BACKGROUND: Alpha hydroxy acids (AHAs) are known to diminish corneocyte cohesion at the innermost levels of the stratum corneum and have been used in the treatment of various disorders of keratinization. However, their effect on skin barrier function and their irritant potential is not fully understood. OBJECTIVE: Our study was done to evaluate the skin irritancy of AHAs in normal human skin. METHODS: Patches with 1%, 5% and 10% solutions of lactic acid (LA) and glycolic acid (GA) were applied to the volar forearm of 20 healthy volunteers for 24 hours using large Finn chambers with filter paper. Visual scores, erythema (E-) index and transepidermal water loss (TEWL) were measured at 30 min, 24 h and 48 h after removal of the patches. RESULTS: The results are summarized as follows. 1. Visual scores were 0.1+/-0.3 (1%), 0.5+/-0.6 (5%) and 1.1+/-0.8 (10%) at 24 h after removal of LA, and were 0.2+/-0.4 (1%), 0.6+/-0.6 (5%) and 1.0+/-0.7 (10%) at 24 h after removal of GA. They were increased in proportion to the concentrations and there were significant differences in skin responses between the control and each concentration of the solutions. 2. E-indices were 9.1+/-2.1 (control), 8.8+/-1.8 (1%), 9.0+/-2.6 (5%) and 10.5+/-3.9 (10%) at 24 h after removal of LA, and were 9.4+/-1.8 (control), 9.3+/-2.3 (1%), 10.0+/-3.0 (5%) and 11.1+/-3.5 (10%) at 24 h after removal of GA. They were not increased in the patch areas of 1% and 5% solutions in both the LA and GA group, but were significantly increased in the patch areas of 10% solutions in both the LA and GA group. 3. TEWL values were 7.3+/-2.3 (control), 8.3+/-4.0 (1%), 9.8+/-4.5 (5%) and 16.7+/-9.1 (10%) at 24 h after removal of LA, and were 8.1+/-3.2 (control), 7.8+/-3.8 (1%), 8.6+/-3.0 (5%) and 10.9+/-4.1 (10%) at 24 h after removal of GA. They were not increased in the patch areas of 1% LA, 1% GA and 5% LA, but there were high significant differences between the controls and 10% solutions of both LA and GA. CONCLUSION: Visual scores were increased in all concentrations of AHAs tested, but the increase in E-index and TEWL values were not significant or minimal in 1% and 5% solutions of AHAs. These findings suggest that AHAs could be classified as non-corrosive irritants.
Erythema ; Forearm ; Healthy Volunteers ; Humans* ; Hydroxy Acids* ; Irritants ; Lactic Acid ; Skin*

Type V hyperlipoproteinemia result from the accumulation of trglyceride(TG)-rich lipoproteins, very low density lipoprotein(VLDL), and chylomicrons. A 53-year old woman has showed asmptomatic, yellowish patches on tie palms and eyelids and papules on the knees with various types of xanthoma including xanthelasma palpebraum, xanthoma striatum palmare, anrl nonspecific papular xanthoma. The blood chemistry revealed a marked elevation of cholesterol and TG, and lipoprotein electrophoresis showed fasting chylomicronemia, prep-b and b-band, On histologic studies, typical foam cells were shown.
Chemistry ; Cholesterol ; Chylomicrons ; Electrophoresis ; Eyelids ; Fasting ; Female ; Foam Cells ; Humans ; Hyperlipoproteinemia Type V* ; Knee ; Lipoproteins ; Middle Aged ; Xanthomatosis

Ki-1 antigen was found by a monoclonal antibody, made against a Hidgkin' disease-derived cell line (L428) that reacted with Reed-Sternberg cells in Hodgkins disease and a few lymphocytes around lymphoid follicle. In 1985, Stein et al identified a large cell anaplastic lymphoma showing a distinctive pleomorphic appearance, sinus growth pattern, and reactivity to Ki-l. We report a case of Ki-1 positive large cell anaplastic lymphoma, which was presenting as a elevated plaque on the skin of popliteal fossa in a 69-year-old female.
Aged ; Antigens, CD30 ; Cell Line ; Female ; Hodgkin Disease ; Humans ; Lymphocytes ; Lymphoma* ; Reed-Sternberg Cells ; Skin

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

We report a case of amelanotic melanoma(AMM) in a 53-year-old man who presented a single, 1.5×1.5cm sized, well-demarcated, bright red nodule with erosion on the right heel for 9 months. Histopathologic findings showed irregular junctional activity in the epidermal-dermal junction and alveolar formation in the dermis. The majority of the tumor cells were seen as bizarre and giant cell of epithelioid type with atypical mitotic figure. We could not find melanin pigment in H & E stain.
Dermis ; Giant Cells ; Heel ; Humans ; Melanins ; Melanoma, Amelanotic* ; Middle Aged

Laureth 9 is a nonionic surfactant and it is used as a sclerosing agen; in the treatment of esophageal and gastric varices and a local anesthetics. We report a 20-year-old male patient presenting with features of alergic contact dermatitis due to laureth 9 used in the oxoralen, ointment.
Anesthetics, Local ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Esophageal and Gastric Varices ; Humans ; Male ; Young Adult

BACKGROUND: The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of the radioallergosorbent test(RAST). The CLA permits quick, siultaneous detection of total and specific IgE in human serum up to 35 different allergens, as well as their semiquantitative concentrations into classes from 0(negative) to 4(very high). The CLA has shown sensitivity, specificity, and a good correlation with the RAST and also with skin pick testing. OBJECTIVE: The purpose of this study was to find the causatix llergens and to evaluate the clinical significance of CLA comparing the results of tbe CLA wi! h hose of the prick test in patients with chronic urticaria. METHODS: We performed the CLA with 35 allergens(MAST immunosunosystems, Inc., California, America) and the prick test with 51 allergens(Bencard Ltd., Bricantord, England) in 70 patients with chronic urticaria. The CLA detects the allergen-IgE reactic say the use of an enzyme-labeled anti-IgE and a coupled photoreagent mixture. lhe amount of the luminescent energy is measured by exposing a polarcid film and then semiquantitation is a sessed by using a densitometer. RESULTS: Except for those over the age of 60, all age-groups ealed a similar positive reaction to the CLA and prick test, but the positive reaction rate o the prick test(91.4%) was higher than that of the CLA(38.6%). The positive reaction rate oringle allergen and compound allergens was 10.0% and 28.6% in the CLA, but 10.0% and 81.4% in the prick test, respectively. In the CLA, the rate of positive reaction was 17(24.3%) in Dermatophagoides(D.) farinae, 15(21.4% ) in D. pteronyssinus, 5(7.1% ) in house dust, an 13(4.3%) in shrimp in that order. In the prick test, the rate of positive reaction was 39(55.7%) in house dust, 35(50.0%) in D. farinae, 29(41.4%) in D. pteronyssinus, and 21(30.0%) in haydrst(30.0%) in that order. The results of the CLA to 3 comrnon allergens showed a concordance rare of 67.6%, sensitivity of 34.3%, and specificity of 97.3% compared with those of the prick case. The levels of total IgE and eosinophils were elevated in 59(n=70, 843%) and in 5(n=56, 84.3%), respectively. CONCLUSION: The results of this study suggest that the CLA may be used as an alternative method for the diagnosis of chronic urticaria because it is and coiomic, safe, simple procedure with very high specificity and trelative low sensitivity, and is sirnilt. neously capable of testing to multiple allergens.
Allergens ; California ; Diagnosis ; Dust ; Eosinophils ; Humans ; Immunoglobulin E ; Luminescent Measurements* ; Sensitivity and Specificity ; Skin ; Urticaria*

BACKGROUND: There are some variables including chamber size in irritant patch test responses. Several non-invasive bidengineering methods for quantifying and obtaining information have been developed in recent decades. OBJECTIVE: Our study was done to compare the effect of chamber size and the volume effect on the irritation potential of 1% SLS solution. METHODS: Patches with 1% sodium lauryl sulfate(SLS) solution were applied to the volar forearm of 14 healthy volunteers for 24 h. Finn chambers with 8mm(20ul), 12mm(60pl), 18mm(80ul, 200ul) inner diameters were used. Visual score and transepidermal water loss (TEWL) were measured at 30 min after removal of the patches, and every 24 h up to 4 days. RESULTS: The results are summarized as follows. 1. Visual scores were 0.18+0.32(8mm), 0.75+0.33(12mm) and 0.64+0.41(18mm) at 24 h after removal of 1% SLS and were 0.11+0.29, 0.50+0.34 and 0.25+0.26 on 4 days after removal. They were inereased 30 min and 24 h after removal and decreased towards normal 4 days after removal. By chamber size, the skin response with the large Finn chamber(12mm) increased more significantly than with the small Finn chamber(8mm). However, there were no significant differences in skin response between large and extralarge Finn chambers(18mm). 2. TEWL values were 11.86+4.09, 23.05+6.1l and 22.24+7.54g/m/h at 30 min after removal and were 9.37+2.30, 1..49+3.08 and 14.56+5.00g/m/h on 4 days after removal. They were increased 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as visual scores. 3. By visual score and TEWL, the skin response with 200pl of 1% SLS increased more significantly than 80pl in the extralarge Finn chamber. CONCLUSION: The small Finn chamber may be too small to elicit sufficient cutaneous irritation for evaluation. The large Finn chamber having larger test areas may be suitable to yield positive reactions to certain irritants. Also, the quantity of test solution per mm skin may be of importance for the skin response.
Forearm ; Healthy Volunteers ; Irritants ; Patch Tests ; Skin ; Sodium

Pigmentary dermarcation lines are boundaries between more deeply pigmented skin and areas of lighter pigmentation. We report 4 cases of pigmentary demarcation lines of pregnancy associated with erythema which developed in the third trimester of pregnancy and were symmetrically located in the buttock and posteromedial portion of the lower extremities. After delivery, the erythema disappeared within 3-7 days, followed by slow resolution of the brownish pigmentation.
Buttocks ; Erythema* ; Female ; Humans ; Lower Extremity ; Pigmentation ; Pregnancy Trimester, Third ; Pregnancy* ; Skin

The peripheral blood eosinophil and serum IgE level in 53 patients with atopic dermatitis (AD) were measured. The patients were divided into 2 groups by severity(mild and severe grous) and into 3 groups by the associated respiratory atopic deseases and/or their family history : respiratory group(patient, with both AD and respiratory atopy), family history group (patient with both AD and family history of respiratory atopy), and atopic group(patient with neither respiratory atopy nor family history of respiratorv atopy). We designed to study which factors are important in the elevation of serum IgE and peripheral blood eosinophil level in AD, and to know possible relationships between the serum eosinophil and IgE level and the several groups of AD. The results are as follows : 1. Peripheral eosinophil counts were higher in severe group(224.8/mm) than in mild group (180.0/mm)(p<0.05). 2. Peripheral eosinophil counts were 220.0/mm in atopic group, l65.0/mm in family history group, and 332.4/mm in respiratory group, but there was no stitistically significant difference among 3 groups. This suggests that concomitant respiatitiry atopy or a family history of respiratory atopy is not an important factor in the elvation of peripheral blood eosinophil counts in AD. 3. Serum IgE was higher in severe group(443.2IU/ml) than in mild group(231.5IU/ml)(p<0.05). 4. Serum IgE level in respiratory group(754.6IU/ml) were signifiiantlly higher than in atopic (286.6IU/ml) or family history group(342.0IU/ml)(p<0,01). But there was no significant. difference between family and atopic group. This result suggests that concomittent respiratory atopy is a potential factor in elevation of serurn Igi in AD. 5. Slightly high correlation between peripheral blood and IgE level appeared in all 53 patients (r=0.434) and severe group(r=0.480). But, respiratory group(r=0.060), family history group(r=0.111) and atopic group(r=0.202) showed poor relationships.
Dermatitis, Atopic* ; Eosinophils* ; Humans ; Immunoglobulin E*