A 5 - Year Clinical Study on Herpes Zoster: 1990 - 1994 / 대한피부과학회지

BACKGROUND: Herpes zoster is an important and troublesome disease. OBJECTIVE: The purpose of this study was the elucidation of the epidemiological and clinical characteristics of herpes zoster through patient assessrnent. METHODS: During a 5- Year period, January 1990 to December 1994, 215 patients with herpes zoster were assessed with regard to annual and monthly frequency in occurrence, age and gender incidence. Associated conditions, dermatomic distributions, the relationship of onset of pain and skin lesions, Multi-CMI test and complications were also evaluated. RESULTS: 1. The annual freguency of herpes zoster ranged from 0.88% to 1.78% (mean 1.23%) during the 5-year period. The highest number of herpes zoster patients was observed in winter (p<0.001) especially in January. 2. Herpes zoster was found to most frequently afflict persons aged 50-59 (27.9%). 71% of the patients were over 40 years of age. 3. In 76 patients (41.8%), neuralgia occurred several days (4 days mean) before the development of skin lesions. In 92 patients (50.5%), pain and skin lesions developed simultaneously while skin lesion development occurred before the onset of pain in 14 patients (7.7%). 4. Among the patients, 42.8% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis, fracture, etc. 5. The dermatomic invclvement of herpes zoster patients having one dermatome was most frequent in thoracic dermatome ca. es (52.6%). Others included cervical (16.7%), trigeminal (11.6%), sacral (6. 0%), lumbar (4.2%), facial (0.5%). Cases having two different dermatomes constituted 8.4%. 6. The most common complication of herpes zoster was postherpetic neuralgia although instance of ophthalmologic compiications, secondary bacterial infection, scar formation, Ramsay-Hunt syndrome, keloid formation, and urinary difficulty were also documented. 7. Multi-CMI (Cell-mediated immunity) tests were done on 88 herpes zoster patients. Thirteen of them (14.8%) were found to have comparatively depressed scores. Ten of the 79 single dermatome involvement patients (12.7%) and three of the 9 two dermatome involvement patients (33.3%) exhibited similar scores. CONCLUSION: These results are in accordance with those of previous reports with the exception of the higher incidence ot two different dermatome involvements and seasonal variation.

Q-Switched Ruby Laser in the Treatment of Nevus of Ota

BACKGROUND: The Q-switched ruby laser has recently shown that it can remove tattoos with-out scarring. Therefore the Q-switched ruby laser is expected to be effective in the treatment of nevus of Ota, which contains pigmented cells in the dermis. OBJECTIVE: The purpose of this study is to evaluate the efficacy of Q-switched ruby laser in the treatment of nevus of Ota. METHODS: Twenty-five patients (6 men, 19 women) with nevus of Ota on the face were treat-ed. The age of the patients ranged from 3 to 62 years. The energy fluence used varied from 6 to 8.5 J/cm². Treatment intervals ranged from 1 to 3 months, and the number of treatments ranged from 2 to 9. Photographs were taken of all patients before and on every return visit. The photographs were then compared with each other. After completion of treatment, we evaluated some parameters including the extent of pigment-free area within the skin lesions (score 0-4), degree of lightening in the remaining skin lesions (score 0-3), and patient's own or their parents' opinions on the result of treatment (score 0-3). The scores of the above three parameters were added and the resulting scores were designated as excellent (score 9-10), good (score 7-8), moderate (score 5-6) and poor (score 0-4). RESULTS: Excellent treatment response (score 9-10) was obtained in 6 of the 25 patients. In all patients disappearance of pigmentation on a 40 percent or larger area was seen. One month after completion of treatment, the remaining lesion size was less than 40 percent of the original lesion in 21 (84.0%) patients. The degree of lightening in the remaining lesion was marked (score 3) in 22 (88%) patients. No scarring was noted following treatment. Transient hyperpigmentation was noted in 7 patients, and transient hypopigmented areas were noted in one patient. CONCLUSION: Q-switched ruby laser appears to be an effective and safe modality for the treatment of nevus of Ota.

Q-switched ruby laser in the treatment of nevus of Ota

The purpose of this study is to evaluate the efficacy of Q-switched ruby laser in the treatment of nevus of Ota, a pigmented lesion on the face. The Q-switched ruby laser has been shown to remove tattoos without scarring. With this in mind, the nevus of Ota with pigmented cells in the dermis could be effectively treated with Q-switched ruby laser. Eighty patients (19 men, and 61 women) with nevus of Ota on the face were enlisted to be tested in evaluating the efficiency of Q-switched ruby laser therapy. The age of patients ranged from 1 to 62 years. The energy fluence used varied from 6 to 8.5 J/cm2. Treatment intervals ranged from 4 to 16 weeks, and the number of treatment sessions varied between 1 to 9 visits. During a 2-year follow-up period, more than fifty percent removal of nevus-pigment was noted in 64 of the 80 patients. Transient hyperpigmentation was noted in 32 patients lasting for 2 to 6 months after treatment; transient hypopigmentation was seen in 3 cases which recovered within one year. No patients had permanent textural or pigmentary changes or scarring. Q-switched ruby laser therapy appears to be an effective and safe modality for the treatment of nevus of Ota.

Prevalence of PPNG in Seoul ( 1993 ) / 대한피부과학회지

BACKGROUND: In recent years gonorrhea has been panendemic and remains one of the most common STDs in the world, especially in developing countries. OBJECTIVE & METHOD: For the detection of a more effective teripeutic regimen and assessing the prevalence of PPNG, will have been trying to study the paieits who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. RESULTS: In 1993, 187 strains of N. gonorrhoeae were isolated, ar, ong which 139(74.3%) were PPNG. CONCLUSION: Our results suggests that the prevalence of PPNG in Seoul is still increasing.

Cutaneous Manifestations and Nail Changes in Diabetes Mellitus / 대한피부과학회지

BACKGROUND: At least 30 per cent of diabetics, which is said to comprise over 3% of general population in Korea, have one or more cutaneous complications during the course of the disease. These skin changes may be the consequences of microangiopathy, arteriosclerosis, direct metabolic disturbances and/or the sequelae of chronic therapy. OBJECTIVE: We tried to observe certain cutaneous and nail changes in diabetics and to relate them with systemic complications, blood sugar level and duration of diabetes. METHODS: During the period of 12 months from March, 1992 to February, 1993, a total of 1858 outpatients diagnosed as diabetes mellitus at Eulji General Hospital were examined. RESULTS: The cutaneous manifestations are observed in 79.5% of diabetics examined and cutaneous infections are the most prevalent(52.3%). Pruritus(p<0.01), anogenital pruritus(p<0.01), peripheral dedema(p<0.05) are more common in females and infections, shin spots, finger pebbles(p<0.01) are more common in males. Systemic complications are observed in 50.7% and the cutaneous manifestations are observed more frequently in patients with systemic complications(p<0.05). Shin spots, diabetic foot, peripneral edema diabetic bullosis are observed frequently associated with systemic microangiopathic complications such as retinopathy, nephropathy and neuropathy(p<0.01). There is a significant correlation between blood sugar level and fungal infections and anogenital pruritus(p<0.01). The frequencies of shin spots, diabetic foot and diabetic bullosis increase with the length of time diabetes has been present. Nail changes are observed in 39.6% of diabetics and onychomycosis is the most frequent(34.5%). CONCLUSION: It is suggested that cutaneous shgns especially fungal infections in diabetics are on the increase in Korea. A variety of skin conditions are encountered with diabetes mellitus and the dermatologist may be able to make a significant contribution in the control of diabetes mellitus by identifying skin signs and conditions as diabetic complications.

A Case of Linear IgA Bullous Dermatosis

This paper deals with a case of linear IgA bullous dermatosis (LABD). The patient was a 58-year-old woman who had multiple pruritic vesicles on the trunk, buttocks, thighs, tongue and buccal mucosa. A biopsy of a lesion revealed subepidermal vesicles. Direct immunofluorescence examination of the perilesional skin showed a linear deposition of IgA along the basement membrane zone (BMZ). Indirect immunofluorescence examination, using NaCl split skin as substrate, showed antiBMZ IgA antibodies bound only to the epidermal side. The skin lesions responded well to oral dapsone therapy.

A Case of Linear IgA Bullous Dermatosis

This paper deals with a case of linear IgA bullous dermatosis (LABD). The patient was a 58-year-old woman who had multiple pruritic vesicles on the trunk, buttocks, thighs, tongue and buccal mucosa. A biopsy of a lesion revealed subepidermal vesicles. Direct immunofluorescence examination of the perilesional skin showed a linear deposition of IgA along the basement membrane zone (BMZ). Indirect immunofluorescence examination, using NaCl split skin as substrate, showed antiBMZ IgA antibodies bound only to the epidermal side. The skin lesions responded well to oral dapsone therapy.

It's clinical analysis and autoantibodies / 대한피부과학회지

BACKGROUND: Vitiligo is riot quite a rare diseasep; it has about 1% prevalence. The cause of vitiligo is not clear, however, in recent studies an autoimmune origin is freqluei itily mentioned. OBJECT: We tried to an lyze some clinical features of vitiligo and relate them with the presence of autoantibodies. MEHTODS: A total of 381 vitiligo patients was included for the analysis of clinical features. A laboratory study included rhumatoid factor, antinuclear antibocoly, antithyroglobulin antibody and antimicrosome antibody. Some 62 patients were examined for opl thmologic changes. RESULTS: One hundred and one(26.5%) of 381 patients exam ned showed at least one of the autoantibodies tested. Twenty nine pateints showed 2 different aitintibodies. The age at aonset of vitiligo in the autoantibody positive group was 6.6 years later than that of the autoantibody negative group. Autoimmune and/or endocrine diseases were more frequinty found among aut.oantibody positive patients. These diseas s included hyperthyroidism, diabetes me litus and alopecia areata. One patient revealed retinal hypoigmentation and showed no autoantibcidics. CONCLUSION: About 9% of vitiligo patients who were autoantiocyte positive had clinical evidence of diseases associated with the autoantibody. However, it is prudent. to xpect that more patients with t.he autoantibody may develop later systemic autoimmune diseases or endocrinopathies. A long term follow-up of these patients seem:, to be very important.

Treatment of uncomplicated male gonococcal urethritis with enoxacin / 대한피부과학회지

No abstract available.

A Case of Lupus Vulgaris Followed by Miliary Tuberculosis

No abstract available.

Epidemiological Treatment for Postgonococcal Urethritis in Uncomplicated Male Gonococcal Urethritis / 대한피부과학회지

An important concern in treatment for gonorrhea is the high frequency of coexisting chlarnydial and gonococcal infections. But there is difficulty in the diagnosing chlamydial infection. And so, CDC recommends epidemiological treatment, of both gonorrhea and non-gonococcal urethritis in the gonorrheal treatment in order to prevent post-gonococcal urethritis(PGU), A total of 140 male patients with uncomplicated gonococcal urethritis at the VD clinic, Choong-ku Publir. Health Center, in Seoul during December, 1987 February, 1988 were subjected to this study. The patients treated with kanamycin(KM), 2g and aqueous penicillin G(ACPG) 8 million units imaccompanied by probenecid(BEN) 1g by mouth. This combination regimen showed good effect in the treatment of gonococcal urethritis (failure rate 4.2% ). After gonorrheal treatment, the patients were divided randomly into group A and group B. In the group A, adminstrated with doxycycline monohydrate, 100mg, by mouth two times daily for 7 days, 44 and 29 patients were followed at 7th and 14th day after gonorrheal treatment. In the group B, administrated with placebo, 1 tablet, by mouth two times daily for 7 days, 49 and 39 patients were followed at 7th and 14th day after gonorrheal treatment. The PGU incidences were 27.3%(12/44), 20.7%(6,'29) in the group A and 55. 1%(27,'49), 53.8(21/39) in the group B at 7th and 14th day after gonorrheal treatment. Conclusively, eoncornitant administration of doxycycline monohydrate, 100mg, by mouth two times daily for 7 days with gonorrheal treatment lowered PGU significantly.

Treatment of Gonorrhoea

Because of increasing resistance of circulating N. gonorrhoeae and frequent failures in the treatment of gonorrhoea, intensive work on gonorrhoea has become of paramount importance. During January 1980-April 1984, at the Choong-Ku VD Clinic in Seoul, 3,340 male patients with uncomplicated gonococcal urethritis were treated with various treatment regimens. Diagnosis of gonorrhoea and declaration of a treatment failure were made on the basis of positive urethral culture. In 1984, the prevalence of Penicillinase Producing N. gonorrhoeae (PPNG) was about 30%, The pretreatment minimun inhibitory concentration of various antibiotics were quite high. Even for non-PPNG urethritis standard penicillin regimens gave unsatisfactory results. For PPNG urethritis, only spectinomycin, cefoperazone and cefotaxim-probenecid regimens gave satisfactory results. No spectmomycin resistant strain of N. gonorrhoeae has been found since 1982 at the Choong-Ku VD Clinic. As an agent of single drug therapy, spectinomycin seems to be one of the most cost effective drugs in the treatment of uncomplicated gonorrhoea in men.

Prevalence of PPNG in Seoul , Korea ( 1987 ) / 대한피부과학회지

The prevalence of PPNG among pretreatment isolates at a VD Clinic in Seoul has been studied and reported annually since 1981. In 1987, 649 strains of N. gonorrhoeae were isolated, among which 339(52.2%) were PPNGs. The prevalence of PPNG in Seoul is still increasing.

Atypical Variant of Bullous Pemphigoid: Prolonged Eruptions of Papulourticarial Lesions

No abstract available.

Treatment of Uncomplicated Male Gonococcal Urethritis with Ofloxacin / 대한피부과학회지

Ofloxacin, one of the new quinolone derivatives, is found to be highly effective against both PPNG and non-PPNG urethritis. The objective of this trial was to establish the efficacy of two ofloxacin regimens in the treatment of uncomplicated male gonococcal urethritis. A total of 138 patients with uncomplicated gonococcal urethritis seen at the VD Clinic, Choong-Ku Public Health Center, in Seoul in the period of March Jun 1988, were subjected to this study. The patients were divided randomly into two groups and assigned to one of two treatment regimens of afloxacin, 400mg, PO and 200mg, PO, twice a day for 2 days. No failure case was seen in both groups. Both of these ofloxacin regimens were found to be highly effective and safe in the treatment of gonococcal urethrithis. It is suggested that, because of high rate of PPNGs among circulating N. gonorrhoeae, they can be recommended as the first line treatment for gonorrhea in Korea.

Treatment of Uncomplicated Male Gonococcal Urethritis: Kanamycin vs . Gentamicin / 대한피부과학회지

Between December 18, 1985 and May 31, 1986 at the VD Clinic, Choong-ku Public Health Center, in Seoul, 274 male patients with uncomplicated gonococcal infection, including 124 penicillinase producing Neisseria gonorrhoeae(PPNG) infection, were entered into the study. They were divided randomly into the group A and the group B. In the group A, treated with kanamycin 2g, im regimen, 126 of 137 patients were followed and 86 patients(68.3%) were cured. In the group B, treated with gentamicin 240mg, im regimen, 125 of 137 patients were followed and 78 patients(62.4%) were cured. The cure rates in PPNG urethritis were 63.9%(39/61) in the group A and 50.9%(29/57) in the group B. The cure rates in non PPNG urethritis were 72.3%(47/65) in the group A and 72.1% (49/68) in the group B. No significant difference was observed in cure rates between two groups. It is suggested that. both kanamycin 2g, im regimen and gentamicin 240mg, im regimen is not suitable for a first line treatment for uncomplicated gonococcal urethritis.

Treatment of Uncomplicated Male Gonococcal Urethritis with Ceftriaxone / 대한피부과학회지

Ceftriaxone is a new semi-synthetic, broad spectrum third generation cephalosporin. It has a high degree of stability in the presence of beta-lactamase and its half-life averages about 8 hours. A total of 109 patients with uncomplicated gonococcal urethritis seen at the VD Clinic, Choong-Ku Public Health Center, in Seoul in the periods of March April 1986, and April-May 1987, were subjected to this study. The diagnosis of gonococcal infection and the test. of cure were made on the basis of culture and Gram staining of urethral smear. The patients were divided randomly into two groups consisting of 49 and 60, and treated with ceftriaxone, 250mg, IM and 500mg, IM respectively. No failure case was seen in both groups. lt is suggested that ceftriaxone, 250mg, IM regimen may be used as the first line treatment for uncomplicated gonococcal urethritis.

A Case of Dyschromatosis Symmetrica Hereditaria / 대한피부과학회지

We described a case of dyschromatosis symmetrica hereditaria in a 20-year old male patient who had spotty hyperpigmentation mingled with patches of hypopigmentation on the dorsal surfaces of both hands, feet., elbows and knees. In his family. the mother and elder brother were also affected by this disease. The histologic finding of the pigmented macule showed mild hyperkeratosis and marked increase of pigmentation at the basal cell layer, and that of the depigmented macule showed a decreased amount of melanin.

Treatment of Uncomplicated Male Gonococcal Urethritis with Clavulanate: Potentiated Amoxycillin / 대한피부과학회지

At the Venereal Disease Clinic of Choong-ku Public Health Center in Seoul ]03 male patients with uncomplicated gonococcal urethritis were allocated randomly into one of 2 treatment regimens and 101 patients were followed. All 51 patients, including PPNG infections, treated with clavulanate-potentiated amoxycillin, 375 mg, PO, t.i.d. for 5 days recovered(100%), Two(4%) of 50 patients treated with clavulanate-potentiated amoxycillin, 3. 25g, PO plus probenecid, lg, PO failed to recover. These cases were 2 of 25 Penicillinase Froducing Neisseria gonorrhoeae(PPNG) infections(failure rate of 8%) and all 25 non-PPNG infections recovered(100%). It is suggested that both of these clavulanate-potentiated amoxycillin regimens ha.ve similarly good effect with minimal side effects in the treatment of gonococcal urethritis and, because of high rate of PPNGs among circulating N, gonorrhoeae, they can be recommended as the first line treatment for gonorrhoa ir Korea.

Prevalence of PPNG in Seoul, Korea ( 1983 ~ 1984 ) / 대한피부과학회지

Penicillinase producing Neisseria gonorrhoeae(PPNG) have been reported from various cauntries throughout the world. We have been tr ying to assess the prevalence of PPNG in Korea since May, 1980 by means of chromogenic cephalosporin method. The total number of isolated Neisseria gonorrhoeae strains in 1983 was 733, among which 679 were tested for p-lactamase production, among which 178(26. 2%) were PPNGs. In 1984, 791 strains were isolated, among which 214(27.1%) were PPNGs. In all, 392(26.7%) strains were found to be PPNGs arnong 1470 Neisseria gonorrhoeae strains tested between 1983-1984.