of RADTS was slightly lawer than those ot RADSS and RADLS and this difference may be due to smaller number of the cells used in immunization for the preparation of the antisera. The author concluded that spleen was as useful as lymphnode or thymus in its antigenicity and in producing effective antilymphocytic serum.

Hodgkin's Disease with Nonspecific Dermatitis: Report of 1 Case / 대한피부과학회지

Hodgkin's disease, as a poly-morphous group of lymphoma, is a disease of reticuloendothelial system, skin and usually affects the lymph node and so primarily, predominantly by proliferation of lymphocyte and histiocyte. This patient is a 42 years old Housewife who was suffered from severe itching sensation on the entire body since she had illed with exfoliative decmatitis, 7 years ago. Skin lesion showed brownish colored hyperpigmentation on entire body, scattered or grouped lichenified patch with scale on extremities and hypertrophy on the palms and soles. On physical examination, she had a egg-sized, right cervical lymph node swelling and chestnut sized, left cervical lymph node swelling without pain. On laboratory findings showed within normal limits. Sternal bone marrow aspiration revealed nonspecifie findings. A chest X-Ray revealed mass shadow on right upper mediastinum. Histologically finding of the skin revealed nonspecific dermatitis picture. On diagnostic excisional biopsy of left cervical lymph node showed numerous Hodgkin's cell Liver scanning didn't show space occeuying lesion. Above as a result, by clinical manifestation, X-ray findings and histological findings of cervical lymph-node, the diagnosis of Hodgkins disease with nonspecific dermatitis was confirmed. Literature was briefly reviewed for the discussion of clinical and histological findings of this dlsease.