Multicenter Prospective Clinico-Epidemiologic Study on the Abuse, Misuse and Adverse Effects of Drugs in Dermatological Field / 대한피부과학회지

BACKGROUND: The abuse, misuse, and resultant adverse reactions of various drugs have been widespread due to lack of division of work of medicine and pharmacy in Korea. OBJECTIVE: This study was conducted to bring people to an awareness of the seriousness of drug abuse and misuse. METHODS: A multicenter, prospective, clinico-epidemiologic evaluation was made from patients with adverse drug reactions who visited 126 dermatologic departments in university hospitals(21) or private clinics(105) nationwide from July 1st to July 31st, 1999. RESULTS: The prevalence of adverse drug reaction was 10.4%, among them 47.9% of the patients had adverse cutaneous effects from external use of topical steroids and 24.1% of the patients had contact dermatitis from external use of various topical agents. The rate(66.3%) of misuse of topical steroids was higher than that(33.7%) of abuse of the drugs. 79.8% of patients had obtained drugs without an accurate diagnosis and prescription from their doctors. Regarding the potency of topical steroids, it was revealed that the lowest potency drugs also caused adverse effects. CONCLUSION: The strict grouping of drugs as prescription drugs or over-the-counter drugs based on drug safety is the key factor to avoid the abuse and misuse of drugs, and to protect the public health from harmful drug effects.

Clinical Aspects of Gonorrhea: V. Double dose of sodium penicillin G. in the treatment of male gonorrhea / 대한피부과학회지

We reported previously that, combined with l. 0 gm of probenecid, sodium penicillin G. 4, 0 m.u.i.m. was slightly less effective than procaine penicillin G. 4. 8 m.u. i.m. in the treatment of uncomplicated male gonorrhea. We now present the effect of double dose of sodium penicillin G. in the treatment of uncomplicated gonorrhea. The subjects were 262 male patients with uncomplicated gonoccccal urethritis at the VD clinic of Choong Ku Public Health Center in Seoul during 5 months period from January to May 198l. The following criteria were used to identify gonococcal infection - Gram negative intracellular diplococci in urethral smear and/or oxidase positive typical colony formation on Thayer-Martin media composed of Gram negative diplococci. They were given 4.0 m.u. sodium penicillin G. i.m. proceeded 15 to 30 min. by 1. 0 gm. probenecid p.o.. Four hours later, same amount of sodium peniciIlin G. i.m. was repeated. Concornitant eomparison of procaine penicillin G. was not done because of recent una,vailability of the drug in Korea. To avoid pain, the drug is dissolved in 6 ml of normal saline plus 2 ml of 2% lidacaine. One hundred eighty five patients were able to be followed 3 to 7 days after the treatment. There were .24 (13%) failures and 17 (10. 6%) postgonococcal urethritis. During this study, l4 strains of PPNG (Penicillinase Producing Keisseria Gonarrhoeae) were detected with chromogenic cephalosporin slide method. There were 10 (5. 8%) failures among 171 patients with urethritis caused by non-PPNG.

Oral Lichen Planus: Report of A Case / 대한피부과학회지

Lichen planus is rare in Korea. and oral lichen planus is even rarer. To our knowledge, this is the first case reporting in Korean dermatological literature. 57 year-old man was seen for erythema with white striation on the oral mucosa in December 1981. The initial lisior s appeared on the buccal mucosa of left side of oral cavity 10 months ago. Thereafter he noticed similar lesions on the right side of buccal mucosa, hard palate, left side of upper and lower gingiva and left side of the lower lip. Histopathological and direct immunofluorescence studies showed typical features of lichen planus. Administration of griseofulvin(0.5gm. of Fulvicin' daily) for 4 weeks resulted in no clinical improvement. Oral retinoid(25mg of Ro 10-9359 daily) for 11 weeks resulte3 in healing of lesions with no side effect except slight dryness of the mouth.

Clinical Aspects of Gonorrhea: IV. Sodium penicillin G in the treatment of uncomplicated male gonorrhea / 대한피부과학회지

Although the penicillin is still the first choice of drug in the treatment of gonorrhea in most areas of the world, Neisseria gonorrhoea has become increasingly less sensitive to penicillin preparations. The proportion of such strains also varies from region to region. Sodium penicillin G. is a short acting preparation which enables to attain quick high blood level. The reason for combining the quick acting sodium penicillin G. with probenecid is that latter inhibits renal excretion of penicillin and maintains effective serum penicillin levela long enough to extinguish gonococcal infections. The subjects were 265 male patients with uncomplicated gonococcal urethritis at the VD clinic of Cboong Ku Public Health Center in Seoul during 5 months period from September 1980 to January 1981. The following criteria is used to identify gonococcal infection Gram negative intracellular diplococci in urethral smear and/or oxidase positive typical colony formation on Thayer-Martin media composed of Gram negative diplococci. The 265 patients were divided in two groups(A and B group). They were administered an oral dose of 1.0 gm. probenecid and, 15 to 30 min. later, 4.0 m.u. of sodium penicillin G. i.m. in A-group(152) and 4.8 m.u. procaine penicillin G. i.m. in B-group(113). Only those who were able to be followed up 3 to 7 days after treatment were contained for final analysis(A-group:108, B-group:88), A-group showed 22 failures(20.4%), and B-group 9 failures(10.2%). A significant difference is found between the two groups(P0.05). We suggest a repeated injection 3 to 4 hours later or increased amonuts of sodium penicillin G. might give better result in the treatment of uncomplicated gonorrhea.

A Case fo Drug Eruption following the Use of Gold Preparation / 대한피부과학회지

Gold preparation had been used frequently in the past in the treatment of rheumatoid arthritis, tuberculosis and lupus erythematosua, etc. It is still used. when other more potent remedies, such as steroid, failed. We report a case of drug eruption following the use of gold preparation. A 38 year-old female was referred to our department from orthopedic surgery because of generalized, multiple, pin head sized, violaceous and flat topped papules of 1 x 2 mm in size and mucosal erosions and ulcers following gold therapy for rheumatoid arthritis. She had received 5 intramuscular injections of gold preparation (Myochrysine'), 220mg in total amounts. Our clinical impression was lichen planus like drug eruption, but histopathological picture disclosed nonapecific dermatitis. The eruption had disappeared gradually following oral administration of antihistaminics and prednisolone and daily starch tub baths.

Clinical Aspects of Gonorrhea / 대한피부과학회지

The efficacy of Thayer-Martin media (abbreviated TM media) recently introduced by the government, is a great concern to us. The results of culture on TM media are compared with the results obtained from Gram stained filrn. The subjects were 235 male patients with urethral discharge who visited the VD clinic of Choong-ku Puhlic Health Center in Seoul during 3 months period from 21th May to 20th August 1979. CDC recommendations are closely followed for Gram staining as well as for cultural identification. Among 151 positives with Gram staining, 142 were also culture positive (94.0%) while 8 were negative(5.2%) indicating reasonably good correlation. One patient was culturally positive(0. 8%) while negative by Gram staining. TM media supplied by Seoul Metropolitian Institute of Public Health which was used for this study is considered to be adequate.