Comparison of the Epidemiological Study on Leprosy in Korea and in Iran / 대한피부과학회지

The registered number of leprosy patient in Korea is 34,064 in May 31, 1973, but many leprosy cases are not detected yet. There is no doubt that the crucial purpose of The leprosy control propram is to find the hidden or unknown cases at their very early stage of the disease and to keep them under regular treatrnent. It is certain tnat the best method to detect all leprosy cases should be the "Mass Survey" exploring all residents in the project area, however, it is impossible to carry out in all villages of the area. At this time being, the most effective method of new case detection is considered to be the "Intensive Village Survey", of which idea is like a fire brigade excercise. To obtain an advanced and correct information for the intensive village survey, all villages in 6 provinces in which the leprosy conntrol program is carrying out are analysed by prevalence rate, lepromatous rate and the positivity (positive patient) rate, and devided into two groups, i.e, higher prevalence rate area(over 3%) and lower prevalence rate area (under 3%). As the first step of the project, the intensive village survey is recommended in this country with a limitted feasibility of personnel, facilities and finance. If the total survey exploring all residents in village to detect new cases is done, the follow-up total survey is not necessary in the same area. Intensive village survey mainly by house hold contact and neighbors examination would be the most effective method for new case finding and controling the aleady registered cases. (countinued..)

A Case of Lichen Scrofulosorum / 대한피부과학회지

Lichen scrofulosorum, also known as Tuberculosis cutis lichenoides, is thought as a tuberculid such as Erythema induratum, Papulonecrotic tuberculid, Tuberculosis miliaris disseminata and Lupus miliaris disseminatus faciei. The lesions of Lichen scrofulosorum are pin-head sized or smaller, normal skin or reddish brown colored, arranged in nummular groups, usually on the trunk, where they persist unchanged or undergo spontaneous involution. As a rule, they appear in children who have tuberculosis of the bones or the lymphnodes. We report a case of Lichen scrofulosorum, 13-year old girl, who showed clinically and histologically typical lesions on the trunk. She was highly sensitive to Mantoux test and had tuberculous lymphadenitis of left cervical lymphnodes, but the chest was negative. Many challenges to the tuberculous origin of the tuberculids including Lichen scrofulosorum have prevailed for the last decade, Several studies and reports indicated that healing responses of Erythema induratum and other tuberculids to corticosteroids were more definite than to anti-tuberculosis drugs. But more recently, some reports recommended that anti-tuberculosis drugs were eftective than corticosteroids (in the treatment of Erythema induratum and other tuberculids). In this case anti-tuberculosis treatment with PAS 10gm., INH 400 mg., and streptomycin 1.0 gm. daily for the first one month and then 1.0gm. twice a week has remarkably improved the clinical manifestation in follow-up of three months. While the follow-up period was no enough, we strongly suggest the tuberculous origin of Lichen scrofulosorum.

Xepoderma Pigmentosum Complicated by Squamous Cell Epithelioma and its Treatment with Bleomycin / 대한피부과학회지

Xeroderma pigmentosum, a rare, genetically determined dermatosis, is often cornplicated by malignant chagnes of various types-most commonly, basal-cell epithelioma, squamous cell epithelioma, less frequently malignant meIanoma, keratoacanthoma, fibrosarcoma, and endothelioma have been reported. In Korea, no case has ever been reported in literature except four cases at a symposium for dermatology, two of them complicated by basal-cell epithelioma, and the others by squamous cell epithelioma. This case reported was complicated by squamous cell epithelioma. As one of the anticancer treatments, especially for skin cancer, Bleomycin is, now, drawing the attention for its high therapeutic index with only few side effects. For this case, we injected Rleomycin 15mg at once, twice a week, for 8 weeks, So total injection was 16 times and 240mg of Bleomycin was given in total. While this amount given for this case was not enough for the complete treatment of squamous cell epithelioma, we got the following results: 1. Clinically, the ulcerated lesion of the cancer on the right ala nasi had shrunken in size with reepithelialization at the margin showing clear surface, and 2. microscopically, the atypical cancer cell masses and individual cell keratinizations had been decreased in size and in number, and less remarkable comparing to those in untreated stage at his first visit to the hospital.