A Study on Anlaysis of Patch Test Positive Reactivity according to the Reading Time with T.R.U.E. TEST(R) / 대한피부과학회지

BACKGROUND: The patch test is widely used for diagnosis of allergic contact dermatitis. However, nearly half of positive reactions can be observed only on day 2 or day 4 and it is difficult to interpret these reactions. OBJECTIVE: The purpose of this study is to assess the frequency of transient and delayed reactions in TRUE-test and detect common antigens that provoke these reactions. METHODS: A total of 311 patients with allergic contact dermatitis were evaluated by TRUE-test between Jan 2007 and December 2011. Records of patch test results of day 2 and day 4 were reviewed and analyzed. RESULTS: A total 311 cases of T.R.U.E. TEST(R) records (male 79, female 232) were analyzed. Persistent reactions were observed in 80.1% patients tested, transient reactions were observed in 18.3%, and delayed reaction in 5%. Frequent allergens which showed transient reactions were cobalt dichloride (2.9%), nickel sulfate (2.2%), thiomersal (1.9%), and carba mix (1.6%), in order of frequency. Allergens which showed delayed reactions were nickel sulfate (0.3%), fragrance mix (0.3%), p-tert-butylphenol formaldehyde resin (0.43). CONCLUSION: Our results showed a relatively high frequency of transient reaction in T.R.U.E. TEST(R). This suggests that additional reading at day 4 in the patch test would be of value.

A Case of Cutaneous Scedosporium apiospermum Infection Successfully Treated with Voriconazole / 대한피부과학회지

Scedosporium apiospermum, an asexual state of Pseudallescheria boydii, is a widely distributed mould that can be found in the soil, manure, stagnant water and decaying vegetation. It has become an emerging pathogen among immunosuppressed patients but it can also cause infections in immunocompetent patients by penetrating trauma. This fungus is a classical cause of mycetoma and the localized skin infections caused by this mould are much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection in a 79-year-old woman. She had erythematous plaque with crust and violaceous supprative nodules on the right forearm. The culture from pus showed typical white to gray colored cottony colonies of S. apiospermum. Treatment was started with voriconazole effectively. Skin lesions completely cured with no reccurence. Thus, voriconazole shows to be an effective treatment for Scedosporium infection.

Ulcerated Perianal Infantile Hemangioma Treated with Propranolol / 대한피부과학회지

Infantile hemangioma is a self-resolving benign tumor that commonly requires no intervention. Despite its distinctive, self-limiting course, infantile hemangiomas may result in ulcerations that cause pain, potential scarring, bleeding, and infection. Active treatment is usually required to manage these lesions. The discovery of propranolol in the treatment of infantile hemangioma was described in 2008 by Leaute-Labreze, et al. Since then, its effectiveness and safety have been confirmed by several cases, and replacing systemic corticosteroids as a first-line therapy. Herein, we report the successful treatment of children with ulcerated perianal infantile hemangioma with propranolol.

A Case of Progressive Cribriform and Zosteriform Hyperpigmentation / 대한피부과학회지

Progressive cribriform and zosteriform hyperpigmentation (PCZH) is a distinctive syndrome first described by Rower et al. in 1978. It characteristically presents as a single area of uniformly tan, cribriform macular pigmentation with zosteriform distribution. Further, it can histologically be characterized by increased melanin pigmentation in the basal cell layer with a complete absence of nevus cells, and a lack of a preceding history of skin rash, injury or inflammation or other associated cutaneous or internal abnormalities. We herein report a case of PCZH that had developed along the right abdomen, right flank area and right back area in a 26-year-old male. The histologic investigation revealed increased melanin pigmentation in the basal layer and a distinct lack of nevus cells.

Treatment of Washboard Nail with Topical Tacrolimus Ointment / 대한피부과학회지

Washboard nail is a dystrophy that presents as a series of ridges that extends across the nail. It is often accompanied by a central depression that extends from the cuticle to the free edge. Washboard nail is often a result of frequently repeated trauma, but sometimes predisposing factors cannot be found. When habitual tic is the cause of the lesions, restraining the habit is the most important treatment. Here, we report a case of a 6-year-old male with washboard nails on both thumbnails and was treated with topical 0.1% tacrolimus ointment. Significant improvement was observed after 4 months of application. This case suggests that topical tacrolimus can be considered as a primary therapy in the treatment of washboard nails in the absence of trauma.