A Case of Multiple Eccrine Spiradenoma with Zosteriform Distribution / 대한피부과학회지

Eccrine spiradenoma is a benign tumor which probably originats in the coil of the eccrine sweat gland. It usually presents as a solitary, slowly-growing, sometimes painful, reddish-brown, and intradermal or deeply subcutaneous nodule on the head and trunk. More than 97% of eccrine spiradenoma appear as solitary lesions. Occasionally, it may appear as multiple lesions, however they are rarely arranged in a linear or zosteriform distribution. A search of literature revealed only 17 internationally reported cases of linear or zosteriform eccrine spiradenomas, including 4 Korean cases. We herein present an unusual case of eccrine spiradenoma, showing multiple, large nodules with zosteriform distribution.

Clinical Study of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) on Drug Eruption Patients Over the last 10 years (1995-2004) / 대한피부과학회지

BACKGROUND: Drug rash with eosinophilia and systemic symptoms (DRESS), previously named drug `hypersensitivity syndrome', is a subset of severe drug eruption with quite distinct clinical presentations. Perhaps because of its relatively late onset and variable presentations, the diagnosis of DRESS may be delayed. OBJECTIVE: This study was designed to determine the incidence and investigate the causative drugs and clinical characteristics of DRESS. METHOD: We retrospectively reviewed the clinical features and laboratory findings of DRESS in 795 drug eruption patients who had visited Pusan National University Hospital over the last 10 years (1995-2004). RESULTS: 1. Of 795 drug eruption patients, 14 (1.76%) received a diagnosis of DRESS. 2. The average age of onset was 44.5 years and there was no significant difference according to sex. 3. The most common causative agent of DRESS was carbamazepine (50%), followed by allopurinol, captopril, phenytoin and antituberculous medications. 4. DRESS developed 2-10 weeks after administration of the causative agent, and the average latent period was 4.6 weeks.

Reactivity to Autologous Serum Skin Test and Clinical Features in Chronic Idiopathic Urticaria / 대한피부과학회지

BACKGROUND: Although the pathogenesis of chronic idiopathic urticaria (CIU) has not yet been fully elucidated, previous studies have identified functional, histamine-releasing autoantibodies against either alpha subunit of the high affinity IgE receptor (Fc epsilon RI alpha) or IgE in the serum of some patients with CIU. Therefore an autologous serum skin test (ASST) can be used as a predictive clinical test to determine the presence of circulating histamine-releasing factors in the serum of CIU patients, and there are some reports stating that patients with positive ASST tend to have more severe symptoms of urticaria than patients with a negative result. OBJECTIVE: This study was designed to determine the incidence of positive ASST in CIU patients and examine whether there are significant differences in the clinical features and laboratory findings between groups of positive and negative responses to ASST. METHOD: We prospectively performed ASST and laboratory tests on 70 patients with CIU, and also checked clinical features. RESULTS: Intradermal injection of autologous serum or plasma induced a wheal and flare response in 44 out of 70 CIU patients (62.9%). However, no significant difference in the clinical features and laboratory findings, other than angioedema, was noted between ASST-positive and negative groups. CONCLUSION: According to our results, the incidence of positive ASST was high in CIU patients, but ASST is not helpful to predict the severity or clinical course of CIU.

A Case of Carcinoma En Cuirasse of Which Primary Origin is Supposed to be Male Breast Cancer / 대한피부과학회지

Metastases to the skin from internal malignancy is rare condition which range from 0.7 to 9%. Because skin metastases sometimes represent the first sign of malignancy from an unknown primary origin and managing primary carcinoma may be mandated by detection of cutaneous metastases, it is important to recognize the clinical and histopathologic features of the metastatic skin cancer. Male breast cancer is uncommon disorder and cutaneous involvements in male breast cancer show various clinicopathologic types. We report 49-year-old man presented with a diffuse morphea-like induration on neck, chest and upper back which turned out to be carcinoma en cuirasse originating from breast cancer.

The Effect of Repeated Stress on the Modulation of Neuroactive Steroids at the GABAA-Benzodiazepine Receptor Complex in Rats / 신경정신의학

OBJECTIVES: Pregnanolone is a potent positive modulator of the gamma-aminobutyric acid(GABA) response that enhances the binding of [3H]flunitrazepam to the GABA A receptor. Recently, it was reported that chronic treatment with pregnanolone uncouples allosteric interactions between steroid and benzodiazepine recognition sites. The present study was designed to assess the effect of repeated stress on the modulation of neuroactive steroids on the GABA A receptor. METHODS: The effect of steroids on the ligands binding to GABA A receptor was investigated using cerebral cortices of unstressed and repeatedly immobilized rats. Male Sprague-Dawley rats, weighing 200-250g were forced to suffer an immobilization stress for 2 hours. RESULTS: Pregnanolone enhanced the binding of [3H]flunitrazepam to GABA A receptor in both of unstressed and repeatedly stressed rats. However, repeatedly stressed rats showed significantly higher values in EC50 and lower values in E max of enhancement binding of [3H]flunitrazepam than those of unstressed rats. CONCLUSIONS: From these findings, it can be concluded that repeated stress reduced the positive modulation of neuroactive steroid on the GABA A-receptor complex.