ABSTRACT
BACKGROUND: It has been reported that the phototherapy with blue light (415 nm) or a mixed blue and red light (415 nm and 660 nm) is effective in the treatment of acne vulgaris. however, the effects of red light on acne vulgaris have not been investigated. OBJECT: To examine the effects of red light (680 nm) on patients with moderate acne vulgaris. METHODS: Patients treated their skin by themselves, using portable light source (680 nm), and irradiation was performed for 7 minute twice daily. Each patient was evaluated every 2 weeks with Burton scale and the numbers of papules and pustules. After 6 weeks, the degrees of satisfaction of patients and physicians were assessed. RESULT: Therapy with red light significantly decreased the numbers of papules and pustules (p<0.01). The numbers of satisfied patients and physicians at the end of treatment were 59 (83.1%) and 56 (78.9%) respectively. Side effect was not reported, except only one patient complained of headache. CONCLUSION: Phototherapy with red light (680 nm) was effective and safe treatment for patients with acne vulgaris.
Subject(s)
Humans , Acne Vulgaris , Headache , Phototherapy , SkinABSTRACT
We herein report a case of mastocytosis with unusual cutaneous manifestations resembling pseudoxanthoma elasticum or xanthoma which were exaggerated on the intertriginous areas including axillae, groin and neck in a 39-year-old woman. It was characterized by multiple yellowish papules and plaques with a cobblestone appearance. In addition, there were diffuse red-dish macules and papules of varying sizes mainly on the trunk and extremities. Histopathologic findings showed a very dense infiltrate of large numbers of round to oval cells in the upper and mid dermis. These cells revealed metachromasia on the toluidine blue stain. She also had hepatosplenomegaly and some evidence of bone marrow involvement. There was significant improvement in,the skin lesions with psoralen plus ultraviolet A(PUVA) therapy and potent topical corticosteroid.
Subject(s)
Adult , Female , Humans , Axilla , Bone Marrow , Dermis , Extremities , Ficusin , Groin , Mastocytosis , Neck , Pseudoxanthoma Elasticum , PUVA Therapy , Skin , Tolonium Chloride , XanthomatosisABSTRACT
BACKGROUND: The human keratinocyte can synthesize interleukin 6 (IL-6) under certain conditions, and the IL-6 synthesis is inhibited by interleukin 4 (IL-4) in the human monocyte. OBJECTIVE: To find out what kind of stimulating agents can induce the IL-6 production and whether IL-4 affects the production of IL-6 in the human cultured keratinocytes. METHODS: We stimulated the keratinocytes with either lipopolysaccharide (LPS), fetal bovine serum (FBS), human recombinant interferon-gamma(IFN-gamma) to induce the IL-6 production, and treated the keratinocytes, which stimulated either with 10% FBS or human recombinant IFN-gamma, with human recombinant IL-4. RESULTS: The LPS stimulation resulted in no increase of IL-6 levels in the keratinocyte supernatants. When the keratinocytes were stimulated either with 1%, 5%, 10% FBS with or without 5 microgram/ml LPS, significantly increased amounts of IL-6 were detected. The level of IL-6 in the keratinocytes treated with the human recombinant IFN-gamma increased, too. The human recombinant IL-4 downregulates the secretion of IL-6 by the keratinocytes which were activated either with 10% FBS or human recombinant IFN-gamma. CONCLUSION: We have shown that it is possible to induce the IL-6 synthesis by stimulating the keratinocytes and that human recombinant IL-4 profoundly inhibits the synthesis of IL-6. So we suggest that there may be a cytokine network which regulates the primary immune response in the skin.
Subject(s)
Humans , Interleukin-4 , Interleukin-6 , Interleukins , Keratinocytes , Monocytes , SkinABSTRACT
We report herein a case of lymphomatoid papulosis showing atypical clinical manifestations. A 54- year-old man had had recurrent erythematous necrotic papules and nodues, numbering more than 200 lesions at the most aggravated time, on the trunk, extremities, buttok, and face for the last twenty years. Recently, he complained of tender swelling on the neck, axillae, and inguinal lymph nodes accompanied by mild fever and gerneral weakness. We had performed thorough examinations including biopsy from the skin lesions, lymph node, and bone marrow to detect some evidences of transforming to malignant lymphoma, but found no evidence of malignant lymphoma except aneuploidy on DNA histogram. The patients showed proinpt response to methotrexate 10-30mg par week wit,hout showing distinct side reactions to the accurvulated dose of 780mg for the last 16 months.
Subject(s)
Humans , Aneuploidy , Axilla , Biopsy , Bone Marrow , DNA , Extremities , Fever , Lymph Nodes , Lymphoma , Lymphomatoid Papulosis , Methotrexate , Neck , SkinABSTRACT
BACKGROUND: It is well-known that the giant congenital nevi prcgress to malignant, melanama more frequently than other benign melanocytic nevi but to date the laor tory methods for early detection of such progression were not avsilable. The proliferating cell uncleai antigen(PCNA) staining has been regsrded as an useful marker in determining prognosis of some maignant diseases. OBJECTIVE: The PCNA taining was performed as a predictive value of malignant transformation from benign meanocytic skin lesions. We investigated the differcnces between malignant melanoma and the benign lesions. MATERIAL AND METHODS: Immunohistochemical study was employee using anti-PCNA, anti-S-100, and anti-CD45RO antibody in 6 giant congenital nevi, 8 small and medium sized congenital nevi, 10 acquired nevi, and 10 malignant meanomas. Only cells positive for both PCNA and S-100, and negative for CD45RO on the serial sections were identified as melanocyts. RESULTS: The number of PCNA-posit,ive cells per 1000 melanocy,es averaged 6.0+7.5 in giant, congenital nevi, 2.9+1,9 in small and medium sized congenital novi, 3.1+2.7 in acquired nevi, and 61.5+ 39.4 in malignant, melanomas. Malignant melanomas showed onger intensity of PCNA staining than the other melanocytir nevi. CONCLUSION: There was not significant difference of the numter of PCNA-positive cells among the groups of congenital neviind PCNA staining can't be used in prditive measure of malignant. progression and studying mechansm of malignancy in giant congenital nevi. But, PCNA staining is considered as an useful method in differentiat,ing malignant melanoma from mllanocytic nevi.
Subject(s)
Melanoma , Nevus , Nevus, Pigmented , Prognosis , Proliferating Cell Nuclear Antigen , SkinABSTRACT
We report a case of sarcoidosis which developed in the skin, lung and eyes in a 50-year-old woman. The skin lesions showed two types of cutaneous manifestations which were subcutaneous nodules on her back and erytrematous papules on the face for several months. Our patient's seurm angiotensin converting enzyme (ACE) level was elevated at 33.5 IU/L(reference range, 8.3-21.4 IU/L) and the purified protein derivative(PPD) skin test had a negative result. On her roentgenographic examinations, we could find multiple nodular densities with hazziness on both her lungs and radionuclides(Gallium 67) uptakes in right lower lung field. The ratio of helper to suppressor T cells was 9 in bronchial lavage. Diagnosis of sarcoidosis was made on the basis of histologic findings of non-caseating granulomas from skin and lung tissue. Treatment was initiated with oral alternate-day prednisone 40mg. The cutaneous lesions and dyspnea improved in 2 and 4 weeks respectively, and serum ACE level returned to normal in 2 months.
Subject(s)
Female , Humans , Middle Aged , Bronchoalveolar Lavage , Diagnosis , Dyspnea , Granuloma , Lung , Peptidyl-Dipeptidase A , Prednisone , Sarcoidosis , Skin , Skin Tests , T-LymphocytesABSTRACT
We report a case of plexiform neurofibroma developed under the overlying speckled lentiginous nevus, which occurred in a 20 year-old man. In this patient and his family no other signs of von Recklinghausens disease were found. Discussion is focussed on the fact that both plexiform neurofibroma and speckled lentigmous nevus, which represent a defect in the neural crest, occurred in the same area of the skin.
Subject(s)
Humans , Neural Crest , Neurofibroma, Plexiform , Neurofibromatosis 1 , Nevus , SkinABSTRACT
We present two very interesting cases of acute graft-versus-host disease (GVHD), whose skin rashes initially appeared on the localized area of total nodal irradiation (TNI) performed previously to prevent graft rejection and/or GVHD. The histopathologic findings showed some dyskeratotic cells in the epidermis and perivascular mononuclear cell infiltration in the upper dermis. The immunohistochemical studies revealed that HLA-DR was diffusely strongly positive in a number of keratinocytes, whereas both CD4 and CD8 were focally weakly positive in the perivascular lymphocytes in the upper dermis. Later on, liver dysfunction and diarrhea developed and skin rashes began to spread over the other parts of the body in those two patients.
Subject(s)
Humans , Dermis , Diarrhea , Epidermis , Exanthema , Graft Rejection , Graft vs Host Disease , HLA-DR Antigens , Keratinocytes , Liver Diseases , Lymphocytes , SkinABSTRACT
A 54-year-old woman with severe bullous pemphigoid (BP) associated with insulin dependent diabetes mellitus (DM), who showed unresponsiveness to conventional therapy with corticosteroids in combination of either cyclosporme or dapsone, was successfully treated with plasmapheresis followed each time by 3 successive days of pulse therapy of cyclophosphamide (500mg, intravenously). After six times of plasmapheresis, anti-basement membrane zone (BMZ) antibody titer decreased from 1:1280 to 1:40 and no new lesions developed at all. In severe refractory BP patients with uncontrolled DM, plasmapheresis is one of the valuable treatment modalities for a short period and the need for corticosteroids thus avoiding corticosteroid induced side effects. Herein we report a case of BP with uncontrolled DM who showed an excellent response to a low dose of corticosteroid and 150 mg oral azathioprine following plasmapheresis and cyclophosphamide pulse therapy.
Subject(s)
Female , Humans , Middle Aged , Adrenal Cortex Hormones , Azathioprine , Cyclophosphamide , Dapsone , Diabetes Mellitus , Insulin , Membranes , Pemphigoid, Bullous , PlasmapheresisABSTRACT
We report a case of secondary anetoderma due to pilomatricoma. A 15-year-old girl presented with a soft, 1.5 × 1.5cm in size, atrophic, pinkish and bulged-out lesion overlying the palpable subcutaneous mass on the left upper arm for several months. Histologic examination revealed the reduced number of dermal elastic fibers overlying a typical pilomatricoma.
Subject(s)
Adolescent , Female , Humans , Anetoderma , Arm , Elastic Tissue , PilomatrixomaABSTRACT
We report a case of secondary anetoderma due to pilomatricoma. A 15-year-old girl presented with a soft, 1.5 × 1.5cm in size, atrophic, pinkish and bulged-out lesion overlying the palpable subcutaneous mass on the left upper arm for several months. Histologic examination revealed the reduced number of dermal elastic fibers overlying a typical pilomatricoma.
Subject(s)
Adolescent , Female , Humans , Anetoderma , Arm , Elastic Tissue , PilomatrixomaABSTRACT
Two patients with cutaneous leishmaniasis were treated with itraconazole. One patient was a 24-year-old man who had several erythematous papulonodules on the extremities for 1 month, which revealed cutaneous leishmaniasis, histopathologically. He was treated with itraconazole (200 mg/day) for 2 months. After treatment he showed clinical healing and the biopsy specimens no longer showed leishmania organisms. The other patient was a 27-year-old female who had several erythematous papulonodules on the face and neck for 3 months. The skin lesions revealed leishmania organisms in the tissue sections and culture media. She was also treated with itraconazole (200 mg/day) for 2 months. After treatment she also showed satisfying clinical healing and the biopsy specimens revealed no leishmania organisms. No specific side effects were encountered in both patients during the treatment. From these results, itraconazole is considered to be one of the promising anti-leishmanial drugs.
Subject(s)
Adult , Female , Humans , Young Adult , Biopsy , Culture Media , Extremities , Itraconazole , Leishmania , Leishmaniasis, Cutaneous , Neck , SkinABSTRACT
This study was carried out to reveal the epidemiologic characteristics of psoriasis in Korea. Seventeen university hospitals were engaged in this study, and the results were as follows : 1. The number of psoriasis patients during the 10 years from January 1977 to March 1987 was 1.05% of all the outpatients; the male to female-ratio was 1.08:1. 2. In the prospective study, the number of psoriasis patients was 2.3% of all the outpatients in 1987, 2.8% of all the outpatients in 1988 and the male to female ratio was 1.26:1. 3. The most prevalent age of onset was 20-29 years ; 81.1% were living in urban areas; and a family history was obtainable in 19.8% with parents holding the highest rank of 7.8%. 4. The most frequent duration of disease activity was under 5 years in 63.3%; the most common age for the worst condition was 20-29 yrs. The most common area size of skin involvement at the peak of the worst condition was less than 10%. 5. The most common initiating skin lesion began on the scalp in 20.2%, on the nail in 17.2%, pruritus in 63.0% with joint symptoms in 10.8%, and Koebner phenomena in 50.6%. 6. Emotional stress was the most common aggravating factor in 34.4%. The method of treatment that attained the best result was the combination therapy of oral medication and a topical agent. The best treatment modality was said to be the application of ointment with p.o.medication by as many as 28.4% of patients who took the leading rank. Photo-chemotherapy, effective with few complications, was not used much as it was not well-known in Korea until after 1980. Most people had an accurate knowledge of psoriasis.
Subject(s)
Female , Humans , Male , Age of Onset , Epidemiologic Studies , Epidemiology , Hospitals, University , Joints , Korea , Methods , Outpatients , Parents , Prospective Studies , Pruritus , Psoriasis , Scalp , Skin , Stress, PsychologicalABSTRACT
Parakeratosis pustulrisa occurs most often on the upper cxtiemities of girls and that is considered to be a variant of either eczema or psoriasis. It presents with scaling of the tip of the finger, subungual hyperkeratosis, and irregular t.hickening and rumblirg of the distal nail plate. We report a 4-year-old female child patient, who showed spon.aneous nail extraction with erythematous scaly path with pustule formation on the left thumb, ring finger and right middle finger nails. The microbiologic and mycologic examinaiors revealed negative results. Histopathologic examination showed focal parakeratosis of the nail bed and the lower part of the nail plate. We treated her with etretinate(Tigason, 0.6mg/kg/day).
Subject(s)
Child , Child, Preschool , Female , Humans , Eczema , Etretinate , Fingers , Parakeratosis , Psoriasis , ThumbABSTRACT
We report herein a case of smooth muscle hamartoma associated with Beckers nevus in a 5-year-old female. The child presented with a slight.ly brownish. 2 x 3 cm sized, pigmentecl patch with follicular accentuation on the right forearm, witch had been observecl since age of 2. Histopathologic findings showed the epidermal changes most consistent with Becker's nevus and the presence of irregularly arranged hyperplastic smooth muscle hundless in the dermis.
Subject(s)
Child , Child, Preschool , Female , Humans , Dermis , Forearm , Hamartoma , Muscle, Smooth , NevusABSTRACT
A 17-year-old male was presented withfpruritic grouped erythematous papules on the face, chest, upper back, both axillae, and genital area. The histologic picture of a benign papilloma and spongiosis around the acrosyringium were prominent findings. The term acrosyringeal epidermal nevus is proposed for this histological picture, and some explanations for its pathogenesis are suggested.
Subject(s)
Adolescent , Humans , Male , Axilla , Nevus , Papilloma , ThoraxABSTRACT
Phakomatosis pigmentovascularis is characterized by the coexistence of pigmentary and vascular nevi, which are occasionally associated with systemic organ involvement. We report a 12-year-old male, who showed bilateral nevus of Ota on the forehead, periorbital area, sclera and soft palate, nevus of Ito on the scapular area, mongolian spot on the sacral area and widespread nevus flammeus. He was also associated with congenital temporal alopecia on the lower portion of left temporal region since birth.
Subject(s)
Child , Humans , Male , Alopecia , Forehead , Mongolian Spot , Neurocutaneous Syndromes , Nevus , Nevus of Ota , Palate, Soft , Parturition , Port-Wine Stain , ScleraABSTRACT
We report two cases of extramammary Paget's disease associated with ad enocarcinoma with metascases. Histologically, Iaget cells in the epidermis and the hair follicles and adenocarcinoma in the der mis was observed in both cases. Of special interest was the demonstration of Eaget cells extending from the involved epidermis to the underlying dermis in case 2, There were metastatic lesioris of 3rd lumbar vertebra in case 1 and of the liver and lymph nodes in rase 2.