No abstract available.
Interleukin-1*

Clear cell hidradenoma is a much less common primary cutaneous tumor originated from sweat gland. Clinically this tumor occurs more frequently in female than in male and in patients of any age although there is a predilection for the middle and older age groups. The lesion is solitary and represents a cutaneous nodular and cystic mass of slow expansible growth. By light microscopy the lesion has been characterized as a solid cataneous tumor composed of clear epithelial cells which are focally arranged in glandular and cystic patterns. We observed a 37-year-old housewife who had suffered from a tumor on her back for 3 years. The tumor was a pedunculated, soft, fixed mass and 3. 5 * 3 * 1. 5 cm in size. Histopathologic finding showed the tumor to be composed of two main types of cells, fusiform and clear cells.
Acrospiroma* ; Adult ; Epithelial Cells ; Female ; Humans ; Male ; Microscopy ; Sweat Glands

BACKGROUND: Even though excellent impression materials are now available for making accurate replication for hard and soft tissue, the numerous dentists have faced lots of obstacles in making simultaneous impressions of multiple abutments. CASE DESCRIPTION: This article describes a modified method of tray fabrication using auto-polymerizing acrylic resin and impression technique for multiple prepared teeth in cases with limitations and difficulties in taking dental impressions. CLINICAL IMPLICATION: This segmental tray technique has several advantages, including higher impression quality, fewer impressions, and being more comfortable for the patient and less stressful for the clinician.
Dentists ; Humans ; Tooth

Xeroderma pigmentosum is characterized by sunlight sensitivit.y, autosomal recessive inheritance, and multiple cutaneous malignancies, usually basal and squamous cell carcinomas. In this work the effects of bleomycin and topical 5-fluorouracil on basal and squamous cell careinomas appearing in the patient of xeroderma pigmentosum were studied and followed up for two years. The material was a 50 year old female patient of xeroderma pigmentosum associated with basal and squamous cell carrinomas occuring in the exposed area, and its mixed tumor in the nose for thirty years. Duringfirst admission blecmycin was given intravenously in a dosage of 15 mg every other day or twice a week for basal cell carcinomas in the exposed area and mixed tumor in the nose. The total amount of bleomycin given was 315 mg. A year later another squamous cell carcinomas developed on the exposed area. She was treated with topical application of 5% 5-fluorouracil cream daily for 40 days during second admission. The results obtained are summarized as follows: l. The effect of bleomycin is more effective in the squamous cell carcinoma than in the basal cell carcinoma which recurred after 2 years. 2. Topical therapy of 5% 5-fluorouracil cream appeared almost complete effectiveness to the squamous cell carcinoma.
Bleomycin ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Female ; Fluorouracil ; Humans ; Ichthyosis* ; Middle Aged ; Nose ; Skin Neoplasms* ; Skin* ; Sunlight ; Wills ; Xeroderma Pigmentosum*

BACKGROUND: Definite criteria for the diagnosis and treatment evaluation for different clinical stags of syphilis are not yet present dute to the inability to dultivate Treponema pallidum in vitro. However, as the staining methods and the serological tests currently used have their limitations, a more definite method for its confirmation is needed. Polymerase chain reaction (PCR), due to its high sensitivity and specificity, is currently being applied to the detection of T. pallidum. OBJECTIVE: We have used PCR for the detection of T. pallidum DNA in various clinical specimens in orber to evaluate its potenital as a diagnostic tool. METHOD: Clinical specimens were collected from patients with different stages of syphilis who visited ithe Deparment of Dermatology of Yonsei medical Center for 1 year beginning from May, 1991. Sera from 63 patients, cerebrospinal fluids from 24 patients, amniotic fluids from 3 patients, and 21 tissues from 19 patients were subjected to PCR and the results were analyzed to evaluate its usefulness as a diagnostic and treatment evaluation tool. A portion of the T. pallidum-specific chromosomal DNA, tpp47, which encodes the 47 kDa surface protein, was used as the template DNA to amplify the 658 bp DNA fragment, and the following results were obtained. PCR using primers 47-1 and 47-2 were applied to amplify 658 bp DNA fragments from the T. pallidum-specific tpp47 gene encoding 47 kDa surface protein. RESULT: 1. To evaluate the sensitivity of the PCR, T. pallida and their chromosomal DNA were diluted. The diluents contataining a single organism and 1 fg of the chromosomal DNA showed positive reactions by the amplification. 2. Specificity of the PCR was determined by using T. pallidum, 4 species beloging to genus Treponema, and 9 species of nonpathogenic or pathogenic organisms. A positive reaction was obtained only when T. pallidum chromosomal DNA was used. 3. PCR was positive in 5 of 9 (55%) sera in primary syphilis, 22 of 26(84%) in secondary syphilis, 3 to 15(20%) in early latent syphilis, 1 of 19 (11%0 in late latent syphilis, 2 of 2 (100%) in neurosyphlis, and 0 of 2 (0%) in congenital syphilis. The differences in the positive rates were statistically significant (P<0.01) in all stages except neurosyphilis and congenital syphilis, as their numbers were too smalll to deduce any significant meaning. Despite their high VDRL titers, the positive rate in early latent syphilis was relatively low when compared to the rate in secondary syphilis. 4. Follw-up PCR of sera in some patients showed positive results 9 months after treatment. However, some with negative PCR before treatment showed positive results after treatment. 5. PCR was positive in 1 of 1 (50%) cerebrospinal fluid in primary syphilis, 3 of 14 (21%) in secondary syphilis, 2 of 7 (29%) in early latent syphilis, and 1 of 1(100%) in neurosyphlis. The differences in the positive rates showed no statistical significance in relation to the clinical stages. Cerebrospinal fluid VDRL test, white blood cell count, and protein content showed no correlation to the PCR results in early syphilis patients. 6. Amniotic fluid showed a positive PCR result only in a pregnant woman whose serum showed a high VDRL titer and a positive PCR. 7. PCR positive rates were 90% in frozed tissues and 50% in paraffin embedded tissues. CONCLUSION: From the results, it is suggested that PCR is not suitable for treatment evaluation but is useful for the detection of T. pallidum in sera of secondary syphilis patients and syphilitic lesions, and for the confirmation of the diagnosis the diagnosis in these cases.
Amniotic Fluid ; Cerebrospinal Fluid ; Dermatology ; Diagnosis ; DNA ; Female ; Humans ; Leukocyte Count ; Neurosyphilis ; Paraffin ; Polymerase Chain Reaction* ; Pregnant Women ; Sensitivity and Specificity ; Serologic Tests ; Syphilis ; Syphilis, Congenital ; Syphilis, Latent ; Treponema pallidum* ; Treponema*

A characteristic dermatosis of infancy and childhood has recently been reported as many names, called juvenile plsntar dermatoais, recurrent juvenile eezema of hands and feet, and atopic winter feet in children. However, the clinicsl and epidemiological features of the published cases are strikingly the same The etiology of the diseaee remains unclear. The role of atopy appears to be highly controversial. We have observed 11 patients with juvenile plantar dermatosis and sumrnarized the results as followa: 1. The disease was found mainly in female children (3 boys, 8 girls) between 1 and 18 years old. Duration of the disease ranged from 1 month to 10 years. 2. The lesions occured or were exacerbated dunng the winter in 9 of them. 3. The disease affected symmetrically on the pressure areas of the feet, mainly the forefeet and toes, the lateral margins of the soles, and the heels. Five of our patients also showed the lesions on the hands simultaneously. 4. We have found a high incidence of atopy among the patients or close relative. Nine patients had a personal history of atopy and 5 gatients also had a history of atopy in the first degree relatives. 5. The serum IgE value increased in one of 6 patients determined. From the above clinical findinge, it is evident that juvenile plantar dermatosis is a true localized atopic dermatitis but also a primary irritant contact derrnatitis to which atopics are prone but which may occur in susceptible non-atopics.
Adolescent ; Child ; Dermatitis, Atopic ; Female ; Foot ; Hand ; Heel ; Humans ; Immunoglobulin E ; Incidence ; Skin Diseases* ; Toes

We described here a case of hyperkeratosis of the nipple and areola. A 23-year- old woman had a verrucous thickening and brownish discoloration on her right nipple and areola that had been present for 4 yeare. The only symptom was an intermittent mild itching sensation. The patient had no other additioa.al hyperkeratotic conditians. She was not married and had never had a pregnancy. Riopsy spccimen showed papillomatous elongation of the epidermis and edema, of the underlying papillary eonnective tissue. The epidermis was parakeratotic and hyperpigmented, and showed focal intercellular and intracellular edema. The present case seems to be the nevoid form by the Levy-Franckel classification. The world literature was briefly reviewed.
Classification ; Edema ; Epidermis ; Female ; Humans ; Nipples* ; Pregnancy ; Pruritus ; Sensation

The term "fixed drug eruption" was coined by Louis Brocq in 1894 to describe a special type of reaction to antipyrine. It is now known that many drugs can cause a fixed drug eruption. Notorious offenders have included phenolphthalein, quinine and barbiturates. We present a case of multiple fixed drug eruption appearing in a 20 year-old male patient who has generalized slate-blue colored pigmentation on neck, trunk and extremities. The area of total pigmented skin lesions are over 50% of body surface. We could confirm the fixed drug eruption by positive phenobarbital provocation test.
Antipyrine ; Barbiturates ; Criminals ; Drug Eruptions* ; Extremities ; Humans ; Male ; Neck ; Numismatics ; Phenobarbital ; Phenolphthalein ; Pigmentation ; Quinine ; Skin ; Young Adult

Using the indirect immunoperoxidase and FTA ABS complement techniques, 36 skin specimen: from 30 patients with primary and secondary syphilis and a gastric mucosal specimen from a patient with secondary syphilis which were confirmed by elinical history, physical examination, VDRL, FTA ABS, TPHA, and 19s(IgM)-FTA test, were examined. The follwing results were obtained. l. Of the 37 specimens, 33(89%) were positive in the indirect immunoperoxidase techique and 26 of the 37 specimens(70g) were positive in the FTA ABS complement technique. Of the 17 specimens, 12(71%) were positive in the darkfield examination. 2. The ratio of agreement of the results between the indirect immunoperoxidase and FTA ABS complement techniques was 81%, The ratio of agreement of the results between the indirect immunoperoxidase technique and darkfield examination was 82%. 3. Most, of the treponemes were located in the upper dermis, epidermis, and blood vessel walls in the order named, and rarely in the lower dermis of the syphilitic skin lesion. There was no remarkable difference in histologic clistribution of treponemes between the clinical stages and types of syphilitic skin lesions. From the results, the indirect immunoperoxidase technique is considered a superior method than the FTA ABS complement technique and darkfield examination for detecting the treponemes in the suspected syphilitic lesions.
Blood Vessels ; Complement System Proteins* ; Dermis ; Epidermis ; Humans ; Immunoenzyme Techniques* ; Physical Examination ; Skin ; Syphilis ; Treponema pallidum* ; Treponema*

Using the avidin-biotin-peroxidase complex(ABC) technique, 36 skin specimens from 30 patients with primary and secondary syphilis and a gastric mucosal specimen from a patient with secondary syphilis which were confirmed by clinical history, physical examination, the VDRL, FTA-ABS, TPHA, and 19s(IgM)-FTA test, were examined. The results were compared with that of the indirect mmunoperoxidase technique which was done by authors previously with same specimens. The following results were obtained. 1. Of the 37 specimens, 35(95%) were positive in ABC technique and 33 of the 37 specirnens(89%) were positive in the indirect immunoperoxidase technique. 2. The ratio of agreement of the results between the ABC and the indirect immunoperoxidase technique was 89%. 3. Most of the treponemes were located in the upper dermis, epidermis, and blood vessel walls in the arder named, and rarely in the lower dermis of the syphilitic skin lesions. There was no remarkable difference in histologic distribution of treponemes between the clinical stages and types of syphilitic skin lesions. :From the results, the ABC technique is considered to be an excellent method for detecting the treponemes in the suspected syphilitic lesions.
Avidin* ; Biotin* ; Blood Vessels ; Dermis ; Epidermis ; Humans ; Immunoenzyme Techniques ; Peroxidase* ; Physical Examination ; Skin ; Syphilis ; Treponema pallidum* ; Treponema*