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Pemphigus foliaceus is a chronic vesiculobullous dermatosis which seems to be an autoimmune etiology, and favorable results are usually able to obtain with massive doses of corticosteroids administration and Imuran or other anticancer drugs. Two cases of typical pemphigus foliaceus, who showed cutaneous candidiasis, one with clinical improvements, and the other one who had lung abscesses of aspergilli as a complication of the long-term corticosteroid treatment, have been presented. The diagnosis of pemphigus foliaceus was confirmed by histopathologically subcorneal bullae containing acantholytic cells, also Tzank test and Nikolsky's sign. First case, 37 year old man who has the history of corticostcroid therapy for 3 years tor rheumatoid arthritis, was treated with high dosage of prednisolone and antibiotics with nystatin for cutaneous candidiasis, but lung abscesses of aspergilli developed while we couldn't even notice its progress and he died suddenly because of it although skin lesions showed marked improvement. Second case, 36 year old house wife who has the history of recurrent aphthous stomatitis like eruptions was recovered from pemphigus foliceus after steroid treatment and cutaneous candidiasis after using antibiotics and nystatin. As the complication of corticosteroid therapy, cushingoid feature, blurred vision, and cutaneous candidiasis were occurred in both patients, especially in the first case, hyperglycemia and metabolic alkaloses were developed. And so, as mention of Saunders, we checked the patient's complete history, body weight everyday, and CBC and occult blood every week, but urine sugar or blood sugar and chest X-ray not periodically. We used anabolic agent for osteoporosis, antibiotics, mycostatm, diuretics, and antacid regimen, but failed to deveIopment of aspergillosis.
Adrenal Cortex Hormones ; Adult ; Alkalosis ; Anti-Bacterial Agents ; Arthritis, Rheumatoid ; Aspergillosis ; Azathioprine ; Blood Glucose ; Body Weight ; Candidiasis, Cutaneous ; Diagnosis ; Diuretics ; Humans ; Hyperglycemia ; Lung Abscess ; Nystatin ; Occult Blood ; Osteoporosis ; Pemphigus* ; Prednisolone ; Skin ; Skin Diseases ; Spouses ; Stomatitis, Aphthous ; Thorax

BACKGROUND: Computerized topography(CT) is the method of choice for establishing patients with abdominal and/or pelvic trauma. However, the sensitivity of CT far detecting bladder rupture has been questioned. We investigated the roles of CT as the initial evaluation of abdominal and pelvic trauma in diagnosis of bladder rupture. METHODS: We reviewed the medical records and radiographs of 53 patients with bladder rupture for last 5 year. And among them, all radiographs of 30 patients who underwent both CT and retrograde cystography were evaluated independently by two urologists who had no knowledge of the patients' final diagnosis. RESULTS: Among 30 patients, all of patients were correctly diagnosed by retrograde cystography, but the CT diagnosis was correct in only 23 patients(76.7%), who were 17 patients(85.0%) with intraperitoneal rupture and 6 patients(60%) with extraperitoneal rupture. And of the 7 patients who were negative by the CT, all showed the sign of inadequate bladder distension. CONCLUSION: We suggest that CT, if properly performed with adequate bladder filling, is as sensitive for detection of bladder injuries as conventional cystography. Especially, in trauma patients with hematuria and suspected other organ injury, CT-cystography with retrograde filing may be as accurate as conventional cystography and obviate the need for an additional plain film cystography,
Diagnosis* ; Hematuria ; Humans ; Medical Records ; Rupture ; Urinary Bladder*