A group of chemicals that have proved to be frequent causes of allergic contact dermatitis from applied ingredients of the vehicle. Fisher (1971) testing with a vehicle tray of 15 chemicals in 100 patients with allergic contact dermatitis due to topically administered medications found 30 positive patch test reactions of patients and reported that most important sensitiiing chemicals are Ethylenediamine, Lanolin, Farabens, Phenylmercuric acid, and. propylene glycol monostearate. These chemicals have been recognized as such common sensitizers that they are nonincluded. in the standard patch test series by many countries. From the standpoint of allergenicity of topical preparations including topical medicaments and cosmetics, prevention and diagnostic procedures of dermatitis should be investigated extensively through the patch test studies. But, in our country, there has only a few investigation conceming the dermatitis from vehicle, particularly the medicaments and cosmetics. Therefore, author has tried to establish the vehicle tray fitted to our country according to the basic consideration used with the vehicle patch test tray of Fisher. 100 patients suspected of having allergic contct dermatitis due to topical medication or cosmetics were patch tested with a group of chemicals composed of substances commonly found in vehicles of current topical medications or cosmetics. There were many significant reactions to Ethylenediamine, Paraben, Lanolin, Sodium lauryl sulfate, Polyethylene glycol and Turpentine which play a significant role as solubilzer, antioxidants, emulsifieis, exirpients, preservatives, stabilizers, and surfactants. Author proposed that a group of chemicals should be patch tested on patients of allergic contact dermatitis for the establishmc,nt and development of the hypoallergenic topical medicaments or cosmetics.
Antioxidants ; Dermatitis ; Dermatitis, Allergic Contact* ; Humans ; Lanolin ; Patch Tests ; Polyethylene Glycols ; Propylene Glycol ; Sodium Dodecyl Sulfate ; Surface-Active Agents ; Turpentine

A case of Toxic epidermal necrolysis in 19 th years old man is presented. This patient has been suffering from erythematous patches and bullae over entire body including vesicles, erosions, and fissures on both lips since 2 days ago after taking some drugs (analgetics, aspirin, chloramphenicol, sulfisoxazole, erythromycine.) for treatment of tonsillitis. Furthermore, it is very difficult for us to say why the disease has occured. Toxic Epidermal Necrolysis (TEN) by talking drugs or Staphylococcal Scalded Skin Syndrpme (4S) by staphylococcus aurues because staphylococcus aureus was found on bacteriai culture from his throat swab. He was treated with corticosteroid, antibiotics and fluids for 20 days with good result. Literature was briefly reviewed.
Anti-Bacterial Agents ; Aspirin ; Chloramphenicol ; Humans ; Lip ; Palatine Tonsil ; Pharynx ; Skin ; Staphylococcus ; Staphylococcus aureus ; Stevens-Johnson Syndrome* ; Sulfisoxazole ; Tonsillitis

Malignant melanoma is a tumor arising within the melanocyte system of the skin, eyes and juxtacutaneous mucous membrane. Tbrough the lymphatic channel developed early metastasis and regional lymphade- nopzthy developed. Malignant melanoma may arise on apparently normal skin, in a junction nevua, rareh in a compound nevus and extremeIy rarely in an intradermaI nevus and 20% of total incidence of malignant melanoma are preceded by a nevocellular nevus. A 41 year-old male patient who had multiple, pea to walnut sized, black colored. nodules developing on entire body visited our Dermto. dept. About one year ago, solitary black colored nodule arose from preexisting pigmented nevus which had been from 20 yrs ago on Rt. ant. axillary area and then nodule remcved by wide exeision and regional lymphadenectomy at a Hosp. 2 months after surgical operation, multiple pea to walnut sized, black colored nodules has developed on entire body. There was no lymphadenopathy on entire body. In H-E & Fontana-Masson stain, numerous bizzarre large cells with hyperchromatic variable sized melanin pigments are seen in the dermis and subcutaneous tissues Mitotic figutes are present. Diagnosis was confirmed by the clinical and histological feature. The patient was treated with BCG waccination(4*10^6-8*10^6 live organisms weekly) by altemately intralesional inj, on the lesion and subcuraneous inj. on both shoulder during 6wks and has been in follow-up.
Adult ; Ants ; Dermis ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Juglans ; Lymph Node Excision ; Lymphatic Diseases ; Male ; Melanins ; Melanocytes ; Melanoma* ; Mucous Membrane ; Mycobacterium bovis ; Neoplasm Metastasis ; Nevus ; Nevus, Pigmented* ; Peas ; Shoulder ; Skin ; Subcutaneous Tissue

The pathogenesis of vitiligo has not been fully elucidated, but three different hypothese have been advanced to explain the cause of vitiligo. One is related to autoimmunity, another concerns neurohumoral factors and the third involves self-destruction of melanocytes. The autoimmune theory of vitiligo is further strengthened by the increased association of vitiligo with a nurnber of autoimmune disorders and by the increased prevalence of organ-specific autoantibodies in vitiligo. Also decreased T lymphocytes in vitiligo patients were reported. The present study was undertaken to evaluate the cell mediated immune status of patients with vitiligo using several in vitro and in vivo immune parameters. Thirty patients between the ages of 12 and 65 were observed at the Department of Dermatology of Ewha Womans University Hospital from Apri11981 through October 1981. Age matched 30 healthy persons comprised the control group. The results were summarized as follow: 1) The mean percentage of T lymphocytes in 30 vitiligo subjects and 30 control subjects were 55.3% and 67.4% respectively. There was a significant decrease of T lymphocytes in patients with vitiligo(p<0.05). 2) The percentage of subjects showing positive delayed hypersensitivity reactions to candidin, trichophytin and PPD were 33.3%, 43%, 50% respectively in 30 vitiligo patients and 60%, 75%, 80% respectively in 20 controls. A slight depression in delayed cutaneous hypersensitivity in gatients with vitiligo. (p<0.1). 3) The percentage of subjects showing positive sensitization with DNCB was 53% in 30 vitiligo patienta and 85% in 20 controls. A slight depression in DNCB sensitization was evident in vitiligo patients(p<0.1).
Autoantibodies ; Autoimmunity ; Depression ; Dermatology ; Dinitrochlorobenzene ; Female ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Immunity, Cellular* ; Melanocytes ; Prevalence ; T-Lymphocytes ; Trichophytin ; Vitiligo*

Melasma is characterized by chronic dark brown pigmentation on the face which is known to be little effective by remedies. It is still unkown the exact cause of the diaease, but pregnancy, oral contraceptives, sun-light, csometics, endocrinologic disturbances and malnutrition could be speculated as causative factors. According to our clinical experiences, some of the melasma patients were related with psychic and physical problems. The disease state of 400 cases with melasma was categorixed by our own designed questionaire, based on the dinical condition and history. 86 of 400 casea were analysed by Cornell Medical Index to elucidate the psycholagical and physiological problems
Contraceptives, Oral ; Cornell Medical Index ; Humans ; Malnutrition ; Melanosis* ; Pigmentation ; Pregnancy

Multiple lentigines syndrome is characterized by the presence of numerous dark brown macules on the skin but not mucous surfaces and known also by the mnemvnic "LEOPARD syndrome" are, besides the lentigines, electrocardiographic conduction defect, ocular hypertelorism, pulmonary stenosis, abnormalities of the genitalia consisting of gonadal or ovarian hypoplasia, retardation of growth, deafness and inherited by autosomal dominant trait. We experienced a case of multipIe lentigine syrrdrome in 20-year old woman. She had numerous pinhead to pea sized, dark brownish macules on the entire body skin a,nd had no associated anomalies of other organ. On laboratory examinations including the CBC, urinalysis., chest X-ray, EKG; EEG, Hormone assay was all normal except for the slight anemic finding. On histologic examina,tion of biopsied macular skin showed a slight elongation of rete ri.dges, an increase in the concentration of melanocyte in the basal layer and mild inflammatory infiltration in the upper dermis. Treatment was done by cryotherapy on the face with marked improvement.
Cryotherapy ; Deafness ; Dermis ; Electrocardiography ; Electroencephalography ; Female ; Genitalia ; Gonads ; Humans ; Hypertelorism ; Lentigo ; LEOPARD Syndrome* ; Melanocytes ; Peas ; Pulmonary Valve Stenosis ; Skin ; Thorax ; Urinalysis ; Young Adult

A case of infantile acropustulosis(I.A.). ariginally reported by Kahn, was seen at the Department of Dermatology, Catholic Medical College in September 1979. An 11 month old male patient had been suffering from 1~2mm sized severe pruritic pustules on both hands and feet from 3 months of age. The lesions had the course of exacerbations and remissions from the onset and aggravated since last summer. The eruptions did not respond to topical and oral steroids and antiboitics. There was no family history of atopy, psoriasis and scabies. Histopathological findings revealed large, well circumscribed, intraepidermal pustules which were filled with neutrophilic polymorphonuclear leukocytes. The scraping tests for S. scabiei and dermatophytic fungi were negative. Bacterial culture from the pustular lesions was negative. Treatment was done with 4,4-diaminodiphenylsulfone(Dapsone), 2mg/kg/day in devided doses. Dramatic effect was noted within 2 days after treatment.
Dermatology ; Foot ; Fungi ; Hand ; Humans ; Incontinentia Pigmenti* ; Infant ; Male ; Neutrophils ; Psoriasis ; Scabies ; Steroids

lt is generally beIieved that several chemical mediators such as histamine, kinine, prustaglandin E and lysosomal enzyme are related to the pathogenesis of sunburn, but the exact mechenism of erythema is unknown. Recently, prostaglandins appear to be important mediators of ultraviolet erythema (UV-erythema) and several investigators has reported that the nonsteroidal antiinflammatory druga and corticosteroids supressed UV-erythema by inhibition of prostaglandin synthesis. This study was undertaken to evaluate the effect of topical nonsteroidaI antiinflammatary drugs and corticosteroids on UV-erythema induced by a artificial sunlamp. Nonsteroidal anti-inflammatory drugs (5% Bufexamac cream, 5% Ibuprofen cream, 5% Indomethacin cream) and corticosteroids(0.05% Fluocinonide cream, 0.5% Fluocortolone oint., 1%, Hydrocortisone cream) were applied immediately after 3~4 minimal erythema dose(MED) irradiation on back skin of 40 healthy volunteers and the delayed UV-erythema response was evaluated at 2, 4, 6, 8, 12, 24, 48 and 72 hours after irradiation, respectively. The resulta were as follows; 1) Minimal erythema dose(MED) was noted 4min. (62.5%), 3min. (25.0%), 5min. (22.5%). The averaged MED was 3. 63min. 2, MED has to be increased on site, applied nonsteroid and steroid agents topically, comparing with control site. 3) Blanching effect was detected in all cases of nonsteroid and steroid agents applicated topically, but in control site. 4) Average score in blanching effect was highest in 5% Indomethacin cream among nonsteroid agents(average score-2. 47) and 1% Hydrocortisone cream (average scoro -2. 63) among steroid agents.
Adrenal Cortex Hormones ; Bufexamac ; Erythema* ; Fluocinonide ; Fluocortolone ; Healthy Volunteers ; Histamine ; Humans ; Hydrocortisone ; Ibuprofen ; Indomethacin ; Prostaglandins ; Research Personnel ; Skin ; Sunburn ; Ultraviolet Rays*

Demodicidosis is caused by the enormous infestation of 400 micron sized demodex folliculorum which normally exist, though in small number, in pilosebaceous unit. Its characteristic clinical feature is erythema and erythematous indurated papulopustular eruptions combined with itching and buming sensation. Microscopic examination of indurated pustule always reveals demodex folliculorum. Many authors have reported that demodicidosis aggravated by avoidance of using soap, long-term use of cosmetic cream, especially cold cream, topical or systemic use of corticosteroid. Our patiednts were housewives of 46,39, and 42 years old and presented characteristic clinical featurss and skin lesions by topical application of corsicosteroid for 1~2 years and were diagnosed as steroid acne. But simple microscopic examination reveled demodex folliculorum. We treated them with 5% sulfur lintment and soap and water cleansing of face with remarkable clinical improvement.
Acne Vulgaris ; Adult ; Erythema ; Humans ; Pruritus ; Sensation ; Skin ; Soaps ; Sulfur ; Water

Housewife's eczema is not a specific disease but an inflammatory pattern of response to variety of stimuli: it is characterized by erythema, papules, vesicles, exudation, and scaling. Nickel is one of the most common causes of allergic contact dermatitis, particularly in women. The authors reported a case of housewife's eczema due to nickel sulfate occuring in a 30 year-old housewife for 3 years which was confirmed by patch test with 5% nickel sulfate and dimethyl glyoxime spot test on patients wedding ring and stainless bowels. Literature were reviewed briefly.
Adult ; Dermatitis, Allergic Contact ; Eczema* ; Erythema ; Female ; Humans ; Nickel* ; Patch Tests