Vitamin A is a fat-soluble, unssturated, long-chain isoprenoid an4 classic active- form found in mammalian tissue is the all-trans alcohol vitamin A (vitamin A alcohol or retinol). Vitamin A acid (VAA) represents the terminal product of vitamin A oxidation. Harris et al in 1332, first proposed the term "antikeraStinizing effect" to expression of tne effect of vitamin A on various epithelia. In 1943, Straufjord,over-enth usiastically reported tbat oral use of vitamin A also had a beneficial effect on acn . Kligman, in 1969, reported that VAA produce peeling effect and fabourable results with topically applied UAA in acne vulgaris. Many investigators reported that VAA was effective in man hyperkeratotic disorders, including psoriasis, senile comedon, verruca plana, keratosis palmaris et plantaris, plantar wart etc. Mode of actio. of VAA is unclear as yet. But, it is obserbed that continued susceptibility of skin to VAA is related to labilize lysosomes, thereby releasing prot.olytic and hydrolytic enzyme capable of inciting inflammatory reaction; VAA accelerates tum over of homey cells and converted hard keratin into soft keratin, so lessening of the coheiveness of homey cells is implied. Thus the effect of VAA in acne treatment are that VAA inhibits the formation of comedon and existing comedones tend to be extruded by the increased production of noncoherent homey cells and acceleration of the flow of cells out of the sebaceous glands. For this study, 52 patients were treated with application of topical VAA alone and 9 patients concurrently with topical VAA anl comedon extraction. The results were as follows: 1. The 43 patients treated with topical VAA alone showed significant improvement up to 70% at the end of third week. In this group, closed comedon, papules, pustules are progressively reduced during the first week but the number of open comedon transiently increased (34%) during first week of treatment, decreased after that. 2. The 9 pa.tients treated with topical VAA and co nedon extraction showed similar effect(80%) at the third week of treatment. But no sign of increase of open comedon was not shown in first week of treatment. 3. Discomfortable clinical effects such as scaling, buming, tightness were seen up to 83%, occassionally pruritus, pain edema., contact dermatitis, lichenifcation were seen.
Acceleration ; Acne Vulgaris* ; Dermatitis, Contact ; Edema ; Humans ; Keratoderma, Palmoplantar ; Lysosomes ; Pruritus ; Psoriasis ; Research Personnel ; Sebaceous Glands ; Skin ; Tretinoin ; Vitamin A ; Vitamins* ; Warts

Puraotix-C(0.1% Clocortolone Picalats Cream) is a new di-halogenated topical corticosteroid, and used in trial for treating several kinds of dermatoses. We treated 30 patients with Purantix-C who had one of the following dermatoses; atopic dermatitis, neurodermatitis, pustulosis palmaris et plantsris, seborrheic dermatitis, pityriasis rosea, nummular eczema, psoriasis vulgaris, pruritus ani and pompolyx. Among these 30 patients, Purantix-C showed excellent or good result (66.7%) either unoccluded or occluded application, 2~3 times daily for 7~10 days. Comparing with Lidex(0.05% fluorocinonide cream) and purantix-C, both of them had similar effect on eczema and psoriatic groups but Lidex was more effective than Purantix-C for treating the patients with the pustulosis palmaris et plantaris. Purantix-C without containing perfume and coloring substapce was less irritative.
Dermatitis, Atopic ; Dermatitis, Seborrheic ; Eczema ; Fluocinonide ; Humans ; Neurodermatitis ; Perfume ; Pityriasis Rosea ; Pruritus Ani ; Psoriasis ; Skin Diseases

Two cases with umbilical polyp are reported. One was 7-year-old boy who had l. 5cm x l. 6cm protruded urnbilieal growth, the other was 2-year-old baby who had 0. 7crn x 0. 6cm umbilical growth. This uncommon malforrnation arises from remnants of the omphalomesenteric duct and should be clinically discerned from a granuloma pyogenicum or other benign umbilical neoplasms. Histllogically umbilical polyp shows blanching glandular structures lined by intestinaI mucosa in connection with the surface of the skin. When the umbilical polyp is not associated with any other types of underlying abnormalities, it may be treated by a simple surgical excision.
Child ; Child, Preschool ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Skin ; Vitelline Duct

The incidence of tinea capitis was the least in the middle of 1970s, and thereafter it has been msrkedly increased along with other superficial mycoses due to Microsporum cania This study was to investigate the recent clinical and mycological trends of tinea capitis among the individuals of both out-patients of dermatologic clinic and orphanage children. These study data were compiled from 47 out-patients, which consisted of 31 patients from St. Pauls Hospital from September, 1980 to August, 1981 and 16 from St. Marys Hospital and Kangnam St. Marys Hospital from February to May in 1981, and from 79 patients of the orphage located in Seoul area in May, 1981. The results were as follows: 1. M. canis was isolated from all 47 out-patients with tinea capitis(male: 21, female 26). In orphanage, from 50 patients(63.3%) among the 79 patients with tinea capitis, 46 strains(92%) of T. ferrugineum from 30 male and 16 female patients, 3(6%) of M. canis from 3 males, and 1(2%) of T. violaceurn from a female were isolated. 2. The incidence of tinea capitis by M. canis in a total 5, 340 out-patients was 0. 58% (0. 62% in male, 0.56% in female) and its monthly distribution was almoat even through the studied period. The male to female ratio was 1:1,24, being more prevalent in female. 3. The age of onset was younger in female with tinea capitis due to M. canis than in male: The median age of onaet was 5 years in female and 7 years in male. In the group below 7 years of age, the maIe to female ratio was 1:1.84 and in the group above 8 years of age, l.74: 1.4. Most lesions of tinea capitis due to M. canis from out-patients showed multiple round grey scaled patches with shrotened hairs or round erythematous scaled alopetic patches. Kerion celsi were found in 4(9%) out of 47 out-patiente. Tinea corporia was combined in 4(9%) out-patients. There were domestic animals shch as kit or dog in 7(29%) among 24 houses of the patients.
Age of Onset ; Animals ; Animals, Domestic ; Child ; Dogs ; Female ; Hair ; Humans ; Incidence ; Male ; Microsporum ; Mycoses ; Orphanages ; Outpatients ; Seoul* ; Tinea ; Tinea Capitis

Purpura fuIminans is a rare form of nonthrombocytapenic purpura characterized by sudden onset, fever, prostration, anemia and symmetrical massive ecchymoses, usually of the lower extremities, and hypotension associated with disseminated intravascular coagulation (DIC). A 18 years old female patieat with characteristic clinical manifestations of purpura fulminans was seen at the department of Dermatology, St. Pauls Hospital. With intensive systemic corticasteroid and heparin treatmemts, the ecchymoses and necrosis began to heal, leaving multiple, thick esehar formation from 8th day, Although purpura fulminana has been known to attack mainly children, this case was of adolescent age.
Adolescent ; Anemia ; Child ; Dermatology ; Disseminated Intravascular Coagulation ; Ecchymosis ; Female ; Fever ; Heparin ; Humans ; Hypotension ; Lower Extremity ; Necrosis ; Purpura Fulminans* ; Purpura*

A carcinoid tumor of the bile duct represents between 0.2 and 2% of all gastrointestinal carcinoids, most of which are located in the gallbladder or in the ampulla of Vater. A carcinoid tumor of the extrahepatic bile duct is extremely rare. A 43-year-old man presented with epigastric discomfort for several months. An abdominal ultrasound revealed a mass of the common bile duct. An endoscopic retrograde cholangiopancreatographic (ERCP) examination showed a 1.5 cm sized filling defect in the distal common bile duct and marked dilatation of the common bile duct and intrahepatic bile ducts. A 7 F endoprosthesis was put in place during the examination. The histological finding following an intralesional biopsy was a carcinoid tumor. We performed a pylorus preserving pancreaticoduodenectomy. The final pathological diagnosis was a well-differentiated carcinoid tumor of a malignant nature.
Adult ; Ampulla of Vater ; Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biopsy ; Carcinoid Tumor ; Common Bile Duct ; Dilatation ; Gallbladder ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Pancreaticoduodenectomy ; Polyenes ; Pylorus