The Skin Responses to Dimethyl Sulfoxide in Normal Human Forearm Skin

BACKGROUND: Dimethyl sulfoxide (DMSO) is a strong urticariogenic agent and a primary irritant. A DMSO test which measures erythema and wheal responses in skin after exposure for 5 min could be a simple and easy method in evaluating cutaneous irritation. Several non-invasive bioengineering methods for the evaluation of skin irritancy have been developed in recent decades. OBJECTIVE: To evaluate whether the DMSO test using filter paper discs instead of the open well with measurements of transepidermal water loss (TEWL) and erythema index (E-index) could be useful to study skin irritancy. METHODS: Twenty healthy volunteers (19-29 years, 10 males and 10 females) with no history of atopic dermatitis were included. DMSO solutions (90%, 95%, and 100%) of 60l were applied to the left volar forearm for 5 min using filter paper discs (12mm) for large Finn chamber. Visual scores (whealing scores and erythema), TEWL and E-index were measured at 30 min after removal of the filter papers. RESULTS: The number of subjects showing erythema and wheals after DMSO exposure were: 6 (30%), 8 (40%) with 90% DMSO solution; 14 (70%), 15 (75%) with 95% DMSO solution; and 20 (100%), 20 (100%) with 100% DMSO solution, respectively. Whealing scores were 0.5±0.6 (90%), 1.4±1.1 (95%), 3.5±0.9 (100%), and erythema ones were 2.9±4.9 (90%), 7.7±7.2 (95%), 20.0±6.5 (100%). E-index results were 10.0±3.4 (90%), 10.9±3.1 (95%), 12.3±2.7 (100%), and TEWL values were 14.6±4.9 (90%), 21.0±8.8 (95%), 44.9±15.3 (100%). As the DMSO concentrations were increased, there were significant increases in whealing scores, and erythema and TEWL values. E-index results were not significant, but showed a rising score tendency. There were no significant differences between the males and the females. CONCLUSION: DMSO testing may be a quick and simple method to assess cutaneous irritation. Also, TEWL measurements may be more accurate and sensitive than those of E-index measurement in the assessment of erythema and wheals. DMSO testing using filter paper discs with TEWL measurement could be a useful method in the study of cutaneous irritation.

A Case of Sebaceous Adenoma

We report an uncommon case of sebaceous adenoma in a 36-year-old male who had a solitary, well-de6ned, 0.5×0.8cm sized, round, erythematous nodule on the right side of his forehead. Microscopically, the nodule was composed of poorly developed sebaceous lobules that were irregular in size and shape in the deep reticular dermis. The lobules were composed of mature sebaceous cells in the center and undifferentiated basaloid cells at the periphery. In most lobules, the two types of cells occured in approximately equal proportions. We excised the lesion completely and no evidence of recurrence was observed for 2 years.

A Case of Allergic Contact Dermatitis to Cephalosporins / 대한피부과학회지

Cephalosporins are B-lactam antibiotics. They are usually bactericidal in action and act by inhibiting mucopeptide synthesis in the bacterial cell wall. Cephalosporins have been used widely in Korea. However, allergic contact dermatitis to cephalosporins has not been reported in the Korean dermatologiy literature. We report a case of allergic contact dermatitis due to cephalosporins in a 23-year-old nurse who suffered from itchy, erythematous patches and plaques with numerous fissures on both hands. A patch test with ceftriaxone and a prick test with cefotiam were positive.

Cytokeratin Expression in Seborrheic Keratosis

BACKGROUND: Using biochemical and immunohistochemical studies, alterations of cytokeratin expression has been reported in seborrheic keratosis. OBJECTIVE: To further investigate the cytokeratin expression in seborrheic keratosis, we have done immunohistochemical staining using a panel of specific anti-keratin antibodies in this study. We also observed the cytokeratin expression in the hair, sebaceous gland and sweat gland of the some epidermis. METHODS: Twenty cases of seborrheic keratosis were collected from the pathologic files. The histological types included acanthotic type (13 cases), hyperkeratotic type (5 cases), and pigmented type (2 cases). All tissues had been fixed in formalin and then paraffin-embedded according to conventional procedures. Each section was mounted on a gelatin-coated glass slide, and incubated with various anti-keratin antibodies. The sections were then immunostained using the avidin-biotin-peroxidase complex system. The peroxidase reaction was visualized with diaminobenzidine (DAB). RESULTS: 1. Cytokeratin expression in seborrheic keratosis lesions On staining with 34βB4 (K1), several staining patterns in the suprabasal layers of the epidermis were observed in 10 out of 20 cases. Using the AE1 (K10,14,15), we observed focal staining in 2 cases. We observed several positive staining patterns in 5 cases with K13,16 antibody. On staining with K10 antibody, we observed focal or irregular staining patterns in 14 cases. Focal staining was also observed with K5,8 antibody in one case. 2. Cytokeratin expression in the hair, sebaceous gland and sweat gland On immunoperoxidase staining of hair, there were positive reactions with CAM5.2 (K8,18) in 2 cases. There were positive reaction with K13,16 antibody in one case, with 34βB4 (K1), and K10 antibody in 3 cases, and with K17 antibody in 2 cases. On immunoperoxidase staining of sebaceous glands, there was one positive reaction with CAM5.2 (K8,18) in the suprabasal cells of sebaceous glands and with K13,16 antibody in sebaceous ducts. There were positive reactions with K17 antibody in the sebaceous ducts in 2 cases, and with K1 antibody in the sebaceous glands in one case. Using 34βB4 (K1), 4 out of 20 cases showed positive reactions in sweat glands. On staining with AE1 (K10,14,15), positive reactions were observed in 8 cases. Staining with CAM5.2 (K8,18) showed positive reactions in 14 cases. There were positive reactions with K19 antibody in 9 cases. CONCLUSION: Our data suggests that the predominant keratin expression in the tumor cells of seborrheic keratosis is high molecular weight keratin (K1/K10) rather than other lower molecular weight keratin. Tumor cells show some proliferative activity and monoclonal antibody K19 could be a marker for eccrine sweat glands like CAM5.2 (K8,18).

Two Cases of Atopic Dermatitis Treated with Thymopentin / 대한피부과학회지

The pat,hogenesis of atopic dermititis(AD) is still undefined. The prominent immunologic abnormalities associated with AD are defective cell-mediated immunity and increased IgE production. Also, the predominant CD4 subset in the skin lesion of AD is a Th2-like. Thymopentin, the active pentapepide of a thymic hormone, promotes differentiation of thymocytes and exhibits immunomodulating function. We experienced 2 case. of severe AD patients who were treated with subcutaneous injection of thymopentin three times a week for 6 weeks or 8 weeks. We compared the effects of cyclosporine A(CsA), FK -506 and thymopentin on the production of IL-2, IL-3, IL-4 and sIL-2R in vitro. In patient 1, there was no clinical response with thymopentin therapy. There was no difference in the serum IgE levels between before and after treatment. The ratio of Th/Ts was increased after treatment. In vitro study, CsA and FK-506 inhibited the production of IL-2, IL-3, IL 4 and sIL-2R, and thymopentin inhibited the production of IL-2, IL-3, IL-4 and sIL-2R. In patient 2, the clinical score of the patient was improved from 15 to 10 after treatment with thymopentin. There was no difference in the serum IgE level. The ratio of Th/Ts was decreased after treatment. In vitro study, the production of IL-2, IL-3 and IL-4 were decreased in lymphocytes added with CsA and FK-506, but the production of sIL-2R was increased by CsA and FK-506. Also, the production of IL-3 and IL-4 were increased in lymphocytes added with thyrnopentin, but the proluction of IL-2 and sIL-2R were increased by thymopentin. Our data suggest that thymopentin could be effective in the treatment of severe AD through the upregulation of Thl-like subset, not via the downregulation of Th2-like subset.