A clinicopathological study of 12 cases of pityriasis lichenoides chronica and 14 cases of small plaque parapsoriasis was performed. Patients with pityriasis lichenoides chranica ranged in age from 15 to 62 years (mean, 30 years) with male predominance. They had erythematous or reddish scaly papules occuring mostly on both trunk and extremities(92%). The lesions were about the size of r ice grains or small peas. Patients with small plaque parapsoriasis ranged in age from 8 to 67 years(mean, 33 years) and presented yellowish or erythematous scaly maculies and patches comrnonly involving the trunk and extremities(64%). The size of the lesions were larger than those of pityriasis lichenoides chronica. Histopatbologically, the distinct feature of pityriasis lichenoides chronica was vacuolar alteration at the dermoepidermal junction characterizing interface dermatitis. The microscopic findings of small plaque parapsoriasis were, although not as distinct as in pityriasis lichenoides chronica, those af either spongiotic dermatitis or superfirial peri vascula dermatitis. We conclude from this study that these two conditions have different clinical and histologic features and we propose that the term guttate parapsoriasis shauld not be used as a synonym of either pityriasis lichenoides rhronica or small plaque parapsoriasis.
Edible Grain ; Dermatitis ; Humans ; Ice ; Male ; Parapsoriasis* ; Peas ; Pityriasis Lichenoides* ; Pityriasis*

Dermatitis Herpetiformis rarely in childhood, and certain features of the disease in children differ from its manifestations in adults. Juvenile dermatitis herpetiformis appears not to be the same disease as the typical dermatitis herpetiformis of adults. Juvenile dermatitis herpetiformis has been described as a predomimantly bullous disease, but rarely papulovesicular eruptions. This bullous eruption in children must be considered in the several entities such as bullous pemphigoid and erythema multiforme. Juvenile bullous dermatitis herpetiformis has not responded routinely to sulfapyridine and sulfone therapy. A 15-month-old child whose skin lesions fulfilled clinical, histologic, and therapeutic criteria for Juvenile dermatitis hepetiformis is reported. The skin lesions showed bullous eruptions and also complained of severe itching sensation different from bullous Juvenile dermatitis herpetiformis.
Adult ; Child ; Dermatitis Herpetiformis* ; Dermatitis* ; Erythema Multiforme ; Humans ; Infant ; Pemphigoid, Bullous ; Pruritus ; Sensation ; Skin ; Sulfapyridine

For the establishment of the association of the chronic fungal infection with cell mediated immunity, delayed cutaneous hypersensitivity was measured for 96 patients with chronic dermatophytosis and 40 healthy adults by means of Multitest CMI. The patient group increased in rates of positivity to candida, trichophyton and diphtheria, but decreased in rates of positivity to proteus, streptococcus and tuherculin. The rate of positivity of the patient group in the antigen of trichophyton(14%) was shown as higher than that of the control group(8%). A big difference in the sum of diameters was shown between patients with nail infection(22.5+/- 113mm for male, 16.3+8.93mm for female) and patients without nail infection(17.8+/- 7.62rnm for male, 11.44.37mm for female). In conclusion, in the present study, the difference in the delayed cutaneous hypersensitivity between patient group and control group is not provided. Even though the possibility of defect of cell mediated immunity in chronic dermatophytosis is admitted, there are some doubts regarding the Multitest CMI being the adequate method ta check the state of cell mediated immunity of individuals who have trivial or partial defect in immunity.
Adult ; Candida ; Diphtheria ; Humans ; Hypersensitivity* ; Immunity, Cellular ; Male ; Proteus ; Streptococcus ; Tinea* ; Trichophyton

Intercellular adhesion molecule I(ICAM-1; CD 54), a 90 kD glycoprotein, counter-receptor for lymphocyte function-associated antigen-I(LFA-1) on T-cells, is critically important to a wide variety of adhesion-dependent leukocyte functions, including antigen presentation and target cell lysis. Induction of ICAM-1 on the keratinocytes(KCs) is an important regulator in initiation, maintenance, and resolution of cutaneous inflammation, which is modulated with cytokines produced by activated T-lymphocytes. This study was designed to further our understanding on modulation effects of ultraviolet B(UVB), gamma interferon(IFN-;v), and retinoic acid(all trans) upon expression of ICAM-1 on cultured human KCs, with emphasis on their correlation. Cell surface expression of ICAM-1 in cultured human KCs was analyzed with the use of indirect immunofluorescence and fluorescence activating cell sorting(FACS) by flow cytometry. The results of this study were as follows: 1) Expression of ICAM-1 was significantly induced with IFN-,-(20 U/ml)(p<0.005). 2) UVB irradiation of 30mJ/cm2 significantly suppressed ICAM-1 expression of KCs 24 hours after irradiation(p<0.05). However, at 72 hours after irradiation, ICAM-1 expression of KCs was considerably increased in comparison to that of initial phase (24 hours after irradiation). 3) High concentrations(10(-5)M) of retinoic acid reduced UVB-induced expression of ICAM-1 in late phase(72 hours after irradiation), although retinoic acid showed induction effect of ICAM- I expression of KCs. In summary, these results indicate that ICAM- I may contribute to the biphasic effect of UVB on delayed hypersensitivity in vivo. Also, retinoic acid, a vitamin A derivative, may have a cutaneous photoprotective effect through a regulation of UVB-induced ICAM-1 expression on the KCs.
Humans

No abstract available.
Polyps* ; Vitelline Duct*

This study aims to investigate the recent clinical and mycological trends of dermatophytoses in Pusan area. The number of patients with dermatophytoses diagnosed by KOH examination and culture at Maryknoll Hospital was 1, 213 during past 2 years from November 1982 to October 1984. The incidence rate of dermatopbytoses was 9. 8% out of 12,377 cases of out patients in total. Tinea pedis (33 .7%,) was the most frequent diagnosis, followed by tinea cruris, tinea unguium, tinea corporis, tinea faciale, tinea manus and tinea capitis, in the order of decreasing frequency. The majority of cases were found in the age group from 20 to 39 4, The over all ratio of male to female patients was ] 2: 1 5 The positive rate in KOH examination was 96. 2A, and it was especially low in the areas of scalp, face and toe webs. The positive culture rate was 55, 9g, and it was higher in the covered area than in the exposed area. 6 678 strains out of the 1, 213 patients were isolated and identified. The species isolated were, in the order of decreasing frequency, Trichophyton rubrum (558 strains, 82.3% of total organisms isolated), Tn'chophyton mentagrophytes (55,8, 1 Microsporum canis (48, 7. 1g) Epidermophyton floccosum (12, 1 8g) and Microsporum gypseum (5, 0. 7gp) Trichophyton rubrum was the major causative organism in all the types of dermatophytoses except tinea capitis and tinea faciale. In tinea capitis, Microsporum canis was the main causative organism, and Trichophyton ferrugineum was not isolated, at all, which was a specific point, compared with the past tendency. In tinea faciale, zoophilic organisms were mainly isolated.
Busan* ; Diagnosis ; Epidermophyton ; Female ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Scalp ; Tinea Capitis ; Tinea Pedis ; Tinea* ; Toes ; Trichophyton

Traumatic epidermoid cysts are rare tumors occuring almost exclusively on the palms, palmar aspects of fingers, and soles. These cysts are thought to originate from a bit of epidermis implanted into the dermis after a penetrating or blunt wound. We report a case of typical traumatic epidermoid cyst on the sole of the right foot of a 23-year-old male student. The lesion was a coin-sized, tender, fluctuating cystic mass occuring 3 years after a penetrating wound by an iron nail. Histopathlogical examination revealed a deep dermal cyst lined by a thick, flattened, keratinizing wall with partial disruption accompanied by foreign-body reaction.
Dermis ; Epidermal Cyst* ; Epidermis ; Fingers ; Foot ; Foreign-Body Reaction ; Humans ; Iron ; Male ; Wounds and Injuries ; Wounds, Penetrating ; Young Adult

In recent years, the rate of the thracolumbar and lumbar fractures rends to be increasing as the traffic accidents and industrial accidents frequently occurs. The purpose of this study is to review the results of conservative treatment for 73 patients with thoracolumbar and lumbar fractures and to review the failed 6 cases after conservative treatment, who were admitted and treated at National Medical Center during the period the period from January 1986 to June 1992. The following results were obtained: 1. Among the 65 cases of compression fracture, we performed hyperextension body cast in patient with height loss more than 30% and bed rest & brace in patient with height loss less than 30%, And in 63 cases, it showed good results. But two cases treated by bed & brace showed complaint such as radicular pain and persisdent back pain. 2. Among the 6 cases of burst fracture without neurological involvement, two cases treated by casting showed good result, but four cases treated by bed rest & brace showed complaint such as claudication and persistent back pain. 3. All cases of Chance fracture treated by casting showed good result. 4. There was no correlation between loss of correction of kyphotic angle and overall result. 5. Among the cases of poor result, we operated four cases which included two cases of instability & two cases of spinal stenosis and their results were good.
Accidents, Occupational ; Accidents, Traffic ; Back Pain ; Bed Rest ; Braces ; Fractures, Compression ; Humans ; Spinal Stenosis ; Spine

The purposes of this clinical study are to observe the clinical findings of the high lumbar disc herniation, to analyze the of the posterior approach and to define the surgical indications of the high lumbar disc herniation. We analyzed the 13 cases which were treated at the Deparment of the Orthopaedic Surgery, National Medical Center from March 1988 to December 1992(Mean follow up rate : 17. 2 months). 1. We operated 10 cases by posterior approach and 1 case by anterior approach due to marked degenerative osteophyte. 2. We evaluated the post-operative results by modified Macnab criteria, the 2 cases showed no symptomatic improvement because of respectively associated high lumbar osteophyte and lower lumbar spinal stenosis. 3. On conclusion, suspicion is important in cases of incompatible clinical symptoms and signs of the intervertebral disc herniation. MRI is the most recommended diagnostic tool, because it can provide the high lumbar levels with saggital section image and differentiate herniation from degenerative osteophyte. As for the surgical indications of high lumbar disc herniations, we suggest marked dural compression by disc or sequestered disc materials in MRI, definite neurological complications such as ankle clonus, increased DTR, weakness of quadriceps and hip flexor muscle and severe radiating pain on the anterior thigh. We recommended the posterior approach for the surgical intervention of high lumbar disc herniation except cases marked degenerative osteophytes.
Ankle ; Clinical Study ; Follow-Up Studies ; Hip ; Intervertebral Disc ; Magnetic Resonance Imaging ; Osteophyte ; Spinal Stenosis ; Thigh

Fournier's gangrene is a fulminating gangrene of the male genitalia. It is associated with severe systemic toxic effect and a high motality rate, and it requires early diagnosis and intensive care with surgical intervention. We report a case of Fournier's gangrene in 33-year-old man, who showed marked swelling and necrosis of the scrotum, and extending cellulitis on the right flank and chest. With prompt excision of all the gangrenous scrotal skin and drainage incisions made on the flank and chest, the healing was successful.
Adult ; Cellulitis ; Drainage ; Early Diagnosis ; Fournier Gangrene* ; Gangrene ; Genitalia, Male ; Humans ; Critical Care ; Male ; Necrosis ; Scrotum ; Skin ; Thorax