My Experiences in Dermatology / 대한피부과학회지

Anti-T cell monoclonal antibodies(OKT series. OKT4a, OKTSA, OKT)1) immunoperoxidase technique study for the presence of T cells in cutaneous lesions from four patients with erythema multiforme showed that most dermal and epidermal lymphoid cells were reactive with monoclonal antibodies to anti-pan T cell (l3KT11) in this semiquantitative assay. In the dermis most of the perivascular lirmphoid infiltrates were reactive with anti-helper/inducer T cell antibody, but in the epidermis and in the derrnopidermal interface the predominant cells were identified as suppressor/cytotoxic T cells. The histologic and immunopathologic changes in erythema multiforme appear to be due in part to cellular immune rnechanisms with the lyrnphocyte as the predominant effector cell. But complex interplays with other humoral immune mechanisms might be in work for the development of erythema multiforme.

Allergic Contact Dermatitis Due to Nail lacquer / 대한피부과학회지

Nail lacquer is a cause of allergic contact dermatitis. Nail lacquer is composed of nitrocellulose(film former), adhesives(also maintain glass), plasticizer, solvent and coloring agent, among these the adhesives-sulfonamide and formaldehyde resin-are the moat common and important antigen. Predilection area of this dermatitis is periungual, face especially upper eye lid, forehead and cheek, and neck. The lesion is usually eczematous, and characteristic lesion is also seen such as mottled, linear or band-like hyperpigmentation and hypopigmentation. Recently allergic contact dermatitis due to nail lacquer is increasing in number, so report with the result of patch test and review of literatures.

Subungual Glomus Tumor: Report of A Case / 대한피부과학회지

One case of subungual glomus tumor was reported which had characteristic clinical manifestations of paroxysmal pain and tenderness for about 20 years. Histopathologically it was confirmed as subungual glomus tumor. This case was treated completely with simple surgics,l excision of the mass.

A Clinical Study of Urticaria / 대한피부과학회지

Urticaria is a common disease and a well known reaction pattern of the skin eharacterized by erythema or wheals and edema, that is the results of a local leakage ef plasma, from minute vessels into the connective tissue of the dermis. Seven hundred and sixty cases of urticaria visited to this department from January 1973 to December 1974 were studied clinically in various ways. Patients were classified as acute and chronic urticaria-acute form when the hives have been present for less than 8 weeks and chronic form when the hives lasted longer. In all patients, a detailed history, a complete physical examination, a total and differential leukocyte count, erythrocyte sedimentation rate and routine stool examination were performed. Foods were incriminated as the exciting causes of urticaria by history, diet elimination test and ingestion test. An ice cube test was done for corroboration of cold allergy. Cholinergic urticaria, was diagnosed by the appearance of small wheals surrounded by erythema after exercise, emotional disturbances or hot drinks. The diagnosis of urticaria due to drug was based on the history of urticaria following the taking of a certain drug. Infection as the inciting cause was determined by history and physical examination. The results: 1. The incidence of urticaria is 4. 6% to total number of dermatologic patients. 2. Among the 760 urticaria patients, acute cases were 498 which were 2 times more than chronic cases, and female patients were 474 cases that revealed marked high incidences than male patients. 3. The age of the patients ranged from 2 months to 87 years, and the patients between 20 and 39 years occupied more than half of the all patients. 4. Abnormal hematologic findings were more marked in acute form; leukocytosis and neutrophilia were dominate in acute form, and lymphocytosis and eosinophilia were more marked in chronic form. 5. Among the etiologic factors, the bacterial infection was the most frequent which occupied 22. 4% of the all urticaria patients. 6. Seven cases of urticaria due to parasites were clonorchis sinensis, in which I had experienced the complete recovery with the treatment of subcutaneous injection of clonorchis sinensis antigen (1: 10,000) 0.01- 0.1ml at the interval of one week. 7. In this study, the inciting or perpetuating causes could not be found in 50.8% of patients-46.2% of acute form and 59.5% of chronic form.

A Study on the Culture of Skin Tuberculosis / 대한피부과학회지

Mycobacteriosis cutis is largely classified to localized forms and exanthematous forms and it is subdivded into five diseases in detail, each. They are 1) primary tuberculous complex, 2) lupus vulgaris, 3) tuberculous verrucosa cutis 4) scrofulo derma, and 5) tuberculosis cutis orificialis in localized ferms and 1) tuberculous miliaris disseminata, 2) lupus miliaris disserninaia faciei, 3) papulonecrotic tuberculid, 4) lichen scrofulosorom and 5) ervthema induratum in exanthematous forms.Rich(1944) insisted on that, the pathogenesis of cutaneous tuberuculosis was essen tially the sarne as that for tuberculosis in general. He said that aII forms of cutaneous tuberculosis were produced by the local action of the bacilus of tuberculosis. In the formerly termed true tuberculosis such as lupus vulgaris, the microorganisrns were found in varing numbers in the lesions, and animal inoculations of tissue were successful, In other forms represented by the tuberculids, the bacillus of tuberculosis was found only in the earilest stages before the true clinical and histological picture had developed, Its short lived existence in this forms was explained by the allergic statc of the tissues and this fact exnlained the failure to find the microorganisms in the lesions, or reproduced the affection by inoculations in animals, in cases sufficiently developed to be recognizable clinically and histologically. The other generally accepted view is that the mycobacteriosis cutis, especially the types in the category of tuberculids are caused by the hematogenous dissemination of tubercle bacilli from a focus, often extrapulmonary in location, into the skin, where they are rapidly destoryed. spiet and Roeckie(1960) agreed with above menitioned plausible theories with the background of their hypothesis, that was the skin was hyperegic, And Miescher(1951) also insisted that, skin had a decreased immunologic resistance. But according to Flegel(1957), if the skin was in a state of hyperegic reaction, the focus from which the dissemination was taking place was also should be in a hyperegic state and vice versa should be right, And moreover, Suizberger(1940) declared that whenever microorganisms or their products were being overcome or neutralized by local lmmunologic reactions, tubercles or tubercles or tuberculoid structures had a tendency to appear. So the theories of different immunologic state between the skin and focus were discarded. After that many authors proposed three factors against a tuberculous etiology of tuberculids. First, inoculation of tissue from lesion into guinea pigs and culturing of such tissue have given no evidence for tuberculosis. Second, active tuberculosis occurs no greater frequency in patients with tuberculids than in the general population. Third, tuberculids does not respond to antituberculous treatment but responds to the adminiatration of corticosteroids. According to Eberhartinger(1963), Schneider and Undeutsch(1965), in erytbema induraturn the primary event is a vasculitis of subcutaneous arteries and veins. And any fat necrosis following vascular damage can develop a tubereuloid appea- rance. Lever(1967) declared with self confidence that it was a relic of the times- when a tuberculoid histology was tantamount to tuberculosis. In this condition we decided to clarify that whether the mycobacteriosis cutis, especially the disease in the category of tuberculids, could be originated from mycobacteria tuberculosis in fact or not. Eleven patients, whose clinical diagnosis were skin tuberculosis or very similar to those diseases such as erythema. nodosum, were biopsied by 5mm puncher after 2% procaine injection on their two of skin lesions, the early one for the culture of tubercle bacilli and the oId one for histopathological study, on the O.P.D. of dermatologic department in Severance Hospital. Those biopsied material of early lesion was digested with proper amount of 4% NaOH and fragmented in tissue grinder about 10 minutes. After that, it was centrifuged in rotating speed of 3,500 r.p.m. for 30minutes, and neutralized by 8% HCl after adding phenol red drop by drop. Again it was centrifuged by same as previous method and its supernatant was discarded. The remnants of precipitin was inoculated on Ogawa's nutrient tuberculous media in incubator at 37C. Finally the acid-fast tubercle bacilli have been grown on the Ogawa's media three months after its first inoculation. The inoculation material was biopsied from the patient of eighteen year-old girl, whose clinical and histopathological diagnosis was erythema induratum. From the result of this study, we got the strong confidence that in spite of many authors powerful countertheories and the extremely poor harvesting of its culture, the erythema induratum can be or in evidently caused from mycobacterium tuberculosis. It may be early days yet to say that erythema induratum is originated fromtubercle bacilli but it is considered to be a truth in Korea, with the result of this study.

Effect if Dexamethasone and Some Drugs on Shope Rabbit Papilloma / 대한피부과학회지

In 1933 Shope described an infectious papilloma of wild cattontail rabbits. Shope rabbit papilloma is a virus-induced epidermal neopIasm indigenous to western cottontail rabbits and readily transmissible to domestic rabbits by inocuiation with an cell-free extract of wild cottontail papilloma. Shope papilloma induced in the domestic rabbits may spoataneously, remain benign, or progress to carcinoma. Kidd et al. (1936) noted that the regression is not correlated with the titer of virus neutralizing antibody. The possibility that papilloma regression is brought about by a mechanism anaIogous to that operating in allograft rejection was suggested by kidd et al. (1938) with the view of the histological resemblance between papilloma regression and rejection of allografted tissue. That regression is mediated by an immune mechanism is strongly indicated by the findings of Evans et al.(1962) that the proportion of rabbits showing regression is substantially increased by vaccination of rabbits with their own papilloma tissue or with papilloma tissue from another rabbits. McMichael (1967) demonstrated that suppression of regression was achieved by use of large doses of corticosteroid. The effect of 5-fluorouracil on human warts was mentioned as being effective by Goldman et al. (1963). In Korea resinous extract from Paulownia coreana has long been used empirically in the treatment of human warts. In this investigation effects of dexamethasone administration on the development and the spontaneous regression of Shope papillomas in domestic rabbits were studied. At the same time, observations were made to evaluate the comparative effectiveness of topical application of 5% 5-fluorouracil ointment and resinous extract from Paulownia coreana on Shope papilloma in the domestic rabbit. The results are summarized as follows: l. Administration of dexamethasone significantly reduced the spontaneous regression of Shope papillomas in domestic rabbits by 12 weeks after virus inoculation. 2. Topical application of 5% 5-fluorouracil ointment on Shope papillomas cured the tumors by 4 weeks of drug application. However, similar treament with resinous extract from Paulownia coreana was without any demonstrable effects. 3. Marked losses of body weights became manifest in dexamethasone treated rabbits. 4. Reinoculation of Shope papilloma virus into 2 rabbits whose papillomas had regressed 3 months ago failed to produce papillomas.

Congenital Ichthyosiform Erthroderma : Bullous type - Report of A case / 대한피부과학회지

Congenital ichthyosiform erythroderma is most severe type of ichthyosis. This disease is characterized clinically by generallized erythroderma covered with flaccid bullae and verruciform scales which are especially prominent on the flexural areas. This disease demonstrates an autosomal dominant mode of inheritance. The distinctive histologic change is the extreme hyperkeratosis associated with granular and vacuolar degeneration of the mid and upper malphigian layers. Cell kinetic studies indicate an increase in the epidermal mitotic turnover tirne. This 8 months old male patient visited to Dermatologic Department of Severance Hospital on April-28, 1973. Seven days after birth the scales were appeared on his flexural region of limbs and shed to leave a raw surface which forms scales anew. And there were the intermittent appearance of flaccid bullae prominantly involve the flexural area of limb but thereafter appearing the other region of body. Skin biopsy shows that of bullous type of congenital ichthyosiform erythroderma. This baby was expired 4 days after the admission day in spite of vigorous systemic and local trea- tments. The autopsy findings had exhibited fatty necrotic degenerative changes of hepatic cells and septic inflammatory changes of meningeal vessels and meninges itself as the causes of death of this pitiful victim.

A Study on the Steroid Acne / 대한피부과학회지

Dermatologic treatment was greatly advanced when topical corticasteroids were introduced for the management of many inflammatory and pruritic dermatoses. Their use reduced or diminished mnst of the undiserable side effects which accompanied the systemic administration of these compounds. The good effects of topical application of hydrocortisone had been demonstration in the treatment of variaus dermatoses eg., atopic dermatitis, seborrheic dermatitis, contact dermatitis etc. The halogenated derivatives followed and led to the trend to most of analogs now in use. Especially, fluocinolone acetonide cream greatly enhanced its therapeutic effectiveness in psoriasis, chronic discoid lupus erythematosus, pustular bacterid, granuloma and neurodermatitis circumscripta. But many side effects of topical corticosteroids such as steroid acne. Stria were developed and also fluorinated topical corticosteroids resulted in telangiectasia, purpura, atrophy in skin. Weber reported that strong topical corticosteroids eg.. Betamethasone valerate and fluocinolone acetonide were resulted in rosacealikc dermatitis and it was steadily increased. These adverse side effcts of topical corticosteroids, especially steroid acne, were indisputable argument in dermatologic field, for the view that this topical corticosterodis is used for cosmetics and treatment of acne vulgaris in our country. Since the strong corticosteroid tnpical preparation, the peculiar form acne, so called steroid acne, was steadily increased in our clinic. Behrman and goodman reported that acneform eruption induced by hormone was not associated with oiliness and there were but few comedone. Sullivan and Zeligman reported that the the acneform eruption due to adrenal corticaa 1 hormone was uniform in size, small papule and few pustule, usualIy erythematous base. There were also differential histologic feature. The most important difference is the normal apperance of sebaceous glands in acneform eruption due to corticosteroids contrast with hyperplasia in acne vulgaris. Abscess formation was more frequent and more extensive in acne vulgaris. Sutton Jr and Van Scott & MacCardle described that histologically, the major component in lesion of steroid acne was excessive keratinization of follicle. Castor and Baker demonstrated that topical application of corticosteroids resulted in decrease of sebaceous gIands, decrease of mitosis and increased cornification in epidermis. The present study investigated clinical case of the steroid acne, which are induced by topical application and systemic administration of corticosteroids and experimentally induced the steroid acne with the topical application of corticosteroid. And also clinical cases and experimentally induced steroid acne were compared with acne vulgaris. Material and method Subjects are 13 Patients of steroid acne induced by strong topical corticosteroid eg., fluocinolone acetonide, fluocortolone, dexamethaone, betamethasone valerate and 4 patients of steroid acne induced by systemic administration of corticosteroid eg., prednisolone and also 10 patients of acne vulgaris. Biopsy was performed from 13 patients of topical steroid acne, 3 patients of steroid acne induced by systemic administration of steroid and one patient of acne vulgaris. In order to induce steroid acne, experimentally, strong topical corticosteroid such as beta methasone valerate, fluocinolone acetonide and fluocortolone were applied on back. Comment and conclusion In Clinical feature, the steroid acne by topical application and systemic administration of corticosteroid and experimentally induced steroid acne had unique clinicall features, that showed absence of comedone and uniform sized follicular papule on deep seated erythematous scaly base. The topical steroid acne was distributed the region where were applied. But the eruption of the steroid acne induced by systemic administration of corticosteroids was distributed to face, neck, and scalp. Above findings are quite different form acne vulgaris. Histopathologically, the steroid acne induced by topical application and systemic administration of corticosterojds showed hypoplasia of sebaceous glands and excessive follicular keratinization. Occlusion of pilosebaceous opening by keratotic plug in severe case by long term application showed atrophy of epidermis and sparsity of sebaceous glands with hypokeratosis and parakeratosis. In experimentally induced steroid acne, it was definitely specific features which were absolutely identcall with above cinical steroid acne.

Incontinentia pigment: Report of Five Cases / 대한피부과학회지

Five cases of incontinentia pigmenti (Bloch-Sulzberge type) were presented and literature were reviewed. They were all girls. 3cases of them were associated with defects of ectodermal or mesodermal development. As the manifestation of those, malformed teeth in 2 cases, delayed dentition in 3 cases, eye problem in 2 cases, and alopecia in 3 cases were noticed. One of 3 cases had eruptions of lichen striatus on her upper extremities. Especially, family history of involvement of maternal relative in one case was noticed. Diagnosis of them were confirmed by characteristic clinical appearance and histopathologic findings.

Vogt-Koyanagi-Harada Sundrome: Report of Eight Cases / 대한피부과학회지

The clinical findings in the Vogt-Koyanagi-Harada syndrome ae reviewed and eight cases reported emphasizing the cutaneaus changes. The syndrome consists of symptoms of poliosis, vitiligo, alopecia, meningeal irritation sign, nontraumatic uveitis, and dysacousia. Meningeal or ocular symptons usually appear first, but in some patients thc cutanious changes have been observed beforc the uveitis. The etiology rernains unsettied, but an allergic mechanism or a virus infection is favaveci by most observers. Early diagnosis is important because ocular mobidity can be reduced significantly in some patients if treated in the early stages. During the course of treatment of our patients, corticosteroid is appeared to be the most effective drug for this uncertain etiologic syndrome and this fact may eventually support. the theory nf autoimmue mechanisn. The daily does of corticosteroid is prednisolone 60mg and the duration of administration is from 15 days to 2 months, after that the dose is graclually decreased in relation with the degree of symptoms. The ophthalrnologic symptoms were markedly improved 10 days after the administvation of prednisolonc. The purpose of this report is to emphasize the cutaneous findings in this syndrome, to point out that the cutaneous manifestations may lead to establishing tne diagnosis and on the basis of that, those patients can be received prompt, suitable treatment to avoid the grave ocular morbidity.

Juvenile DErmatitis Herpetiformis : Bullous Type: Report of a Case / 대한피부과학회지

Dermatitis Herpetiformis rarely in childhood, and certain features of the disease in children differ from its manifestations in adults. Juvenile dermatitis herpetiformis appears not to be the same disease as the typical dermatitis herpetiformis of adults. Juvenile dermatitis herpetiformis has been described as a predomimantly bullous disease, but rarely papulovesicular eruptions. This bullous eruption in children must be considered in the several entities such as bullous pemphigoid and erythema multiforme. Juvenile bullous dermatitis herpetiformis has not responded routinely to sulfapyridine and sulfone therapy. A 15-month-old child whose skin lesions fulfilled clinical, histologic, and therapeutic criteria for Juvenile dermatitis hepetiformis is reported. The skin lesions showed bullous eruptions and also complained of severe itching sensation different from bullous Juvenile dermatitis herpetiformis.

A Case of Scleema Neonatorum / 대한피부과학회지

Sclerema neonatorum is a lesion of degeneration, necrosis or crystallization of adipose tissue of new born, and is classified into two types; the generalized type in which death occurs usually within one week without treatment, and the nodular type which is localized and heals spontaneously. In this report, nodular type was presented. Nut to palm sized indurated plaques on deltoid region, upper back and hip were noted 3 weeks after birth. Histopathologic findings of necrosis of subcutaneous tissue with early granulomatous reaction were showed in biopsy specimen. Literature was briefly reviewed for the discussion of clinical and microscopic findings of this disease.

Malignant Melanoma Developed from Giant Congenital pigmented Nevus: Report of a Case / 대한피부과학회지

A case of malignant melanoma developed from giant congenital pigmented nevus in a seven year old girl was reported. Since the identification of benign juvenile melanoma, the distinct rarity of true cutaneous malignant melanoma in infants and children has become generally recognized. In giant congenital pigmented nevus, the malignant melanoma as a rule arises deep in the dermis. In this case, the histopathologic finding shows no junctional activity in epidermodermal juction other than ordinary nevocellular nevi, but some nevus cell nests and mild inflammatary cell infiltration in the upper dermis. And in the deep dermis, well marginated but not encapsuIated huge tumor mass, in which variable sized, pleomorphic, several vigorous mitotic figures in predominantly cuboidal cells and bizarre giant cells, which was thought to be developed from giant congenital pigmented nevus. The few recorded cases of fatal cutaneous malignant melanoma in early life are of two types: those arising in giant congenital pigmented nevi and ordinary small nevi, de novo including small nevus. The former account for between 22% and 40% of the total. This case is one of the reported 20 cases in the world.

Treatment of Erythroplasia of Queyrat with Topical 5-Fluorouracil Cream / 대한피부과학회지

Erythroplasia of Queyrat is a precancerous lesion, usually located to glans penis or prepuce. It is characterized by a slowly developing, circumscribed, usually velvety and shiny patch. The etiology was unknown, but it is extremely rare in those circumcised in early infancy. It had been suggested that phimosis had some etiologic importance. The typical case of Erythroplasia of Queyrat is presented. A 46 year old man had 4 months history of dark-brownish pea sized maculopapular rashes on sulcus of glans penis and prepuce associated with mild itching, which was increased in number day by day. He had a phimosis. On examination, there are sharply defined, slightly elevated, pea sized dark-brownish maculopapular rashes over erythematous infiltrated base on sulcus of glans penis and prepuce, which have moist and velvety appearance. A biopsy was performed from sulcus of glans penis. Histopathologically, there was acanthosis, with in epidermis many cells are vacuolated and showed individual cell keratiinization. Epithelial cell showed marked atypia, variation in nuclear size and there was intercellular, intracellular edema. The lesion was treaterd with topical application of 5% 5-fluorouracil twice daily 2 weeks and thereafter for 4 weeks. 2 months after treatment, no erythroplastic lesion was found and 3 months after treatment, rebiopsy was perforrned which showed marked improvement histopathologically.

Mycosis Fungoides Originating from Nose: Report of A Case / 대한피부과학회지

The case of a 30 year old man is described, in whom mycosis Fungoides was originating from nose and followed by tumor stage of Mycosis Fungoides on skin. In January 1970, the patient leveloped nasal tumor, when he was n at E.N.T. department of Severance Hospital. At that time a biopsy of nasal tumor demonstrated only a non-specific inflammatory cell infiltrated mass. He received radiation therapy (Co 60) with satisfadory suppression of mass and resulted in right nasal septal deviation. Jn December 1970, thumb sized painful non-tender, movable mass developed on right supraclaviular area. In August 1971, thumb sized painful, tender, movable mass appeared at right posterolateral aspect of neck, which was excied and removed at local clinic. But excised wound was not healed and the mass was enlarged. One month after above lesion, pea sized same mass developed. On physical examination, there were 4*5cm round, erythematous, painful, tender, granulomatous ulceration mass on right postero-lateral aspect of neck and also same mass on postero-inferior site of above lesion. Two times of biopsy was done and it interpreted as tumor stage of Mycosis Fungoids. Treatment included radiation therapy with Co 60 (200r/day, total 6,000r), prednisolone 40mg/day and antibiotics. There has been good response 1 month after radiation therapy and mass is diminished in size and would begin to heal.

Disseminated Superficial Acrinic porokeratosis ( DSAP ): Report of Nine Cases / 대한피부과학회지

This clinical study of nine patients presented Disseminated Superficial Actinic Porokeratosis (DSAP) as a distinctive and recognizable entity characterized by multiple uniformly small, irregular marginated, keratotic plug with atrophic center developing during second or third decade of life on sun exposed area of skin. Six of nine patients had DSAP, which was inherited as autosomal dominant trait. The patient's father, two brothers and two sisters were known to have same skin lesions. Of nine patients, five were female and four were male. Eight patients were developed DSAP lesions during second decade of life and other one was third dcade of life. Three patients had pruritus. In alI patients, lesions were developed bilaterally over sun exposed area but was not always symmetrical. The number of lesion was multiple in all patients. The greatest number of lesions were found on distal part of extremities, neck, face, upper portion of anterior chest and back.

A Case of Mucoepidermoid Carcinoma of Parotid Gland Origin / 대한피부과학회지

Mucoepidermoid earcinoma occurred in about 2% among salivary gland tumor and in about 15% among malignant parotid gland tumor. The tumor occurred usually in elderly persons and arose as innocent-appearing swelling in the parotid gland region with gradual painless enlargement without alarming and it's usual size is less than 2 cm, However, a few of the poorly differentiated neoplasms grew rapidly and were painful and accompanied by facial nerve paralysis in about 15%. But it's prognosis is better than other salivary gland origin. We report a case of typical mucoepidermoid carcinoma of parotid gland origin which is occurred in 15 years old girl. The tumor begins pea sized painless nodule since about 2 years ago, and enlarged gradually to apple size and accompanied by facial nerve paralysis and pain sensation recently. But there was no evidence of tumor in parotid gland itself and no metastasis.

Solitary Trichopeithelioma Treated by 5-Fluorouracil Ointment Application / 대한피부과학회지

Trichoepithelioma, a tumor of the hair follicle, is usually seen as multiple lesions, but occasionally appears as a single tumor. Multiple trichoepithelioma is a dominant hereditary skin conditions whereas solitary trichoepithelioma is not hereditary and is growing tumor, usually seen in adults. A case of 56 year old housewife with solitary trichoepithelioma was reported. The skin lesion appeased as a firm, skin colored papule and the size was 0.5cm in diameter on right side of nose. Shaving biopsy was done and showed a high degree of differentiation toward hair structure and horn cyst that the keratinization is abrupt and complete. The methood of treatment is a surgical excision and electrodesiccation but remain a scar due to surgical trauma. And so, we used a 5-fluorouracil ointment instead of surgical excision and electrodesiccation, The skin lesion on nose was cured completely as a result of 5-FU ointment application without any scar formation cosmetically.

A Case of the Secondary Localized Cutaneous Amyloidosis due to Atopic Dermatitis / 대한피부과학회지

Secondary localized amyloidosis of the skin is occasionaly associated with keratoma, epithelioma, seborrheic keratosis, chronic dermatitis, etc. It was generally known that amyloidosis, especially lichen amyloidosis, is frequently seen in atopic disorders. But the exact mechanism and relationship of atopic disorders to the development of the amyloidosis is obscure still nowadays. This 72 years old male patient was suffered from itching sensation on the whole body which is suggested to be atopic dermatitis since about 35 years ago and pruritic lichenoicl papulonodular eruptions developed on the extensor surface of the lower extremity first since about 10 years ago and then occured gradually on the thigh and extensor surface of the arm and forearm in both side. The charateristic lesions seems to be lichen amyloidosis. But we suggest thc case is secondary localized amyloidosis of the skin probably due to atopic dermatitis in according to past history, physical examination and eosinophilia without other definitive diseases, The therapeutic results were not promissing, however itching and lichenoid papules were much disappeared during the treatment with steroid cream for occlusivc dressing therapy and oral use of steroid.

A Case of Lymphangioma Circumscriptum / 대한피부과학회지

Lymphangioma circumscriptum is a rare disease and the lesions are indistinguishable, clinically and histologically, from lymphangiectasis. The only difference is that lymphangiectasis is usually bilateral and develops in adult or late life, ie, condary to irradiation, surgical interruption, or some malignancies, but lymphangioma circumscriptum is congenital disease or develops soon after birth.