Acrodermatitis continua (AC) of Hallopeau is one of the chronic relapsing pustular eruptions of the extremities. Generalization of AC sometimes occurred spontaneously, or induced by withdrawl of drugs such as corticosteroid, or pregnancy. We report a case of generalized AC in a 50-year-old woman who has been treated intermittently with various medications other than systemic retinoids. The histopathologic findings of the pustules on the fingertips and trunk revealed subcomeal abscesses and/or spongiform pustules. The patient was treated with etretinate in the dose of 50mg/day, and UVB exposure. Two months after treatment, skin lesions were markedly improved.
Abscess ; Acitretin ; Acrodermatitis* ; Etretinate ; Extremities ; Female ; Generalization (Psychology) ; Humans ; Middle Aged ; Pregnancy ; Retinoids ; Skin

BACKGROUND: Previous studies have suggested that pityrosporurr yeasts, normal resident flora of skin, may be important in the pathogenesis of dandruff seborrheic dermatitis and confluent and reticulated papillomatosis. OBJECTIVE: We investigated the incidence and distribution of pityiosorum yeasts on clinically normal skin as a more reasonable method for providing the basic data or proving the relationship of pityrosporum and pathogenesi, of the diseases. MEHTODS: A total of 350 subjects were studied. Skin scrapings were stained with 20% Parker ink-KOH(P-KOH) solution. The numbers of pityrosporum spores and hyphe per high power field( x 400) were counted and designated according to a new grading method using bacterial index(BI) of lepra bacilli. RESULTS: The incidence rates of pityrosporum orbiculare(p. orbiculare) and pityrosporum ovale(p. ovale) were 60-70% and 20-50% of subjects respectively on seborrheic area., The incidence of p. orbicilare was highter than that of p. ovale on all examined sites except for the iterior scalp. And pityrosporal hyphae was present on anteriand posterior scalp and earwax in 24-25% of subjects respectively. The incidence of pityrosporum was higher in summer than other seasons The incidence rate of p. orbiculare and hyphae in the group aged below 9 (except neonates) and above 60, were lower than that of other age groups. The inciderice rates and distribution of grades of pityrosporum of neonates were lower than those of older subjects. CONCLUSION: The results of this study showed that the incidence and distribution of pityrosporum spores were similar to previoureports and hyphal forms were found 25% approximately on clinically normal skin of the scalp and carwax. The significance of the presenet of pityosporal hyphae and the relationship between normal skin and pityrosporal hyphae are to be firther elucidated.
Dandruff ; Dermatitis, Seborrheic ; Humans ; Hyphae ; Incidence* ; Infant, Newborn ; Malassezia ; Papilloma ; Scalp ; Seasons ; Skin* ; Spores ; Yeasts

We report a case of Mycobacterium(M.) fortuitum infection in a 65-year-old female who presented with erythematous to purplish colored tender nodules and plaques with curst and purulent discharge on both upper and lower extremities along the sites of acupuncture. The culture of surgically excised specimen in 3% Ogawa media yielded slightly yellowish colored colonies within 2 days. Several tests for identification of the species were performed and growth on 5% NaCl, negative niacin test, positive results in nitrate reduction, catalase, urease and iron uptake tests were noted. Excision of the lesions followed by administration of minocycline and ciprofloxacin showed no sign of relapse to data a year after treatment.
Acupuncture* ; Aged ; Catalase ; Ciprofloxacin ; Female ; Humans ; Iron ; Lower Extremity ; Minocycline ; Mycobacterium fortuitum* ; Mycobacterium* ; Niacin ; Recurrence ; Urease

BACKGROUND: Pityrosporum yeast is a normal resident flora of the skin. Its hyphal form can be found on the lesions of pityriasis versicolor. Our previous studies showed that pathogenic pityrosporal hyphae coulc be found on a clinically normal scalp. We called it pityriasis versicolor of the scalp. This species may be involved in the pathogenesis of seborrheic dermatitis. OBJECTIVE: We investigated the incidence of pityrosporal hyphae on the scalp of patients with seborrheic dermatitis and normal persons, and compared the results between the two groups. METHODS: 202 patients with seborrheic dermatitis, 350 normal persons were studied. Scalp scrapings were stained with 20% Parker ink-KOH(P-KOH) solution. The number of pityrosporal hyphae per high power field(x 400) were counted according to a grading method(1+ to 3+). RESULTS: The incidence of pityriasis versicolor of the scalp was 28.7% in patients with seborrheic dermatitis, and 21.7% in normal persons. However the incidence of pityriasis versicolor of the scalp in seborrheic dermatitis in the age group of the second and sixth decades was two fold higher, 43.3%, 40.9%, respectively than in the normal control groups, from 9.5% to 25.0%. In the case of sex distribution, the incidence of pityriasis versicolor of the scalp in female patients of seborrheic dermatitis was two fold higher, 34.8%, than in the normal control, 18.8%. According to seasonal variation, the incidence was higher in spring(21.7%) and summer(34.3%) in the control group, and higher in spring, fall and summer, 31.2, 31.4 and 39.2%, respectively, in people with seborrheic dermatitis. CONCLUSION: The results of this study showed that the incidence of pityriasis versicolor of the scalp in patients with seborrheic dermatitis and normal person is similar, There were, however some differences between them according to age, sex and season.
Dermatitis, Seborrheic* ; Female ; Humans ; Hyphae ; Incidence* ; Malassezia ; Pityriasis* ; Scalp* ; Seasons ; Sex Distribution ; Skin ; Tinea Versicolor* ; Yeasts

BACKGROUND: Pityrosporum yeast is a normal resident flora of the skin. Its hyphal form can be found on the lesions of pityriasis versicolor. Our previous studies showed that pathogenic pityrosporal hyphae coulc be found on a clinically normal scalp. We called it pityriasis versicolor of the scalp. This species may be involved in the pathogenesis of seborrheic dermatitis. OBJECTIVE: We investigated the incidence of pityrosporal hyphae on the scalp of patients with seborrheic dermatitis and normal persons, and compared the results between the two groups. METHODS: 202 patients with seborrheic dermatitis, 350 normal persons were studied. Scalp scrapings were stained with 20% Parker ink-KOH(P-KOH) solution. The number of pityrosporal hyphae per high power field(x 400) were counted according to a grading method(1+ to 3+). RESULTS: The incidence of pityriasis versicolor of the scalp was 28.7% in patients with seborrheic dermatitis, and 21.7% in normal persons. However the incidence of pityriasis versicolor of the scalp in seborrheic dermatitis in the age group of the second and sixth decades was two fold higher, 43.3%, 40.9%, respectively than in the normal control groups, from 9.5% to 25.0%. In the case of sex distribution, the incidence of pityriasis versicolor of the scalp in female patients of seborrheic dermatitis was two fold higher, 34.8%, than in the normal control, 18.8%. According to seasonal variation, the incidence was higher in spring(21.7%) and summer(34.3%) in the control group, and higher in spring, fall and summer, 31.2, 31.4 and 39.2%, respectively, in people with seborrheic dermatitis. CONCLUSION: The results of this study showed that the incidence of pityriasis versicolor of the scalp in patients with seborrheic dermatitis and normal person is similar, There were, however some differences between them according to age, sex and season.
Dermatitis, Seborrheic* ; Female ; Humans ; Hyphae ; Incidence* ; Malassezia ; Pityriasis* ; Scalp* ; Seasons ; Sex Distribution ; Skin ; Tinea Versicolor* ; Yeasts

BACKGROUND: An inflammatory mechanism has been suggested to contribute to the progression of diabetic nephropathy. Although retinoid, a known anti-inflammatory agent, has been reported to be beneficial in some experimental renal diseases, it has not been shown whether it prevents disease progression in diabetic nephropathy. Therefore, we investigated whether all-trans retinoic acid inhibits inflammatory changes and improves renal function during the early stages of diabetic nephropathy in streptozotocin-induced diabetic rats. METHODS: We evaluated anti-inflammatory effect of retinoid on streptozotocin-induced diabetic nephropathy. Anti-inflammatory effect was determined by the expression of monocyte chemoattractant peptide-1 (MCP-1). RESULTS: Urinary protein excretion was significantly higher in diabetic rats at four weeks after the induction of diabetes mellitus compared with controls, and proteinuria in the group with retinoic acid treatment was decreased (1.25+/-0.69 vs. 0.78+/-0.72 mg/mg Cr, p=0.056). Urinary excretion of MCP-1 was rapidly increased at two days after induction of diabetes mellitus in diabetic rats, and further increased until four weeks of age compared with control rats. Retinoic acid treatment suppressed to 30% reduction of the urinary level of MCP-1 compared with vehicle treated diabetic rats (119.3+/-74.2 vs. 78.1+/-62.7 pg/mg Cr, p=0.078). Immunohistochemistry revealed a significant increase in staining for MCP-1 protein in the diabetic kidney, and retinoic acid treatment significantly suppressed intrarenal MCP-1 protein synthesis. CONCLUSION: Retinoic acid suppressed proteinuria and inflammatory changes in diabetic rats. These results suggest that retinoic acid may have an anti- inflammatory effect in diabetic nephropathy.
Animals ; Diabetes Mellitus ; Diabetic Nephropathies* ; Disease Progression ; Immunohistochemistry ; Inflammation ; Kidney ; Monocytes ; Proteinuria ; Rats ; Tretinoin

Treatment of ventricular arrhythmias (VA) usually involves managing the underlying cardiac conditions that cause the arrhythmia. However, managing the underlying disease is often challenging, and catheter ablation, or treatment targeting the VA itself might be required in a few patients. In this article, we explored evidence and recommendations regarding the treatment of VA in patients with structural heart disease focusing on the utilization of catheter ablation in these patients. The administration of optimal medical therapy, insertion of an implantable cardioverter-defibrillator, or resynchronization therapy improves survival in patients with left ventricular dysfunction. The role of catheter ablation in preventing sudden cardiac death remains uncertain in this population. In patients with coronary artery disease, reversing myocardial ischemia via revascularization is important in managing VA. Catheter ablation is recommended in patients with recurrent ventricular tachycardia in a setting of ischemic heart disease. In patients with non-ischemic cardiomyopathies such as dilated cardiomyopathy or hypertrophic cardiomyopathy, catheter ablation may be considered for those presenting with drug-refractory ventricular tachycardia.
Arrhythmias, Cardiac ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic ; Catheter Ablation ; Catheters ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Heart Diseases ; Humans ; Myocardial Ischemia ; Tachycardia, Ventricular ; Ventricular Dysfunction, Left

The recommendations outlined constitute the first clinical practice guidelines of the Korean Heart Rhythm Society regarding catheter ablation of ventricular arrhythmias (VA). This is a guideline PART 2, which includes VA in the structurally normal heart, inherited primary arrhythmia syndromes, VA related to congenital heart disease, as well as VA and sudden cardiac death observed in specific populations. In the structurally normal heart, treatment is guided by the occurrence of symptoms or the frequency of arrhythmias that cause ventricular dysfunction over time. Catheter ablation can be recommended in patients in whom anti-arrhythmic medications are ineffective. The sites of origin of arrhythmic activity are known to be the outflow tract, fascicles, papillary muscle, or the annulus. Specific cardiac channelopathies include congenital long QT and Brugada syndrome. This guideline discusses the diagnostic criteria, risk stratification, and treatment of these syndromes. We have included recommendations for adult congenital heart disease. Moreover, we have discussed the management of VA occurring in specific populations such as in patients with psychiatric and neurological disorders, pregnant patients, those with obstructive sleep apnea or drug-related pro-arrhythmias, athletes, and elderly patients.
Adult ; Aged ; Arrhythmias, Cardiac ; Athletes ; Brugada Syndrome ; Catheter Ablation ; Catheters ; Channelopathies ; Death, Sudden, Cardiac ; Heart ; Heart Defects, Congenital ; Humans ; Nervous System Diseases ; Papillary Muscles ; Sleep Apnea, Obstructive ; Ventricular Dysfunction

Ventricular arrhythmias (VA) are a major cause of sudden cardiac death (SCD) in patients with known heart disease. Risk assessment and effective prevention of SCD are key issues in these patients. Implantable cardioverter defibrillator (ICD) insertion effectively treats sustained VA and reduces mortality in patients at high risk of SCD. Appropriate anti-arrhythmic drugs and catheter ablation reduce the VA burden and the occurrence of ICD shocks. In this guideline, authors have described the general examination and medical treatment of patients with VA. Medications and catheter ablation are also used as acute phase therapy for sustained VA.
Arrhythmias, Cardiac ; Catheter Ablation ; Catheters ; Death, Sudden, Cardiac ; Defibrillators ; Heart Diseases ; Humans ; Mortality ; Risk Assessment ; Shock

Background and Objectives: Atrial tachycardias (ATs) from noncoronary aortic cusp (NCC) uncovered after radiofrequency ablation for atrial fibrillation (AF) are rarely reported. This study was conducted to investigate the prevalence and clinical characteristics of NCC ATs detected during AF ablation and compare their characteristics with de novo NCC ATs without AF. Methods: Consecutive patients who underwent radiofrequency catheter ablation for AF were reviewed from the multicenter AF ablation registry of 11 tertiary hospitals. The clinical and electrophysiological characteristics of NCC AT newly detected during AF ablation were compared with its comparators (de novo NCC AT ablation cases without AF). Results: Among 10,178 AF cases, including 1,301 redo ablation cases, 8 (0.08%) NCC AT cases were discovered after pulmonary vein isolation (PVI; 0.07% in first ablation and 0.15% in redo ablation cases). All ATs were reproducibly inducible spontaneously or with programmed atrial stimulation without isoproterenol infusion. The P-wave morphological features of tachycardia were variable depending on the case, and most cases exhibited 1:1 atrioventricular conduction. AF recurrence rate after PVI and NCC AT successful ablation was 12.5% (1 of 8). Tachycardia cycle length was shorter than that of 17 de novo ATs from NCC (303 versus 378, p=0.012). No AV block occurred during and after successful AT ablation. Conclusions Uncommon NCC ATs (0.08% in AF ablation cases) uncovered after PVI, showing different characteristics compared to de-novo NCC ATs, should be suspected irrespective of P-wave morphologies when AT shows broad propagation from the anterior interatrial septum.