No abstract available.
Eczema, Dyshidrotic* ; Pigmentation*

BACKGROUND: Local bath-PUVA(LB-PUVA) therapy has been recently tried for the treatment of palmoplantar pustular psoriasis and chronic eczema with successful results. However it has not been reported that the effectiveness of LB-PUVA was compared with that of steroid treatment which is the most available treatment. OBJECTIVES: The purpose of this study was to assess the effectiveness, symptom-free interval, recurrence rate and side effects of local bath-PUVA(LB-PUVA) therapy in palmoplantar pustular psoriasis and dyshidrotic eczema which had been resistant to conventional treatments and to compare these results with those of the steroid treatment. METHODS: Twenty four patients with palmoplantar pustular psoriasis, dyshidrotic eczema and palmoplantar keratoderma were treated with local bath-PUVA and the control group of twenty patients with systemic and topical steroid. 1. Local bath-PUVA therapy After a 15-minute bath in 1mg/L of methoxsalen solution(0.0001%), the palms or soles or both were exposed immediately to UVA radiation by UV/PUVA200. The initial standard dose was 1.5 J/cm2, and the patients were treated three times a week. 2. Systemic and topical steroid therapy The patients treated with 10-15mg of oral prednisolone once a day and high-potency steroid(Dermovate ointment) to the lesion topically for 4-8 weeks. The efficacy, symptom-free interval and side effects were assessed for 6-12 months after termination of the treatments. RESULTS: The following results were obtained from this study. 1. In the objective study, severity scores before and after treatment significantly differed in palmoplantar pustular psoriasis treated with local bath-PUVA (p<0.001). 2. In the subjective study, steroid treatment was more effective than LB-PUVA treatment for dyshidrotic eczema and palmoplantar pustular psoriasis. 3. Remission period was significantly longer (mean 9.1+/-2.8 months vs. 5.2+/-3.1 months) and recurrence rate, lower (26.7% vs. 68.9%) after LB-PUVA treatment than after steroid treatment in palmoplantar pustular psorisis and dyshidrotic eczema. 4. One patient with palmoplantar keratoderma was effectively treated by LB-PUVA. CONCLUSION: Local bath-PUVA therapy can be used as an effective and safe treatment method of palmoplantar pustular psoriasis and possibly palmoplantar keratoderma.
Baths ; Eczema ; Eczema, Dyshidrotic* ; Humans ; Keratoderma, Palmoplantar ; Methoxsalen ; Prednisolone ; Psoriasis* ; Recurrence

BACKGROUND: Palmoplantar pustulosis (PPP) and pompholyx are both chronic vesiculopustular conditions of the palms and soles. Because both share similar clinical and histological features, it is difficult even for dermatologists to differentiate between these two diseases. OBJECTIVE: To analyze clinical features that can be helpful in differentiating the two diseases. METHODS: The clinical history of 133 patients with vesicles or pustules on the palms and/or soles was evaluated. Patients were divided into a PPP group and a pompholyx group. RESULTS: There was no sex or age predilection in either group and no significant difference in overall localization and symmetry of lesions. Bilaterality was found in 75.0% of cases of PPP and 82.0% of cases of pompholyx. More lesions were found on the tip of the finger/toe, and the side of the toe in the pompholyx group than in the PPP group. However, there was no difference between two groups in lesions on the sides of fingers. More cases of PPP involved right distal interphalangeal (DIP) and bilateral proximal interphalangeal (PIP) joint areas compared with pompholyx. There were more smokers in the PPP group. Among several comorbidities, only atopic dermatitis and nummular eczema were associated with pompholyx. CONCLUSION: Several characteristics of patients and clinical findings may serve as useful “clues” to differentiate between and determine treatment for PPP and pompholyx.
Comorbidity ; Dermatitis, Atopic ; Diagnosis, Differential* ; Eczema ; Eczema, Dyshidrotic* ; Fingers ; Humans ; Joints ; Toes

No abstract available.
Eczema, Dyshidrotic* ; Guillain-Barre Syndrome* ; Immunization, Passive* ; Immunoglobulins*

BACKGROUND: The high rates of atopic dermatitis among children, treatment failures and treatment costs have created the search for new therapies to control flares of atopic dermatitis. OBJECTIVES: We compared the efficacy and safety of topical essential oil (German Chamomile) versus topical steroids (hydrocortisone 1%) in controlling flares of atopic dermatitis. METHOD: We randomly selected 60 children diagnosed of AD or children that qualified to the criteria of AD. They we’re randomly grouped into three. Twenty for Essential Oil (EO) group, twenty for Steroid group (SG) and Twenty for placebo (distilled water) group. They were advised to apply medicine kept in uniform brown plastic bottles 3x a day for 4 weeks. Data were recorded weekly using the EASI (Eczema Score Index) scoring. Other topical medications such as emollients and moisturizers were continued. RESULTS: At week 4 control of flaring was achieved; 42% for EO group and 55% for steroid group. The differences in treatment effects were not statistically significant. CONCLUSION Essential oil was comparable in cure rate to mild topical steroid. Essential oil can be safe and affordable. However further study in a wider scale is recommended.
Eczema

Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN.
Biopsy ; Eczema, Dyshidrotic ; Extremities ; Genitalia ; Humans ; Lichen Nitidus ; Lichens ; Pruritus ; Skin

BACKGROUND: Three age-depedent clinical phases(infantile, childhood and adult phase) of atopic dermatitis(AD) were recognized. We think that for t he diagnosis of AD there seems to be some differences in minor clinical features of diagnosic significance according to each phase, yet only a few studies about them. OBJECTIVES: The purprrse of the present study was to evalute the diagnostic significance of total 39 minor clinical features of AD in Korean adolescenc and adult popluation, all but only skin were proposed by our previous study for Korean children. METHODS: The frequeney of 39 minor clinical features wistudied in 82 patients with typical AD compared to that in 109 control subjects. The age all studied individuals ranged from 13 to 42 years. Furthermore, some characteristic micro features of AD in them were compared with those from our previous study for Korean children. RESULTS: Twenty-seven minor features including xerosis, peifolhcular accentuation, frontal lichenification, anterior neck folds, eyelid eczema, Dennie-Mogan folds, auricular fissure/eczema, pityriasis alba, ventiral wrist eczema, infragluteal eczcm, sandpaper-like skin lesions on elbow/knee/lateral malleblus, white dermographism, scalaling, Hertoghes sign, orbital darkening, cheilitis, facial erythema/pallor, hyperlinear paln, ichthyosiform skin lesions, nipple eczema, nummular eczema, pompholyx, itchy hyperker totic lesions of dorsal hands, knuckle dermatitis of hands, hangnail, non-specific hand/foot dermatitis, chronic dermatophytosis were shown to be of much diagnostic signiic, nce(P<0.001). CONCLUSION: We think tiat 13 minor features such as Hert piges sign, cheilitis, facial erythe- mapallor, hyperlinear ichthyosiform skin lesions, ripile eczema, nummular eczema, pompholyx, itchy hyperkpratotic lesions of dorsal hands, kzukle dermatitis of hands, hangnail, non-specific hand/foot dermatitis, chronic dermato h tosis are specific for Korean adolescence and adult population with AD. Taken together, to propose that these 13 minor features be added to a gardeline for the large scale field sirvy on the incidence and prevalence of AD in the Korea adolescence and adult population.
Adolescent* ; Adult* ; Cheilitis ; Child ; Dermatitis ; Dermatitis, Atopic* ; Diagnosis ; Eczema ; Eczema, Dyshidrotic ; Eyelids ; Hand ; Humans ; Incidence ; Korea* ; Neck ; Nipples ; Orbit ; Pityriasis ; Prevalence ; Skin ; Tinea ; Wrist

Tinea manuum comprises roughly 5% of all cases of tinea, and the main culprit is known to be Trichophyton (T.) rubrum, T. mentagrophytes var. erinacei is a dermatophyte that may be transmitted from hedgehogs, and it has been reported in Korea now that vast diversity of pets are brought into existence. Tinea manuum caused by T. mentagrophytes var. erinacei, is frequently localized to the initial site of exposure, and thus may be confused with hand eczema or pompholyx. The patient visited the outpatient clinic with an erythematous scaly patch with pustule on the right finger after being initially misdiagnosed with housewife eczema. Numerous hyphae were evident on KOH smear examination, and confirmative diagnosis of tinea manuum caused by T. mentagrophytes var. erinacei was made after culturing scales from the lesion for molecular biological analyses. The patient is currently under follow-up without relapse after being treated systemic and topical antifungal agents.
Ambulatory Care Facilities ; Antifungal Agents ; Arthrodermataceae ; Eczema ; Eczema, Dyshidrotic ; Fingers ; Follow-Up Studies ; Hand ; Hedgehogs ; Humans ; Hyphae ; Korea ; Recurrence ; Tinea ; Trichophyton ; Weights and Measures

BACKGROUND: Hand eczema is a common skin disease in the general population. The etiology of hand eczema is obscure and many causative factors have been proposed. However, there are only a few reported studies of the relevance of contact allergy in hand eczema. Objective: The purpose of this study was to evaluate the diagnostic value of the patch test for patients with hand eczema. METHODS: We analyzed the clinical characteristics and the results of the patch tests of the 37 patients with hand eczema and we then compared these with the clinical subtypes. RESULTS: 26 patients (70.3%) showed a positive test to one or more allergens. The common allergens were nickel sulfate (35.1%), mercury ammonium chloride (21.6%), and cobalt chloride (18.9%). The positive rates for a patch test were 82.4% for the vesicular form, 77.8% for the fissured form, 20.0% for the hyperkeratotic form and 66.7% for pompholyx, respectively. We found more significant improvement of the clinical symptoms in the vesicular group (57.1%) than that in the non-vesicular group (9.3%) after avoiding the verified allergens. CONCLUSION: This study shows that the patch test is a useful tool for the detection of contact allergens and it must be performed for the patients with hand eczema, and especially for those patients with the vesicular type.
Allergens ; Ammonia ; Ammonium Chloride ; Cobalt ; Dermatitis, Allergic Contact ; Eczema ; Eczema, Dyshidrotic ; Hand ; Humans ; Hypersensitivity ; Mercuric Chloride ; Nickel ; Occupations ; Patch Tests ; Skin Diseases

BACKGROUND: Hand eczema is a common skin disease in the general population. The etiology of hand eczema is obscure and many causative factors have been proposed. However, there are only a few reported studies of the relevance of contact allergy in hand eczema. Objective: The purpose of this study was to evaluate the diagnostic value of the patch test for patients with hand eczema. METHODS: We analyzed the clinical characteristics and the results of the patch tests of the 37 patients with hand eczema and we then compared these with the clinical subtypes. RESULTS: 26 patients (70.3%) showed a positive test to one or more allergens. The common allergens were nickel sulfate (35.1%), mercury ammonium chloride (21.6%), and cobalt chloride (18.9%). The positive rates for a patch test were 82.4% for the vesicular form, 77.8% for the fissured form, 20.0% for the hyperkeratotic form and 66.7% for pompholyx, respectively. We found more significant improvement of the clinical symptoms in the vesicular group (57.1%) than that in the non-vesicular group (9.3%) after avoiding the verified allergens. CONCLUSION: This study shows that the patch test is a useful tool for the detection of contact allergens and it must be performed for the patients with hand eczema, and especially for those patients with the vesicular type.
Allergens ; Ammonia ; Ammonium Chloride ; Cobalt ; Dermatitis, Allergic Contact ; Eczema ; Eczema, Dyshidrotic ; Hand ; Humans ; Hypersensitivity ; Mercuric Chloride ; Nickel ; Occupations ; Patch Tests ; Skin Diseases