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

These are the first reported cases of granuloma faciale in two Koreans. Unilateral, slightly elevated violaceous plaque with illdefined margin on cheeck since 20 years ago was observed in 36 year old house-wife, and 40 year old male has had bilateral plaques on both cheek areas since 10 years ago, These plaques were showed the typical histological appearance of granuloma faciale respectively on both of two patients. Literature was briefly reviewed for the discussion of clinical and microseopic findings of this disease. Both patients were treated by intralesional injections and ointment of steroid with relative clinical improvements.
Adult ; Cheek ; Granuloma* ; Humans ; Injections, Intralesional ; Male

Dermatologic treatment was greatly advanced when topical corticasteroids were introduced for the management of many inflammatory and pruritic dermatoses. Their use reduced or diminished mnst of the undiserable side effects which accompanied the systemic administration of these compounds. The good effects of topical application of hydrocortisone had been demonstration in the treatment of variaus dermatoses eg., atopic dermatitis, seborrheic dermatitis, contact dermatitis etc. The halogenated derivatives followed and led to the trend to most of analogs now in use. Especially, fluocinolone acetonide cream greatly enhanced its therapeutic effectiveness in psoriasis, chronic discoid lupus erythematosus, pustular bacterid, granuloma and neurodermatitis circumscripta. But many side effects of topical corticosteroids such as steroid acne. Stria were developed and also fluorinated topical corticosteroids resulted in telangiectasia, purpura, atrophy in skin. Weber reported that strong topical corticosteroids eg.. Betamethasone valerate and fluocinolone acetonide were resulted in rosacealikc dermatitis and it was steadily increased. These adverse side effcts of topical corticosteroids, especially steroid acne, were indisputable argument in dermatologic field, for the view that this topical corticosterodis is used for cosmetics and treatment of acne vulgaris in our country. Since the strong corticosteroid tnpical preparation, the peculiar form acne, so called steroid acne, was steadily increased in our clinic. Behrman and goodman reported that acneform eruption induced by hormone was not associated with oiliness and there were but few comedone. Sullivan and Zeligman reported that the the acneform eruption due to adrenal corticaa 1 hormone was uniform in size, small papule and few pustule, usualIy erythematous base. There were also differential histologic feature. The most important difference is the normal apperance of sebaceous glands in acneform eruption due to corticosteroids contrast with hyperplasia in acne vulgaris. Abscess formation was more frequent and more extensive in acne vulgaris. Sutton Jr and Van Scott & MacCardle described that histologically, the major component in lesion of steroid acne was excessive keratinization of follicle. Castor and Baker demonstrated that topical application of corticosteroids resulted in decrease of sebaceous gIands, decrease of mitosis and increased cornification in epidermis. The present study investigated clinical case of the steroid acne, which are induced by topical application and systemic administration of corticosteroids and experimentally induced the steroid acne with the topical application of corticosteroid. And also clinical cases and experimentally induced steroid acne were compared with acne vulgaris. Material and method Subjects are 13 Patients of steroid acne induced by strong topical corticosteroid eg., fluocinolone acetonide, fluocortolone, dexamethaone, betamethasone valerate and 4 patients of steroid acne induced by systemic administration of corticosteroid eg., prednisolone and also 10 patients of acne vulgaris. Biopsy was performed from 13 patients of topical steroid acne, 3 patients of steroid acne induced by systemic administration of steroid and one patient of acne vulgaris. In order to induce steroid acne, experimentally, strong topical corticosteroid such as beta methasone valerate, fluocinolone acetonide and fluocortolone were applied on back. Comment and conclusion In Clinical feature, the steroid acne by topical application and systemic administration of corticosteroid and experimentally induced steroid acne had unique clinicall features, that showed absence of comedone and uniform sized follicular papule on deep seated erythematous scaly base. The topical steroid acne was distributed the region where were applied. But the eruption of the steroid acne induced by systemic administration of corticosteroids was distributed to face, neck, and scalp. Above findings are quite different form acne vulgaris. Histopathologically, the steroid acne induced by topical application and systemic administration of corticosterojds showed hypoplasia of sebaceous glands and excessive follicular keratinization. Occlusion of pilosebaceous opening by keratotic plug in severe case by long term application showed atrophy of epidermis and sparsity of sebaceous glands with hypokeratosis and parakeratosis. In experimentally induced steroid acne, it was definitely specific features which were absolutely identcall with above cinical steroid acne.
Abscess ; Acne Vulgaris* ; Adrenal Cortex Hormones ; Atrophy ; Betamethasone Valerate ; Biopsy ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Epidermis ; Fluocinolone Acetonide ; Fluocortolone ; Granuloma ; Humans ; Hydrocortisone ; Hyperplasia ; Lupus Erythematosus, Discoid ; Mitosis ; Neck ; Neurodermatitis ; Parakeratosis ; Prednisolone ; Psoriasis ; Purpura ; Scalp ; Sebaceous Glands ; Skin ; Skin Diseases ; Telangiectasis

A case of glomus tumor was reported with literature review. 36 year old Korean male has had a single corn sized painful nodular eruption on flexor surface of right side forearm since 2 years ago. This single nodule was confirmed histopathologically as glomus tumor but patient had not any trauma and injury history. Simple surgical excision was very excellent for complete cure of this tumor.
Adult ; Forearm ; Glomus Tumor* ; Humans ; Male ; Zea mays

Large numbers of any population of shoe wears have abnormalities of the skin of their toe clefts, but most of them have no recognized pathogen there. The term tinea pedis, or athlete's foot, should be strictly reserved for those infected with a dermatophyte fungus. The prevalance of this condition in the general population is unknown, and a survey of a true representative sample would present considerable difficulties. The toe webs and the soles as well as other area of the feet which showed any clinical changes were scraped and the scales ohtained were examined microscopically after clearing with 10% KOH and were inoculated on to Sabouraud's glucose agar. Pathogenic fungi were identified in slide culture and fermentation test with macro and microscopically. Total 1669 workers were examined in Cotton Mill Industry. Patients from 648 (38.7%) workers {85(28.1%) of 302 men and from 563 (41.1%) of 1367 women) showed clinically diagnosed tinea pedis. Their ages varied from 15 to over 50 years, with most of those examined in the second decade, especially women. The positivc rate of 10% KOH preparation found, that 21.3% of 72 men and 78.7% of 267 women were clinical diagnosed. An analysis of 221 identified strains with mycologic examination has shown that trichophyton rubrum (88 strains) is more isolated than T.mentagrophytes (66 strains), also candida species (50 strains are included C. albicans, C. tropicalis, C. pseudotropicalis, C. parakrusei and C. stellatoidea.) Authors figures indicate that the incidence of dermatophytosis is high in workers of Cotton Mill Industry for following reasons; 1. Environmental condition of working place are maintained constantly high temperature and humidity. 2. Workers are used in industrial bath room after working, and living a communal life.
Agar ; Arthrodermataceae ; Baths ; Candida ; Female ; Fermentation ; Foot ; Fungi ; Glucose ; Humans ; Humidity ; Incidence ; Male ; Shoes ; Skin ; Tinea Pedis ; Tinea* ; Toes ; Trichophyton ; Weights and Measures

Erythroplasia of Queyrat is a precancerous lesion, usually located to glans penis or prepuce. It is characterized by a slowly developing, circumscribed, usually velvety and shiny patch. The etiology was unknown, but it is extremely rare in those circumcised in early infancy. It had been suggested that phimosis had some etiologic importance. The typical case of Erythroplasia of Queyrat is presented. A 46 year old man had 4 months history of dark-brownish pea sized maculopapular rashes on sulcus of glans penis and prepuce associated with mild itching, which was increased in number day by day. He had a phimosis. On examination, there are sharply defined, slightly elevated, pea sized dark-brownish maculopapular rashes over erythematous infiltrated base on sulcus of glans penis and prepuce, which have moist and velvety appearance. A biopsy was performed from sulcus of glans penis. Histopathologically, there was acanthosis, with in epidermis many cells are vacuolated and showed individual cell keratiinization. Epithelial cell showed marked atypia, variation in nuclear size and there was intercellular, intracellular edema. The lesion was treaterd with topical application of 5% 5-fluorouracil twice daily 2 weeks and thereafter for 4 weeks. 2 months after treatment, no erythroplastic lesion was found and 3 months after treatment, rebiopsy was perforrned which showed marked improvement histopathologically.
Biopsy ; Edema ; Epidermis ; Epithelial Cells ; Erythroplasia* ; Exanthema ; Female ; Fluorouracil* ; Humans ; Male ; Middle Aged ; Peas ; Penis ; Phimosis ; Pruritus

Sclerema neonatorum is a lesion of degeneration, necrosis or crystallization of adipose tissue of new born, and is classified into two types; the generalized type in which death occurs usually within one week without treatment, and the nodular type which is localized and heals spontaneously. In this report, nodular type was presented. Nut to palm sized indurated plaques on deltoid region, upper back and hip were noted 3 weeks after birth. Histopathologic findings of necrosis of subcutaneous tissue with early granulomatous reaction were showed in biopsy specimen. Literature was briefly reviewed for the discussion of clinical and microscopic findings of this disease.
Adipose Tissue ; Biopsy ; Crystallization ; Hip ; Necrosis ; Nuts ; Parturition ; Sclerema Neonatorum ; Subcutaneous Tissue

Five cases of incontinentia pigmenti (Bloch-Sulzberge type) were presented and literature were reviewed. They were all girls. 3cases of them were associated with defects of ectodermal or mesodermal development. As the manifestation of those, malformed teeth in 2 cases, delayed dentition in 3 cases, eye problem in 2 cases, and alopecia in 3 cases were noticed. One of 3 cases had eruptions of lichen striatus on her upper extremities. Especially, family history of involvement of maternal relative in one case was noticed. Diagnosis of them were confirmed by characteristic clinical appearance and histopathologic findings.
Alopecia ; Dentition ; Diagnosis ; Ectoderm ; Female ; Humans ; Incontinentia Pigmenti ; Lichens ; Mesoderm ; Tooth ; Upper Extremity

A case of znelanotic whitlow is presented which resembles clinically as chronic paronichia. Patient was 71 years old man and he has had a single brownish pigmented spot on left mid. finger since 3 years ago which was progressively grow and skin biopsy could be established the pathological diagnosis of superficial malignant melanoma.
Aged ; Biopsy ; Diagnosis ; Fingers ; Humans ; Melanoma ; Skin

Secondary localized amyloidosis of the skin is occasionaly associated with keratoma, epithelioma, seborrheic keratosis, chronic dermatitis, etc. It was generally known that amyloidosis, especially lichen amyloidosis, is frequently seen in atopic disorders. But the exact mechanism and relationship of atopic disorders to the development of the amyloidosis is obscure still nowadays. This 72 years old male patient was suffered from itching sensation on the whole body which is suggested to be atopic dermatitis since about 35 years ago and pruritic lichenoicl papulonodular eruptions developed on the extensor surface of the lower extremity first since about 10 years ago and then occured gradually on the thigh and extensor surface of the arm and forearm in both side. The charateristic lesions seems to be lichen amyloidosis. But we suggest thc case is secondary localized amyloidosis of the skin probably due to atopic dermatitis in according to past history, physical examination and eosinophilia without other definitive diseases, The therapeutic results were not promissing, however itching and lichenoid papules were much disappeared during the treatment with steroid cream for occlusivc dressing therapy and oral use of steroid.
Aged ; Amyloidosis* ; Arm ; Bandages ; Carcinoma ; Dermatitis ; Dermatitis, Atopic* ; Dronabinol ; Eosinophilia ; Forearm ; Humans ; Keratosis ; Keratosis, Seborrheic ; Lichens ; Lower Extremity ; Male ; Physical Examination ; Pruritus ; Sensation ; Skin ; Thigh