KOH examination is a simple, rapid and diagnostic procedure to confirm dermatophytic infections. It is important to select a proper examination site of the lesion. To determinate the proper examination site of the lesion, mycologic studies were done with multiple specimens collected from the center, margin and out of margin of the ring-shaped dermatophytic skin lesion on the 58 patients. The results were as follows. Positive rate of KOH wet smear was 94.8% at the center and 100% at the margin of the lesions, 22.4% at the 1 cm and 5.2% at the 2 cm out of the lesions. The more hyphae were found in the lesion, the more hyphae were found out of the lesion. Culture was done on the Sabouraud's glucose agar from the highest KOH positive area and the positive culture was 48 strains (82.8%) of 58 patients. These findings suggested that the ring-shaped active margin was the best site to examine mycologic studies.
Agar ; Glucose ; Humans ; Hyphae ; Skin*

Immunosuppressive therapy based on the use of antilymphocyte globulin (ALG) has become standard therapy for patients with splastic anemia who are not eligible for bone marrow transplantation. In this study, T cell subsets before and after ALG therapy, hematologic responses, complications and prognostic factors were analysed. Eleven (42%) out of twenty-six patients treated with ALG showed response, but two patients showed relapse. Most of the response (9 cases) was noticed within 6 months after the initiation of ALG therapy (median: 3 months). The main complications of ALG therapy were fever (91%), thrombocytopenia (86%), neutropenia (63%), and serum sickness (56%). Four patients were died just ALG therapy because of serum sickness (2 cases), intracranial hemorrhage (1 case), and shock (1 case). Short interval from diagnosis to treatment suggested to show good response (P=0.0575), but it was not significant statistically. Lymphocyte subsets were measured in the blood of 23 patients. Helper T/suppressor T cell ratio (T4/T8 ratio) at the initiation of ALG therapy (day 0) was higher significantly in patients who were responded (P=0.0299). The patients who showed above 1.0 of T4/T8 ratio on day 0 might be speculated good response (P=0.032). More difference of T4/T8 ratio between day 14 after ALG therapy and day 0 might show good response (P=0.0673). Then the actuarial probability of survival at 3 years in patients treated with ALG was 77%. Our data suggest that ALG therapy may be used as an alternative treatment to bone marrow transplantation, and T4/T8 ration of peripheral blood at the initiation of therapy may be used as one of the prognostic factors.
Anemia ; Anemia, Aplastic* ; Antilymphocyte Serum* ; Bone Marrow Transplantation ; Child* ; Diagnosis ; Fever ; Humans ; Intracranial Hemorrhages ; Lymphocyte Subsets ; Neutropenia ; Recurrence ; Serum Sickness ; Shock ; T-Lymphocyte Subsets ; Thrombocytopenia

BACKGROUND: PUVA has been used effectively in the treatment of vitiligo, but the mechanism by which PUVA stimulates melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. OBJECTIVE: To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and the incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. METHODS: The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. RESULTS: 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo.
Antibodies ; Autoantibodies ; Candida* ; Classification* ; DNA* ; Electrophoresis, Polyacrylamide Gel ; Fibroblasts ; Ficusin ; Humans ; Immunoblotting ; Incidence ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Melanocytes ; Melanoma ; Thymidine ; Ultraviolet Rays ; Vitiligo

BACKGROUND: PUVA has been used effectively in the treatment of vitiligo, but the mechanism by which PUVA stimulates melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. OBJECTIVE: To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and the incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. METHODS: The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. RESULTS: 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo.
Antibodies ; Autoantibodies ; Candida* ; Classification* ; DNA* ; Electrophoresis, Polyacrylamide Gel ; Fibroblasts ; Ficusin ; Humans ; Immunoblotting ; Incidence ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Melanocytes ; Melanoma ; Thymidine ; Ultraviolet Rays ; Vitiligo

Angiogenesis is essential for the growth of solid tumors. Microvessel counts, which represent a measure of tumor angiogenesis, have been correlated with the overall survival of patients with a variety of malignancies. However, the significance of angiogenesis in renal cell carcinoma remains controversial. To determine whether angiogenesis correlates with prognosis of patients with renal cell carcinoma, we counted the microvessels within the primary tumors and compared their numbers with patients' prognosis. Tumor specimens from 42 patients were investigated. Microvessels were stained with anti-CD34 and anti-factor VIII-related antigen monoclonal antibodies. Significant correlation between microvessel counts for two antibodies was observed (r=0.875, p<0.01), although microvessel counts for CD34 were approximately two times higher. Microvessel counts were higher in clear cell than in non-clear cell carcinoma (p<0.05). These results suggest that immunostaining with anti-CD34 antibody may provide a more sensitive and accurate measure of tumor angiogenesis. There was no correlation between microvessel counts and nuclear grade, or TNM stage. In univariate analyses, nuclear grade and TNM stage were significantly associated with patient survival (p<0.01). But further studies on tumor angiogenesis of renal cell carcinoma are needed before it can be adopted as a prognostic marker.
Antibodies ; Antibodies, Monoclonal ; Carcinoma, Renal Cell* ; Humans ; Microvessels ; Prognosis ; von Willebrand Factor

Angiogenesis is essential for the growth of solid tumors. Microvessel counts, which represent a measure of tumor angiogenesis, have been correlated with the overall survival of patients with a variety of malignancies. However, the significance of angiogenesis in renal cell carcinoma remains controversial. To determine whether angiogenesis correlates with prognosis of patients with renal cell carcinoma, we counted the microvessels within the primary tumors and compared their numbers with patients' prognosis. Tumor specimens from 42 patients were investigated. Microvessels were stained with anti-CD34 and anti-factor VIII-related antigen monoclonal antibodies. Significant correlation between microvessel counts for two antibodies was observed (r=0.875, p<0.01), although microvessel counts for CD34 were approximately two times higher. Microvessel counts were higher in clear cell than in non-clear cell carcinoma (p<0.05). These results suggest that immunostaining with anti-CD34 antibody may provide a more sensitive and accurate measure of tumor angiogenesis. There was no correlation between microvessel counts and nuclear grade, or TNM stage. In univariate analyses, nuclear grade and TNM stage were significantly associated with patient survival (p<0.01). But further studies on tumor angiogenesis of renal cell carcinoma are needed before it can be adopted as a prognostic marker.
Antibodies ; Antibodies, Monoclonal ; Carcinoma, Renal Cell* ; Humans ; Microvessels ; Prognosis ; von Willebrand Factor

No abstract available.
Antifungal Agents* ; Trichophyton*

Extramammary paget's disease is uncommon intraepithelial carcinoma of the skin and frequently associated with a subjacent or a regionally proximate carcinoma. We have experienced a case of extramammary Paget's disease affecting 71 year-old man. The patient has been suffered from a well demarcated, and slowly growing erythematous plaque on the left suprapubic area of 3 years. A biopsy specimen reveals infiltration of typical Paget's cells within the epidermis and the adnexa. We review the literature briefly.
Biopsy ; Carcinoma in Situ ; Epidermis ; Humans ; Paget Disease, Extramammary* ; Skin

A case of sporotrichosis misdiagnosed as lupus vulgaris was presented. A 56-year-old woman had been to pea sized, nontender pustules and a hypertrophic-scar-like nodule on the right thigh. She denied any trauma before the lesions developed. Histopathologic findings from the lesion showed tuberculosis-like granulomatous changes. And she was diagnosed as lupus vulgaris. She also had pulmonary tuberculosis and had been treated with antituberculous drugs for 1 year. But skin lesions was not cleared. We suspected the lesions as one of deep mycoses and could confirm sporotrichosis by mycologic studies. They showed characteristic gross colonies and microscopic findings of Sporothrix schenckii..
Female ; Humans ; Lupus Vulgaris* ; Middle Aged ; Mycoses ; Peas ; Skin ; Sporothrix ; Sporotrichosis* ; Thigh ; Tuberculosis, Pulmonary

We report a case of piroxicam-induced photosensitive dermatitis in a 54-year-old female. She had taken oral piroxicam and was exposed to the sunlight on her way home for a few minutes. Several hours after the sun-exposure she developed well-defined, confluent, erythematous plaques and numerous vesicobullae with pruritus and prickling sensation on the sun-exposed areas. A phototest was done on her first visit. The minimal erythemogenic dose (2 J/cm²) of ultraviolet (UV) A was markedly decreased whereas that of UVB was within a normal limit. Visible light irradiation for 30 minutes did not cause skin lesions. Six months after the initial skin lesions, a photopatch test with 1% and 10% piroxicam solution followed by UVA (10 J/cm²) irradiation showed positive responses on both concentrations.
Dermatitis* ; Female ; Humans ; Light ; Middle Aged ; Piroxicam ; Pruritus ; Sensation ; Skin ; Sunlight