Nail Avulsion by Urea Treatment in Onychomycosis / 대한피부과학회지

The authors aimed to apply a nonsurgioal and atraumatic method for avulsing dystrophic nails due to onyohomyoosis by using 22.25% urea ointment under occlusive dressing. One hundred and eighty-nine nails with onychomycosis in fifty-five patients were treated by this rnethod. The results obtained a,re as follows: 1. Of a total of 82 fingernails and 107 toenails in 55 patients, all fingernails and 103 toenails showed an excellent response with easy removal of the diseased nails. 2. The duration tha.t the occluded urea ointment remained in place before sucessful avulsion was 6.7(range, 3 to 18) days for fingernails, and 9.1(range, 3 to 18) days for toenails with onychomycosis. 3. Of 4 nails of control group which were treated with white petrolatum, none showed the significant improvernent. 4. The problems during this treatment were; severe irritation with pain(l case), mild irzitation and/or itching(5 cases), and pin-point bleeding on curettage of nail bed (19 cases). It is suggested the urea treatment has many advantages and seemed to be ideal for patients with digital vascular insufficiency and increased susceptibility to infection.

A Case of Epidermodysplasia Verruciformis Associated with Bowen's Disease and Squanmous Cell Carcinoma / 대한피부과학회지

Epidermodysplasia vertuciformis (E.V.) is a generalized viral infection due to the wart virus, which is chacterized by wartlike papules often distributed over the entire body and generally starting in infancy, of which a high percetage develops into cancer. We present a case of E.V. in a 31 year old male with typical skin lesions resembling flat warts and tinea versicolor-like lesions that eventuated in malignancy, i.e., Bowens disease and squamous cell carcinoma on the forehead. The skin lesions appeared initially on the foerhead at the age of 6 and gradualIy generalized all over the whole bcdy thereafter. The light brown scaling papules on erythernatous hase and walnut sized ulcerative lesion on the forehead had been noticed for 4 to 6 years and identified as Bowens disease and squamous cell carcinoma.

Bullous Congenital Ichthyosiform Erythroderma: Report of a Case / 대한피부과학회지

We present a case of bullous congenital ichthyosiform erythroderma in a two year old female, in whom no hereditary background was found. The skin lesion was characterized clinically by blister formation with generalized erythematous hyperkeratosis which was especially prominent on the flexural surfaces of extremities and intertriginous areas. The histopathologic examination revealed marked hyperkeratosis, cavity changes of the malpighian cells with perinuclear vacuoles and markedly thickened granular layer containing many keratohyaline granules.

A Case of Granuloma Annulare / 대한피부과학회지

Granuloma, annulare is a chronic dermatosis characterized by skin colored, firm intradermal papules or subutaneous nodules, which may be discrete or arranged in an annular configuration. Histologically the dermis shows well define8 areas of necrobiosis of collagen tissue surrounded. by palisading histiocytes and lymphocytes. There may be lobules of epithelioid cells ani multinucleated giant ce.1s surrounding the necrobiotic areas. Many factors have been implicated in the genesis of this reaction. Recent studies have indicated that delayed hypersensitivity reactions rnay be involved in the pathogenesis of granuloma annulare. We present a typical granulorna annulare on a 16 year-old boy who had flesh colored, hyperkeratotic small nodules arranged in ring fashion on the dorsum of hands and right ear auricle.

A Case fo Infantile Digital Fivromatosis / 대한피부과학회지

A case of infantile digital fibromatosis which developed on the right fifth toe of 2 year-old girl is reported. Microscopically, the eosinophilic cytoplasmic inclusions were frequently seen in the cytoplasm and outside of the fibroblasts.

A Case of Keratosis Punctata of the Palmar Greses / 대한피부과학회지

Keratosis punctata of palmar creases has been considered an uncommon variant of keratosis punctata, which itself is considered rare condition. Clinically our case, 32-year-old seaman, shows cup-shaped depression of the epidermis of varying size, from 1-3mrn in diameter, limited to the large flexor creases of the palms and digit. The histologic features are hyperkeratotic and slight acanthotic central epidermal depression without parakeratosis and loss of granular layer. A sparse mononuclear infilterate are seen arround the capillaries in the dermal papillas. No relationship to arsenical agents, syphilis, or genetic factors can be ascertained by history.

Two Cases of Acute Febrile Neutrophilic Dermatosis (Sweet's Syndrome) / 대한피부과학회지

We present two cases of acute febrile neutrophilic dermatosis developed in women aged 56 and 52. One of the two patients deveIoped the lesions during longterm antituberculosis chemotherapy for her advanced pulmonary tuberculosis, The other case developed the lesions, initially at the site of acupuncture done for relief of her arthralgia, followed by the involvement of the other sites. The etiology of acute febrile neutrophilic dermatosis is not clear, however, hypersensitivity and association with systemic diseases such as upper respiratory infection, malignancies, ulcerative colitis and pyoderma gangrenosum are postulated.

A Case of Xanthoma Tuberosum / 대한피부과학회지

A 43 year-old Korean male has had multiple, grouped, asymptomatic, yellowish brown flat papules and nodules on the knees, elbows, buttocks, palms and soles for 3 years. Small yeIlowish, discrete papules first appeared on the right palm and left elbow, and gradually increased in size and number and spread to knees, buttocks and soIes. Physical examination revealed normal except for the skin lesions and no familial occurrence was noted. Gross finding of the serum was turbid, more or less creamy and paper electrophoresis revealed marked increase of prebetalipoprotein, increase of betalipoprotein and alphalipoprotein and absence of chylomicron, suggesting type III or type IV hyperlipoproteinemia. Serem choleterol was 200mg% and fasting blood sugar was 115.0mg%. with normal glucose tolerance test. Histopathology showed many aggregates of foam cells on H-E stain and many lipid droplets in the dermis on Sudan red stain. Based on the clinical and histopathological findings and lipoprotein analysis by the paper electrophoresis, the patient was diagnosed as type IV hyperlipoproteinemia with xanthoma tuberosum.

A Clinical Study on Basal Cell Caricinoma / 대한피부과학회지

A clinical study was done on 43 patients witb basal cell carcinoma encountered in the Department of Dermatology, Busan National University Hospital during the past 10-years period frorn January 1968 to December 1977. Tbe results were summarized as follows: 1) Of 43 patients, 15 ceses were male and 28 cases were female with ratio of 1: 1.87. 2) Age incidence ranged frorn 15 years to 87 years with the highest incidence rate in the age group 40-49 years and incidence rate increased remarkbly in numlxr after over 40 years of age. Average age was 55 years. 3) The most common site was face occuring in 39 casts(90.7%), comprising 18 cases on nose, 12 cases on eyelids, 6 cases on cheeks, each 1 case on forehead, upper lip and auricle. 4) Noduloulc rative lesion was most common, otscrved in 29 cases(67.4%), nodular lesion in 9 cascs(20.9%), and pigmented lesion in 5 csses(11.6%). 5. The ratio of basal cell carcinoma was 1:1.2. 6) Three cases of precancerous states including 2 cases of xeroderma pigmentosa and 1 case of irradiated skin lesion were observed.

A Case of Malignagr Lymphoma / 대한피부과학회지

A 28-year-old male patient is described who developed multiple erythematous nodules and papules on the face, upper chest, back, upper and lower extrimities, leading to extensive ia.filtration of the skin and lymph nodes. Histology from the involved lymph node and skin nodule revealed widely scattered patchy infiltration of abnormal. hyperchromatic polymorphous histiocytes in the dermis. The patient died at about 8 months after onset of the disease, in spite of antineoplastic treatment.

Three Cases of Familial Benign Chronic Pemphigus / 대한피부과학회지

Familial Renign Chronic Femphigus(FRCP) is rare, persistent and vesicobullous genodermatoai. Three casee of FRCP with typical clinical and histapathological findings are reported. The first case of FBCP was 27-year-oId man who had recurrent episodes of grou vesicles and rust with miId pruritue at the posterior neck, in both axillae and in inguinal area for 10 years. The second case was 49-year-old woman with skin lesions of recurrent persistent. vesicles, pustules on the erythematous skin, crust and lichenification on the flexural area of extrimeties, axillae, ingumal and neck area for 10 yeara. The third case was 49-year-old male patient who had recurrent pruritic grouped vesicles with crust on the neck and axillary area. In all three patients, skin eruptions usually began and or aggravated in the spring or summer and tend to heal spontaneously in the autumn and winter and showed positive Nikolsky sign. The only one case of the reported three casea had familiaI history of skin lesions similar to FRCP. Histopat,holag;ic finding of biopsy specimens from the vesicular eruption showed auprabasal vesiculation with acantholysis, lacunae and villi formation in all 3 cases.

Nevus Lipomatosus Cutaneous Superficialis: Report of A Case / 대한피부과학회지

Nevus Lipomatous cutaneous superficialis (Hoffman-Zurhelle) is distinct clinical entity. A case is reported in which the lesions appeared in childhood and were elevated plaques and nodules in distribution on the tight side of the buttock.

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 Clinicla Study on Skin Tuberculosis / 대한피부과학회지

This study was performed with 31 cases of cutaneous tuberculosis among 18,846 cases of out-patients in Dermatologic Department of Busan National Universicy Hospital from 1967 to 1976. These 31 cases were consistent with skin tuberculosis in histological and clinical findings. The results were as follows. 1. The incidence of skin tuberculosis is 0.16%, among 18,846 cases of outpatients, 2. The localized tuberculosis of the skin, i.e. lupes vulgaris, tuberculosis verrucosa cutia and scrofuloderma was more common than disseminated type of tuberculosis of the skin. Among the disseminated types, papulonecrotic tuberculid is rather common than other types. 3. The ratio between male and female was l. 2: 1. 4. The age of onset varied according to types, but 70% of all cases occurred in the age group between 10-30 years. 5. Lung tuberculosis was associated in abaut 20 of skin tuberculosis. 6. Tubercle and tuberculoid structure were noticed in all biopsy specimens ancl in 55% the caseation necrosis was noticed.

A Case of Keratoma hereditaria Mutilans / 대한피부과학회지

A patient with keratoma hereditaria mutians, 20 years old Korean girl, presented the following classic features of this rare disease, palmar and plantar hyperkeratosis beginning early in life, starfishlike keratosis of the dorsa of the hands, hyperkeratotic patches of dorsa of the feet with thickening of the toe nails, keloid-like keratoma of the elbows and knees, and constriction of the all fingers begining in early life and spontaneous amputation of theleft 5th finger. No family history was demonstrated in this patient.

A Case of Follicular mycnosis / 대한피부과학회지

We reported a case of follicular mucinosis which occurred in a 51 year old m;', . He had a firm grouped folliculopapular plaque above left eyebrow with ill-defined border, without any loss of eyebrow. But histopathologic findings showed charac- teristic changes in hair follicles and sebaceous glands with mucinous degeneration and no evidence of suggesting mycosis fungoides. Relatively rapid response to systemic corticosteroid suggested that this therapy had an actual effect.

A Case of Glomus Tumor / 대한피부과학회지

A case of solitary painful glomus tumor occurring in a 36-year-old Korean rnale is reported. This tumor was a slightly elevated, bluish subcutaneous nodule about 1cm. in diameter on the left antecubital fossa. We performed a complete surgical excision of the nodule, which was histopathologically cnnfirmed as a typical solitary glomus tumor.

A Case of Acne Conglobata / 대한피부과학회지

A case of acne conglobata associated with hidradenitis suppurativa, dissecting cellulitis and disseminated superficial actinic porokeratosis in 44 year-old man is presented with brief review of literature. The patient had acne vulgaris for a few years during his highschool days, about 5 years prior to the development of such a typical lesions of acne conglobata as multiple comedones, papules, pustules, abscesses, cysts and draining sinnses and subsquent hypertrophic scars and keloids. We are ps,rticularly interested in association of hidradenitis suppurativa and dissecting cellulitis with ance conglobata that comprise follicular occlusion triad in tbis teint. The pstient was treztei with systemic antibiotics and corticosteroids injections and surgical interventions with considerable improvement.

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.