A 48-year-old male patient had white to ivory colored patches on brown colored bases over the right side of his back for 8 years without accompanying pruritus or pain. Six months prior to the onset of his skin eruption, he received acupuncture for the relief of right sided back pain for 1 month. Histopathologic examination of the white patches showed follicular plugging, epidermal atrophy, focal hydropic degeneration of basal cells, lymphedema of papillary dermis, thickened homogenization of collagen fibers; consistent with findings previously reported in lichen sclerosus et atrophicus. We report this case to document the occurence in an acupuncture site and stress the unusual clinical manifestation of a zosteriform distribution.
Acupuncture ; Atrophy ; Back Pain ; Collagen ; Dermis ; Humans ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Lymphedema ; Male ; Middle Aged ; Pruritus ; Skin

From August to November 1985 244 bacteriologically proven male uncomplirated goncicoccal urethritis patients at the VD clinic of Choong-Ku Public Health Center form August to November 1985 were divided into group A and group B according to a random number sheet. In group A, treated with kanamycin 2.Ogm, im plus benzyl penicillin-G 5 mega units, im plus probenecid, 1.Ogm, PO; 112 of 121 patients were followed and 10 patients (8.9%) failed to be recovered. In group B, treated with kanamycin, 2,Ogm, im plus trimethoprim-sulfamethoxazole, 9 tahlets, PO; 112 of l23 patients were followed and 7(6.3%) failed. There is no sign.ificant difference between the two groups (p>0. 05) The failure rates in PPNG urethritis were 14.3% and 8.0% in group A and group B respectively. There is a signficant difference in failure rate between the two groups (P<0.05). It is suggested that, because of high rate of PPNG among circulating N.gonorrhoeae, the combinatioin regimen of kanamycin and trime.thoprim-sulfamethoxazole may be used as a first line treatrnent regimen for uncomplicated gonococcal urethritis.
Gonorrhea* ; Humans ; Kanamycin* ; Male ; Penicillin G* ; Penicillins* ; Probenecid* ; Public Health ; Trimethoprim, Sulfamethoxazole Drug Combination* ; Urethritis

Reticulated pigrnented anomalies of the flexures is a pigmentary disorder bearing genetic back ground, also known as Dowling Degos disease or dark dot disease. It is characterized reticulated brownish black macules on the flexural areas with the histological features of filiform pigmented epidermal downward proliferation and the presence of intraepidermal keratin containing cysts. We report 34-year-old housewife who showed brawnish black reticulated macules on her axillae, anterior neck and genitocural folds. Pigmented comedones were also found at the marginal areas of the axillae. Biopsy specimen revealed the presence of intraepidermal keratin containing cysts and basilar hyperpigmentation.
Adult ; Axilla ; Biopsy ; Humans ; Hyperpigmentation ; Malignant Atrophic Papulosis ; Neck ; Pigmentation

BACKGROUND: Apoptosis is a highly selective form of cell suicide with characteristic morphologieal and biochemical features, including chromatin condensation, formation of apoptotic bodies, and DNA fragmentation by the activation of endonucleases. Various cytokines and physical or chemical factors can provoke apoptotic changes in the skin. OBJECTIVE: We investigated the cytotoxic effects with epidermal cytokines and their combinations, K+ ionophores, protein synthesis inhibitor(emetine), inhibitor of endogenous endonuclease(aurintricarboxylic acid, ATA), sodium azide, and retinoic acid witp human epithelial tumor cell lines(A431 cells) to examine the degree of induction of apoptosis in the epidermal keratinocytes. METHODS: Induction of apoptosis was measured in cultured human keratinocytes, keratinocyte cell lines(A-431, HaCat, KB cells), cultured human melanocytes and malignant melanoma cell lines(SK-28, SK-30) using a mixture of ethidium bromide and acridine orange, DNA agarose gel electrophoresis and TUNEL staining. RESULTS: l. In the A-431 cells, (1 to a certain degree, the combination of IFN-gamma and TNF-alpha could only induce apoptosis. Q2 most of K+ ionophores were observed to induce necrosis rather than apoptosis. Q3 emetine, a protein synthesis blocker, was found to induce apoptosis in a dose-dependent pattern. Q4 sodium azide at a concentration of 1% .induced apoptosis rather than necrosis. Q5 retinoic acid inhibit the beuvericin induced apoptosis. 2. In human keratinocytes, Ql more resistant in the induction of apoptosis than any cultured keratinocyte cell lines p aurintricarboxylic acid(ATA)-an endonuclease inhibitor, could inhibit UV induced apoptosis 3. In human keratinocytes and cultured keratinocyte cell lines, c-PAF inhibit the beauvericin induced apoptosis. 4. Human melanocytes is very resistant for the induction of apoptosis by beauvericin. 5. In the melanocytes and melanoma cell lines, sodium azide and beauvericin induced necrosis rather than apoptosis. CONCLUSIONS: The epidermis is continuously exposed to toxic factors which might induce cell death. With the above results, the induction of appeared to be rather resistant, epidermal cell apoptosis which may reflect the existence of some endogenous protective mechanisms in the epidermis to survive at certain toxic environments; melanocytes showed high expression of bcl-2 protein which could play a role in endogenous defense against toxic environments of the epidermis.
Acridine Orange ; Apoptosis* ; Cell Death ; Cell Line ; Chromatin ; Cytokines ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Emetine ; Endonucleases ; Epidermis ; Ethidium ; Humans ; In Situ Nick-End Labeling ; Ionophores ; Keratinocytes ; Melanocytes ; Melanoma ; Necrosis ; Skin ; Sodium Azide ; Suicide ; Tretinoin ; Tumor Necrosis Factor-alpha

Epithelioid hemangiomo, is belong to a group of unusual vascular proliferation accompanying prominent eosinophilic infiltration. It is usually classificed as a subset of angiolymphoid hyperplasia with eosinophilia despite of its peculiar endothelial morphology(i.e., vacuolization and hobnail appearance etc.). Histopathologically, the lesion was characterized by exuberant. proliferation of capillaries, epithelioid-appearing erdothelial cell, endothelial cytoplasmic vacuolization, solid sheets of endothelial cells, massive eosinophilic infiltration and lymphoreticular hyperplasia. The lesions are most common in he head-neck region and are characterized by single or multiple smooth-top papules or plnqu s of varying colors. We report two cases of epithelioid hemangioma occurring on the left auricle and scalp. The chiet complaints were pruritus and they have been early bleeding even in trivial trauma. Microscopically, the lesions were consisted of a prolifration of small to medium-sized blood vessels surraunded by inflammatory infiltrates predominantly composed of lymphocytes, histiocytes and eosinophils. The vessels were lined by epithelioid-appearing endothelial cells haveing enlarged round nuclei and abundant easinophilic or clear cytoplasm. Some vessels showed luminal obliteration by proliferating epithelioid endothelial cells. Occasionally, blood vessels were lined by hobnailor scallop-shaped endothelial cells. In immunohistochemical finolings, the epithelioid endothelial cells or proliferated capillaries were immunoreactive to factor VII-related antigen and negative to lysozyme.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Capillaries ; Cytoplasm ; Endothelial Cells ; Eosinophils ; Hemangioma* ; Hemorrhage ; Histiocytes ; Hyperplasia ; Lymphocytes ; Muramidase ; Phenobarbital ; Pruritus ; Scalp

Anti-T cell monoclonal antibodies(OKT series. OKT4a, OKTSA, OKT)1) immunoperoxidase technique study for the presence of T cells in cutaneous lesions from four patients with erythema multiforme showed that most dermal and epidermal lymphoid cells were reactive with monoclonal antibodies to anti-pan T cell (l3KT11) in this semiquantitative assay. In the dermis most of the perivascular lirmphoid infiltrates were reactive with anti-helper/inducer T cell antibody, but in the epidermis and in the derrnopidermal interface the predominant cells were identified as suppressor/cytotoxic T cells. The histologic and immunopathologic changes in erythema multiforme appear to be due in part to cellular immune rnechanisms with the lyrnphocyte as the predominant effector cell. But complex interplays with other humoral immune mechanisms might be in work for the development of erythema multiforme.
Antibodies, Monoclonal ; Dermis ; Epidermis ; Erythema Multiforme* ; Erythema* ; Humans ; Immunoenzyme Techniques ; Lymphocytes ; T-Lymphocytes*

BACKGROUND: The Fas antigen is a cell surface molecule that mediates apoptosis in many cell types. Matsues group indicated that keratinocytes constitutively express the Fas antigen and apoptosis was induced only on pretreatment with interferon-r (IFN-y) in cultured normal human keratinocytes (NHK). OBJECTIVE: We undertook this study to determine the induction of apoptosis by Fas antibody alone and/or in combination with IFN y, IL-1a in normal human keratinocytes (NHK) and transitional epithelioma cell lines (KB cell) which had lower levels of intracellular IL-1 receptor antago- nists (IL-1ra ). METHODS: We used cultured NHK and KB cells. Each cell was treated with IFN-r, IL-la and Fas antibody for induction of apoptosis. For quantifying the apoptosis, index fluorescent DNA- binding dyes were used. Result: Fas antibody alone could induce apoptosis not only in KB cells but also in NHK cells. The combination of Fas antibody and IFN-r enhanced the induction of apoptosis in NHK and KB cells. The IL-la alone could induce apoptosis only in KB cells which had relatively small amounts of IL-1ra compared to NHK. CONCLUSION: Our result may indicate that Fas antigen in human keratinocytes can regulate normal epidermal cellular differentiation and proliferation.
Antigens, CD95 ; Apoptosis* ; Carcinoma ; Cell Line ; Coloring Agents ; Humans* ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1 ; Interleukin-1alpha ; KB Cells* ; Keratinocytes*

Eccrine poromas mainly involve the non-hairy surfaces of the skin, however, have also been found on hair bearing areas. Pigmentation in the tumor cells is rare but has been mentioned in a few papers. The following case documents an example of a pigmented eccrine poroma which occurred in an unusual location; the posterior scalp.
Hair ; Pigmentation ; Poroma* ; Scalp* ; Skin

BACKGROUND: Indomethacin is a potent inhibitor of prostaglandins biosysnthesis. Sunburn erythema is mainly mediated by prostaglandins. OBJECTIVE: Our purpose was to compare objectively the effectiveness of topical indomethacin with topical corticosteroid on the suppression of UVB erythema METHODS: Sixteen male medical students who had not exposed their back skin during the last year were included in this study. According to the individual´s MED, 1,2, and 3 MED of UVB were irradiated on each back in triplicate lines. Immediately after UVB irradiation, 2.5% indomethacin solution and 0.25% desoximethasone were applied to each row with one row left for control. 24 hours after the initial application the intensity of each erythema was measured by the naked eye and by colorimeter. RESULTS: The suppressive effectiveness of 2.5% indomethacin solution on UVB induced erythema was superior to that of 0.25% desoximethasone. The L* and a* value of colorimeter were significantly correlated to the differencies of UVB induced erythema among the experimental and control groups is a useful and rapid method to evaluate the UVB induced erythema, and can give a numerical expression to eye perception. CONCLUSION: Our data confirm that topical indomethacin has a stronger suggestive effect on UVB erythema than that of topical corticosteroid.. We suggest that the suppressive effect of indomethacin is mainly due to the inhibition of prostaglandins biosynthesis. The colorimeter CR-200(MINOLTA) is well correlated with the naked eye score and is a useful instrument for objective measurement of the degree of erythema.
Erythema* ; Humans ; Indomethacin* ; Male ; Methods ; Prostaglandins ; Skin ; Students, Medical ; Sunburn

We report a case of zosteriform cutaneous metastasis from choangiocarcinomasin a 56-year-old male patient who has asymptomatic and painless erythematous papules and scaly patches over the anterior side of his right upper abdomen along the back, Tendernatome level. Histopathologic examina.tions of the cutaneous lesion reveaed a tumor cell showing glandular structure and multifocal tumor emboli within dilated lymphalics. and a few signetring cells in the dermis. We found that the retrograde studies revealed cholangiocarcinom. after confirmation of zosteriform cutaneous metastasis. He died eight months after the appearance of zosteriform cutaneous metastasis.
Abdomen ; Adenocarcinoma* ; Cholangiocarcinoma* ; Dermis ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis