In this study, we examined the morphine-induced modulation of the nociceptive spinal dorsal horn neuronal activities before and after formalin-induced inflammatory pain. Intradermal injection of formalin induced time-dependent changes in the spontaneous activity of nociceptive dorsal horn neurons. In naive cats before the injection of formalin, iontophoretically applied morphine attenuated the naturally and electrically evoked neuronal responses of dorsal horn neurons. However, neuronal responses after the formalin-induced inflammation were significantly increased by morphine. Bicuculline, GABAA antagonist, increased the naturally and electrically evoked neuronal responses of dorsal horn neurons. This increase in neuronal responses due to bicuculline after the formalin-induced inflammation was larger than that in the naive state, suggesting that basal GABAA tone increased after the formalin injection. Muscimol, GABAA agonist, reduced the neuronal responses before the treatment with formalin, but not after formalin treatment, again indicating an increase in the GABAergic basal tone after the formalin injection which saturated the neuronal responses to GABA agonist. Morphine-induced increase in the spinal nociceptive responses after formalin treatment was inhibited by co-application of muscimol. These data suggest that formalin-induced inflammation increases GABAA basal tone and the inhibition of this augmented GABAA basal tone by morphine results in a paradoxical morphine- induced increase in the spinal nociceptive neuronal responses after the formalin-induced inflammation.
Animals ; Bicuculline ; Cats ; Formaldehyde ; GABA Agonists ; Inflammation ; Injections, Intradermal ; Morphine ; Muscimol ; Neurons ; Nociceptors ; Posterior Horn Cells* ; Spinal Cord

BellaGen(TM) is an injectable acellular dermal matrix granule derived from donated human skin tissue that was recently developed for soft tissue augmentation. Its use has been sporadically reported in penile girth enhancement procedures. Many cases of complications have been reported after injecting acellular dermal matrices like AlloDerm or SureDerm(TM) but few reports on complications associated with BellaGen(TM) injection. We report here on penile skin inflammation and necrosis following augmentation phalloplasty with BellaGen(TM), which developed 3 days after the injection and persisted for more than 2 weeks. The patient had a 15 year history of type 2 diabetes mellitus, and he was treated with oral antibiotics and wet dressings with KMNO4 solution to combine preservation of the remaining penile soft tissue with debridement of avascular tissue. The lesion improved with this treatment, but the patient experienced pain for about 2 weeks. All patients should be informed of the potential complications with the use of injectable acellular dermal matrices before treatment. Patient selection for augmentation is also important to have the most desirable results.
Acellular Dermis ; Anti-Bacterial Agents ; Bandages ; Collagen ; Debridement ; Diabetes Mellitus, Type 2 ; Humans ; Inflammation ; Necrosis ; Patient Selection ; Skin

No abstract available.
Injections, Intralesional ; Isotretinoin ; Triamcinolone ; Triamcinolone Acetonide

BACKGROUND: Short stature is sometimes seen in children with atopic dermatitis (AD); however, the topic has never been studied systematically. Objective: The aim of this study was to show whether AD itself affects stature in children and to evaluate the influence of other relevant factors such as genetic background, diet restrictions, and sleep disturbance on the stature of children with AD. OBJECTIVE: The aim of this study was to show whether AD itself affects stature in children and to evaluate the influence of other relevant factors such as genetic background, diet restrictions, and sleep disturbance on the stature of children with AD. METHODS: The study population included Korean children 7 to 8 years of age who live in one district of Seoul, Korea. We used a questionnaire as an investigating tool to survey genetic backgrounds, environmental factors, and comorbidities. Student's t-test and linear regression were employed for statistical analysis. RESULTS: In univariate analysis, the average stature in the AD group was short compared with the normal control group. Parental stature, dietary habit, and sleep patterns were also relevant factors with respect to stature. However, in multivariate analysis, AD itself had no influence on stature. Significant correlations were found for such factors as parental height, sleep disturbance, presence of asthma, and dietary restrictions, in decreasing magnitude. CONCLUSION: These results suggest that AD itself may not be the causative factor for short stature in children with AD. Therefore, consideration of other relevant factors related to short stature in patients with AD will be important for the proper management of the disease.
Asthma ; Child ; Comorbidity ; Dermatitis, Atopic ; Diet ; Food Habits ; Humans ; Korea ; Linear Models ; Multivariate Analysis ; Parents ; Surveys and Questionnaires

Partial unilateral lentiginosis (PUL) is an unusual pigmentary disorder that's characterized by multiple lentigines in a unilateral distribution. The lesions often have a segmental pattern with a sharp demarcation at the midline. This is sometimes combined with other disorders such as neurofibromatosis or cafe-au-lait macules (CALMs). The presence of multiple CALMs in the same distribution as the lentigines on a PUL patient makes it difficult to differentiate PUL from segmental neurofibromatosis. We present here a 25-year-old woman with an unusual combination of several caf?-au-lait macules and scattered numerous lentigines involving the left side of the abdomen, flank and back.
Abdomen ; Adult ; Female ; Humans ; Lentigo ; Neurofibromatoses

Urticaria pigmentosa (UP) is the most common variant of cutaneous mastocytosis. Primarily a disease of childhood, in over one-half of the cases onset is before 2 years of age, and in 90%, the disease is confined to the skin. UP precedes the diagnosis of systemic mastocytosis and is more common in adults than in children. Therefore, systemic examination should be performed in patients with UP. We report a case of adult-onset UP with systemic involvement.
Adult ; Child ; Humans ; Mastocytosis, Cutaneous ; Mastocytosis, Systemic ; Skin ; Urticaria ; Urticaria Pigmentosa

BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by the development of smaller, disseminated, papulosquamous and ovoid macules. OBJECTIVE: The aim of this study was to evaluate the clinical manifestations of pityriasis rosea. METHODS: We examined a total of 101 patients with pityriasis rosea who visited the Department of Dermatology in Chung-Ang University Medical Center from March of 2005 to February of 2010. RESULTS: There were 1.53 times more women (61 patients) than men (40 patients) among the study subjects. The age of onset varied from 4 years to 71 years with a mean age of 28.7 years and 60% of the cases were 20 years to 39 years old. The percentage of seasonal variation was 34% in winter, 24% in summer, 22% in spring and 21% in autumn. A herald patch was found in 43% and the main predilection sites were the trunk and the thigh. Secondary eruptions could be classified into the macular type (67%), papular type (30%), urticarial type (2%) and purpuric type (1%). They appeared on the back, the chest, the abdomen, the upper arms, the thighs, the neck, the forearm, the lower legs, the face, the hands and the feet. The histopathological findings of all the types of lesions were focal parakeratosis, intraepidermal vesicles and papillary dermal edema. As compared to the macular type, hyperkeratosis, parakeratosis and exocytosis of lymphocytes were less commonly observed in the papular type. CONCLUSION: Most of the study results were compatible with those of other previous studies. However, the number of patients with papular type pityriasis rosea was currently increasing.
Abdomen ; Academic Medical Centers ; Age of Onset ; Arm ; Dermatology ; Edema ; Exocytosis ; Female ; Foot ; Forearm ; Hand ; Humans ; Leg ; Lymphocytes ; Male ; Neck ; Parakeratosis ; Pityriasis ; Pityriasis Rosea ; Seasons ; Skin Diseases ; Thigh ; Thorax

BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by the development of smaller, disseminated, papulosquamous and ovoid macules. OBJECTIVE: The aim of this study was to evaluate the clinical manifestations of pityriasis rosea. METHODS: We examined a total of 101 patients with pityriasis rosea who visited the Department of Dermatology in Chung-Ang University Medical Center from March of 2005 to February of 2010. RESULTS: There were 1.53 times more women (61 patients) than men (40 patients) among the study subjects. The age of onset varied from 4 years to 71 years with a mean age of 28.7 years and 60% of the cases were 20 years to 39 years old. The percentage of seasonal variation was 34% in winter, 24% in summer, 22% in spring and 21% in autumn. A herald patch was found in 43% and the main predilection sites were the trunk and the thigh. Secondary eruptions could be classified into the macular type (67%), papular type (30%), urticarial type (2%) and purpuric type (1%). They appeared on the back, the chest, the abdomen, the upper arms, the thighs, the neck, the forearm, the lower legs, the face, the hands and the feet. The histopathological findings of all the types of lesions were focal parakeratosis, intraepidermal vesicles and papillary dermal edema. As compared to the macular type, hyperkeratosis, parakeratosis and exocytosis of lymphocytes were less commonly observed in the papular type. CONCLUSION: Most of the study results were compatible with those of other previous studies. However, the number of patients with papular type pityriasis rosea was currently increasing.
Abdomen ; Academic Medical Centers ; Age of Onset ; Arm ; Dermatology ; Edema ; Exocytosis ; Female ; Foot ; Forearm ; Hand ; Humans ; Leg ; Lymphocytes ; Male ; Neck ; Parakeratosis ; Pityriasis ; Pityriasis Rosea ; Seasons ; Skin Diseases ; Thigh ; Thorax

Increased transepidermal water loss (TEWL) and downregulated antimicrobial peptides (AMPs) are observed in patients with atopic dermatitis (AD). Tacrolimus and ceramide-dominant emollients are effective in the treatment of AD by preventing the production of inflammatory cytokines and by correcting skin barrier dysfunctions, respectively. Present study was designed to investigate the relationship between antimicrobial and barrier factors by measuring the changes of AMPs and TEWL after topical application of tacrolimus and ceramide-dominant emollient in the patients with AD. A total of three patients with AD were treated with tacrolimus in one lesion and ceramide-dominant emollient in another lesion for 4 weeks. RT-PCR and western blotting revealed that the mRNA and protein expression levels of hBD-2 and LL-37 were increased on the both study sites. Immunohistochemical analysis showed significant increase of AMPs and IL-1alpha, while, IL-4 was decreased on the both study sites. The mean changes of TEWL and AMPs showed no statistical difference between both sites. Tacrolimus and ceramide-dominant emollient influence on both TEWL and AMPs expression in patients with AD, namely they have similar effects on both of the two. This study shows that restoration of permeability barrier function is accompanied by the concomitant improvement of antimicrobial defense in patients with AD.
Administration, Topical ; Adolescent ; Antimicrobial Cationic Peptides/*metabolism ; Ceramides/*administration & dosage ; Dermatitis, Atopic/*drug therapy/*metabolism ; Emollients/administration & dosage ; Female ; Humans ; Immunosuppressive Agents/administration & dosage ; Male ; Skin Absorption/*drug effects ; Tacrolimus/*administration & dosage ; Treatment Outcome ; Water Loss, Insensible/*drug effects ; Young Adult