Photosensitive psoriasis is a rare disease defined as psoriasis in which the lesions deteriorate or new lesions develop after sun exposure. It should be differentiated from other photosensitive conditions that may be a vated or confused on sun-exposure. Half of the patients have a history of polymorphic light eruption(PMLE), whieh several weeks later develops into psoriasis lesions and the others have no history of preceding PMLE reaction. PUVA therapy is recommended for the treatment of choice. In this report, we describe two cases of photosensitive psoriasis. A 51-year-old woman without underlying psoriasis suffered from erythemato-squamous papular lesions on the face, neck and dorsum of hands after sun-exposure. She revealed a lowered minimal erythema dose(MED) for UVA which was confused with a photosensitive disease. But characteristic psariatic plaques on the elbow, knee and palm and histologic findings made the diagnosis photosensitive psoriasis. She showed a good result to cyclosporine therapy. The other patient, a 44-year-old woman with underlying psoriasis, experienced an exacerbation with preceding PMLE and showed a lowered erythema threshold for UVB. She was treated with sun-screen and topical corticosteroids.
Adrenal Cortex Hormones ; Adult ; Cyclosporine ; Diagnosis ; Elbow ; Erythema ; Female ; Hand ; Humans ; Knee ; Middle Aged ; Neck ; Psoriasis ; PUVA Therapy ; Rare Diseases ; Solar System

There have been several reports in the literature of coexistent psoriasis and bullous pemphigoid. In most cases, the bullous pemphigoid lesions have been considered to be induced by antipsoriatic treatments. We describe a patient with psoriasis in whom bullous pemphigoid developed during psoriasis treatment, but the exact etiologic factor was not identified. Recently, some reports have suggested that an immunologic or biochemical association between the two diseases plays a role in the pathogenesis.
Humans ; Pemphigoid, Bullous* ; Psoriasis*

Congenital immature teratoma of the tongue is a exceedingly rare form of epignathus. We report here an autopsy case of a huge immature teratoma protruding from the tongue of a newborn female infant. The mass obstructed the mouth and caused hydramnios. The mother's serum level of alpha-fetoprotein was elevated, and the tumor was identified by a ultrasonogram subsequently done. Discussion on the histogenesis of epignathus was made through a review of literatures.
Infant ; Male ; Female ; Infant, Newborn ; Humans

BACKGROUND: PUVA photochemotherapy has been accepted as an effective treatment modality in the treatment of psoriasis. Many combination therapies have been tried to reduce the long-term side effects of UV radiation. OBJECTIVE: We performed conventional PUVA and calcipotriol-PUVA combination therapy to compare the effectiveness between two treatment modalities. METHODS: We treated 38 Korean patients with conventional PUVA and 54 with D-PUVA. We compared the total number, duration and total UVA dose of PUVA therapy to reach grade 4 between two groups. We categorized each patient into clearing, improvement, or failure groups based on the therapeutic efficacy, and evaluated PASI score at patient`s visits. RESULTS: The irradiation number and total cumulative dose of D-PUVA phototherapy to achieve grade 4 were significantly smaller than PUVA phototherapy. CONCLUSION: Combining PUVA with a vitamin D analogue, calcipotriol, in the treatment of psoriasis may lead to lowering the risk of long-term exposure to UV radiation with higher efficacy.
Humans ; Photochemotherapy ; Phototherapy ; Psoriasis* ; PUVA Therapy ; Vitamin D

BACKGROUND: Narrow-band UVB phototherapy using 311+-2nm wavelength is in widespread use due to its greater efficacy and, possibly, safety compared with broad-band UVB sources. OBJECTIVE: We performed emollient narrow-band UVB(NBUVB) phototherapy to evaluate the clinical efficacy and safety in Korean psoriasis patients. METHODS: Fifteen psoriasis patients received narrow-band UVB phototherapy. We categorized each patient into clearing, improvement, or failure groups based on the therapeutic efficacy, and measured the PASI score every two weeks. RESULTS: 1. Among patients who received narrow-band UVB phototherapy, clearing was shown in 40.0% and improvement in 27.7%, and failure in 33.3%. 2. The total number, duration, final and cumulative doses to achieve grade IV were 16.3, 39 days, 1,050mJ/cm2 and 12,125mJ/cm2 respectively. 3. There were some side effects of NBUVB phototherapy such as pruritus(53.3%) and mild burning(13.3%). CONCLUSION: Narrow-band UVB phototherapy is a effective treatment modality which is convenient and less erythemogenic in psoriasis. It will be used more and more and play an important role in the treatment of psoriasis.
Humans ; Phototherapy* ; Psoriasis*

BACKGROUND: Hearing loss is associated with environmental noises. Not only the strength of the noise but also the exposure time of that seems important. We investigated to find the factors associated with hearing loss in pilots. METHOD: For the anlysis of hearing loss in pilots in the air force, we performed an audiometiric test on 563 pilots from 2000 to 2001 and analysed the results. REUSLT: The type of aircraft or regiment is not associated with hearing loss. The age, tenure and total flight time are the factors associated with hearing loss, especially in the high frequency zone. The flight time in the recent six months is shown not to be associated with hearing loss which means an exposure to noise in a longer term is important. In this study, the hearing threshold increased at 6,000 Hz regardless of age. CONCLUSION: The reason may be due to the noise environment of pilots. Therefore an additional study about pilots' normal limits of hearing threshold at 6,000 Hz and clinical meanings of that is necessary.
Aircraft ; Hearing Loss* ; Hearing* ; Noise

BACKGROUND: Although retinoid and PUVA monotherapy is effective for psoriasis, both treatment regimens have some limitations because of the risk of long-term toxicity. OBJECTIVE: We performed Re-PUVA combination therapy to evaluate the clinical efficacy and safety in comparison with retinoid and PUVA monotherapy. METHODS: Seventy-eight psoriasis patients received Re-PUVA combination therapy as well as conventional retinoid and PUVA monotherapy. Pretreatment with etretinate for 1 week was followed by PUVA therapy in combination with etretinate. RESULTS: 1. Among patients who received Re-PUVA combination therapy, clearing was shown in 77.3% and improvement in 13.6%, which were higher than retinoid, 27.8%/61.1%, and PUVA monotherapy, 65.8%/21.0%.2. In patients who reached grade 4 with Re-PUVA therapy, the duration and total dose of etretinate were 56.4 days and 1616mg. These were significantly lower than retinoid monotherapy, 107.5 days and 2577.5mg.3. In patients who reached grade 4 with Re-PUVA therapy, the number and total dose of UVA were 13.3 and 82.8 J/cm2, which showed no difference compared with those of PUVA monotherapy, 16.2 and 120.2 J/cm2. However, excluding the cases who did not respond to previous monotherapy, the number and total dose of UVA in Re-PUVA were 10.4 and 49.0J/cm2, which were significantly lower than those of PUVA4. The side effects of Re-PUVA were reported in 54.5%, which were similar to PUVA monotherapy, 52.6%, and lower than retinoid monotherapy, 83.3%. There were some side effects of retinoid, such as cheilitis, dry mouth, elevation of sGOT/sGPT and triglycerides, and side effects of PUVA, such as itching, erythema, anorexia, nausea and vomiting. CONCLUSION: Our study suggests that Re-PUVA combination therapy is more effective and tolerable than retinoid and PUVA monotherapy in the treatment of psoriasis, especially in severe and recalcitrant cases.
Acitretin ; Anorexia ; Cheilitis ; Erythema ; Etretinate ; Humans ; Mouth ; Nausea ; Pruritus ; Psoriasis* ; PUVA Therapy ; Triglycerides ; Vomiting

A 29-year-old woman complained of a painless, firm nodule with browunish patch on her left cheek for 5 months. She had had undergone a traffic accident 6 months before, and the normally healed wound on her cheek became reddish and infiltrated. A Skin biopsy specirinen obtained from her skin lesion showed a foreign body reaction with histiocytes and numerouse crystalline structures. These particle. were birefringent under polarized light microscopy. Scanning electron microscopy revealed numerous crystalline particles. Energy dispersive x-ray analysis of the crystal revealed a sharp peak representing silia.
Accidents, Traffic ; Adult ; Biopsy ; Cheek ; Crystallins ; Female ; Foreign-Body Reaction ; Granuloma* ; Histiocytes ; Humans ; Microscopy, Electron, Scanning ; Microscopy, Polarization ; Silicon Dioxide* ; Skin ; Wounds and Injuries

No abstract available.
Nevus*

BACKGROUND: Complete clearance of the lesions by using calcipotriol alone have not been re-ported commonly in the treatment of psoriatic patients. Moreover, lesional and perilesional irritation are reported in some patients using calcipotriol, which may result in premature termination of the treatment due to impairing the compliance. OBJECTIVE: A clinical study was conducted to determine whether, in the topical treatment of psoriasis, a combination of calcipotriol cream and methylprednisolone aceponate was more effective than calcipotriol monotherapy. METHODS: Twenty-one psoriasis patients who had the symmetric lesions on the right and left lower legs were enrolled in the study. A combination of calcipotriol cream and methylprednisolone aceponate therapy was done on the left lower legs, whereas calcipotriol alone was applied on the right lower legs twice daily. PASI score and adverse events were recorded at each visit (1, 2, 3, 4, 6 week). The overall therapeutic result was also assessed by the physician and patients. RESULTS: The initial PASI score was 7.09 on both legs. After 6 weeks, the mean PASI score was 3.85 on the left leg, and 5.70 on the right leg (p<0.05). In the physicianOs global assessment, the percentage of patients who showed the improvement of more than half of lesions was 29% in the monotherapy and 62% in the combination therapy area. Two patients complained of mild itching sense on monotherapy, but there was no specific side effect on combination area. CONCLUSION: The combination therapy was more effective, as assessed by all evaluated variables. Furthermore, this combination reduces the adverse effects caused by long-term use of topical corticosterois as well as the irritation associated with. calcipotriol.
Compliance ; Humans ; Leg ; Methylprednisolone* ; Pruritus ; Psoriasis*