Comparison of MAST Chemiluminescent Assay(MAST-CLA) with Skin Prick, Test in Patients with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Allergic reactions are known to be associated with symptomatic aggravation of atopic dermatitis. Skin prick tests were used as a routine in vivo screening test for the evaluation of allergic patients. Many tests to detect specific IgE antibody including RAST, FAST and MAST chemilu-minescent assay (MAST-C~LA) were also used. Previous studies revealed that the results of skin prick tests and MAST-CLA were well correlated in patients with asthma, allergic rhinitis and urticaria. OBJECTIVES: The purpose of this study was to evaluate the effectiveness of MAST-CLA compared with skin prick tests in patients with atopic dermatitis. METHODS: We performed the chemiluminescent assay with 35 allergens and skin prick tests with 23 allergens common with allergens used in MAST-CLA in 34 patients with atopic dermatitis. The positive reaction rate of allergens in each test and sensitivity, specificity, efficiency, positive predictive value and negative predictive value of MAST-CLA to the skin prick test were evaluated and MAST net volts of serum total IgE was compared with PRIST.

A Case of Alopecia Areata Associated with Myasthenia Gravis and Thymoma / 대한피부과학회지

Alopecia areata is infrequently associated with other diseases, such as, atopic dermatitis, Down syndrome and various autoimmune diseases including thyroiditis, vitiligo, connective tissue diseases, Addison's disease and pernicious anemia. However the association of alopecia areata with myasthenia gravis, a known autoimmune disease, accompanied by thymoma has been rarely reported. We describe herein such a case.

Therapeutic Effects of Calcipotriol Solution in the Treatment of Scalp Psoriasis / 대한피부과학회지

BACKGROUND: Calcipotriol ointment has been reported to be a safe and effective treatment for patients with psoriasis vulgaris. Scalp involvement of psoriasis is extremely common and in some patients the scalp may be the only affected site. OBJECTIVE: Our purpose was to assess the efficacy, safety and tolerability of calcipotrial solution(50 u g/ml) in the treatment of scalp psoriasis. METHODS: Twenty five patients with mild to moderate scalp psoriasis were treated with calcipotriol solution(50 u g/ml) twice daily for 8 weeks. Efficacy as measured by erythema, thickness and scale of the lesions and safety were assessed every 2 weeks. RESULTS: Reduction of scores of erythema, thickness and scale of the lesions was statistically significant through the treatment. The extent of psoriasis and itching also decreased. An analysis of the overall assessment by investigator and patients at the end of the treatment showed cleared or marked improvement in 80% and 68% individually. Some patients developed a mild and transient burning sensation(2%) or lesional irritation(2%). Laboratory tests including serum calcium levels did not show any significant changes. CONCLUSION: Calcipotriol solution can be used as an effective and safe treatment method for scalp psoriasis.

Longitudinal Melanonychia due to Candida Species

A 55-year-old Korean female patient who presented with longitudinal black pigmentation affecting the right thumbnail is described. Direct microscopic examination of nail tissue in 15% potassium hydroxide and cultures on Sabourauds glucose agar revealed Candida species. Cardida species as a cause of longitudinal melanonychia has, to our knowledge, been described only once in the literature. Our case may be the second one.

Clinical Study of ZalsmingR on Xerosis and Pruritus / 대한피부과학회지

BACKGROUND: Xerosis is a relatively common disorder, especially in the elderly. The condition is characterized by fine scaling and is associated with generalized pruritus. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy, safety and tolerability of Zalsming cream in patients with xerosis and pruritus. METHODS: Thirty patients were treated with Zalsming cream. Clinical efficacy, as measured by the score of subjective symptom and objective signs, transepidermal water loss(TEWL) and electron microscopic finding, were asessed at 2, 4, and 6 weeks after topical application of the cream. RESULTS: The scores of clinical signs and TEWL showed statistically significant improvements. No one developed any local or systemic side effects. CONCLUSION: Topical application of Zalsming cream was found to be effective and safe for patients suffering from xerosis and pruritus.

Clinical Features and Detection of Human Papillomavirus in Inverted Follicular Keratosis / 대한피부과학회지

BACKGROUND: Inverted follicular keratosis has distinctive histopathological features and is infre quently encountered by dermatologists. To date, the pathogenesis of inverted follicular keratosis has not, been concluded. Many authors have suggested several theories for the nature of inverted follicular keratosis including vearuca vulgaris with squamous eddies, irritated seborrheic keratosis and dist,inctive follicular tumors. OBJECTIVE: It is the purpose of this study to observe and compare the clinical features of in verted follicular keratosis with previous studies and evaluate the possible relationship between in verted follicular keratosis and human papillomavirus to clarify the nature of this condition. METHODS: We studied 9 patients with inverted follicular keratosis for clinical features including the duratiori of the disease, the location and size of the lesions, the clinical impressions at the first visit and we made a record of the patients age and sex. To evaluate the relationship be tween inverted follicular kerato is and the human papillomavirus, we performed immunohistochvm ical staining using polyclonal antibodies to the human papillomavirus common antigen. We also used the polymerase chain relation to detect hurnan papillomavirus DNA in inverted follicular keratosis from paraffin embedded tissue preparation. RESULTS: 1. Seven of the 9 patients were male and the ages ranged fiom 36 to 77 years(mean 53 years). The lesions were situat d on the face(4/9), abdomen(1/9), back(1/9), chest(1/9), scapular area(1/9) and leg(1/9). The average size of the lesions was 1.5 cm. Verruca vulgaris was the most common clinical diagnosis(3/9), followed by seborrheic keratosis(2/9), soft fibroma(2/9), pigmented nevi(1/9), and granioloma pyogenicum(1/9). 2. Immunohistochemical stainiiigs using polyclonal antibodies to the human papillomavirus common antigen were negative for all 9 cases. 3. Polymerase chain reaction; using primers for human papillomavirus DNA were negative for all 9 cases. CONCLUSION: In general, our linical findings are similar to those of others in previous studies. Our results of immunohistocheriiical staining and the polymerase chain reactions suggest, that in verted follicular keratosis is ncl, related to the human papillomavirus. Further investigations inf'o the nature of inverted follicular keratosis, should be centered on initated seborrheic keratosis and distinct follicular tumors.

A Study on the Changes of T Lymphocyte of the Peripheral Blood in Patients with Alopecia Areata using Flow Cytometry / 대한피부과학회지

BACKGROUND: The immunologic mechanism of alopecia areata is not definitely confirmed although alopecia areata is regarded as a disease occuring from certain immunologic process. T lymphocyte infiltration in and around hair follicle demonstrated by many investigators and frequent detection of nonspecific autoantibodies in the serum of patients with alopecia areata suggest that certain systemic factors are related to the development of alopecia areata. But, the changes of T lymphocyte of the peripheral blood in patients with alopecia areata is not confirmed despite of many investigations OBJECTIVE: The purposes of this study were to determine the changes of T lymphocyte of the peripheral blood in the patients with alopecia areata compared with normal control subjects and to compare T lymphocyte subsets(CD3, CD4,CD8, CD4/CD8 ratio and CD1) based on activity, extent and duration of disease within patients with alopecia areata. METHODS: We performed analysis of T lymphocyte subsets of the peripheral blood in 38 patients with alopecia areata and 307 normal control subjects using flow cytometry. The patients with alopecia areata were sublivided into active and stable based on activity, into patchy, diffuse and alopecia totalis and alopecia universalis based on severity and into less t.han one year and more than one year based on duration and T lymphocyte subsets were compared according to subdivision. RESULT: In the patients with alopecia areata, total T lymphocyte, helper/inducer T lymphocyte and suppressor/cytotoxic T lymphocyte were decreased and helper/suppressor ratio and CD1 were increased compared with normal control subjects(p0.05). Also, there were no significant differences in total t lymphocyte, helper/inducer T lymphocyte suppressor / cytotoxic T lymphocyte, helper/suppressor ratio and CD1 compared based on extent and duration of disease(p>0.05). CONCLUSION: From the above result it is suggested that the decrease of suppressor T lympho cyte is related to development of alopecia areata and CD1 is related to activity of disease.

A Case of Erythema Nodosum Associated with Ulcerative Colitis / 대한피부과학회지

We report a case of erythema nodosurn associated with ulcerative colitis which occurred in a 13-year-old girl who showed well demarcated, painful, erythematous nodules and plaques on both upper and lower extremities. The patient also experienced frequent intermittent abdominal pain and bloody stools for about 1 year. Laboratory findings revealed polymorphonuclear leukocytosis and occult blood in the stool. Findings of sigmoidoscopy, barium enema, and rectal biopsy were consistent. with ulcerative colitis. A skin biopsy from the lesion on the right shin revealed a moderate inflammatory cell infiltrate in the septa of the subcutaneous fat layer, composed chiefly of lymphohistiocytes and a few epitheloid cells. The symptoms and signs responded well to orally administered prednisolone and sulfasalazine.