Significance of Blood TNF-alpha and Interleukin 10 Levels in Vibrio Vulnificus Cytolysin Toxemia / 대한피부과학회지

BACKGROUND: Pro-inflammatory cytokines, such as tumor necrosis factor(TNF)-alpha and interleukin (IL)-1, have been incriminated in the pathogenesis of septic shock in animals and humans. IL-10 reduces the release of pro-inflammatory cytokines, nitric oxide and reactive oxygen species. IL-10 prevents endotoxin-induced toxicity. OBJECTIVE: The aim of this study was to investigate the relation between IL-10 and TNF-alpha in toxemic mice according to concentrations of V. vulnificus cytolysin. METHODS: First, after administration of V.vulnificus cytolysin(2, 4, 6, 8, 10 hemolytic units; HU) and physiologic saline through a mouse tail vein, we obtained blood samples from the heart at 60 minutes which was a peak time of IL-10 and TNF-alpha release. We measured serum concentration of circulating TNF-alpha and IL-10 using commercially available enzyme-linked immunosorbent assay methods. Second, after administration of 1,000U recombinant mouse IL-10 through a mouse tail vein 30 min before infusion of the lethal dose(8HU) of V. vulnificus cytolysin. We obtained blood samples from the heart at 60 minutes and measured serum concentration of circulating TNF-alpha level. RESULTS: Both IL-10 and TNF-alpha levels were significantly correlated with V. vulnificus cytolysin concentration(P=0.002). TNF-alpha levels were 76.9+/-9.5 pg/ml in 2HU, 315.8+/-39.8 pg/ml in 4HU, 426.1+/-27.9 pg/ml in 6HU, 931.3+/-22.3 pg/ml in 8HU, 1825.2+/-18.8 pg/ml in 10HU and 23.6+/-5.1 pg/ml in physiologic saline. IL-10 levels were 80.2+/-21.5 pg/ml in 2HU, 244.4+/-35.4 pg/ml in 4HU, 382.2+/-22.6 pg/ml in 6HU, 740.1+/-33.0 pg/ml in 8HU, 997.3+/-16.8 pg/ml in 10HU and 35.8+/-15.0 pg/ml in physiologic saline. After administration of 1,000U recombinant mouse IL-10, comparing to control group(931.3+/-22.3 pg/ml), TNF-alpha level was reduced to 307.2+/-23.9 pg/ml(P=0.003). CONCLUSION: IL-10 has an inhibitory effect on the production of TNF-alpha although it is released together with TNF-alpha in toxemic mice. IL-10 blood levels are directly related to the severity of toxemia. We conclude that IL-10 is a prognostic factor for the development of sepsis and might be used for the treatment of sepsis.

Finger-Tip Unit in Korean Adults and It's Clinical Application According to Anatomical Sites / 대한피부과학회지

BACKGROUND: Dermatologic patients need advice on how much ointment or cream to apply, in particular topical corticosteroids. The instructions given to patients concerning topical therapy are frequently vague. OBJECTIVE: The aims of this study are to make simple guidelines on the topical application of ointments or creams for patients, parents, doctors and nurses, and to check the accuracy of these guidelines in practice. METHODS: The average height and weight according to the different age groups and sex were measured from Korean standard growth and developement chart. From this chart, their total body surface areas(BSA) were calculated using a standard nomogram. The length of the tips of their index fingers was measured; measuring from the distal skin-crease to the end of the finger. One finger-tip unit(FTU) was defined as the amount of ointment expressed from a tube nozzle with a 5 mm in diameter, covering from the distal skin-crease to the tip of the palmar aspect of the index finger. The average area of abdominal skin covered by one finger-tip unit, and that of one palm were measured by computer scanner(Hurapack scanner, 4C) and image analyzed program(Image Pro. Plus(R) V. 3.0, Micromedical). Each patient then placed his or her right hand lightly, palm side down with the fingers and thumb closed, onto Hurapack scanner 4C. A tracing of the outer edge of the hand was made from the ulnar to radial styloid by photoshop program. The outlined area and enclosed area were measured by an image analyzer. RESULTS: 1. The average length of each finger-tip was 2.48+/-0.2cm in males and 2.24+/-0.13cm in females. 2. The average weight of one FTU was 0.46+/-0.03g in males and 0.40+/-0.02g in females. 3. The average area of palm was 145+/-12.4cm2 in males and 115.9+/-10.1cm2 in females. 4. The average area of abdominal skin covered by one FTU was 278+/-34.4cm2; The average area was 303+/-24.3cm2 in males and 253+/-21.9cm2 in females. 5. The number of FTU of adult male required to treat various anatomical sites was : face and neck, 2.6; trunk and buttock, 10.5; arm and hand, 5; leg and foot, 10. The number of FTU of adult female was : face and neck, 2.8; trunk and buttock, 11; arm and hand, 5.5; leg and foot 11. 6. The number of FTU of children required to treat each anatomical site was variable because of differential growth according to different age. CONCLUSION: The concept of FTU provides convenient means of rapidly assessing the approximate amount of ointment or cream required for the treatment of patients.

The Role of the Cytokines (IL-12, IFN-gamma) in the Generalized Shwartzman Reaction Induced by Vibrio Vulnificus Cytolysin / 대한피부과학회지

No Abstract Available.

Three Cases of Iinear Focal Elastosis / 대한피부과학회지

Linear focal elastosis is a new disease that clinically shows asymptomatic, palpable, striae-like lines extending horizontally across the middle and lower back and histologically a focal increase in elastic fibers separating the dermal collagen bundles. We report typical cases of linear focal elastosis clinically and histologically in three teenaged males.

A Case of Cervical Tab / 대한피부과학회지

Cervical tab is one of rare developmental anomalies of the brachial apparatus which appears as firm, protruding papule or nodule on the neck along the line of anterior border of the sternocleidomastoid muscle. A 5 year-old male patient developed a pea sized, movable, semi-solid mass on the lower portion of right sternocleidomastoid muscle area. On microscopic examination, well-marginated oval shaped cartilage was present. Individual cells in the lacunae had ample cytoplasm and eccentric nucleus. Verhoeff-van Gieson stained section of the mass showed cartilage with a rich elastic network in the matrix, most heavily concentrated about the chondrocyte. We report a rare case of cervical tab manifesting as a skin-colored nodule on the sternocleidomastoid muscle area.

A Case of Mondor's Disease / 대한피부과학회지

Mondor's disease, thrombophlebitis of the subcutaneous veins, is an uncommon condition. It has clinical features of sudden development of localized pain to be followed by a palpable and visible tender, linear, branching cutaneous groove. The patient was a 43-year-old man who showed two cord like tender subcutaneous grooves on the left lower quadrant of the abdomen. He had done vigorous weightlifting for one month prior to his visit. Histopathologic finding showed occlusion of vessels by organized thrombus.

A Case of Eosinophilic Pustular Folliculitis / 대한피부과학회지

Eosinophilic pustular folliculitis(EPF) is characterized by recurrent crops of pruritic follicular papules and pustules that occur mainly on the face, trunk, and extremities. Histologically, the major distinguishing feature is abundant eosinophils that invade sebaceous glands and outer root sheaths of hair follicles. We herein report a typical case of eosinophilic pustular folliculitis for promoting research of this rare disease.

A Case of Mycosis Fungoides / 대한피부과학회지

We describe a case of mycosis fungoides (infiltrative plaque type) in an 86-year-old male. He had experienced dark erythematous round plaques on the face, trunk, buttock, upper and lower extremities. Histopathologic findings revealed band-like superficial dermal infiltration of atypical lymphocytes, epidermotropism, and Pautrier's microabscess in the epidermis. The infiltrative cells were positivly stained with CD3, but not with a CD20. He was treated with a topical application of 0.2% carmustine, but he died due to poor general condition and septicemia.

Clinicopathologic Studies of 7 Cases with Cutaneous Metastatic Carcinomas from Lung Cancers / 대한피부과학회지

BACKGROUND: Cancer that tends to metastasize to other internal organs also involves the skin with various clinical features. OBJECTIVE: We studied the clinical and histopathological findings of metastatic skin cancer and primary lung cancer. METHODS: We reviewed the clinical features and histopathological findings in 7 patients with metastatic skin cancer from the lung cancer. We performed routine hematoxylin-eosin stain and immunohistochemical staining with monoclonal antibody to cytokeratin, neuron specific enolase, S-100, leukocyte common antigen, and epithelial membrane antigen using the formalin-fixed paraffin embedded skin tissue of cutaneous metastatic and primary lung cancer. RESULTS: All patients are men ranging from 44 to 72 years in age(mean, 63.0 years). Cutaneous lesions were nodule, tumor, and sclerotic plaque. Skin lesions appeared on all parts of body. The neck, chest, and scalp were the most common locations of metastases. Pathologic findings were squamous cell carcinoma in 5 patients, adenosquamous cell carcinoma in 2 patients. We found some different immunophenotypes in cutaneous metastatic lesion and lung cancer. Mean survival time from the diagnosis of lung cancer was 10.4 months, and 8.4 months from the diagnosis of skin metastasis. CONCLUSION: We conclude that patients with cutaneous metastasis of lung cancer reflect progressive, terminal stage, and poor prognosis of the disease.

A Case of Delayed Postburn Blister / 대한피부과학회지

Delayed postburn blister is defined as a spontaneous blistering condition at the burn scar or donor sites for split thickness skin grafts. It occurs within weeks following healing and spontaneously ceases to develop for several months. It is true that this condition has been regarded as a normal spectrum of wound healing even though it is not uncommon among convalescent burn patients. A 51-year-old male patient presented with spontaneously developed tense, hemorrhagic bullae on the red brownish burn scar after second degree superficial flame burn. Histopathological finding of the blister showed subepidermal bulla. We herein report a delayed postburn blister to promote interest of this common condition.