The Antipruritic Effect of 5% Doxepin Cream on Korean Patients with Eczematous Dermatitis / 대한피부과학회지

BACKGROUND: Eczematous dermatitis is associated with severe pruritus, but there are only a few effective treatment modalities. Preliminary studies suggest that topical application of doxepin cream is effective in the treatment of eczematous dermatitis. OBJECTIVE: This study was undertaken to evaluate the efficacy and safety of topical 5% doxepin cream in reducing ruritus associated with eczematous dermatitis in Korea. METHODS: A total of 62 patients with eczematous dermatitis, who daily experienced severe pruritus for at least 1 week, were enrolled in the study. Five percent doxepin cream was applied twice a day on the baseline visit, and four times daily for up to 7 days. We evaluated pruritus scores using visual analog scales, which consisted of a 100-mm horizontal line labeled "no itch" and "worst itch imaginable" at opposite ends. RESULTS: Pruritus scores evaluated by patients revealed significantly-better improvement on each visit day. Furthermore, there was a significant decrease in the pruritus scores and erythema evaluated by physicians on each visit day. Furthermore, the most common adverse effects were a stinging sensation and aggravation of erythema at the site of application. CONCLUSION: Five percent doxepin cream is safe and effective in reducing pruritus in patients with eczematous dermatitis.

Comparison of Skin Responses for Irritation Produced by Benzalkonium Chloride and Sodium Lauryl Sulfate / 대한피부과학회지

BACKGROUND: With the development of bioengineering techniques for noninvasive characterization of skin pathophysiology, the induction of irritant dermatitis by surfactants has been extensively studied. OBJECTIVE: We performed this study to compare the skin responses in terms of transepidermal water loss (TEWL) and erythema induced by benzalkonium chloride (BAC), a well-known non-corrosive irritant, in comparison with sodium lauryl sulfate (SLS), a representative corrosive irritant. METHOD: We applied 0.1, 0.2, 0.5, 1, and 2% solutions of BAC and SLS on volar forearm skin for 24 hours using a large Finn chamber with filter paper disc on 19 normal healthy subjects. TEWL and erythema index (E-index) were measured prior to testing, then at 30 minutes, one day, two days, three days, one week, and two weeks after the removal of the patches. RESULTS: TEWL values of BAC and SLS patch areas increased with concentration. However, BAC induced a significantly lower TEWL increase than SLS did at the corresponding concentrations. TEWL induced by BAC was highest at 30 minutes after the removal of the patch, whereas TEWL induced by SLS was highest at one day. TEWL values had recovered with the passage of time to baseline values at 2 weeks after removal of the patch at lower concentrations (0.1, 0.2, 0.5%) of SLS, but still showed significantly high TEWL values at 1% and 2% concentration SLS patch areas. TEWL values of BAC in 0.1, 0.2, 0.5 and 1% concentrations had recovered to the baseline values at 2 weeks after the removal of the patch, but not in 2% concentration BAC patch areas. E-indices of BAC and SLS increased with concentration in a similar reaction pattern. E-index induced by BAC was highest at 30 minutes after the removal of the patch, and E-index induced by SLS was highest at 30 minutes or 1 day after the removal of the patch. E-index of each concentration, except 2%, had recovered with the passage of time to baseline values on both BAC and SLS patch areas at 2 weeks, but E-indices of both 2% BAC and SLS did not recover at 2 weeks. CONCLUSION: Benzalkonium chloride showed much less damage to the skin barrier function compared to the corresponding concentration of SLS, whilst they showed a similar degree of erythema. Skin barrier function affected by the corrosive irritant SLS would need a more prolonged recovery time than skin barrier disruption by non-corrosive irritant BAC.

A Case of Anaphylaxis Induced by Peanut / 대한피부과학회지

Peanut allergy is a significant health problem because of the potential severity of the allergic reaction, the life-long nature of the allergic hypersensitivity, and the ubiquitous use of peanut products. Peanut is one of the most common foods causing serious anaphylactic reactions. Three major peanut allergens, Ara h 1, Ara h 2, and Ara h 3 are 64.5, 17.5, 14 kd glycoproteins belong to the vicillin, conglutin, and glycinin families of seed storage proteins, respectively. We report a case of anaphylaxis induced by peanut with generalized edema, skin rash, dyspnea, hypotension, syncope after accidental peanut ingestion of a 33-year-old man. The diagnosis could be confirmed as peanut-induced anaphylaxis on the basis of prick test, open patch test, MAST, and T cell proliferation assay in addition to history.

The Skin Response to Dimethyl Sulfoxide in Normal Persons and Atopy Patients / 대한피부과학회지

BACKGROUND: Dimethyl sulfoxide (DMSO) acts as an urticariogenic agent or a primary irritant, and a DMSO skin test which measures responses in skin after exposure for 5 minutes could be a simple and easy method in evaluating cutaneous irritation . Atopy is a hereditary allergy (such as atopic dermatitis, allergic rhinitis, asthma, or hay fever) characterized by symptoms produced upon exposure to the exciting antigen without inoculation . Some atopy such as atopic dermatitis are more likely to be susceptible to various irritants and have defects in cutaneous barrier function. OBJECTIVE: The purpose of this study was to compare the differences of cutaneous responses between atopy patients (atopic dermatitis and respiratory atopy) and normal persons after skin irritation with several concentrations of DMSO. METHODS: We used DMSO concentrations of 90%, 95% and 100%, and evaluated the skin responses such as visual scores by wheal, transepidermal water loss (TEWL) and erythema index (E-index) after DMSO testing on the forearm skin of atopic dermatitis patients, respiratory atopy patients and normal healthy persons. RESULTS: 1. The TEWL values were increased as DMSO concentrations increased, and both baseline and postirritation TEWL values of the lesional area in atopic dermatitis patients were higher than in normal areas of atopic dermatitis patients and in respiratory atopy patients and in normal persons. There were no maj or differences in baseline and postirritation TEWL values among the last three groups. 2. Both baseline and postirritation E-index of the lesional area in atopic dermatitis patients were higher than in normal areas of atopic dermatitis patients and in respiratory atopy patients and in normal persons . There were no significant increases in E-index after irritation with 90% and 95% DMSO of normal areas of atopic dermatitis patients and 95%, 100% DMSO of normal persons. Also, there were no differences in baseline and postirritation E-index among normal areas of atopic dermatitis patients and respiratory atopy patients and normal persons . 3.The visual scores were increased as DMSO concentrations increased. The visual scores of the lesional area in atopic dermatitis patients were likely to increase as DMSO concentrations increased than in normal areas of atopic dermatitis patients and in respiratory atopy patients and in normal persons. There were no differences in visual scores among normal areas of atopic dermatitis patients and respiratory atopy patients and normal persons. CONCLUSION: The lesional skin of atopic dermatitis is more susceptible to DMSO irritation. However, there were no significant differences in susceptibility to DMSO irritation between the normal skin of atopic dermatitis, the skin of respiratory atopy and the control group.

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.

A Case of Atopic Dermatitis with Egg and Budesonide Hypersensitivity / 대한피부과학회지

The egg is one of the most common food allergens, and immunologic reactivity to egg antigens may be an early marker of atopic disorders. Budesonide is a synthetic non-halogenated corticosteroid with 16 , 17 -butylidene dioxy portion, and it is one of the common causes of corticosteroid allergy together with tixocortol pivalate and hydrocortisone butyrate. The patient was a 12 year old female. She had developed atopic dermatitis mainly on the face since she was 1 year old. She applied budesonide cream for treating atopic dermatitis in our dermatologic clinic, but her facial lesion was aggravated. On past medical history, she had been suffered from an egg allergy since 1-year-old, and she was accidentally exposed to egg and developed large pruritic erythematous patch on entire body. This case could be considered as atopic dermatitis with egg and budesonide hypersensitivity on the basis of the clinical features and prick test, MAST, open food challenge and patch test.

A Case of Anhidrotic Ectodermal Dysplasia with Atopic Dermatitis / 대한피부과학회지

Anhidrotic ectodermal dysplasia(AED) is a rare hereditary disorder characterized by hypohidrosis or anhidrosis, hypotrichosis, dental hypoplasia and characteristic facies. Additional less consistent symptoms include nail dystrophy, hyperkeratosis of the palms and soles, cleft palate, hyperplasia of facial sebaceous glands, susceptibility to atopic dermatitis, dryness of mouth and eyes, and hypoplasia of mucous and mammary glands. In general, the inheritance of this syndrome is determined by an X-linked recessive gene, and several hundred cases, of which over 90% are male, have been reported in many differnt races. We experienced a case of AED associated with atopic dermatis.

A Case of Kerion Celsi Caused by Trichophyton tonsurans / 대한피부과학회지

No Abstract Available.

Two Cases of Cefotiam-induced Contact Urticaria Syndrome

Contact urticaria refers to a wheal-and-flare response after cutaneous exposure to certain chemicals. If contact urticaria is accompanied by systemic symptoms, it is referred to as contact urticaria syndrome. Herein we report two cases of contact urticaria syndrome occur-ring in nurses due to occupational exposure to cefotiam.

A Case of Neuroma Cutis / 대한피부과학회지

Cutaneous neuromas are uncommon, and three true neuromas exist in the skin: palisaded encapsulated neuroma, multiple mucosal neuroma, and traumatic neuroma. Traumatic neuroma is usually a solitary, skin-colored or pink, firm papule or nodule at the site a of scar following local trauma. The patient was a 51-year-old female and presented with a solitary 1X2X1.5cm sized erythematous to brownish tender polypoid firm mass on the left shoulder for 24 years. Although she could not remember any history of trauma or surgery on the lesional area, this case could be considered as traumatic neuroma on the basis of both the clinical and characteristic histological features and by ruling out other types of neuroma.

A comparison study on allergen components between Korean (Arachis fastigiata Shinpung) and American peanut (Arachis hypogaea Runner)

The prevalence of peanut allergy in Korea is lower than in America. Peanut extract allergens between the two countries have not been standardized. This study was performed to compare the allergenicity of raw Korean and American peanuts with that of roasted peanuts. We prepared the peanut extracts in Korean raw (KP) and roasted peanuts (KRP), and also in American raw (AP) and roasted (ARP) peanuts. We compared the peanut extract allergens of KP, KRP, AP and ARP in vitro with sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting, T-cell proliferation assay and skin prick test with sera from peanut-allergic patients. SDS-PAGE and Western blotting demonstrated four allergenic extracts, numerous bands that displayed a high prevalence of IgE binding. IgE-binding bands were at 64, 36 and 17 kDa. Western blot inhibition revealed that either KP or AP could almost completely inhibit the reactivity of the other extract. There were no differences between T-cell proliferation assay and skin prick test. In conclusion, this investigation showed no different allergic components in both raw and roast extracts of Korean and American peanuts.