Pruritus or itching is an unpleasant sensation well know to all of us which provokes the desire to scratch, usually lasting for minutes in hours and related to cutaneous diseases. However, generalized idiopathic pruritus may affect large areas, last longer, from months to years. Generalized pruritus can often be the primary manifestation of systemic diseases. Pruritus shares many features and pathways with pain but is a separate sensation from pain with its own precipitants and blockers. For example, loss of touch sensitivity dose not stop itching(e.g.,tabes dorsalis), however, in an area insensitive to pain, itching does not occur(e.g.,syringomyelia, leprosy). Unlike pain, specific receptors for pruritus and clear pathways for its transmission have not yet been identified. Until now, it has not been possible to isolate a universal mediator to explain pruritus. There are a wide variety of chemical substances known to be the mediators of pruritus. Well known among these is histamine, but in most cases of generalized pruritus is is not the main cases of generalized pruritus it is not the main mediatro. Our lack of understanding of the mechanism of pruritus is reflected by the inefficiency of many of the available antipruritic agents. I herein present an update review of the pathophysiology of pruritus, possible causes of generalized pruritus, the differential diagnosis and the basic principles of treatment.
Antipruritics ; Diagnosis, Differential ; Histamine ; Pruritus* ; Sensation

BACKGROUND: Superoxide disrnutase(SOD) provides a protective defease mechanism against potential cytotoxicity of superoxide radical in the aerobic organism. Although human skin is constantly at risk for developing acute and chronic changes by ultraviolet radiation and phototoxic reactions with exogenous and endogenously procluced photosensitizing molecules, studies in SOD in the human skin are rare. OBJECTIVE: We measured the level of SOD activities in the scar tissues and the normal human skin specimens. This study was to investigate changes of SOD activity by age, sex, and regional differences of SOD activities in the scar issues and the normal skin. METHODS: Aut,hors assayed the level of SOD activit,ies in 32 scar tissues(male 8, female 24) and 11 normal human skin specimens(male 8, female 3), which were obtaine 3 from face/neck(17 and 3 specimens), forearm(only 4 scar tissues), trunk(10 and 8 specimens), and lower extremity(only 1 scar tissue). RESULTS: First, activities of total SOD, Cu, Zn-SOD, and Mn-SOL ere 18.93+5.49, 16.97+55.31, and 1.96+0.90 units/mg proteiii respectively in the scar tissues. Second activities of total SOD, Cu, Zn-SOD, and Mn-SOD were 17.27+7.09, 13.82+6.44, and 3.45+1.07 units/mg protein respectively in the normal skin. Third, the changes of total SOD, Cu, Zn-SOD, and Mn-SOD activities by age and sex were similar each other and three were no significant, differneces between age groups in total, Cu, Zn- SOD, and Mn-SOD activities. Fourth, in sun exposed area and unexposed area there were no significant differences in the scar tissues in SOD activities. But, SOD activite.(total, Cu, Zn, and Mn-SOD) in face/neck were higher than those in trunk and lower extremity in tae normal skin(P<0.05). CONCLUSION: These findings suggest that there are no differences in the intrinsic SOD activities by age and sex in the mature scar tissues and the normal skin. Differences between exposed and unexposed area in the normal skin are due to the induction of exogenous SOD activity by sun-light generation of superoxide radicals. In wound, increased production of leukocyte derived superoxide radicals is the main factor of increased level of SOD activity.
Cicatrix* ; Female ; Humans ; Leukocytes ; Lower Extremity ; Skin ; Solar System ; Superoxide Dismutase* ; Superoxides* ; Wounds and Injuries

BACKGROUND: The large surfaces of the skin are often initial site of contact between microorganism and human. The skin are coated with epidermis and epithelial cells can recognize microorganism and mount a fast defense through the production of various inducible antibiotic peptides. This leads to chracteristic broad spectrum of antimicrobial activity against bacteria, fungi, and viruses. Recent studies introduce us new peptides with antimicrobial activity such as P,-defensins and cathelicidins. They are expressed on the epithelia and polymorphonuclear leukocytes, which are first lines of defence from various invasive environments. Futhermore, they are considered very interesting and important endogenous antibiotics. Our previous study has shown that the expression of human defensin(hBD-2) mRNA, which is potent antibiotic peptide against Gram-negative bacteria(P. aeruginosa), was upregulated with ultraviolet(UV) irradiation, tumor necrosis factor-α(TNF-α) and lipopolysaccharide(LPS) in HaCaT cells. A novel hBD-3, 5-kDa, nonhemolytic antimicrobial peptide, was demonstrated a salt-insensitive broad spectrum of potent antimicrobial activity against many potentially pathogenic microbes in especially, multiresistant S. aureus. We have analyzed the expression patterns of hBD-3 in HaCaT cell lines. OBJECTIVE: This research have done in order to evaluate the expression and regulation of hBD-3 mRNA in human keratinocyte cell lines. METHODS: HaCaT cell lines were used to all culture experiments. Cultured human keratinocytes were stimulated with UV irradiation or TNF-α or LPS to determine whether hBD-3 mRNA production occurred. Reverse transcription-polymerase chain reaction (RT-PCR) was per-formed to amplify hBD-3 cDNA from stimulated keratinocytes in a time dependant manner, and densitometry was used to verify the specificity of RT-PCR amplication products. RESULTS: Expression of hBD-3 was upregulated with UV irradiation, TNF-α and LPS in Ha-CaT cells compared to control CONCLUSIONS: Human keratinocytes are capable to induce hBD-3 mRNA, as well as hBD-2, in response to UV irradiation, TNF-α and LPS. suggesting that these cells could play an important role against the bacterial infection and UV light damage in human skin.
Anti-Bacterial Agents ; Bacteria ; Bacterial Infections ; Cathelicidins ; Cell Line* ; Densitometry ; DNA, Complementary ; Epidermis ; Epithelial Cells ; Fungi ; Humans* ; Keratinocytes ; Necrosis ; Neutrophils ; Peptides ; RNA, Messenger ; Sensitivity and Specificity ; Skin ; Ultraviolet Rays

BACKGROUND: Superoxide dismutases (SOD) are important metallo-enzymes which scavenge and dismutase the superoxide free radical. They are thought to be the main enzymes in the antioxidant defense system. In the several cell ines the induction of Mn-SOD expression by tumor necrosis factor (TNF)-alpha which is a known inflammatory cytokine, suggests that Mn-SOD may play a role in the inflammatory process. However, this effect is occurred. OBJECTIVE: The present study was undertakento determine whether the induction of SOD expression by TNF-alpha, in the keratinocytes is occurred. METHODS: Primary keratinocyte cultures from neonatal foreskins were grown in complete MCDB 153 medium. Measurement of superoxide radical and SOD activity were performed according to Babior and Fridovich methods, respectively. RESULTS: 1. The release of superoxide radical were measured after 30, 60, 90 minutes exposure to 10ng/ms TNF-alpha, THE RESULTS SHOWS 2.94+/-0.30 NMOL/2x105, 3.55+/-0.52 NMOL/2x105, 4.13+/-0.70 nmol/2x105 respectivelyl The increase of superoxide radical release was detectable in a time dependent manner. 2. Total SOD activity without treatment of TNF-alpha at 24 hours was 18.46+/-2.85, Total SOD activities after treatment of 1, 10, 100 ng/ml TNF-alpha at 24hours were 36.47+/-6.80, 88.01+/-7.79, 94.50+/-8.97 respectively, which suggested that TNF-alpha induced increase of total SOD significantly (p<0.050. TNF-alpha stimulate total SOD induction in a dose and time dependent manner, although the effects were not outstanding. Mn-SOD activity after treatment of 100 ng/ml TNF-alpha at 48 hours was 84.12+/-14.83, which was approxdimately 10.5 fold of that of the untredated case. TNF-alpha also induced the Cu, Zn-SOD activity, but the effect was not so much as in the case of Mn -SOD. CONCLUSION: TNF-alpha induces production of total SODD activities, especially Mn-SOD in the human kerati ocytes, which may be to protect cells from inflammation mediated oxidative damage, namely production of total SOD protein, especially Mn-SOD in response to TNF-alpha induced and scavenged overproduced superoxide radical which in turn may result in protection of the keratinocytes.
Foreskin ; Humans* ; Inflammation ; Keratinocytes* ; Superoxide Dismutase* ; Superoxides* ; Tumor Necrosis Factor-alpha*

A 6-year-old male patient had been suffering from angular cheilitis and paronychia with fragmentation and dystrophic change of the finger nails. Laboratory findings showed low serum iron level and anemia. Immunologic studies revealed defects in cell mediated immunity. KOH examination and culture of specimens from the lesions showed hyphal elements and growth of Candida albicans respectively. Concomitantly itraconazole and iron sulfate were administered. Four months after treatment he was free of any clinical evidence of the disease.
Anemia ; Candida albicans ; Candidiasis, Chronic Mucocutaneous* ; Cheilitis ; Child ; Fingers ; Humans ; Immunity, Cellular ; Iron ; Itraconazole ; Male ; Paronychia

No abstract available.
Dermatitis, Exfoliative ; Phototherapy ; Psoriasis

BACKGROUND: The keratinocyte growth factor(KGF) is a recently identified mitogen for epithelial cells produced by nomal stromal fibroblasts. ln the skin, KGF has been shown to stimulate keratinocyte proliferation and differentiatian. Dendritic epidermal T cells(DETC) are skin-specific members of the epithelial y 8 T-cell family that reside normally in the murine epidermis. The DETCs recognize antigen expressed by damaged or diseased neighboring keratinoctyes and consequently secrete cytokines sueh as IFN- y, lL-2, IL-4, GM-CSF. OBJECTIVE: The purpose of this study was to observe the expression of KGF mRNA in keratinocyte and DETC as well as to investigate the cytokine-mediated intercellular communication between kerati- nocyte and DETC. METHODS: Using a RT-PCR(reverse transcription-polymerase chain reaction), we examined the expression of KGF mRNA in keratinocyte and DETC, and compared the level of KGF mRNA between resting and activated DETC with Con-A (concanavalin A).
Cytokines ; Epidermis ; Epithelial Cells ; Fibroblast Growth Factor 7* ; Fibroblasts ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Interleukin-4 ; Keratinocytes* ; RNA, Messenger* ; Skin ; T-Lymphocytes

BACKGROUND: Superficial fungal infections are common diseases acid the prevalence of superficial fungal diseases are not static but change under the influence of various forces such as climate, migration of peoples and development in prophylaxis and therapy. OBJECTIVE: To investigate the present status of superficial dermatiphytoses and some changes on the frequency of the diseases, sex distributions and varieties of the casiative organisms. MEHTODS: The clinical and rnycological aspects of superficial fungal diseases of 3,222 patients from July 1989 to June 1992 were analyzed. Results : 1) The incidence of superficial fungal diseases was 25.4% of total out-patients. 2) The superficial fungal diseases showed a higt incidence in the third(26.4%) and the fourth decade(24.3%). 3) The ratio of male to female was 2.11:1(2,188:1,034). 4) The monthly prevalence of super ficial fungal diseases was high inhuly(17.8%), August(15.2%) and June(1.7%). 5) The incidence of superficial fungal diseases in order of frequency were tinea pedis ,28.1%, tinea cruris(19.5%), onychomycosis(15.6%), tinen orporis(11.5%), tinea manus(7.8%), tinea versicolar(7.8%), candidiasis(7.4%) and tinea capitis(2.3%), 6) Coexisting fungal infections were found in 644 patients(19.9%) and the case of tinea pedis with onychomycosis was the most common. 7) The positive rate of KOH scraping was 54.0% and the positive rate of culture on ordinary Salourauds dextrose agar media was 42.7%. 8) Trichophyton rubr,im was the most common causative orantism of superficial dermatophytes(38.4%), and other in decreasing frequency were Candida albicans(36.9%), Trichophyton mentagrophytes(23.6%) Microsporum canis(0.7%), Trichophyton ferrvgiteum(0.3%) and Epidermophyton floccosum(0.1%). CONCLUSION: These results are not significantly different from those iif previous studies. But the incidence rate of the superficial pungal diseases(25.4%) were higher thar, previous studies and showed a high incidence in young male patients and in the summer. The positiv rate of KOH scraping(54.0%) was lower than previous studies. The most common causative organism was Trichophyton rubrum(38.4 %).
Agar ; Candida ; Climate ; Epidermophyton ; Female ; Glucose ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Prevalence ; Sex Distribution ; Tinea ; Tinea Pedis ; Trichophyton

Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans

BACKGROUND: Herpes zoster is characterized by vesicular skin lesions over the unilateral sensory dermatomes being caused by the reactivation of varicella-zoster virus and its incidence seems to be increasing recently. OBJECTIVE: The purpose of this study was to elucidate the epidemiology and the clinical characteristics of herpes zoster. METHODS: The authors observed 877 cases of herpes zoster clinically for annual incidence, age, sex, monthly distribution, predilection site, associated disease, and complications at the Department of Dermatology in Chung-Ang University Hospital during a 10 years period(1982.9-1992.8). RESULTS: 1) The annual incidence averaged over 10 years was 2.26%(877 cases of total 38.717 outpatients) being on the increase recently. 2) The age distribution was in the range of 2-86 years old being most prevalent in the 6th decade and there was equal sex ratio(444:433). 3) There was no statistically significant monthly or seasonal variation in the incidence of herpes zoster. 4) The most common anatomical distribution was thoracic dermatome(51.7%), followed by trigeminal(17.1%), cervical(16.1%), lumbar (10.6%), sacral(1.4%)and multiple deramatomic involvement(3.1%). Left or right side was affected in about the same ratio(439:437), and bilateral involvement was in 1 case. 5) Associated disease of herpes zoster were observed in 210 patients(23.9%) ; hypertension(7.0%), diabetes mellitus(4.1%), tuberculosis(1.8%), postoperative status(0.7%), malignancy(0.7%), gastric ulcer(0.7%), and so on, 6) The most common complication of herpes zoster was postherpetic neuralgia(7.4%), followed by eye complication(2.1%), bacterial infection(1.4%), scar formation(0.7%), neurogenic bladder(0.2%), Ramsay-Hunt syndrome(0.2%), motor paralysis(0.1%), herpes zoster generalisatus(0.1%) 7) The incidence of postherpetic neuralgia increased with age and was highest in trigeminal dermatome. 8) Recurrence of herpes zoster was observed in 4 patients(0.5%). CONCLUSION: According to this study, the annual incidence of herpes zoster showed a tendency to increase recently but there was no significant monthly or seasonal variation. The anatomical distribution was most commom on the thoracic dermatome. The incidenc of postherpetic neuralgia increased with age being most common in trigeminal nerve.
Age Distribution ; Cicatrix ; Dermatology ; Epidemiology ; Herpes Zoster* ; Herpesvirus 3, Human ; Incidence ; Neuralgia, Postherpetic ; Recurrence ; Seasons ; Skin ; Trigeminal Nerve