We herein report a case of therapy-resistant dermatomyositis treated with oral prednisolone and chlorambucil combination therapy. Concurrently, she showed cervical carcinoma in situ(CIS). Initially, we started to treat her with combination oral prednisolone, intramuscular methotrexate, hydroxychloroquin, and removal of cervical CIS. However, our patient failed to respond to these regimens. Thus, we had have another combination treatment of oral prednisolone and chlorambucil. After the treatment of this combination regimen, her recalcitrant dermatomyositis improved dramatically without recurrence. There were no significant adverse side effects with chlorambucil therapy.
Chlorambucil* ; Dermatomyositis* ; Humans ; Methotrexate ; Prednisolone ; Recurrence

BACKGROUND: The clinical and histopathological classification of erythema multiforme(EM) and Stevens-Johnson syndrome (SJS) are difficult due to a lack of clear-cut criteria. In recent studies, some authors suggested that erythema multiforme and Stevens-Johnson syndrome were clinically and histopathologically different disorders. OBJECTIVE: The purpose of this study was to review the clinicopathological characteristics of the EM and SJS and to suggest specific findings for differentiating between the two diseases. METHODS: Fifty four patients with EM and SJS diagnosed in the Department of Dermatology of Dong-San Hcepita1 from January 1987 through to December 1996 were studied retrospectively. RESULTS: The results were summarized as follows. l. In view of causal factors, 54 cases were classified as drug-induced (n=22, 41%), herpes-induced (n=16, 30%), tuberculosis (n= 2, 3%), pneumonia (n=l, 2%), unknown (n=13, 24%). 2. Fifty four cases were clinically classified as SJS (n= 29, 54%), EM minor (n=-15, 2S%) and EM major (n = 10, 18%). 3. Erythema multiforme was found to be more related to herpes (13 of 25 cases) than to drugs (3 of 25 cases), while SJS was more related to drugs (19 of 29 cases) than to herpes (3 of 29 cases). 4. Varying degrees of necroti changes of keratinocytes were found in all the cases. The severity of degree or extent of necrosis was higher in patients with SJS than EM. 5. In demial changes, EM showed differences from SJS by having a denser and deeper lymphocytic infiltrate, and increased amount of extravasated erythrocytes. CONCLUSION: Taken together, although our findings could not provide a defmite clue to determine whether EM and SJS are different distinet entities or not, this study may be useful to differentiate and to understand the pathogenesis of EM and SJS. A prospective large scaled study should be conducted to definitively characterize these entities.
Classification ; Dermatology ; Erythema Multiforme* ; Erythema* ; Erythrocytes ; Humans ; Keratinocytes ; Necrosis ; Pneumonia ; Retrospective Studies ; Stevens-Johnson Syndrome ; Tuberculosis

Prosthetic replacement was performed in 31 patients (32 cases) with femoral neck fractures at National Medical Center from 1968 to 1981. We reviewed the records of 28 patients having Austin-Moore prosthetic arthroplasty in 29 cases, and of 3 patients having Thompson prosthetic arthroplasty; then obtained following results. l. Of the 31 patients, 23 were female and 8 were male. The left hip was involved in 20 patients, right in 10, and the both sides in one. 2. The age range was between 35 and 84 years, with the average age of 61.2 years. 74.2% of patients were older than 51 years of age. 3. The most common cause of fracture was slipping or fall (65.6%), and the fracture sites were subcapital in 11 (34.4%), transcervical in 12 (37.4%), and basilar in 3 (9.4%). 4. Three cases (9.4%) were operated within a week, and 21 cases (65.6%) more than 3 weeks after injury. Good results were obtained in fresh fracture which was operated within a week. 5. In comparing the blood loss in Moores and modified Gibson's surgical approaches, the average total loss by the former was 1,290 ml and 1,720 ml by the latter. 6. In complications, one case of fracture of the posterior rim of acetabulum with subsequent subluxation and two cases of fracture of the greater trochanter were notable as operative complicatiens. 7. In a follow-up study averaging 13.1 months, good to excellent results were obtained in 8 cases, fair in 6, poor or bad in 5, respectively.
Acetabulum ; Arthroplasty ; Female ; Femoral Neck Fractures ; Femur ; Femur Head ; Follow-Up Studies ; Hip ; Humans ; Male

In a large proportion of patients with chronic urticaria, at present, the definite tiology can't be found. There have been occasional attempts to identify the aIIergic causes uaing allergic skin tests, only ta suggest the Candicla albicans and. some food yeasts ae probabIe causes. Thia atady was designed to investgate how often patients with chronic urticaria from Chonnam Province react positively to skin tests with extracts of 42 common. allergene in the standard group Al-13 produced by Bencard Ltd. in England. The authora alao surveyed the clinical characteristics of 63 patients with chronic urtimria of more than 3 months duration, who bad visited the skin clinic of Chosun Univeresity HcepitaI from May. 1977 throug 3. Apr. 1979. The results were summarized as follows; 1. Among 63 patients, the maIe to female ratio was 1: l.2, and the peak incidence was in the 20s and 30s. 2, In regard to the duration of chroic urticaria, the highst frequency waa below one year duration. 3. Among 60s of the pa,tients who experienced seasonal changes, 32.4% had suffered aggravation during the winter. 4. The most common diseases combined with chronic urticaria were allergic rhinitis and atopic dermatitis, occuring in 9.5% of all subjects. 5. Of thase examined, 69.8% showed positive reactions to the prick test with the peak incidence in the 20s and 30s. 6. Among 42 allergens used far the prick test, 28 allergens turned out to be possibly casal agents, the rnost frequent group of allergens involved were grain du sts (27.1%), animal hairs(21.8%) and moulds(16.5%) in that order of frequency and occupying over 65% of the total positive reactions. And the most frequently involved specific allergens were hay dust, mixed grain dust straw dust and tree in that order of frequency. Moreover, 90 of the involved allergens were inhalants. 7. In teen-agers, the reactions to grain dusts, animal ha.irs, rnoulds and pollens were the rnost frequent while reactions to food allergens were most frequent in the 20s, and cotton and house dust are most frequently involved in tbe 40s. 8. Multiple sensitivity was not:d in a majority of cases and the most frequent combination was 2 to 5 allergens. 9. The rnost common abnormal hematologic finding in chronic urticaria was eosinophilia.
Allergens ; Animals ; Edible Grain ; Dermatitis, Atopic ; Dust ; England ; Eosinophilia ; Female ; Humans ; Incidence ; Jeollanam-do ; Pollen ; Rhinitis ; Seasons ; Skin ; Skin Tests ; Urticaria* ; Yeasts

Clear cell hidradenoma, generally as an eccrine sweat gland origin, is a fairly uncommon tumor and occurs as a slowly growing, usually solitary nodule. The histological patterns vary from one tumor to another and in different parts of the same tumor. We experienced three cases of clear cell hidradenoma which were diagnosed by the histopathologic examination of the tumor mass removed by surgical excision. Clinical and histopathologic features of each case were reviewed and compared.
Acrospiroma* ; Sweat Glands

Desmoplastic trichoepithelioma, a tumor of hair follicle, is usually seen as solitary lesions. Its clinical configuration is hard and annular, asympromatic, white or yellowish and varied in size from 3 to 8 mm, but the appearance of these lesion is not so distinctive to hair follicle tumors that the diagnosis is estabilished by the histopathologic findings. Microscopical findings of desmoplastic trichoepithelioma consist of narrow strands of tumor cells, horn cyst, desmoplastic stroma. We present here a case of desmoplastic trichoepitheliorna, which develops as 6 mm sised papule on the left cheek in a 57-year-old woman.
Animals ; Cheek ; Diagnosis ; Female ; Hair Follicle ; Horns ; Humans ; Middle Aged

A case of Ramsay Hunt syndrome, though more often seen at the ENT clinic because of the patients' concern with symptoms in the ear, was seen and treated at the Dermatologic Clinic of Chosun University. A 29 year old male patient presented earache, pinhead to rice sized erythematous vesicular eruption on the external auditory canal, auricle and superior auricular area, and facial paralysis, all involving the right side of the face, duration of which were 7 days, 5 days and 1 day respectiveIy. High doses of prednisolone alone made it possible to remit the otalgia, control the vesicular eruption and resolute the facial paralysis almost completely within 18 days in the order of their appearance, indicating that this is one of the more easily treated diseases for dermatologists, The 22 cases of this syndrome reported in Korean literature were reviewed and the conceptual development of its pathogenesis and definition was described.
Adult ; Ear ; Ear Canal ; Earache ; Facial Paralysis ; Herpes Zoster Oticus* ; Humans ; Male ; Prednisolone

BACKGROUND: The skin of patients with atopic dermatitis (AD) exhibits a striking susceptibility to colonization with Staphylococcus aureus (S. aureus). Superantigens produced by S. aureus and their specific IgE antibodies are thought to be important precipitating factors of AD, but there are few reports evaluating these 2 factors at the same time, particularly in adult AD patients. OBJECTS: Our purpose was to investigate the differences in the culture degree of S. aureus from the lesion, non-lesion, and control group of child and adult AD patients, to research the correlation between the exotoxin production, total IgE, anti-SEA IgE and the disease severity by SCORAD index, to ascertain the differences between child and adult AD patients. METHODS: The clinical severity of 30 child (2 to 15 years of age) and 30 adult patients (16 to 40 years of age) with AD was evaluated by using SCORAD index. S. aureus was isolated from lesional and non-lesional skin of AD patients, and from healthy controls. Staphylococcal exotoxins were detected by using reversed passive latex agglutination toxin detection kits. Anti-SEA IgE antibody was determined by using AlaSTATt assay RESULTS: S. aureus colonizations were found in 11 (36.7%) of the lesional skin, in 5 (16.7%) of the non-lesional skin of 30 child AD patients, and in 26 (86.7%), in 20 (66.7%) of 30 adult AD patients, respectively. The colonization rates of S. aureus in child patients were much lower than those in adult patients, both form lesional skin and non-lesional skin. Staphylococcal exotoxins were detected in 5 (45.5%) of the 11 colonizations from lesional skin, in 2 (40%) of the 5 colonizations from non-lesional skin of children, and in 10 (38.5%) of the 26 colonizations, in 9 (45%) of the 20 colonizations of adults, respectively. Staphylococcal enterotoxin A (SEA) was most frequently detected in both groups. S. aureus colonization was correlated with the severity of AD in childhood, but not in adulthood. However, there were no statistical significances between severity of AD and others such as exotoxin production, and the level of total IgE and anti-SEA IgE in both groups. CONCLUSION: The colonization of S. aureus was more common in adult AD patients than child AD patients. Anti-SEA IgE level was much higher in adult AD patients than in child AD patients. It is tempting to speculate that the colonization of S. aureus and exotoxin production might be related to the disease. duration rather than clinical severity of AD.
Adult ; Agglutination ; Antibodies ; Child ; Colon ; Dermatitis, Atopic* ; Enterotoxins* ; Exotoxins* ; Humans ; Immunoglobulin E* ; Latex ; Precipitating Factors ; Skin ; Staphylococcus aureus ; Strikes, Employee ; Superantigens

We experienced a case of unilasteral vocal cord paralysis following cuffed endotracheal intubation for abdominal surgery. The patient had have no laryngotracheal symptoms prior to the operation and anesthesia was uneventful. He complained of hoarseness post-operatively but no visible evidence of trauma secondary to the intubation was mainfested on the indirect laryngoscopic examination, except left vocal cord paralysis. There were no obvious causes for the vocal cord paralysis and possible etiologic factors. Therefore, no specific treatment was done except for the bed rest, humidification and gurgling. Vocal cord function returned nearly normal after six months.

The influence of serum IgE level on T cell function and number in atopic dermatitis was performed. For the study we selected 2 groups of atopic derrnatitis patients which were 10 cases of atopic dermatitis patients with more than 400 IU/ml of serum 1gE level and 1(l cases with less than 400 IU/ml, The lymphocyte transformation test with phytohernagglutinin and E-rosette test with AET treated sheep cell were perforrned in each group and compare the result of each group with each other and al'o with those of control group. The reults are as follows; l. The mean serum level of IgE in AD(538. 8 407.42 IU/ml) was higher than in normal control(126. 5 133, R8 IU/ml) (p<0.01). 2 The mean LTT S.I. in AD(8.83 -3.85) was lower than in nomnal control (13.99 5.55) (p<0.01). 3. The mean percentage of E-rosette in AD(68,65+6.6g) was lower than 4pp IU/ml(mean+2x SD of serum IgE of control groups), 1) The LTT S, I. was decreased in both groups according to increment of serum IgE, The higher IgE group(8.64+3,9p) had statistical significance compared to normal control(13.gg+5.55) (p<0.01) but not in low IgE group(9.08:4.11).2) The percentage of E-rosette was decreased in both groups according to increment of serum IgE. The both groups of low IgE(71.08.-6,24) and high IgE(66. 22 6. R7) had statistical significance compared to normal control(77.65+4.39 %) (p 0.01).
beta-Aminoethyl Isothiourea ; Dermatitis, Atopic* ; Humans ; Immunoglobulin E* ; Lymphocyte Activation ; Sheep