Clinical Trial of Low Level Laser Therapy in 20 Patients with Postherpetic Neuralgia / 대한피부과학회지

Postherpetic neuralgia(PHN) can be extremely debilitating condition. Treatment protocols for PHX may vary from center to center, such as conservative and intensive supportive therapeutic regimens, for example, oral medication, cutaneous nerve stimulating therapy, even acupuncture and hypnotherapy have been stressec In spite of all these measures, some 15% of PHN suffers gain little or no ra lief. Anecdotal reports have suggested that low level laser therapy(LLLT) is effective in the relief of various types of neuralgia. Rased on these, we were interested to apply LLLT for crucial condition of PHN. This is a prelirninary clinical trial to evaluate the efficacy of LLLT in the treatment of the pain for well established and unrelieved PHN. In order to get more accurate result, subjective and objective criteria. were applied. The cases who showed the effectiveness in criteria of Excellent were 6/20(30 %) the cases who showed the effectiveness in criteria of Good were 3/20(15%), and the cases who showed the effectiveness in criteria of Fair were 3/20(15%). So the total cases who showed onset of the effectiveness of LLLT were 12 out of 20 cases(60%).

An Epiderniological Study of Contact Dermatitis: I . Multicenter Trials / 대한피부과학회지

The present work is the first joint epidermiological study of contact dermatitis carried out by the Korean Contact Dermatitis Research Group which was organized in 15i8p. For the past 2 years total 937 patients with contact dermatitie and suspected contact dermatitis have been routinely patch tested with Hollister-Stier standard battery (28 different antigens) by using Finn Chamber at 10 different General Hospitals which were located around Seoul area. The MOHL index was quite different from the western data, which was characterized with less male, rare leg ulcer and less occupational cases. However, housewife hand eczema cases were more common. The most common senaitiaers were ammoniated mercury, nickel sulfate, potassium dichromate, cinnamic alcohol, neomycin sulfate, paraphenylendiamine, balsam of Peru and thimerosal in order of frequency.

Water Content of Stratum Corneum in Healthy Individuals and Leprosy Patients / 대한피부과학회지

We evaluate the water content, hygroscopicity and water holding capacity in 40 healthy individuals and 17 leprosy patients by skin surface hydrometer(IBS Inc, Japan), and the correlation between the nerve destruction and the hydration state. In Eiealthy individuals the measuring sites were the flexor and extensor surfaces of the arm, forearm, thigh and leg, In leprosy patients we measured on the extensor surface of forearm with shows abnormal sensation, and opposite ar neighboring skin which shows normal sensation. The results are as follows: 1. The water content of healthy individuals is highest in the flexor surface af arm (49. 50 + 18.38ug ) and lowest in the extensor surface of leg(30.75 -12.09ug) 2. The hygrosccpicity of healthy individuals is highest in the flexor surface of arm(296. 30 + 70.75ug ) and lowest in the extensor surface of leg(24$. Q7+5) 5ppg) 3. The water content of the extensor surface of lorearm in leprosy patients, which .hows abnormal sensation, is decreased(16. 35 +20. 82 ug) and it is statisti calli significant when compared with healthy individuals(p<0.005). 4. The hygroscopicity of the extensor surface of forearm in leprosy patients. which shows abnormal sensation, is decreased(94. 29 + 71. 62 ug) and it is statistically significant when compared with opposite or neiphboring skin and healthy individuals(p<0. 005)

A Case of Juvenile Xanthogranuloma Associated with Cranial Bone Lesion / 대한피부과학회지

Juvenile xanthogranuloma is a benign disseminated xanthomatous and granulomatous condition of the skin and other organs. The skin lesions usually disappear spontaneously within 1 to 5 years. Our case was 4 month-old boy who had have match head to pea sized scattered yellowish papules and nodules on scrotum since age of 1 month and then these skin lesions gradually spread to trunk, face and scalp without subjective symptoms. Histopathologically, biopsy specimen of the trunk revealed massive accumulation of histiocytes at dermis. With fat stain, fat substance is demonstrated within the foamy histiocytes. The skull x-ray revealed coin sized, well circumscribed osteolytic lesion on the left parietal bone. By the age of two and half, most of the skin lesions and bone defect on skull x-ray disappeared spontaneously.

Quantitation of Immune Cells (T Cells, TM, TG and B Cells) and NK Cell Activities in Patients with Herpes Zoster / 대한피부과학회지

By recent advance of immunologic techniques, it made possible to measure the immune cells and NK cell activity in peripheral blood of various immune altered eonditions. NK cell activity is related not only to malignancies but also to viral infectiona. The facts that the impairment of cell mediated immunity inducea the herpes zoster infection and frequent association with herpes zoster in the patienta with malignancy promote author to atudy the alteration of immune cells and NK cell activity in peripheral block. So author evaluated irnmune cells and NK cell activity of 18 patients with berpes zoster. The results are as follows; 1. The mean value of T cells, T cells showed significant differences between patients group(58.4-i-6.9%, 33.7-+11.7%) and normal healthy control group (68. 6+ 4. 7yo, 44. 2+-7. 0%) but T,' and B cells showecl no significant between patientagroup(6.9-+2.4%, 12.5+-5.7%) and.controlgroup(7.8-1.5%, 13.9-+2.3g%), statistically. 2. The mean value of NK cell activity in patients with herpes zoster group (62. 9+-ll. 2%) showed no significance cornpaired with the mean value of normal healthy control group(57. 9+-l4. 8%), statiatically.

A Case of Erythrasma / 대한피부과학회지

Erythrasma is a chronic, superficial bacterial skin infection involving the body folds and toewebs, and sametimes it may be generalized. The causative organism of this disease is Corynebacterium minutissimum. But, in Korea, there are few reported case about this common condition. We experienced a case of erythrasma on 39-year-old male who have had well defined, brownish fine scaly patches on both crural areas for 15 years. We had treated this patient with topical antifungal agent for 1 month under impression of tinea cruris, But skin lesion was not improved. So, we reexamined the lesion and diagnosed it as genitocrural form of erythrasma with it's clinical appearance, red fluorescence under Wood's light. And we treated it with oral erythromycin.

A Case of Acropustulosis of Infancy / 대한피부과학회지

Acropustulosis of infancy is an uncommon, but not rare syndrome established as a new disease entity by Kahn and Rywlin(1976), which is characterized by recurrent, intensely pruritic vesicopustules on the distal extremities. We'd like to report a case of acropustulosis of infancy. Our patient was 19 month old girl who had been suffering from her skin disease since the age of 12 months. Intensely pruritic, 1 to 2 mm vesicopustules erupted on the palms, soles and the ventral aspects of the fingers. There were no bacteria, fungus and parasites(Sarcoptes scabiei) on the pustular lesions. Histopathologically, biopsy specimen of the left sole revealed large, well circumscribed intraepidermal pustule which was filled wth polymorphonuclear leukocytes. We confirmed our case as typical case of acropustulosis of infancy by it's characteristic clinical features and histopathologic findings. Severity of the skin lesions seems closely related to the dosage of dapsone. The eruptions were unresponsive to topical steroid, antibiotics and antihistaminics. But we observed that dapsone has dose dependent relationship with acropustulosis of infancy.

Immune Cells (T Cell, T Subsets and B Cell) in the Peripheral Blood of Patients with Psoriasis and Effects of Photochemotherapy (PUVA) on These Cells / 대한피부과학회지

Recent studies have demonstrated that the patients with psoriasis have various immune alternation in both humoral and cellular immunities. However the results of these are still controversial. These facts promoted us to analyze the immune cells (T cell, T subsets and B cell) by rosette method for these cells in peripheral blood of 15 patients with psoriasis. And we also analyzed the effects of photo- chemotherapy(PUVA) on these cells. The results were summerized as follows; 1. The mean values of T cell, T, T, cell and B cell in peripheral blood of the- patients with psoriasis before PUVA therapy were 56. 2+-5.7%, 35.1+-6.9%, 5. 5+l.4%, 11.6+4. 0% respectively, These results of immune cells showed signi- ficantly lower mean values when these were compaired with the mean values. of nomnal control group(T cell; 65. 2+-2.9%, TM cell; 45.8+-3.2%, T cell; 7.3+ 1.3% B cell; 16.2+2.4%), respectively (T cell, Tm Tg, p<0.01, B cell; p<0.05). 2. The mean values of T cell, T, T, cell and B cell in peripheral blood (countinue..)

Two Cases of Marjolin's Ulcer / 대한피부과학회지

Marjolin's ulcer seated upon an old cicatrix, especially old burn scar, which may chiefly degenerated into a squamous cell carcinoma with propensity for metastasis. We are experienced two cases of Marjolins ulcer recently. A 54-year-old male who had a Marjolins ulcer(15x40cm) on his left lower extremity. He was experienced burn at the age of eight and rice sized ulcer was developed at the site of burn scar about 21 years ago. The ulcer progressively enlarged in size to reach 15x40cm for 21 years. The pathologic diagnosia was squamous cell carcinoma grade 1, but cancer cells invaded to deep dermie and subcutaneous tissues. Severe skin lesion and irreversible osteoporotic degeneration on knee joint of affected limb were present. So he was treated by high above knee amputation. Another 58-year-old female who had a Marjolins ulcer(10x20cm) on her right lower extremity. She was experienced burn at the age of forty eight and bean sized ulcer was developed at the site of burn scar about 1 year ago. The pathological diagnosis was squamous cell carcinoma grade 1 and invasian of cancer cells was limited upper dermis. On lymph node biopsy, the histological diagnosis was within normal limit. So she was treated radical surgical excision with split thickness skin graft(Mesh).

Erythema Dyschromicum Perstans: Report of Three Cases / 대한피부과학회지

We observed three patients who showed widespread macular ashy-colored eruptions. They fit clinically and histopathologically with the typical erythema dyschromicum perstans (ashy dermatosis). Erythoma dyschromicum perstans is a peculiar pigmented condition of unknown etiology characterized by persistent ashy-gray colored macule, refractory to any modality. All of them have similar skin lesions which are multiple, variable sized oval-shaped, ash-colored macular eruption on the trunk and extremities. Histologic findings of 2 patients reveal the characteristic feature of focal hydropic degeneration of the basal cell layer of the epidermis, perivascular infiltrates of lymphocytes and histiocytes and melanin-laden macrophages in the corium, however, merely pigmentary incontinence into the corium in 1 patient. Literatures are briefly reviewed.

Photochemotherapy of Vitiligo with Topical Methoxsalen and longwave ultraviolet light / 대한피부과학회지

Vitiligo is a common acquired Thypornelanotic disease but the pathogenesis is still unknown and also the traatment is still unsatisfactory. The introduction in 1947 of psoralen therapy in vitiligo by El Mofty announced a new era in the treatment of this cosmetically disfiguring disease. Many investigators have developed therapeutic regimens for both topical and systemic poralen using various ligbt sources. The erythema action spectrum in UVA range of psoralen were defined, which consequently enabled the development of a more accurate regimen, namely psoralen and UVA(FUVA, exposure. The present study was undertaken to evaluate the efficacy of topical PUVA therapy in patients with vitiligo and to compare the result of PUVA therapy according to the age, sex, type of disease, total exposure dose, duration of disease nd involved site. Twenty one patients selected in the Department of Dermatology of Kyung hee University Hospital with various clinical types of vitiligo were treated with 03% 8-MOP ointment followed by exposure to longwave ultraviolet energy. Clinical response was graded as follows: Grade 0: No repigmentation Grade 1; Up to 25% repigmentaton Grade 2; 25% to 50% repigmentation Grade 3; 50% to 90% repigmentation Grade 4; Greater than 90% repigmentation A responsive case wss defined as a case with greater than 25% repigmentation. A effective case was defined as a case with greater than 50;o repigmentation.

A Case of Epidermolytic Hyperkeratosis / 대한피부과학회지

Epidermolytic hyperkeratosis is a rare disease which is extremely variable in its severity. In some patients it may be so severe and generalized during the neonatal period as to be lifethreatening, in others, it is relatively inconspicuous. A bullous eruption is the characteristic finding of the epidermolytic hyperkeratosis The bullous episodes soon become less frequent and more localized and may eventually cesse, but continue into adult life after the age of 20 years in at least 20% of cases. A case of epidermolytic hyperkeratosis is represented. The patient was a 25-year-old male who had ichthyosiform erythroderma and the frequent episades of bullous eruption. The bullous eruption had been subsided under the treatment with oral penicillin administration. The histopathological features of the bullous lesion on his abdomen revealed the features of epidermolytic hyperkeratosis.

Nevus Lipomatosus Cutaneus Superficialis: Report of two Cases / 대한피부과학회지

Nevus lipomatosus cutaneus superficialis is a very rare skin disease which appears at birth or within the firat two decades of life. This uncommon condition is due to collections of ectopic fat cells within the upper and mid-dermis. There are two clinical forms. The first form is a lesion of zonal distribution, present from birth or childhood, usually on the buttocks or the lower back. The second form, a dome or sessile, papule, begins in adult life and is less restricted in distribution, and occurs also on the limbs Coalescence of soft, yellowish papules tends to form cerebriform plaques. The authors experienced two cases of typical nevus lipomatosus cutaneus superficialis. The first case was a 23-year male who had asymptomatic, soft, skin colored, and pea sized confluent nodules on the right lower back area since at birth. The second case was a 35-year female who had asymptomatic, multiple, soft, skin colored from rice to walnut sized confluent nodules on the coccygeal area which developed at the age of 27. Diagnosis was confirmed by clinical and histopathological findings.

T and B Cells, T cell Subsets in Vitiligo Vulgaris / 대한피부과학회지

The basic pathophysiology of vitiligo is still obscure. Most researchers emphasized that poasible immunologic role is very important in pathophysiology of vitiligo. Also the type of vitiligo is classified by various type baaed on clinical manifestations. These facts promoted us to analyse the immunologic state in each type of vitiligo in order to verify whether there is present any immunologic alteration in this permatosis or any differences of immune state in each type of vitiligo. The following immune cells were analysed, T cell, B cell, and T cell subsets such as helper T cell and suppresaor T cell. Vitiligo vulgaris in our study showed alteration of immune cell such as low level of T cell and helper T cell.

A Case fo Multiple Neurilemmomas / 대한피부과학회지

Neurilemmoma reprsents a benign nerve sheath tumor derived from Schwann cells. Lesions almost always are solitary, although multiple lesions may occur in association with multiple neurofibromatosis. We report a case of multiple neurilemmomas not in asaociation with neurofibromatosis. The patient was a 28-year-old male who had multiple tender nodules along the course of peripheral nerves on the palmar aspect of the right hand. A local excision of all lesions was performed and the microscopic diagnosis of neurilernmoma was established.

A Case of Generalized Cutaneous Lichen Amyloidisus / 대한피부과학회지

A typical case of gelinerazed cutalineous lichen amyloidosus is reported. A 62-year-old female had had brownish papular lesions on the lower legs, hands, and shoulders for about 8 years. Three years later, the papular lesions extended through the whole body surface. She complained of severe itching and tingling sensation. Physical findings were confined to the skin. The skin lesions were diffusely distributed. The size of the lesion was from pin-head to rice, The color was dark brownish. The papules were over generalized skin except for the face, palms, and sole.. Diagnosis was made by the characteristic clinical manifestations and histopathologic findings of the skin. However, the specimens of the liver and rectal biopsies did not show amyloid deposits. Based on these findings, authors concluded that this is a case of generalized cutaneous lichen amvloidosus and this is the second case in the literature in Korea. Even though the subjective symptom such as itching is getting decrease, the clinical course of this disease could not be aliernated by classical and conventional therapeutic regimens.

A Clinical Study of 217 Cases of Vitiligo / 대한피부과학회지

Vitiligo is an acquired, disfiguring skin disease characterized by the loss of melanin, which results in depigmented areas of the skin. It affects at least 1% of the world's population. In countries where people are dark skinned, vitiligo is a major health problem. The pathogenesis of vitiligo has not been fully elucidated, but three possible origins, autoimmune, neurohumoral and self destruction of melanocyte, have been described. The clinical manifestations of vitiligo are well described in many reports. However in Korea, a few studies on the clinical features of vitiligo have been performed. Authors studied 217 Korean cases of vitiligo who had been visited at the Department of Dermatology, Kyung Hee University Hospital during the last 1 year (1978.4.1~1979.3.31). (countinued..)

The Findings of Cerebrospinal Fluids in 338 parients with Syphilis / 대한피부과학회지

We examined cerebrospinal fluids of 338 patients with syphilis who underwent the routine physical examinations or visited out-patient skin clinic at Kyunghee University hospital from January, 1978 to December, 1979. They were diagnosed as syphilis only with serological tests such as VDRL and TPHA tests. The patients did not have any neurologic symptoms associated with syphilis or any other clinical syphilitic syrnptoms. They did not have any history of receiving antisyphilitic treatment. The VDRL test, cell count, protein value, sugar and chloride levels in cerebr-ospinal fluid were tested in these patients. The results were as follows. 1) CSF VDRL reactive rate was 2. 1% among 388 patients with syphilis. 2) CSF celI count was not less than 5/mm in 2 patients (28. 6%) among the 7 patients with syphilis, who showed the positive reactivity of CSF VDRL, and in 13 patients (3. 9%) among the 331 patients with syphilis who did not show the positive reactivity of CSF VDRL. 3) CSF protein level was more thnn 45ml/dl in 3 patients (42. 9%) among the 7 patients with syphilis who showed the positive reactivity of CSF VDRL anct ig, 65 patients (19. 6%) among the 331 patients with syphilis who did not show the positive reactivity of CSF VDRL. 4) Both CSF sugar and chloride levels were within norrnal limits in all of the 7 patients who showed the positive reactivity of CSF VDRL.

A Case of Forduce's Disease / 대한피부과학회지

The authors eneountered a 39 years old male patient with extensive Fordyce's disease involving the upper lip and buccal mucous mernbrane. The skin lestens were small, discrete and grouped yellowish white papules of about 10 years duration. Diagnosis was made by the characteristic clinical and histopatholqgiC findings.

A Case of Pellagra with Psychoneurotic Symptoms and Neurologic Disturbances / 대한피부과학회지

The authors experienced a case of typical pellagra in 45-year old male. He has been a heavy alcoholic history about 30 years duratian. Well-marginated erythematous created scaly patches, hyperpigmentation and fissures developed on both forearms and both ear lobes, both periorbicular areas, and Casals and klace on the aa0erior neck repeatedly. The skin leaions were aggravated in summers, improving a little in winters from 3 years ago. The psychoneurotic symptoms, neurologic disturbances, and GI troubles accompanied the skin lesions. Diagnosis was made by the characteristic clinical findings. He was treated with nicotinamide and vitamin B complex, and most of symptoms improved much. Authors reported the case and reviewed the literatures.