Antenatal Corticosteroid Therapy to Prevent Neonatal Respiratory Distress Syndrome / 대한주산의학회잡지

OBJECTIVES: Our purpose was to determine the efficacy of maternal corticosteroid therapy in the prevention of neonatal respiratory distress syndrome. STUDY DESIGN: The data in this study was taken from 136 women who participated in prematurity prevention programs at two hospital. Of 136 women who were delivered at 25 to 34 weeks, 68 received dexamethasone and 68 did not. 'I'he frequency and relative risk of adverse outcomes, including repiratory distress syndrome, necrotizing enterocolitis, neonatal sepsis and maternal infection wcre compared by means of univariate techniques. RESULT: When dexamethansone was administered, there was a lower incidence of respiratory distress syndrome at between 30 to 32 weeks gestation (relative risk of treatment group vs control group=0.425, p0.05). I'here was no statistical difference between 33 weeks to 34 weeks (relative risk of treatment group vs control group=0.782, p>0.05). 'I'here was no statistical significance in the incidence of maternal infection, neonatal sepsis or necrotizing enterocolitis (p=0.808, p=0.698, p=0.559). CONCLUSION: Dexamethasone appears to significantly reduce neonatal respiratory distress syndrome at between 30 and 32 weeks gestation.

Two Cases of Prurigo Pigmentosa / 대한피부과학회지

Prurigo pigmentosa is a chror ic pruritic inflammatory dermatosis characterized by erythematous papules in a reticulated pattern that resolve leaving a reticulated, mottled hyperpigmentation and rapidly response to dapsone therapy. Most cases that have been reported are from Japan. We report two cases of prurigo pigmentosa in a 21 year-old female and a 23-year-old female. Histopathologic findings of erythematous papules showed exocytosis, spongiosis, liquefaction degeneration of basal cell layer and perivascular lymphohistiocytic infiltration on the upper dermis. We treated them with dapsone, 100mg daily, which resulted in a remarkable regression of the ery thematous papules and improvenien of pruritus.

Expression of ICAM-1 on Short-Term Cultured Human Keratinocytes: Modulation by IFN-gamma, UVB and retinoic acid

Intercellular adhesion molecule I(ICAM-1; CD 54), a 90 kD glycoprotein, counter-receptor for lymphocyte function-associated antigen-I(LFA-1) on T-cells, is critically important to a wide variety of adhesion-dependent leukocyte functions, including antigen presentation and target cell lysis. Induction of ICAM-1 on the keratinocytes(KCs) is an important regulator in initiation, maintenance, and resolution of cutaneous inflammation, which is modulated with cytokines produced by activated T-lymphocytes. This study was designed to further our understanding on modulation effects of ultraviolet B(UVB), gamma interferon(IFN-;v), and retinoic acid(all trans) upon expression of ICAM-1 on cultured human KCs, with emphasis on their correlation. Cell surface expression of ICAM-1 in cultured human KCs was analyzed with the use of indirect immunofluorescence and fluorescence activating cell sorting(FACS) by flow cytometry. The results of this study were as follows: 1) Expression of ICAM-1 was significantly induced with IFN-,-(20 U/ml)(p<0.005). 2) UVB irradiation of 30mJ/cm2 significantly suppressed ICAM-1 expression of KCs 24 hours after irradiation(p<0.05). However, at 72 hours after irradiation, ICAM-1 expression of KCs was considerably increased in comparison to that of initial phase (24 hours after irradiation). 3) High concentrations(10(-5)M) of retinoic acid reduced UVB-induced expression of ICAM-1 in late phase(72 hours after irradiation), although retinoic acid showed induction effect of ICAM- I expression of KCs. In summary, these results indicate that ICAM- I may contribute to the biphasic effect of UVB on delayed hypersensitivity in vivo. Also, retinoic acid, a vitamin A derivative, may have a cutaneous photoprotective effect through a regulation of UVB-induced ICAM-1 expression on the KCs.

A case of Kaposi's sarcoma Treated with radiotherapy / 대한피부과학회지

Kaposi's sarcoma is a neoplasm of multifocal origin which manifest primarily as vascular nodules in the skin and other organs. We report a case of Kaposis sarcoma of classic type in a 17-year-old boy, who had a 4 x 5cm sized, dusky erythematous plaque with multiple spots of acupuncture on the left foot for 1 year. Histopathologic examination showed dilated, bizarre-shaped vessels, ndothelial cell proliferation, and spindle cell formation with vascular slits throughout the dermis. He was treated with 3000 rads of radiation(300 rad per day for l0 successive days). Six months after radiotherapy, gross findings were much improved and histopathologic findings showed only fibrosismc hemosiderin deposits in the dermis.

A cases of sarcoidosis with annular cutaneous lesions / 대한피부과학회지

Cutaneous manifestations of sarcoidosis are highly variable and can be devided into the specific lesions which reveal noncaseating granuloma and the nonspecific lesio is which are referred to as cutaneous changes. Among speciific lesions, annular lesions may be foimied from coalescing papular lesions that may clear centrally and elevate peripherally. We report a case of sarcoidosis with multiple annular lesions on the face in a 33-year-old female who had systemic involvements in the intrathoracic organs and eyes. The main histopathologir. findings were well-demarcated islands of epitheloid cells with a few giant cells in the dermis. In addition, a slight admixfure of lymphoid cells was present at the margins of the epitheloid cell granulomas. Complete regression of t!he skin lesions was obtained with systemic cortiocosteroid therapy and no recurrence has been found for 2 1/2years.

Atrophoderma of pasini and pierini / 대한피부과학회지

We report a case of atrophoderma of Pasini and Pierini in which the characteristic soft atrophic patch with cliffdrop border developed on the neck and two well-demarcated indurated atrophic patches were on both shoulders. We took biopsies from centers and margins of each lesion. Histipathologic findings from atrophic center showed marked dermal atrophy comparing to that from margin of the lesion on the neck, but the atrophic center and margin of the lesion on the shoulder showed morphea-like features without, distinct differences between two.

Clinical and histopathologic findings of pathergy test sites in patients with Behcet's disease / 대한피부과학회지

Through the clinicopathologic study of pathergy test sites of 16 patients with Behrets disease in the active or inactive stage, the following results were obtained; 1. In the active stage, six of 16 patients (37.5%) showed positive reactions in clinical pathergy tests, which are much higher than that in the inactive stage when only one patient showed a positive reaction. The severity of the ciniral pathergy reaction was directly related to the activity of the disease. 2. The characteristic histopathologic finding in the active stag was a dermal inflammatory cellular infiltration composed mainly of polymorphonuclear lukocytes and of lymphomononuclear cells accompanied by leukoctocylasia. Two of 16 patients showed true leukocytoclastic vasculitis. 3. Although the type of disease and the reactivity of the clinical pathergy test were related in terms of the severity of the histopathologic findings, there were some notible histopathologic changes even in the cases with negative clinical pathergy reactions. We concluded that the histopathologic findings of the pathergy test sites were more reliable for the diagnosis of Behcet's disease than the clinical findinigs.

A case of polyarteritis nodosa, possibly of cutaneous type / 대한피부과학회지

No abstract available.

A comparative clinicopathological study of pityriasis lichenoides chronica and small plaque parapsoriasis / 대한피부과학회지

A clinicopathological study of 12 cases of pityriasis lichenoides chronica and 14 cases of small plaque parapsoriasis was performed. Patients with pityriasis lichenoides chranica ranged in age from 15 to 62 years (mean, 30 years) with male predominance. They had erythematous or reddish scaly papules occuring mostly on both trunk and extremities(92%). The lesions were about the size of r ice grains or small peas. Patients with small plaque parapsoriasis ranged in age from 8 to 67 years(mean, 33 years) and presented yellowish or erythematous scaly maculies and patches comrnonly involving the trunk and extremities(64%). The size of the lesions were larger than those of pityriasis lichenoides chronica. Histopatbologically, the distinct feature of pityriasis lichenoides chronica was vacuolar alteration at the dermoepidermal junction characterizing interface dermatitis. The microscopic findings of small plaque parapsoriasis were, although not as distinct as in pityriasis lichenoides chronica, those af either spongiotic dermatitis or superfirial peri vascula dermatitis. We conclude from this study that these two conditions have different clinical and histologic features and we propose that the term guttate parapsoriasis shauld not be used as a synonym of either pityriasis lichenoides rhronica or small plaque parapsoriasis.

A Case of solar Urticaria / 대한피부과학회지

A 23-year-old woman had solar urticaria that was activated by visible light and UVA, but the intensity of the urticarial reaction of visible light was more pronounced than that of UVA. The results of passive and reverse passive transfer studies were negative, We report a case of solar urticaria which is characterized by overlapping features of 60th type Il and Il[ in the classification of Harber.

Delayed Cutaneous Hypersensitivity Reactions in Chronic Dermatophytosis / 대한피부과학회지

For the establishment of the association of the chronic fungal infection with cell mediated immunity, delayed cutaneous hypersensitivity was measured for 96 patients with chronic dermatophytosis and 40 healthy adults by means of Multitest CMI. The patient group increased in rates of positivity to candida, trichophyton and diphtheria, but decreased in rates of positivity to proteus, streptococcus and tuherculin. The rate of positivity of the patient group in the antigen of trichophyton(14%) was shown as higher than that of the control group(8%). A big difference in the sum of diameters was shown between patients with nail infection(22.5+/- 113mm for male, 16.3+8.93mm for female) and patients without nail infection(17.8+/- 7.62rnm for male, 11.44.37mm for female). In conclusion, in the present study, the difference in the delayed cutaneous hypersensitivity between patient group and control group is not provided. Even though the possibility of defect of cell mediated immunity in chronic dermatophytosis is admitted, there are some doubts regarding the Multitest CMI being the adequate method ta check the state of cell mediated immunity of individuals who have trivial or partial defect in immunity.

A Case of Fournier's Gangrene / 대한피부과학회지

Fournier's gangrene is a fulminating gangrene of the male genitalia. It is associated with severe systemic toxic effect and a high motality rate, and it requires early diagnosis and intensive care with surgical intervention. We report a case of Fournier's gangrene in 33-year-old man, who showed marked swelling and necrosis of the scrotum, and extending cellulitis on the right flank and chest. With prompt excision of all the gangrenous scrotal skin and drainage incisions made on the flank and chest, the healing was successful.

Coexistence of Linear Porokeratosis with Disseminated Superficial Actinic Porokeratosis / 대한피부과학회지

The coexistence of the variants of porokeratosis is very rare. We report a case of coexistence of linear porokeratosis with disseminated superficial actinic porokeratosis (DSAP). A 43-year-old wornan first noticed a brownish papule on the left side of groin in early infancy. She developed multiple discrete or confluent keratotic plaques in linear fashion on the left lower extrernity and trunk in childhood. These leaions became pruritic in summer. Two years ago, she developed multiple scattered small annular lesions on the face and forearms. Her family history showed no abnormalities. Biopsy specimene from the groin and trunk showed eornoid lamella.

Statistical Analysis of Serologic Test for Syphilis in Normal Population (1981 ~ 1984) / 대한피부과학회지

Serologic tests for syphilis including VDRL and TPHA tests were carried out in 5,413 VISA applicants for emigration, from January, 1981 to December, l984 The results are summarized as follows: 1. In 5,413 VISA applicants, the reactive rate of VDRL test was 2,0% totally. The reactive rate of VDRL test of male was 2. 6%, and that of female was 1. 6% 2. The reactive rate of 1983 was 1.4% and that was the lowest in annual incidence, but there was no statistically significant differences in comparing the annual incidences. 3. The reactive rate increased with age, and males above the 5 th decade revealed an especially high reactive rate. 4. The biologic false positive rate of VDRL teet was 16. 5%, in gl VDRL reactive persons, using TPHA as standard. 5. The quantitative test of VDRL showed low titer below 1: 4 in 88. 4%, and high titer above 1: 8 in 11. 6% of the applicants.

Dermatophytoses in Pusan Area / 대한피부과학회지

This study aims to investigate the recent clinical and mycological trends of dermatophytoses in Pusan area. The number of patients with dermatophytoses diagnosed by KOH examination and culture at Maryknoll Hospital was 1, 213 during past 2 years from November 1982 to October 1984. The incidence rate of dermatopbytoses was 9. 8% out of 12,377 cases of out patients in total. Tinea pedis (33 .7%,) was the most frequent diagnosis, followed by tinea cruris, tinea unguium, tinea corporis, tinea faciale, tinea manus and tinea capitis, in the order of decreasing frequency. The majority of cases were found in the age group from 20 to 39 4, The over all ratio of male to female patients was ] 2: 1 5 The positive rate in KOH examination was 96. 2A, and it was especially low in the areas of scalp, face and toe webs. The positive culture rate was 55, 9g, and it was higher in the covered area than in the exposed area. 6 678 strains out of the 1, 213 patients were isolated and identified. The species isolated were, in the order of decreasing frequency, Trichophyton rubrum (558 strains, 82.3% of total organisms isolated), Tn'chophyton mentagrophytes (55,8, 1 Microsporum canis (48, 7. 1g) Epidermophyton floccosum (12, 1 8g) and Microsporum gypseum (5, 0. 7gp) Trichophyton rubrum was the major causative organism in all the types of dermatophytoses except tinea capitis and tinea faciale. In tinea capitis, Microsporum canis was the main causative organism, and Trichophyton ferrugineum was not isolated, at all, which was a specific point, compared with the past tendency. In tinea faciale, zoophilic organisms were mainly isolated.

Two Cases of Norwegian Scabies / 대한피부과학회지

Norwegian scabies is a rare clinical variant of human infestation with Sarcoptes sabiei var, hominis, distinguished from the common form of scabies by the presence of remarkable hyperkeratotic scaly crusted skin lesions. We report two cases of Norwegian scabies occuring in a 25-year-old man with merital retardation and in a 9-year-old boy with aplastic anemia, The first case is characterized. by an extensive hyperkeratotic thickening and crusting of the dorsa of hands, knee 8: elbow joints. There is also subungual accumulation of horny rlebris with nail distortion. Histologically, the epidermis shows a mite in straturn comeurn and mild acanthosis in stratum malpighii. Immunoperoxidase for Ig G,M,A is not stained in the clermoepiderrnal junction and capillary wall of upper dermis. The second case shows hyperkeratotic scaly papules and p]aques on the hands, feet, extremities and trunk. 1'he diagnosis vvas confirrned by the demonstration of adults, nymphs, larvas and eggs of Sarcoptes scabiei con the KOH examination of the skin scrapings. hey l3'ords: Norwegian scabies, Mental retardation, Aplastic anemia

A Case of Multiple Lentigines Syndrome / 대한피부과학회지

We report a case of multiple leatiginea syndrome in an 8 year old boy. He had numeroua lentigines acattered over his face, trunk, buttock and thlghe, and eome larger black macular leeians on the trunk and thighs. Gn phyaiaal examinatlon, he wae well developed but he had ocular hyperteloriem. Chest roentgenogram showed hypertrophy of both ventricles. Electrocardiogram and audiogram revealed conduction defects and severe sensorineural deafness, reepectively. Blopsy af dark brown lesion from the back showed the histopathologlc pattern of lentigo.

A Case of Umbilical Omphalomesenteric Duct Polyp / 대한피부과학회지

No abstract available.

A Case of Early Lepromatous Leprosy Showing Unusual Skin Manifestations / 대한피부과학회지

The skin lesions of leprosy have a great similarity to various other lesions. Fasal has called it the great imitator. Sometimes these skin lesions can b misdiagnosed because the physician does not consider leprosy. We reported a case of early lepromatous leprosy in 42 year old male. His skin lesions were similar to secondary syphilid. There were no sensory changes on the skin lesions and no enlargement of the peripheral nerves. Numerous AFB(+) bacilli from the skin smear confirmed our diagnosis of leprosy.

A Case of Traumatic Epidermoid Cyst / 대한피부과학회지

Traumatic epidermoid cysts are rare tumors occuring almost exclusively on the palms, palmar aspects of fingers, and soles. These cysts are thought to originate from a bit of epidermis implanted into the dermis after a penetrating or blunt wound. We report a case of typical traumatic epidermoid cyst on the sole of the right foot of a 23-year-old male student. The lesion was a coin-sized, tender, fluctuating cystic mass occuring 3 years after a penetrating wound by an iron nail. Histopathlogical examination revealed a deep dermal cyst lined by a thick, flattened, keratinizing wall with partial disruption accompanied by foreign-body reaction.