Therapeutic Effects of Topical Application of Ozone on Acute Cutaneous Wound Healing

This study was undertaken to evaluate the therapeutic effects of topical ozonated olive oil on acute cutaneous wound healing in a guinea pig model and also to elucidate its therapeutic mechanism. After creating full-thickness skin wounds on the backs of guinea pigs by using a 6 mm punch biopsy, we examined the wound healing effect of topically applied ozonated olive oil (ozone group), as compared to the pure olive oil (oil group) and non-treatment (control group). The ozone group of guinea pig had a significantly smaller wound size and a residual wound area than the oil group, on days 5 (P<0.05) and 7 (P<0.01 and P<0.05) after wound surgery, respectively. Both hematoxylin-eosin staining and Masson-trichrome staining revealed an increased intensity of collagen fibers and a greater number of fibroblasts in the ozone group than that in the oil group on day 7. Immunohistochemical staining demonstrated upregulation of platelet derived growth factor (PDGF), transforming growth factor-beta (TGF-beta) and vascular endothelial growth factor (VEGF) expressions, but not fibroblast growth factor expression in the ozone group on day 7, as compared with the oil group. In conclusion, these results demonstrate that topical application of ozonated olive oil can accelerate acute cutaneous wound repair in a guinea pig in association with the increased expression of PDGF, TGF-beta, and VEGF.

Pyoderma Gangrenosum: A Clinical Study / 대한피부과학회지

BACKGROUND: Pyoderma gangrenosum (PG) is a rare noninfectious skin disorder characterized by chronic recurrent painful ulcers. Because of its low incidence and diagnostic difficulty, there were few comprehensive studies of the clinical features of PG in Korea. OBJECTIVE: Our purpose was to delineate the clinical features of PG. METHODS: 22 patients who presented with PG at 6 hospitals of Catholic Medical Center over ten years were enrolled in this study. We reviewed all medical records of the patients. RESULTS: The mean age was 47.9 years. The male to female ratio was 1:1.4. Cases in children account for 2 out of twenty two. Sixty-one percent of the patients had lesions on their lower legs. The typical ulcerative variant was found in 19 patients, bullous PG in 3 patients. An association with other internal diseases was noted in 9 patients. Two cases were developed in heavy alcoholics. 15 patients were treated with systemic corticosteroid, 12 cases with systemic corticosteroid only, one case with systemic corticosteroid and cyclosporine, one case with systemic corticosteroid and dapsone, one case with systemic corticosteroid, cyclosporine and colchicine. 1 patient was treated with cyclosporine and colchicine, 1 patient with colchcine, rifampicin and antibiotics. Five cases were treated with antibiotics only. In the only systemic corticosteroid therapeutic group, the response rate was 83%. 3 patients experienced recurrence and 3 patients showed positive pathergy reactions. CONCLUSION: PG is a rare disease with the ulcerative variant being most frequent. The lower legs were the most commonly affected sites. PG was accompanied with systemic disease in 46% of the cases. Comparing with foreign literature, the response rate of treatments was generally fine and the recurrence rate was low.

A Case of Cutaneous Protothecosis / 대한피부과학회지

Protothecosis is an unusual human infection caused by the achlorophyllic algae Prototheca, and most commonly by Prototheca wickerhamii. A 65-year-old man presented with a 2-month history of a painful, erythematous, non-healing, ulcerative plaque on the extensor surface of his left forearm. He was previously diagnosed with diabetes and iatrogenic Cushing syndrome. A skin biopsy specimen revealed characteristic morula-like sporangia in the dermis by PAS positive staining. Prototheca wickerhamii was identified by culture and biochemical studies. Initially, itraconazole was administered for 8 weeks, followed by fluconazole, and the patient's condition was greatly improved.

A Case of Atypical Basal Cell Carcinoma on Female External Genitalia / 대한피부과학회지

Basal cell carcinoma(BCC)s are most frequently found on the sun-exposed skin of the head and neck regions. Rarely, BCCs occur in odd sites such as the scrotum, vulva, perineum, nipple, and axilla without any apparent carcinogenic factor such as arsenic, radiation, chronic ulceration or scars. Genital BCC accounts for fewer than 1% of all BCCs and vulvar BCCs represent fewer than 5% of all vulvar neoplasms. We report a case of BCC arising on the mons pubis clinically mimicking malignant melanoma, which presents with 2cm sized, deep purple colored protruding mass.

A Case of Primary Cutaneous Mucoepidermoid Carcinoma Developed on the Scrotum / 대한피부과학회지

Mucin producing squamous cell carcinoma (mucoepidermoid carcinoma) is a carcinoma showing squamous and adenomatous differentiation. It is more aggressive than the usual carcinoma of the skin and it must to be evaluated and treated more carefully. We report herein a case of mucoepidermoid carcinoma associated with previous multiple skin cancer. The patient, a 56-year-old male with prior arsenical exposure, presented with a itching irregular marginated ulcer on the left scrotum and other scaly macular erytheinatous skin lesions on the left shoulder and lower back. The histopathological findings from the scrotal lesion showed multiple foci of mucin deposition throughout the squamous cell carcinoma. Special mucin and CEA immunohistochemical staining revealed the epithelial nature of mucin and its glandular structure. We diagnosed this scrotal lesion as mucoepidermoid carcinolna, and it was totally removed by surgical excision.

A Case of Favre-Racouchot Syndrome Treated with Retinoic Acid and Surgical Excision / 대한피부과학회지

Favre-Racouchot syndrome is a disease of senile or actinic processes and another name is nodular elastosis with cysts and comedones. Clinically, facial skin shows, especially lateral to the eyes, multiple open and cystically dilatated comedones and can be defined as cutaneous disturbances characterized by a degenerative process of the dermis associated with cysts and comedones. Sunlight is a strong causative factor and dermal degenerative processes result in this condition. We report the case of a 78-year-old man who showed multiple yellowish papules on both sides of cheeks, the periorbital and, malar areas. He had had this condition for 25-years. His job used to involve physical labor and much exposure to sunlight. An excisional biopsy specimen from the facial malar lesion showed cystically dilated comedones with basophilically degenerated dermal tissue. We performed a therapeutic excision on the two large nodular lesions on both malar areas and applied topical tretinoin. The Patients clinical appearance was much improved 2 months later.

Eczema Herpeticum in Darier's Disease

Eczema herpeticum is a herpes simplex virus infection with disseminated skin involvement superimposed on a pre-existing dermatosis. Dariers disease has been reported to be among the dermatoses susceptible to the sudden onset of a widespread vesicular eruption accompanied by high fever known as Kaposis varicelliform eruption. We report a case of eczema herpeticum in a 46-year-old woman associated with Dariers disease.

A Case of Chemical Burn Wound Treated by Suction Blistered Epidermal Grafting

The patient was a 34-year-old male who had the dorsum of his right foot burned with strong alkali. Subsequently, the wound changed to an ulcer 3 days after the accident, and it was resistant to conventional treatment. After seventeen days of a granulation tissue-forming period, we applied a suction blistered epidermal graft using an intrinsic heating system we had devised. Suction blistered epidermal grafting is a less painful method with minimal scarring that is applicable to various skin diseases and researches. However, currently used techniques require patients to be immobile for some time and it makes physicians and patients feel uneasy and uncomfortable. The time needed for the suction blister formation is dependent on many factors. Among them, the temperature and the suction pressure are the important factors that can be modified easily. So, we devised a suction device having the capability to heat itself and used a suction machine with a pressure meter. We applied this to the above patient. We present a case of a chemical burn wound treated with suction blistered epidermal grafting.