A Case of Acrodermatitis Enteropathica / 대한피부과학회지

Diiodohydroxyquin introduced by Dillaha et al in 1953, had been the mainstay for the treatment of acrodermatitis enteropathica (A.E.). However, following the report by Moynahan and Barnes in 1973 of successful treatment with the oral administration of zinc sulfate, the clinical response to this treatment has been confirmed by different investigators in many countries. In Korean literature, Rhim et al reported two cases of A,E. in siblings successfully treated with oral zinc sulfate in 1980. In our case of cow's milk-fed, 7 month-old male infant, typical claasical features of total alopecia, diarrhea and periorificial dermatitis developed at about 3 months. of age and the zinc level in serum was 101 ug/dl at the first visit. Treatment first with diiodohydroxyquin was initiated at a dose of 315 mg/day by mouth for the first week and 630 mg/day for the second week, but this therapeutic regimen brought about little or no effect. Because of no definite improvement even with increasing dose of 1260 mg/day for another week, treatment was. changed to oral zinc sulfate. The patient began to receive zinc sulfate 50mg at first day by mouth and the dosage was immediately increased to l00mg daily from the next day. Within 72 hrs there found dramatic improvement in the skin lesions and diharrhea stopped. Twenty days after the start of zinc therapy, nearly all the skin lesions disappeared and the patient was discharged in satisfactory condition with only mild residual erythema. (countinued..)

A Case of the Sign of Leser-Trelat / 대한피부과학회지

The sign of Leser-Trelat refers to the sudden appearance and rapid increase in size and number of freckles and seborrheic keratoses, It is considered to be a sign of internal malignant tumors, most probable of the gastrointestinal tract. We report a case of adenocarcinoma of the stomach associated with the sign of Leser-Trelat and the literatures were reviewed. This 62-year-old man, over a period of 5 months, developed multiple seborrheic keratoses over his trunk and extremities. He came to our department in August 1981, because of sudden increse in their number and size during the several preceding months. He had never complained of the symptoms of gastrointestinal tract such as gastric pain, vomiting, indigestion, and weight loss. On examination of the skin, hundreds of brown or brown-black, more or less greasy verrucous papules were found almoat exclusively on the extensor aspects of forearms and lower legs. These lesions were variable in size and were consistent clinically with seborrheic keratoses. The findings of both fiberoptic biopsy and upper gastrointestinal tract series of roentgenographic studies were compatible with ulcer and adenocarcinoma of the stomach. Based on our experience, it is again suggested that though seborrheic keratoses are very common in the elderly, the rapid increase in size and number should arouse suspicion of an internal malignancy.