Lâmpada de Wood na dermatologia: aplicações na prática diária / Wood's lamp in dermatology: applications in the daily practice

A prática clínica do dermatologista baseia-se na análise das lesões cutâneas. Essa análise é feita essencialmente pela observação clínica, e atualmente complementada com exames como a dermatoscopia e a microscopia confocal. Apesar de seu baixo custo, a lâmpada de Wood tem sido cada vez menos utilizada como método diagnóstico auxiliar. Apresentamos diversos casos de utilização da lâmpada de Wood sendo de grande auxílio ao dermatologista. Esperamos assim incentivar o uso desse aparelho na prática diária.

The dermatologist's clinical practice is based on the analysis of cutaneous lesions that is carried out mainly by clinical observation, and currently supplemented with tests such as dermoscopy and confocal microscopy. Despite its low cost, the Wood's lamp has been decreasingly used as an auxiliary diagnostic method. The authors of the present study describe several cases of use of the Wood's lamp where it provided valuable assistance to the dermatologist, aiming at encouraging the use of this device in the daily practice.

A Clinical Analysis of 133 Cases of Pitted Keratolysis / 대한피부과학회지

BACKGROUND: Pitted keratolysis (PK) is an acquired, chronic, usually asymptomatic, non-inflammatory, superficial bacterial infection of the stratum corneum of the soles. Corynebacterium species are thought to be the causative organisms of PK. This condition is common in feet of active people wearing sweaty shoes, namely, athletes and soldiers. OBJECTIVE: To analyze the clinical manifestations of pitted keratolysis. METHODS: A total of 133 Korean male soldiers diagnosed with PK (aged between 19 and 33, mean 21.9 years) were included in this study. All patients were investigated between April 2004 and May 2005. Factors investigated included age, location, duration, date of visit, physical examination, subjective symptoms, associated medical conditions, and treatment modalities. All patients were examined carefully to verify accompanying erythrasma or trichomycosis axillaris (TMA). RESULTS: About half of the patients visited our department in spring (March, April, and May). However, PK was found in all the seasons. The ball of the foot was the most frequently involved site (92.5%). The big toe (72.2%) was also a frequent site of involvement. Forty-five patients (41.7%) had coexistent erythrasma, 22 (20.4%) had TMA, and 14 (13.0%) had a simultaneous presence of both erythrasma and TMA. Hyperhidrosis (98.5%) and foul odor (95.5%) were the main complaints in most of the patients. Other symptoms associated with PK were sliminess (38.3%), burning (23.3%), itching (18.8%), and prickling (13.5%) sensations. Various treatment modalities such as topical antibiotics, topical antifungal agents, and oral erythromycin have been used. All lesions subsided within 1 month after treatment. Although recurrence rate was high (64.3%), parameters such as period of prevalence, size and shape of the lesion, and treatment modality were not associated with the recurrence rate. CONCLUSION: The present study provides basic clinical information on PK, which is a common condition of the feet of Korean male soldiers.

A Case of Generalized Annular Lichen Planus Controlled by Erythromycin / 대한피부과학회지

A 69-year-old man presented with annular lichen planus involving both forearms, hand dorsa, wrists, inner sides of the thighs, knees and ankles. He was treated initially with systemic corticosteroids and etretinate, but rernission and recurr ence of the skin lesions were observed. During the follow-up, we found erythrasma on all his toewebs and both soles. After administration of erythromycin for the treatment of erythrasma, lesions of the lichen planus rapidly improved. Five months later, some lesions of lihen planus and erythrasma had recurred. After administration of erythromycin, the lesions of lichen planus improved again. No recurrence was observed for the following 8 months. We suspect that eradication of the chronic focus of infection and the anti-inflammatory effect, of erythromycin may lead to supression of abnormal immunological reactions and resolution of lichen planus.

The Incidence and Culture of Erythrasma in Korea / 대한피부과학회지

BACKGROUND: The authors did not find any study about erythrasma in Korea, where as there are several studies about the incidence and bacteriology of erythrasma in some areas. Failure to differentially diagnose the clinical entities of tinea pedis versus erythrasma can lead to mistreatment and disability because of the clinical similarities. OBJECTIVE: This study was carried out to investigate the incidence of erythrasma according to the seasons and sites, to determine the useful culture media, and to evaluate the antibiotic sensitivities and the treatment responses. METHODS: The incidence of erythrasma was investigated among the unselected dermatologic patients. The axillae, groins and toewebs were examined under Wood's light. The scale showing characteristic coral-red fborescence was Gram-stained and Corynebacterium minutissimnm was cultured using Loeffler slant media, Brucella blood agar plates and usual blood agar plates. RESULTS: Clinical erythrasma was found in 26.7% of the 240 patients examined. The incidences of erythrasma in summer and fall were higher than winter In the bacteriologic study Gram positive cocco-bacilli were found in all erythrasma patients and Corynebacterium minutissimum was cultured and identified in 24 0%. Most of cultured causative organisms were sensitive to usual antibiotics in the clinical uses. The average interval from the oral administration of erythrasma to the loss of coral-red fluorescence was 4.1 weeks, and the patients in severe erythrasma group were needed more time(2.2 weeks) for clinical improvement than the patients in mild one. CONCLUSION: Erythrasma is common in the dermatologic patients and it is important to differentially cliagnose the clinical entities of tinea pedis versus erythrasma.