Ichthyosis Hystrix: A Case Report Treated with Etretinate / 대한피부과학회지

Ichthyosis hystrix is characterized by extensive bilateral systemic involvement of thick hyperkeratotic verrucous papules forming confluent plaques or linear arrangement and is currently classified into a systematized epidermal nevi, which was once conaidered as an extreme variant of congenital ichthyosiform erythroderma. Here is presented a case with typical clinical features and characteristic histopathologic findings of epidermolytic hyperkeratosis. Our patient exhibited no skeletal or CNS abnormalities reported to be associated with this condition. Marked improvement was obtained with oral administration of etretinate.

In Vitro antifungal Activities of Imidazole Derivatives / 대한피부과학회지

The present study was designed to obtain omparative data on in vitro antifungal activities of imidazole derivatives. Minimum inhibitory oncentrations of clotrimazole, miconazole, econazole, ketoconazlole and griseofulvin on 4 strains of Trichophyton mentagrophytes, 3 strains of Trichophyton rubrum, 2 strains of Microsporum canis and ] strain of Sporothriv: schenckii were etermined after 3 week' incubation at room temperature on Sabouraud's dextrose liquid media. In addition, the fungicidal activities of miconazole and econazole were tested against Z'richophyton mentagrophytes and Microsporum canis, using the techniques described by Vanbreuseghern(1967) The results are summarzed as follows: ] In most of the dermatophytes studied, 1 to 10 pg/ml of M1C were detected. Diverse susceptibility pattern was observed among different fungal species, but no or minor variability was noted within the same species. The susceptibility of Z'ri- chophyton rubrum showed at MIC of 0. 01 to 10 pg/ml, T ichophyton mentagro- phyt.es and Mic osporum canis at 0.1 to 10 pg/ml and 0. 1 to 1000 gg/ml respec- tively. The Trichophyton rubrum was the most sensitive. In the susceptibility test of Sporothrix schenckii, the high resistance to clotrimazole and griseofuhin was observed. The fungistatic activities of miconazole, econazole and ketoconazole were observed only at concentrations higher than JpQ pg/ml.

A Case of Leukemia Cutis / 대한피부과학회지

The specific cutaneous lesions of acute myeloblastic leukemia was described, in which the skin lesions were the initial sign of the leukernia and the performance of the bone marrow aspiration led to correct diagnosis. A 55 year old man had admitted to our hospital with complaints of multiple nodules and tumors on the skin. Four month prior to admission, he had noticed small papules on his back. These lesions become nodular, increased in size and number. And then spread to anterior chest, extremities and face. Skin biopsy specimen showed diffuse dermal and subcutaneous infiltration of abnormal cells that appeared to be leukemic cell in nature. Bone marrow biopsy specimen showed changes of acute myeloblastic leukemia. Treatment was initiated with combined chemotherapy (cytosine arabinoside and adriamycin) and the eruption began to fade away.

Experimental Dermatitis by Pityrosporum ovale in Guinea Pigs / 대한피부과학회지

No abstract available.

The Incidence of Pityrosporum Orbiculare and Pityrosporum Ovale on Normal Skin / 대한피부과학회지

In microscopical survey of clinically normal skin, P. orbiculare was found to be present on scalp, face, anterior chest, back, arm and leg in 68.2%, 68.3%, 90.2%, 86.4%, 28.6% and 16.7% respectively, and P. ovale was present in scalp, face, anterior chest, back, arm and leg in 84.1%, 56.1%, 51.2%, 38.6%, 19.0% and 7.1%. P. ovale was dominant species in scalp, on the other hand P.orbiculare was dominant species in anterior chest and back. The large number of spore of P. ovale was present on scalp, on which P. ovale was dominant species, and on anterior chest and back, the number of spore of P. orbiculare was more increased than the numbers of P. ovale. The hyphae, identical in size and shape with those of Malassezia furfur, were found on scalp in one subject. In cultural survey, the pcsitive culture rate in P. orbiculare was showed in over all from 87.5% to 80.8% and in P. ovale from 33.3% to 88.2%. Germ tube formation on culture was found in 3 subjects on anterior chest and in one subject on back.

A Case Report of Amelanotic melanoma / 대한피부과학회지

A case of amelanotic melanoma developed on a 19 years old boy was reported. Since the identification of amelanotic melanoma, there were few reports about the tumor but none in Korea. In this case, the histologic findings showed ulceration of the epidermis and irregular junctional activity, and in the dermis, there showed alveolar formation and nevus cell nest like cell masses. And in the deep dermis, the loss of dermal stroma with numerous bizzare giant cells and variable sized, hyperchromatic, plemorphic, mitotic figures were also seen, Strikingly, there were no melanin pigments in H-E stain as well as in Masson-Fontana stain, which was thought to be a amelanotic melanoma. The patient was treated with B.C.G caccination by intralesional and hypodermic injection, on the lesion and on both, the lesion was markedly improved with only scarformation on previously ulcerated lesion. The patient shall be followed up continuously.

Erythema ANnulare Centrifugm: Report of one Case / 대한피부과학회지

Erythema Annulare Centrifugum is characterized by migratory annular, arcuate or polycyclic erythemas with central clearing. Its etiology is not conclusive but there are many reports about the etiology, i.e." due to dermatophytid"," the drugs",' intemal diseases", or" unknown etiology" etc. A case of Erythema Annulare Centrifugum with "unkown etiology" was reported. The patient revealed slightly elevated, migratory annular erythemas with central clearing on the both posterior portions of thighs. Histopathologically, there was no abnormality in the epidermis. In the dermis, cellular infiltrates sbowing fairly well demarcated perivascular coat-sleeve like arrangement and endothelial prolifera01

A Case of Lymphocytoma Cutis Treated with CD2 Slush / 대한피부과학회지

A case of lymphocytoma cutis, the circumscribed form in 9 year-old girl is reported. This is seldom conclusive without histological examinatien for a wide variety of conditions has to be considered. The circumscribed form usually responds rapidly to radiotherapy, although recurrence is possible and good results from the use of procaine penicillin especially in the disseminated form. In this case, I experienced good results from CO, slush and topical application of 0.25 % fluocortolone 3 times a day without recurrence in 3 months after treatment.

Mucha - Habermann's Disease ( Pityriasis Lichenoides et Varioliformis Acuta ): Report of A Case / 대한피부과학회지

Muchz-Habermann disease is cutaneous disease of unknown etilogy and characterized by a, polymorphous eruption consisting of papulosquamous, bemorrhagic, ulceronecrotic lesion eventually into varioliform scars. It is also classified into parapsoriasis group according to Broq with parapsoriasis en guttata (pityriasis lichenoides chronica), parapsoriasis en plaques, parapsoriasis en lichenoides. The 61-year-old male patient visited to Dermatologic Department of Severance Hospital due to sudden onset of generalized eruption. He presented pea to fingr tip sized erythematous, silvery maculo-papulo-squamous eruptions on trunk, extre- mities and buttock, but didnt complain of any subjective symptoms except markel fatigue. Skin biopsy was done on right forearm and was confirrr.ed to pityriasis lichenoides et varioliformis acuta by histopathologic finding. The lesion was completely controlled by oral tetracycline 2. Ogm per daily for first 4 wecks and reduced dosage l. Ogin per day for second 2 weeks.

Study for the Clinical use of Dermatophyte Test Medium ( DTM ) / 대한피부과학회지

Diagnosis of dermatophytosis is relatively easy with the typical clinical feature but sometimes we need more studies such as direct microscopy and culture to confirm the diseaee. The direct microscopic test is simple and ra.pid, but the result is often complexing, and the culture needs rnuch experience, skill, and deep knowledge in mycology. In 1959, Taplin et al. devised Dermatophyte Test Medium(DTM) which contains phcnol red as a color indicator for the simplified diagnosis of dermatophytosis. Result can be evaluated by noting the change of the color indicator of the medium. from yellow to red without detailed knowledge of colony morphology. So the non-mycologist can recognize well by color change of the medium. Moreover DTM is superior to Sabouraud medium in eliminating bacterial contamination, allowing a higher recovery rate and early recongnizing, since the color change of the medium begin to appear with the growth of fungus. The cultures were done on DTM and Sabouraud medium in 105 cases of the suspected dermatophytosis. In DTM, dermatophytes were cultured in 53 cases(M. canis 1, T. mentagrophytes 24, T. rubrum 28) and the color changes were observed in all of them. The others were 29 cases of Candida spp. 5 cases of saprophytes, and only one case of bacterial contaminatiion was observed. Compared with DTM, the dermatophytes were cultured in 36 cases and bacterial contamination were 16 csses in Sabouraud medium. The colors of DTM of 53 cases of dermatophytes were changed to red between the second to fourteenth day after culture. In 8 cases of Candida spp. among 29, 3 cases of saprophytes among 5, thc color change of DTM begin to appear after tenth day of culture. So DTM is very useful for the diagnosis of dermatophytosis by unsk;illed personnel under most environmental condition with only redimentary knowledges of colonial morphology to distinguish contaminant fungi and bacteria from dermatophytes.

Poikilodermatomyositis / 대한피부과학회지

The authors observed 2 cases of poikilcdermatomyositis who were 16 and l0 years old female. The former visited our dept. due to rashes on the anterior portion of right thigh with 3 months duration. The skin lesion revealed mottled skin pigmentation, telangiectasia, atrophy, and cigarrette paper like wrinklings. On the palpation, hardness and tenderness in the lesion were felt. The latter visited our dept. due to weakness of the right lower extremity for 3years. The skin lesion revealed the same feature as the former but more prominent. Histophthologically, P.V.A. patterns are seen in the both skin lesions. The epidermis shows moderate atrophy of St. malphigi and flattening of reteridges. The dermis is edematous, vascular dilatations, and cellular infiltrations, most of lymphocytes, around the blood vessels. The muscle biopsies for the Quardriceps Femoris sbow Dermatomyositis patterns which the muscle bundles are degenerative changes and many cellular infiltrations, chiefly of lymphocytes, are seen between the muscle bundles. Diagnosis was confirmed by the clinical and histological pictures. These patients were markedly improved by the prednisolone therapy.

Mycosis Fungoides Originating from Nose: Report of A Case / 대한피부과학회지

The case of a 30 year old man is described, in whom mycosis Fungoides was originating from nose and followed by tumor stage of Mycosis Fungoides on skin. In January 1970, the patient leveloped nasal tumor, when he was n at E.N.T. department of Severance Hospital. At that time a biopsy of nasal tumor demonstrated only a non-specific inflammatory cell infiltrated mass. He received radiation therapy (Co 60) with satisfadory suppression of mass and resulted in right nasal septal deviation. Jn December 1970, thumb sized painful non-tender, movable mass developed on right supraclaviular area. In August 1971, thumb sized painful, tender, movable mass appeared at right posterolateral aspect of neck, which was excied and removed at local clinic. But excised wound was not healed and the mass was enlarged. One month after above lesion, pea sized same mass developed. On physical examination, there were 4*5cm round, erythematous, painful, tender, granulomatous ulceration mass on right postero-lateral aspect of neck and also same mass on postero-inferior site of above lesion. Two times of biopsy was done and it interpreted as tumor stage of Mycosis Fungoids. Treatment included radiation therapy with Co 60 (200r/day, total 6,000r), prednisolone 40mg/day and antibiotics. There has been good response 1 month after radiation therapy and mass is diminished in size and would begin to heal.

Disseminated Superficial Acrinic porokeratosis ( DSAP ): Report of Nine Cases / 대한피부과학회지

This clinical study of nine patients presented Disseminated Superficial Actinic Porokeratosis (DSAP) as a distinctive and recognizable entity characterized by multiple uniformly small, irregular marginated, keratotic plug with atrophic center developing during second or third decade of life on sun exposed area of skin. Six of nine patients had DSAP, which was inherited as autosomal dominant trait. The patient's father, two brothers and two sisters were known to have same skin lesions. Of nine patients, five were female and four were male. Eight patients were developed DSAP lesions during second decade of life and other one was third dcade of life. Three patients had pruritus. In alI patients, lesions were developed bilaterally over sun exposed area but was not always symmetrical. The number of lesion was multiple in all patients. The greatest number of lesions were found on distal part of extremities, neck, face, upper portion of anterior chest and back.

Treatment of Erythroplasia of Queyrat with Topical 5-Fluorouracil Cream / 대한피부과학회지

Erythroplasia of Queyrat is a precancerous lesion, usually located to glans penis or prepuce. It is characterized by a slowly developing, circumscribed, usually velvety and shiny patch. The etiology was unknown, but it is extremely rare in those circumcised in early infancy. It had been suggested that phimosis had some etiologic importance. The typical case of Erythroplasia of Queyrat is presented. A 46 year old man had 4 months history of dark-brownish pea sized maculopapular rashes on sulcus of glans penis and prepuce associated with mild itching, which was increased in number day by day. He had a phimosis. On examination, there are sharply defined, slightly elevated, pea sized dark-brownish maculopapular rashes over erythematous infiltrated base on sulcus of glans penis and prepuce, which have moist and velvety appearance. A biopsy was performed from sulcus of glans penis. Histopathologically, there was acanthosis, with in epidermis many cells are vacuolated and showed individual cell keratiinization. Epithelial cell showed marked atypia, variation in nuclear size and there was intercellular, intracellular edema. The lesion was treaterd with topical application of 5% 5-fluorouracil twice daily 2 weeks and thereafter for 4 weeks. 2 months after treatment, no erythroplastic lesion was found and 3 months after treatment, rebiopsy was perforrned which showed marked improvement histopathologically.

A Study on the Steroid Acne / 대한피부과학회지

Dermatologic treatment was greatly advanced when topical corticasteroids were introduced for the management of many inflammatory and pruritic dermatoses. Their use reduced or diminished mnst of the undiserable side effects which accompanied the systemic administration of these compounds. The good effects of topical application of hydrocortisone had been demonstration in the treatment of variaus dermatoses eg., atopic dermatitis, seborrheic dermatitis, contact dermatitis etc. The halogenated derivatives followed and led to the trend to most of analogs now in use. Especially, fluocinolone acetonide cream greatly enhanced its therapeutic effectiveness in psoriasis, chronic discoid lupus erythematosus, pustular bacterid, granuloma and neurodermatitis circumscripta. But many side effects of topical corticosteroids such as steroid acne. Stria were developed and also fluorinated topical corticosteroids resulted in telangiectasia, purpura, atrophy in skin. Weber reported that strong topical corticosteroids eg.. Betamethasone valerate and fluocinolone acetonide were resulted in rosacealikc dermatitis and it was steadily increased. These adverse side effcts of topical corticosteroids, especially steroid acne, were indisputable argument in dermatologic field, for the view that this topical corticosterodis is used for cosmetics and treatment of acne vulgaris in our country. Since the strong corticosteroid tnpical preparation, the peculiar form acne, so called steroid acne, was steadily increased in our clinic. Behrman and goodman reported that acneform eruption induced by hormone was not associated with oiliness and there were but few comedone. Sullivan and Zeligman reported that the the acneform eruption due to adrenal corticaa 1 hormone was uniform in size, small papule and few pustule, usualIy erythematous base. There were also differential histologic feature. The most important difference is the normal apperance of sebaceous glands in acneform eruption due to corticosteroids contrast with hyperplasia in acne vulgaris. Abscess formation was more frequent and more extensive in acne vulgaris. Sutton Jr and Van Scott & MacCardle described that histologically, the major component in lesion of steroid acne was excessive keratinization of follicle. Castor and Baker demonstrated that topical application of corticosteroids resulted in decrease of sebaceous gIands, decrease of mitosis and increased cornification in epidermis. The present study investigated clinical case of the steroid acne, which are induced by topical application and systemic administration of corticosteroids and experimentally induced the steroid acne with the topical application of corticosteroid. And also clinical cases and experimentally induced steroid acne were compared with acne vulgaris. Material and method Subjects are 13 Patients of steroid acne induced by strong topical corticosteroid eg., fluocinolone acetonide, fluocortolone, dexamethaone, betamethasone valerate and 4 patients of steroid acne induced by systemic administration of corticosteroid eg., prednisolone and also 10 patients of acne vulgaris. Biopsy was performed from 13 patients of topical steroid acne, 3 patients of steroid acne induced by systemic administration of steroid and one patient of acne vulgaris. In order to induce steroid acne, experimentally, strong topical corticosteroid such as beta methasone valerate, fluocinolone acetonide and fluocortolone were applied on back. Comment and conclusion In Clinical feature, the steroid acne by topical application and systemic administration of corticosteroid and experimentally induced steroid acne had unique clinicall features, that showed absence of comedone and uniform sized follicular papule on deep seated erythematous scaly base. The topical steroid acne was distributed the region where were applied. But the eruption of the steroid acne induced by systemic administration of corticosteroids was distributed to face, neck, and scalp. Above findings are quite different form acne vulgaris. Histopathologically, the steroid acne induced by topical application and systemic administration of corticosterojds showed hypoplasia of sebaceous glands and excessive follicular keratinization. Occlusion of pilosebaceous opening by keratotic plug in severe case by long term application showed atrophy of epidermis and sparsity of sebaceous glands with hypokeratosis and parakeratosis. In experimentally induced steroid acne, it was definitely specific features which were absolutely identcall with above cinical steroid acne.

Nodular vasculitis Simulate to papulonecrotic Tuberculid / 대한피부과학회지

The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.

A Case of Mucoepidermoid Carcinoma of Parotid Gland Origin / 대한피부과학회지

Mucoepidermoid earcinoma occurred in about 2% among salivary gland tumor and in about 15% among malignant parotid gland tumor. The tumor occurred usually in elderly persons and arose as innocent-appearing swelling in the parotid gland region with gradual painless enlargement without alarming and it's usual size is less than 2 cm, However, a few of the poorly differentiated neoplasms grew rapidly and were painful and accompanied by facial nerve paralysis in about 15%. But it's prognosis is better than other salivary gland origin. We report a case of typical mucoepidermoid carcinoma of parotid gland origin which is occurred in 15 years old girl. The tumor begins pea sized painless nodule since about 2 years ago, and enlarged gradually to apple size and accompanied by facial nerve paralysis and pain sensation recently. But there was no evidence of tumor in parotid gland itself and no metastasis.