Comparative Evaluation of the Treatment of Herpes Zoster with and without Sympathetic Block / 대한피부과학회지

BACKGROUND: Prevention of postherpetic neuralgia as well as management of the symptoms of the acute stage is an important therapeutic goal in the treatment of herpes zoster. Corticosteroid, acyclovir and sympathetic block have all been advocated as effective therapeutic tools for the treatment of the disease. OBJECTIVE: This study was conducted to evaluate the necessity of sympathetic block for prevention of postherpetic neuralgia in acute herpes zoster. METHODS: The author observed the duration and degree of pain and the incidence of postherpetic neuralgia in 54 patients with herpes zoster treated with three different therapeutic measures. Group A was treated with triamcinolone acetonide 80mg three times, acyclovir and sympathetic blockade, group B with triamcinolone acetonide 80mg three times and acyclovir, and group C with triamcinolone acetonide 40mg three times and acyclovir. RESULTS: 1. Addition of sympathetic blockade to corticosteroid and acyclovir therapy did not seem to reduce the duration of pain and incidence of postherpetic neuralgia. 2. The Incidence of postherpetic neuralgia was higher in the elderly, especially with underlying systemic disease including diabetes melitus, hypertension, etc. Al] the therapeutic measures could not completely prevent the development of postherpetic neuralgia in those patients. 3. Regarding corticosteroid dosage, daily triamcinolone acetonide 80mg for three consecutive days showed no better effect than daily 40mg for consecutive days. CONCLUSION: When herpes zoster was treated with proper dosages of corticosteroid and acyclovir in its acute stage, sympathetic block showed no additional beneficial effect.

Trichophyton tonsurans Infection in Wrestlers and a Child / 대한피부과학회지

Trichophyton tonsurans has been the main agent of tinea capitis in the United States since 1950s. In Korea, dermatophytosis due to Trichophyton tonsurans has begun to be reported since 1995. These Korean cases were all confined to wrestlers. We report eight patients with dermatophytosis due to Trichophyton tonsurans, Seven of them were middle-school wrestlers and the other, a six-year-old boy, was a non-wrestler. The infection of the wrestler patients was known to have originated from contact with infected persons during wrestling competitions. The source of Trichophyton tonsurans in the boy patient was obscure. To our knowledge, tinea capitis caused by Trichophyton tonsurans in a non-wrestler Korean has not been reported previously.

A Case of Multiple Actinic Keratoses during PUVA Therapy in a Vitiligo patient / 대한피부과학회지

Actinic kratosis can develop dnring PUVA therapy especially at high accumulative doses(more than 1000Joules/cm) but it can also develop at low accumulative doses(lese than 200Joules/cm). PUVA therapy should be done carefully and the dermatologist has to observe the patients skin more closely to detect development of the keratosis. We present a case of multiple actinic keratoses that developed during PUVA therapy in a 53 year old vitiligo patient. They developed during relatively low accumulative dose PUVA therapy (827Joules/cm2).