A Histopathologic Study of Pilosebaceous Changes in Psoriatic Lesion of the Scalp / 대한피부과학회지

BACKGROUND: Although there have been many studies on psoriasis, only a few studies have been conducted on pilosebaceous changes and even those results are controversial. While a few studies have been conducted on the morphological changes of the pilosebaceous unit in scalp psoriasis, comparative studies on the morphometric changes of pilosebaceous structures with a normal control group have not been conducted. OBJECTIVE: The purpose of this study is to elucidate the morphological change of the pilosebaecous unit in scalp psoriasis. METHODS: We conducted a comparative study an the morphometric changes of the pilosebaceous structure in 10 cases of scalp psoriasis with a normal control group. Results : The results of this study are summarized as follows : 1. Total hair counts, telogen hair counts, telogen hair counts, and the sizes of hairs and follicles in the lesional scalp showed no statistically significant increase than in the normal control. 2. The intrafollicular hyperkeratosis in infundibulum and sebaceous atrophy were more proininet in the lesional area than in the normal control area. These findings were also significantly prominent in the uninvolved normal-appearing area than in the normal control area. 3. Perifollicular inflammation, squamous metaplasia of the sebaceous gland and telangiectasia in the lesional and uninvolved areas were prominent, and these findings were not found in the normal control areas. Conclusion : The sebaceous atrophy and squamous metaplasia are very important findings of morphologic changes in psoriasis, and this paradoxical change may be an important clue to clarify the pathogenesis of psoriasis.

A Comparative Study for Diagnosing Onychomycosis Using KOH Smear, Fungal Culture, KONCPA and Fungi-Fluor(R) Stain / 대한의진균학회지

BACKGROUND: Onychomycosis is common nail problem and requires administration of antifungal agent for long period. But several cutaneous diseases can produce similar nail changes and an inexpensive, quick and sensitive test is essential for screening nail specimens. Recently, there have been several reports of new method for diagnosing onychomycosis and fungi-Fluor(R)stain, which had been used to detect fungal elements in the tissue, was not used for diagnosing onychomycosis. OBJECTIVE: This study was undertaken to evaluate the usefulness of the new method using Fungi-Fluor(R)solution for the diagnosis of onychomycosis, and compare with other methods. METHODS: During the study period, nail samples obtained from 72 patients with onychomycosis were tested for Fungi-Fluor(R)solution and the results of that were compared with those of KOH smear, fungal culture and KONCPA test. RESULTS: The results of this study are summarized as follows: 1. The positive rates of conventional KOH nail scraping preparation, fungal culture, KONCPA and Fungi-Fluor(R)staining were 47.2%,40.3%, 77.8%, and 86.1%, respectively. 2. Fungi-Fluor(R)staining proved to be less time-consuming than KONCPA test. 3. Compared to KONCPA and Fungi-Fluor(R)staining, KOH preparation and fungal culture showed high false positive rate. 4. Though both KONCPA and Fungi-Fluor(R)staining showed higher positive rate in toenail than fingernail, there were no statistic significance. CONCLUSION: The Fungi-Fluor(R)solution staining is rapid, inexpensive, and highly sensitive method to detect fungal elements in the nails.

A Case of Multiple Agminated Spitz Nevi Showing Desmoplastic Changes

We report a case of multiple agminated Spitz nevi in a 16-year-old boy who presented with multiple nodules on the right side of his face. His past history revealed that there had been erythematous and brown colored papules on the same site at the age of four. At that time one lesion was excised and histopathological findings showed fairly well circumscribed spindle and epithelioid cell nests consistent with a Spitz nevus. Twelve years later, he presented with multiple agminated brown to black colored nodules on the face. Microscopic evaluation revealed nevus cells diffusely distributed throughout the dermis showing no or little junctional activity. In addition, these cells were embedded in a strikingly desmoplastic stroma which consisted of acellular collagen fiber. Immunohistochemical staining for S-100 protein was positive. To our knowledge this is the first report of multiple agminated Spitz nevi in Korea.

A Study on the Diagnostic Value of Fungi-Fluor(R) Solution Staining in the Superficial and Deep Mycoses / 대한피부과학회지

BACKGROUND: Mycoses of deep tissues requir e prompt recognition and early institution of treatment. Sometimes, it is quite difficult to find fungal elements in tissue section with special stains and to culture on Sabouraud media. Previously it has been shown that Fungi-Fluor(R) solution (calcofluor white) bind t fungi present in frozen and paraffin tissue sections. Fungi present in such specimens stained with Fungi-Fluor(R) solution have a distinct green-blue fluorescence when examined by fluorescent microscopy. OBJECTIVE: The purpose of this study is to evaluate the diagnostic value of the Fungi-Fluor(R) solution for detecting fungal element in the tissue. METHODS: Fungi-Fluor(R) staining was done with a paraffin-embedded tissue section of several superficial and cutaneous deep mycoses. Then we viewed this through a fluorescent microscope with excitation of 250-400 nm and compared these staining results to PAS staining. RESULTS: The results of this study are summarized as follows : 1. In the several superficial mycoses such as tinea corporis & tinea capitis, Fungi-Fluor(R) staining method revealed more fungal elements with high sensitivity compared to PAS stain. 2. In the several cutaneous deep mycoses such as sporotrichosis, Fungi-Fluor(R) staining method revealed more fungal elements than PAS stain, and revealed some fungal elements which were not detected by PAS stain. CONCLUSION: The Fungi-fluor staining solution is a rapid, inexpensive, highly sensitive method to detect fungal element in the tissue.

A Study on the Changes of Clinical Findings in Sporotrichosis for Recent 30 Years / 대한의진균학회지

BACKGROUND: The clinical types of sporotrichosis are generally classified into four groups: lymphocutaneous, fixed cutaneous, and cutaneous disseminated, and hematogenous. Of these, the lymphocutaneous variety is the most frequently encountered pattern, constituting 80% of sporotrichosis patients and the fixed cutaneous sporotrichosis is the next Potassium iodide (KI) was the most commonly used drug for the treatment of sporotrichosis. Many studies about these clinical findings of sporotrichosis have been reported, but comparative study on the changes in clinical findings has not been reported. OBJECTIVE: The purpose of this study is to clarify the changes of the clinical findings in sporotrichosis in Korea. METHODS: A total of 58 patients with sporotrichosis who had visited the Department of Dermatology, Pusan National University were divided into 2 groups according to the period and then the clinical findings of sporotrichosis were compared. RESULTS: The results of study are summarized as follows: 1. During this period, there were 58 cases of sporot.ichosis. In the past period (1967~1979) there were 35 cases of sporot.ichosis, and there were 23 cases in the recent period (1980 ~1997). 2. In the past period, most cases (71.4%) were lymphocutaneous type, however in the recent period, most cases (69.2%) were fixed cutaneous type. 3. The most commonly affected site was right upper extremity in the past period, but face & right upper extremity were the most commonly affected sites in the recent period. 4. In the past period, 2nd and 3rd decades were prevalent age group, but 5th to 7th decades were prevalent age group in the recent period. 5. In the treatment of sporotrichosis, potassium iodide (KI) was the choice of treatment in the past period, however itraconazole is gradually used in the recent period. CONCLUSION: According to this study, many changes in clinical findings of sporotrichosis were noted, especially in the clinical type. We found that conical type of sporotrichosis changed from lymphocutaneous type to the fixed cutaneous type with time. And we suggest that further observation would be necessary to define the meaning of these changes.