Pigmentary Changes Following Photodynamic Therapy with 5-aminolevulinic Acid or Methyl Aminolevulinate Cream / 대한피부과학회지

BACKGROUND: Several side effects such as pain, erythema, and hyperpigmentation have been reported following photodynamic therapy (PDT). OBJECTIVE: We sought to compare the pigmentary changes induced by PDT with 5-aminolevulinic acid (ALA) and those induced by PDT with methyl aminolevulinate (MAL) in people with skin phototypes III-IV over a 6 month period. METHODS: In ten healthy volunteers, six skin areas on the upper arm of each subject were treated with (A) ALA 20% in base cream without irradiation, (A1) MAL 16.8% without irradiation, (B), (B1) control vehicles, (C) ALA 20% in base cream, and (C1) MAL 16.8%. Areas (B), (B1), (C), and (C1) were irradiated at four hours after photosensitizer or vehicle application. Irradiation was administered twice with a 1 week interval. The effects on the skin were assessed by visual and colorimetric evaluations. RESULTS: On (C) and (C1) areas, erythema and pigmentation were most pronounced at 30 minutes after the second irradiation. Erythema rapidly diminished but pigmentation persisted throughout the study. Erythema and pigmentation on (C)-treated areas were more prominent and prolonged than those on (C1)-treated areas. CONCLUSION: In subjects with skin phototypes III-IV, pigmentation tends to last for more than 6 months after PDT. The ALA-treated skin areas developed more severe and prolonged erythema and pigmentation than the MAL-treated skin areas.

A Case of Plasma Cell Balanitis Controlled by Fusidic Acid Cream / 대한피부과학회지

In 1952, Zoon described eight cases of benign circumscribed chronic balanitis characterized by an extensive infiltration of plasma cells with no evidence of dysplasia of the overlying epidermis. Plasma cell balanitis can often be confused clinically with other conditions, such as erythroplasia of Queyrat, fixed drug eruptions, secondary syphilis, candidiasis and Reiters disease. We report a case of plasma cell balanitis in a 65-year-old man. He complained of a single, red, shiny and smooth patch involving the glans penis and adjacent prepuce. This patch was unresponsive to systemic and topical steroid treatment. Laboratory studies were negative or within the normal range. Histopathological findings showed a band-like mainly plasmacytic inflammatory infiltrate of the upper dermis. This patient was treated once daily with 2% fusidic acid cream topically for 5 weeks. The lesions resolved and no recurrence was observed during 2 years of follow-up.

A Case of Hypopigmented Mycosis Fungoides / 대한피부과학회지

No abstract available

A Case of Lymphoma en cuirasse / 대한피부과학회지

Lymphomatous involvement of the skin has been reported to occur in approximately 15% to 20% of patients with lymphoma and in 5% it constitutes the initial presentation of lymphoma. In 1986 Saekow et al. described a patient with a progressively enlarging, indurated lymphomatous plaque on the chest and upper abdominal region that had the shape of a breastplate. They used the term lymphoma en cuirasse. We report a case of lymphoma en cuirasse in a 71-year-old female. She had a well defined, erythematous, hard, indurated plaque on the neck and chest. On physical examination, the right supraclavicular, left inguinal and both axillary lymph nodes were palpable. A Bone marrow aspiration test, chest X-ray and cmputerized tomogram revealed bone marrow and lymph node involvement. Histopathologic examination of the involved skin showed that hyperchromatic and anaplastic lymphocytes were clensely packed in the dermis and subcutaneous fat. On immunohistochemical examination, the tumor cells were positive for the leukocyte common antigen and UCHL-1. We tried to treat the patient with combination chemotherapy, but she refused. After discharge, the patient died one week later.

The Effect of All-Trans-Retinoic Acid and Ursolic Acid on the Ultraviolet A Radiation Induced AP-1 (Fos/Jun) Activity in Cultured Human Dermal Fibroblasts / 대한피부과학회지

BACKGROUND: Recently, UVB irradiation was found to activate AP-1, which is known to be a major enhancer factor of the collagenase gene. However, tbe effect of UVA irradiation on the activity of AP 1 in derrnal fibroblasts is unclear. Although all trans-retinoic acid(tRA) has been known to prevent. the AP 1 and collagenase stimulatory effect of UVB irradiation, the effect of tRA and ursolic acid(UsA) on the enhancement of AP-1 activity hy UVA irradiation is unknown. OBJECTIVE: In this stuc y, the effect of UVA irradiation on the AP-1 activity in cultured human dermal fibroblasts was studied. The effect. of tRA and UsA on the enhancement of AP-1 activity by UVA irradiation was also investigated. METHODS: Confluent human dermal fibroblasts were irradiated with 15J/cm of UVA. Drugs were administered and kept in a culture rnedia for 12 hrs before or immediately after UVA irra diation. Nuclear protein extracts were isolated 12 hrs after UVA irradiation and were subjected to gel retardation assay ising oligolabeled DNA probe for AP l binding site. RESULTS: 1. The activity of AP-1 was increased by UVA irradiation and prominent activation was detected at 6 and 12 hrs postirradiation. 2. Compared to the UVA irradiated group, tRA and the high concentration(10(-5)M) of UsA administered before or al ter UVA irradiation inhibited the increase of AP-1 activity. CONCLUSION: These res ilts suggest that UVA irradiation enhance the AP-1 activity, which is known to be a major er hancer factor of the collagenase gene, and tRA and UsA downregulate the 1JVA induced AP-l activity enhancement.