BACKGROUND: Pemphigus is a rare, chronic blistering disease of the skin and mucous membranes with severe morbidity and occasional mortality. The clinical data of Korean pemphigus patients are quite limited, and an appropriate treatrnent regimen is not yet established. OBJECTIVE: Our purpose was to analyze the clinical characteristics of, and establish an appropriate treatment regimen for Korean pemphigus patients. METHODS: A retrospective analysis was conducted for 24 pemphigus patients seen between 1992 and 1996. RESULTS: Pemphigus vulgaris(PV) was the most common type with 17 cases, followed by seven cases of pemphigus foliaceus(PF). There were no sexual preferences, and the average age at onset for PV and PF was 46 and 50 years old, respectively. Mucosal involvement was noted in 14 cases(82%) of PV and only in one case(14/o) of PF. There was no correlation between the extent of involvement and the titer of anti ICS(intercellular substance) antibody. Most patients received prednisolone of lmg/kg, and 12 PV patients also received immunosuppressive agents. Systemic side effects were noted in 10 cases of PV, and seven PF cases did not manifest any systemic side effects. CONCLUSIONS: The clinical manifestations and results of imrnunofluorescent studies of 24 Korean pemphigus patients were similar to those of the previous studies. For treatment of pemphigus, the lowest possible doses(less than 1mg/kg) of corticosteroid in combination with immunosuppressive agents appears to be more effective and less toxic than high doses of corticosteroid. We propose a regimen for treatment of Korean pemphigus patients based on these experiences. Further rnulti-center clinical trials are advocated to confirm an effective management protocol for Korean pemphigus patients.
Blister ; Humans ; Immunosuppressive Agents ; Middle Aged ; Mortality ; Mucous Membrane ; Pemphigus* ; Prednisolone ; Retrospective Studies ; Skin

BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia ; Epinephrine ; Fentanyl ; Humans ; Lidocaine ; Nausea ; Pruritus ; Research Personnel ; Sensation ; Urinary Retention

No abstract available.
Ankle Fractures* ; Ankle*

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

No abstract available.
Craniocerebral Trauma* ; Head*

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*

Monilethrix is a rare hereditary disorder of hair which was described by smith in 1879. The scalp hair is most frequently affected but the body or sexual hair are rarely affected. The affected hair shows periodic constrictions that break easily, so the hair could not grow more than a few millimetere long. It is thought that the node of the affected hair is normal and the thin internodal segment is deficient in hair matrix. Keratosis pilaris is generally an associated feature. We experienced a case of monilethrix with keratosis pilaris. The 4 years old male patient with monilethrix affected only scalp hair with keratosis. The family history was non-contributory.
Child, Preschool ; Constriction ; Hair ; Humans ; Keratosis* ; Male ; Monilethrix* ; Scalp

BACKGROUND: Recently doubts have been raised regarding the diagnostic significance of some of the minor clinical features of atopic dermatitis (AD) proposed by Hanifin and Rajka. Some of them may be nonspecific and racial difference was suggested. OBJECTIVE: The purpose of this study is to evaluate the diagnostic significance of 14 minor clinical features out of Hanifin and Rajka's 23 minor features of AD in the Korean pediatric population. The significance of 5 more items was evaluated as additional minor features. METHODS: The difference in frequency of the total 19 features of AD was compared between 100 patients with AD and 76 controls. RESULTS: Fourteen of these were shown to be significantly more frequent in patients than in controls including our 5 additional clues such as scalp scaling, postauricular fissure, infraauricular fissure, forehead lichenification, and infragluteal eczema. CONCLUSION: Our study about the minor features may be a valuable guideline for the diagnosis of AD in the Korean pediatric population.
Dermatitis, Atopic* ; Diagnosis ; Eczema ; Forehead ; Humans ; Scalp

BACKGROUND: Recently doubts have been raised regarding the diagnostic significance of some of the minor clinical features of atopic dermatitis (AD) proposed by Hanifin and Rajka. Some of them may be nonspecific and racial difference was suggested. OBJECTIVE: The purpose of this study is to evaluate the diagnostic significance of 14 minor clinical features out of Hanifin and Rajka's 23 minor features of AD in the Korean pediatric population. The significance of 5 more items was evaluated as additional minor features. METHODS: The difference in frequency of the total 19 features of AD was compared between 100 patients with AD and 76 controls. RESULTS: Fourteen of these were shown to be significantly more frequent in patients than in controls including our 5 additional clues such as scalp scaling, postauricular fissure, infraauricular fissure, forehead lichenification, and infragluteal eczema. CONCLUSION: Our study about the minor features may be a valuable guideline for the diagnosis of AD in the Korean pediatric population.
Dermatitis, Atopic* ; Diagnosis ; Eczema ; Forehead ; Humans ; Scalp

No abstract available.
Atrophy* ; Temporal Lobe*