The Change of Bacillary Index during WHO Standard Multi-drug Therapy in Multi-bacillary Leprosy: Among the patients in The National Sorokdo Hospital / 대한피부과학회지

BACKGROUND: There were no effective methods to monitor the treatment of leprosy. Anti-PGL-1 ELISA test and polymerase chain reaction(PCR) were used for monitoring the treatment, however many restrictions have been found to apply to those methods in the field. Bacillary index(BI) is a popular and not an expensive method. For this reason, the exact data to assess the efficacy of the standard multi-drug therapy(MDT) with BI is required for evaluation of the treatment in Korea. OBJECTIVE: The purpose of this study was to clarify the change of bacillary index during MDT in multi-bacillary leprosy(MB) cases. METHODS: A total of 72 patients in the National Sorokdo Hospital were included in this study. With the retrospective method, BI, type of leprosy, relapse, age, and duration of treatment were evaluated. RESULTS: The results were as follows; 1.In this study, the mean duration of BI changing from 6 to 5 was 5.7 months, from 5 to 4 was 6.6 months, from 4 to 3 was 13.1 months, from 3 to 2 was 13.8 months, from 2 to 1 was 12.4 months, from 1 to 0 was 29.4 months. 2.The time of initial change of BI after MDT were as follows: within 3 months(26.4%), 4-6 months(29.2%), 7-12 months(26.4%), 13-18 months(8.3%), 19-24 months(4.2%), 25-48 months(5.5%). The mean duration was 8.9 months. 3.The mean cumulative time of BI to 0 was 68.4 months CONCLUSION: These results suggest that after MDT, in most of MB, BI decreased within one year and it took 68.4 months for BI to be 0. At first, BI decreased relatively fast, however a longer period was required to become a state of BI 0.

A Case of Dyskeratosis Congenita

Dyskeratosis congenita is a rare genodermatosis of ectodermal dysplasia, which is characterized by the diagnostic triad consisting of reticulated hyperpigmentation, dystrophic nails, and leukoplakia. There is a predisposition to malignancy, particularly at sites of leukoplakia. Bone marrow failure can occur in about a half of the cases. A 16-year-old boy was presented with asymptomatic reticulated pigmentation of the neck and nail dystrophy. The patient also had leukoplakia on the tongue, nasolacrimal duct obstruction and cataract. The histopathological findings taken from the reticulated lesion were consistent with poikiloderma atrophicans vasculare. These clinical and histopathological findings were typical features of dyskeratosis congenita.

Subepidermal Calcified Nodule of the Buttock

Subepidermal calcified nodule, a form of idiopathic calcinosis cutis, typically present as a hard, 3 to 11 mm, solitary lesion on the exposed area of the head and the extremities. Here we re-port an unusual case of subepidermal calcified nodule occurring on the buttock. A 15-year-old girl presented with a 6-month history of a 12 × 6 mm, oval, hard, erythematous nodule on the right buttock. Histopathologic examination of an excision biopsy specimen revealed extensive deposition of calcium in the whole dermis as large multilobulated masses.

Two Cases of Invasive Carcinomas Arising from Bowen's Disease / 대한피부과학회지

Bowen's disease is a premalignant condition, which may evolve into invasive carcinoma. Most invasive carcinomas arising from Bowen's disease show squamous differentiation, but rarely basaloid, pilar, pilosebaceous or sebaceous differentiation. We herein describe two cases of invasive carcinoma arising from Bowen's disease. First case, a 78-year-old male, presented with an erythematous plaque with ulcerated and fungating changes on his back. Biopsy specimen revealed Bowen's disease transformed into invasive squamous cell carcinoma. Second one, a 67-year-old male who had been diagnosed histologically as Bowen's disease on the right inguinal area 5 months ago, complained of enlargement and infiltration of the previous lesion. Biopsy specimen showed invasive carcinomatous change of basosquamous differentiation. Our cases represent unusual invasive changes of Bowen's disease into squamous cell carcinoma and carcinoma of basosquamous differentiation.

Two Cases of Infantile Eosinophilic Pustular Folliculitis / 대한피부과학회지

Eosinophilic pustular folliculitis(EPF) is a rare inflammatory follicular disorder of unknown etiology. EPF is characterized by recurrent clusters of pruritic, follicular, sterile papules and pustules on the seborrheic area of young men. Compared with classical adult type, infantile EPF reveals the distinctive clinical features, such as constant involvement of the scalp, self-healing recurrent crops, and the possibility of lasting until 3 years of age. We describe two patients with infantile EPF. Both patients commonly had recurrent crops of papules and pustules affecting the scalp only. Bacterial and fungal cultures were negative, and one patient showed an eosinophilia. Biopsy specimens revealed folliculitis with a predominant eosinophilic infiltrate. Clinical response to oral antihistamines and topical corticosteroids was noted, but the lesions have been recurrent during the long-term follow-up period of 1 year.

Seven Cases of Cutaneous Sarcoidosis / 대한피부과학회지

We report seven cases of cutaneous sarcoidosis without systemic involvement. All cases showed specific skin lesions which were papules (2 cases), patches (2 cases), subcutaneous nodules (2 cases) and plaques (1 case), respectively. Histologic examinations of the specimens commonly showed typical noncaseating granulomas. Although we performed the various laboratory studies, there was no evidence of systemic involvement in any case. Treatment with intralesional and/or topical steroid resulted in good responses, but we experienced some relapses of the skin lesions after withdrawal of treatment. Excision was the choice of treatment for subcutanous nodules. During the follow-up periods (1 - 4 years), we could not find any evidence of systemic involvement. Our cases represent the unusual cases of cutaneous sarcoidosis without systemic involvement.

A Case of Contact Urticaria from a Latex Glove Occurred to an Operationg Room Nurse

The prevalence of latex allergies has been on the increase along with the greater use of rubber products in daily life, medical, dental and occupational settings. Allergic reactions to latex can take two clinical forms of either contact dermatitis or immediate hypersensitivity reactions, which are provoked by the natural latex proteins or chemical additives used in the manufacturing process, respectively. A 25-year-old female, an operating room nurse, complained of recurrent pruritic erythematous wheals on both hands after the wearing of latex rubber gloves. The prick test and the usage Mlit't to the latex gloves were positive, and the RAST was class 3. To the best of our knowledge, is the first case report of contact urticaria from latex rubber gloves in Korean dermatologic literature.

A Case of Elastofibroma / 대한피부과학회지

Elastofibroma is a rare disease which presents as a slowly-growing, solid, ill-defined fibroelastic mass occuring almost exclusively in elderly women and arising mainly from the connective tissue between the lower part of the scapula and chest wall. Of the 270 cases of elastofibroma which have been reported, 170 cases had developed in Japanese patients. Despite the fact that there have been only two case reports in Korea, there might be a higher prevalence of elastofibroma in Korea than expected because of geographical similarity. We experienced a case of elastofibroma occurring in a 56-year-old man. To our knowledge, this is the first case report of elastofibroma in Korean dermatologic of literature.

The Study of Irritancy of Surfactants with Low Concentrations by Non-invasive Bioengineering Methods / 대한피부과학회지

BACKGROUND: The bioengineering methods for investigating irritant skin reaction have been developed for several decades to evaluate the irritation potential more objectively and quantitatively and obtain the information which is not obvious by the visual examination. OBJECTIVE: The purpose of this study was to compare the irritant skin reaction of three kinds of surfactants with various low concentrations which produce little reaction visually and investigative the threshold concentration that is reliable for a patch test. Also we investigated the sensitivity and the correlation between visual examination and bioengineering methods in four different concentrations of surfactants METHODS: Twenty healthy volunteers were patch tested with 0.01%, 0.05%, 0.1%, 1.0% of sodium lauryl sulfate(SLS), cetyl trimethyl ammonium chloride(CETAC), POE(20) sorbitan monolaurate (Tween-20) on the flexor side of the Lt. forearm. The result of patch test was evaluated by visual scoring, evaporimeter, colorimeter, and corneometer until 72 hours. RESULTS: 1. SLS, anionic surfactant, showed the highest irritation potential in visual scoring, TEWL, and skin color measurement. And CETAC, cationic surfactant, showed the greatest irritation in corneometer measurements than other surfactants. 2. TEWL was the most sensitive method for evaluation of skin irritation and correlated most closely with visual examination. 3. Concentration of surfactant higher than 0.1% showed to produce reliable and constant result of skin irritation as the experimental primary irritant. CONCLUSION: SLS is proved to be the most appropriate primary irritant for studying irritant contact dermatitis, and the degree and mode of skin irritation is different according to the concentration and kinds of surfactants. TEWL measurement is the most sensitive bioengineering method, which could detect early stages of irritation and correlate well with visual examination.

A Case of Familial Partial Lipodystrophy / 대한피부과학회지

Partial lipodystrophy(PLD) is a rare disorder characterized by frequent occurrence in women, usually onset in childhood, and slowly progressive symmetrical loss of subcutaneous fat on the upper half of the body. The etiology is unknown. However, many immunologic abnormalities were reported in PLD. Herein, we report a case of PLD in a 34-year-old man with familial occurrence of PLD in his brother.

Two Cases of Angioma Serpiginosum

Angioma serpiginosum is a rare vascular naevoid disorder due to progressive ectatic dilatation of capillaries in the papillary dermis. We report two cases of angioma serpiginosum. A 24-year-old woman presented with asymptomatic multiple deeply red macules arranged in a serpiginous pattern on the left posterior thigh. In the other case, an 8-year-old girl had asymptomatic red nonpalpable puncta that were grouped closely together in a linear pattern from the left lower abdomen to thigh. On the histopathological examination, both cases commonly showed grouped, dilated, ectatic vessels in the upper dermis. These clinical and histopathological findings were typical of angioma serpiginosum.

Sequential Change of Fibrosing Alveolitis On High-Resolution CT: Correlation with Finding at Pulmonary Function Test and Bronchoalveolar Lavage

PURPOSE: To evaluate prospectively relationship between the extent of abnornelities of fibrosing on high resolution CT and these of pulmonary function test, and bronchoalveolar lavage. MATERIAL AND METHODS: This study included 27 patients with pathologically proved UIP. We prospectivel analyzed correlation of the extent of gound glass opacity, consolidation, irregular lines with honeycombing initial CT scan and quantitative change of ground glass opacity on follow up CT scans with pulmonary function test(PFT) and bronchoalveolar lavage(BAL). RESULTS: On initial CT scan, score of extent of disease significantly correlated with FEV1(r=-0.5148, p=0. 0310) and DLco(r=--0.7102, p=0.0001). Proportion of indivisual cell in BAL was not correlated with ground glass opacity or extent of disease;lymphocyte(p=-0.0165, r=0.9616), eosinophil(p=-0.0077, r=0.9832), neutrophil: (p=-0.1732, r=0.5903). On follow up CT scan, quantitative change of ground glass opacity correlated with DLco/VA(r=-0.6825, p=0. 0025) and TLC(r=0.5248, p=0.0429). CONCLUSION: The quantitative analysis of extent of disease on HRCT is useful for evaluation of clinical statu& Also change of ground glass opacity on follow-up HRCT significantly correlated with improvement of diffusing capacity in fibrosing alveolitis.