A Case of Allopurinol Hypersensitivity Syndrome

Allopurinol is a xanthine oxidase inhibitor widely used to control plasma uric acid levels. Serious and life threatening adverse effects such as the allopurinol hypersensitivity syndrome(AHS) are rare. We describe a 32-year-old female patient who was treated with allopurinol and developed fever, rash, and renal and liver dysfunction.

A Case of Generalized Pustular Psoriasis Associated with Myasthenia Gravis / 대한피부과학회지

Generalized pustular psoriasis(GPP) is an uncommon and severe form of psoriasis. The possible provocative factors such as steroid therapy, infection, stress, drugs, pregnancy, sun exposure, and metabolic disorders were reported. Among them, corticosteroid therapy is thought to be the most common factor. Although the cause of psoriasis remain obscure, the coexistence of psoriasis and autoimmune disease and cyclosporin accepted for the treament of psoriasis emphasize the importance of immunologic mechanism in the pathogenesis of psoriasis. We present a case of GPP in a 48-year-old male, who has had a history of myasthenia gravis since the age of 34 years and managed with long-term corticosteroid therapy. With the administration of acitretin and cyclosporin, generalized pustular eruptions nearly cleared and clinical improvement was achieved.

A Case of Pigmented Neurofibroma

Pigmented neurofibroma, a variant of neurofibroma, has rarely been observed in patients with or without neurofibromatosis. Pigmented neurofibroma is characterized histologically by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiation. We report a case of pigmented neurofibroma in a 22-year-old female patient.

A Study of Food Allergy in Atopic Dermatitis Using CAP-RAST FEIA and Open Food Challenge Test / 대한피부과학회지

BACKGROUND: The role of dietary factors in atopic dermatitis has been the subject of debate for several decades. Recently it has received convincing support from a double-blind controlled trial of an exclusion diet, showing benefit from careful avoidance of egg and milk in a group of atopic children. OBJECT: The purpose of this study was to determine the prevalence of specific food allergies in Korean atopic dermatitis and the potential utility of the Pharmacia CAP-RAST FEIA in the diagnosis of food allergy. METHODS: One hundred ten patients with atopic dermatitis were evaluated for food hypersensitivity by history, skin prick test, CAP-RAST FEIA, and open food challenge test(OFCT). RESULTS: The prevalence of specific food allergies in the study population was 28.2% in history and 18.2% in CAP-RAST FEIA and OFCT. The frequent food allergens were milk, egg, peanut, and wheat. There was no correlation between the clinical severity of atopic dermatitis and CAP-RAST FEIA and OFCT results. Plasma eosinophil and IgE levels were correlated with CAP-RAST FEIA results, but not OFCT results. According to the history, 31 atopic dermatitis patients answered that their dermatitis was related to food, and of the 31 patients, positive reactions to prick test and CAP-RAST FEIA were observed in 8 and 22 patients, respectively. Among the other 79 patients who answered that there was no relation between atopic dermatitis and food, 14 patients reacted positively to prick test and 47 patients showed positive result to CAP-RAST FEIA. CONCLUSION: The CAP-RAST FEIA provides standardized measurement of food specific IgE antibodies which may be useful to diagnose food allergy in atopic dermatitis.

A Case of Intradermal Nevus with Seborrheic Keratosis / 대한피부과학회지

A review of the literature indicates that the simultaneous occurrence of two or more neoplasms in one specimen is a relatively infrequent finding. The finding of nevocellular nevi in close association with seborrheic keratosis, desmoplastic trichoepithelioma, syringoma, basal cell carcinoma, trichilemmal cyst, and epidermoid cyst raises interesting points about the histogenesis of these lesions. The combined occurrence of nevus with other epithelial neoplasms may indicate that changes in the microenvironment produced by nevus result in the induction of growth of the ectodermal origin neoplasms. We report a case of simultaneous occurrence of intradermal nevus and seborrheic keratosis.

A Case of Metastatic Cancer of the Penis from Urinary Bladder Carcinoma / 대한피부과학회지

Despite abundant blood supply, metastatic tumors of the penis are rare. We report herein a case of metastatic cancer of the penis from urinary bladder carcinoma in a 80-year-old man. He presented with 1 month history of erythematous tender mass on the penis which developed 16 months later after the diagnosis of carcinoma of the urinary bladder had been made. Skin biopsy from this lesion revealed variable sized atypical cells with hyperchromatic and pleomorphic nuclei similar to those of the urinary bladder. On immunohistochemical staining, infiltrating cells of both bladder and penis showed positive reaction to thrombomodulin and carcinoembryonic antigen(CEA), but negative reaction to cytokeratin20 and C-erB-2 oncogene.

A Case of Ramsay Hunt Syndrome with Vocal Cord Paralysis / 대한피부과학회지

Ramsay Hunt syndrome or herpes zoster oticus is a viral disease associated with otalgia, vesicular eruption, facial paralysis, hearing disturbance, tinnitus, vertigo and other symptoms. Rarely it can be associated with involvement of IV, V, IX, X, XI, XII cranial nerves, cervical plexus, and diffuse encephalitis. We report a case of Ramsay Hunt syndrome with vocal cord paralysis which developed prior to facial nerve paralysis.

A Case of Acroangiodermatitis associated with Arteriovenous fistula / 대한피부과학회지

Acroangiodermatitis is a reactive vasoproliferative disorder of cutaneous blood vessels. It usually has underlying conditions of increased venous pressure or circulatory abnormality. We report a case of acroangiodermatitis associated with arteriovenous fistula. A 52-year-old man was referred to our department because of purplish brown colored crusted plaques on his left third, fourth, and fifth fingers. He was chronic renal failure patient who had received hemodialysis by arteriovenous fistula on his left forearm for 2 years. Histopathologically, a biopsy revealed proliferation of capillaries and extravasated erythrocytes in the dermis.

Characterization of a Species-specific Antigen in Rickettsia typhi

Murine typhus is an acute febrile illness caused by Rickettsia typhi. It is one of the four major acute febrile illnesses in Korea during autumn. To study a species-specific antigen of R. typhi, two clinical isolates (87-91 and 87-100) and two reference strains (VR-144 and VR-738) were analyzed by mouse antisera and monoclonal antibodies (MAbs). On SDS- polyacrylamide gel electrophoresis (PAGE), R. typhi showed major antigen bands of 135, 80, 75, 64, 47, 22, and 19 kDa and these bands differed with those of other species. On Western blot analysis, the MAbs reacting only with R. typhi could only detect 135 kDa protein. The 135 kDa protein appeared to be the species-specific antigen. Other MAbs showing cross-reactivity with R. prowazekii reacted with 135 kDa protein in fresh culture supernatant of R. typhi infected host cell. However, the cross-reacting antibody did also react with smaller protein bands, most of which seem to be degradation products of the 135 kDa protein since they increase in old protein stocks purified from R. typhi harvested from infected host cell. These suggest that 135 kDa protein is unstable and the R. typhi specific epitopes are located at the regions of 135 kDa protein that are removed when the protein is degraded. The 135 kDa protein or its specific and stable recombinant protein would serve an important target for the development of vaccine and specific diagnostic antigen.

A Case of Dystrophic Calcinosis Cutis on the skin graft site / 대한피부과학회지

Calcinosis cutis is the deposition of calcium phosphate into the skin. It is classified as dystrophic if the calcium is deposited in previously damaged tissue and serum calcium and phosphorous levels are normal. We report a case of dystrophic calcinosis cutis in a 35-year-old man. About 2 months ago, he developed an ulcer in the left thigh that was treated by grafting. Histopathologically, amorphous basophilic materials that stained with von Kossa were deposited in the dermis.

Diseases Associated with Psoriasis: Multicenter Study / 대한피부과학회지

BACKGROUND: The prevalence of other diseases associated with psoriasis has been investigated in recent years. OBJECTIVE: This study was performed to see diseases associated with psoriasis in Korea. METHODS: From september 1999 to May 2000, a total of 293 patients with psoriasis, who visited the department of dermatology in 6 hospitals were enrolled in a subject group for the study. We surveyed the incidence rates of associated diseases. RESULTS: In our study, diseases more concomitantly present in patients with psoriasis were dermatophyte infection, seborrheic dermatitis and benign tumor and nevus in skin diseases and obesity, diabetes mellitus, hypertension, gastritis and hepatitis in systemic diseases. Less concomitantly present in patients with psoriasis were erythroderma, acne, contact dermatitis, atopic dermatitis, bacterial infection, tonsillitis, and internal cancer. CONCLUSION: Our observations show a distinct pattern of diseases associated with psoriasis in Korea. Further investigation will be mandatory to elucidate concomitant diseases in psoriasis.

A Case of Solar Urticaria / 대한피부과학회지

Solar urticaria is an uncommon disorder characterized by pruritus, erythema and whealing occurring minutes after exposure to sunlight or artificial radiation, and generally resolves in a few hours. A 46-year-old woman presented with a 2-year history of pruritus and whealing, which occurred immediately after exposure to sunlight. Phototesting elicited urticarial reactions in the UVA and visible sepectra. The results of passive and reverse passive transfer studies were all negative. The patient was treated with cetirizine, doxepin and prednisolone. After 2 months of the treatment, the symptoms did not appear.