Dermatologic treatment was greatly advanced when topical corticasteroids were introduced for the management of many inflammatory and pruritic dermatoses. Their use reduced or diminished mnst of the undiserable side effects which accompanied the systemic administration of these compounds. The good effects of topical application of hydrocortisone had been demonstration in the treatment of variaus dermatoses eg., atopic dermatitis, seborrheic dermatitis, contact dermatitis etc. The halogenated derivatives followed and led to the trend to most of analogs now in use. Especially, fluocinolone acetonide cream greatly enhanced its therapeutic effectiveness in psoriasis, chronic discoid lupus erythematosus, pustular bacterid, granuloma and neurodermatitis circumscripta. But many side effects of topical corticosteroids such as steroid acne. Stria were developed and also fluorinated topical corticosteroids resulted in telangiectasia, purpura, atrophy in skin. Weber reported that strong topical corticosteroids eg.. Betamethasone valerate and fluocinolone acetonide were resulted in rosacealikc dermatitis and it was steadily increased. These adverse side effcts of topical corticosteroids, especially steroid acne, were indisputable argument in dermatologic field, for the view that this topical corticosterodis is used for cosmetics and treatment of acne vulgaris in our country. Since the strong corticosteroid tnpical preparation, the peculiar form acne, so called steroid acne, was steadily increased in our clinic. Behrman and goodman reported that acneform eruption induced by hormone was not associated with oiliness and there were but few comedone. Sullivan and Zeligman reported that the the acneform eruption due to adrenal corticaa 1 hormone was uniform in size, small papule and few pustule, usualIy erythematous base. There were also differential histologic feature. The most important difference is the normal apperance of sebaceous glands in acneform eruption due to corticosteroids contrast with hyperplasia in acne vulgaris. Abscess formation was more frequent and more extensive in acne vulgaris. Sutton Jr and Van Scott & MacCardle described that histologically, the major component in lesion of steroid acne was excessive keratinization of follicle. Castor and Baker demonstrated that topical application of corticosteroids resulted in decrease of sebaceous gIands, decrease of mitosis and increased cornification in epidermis. The present study investigated clinical case of the steroid acne, which are induced by topical application and systemic administration of corticosteroids and experimentally induced the steroid acne with the topical application of corticosteroid. And also clinical cases and experimentally induced steroid acne were compared with acne vulgaris. Material and method Subjects are 13 Patients of steroid acne induced by strong topical corticosteroid eg., fluocinolone acetonide, fluocortolone, dexamethaone, betamethasone valerate and 4 patients of steroid acne induced by systemic administration of corticosteroid eg., prednisolone and also 10 patients of acne vulgaris. Biopsy was performed from 13 patients of topical steroid acne, 3 patients of steroid acne induced by systemic administration of steroid and one patient of acne vulgaris. In order to induce steroid acne, experimentally, strong topical corticosteroid such as beta methasone valerate, fluocinolone acetonide and fluocortolone were applied on back. Comment and conclusion In Clinical feature, the steroid acne by topical application and systemic administration of corticosteroid and experimentally induced steroid acne had unique clinicall features, that showed absence of comedone and uniform sized follicular papule on deep seated erythematous scaly base. The topical steroid acne was distributed the region where were applied. But the eruption of the steroid acne induced by systemic administration of corticosteroids was distributed to face, neck, and scalp. Above findings are quite different form acne vulgaris. Histopathologically, the steroid acne induced by topical application and systemic administration of corticosterojds showed hypoplasia of sebaceous glands and excessive follicular keratinization. Occlusion of pilosebaceous opening by keratotic plug in severe case by long term application showed atrophy of epidermis and sparsity of sebaceous glands with hypokeratosis and parakeratosis. In experimentally induced steroid acne, it was definitely specific features which were absolutely identcall with above cinical steroid acne.
Abscess ; Acne Vulgaris* ; Adrenal Cortex Hormones ; Atrophy ; Betamethasone Valerate ; Biopsy ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Epidermis ; Fluocinolone Acetonide ; Fluocortolone ; Granuloma ; Humans ; Hydrocortisone ; Hyperplasia ; Lupus Erythematosus, Discoid ; Mitosis ; Neck ; Neurodermatitis ; Parakeratosis ; Prednisolone ; Psoriasis ; Purpura ; Scalp ; Sebaceous Glands ; Skin ; Skin Diseases ; Telangiectasis

The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.
Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative ; Polyarteritis Nodosa ; Prednisolone ; Recurrence ; Skin ; Streptomycin ; Tuberculosis, Cutaneous* ; Vasculitis*

No abstract available.
Clonorchiasis*

Erythroplasia of Queyrat is a precancerous lesion, usually located to glans penis or prepuce. It is characterized by a slowly developing, circumscribed, usually velvety and shiny patch. The etiology was unknown, but it is extremely rare in those circumcised in early infancy. It had been suggested that phimosis had some etiologic importance. The typical case of Erythroplasia of Queyrat is presented. A 46 year old man had 4 months history of dark-brownish pea sized maculopapular rashes on sulcus of glans penis and prepuce associated with mild itching, which was increased in number day by day. He had a phimosis. On examination, there are sharply defined, slightly elevated, pea sized dark-brownish maculopapular rashes over erythematous infiltrated base on sulcus of glans penis and prepuce, which have moist and velvety appearance. A biopsy was performed from sulcus of glans penis. Histopathologically, there was acanthosis, with in epidermis many cells are vacuolated and showed individual cell keratiinization. Epithelial cell showed marked atypia, variation in nuclear size and there was intercellular, intracellular edema. The lesion was treaterd with topical application of 5% 5-fluorouracil twice daily 2 weeks and thereafter for 4 weeks. 2 months after treatment, no erythroplastic lesion was found and 3 months after treatment, rebiopsy was perforrned which showed marked improvement histopathologically.
Biopsy ; Edema ; Epidermis ; Epithelial Cells ; Erythroplasia* ; Exanthema ; Female ; Fluorouracil* ; Humans ; Male ; Middle Aged ; Peas ; Penis ; Phimosis ; Pruritus

Mucoepidermoid earcinoma occurred in about 2% among salivary gland tumor and in about 15% among malignant parotid gland tumor. The tumor occurred usually in elderly persons and arose as innocent-appearing swelling in the parotid gland region with gradual painless enlargement without alarming and it's usual size is less than 2 cm, However, a few of the poorly differentiated neoplasms grew rapidly and were painful and accompanied by facial nerve paralysis in about 15%. But it's prognosis is better than other salivary gland origin. We report a case of typical mucoepidermoid carcinoma of parotid gland origin which is occurred in 15 years old girl. The tumor begins pea sized painless nodule since about 2 years ago, and enlarged gradually to apple size and accompanied by facial nerve paralysis and pain sensation recently. But there was no evidence of tumor in parotid gland itself and no metastasis.
Adolescent ; Aged ; Carcinoma, Mucoepidermoid* ; Facial Nerve ; Female ; Humans ; Neoplasm Metastasis ; Paralysis ; Parotid Gland* ; Peas ; Prognosis ; Salivary Glands ; Sensation

This clinical study of nine patients presented Disseminated Superficial Actinic Porokeratosis (DSAP) as a distinctive and recognizable entity characterized by multiple uniformly small, irregular marginated, keratotic plug with atrophic center developing during second or third decade of life on sun exposed area of skin. Six of nine patients had DSAP, which was inherited as autosomal dominant trait. The patient's father, two brothers and two sisters were known to have same skin lesions. Of nine patients, five were female and four were male. Eight patients were developed DSAP lesions during second decade of life and other one was third dcade of life. Three patients had pruritus. In alI patients, lesions were developed bilaterally over sun exposed area but was not always symmetrical. The number of lesion was multiple in all patients. The greatest number of lesions were found on distal part of extremities, neck, face, upper portion of anterior chest and back.
Extremities ; Fathers ; Female ; Humans ; Male ; Neck ; Porokeratosis* ; Pruritus ; Siblings ; Skin ; Solar System ; Thorax

The case of a 30 year old man is described, in whom mycosis Fungoides was originating from nose and followed by tumor stage of Mycosis Fungoides on skin. In January 1970, the patient leveloped nasal tumor, when he was n at E.N.T. department of Severance Hospital. At that time a biopsy of nasal tumor demonstrated only a non-specific inflammatory cell infiltrated mass. He received radiation therapy (Co 60) with satisfadory suppression of mass and resulted in right nasal septal deviation. Jn December 1970, thumb sized painful non-tender, movable mass developed on right supraclaviular area. In August 1971, thumb sized painful, tender, movable mass appeared at right posterolateral aspect of neck, which was excied and removed at local clinic. But excised wound was not healed and the mass was enlarged. One month after above lesion, pea sized same mass developed. On physical examination, there were 4*5cm round, erythematous, painful, tender, granulomatous ulceration mass on right postero-lateral aspect of neck and also same mass on postero-inferior site of above lesion. Two times of biopsy was done and it interpreted as tumor stage of Mycosis Fungoids. Treatment included radiation therapy with Co 60 (200r/day, total 6,000r), prednisolone 40mg/day and antibiotics. There has been good response 1 month after radiation therapy and mass is diminished in size and would begin to heal.
Adult ; Anti-Bacterial Agents ; Biopsy ; Humans ; Mycosis Fungoides* ; Neck ; Nose* ; Peas ; Physical Examination ; Prednisolone ; Skin ; Thumb ; Ulcer ; Wounds and Injuries

No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

No abstract available.
Classification* ; Tibia*

BACKGROUND: The SF-6D, derived from the SF-36, is a preference-based instrument measuring health-related quality of life (HRQOL). Using this tool, we measured the HRQOL of persons disabled by stroke dwelling in Gyeongju city and identified factors affecting the HRQOL. METHODS: As of March 2008, 991 persons who had had a stroke and were aged 50 and over were identified on the Gyeongju city disabled registry. Interviewers specifically trained for this face-to-face survey gathered pertinent information including general and clinical characteristics from June to October 2008. In addition, the health status was measured using the Modified Rankin Scale, the Barthel ADL index, and the SF-36. The SF-6D index was derived from the SF-36. We analyzed the known-group construct validity and convergent validity. Finally, we performed multiple regression analyses to identify factors affecting the HRQOL. RESULTS: Of the 991 potential subjects, 498 persons participated in the interviews (response rate: 50.3%). The SF-6D indices for females and those aged 70 and over were lower than indices for males and those aged 60 and less. Correlation coefficients between the Modified Rankin Scale, the Barthel index, and the SF-6D index were relatively high (-0.533 and 0.555, respectively) and statistically significant (P<0.001). Multiple regression analyses showed that sex, age, smoking, alcohol use, comorbidity, the Modified Rankin Scale, and the Barthel index had an effect on the SF-6D index of persons with stroke, and the Barthel index was the most important factor. CONCLUSIONS: Our results indicate that the SF-6D can be a valid tool for evaluating health states of persons disabled by stroke, and functional limitation was the main factor affecting the HRQOL.
Activities of Daily Living ; Aged ; Comorbidity ; Disabled Persons ; Female ; Humans ; Male ; Quality of Life ; Smoke ; Smoking ; Stroke ; Value of Life ; Surveys and Questionnaires