Toxic epidermal necrolysis(T.E.N.) is a toxic erythema of the skin that undergoes epidermal necrolysis and peding so that it appears to have been scalded. There seem to be two basic form of T.E.N. In children, the deavage of the epidermis that results from an acantholytic-dyskeratotic cytolytic process is in the malpighian or granular layer and is usually induced by a staphylococci toxin. In adult, it is characterized by a full-thicknees cytolytic cleavage of skin above the basal layer and is usually precipitated by a drug. The authors observed a 17 year-old male with T.E.N. He began to notify the erythematous skin lesion with burning sensation on the whole body surface at 12 hours after oral administration of some drugs for common cold and developed the characteristic flaccid bullous and denuded lesions with tenderness within next 20 hours.
Administration, Oral ; Adolescent ; Adult ; Burns ; Child ; Common Cold ; Epidermis ; Erythema ; Humans ; Male ; Sensation ; Skin

Erythema nodosum is clinical entity defined easily, but because of the variable histopathologic findings showing involvement of the vessels, septa, and fat lobules, the histopathologic features often are not compatible with the clinical diagnosis, We present the results of clinical and histopathologic findings in 26 patients with erythema nodosum observed at the Department of Dermatology, Seoul National University Hospital, fram January 1973 to August 1976. 1. Clinical Findings Erythema nodosum is characterized by painful erythematous nodose lesion occurring symmetrically(92%) on shins(50%) or shins and calves(50%) of women(M: F==4: 22) between sixteen to twenty five years old of age(58%) chiefly. In laboratory study, leukocytosis(1/17) was rare but increased titers of antistreptolysin(64%) and elevation of E.S.R.(88%) were found frequently. 2. Histopathologic Findings Even though hemorrhage(73%), perivascular(100%) and periadnexal(85%) inflammatory cell infiltration were frequently seen in histopathologic changes of erythema nodosum, these changes were nonspecific. Moreover, granulomatous change (38%), thrombophlehitis(35%) and necrosis of fatty tiasue(38%) were observed not infrequently in erythema nodosum. So we concluded that there were no specific histopathologic findings in erythema nodosum which differentiated from the other erythematous nodose diseases on the legs consisted of panniculitis, thrombophlebitis or granulomatous changes.
Dermatology ; Diagnosis ; Erythema Nodosum* ; Erythema* ; Humans ; Leg ; Necrosis ; Panniculitis ; Seoul ; Thrombophlebitis

Nevus Iipomatosus cutaneous superficialis (NLCS) is a very rare skin disease which usually is present at birth. The lesion consists of grouped papules and nodules which on histological examination show the presence of ectopic fatty tissue in the corium. The authors observed a 17year old female with NLCS. She noticed soft papules and nodules on the coccygeal area since 8 years old. We confirmed this case by clinically and histopathological findings which showed the strands or islands of mature fatty tissue within papillay, mid and lower dermis.
Adipose Tissue ; Child ; Dermis ; Female ; Humans ; Islands ; Nevus* ; Parturition ; Skin Diseases

Since the classical description of pyoderma gangrenosum by O'Leary, Brunsting and Goecgerman in 1930, a considerable nurnber of reports of this clinical entity has appeared. Pyoderma gangrenosum is a painful, ulcerative disease of the skin. The ulcers are highly characteristic in clinical feature as necrotic pus covered lesions having purple colored and elevated border with red halo. Frequently, the ulcers heal with a cribriform type of scar. Its pathogenesis is not understood clearly. We present a case of pyoderma gangrenosum deveIoped on the leg in a 11-year old boy occurring with rectal poIyp, the association of whicb is very rare in world wide. And this case has the evidence of cell mediated immunity impairment characterized by no response to mumps antigen and purified protein derivatives, and not to be activively sensitized by DNCB.
Child ; Cicatrix ; Dinitrochlorobenzene ; Humans ; Immunity, Cellular ; Leg ; Male ; Mumps ; Polyps* ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Suppuration ; Ulcer

Since the description of Familial Benign Chronic Pemphigus by Hailey-Hailey, several cases of this clinical entity have reported in Korea. Familial Benign Chronic Pemphigus is a rare hereditary acantholytic disorder, transmitted as an irregular autosomal dominant traits, characterized by recurrent eruption of vesicles, bullae and impetiginous lesions mainly on the sides of neck, axillae and groins symmetrically. We presented a case of Familial Benign Chronic Femphigus in a 49 years old woman. She had suffered from these characteristic skin lesions have spread to the axillae, inframammary areas, antecubital fossae, inguinal and perianal area progressively. Moderate itching was associated with skin lesions, which were worse in summer and better in winter. Biopsy findings showed hyperkeratosis, irregular acanthosis, multilocular suprabasal clefts of bullae with extensive acantholysis and villi formation. Two daughtera of the patient has had the same clinical features on the sides of neck since puberty,
Acantholysis ; Adolescent ; Axilla ; Biopsy ; Female ; Groin ; Humans ; Korea ; Middle Aged ; Neck ; Pemphigus, Benign Familial* ; Pruritus ; Puberty ; Skin

Intimal hyperplasia is considered to be a most frequent cause attributing to occlusion of a blood flow after vascular surgeries such as endarterectomy, bypass surgery and angioplasty. Clearly this response is a significant cause of morbidity in patients undergoing vascular procedures and studies to find out the strategy for avoid intimal hyperplasia are of great importance. The precise pathophysiologic pathways leading to the development of intimal hyperplasia have not been yet clear. The initial event is thought to be damage to the vascular intimal endothelium. Intimal hyperplasia is the characteristic fibromuscular cellular response on intimal injury and some author advocated the "response-to-injury" hypothesis of atherogenesis to be inducing factors of intimal hyperplasia. Endothelial cells release a number of vasoactive substances such as relaxing factor, including nitric oxide(NO). The NO has not only relaxing effect to the smooth muscle cells, but also inhibitory effect to intimal hyperplasia. In this study, we investigated on rat inhibitory effect of NO donor(SNAP, SNP) to intimal hyperplasia on endothelial denudation and reversed by coadministration of the NO synthase inhibitor, L-NAME. Balloon catheter denudation of common carotid artery was performed in 35 rats pharmacologically treated from 3 days before to 14 days after surgery(5 mg/kg/day, intraperitoneally) and divided into 5 groups: control group, without any medical treatment; SNAP group, S-Nitroso-N- acetylpenicillamine; SNP group, sodium nitroprusside; SNAP+L group, both SNAP and N(G)-Nitro-L-arginine methylester; SNP+L group, both sodium nitroprusside and N(G)-Nitro-L-arginine methylester. Animals were killed and left common carotid arteries were perfused and fixed with 10% formalin solution at 14 days after endothelial denudation. Cross sectional intima-to-media area ratios(I-M ratio, intimal area/[intimal area medial area]x100) were calculated by an image analyzer system and serum level of NO was measured directly by electrochemical methods. The results of the this experimental study were as follows: 1) Morphometric analysis of cross sections showed marked intimal thickening in the control group with an mean I-M ratio of 64.71+/-4.96%. In contrast, the I-M ratios in the SNAP group were significantly reduced by 53.14+/-7.86%(P<0.05) and in the SNP group by 43.43+/- 9.32%(P<0.05). The IM ratios of animals treated with L-NAME in group SNAP-L and group SNP-L were 68.43+/-3.91% and 67.71+/-5.50% respectively(P=NS). No significant change was noted when L-NAME was coadministered with SNAP and SNP compared to control group. 2) The serum level of NO in SNAP group(2509.7+/-354.95 nM) and SNP group(3430.4+/-236.70 nM) were significantly increased compare to control group(1339.2+/-101.04 nM)(P<0.05). Coadministration of L-NAME in group SNAP-L(1719.8+/-483.65 nM) and group SNP-L(1415.7+/-219.04 nM)were no significant changed compare to control group(1339.2+/-101.04 nM). These experiments suggest that SNAP and SNP reduced intimal hyperplasia and increased serum level of NO, reversed by coadministration of L-NAME. The relation between the intimal hyperplasia suppression and NO increase should be speculated.
Angioplasty ; Animals ; Atherosclerosis ; Carotid Arteries ; Carotid Artery, Common ; Catheters ; Endarterectomy ; Endothelial Cells ; Endothelium ; Formaldehyde ; Humans ; Hyperplasia ; Microelectrodes ; Myocytes, Smooth Muscle ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Nitric Oxide ; Nitroprusside ; Rats

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure