In 1932, Harris, et al., reported that vitamin A had an anti-keratinizing effect on acne vulgaris, and in 1948, Straumfjord, somewhat over-enthusiastically reported that oral use of vitamin A also had a beneficial effect on acne. In spite of studies by Lynch and Cook (1947), and Andrew and Stokoe (1963), which questioned its effectiveness, the original enthusiasm for this regimen has not been completely dampened. Kligman (1969) reported that vitamin A acid (VAA), a metabolic end-product of vitamin A metabolism, produced a peeling effect and when applied topical was effective in tbe treatment of acne. The mechanism of action of VAA is incompletely understood, however, it is observed to cause, arnong other things, an increase in the speed of proliferation of the cells of the epidermis; dissolution of the intracellular lysosomes; increase in the rate of keratin formation and the conversion of hard keratin to soft keratin; and an increase in the secretion of the sebaceous glands. The effect of VAA in acne treatment is due to the increase in the secretion of the sebaceous glands which prevents the formation of comedones. It is believed that the increased spced of cell division, increased keratinization and softening of the keratin cause a weakening of the intercellular adhesion. These processes cause an acceleration of the flow of cells out of the sebaceoua glands which prevents the formation of comed.ones and forces existing comedones to the surface of the skin. For this study, thirty eight patients with acne vulgaris were selected from among the outpatients of Severance Hospital. They were divided into two groups. The first group was treated with application of vitamin A acid alone. The second group was treated concurrently with topical vitamin A acid and oral tetracycline. The results were a.s folIows: l. The group treated for three weeks with VAA alone showed significant improvement in up to 70 of the cases. 2. The group treated with VAA and oral tetracycline showed results which were sirnilar to the group on VAA alone. 3. In both groups. closed cornedones and papules gradually disappeared, however, the number of open com.dones increased in the first week, but decreased threafter, In combined therapy, pustules disappeared grad.ually just like the papules, but in therapy with VAA alone, the number of pustules increased during tbe first week and decreasd. thereafter. 4. In the group which was treated with VAA alone, undesirable side effects such as scaling, erythema, tightness, itching and burning sensation were seen, and also occasionally fissures, edema, pain and oozing were noted. In the group treated with combined therapy, similar findings were recorded.
Acceleration ; Acne Vulgaris* ; Burns ; Cell Division ; Edema ; Epidermis ; Erythema ; Humans ; Lysosomes ; Metabolism ; Outpatients ; Pruritus ; Sebaceous Glands ; Sensation ; Skin ; Tetracycline ; Tretinoin* ; Vitamin A* ; Vitamins*

Although many regimens for the acne therapy were proposed and vere used upto date, there is, no ideal choice of treatment. Since a certain relationship between the vitamin A and some dermatoses accompanied, with dyskeratoses had been proposed by Harris in 1932. many studies have been reported for the acne treatment with vitamin A topical or oral administration. (Straumfjord 1943, Lynch & Cook 1947, Anderson & Stokoe 1968). In 1969, Kligman observed the peeling effect of vitamin A acid (VAA), a metabolite of vitamin A, on the human skin and he experienced very good effect of VAA topical application on acne patients. Tbereafter, many authors studied about the VAA and reported the excellent effect on acne (McGills et al. 197l, Mills R Plewig 1972, Juhlin 1975). Moxeover, in 1976, Kim & Lee observed similar results with the authors mentioned above in its cure rate and side effects. In contrast to their high cure rate in those studies, however, its untoward side effects were freqvently elicited with severe intensity. So, author studied the effectiveness and side effects of VAAD which was changed in its chemical structure to diminish the side effects of VAA. Thirty-seven patients (M:F=4:33) were studied, and the results obtained were as follows. 1. The total number of lesions decreased significantly from third week and decreased by half in 4th. week. 2. The number of closed comedones decreased significantly from second week but the number of open comedones temporarily increased in 1st. week and decreased thereafter. 3. pustules and papul s continually decreased but new pustule formation developed in 3 patients and also disappeared in 4 weeks of treatment. 4. Allergic contact dermatitis was developed in 1 patient among 37 patients in 4th. week. 5. There were some undesirable side effects of scaling, pruritus, buming sensation in about 80% respectively, but its intensity was mild or moderate, and fissure, edema and exudation which appeared in VAA treatment were not observed. only a few patients complained tightness, erythema and pain. In comparison with VAA, the duration of treatment with VAAD was delayed about 1-2 weeks and the effectiveness in acne therapy with VAAD was almost equal to VAA therapy, and the side effects were markedly diminished.
Acne Vulgaris* ; Administration, Oral ; Dermatitis, Allergic Contact ; Edema ; Erythema ; Humans ; Pruritus ; Sensation ; Skin ; Skin Diseases ; Tretinoin* ; Vitamin A* ; Vitamins*

Our present knowledge of impetigo contagiosa extends from its first description as a separate clinical entity by Fox in I864, and the proof of its bacterial etiology by Radcliffe-Crocker in 1881. Both staphylococci and streptococci have been discovered from the lesions, but the relative preponderance of each varies greatly, and reports are contradictory. Seventy-eight patients with impetigo contagiosa were studied bacteriologically in order to ascertain the primary etiologic agent. Also, a susceptibility test (Bauer- Kirby method) was done on the isolated organisms with 7 antibiotics which are used frequently in the clinical field. Specimens obtained from the skin lesions were cultured and organisms were isolated. They were identified by various biochemical and serological tests. A DN ase test, a carbohydrate fermentation test, and a coagulase test were done for the isolated staphylococci. A bacitracin disc method and a precipitin test(Lancefield method) were done for the isolated B-hemolytic streptococci. The results were as follows: Fifty-six cases(71.8%) were infected by staphylococcus only. Twenty cases(25.6%) were infected by a mixture of staphylococcus and p-hemo- lytic streptococcus. Only 2 cases(2.6%) were infected by B-hemolytic streptococcus alone. All 76 strains of staphylococci were identified as coagulase positive staphylococci. Among the 22 strains of B-hemolytic streptococci, 15 strains were identified as group A and remaining 7 strains were identified as group B. Coagulnse negative sta,phylococcus was not found. In the susceptibility test to 7 antibiotics, staphylococci showed susceptibility to lincomycin, erythromycin, cloxacillin, and chloramphenicol, and resistance to tetra-cycline, penicillin, and ampicillin. Streptococci showed susc.ptibility to all of the above antibiotics except tetracycline. From the results of this experiment, it was concluded that the primary etiologic agent of impetigo contagiosa was coagulase positive staphylococcus and streptococcus for the most part can be considered as a secondarily infecting agent. Coagulase negative staphylococcus apparently is not implicated as an etiologic agent of impetigo contagiosa. The results of the antibiotic susceptibility tests would seem to indicate that the use of such antibiotics as tetracycline, penicillin, and ampicillin is not indicated in the treatment of impetigo contagiosa.
Ampicillin ; Anti-Bacterial Agents ; Bacitracin ; Chloramphenicol ; Cloxacillin ; Coagulase ; Erythromycin ; Fermentation ; Humans ; Impetigo ; Lincomycin ; Penicillins ; Serologic Tests ; Skin ; Staphylococcus ; Streptococcus ; Tetracycline

A black pigmented ulcerative, 1cm x 3cm nodule was developed in a 43 year old woman since 5 years ago. Clinically, it resembled the malignant melanoma and histopathological study revealed the combination of pigmented and morphea like basal cell epithelioma. Wide and deep excision down to oral mucosa with frozen section of free margin and primary closure had performed to bring the excellent cosmetic outlook, Both the pigmented basal cell epithelioma and morphea like basal cell epithelioma are reported rarely, however, to the best of our review of the English literature, this is the first of reported case of combinated type of pigmented and morphea like basal cell epitheliorna. We are now on close observation of the patient for recurrence and metastasis of the tumor.
Adult ; Carcinoma, Basal Cell ; Female ; Frozen Sections ; Humans ; Melanoma ; Mouth Mucosa ; Neoplasm Metastasis ; Recurrence ; Scleroderma, Localized* ; Ulcer

Incontinentia pigmenti(IP) is an X-linked dominantly inherited disorder with female predominance. Skin lesions are characterized by three or four stages; vesicobullous, verrucous, hyperpigmented and hypopigmented lesions. About 80% of patients with incontinentia pigmenti have one or more associated ectodermal or mesodermal anomalies involving teeth, nail, hair, eye, breast, bones and nervous system. A newborn girl had erythematous based vesicles and bullae on her trunk and extremities with peripheral eosinophilia. Within several days, she showed linear verrucous plaques. A skin biopsy specimen showed eosinophilic spongiosis in the epidermis and numerous eosinophils in the dermis. The diagnosis of IP was made. She was revealed to have some congenital heart anomalies; atrial septal defect (ASD) and patent ductus arteriosus(PDA). Cases of IP with congenital heart disease have been reported very rarely. Therefore, we report this unique case of IP associated with ASD and PDA.
Biopsy ; Breast ; Dermis ; Diagnosis ; Ectoderm ; Eosinophilia ; Eosinophils ; Epidermis ; Extremities ; Female ; Hair ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart* ; Humans ; Incontinentia Pigmenti* ; Infant, Newborn ; Mesoderm ; Nervous System ; Skin ; Tooth

Authors have quantitated the T cell and T subsets(T and T cell) in the per- ipheral blood of 16 patients with alopecia areata and 16 normal healthy controls. The results are as follows: 1. The mean values of the T cell in total patient group(54,6+7.9g) and AAP group(5,3. 1+8. 1%) showed staticstially significant decrease when it compared with the mean value of the control group(64.6+3.6%) respectively(p<0.005). In ATU group the mean value of the T cell(53. 1+8. 1%) also showed decreasing tendency in comparison with that of control. The mean values of the T cell in total patient group(30.9+8. 9%) RIld AAP group(3'l. 5+8. %) showed statistically significant decrease when it compared with the mean value of the control group(42,6+8.9%) respectively(p<0. 005). In ATU group the mean value of the T< cell(28. 7+10. 9%) also showed decreasing tende- ncy in comparison with that of control. 3. The mean values of the Tr, cell in total patient group(6. 1+2. 2%) and AAP group(5.9+2.4%) showed staticstially significant decrease when it compared with the mean value of the control group(7.9+1.3%) respectively(p(p pl, pgp p25) In ATU group the mean value of the T cell(6. 7+0. 9%) also showed decreasing tendency in comparison with that of control. 4. The mean values of the T/T ratio showed no significant difference between the patient groups(total, AAP, ATU) and control group, respectively. Above data showed that defect of T cell and T subsets may be associated with the pathogenesis of alopecia areata.
Alopecia Areata ; Humans

A 45 year old male patient complained of mucous fluid drainage in the vicinity af the manubrium sterni for 5 years. Skin around the lesion had normal appearance except pinpoint sized sinus opening. H.istopathology showed a cyst in the upper and mid-dermis which consisted of pseudoetratified columnar epithelium with interspersed goblet cells. Goblet; cells were confirmed by positive stain to D-PAS and alcian blue and by metachromatic stain to toluidine blue. VFe present here a case of cutaneous bronchogenic cyst clinically and histopathologically which is thought to be the first cace in Korea.
Alcian Blue ; Bronchogenic Cyst* ; Drainage ; Epithelium ; Goblet Cells ; Humans ; Korea ; Male ; Manubrium ; Middle Aged ; Skin ; Tolonium Chloride

The role of the immune system in pathogenesis of skin cancer has been attracted increasing attention in recent years. Some limited studies and observations suggest that altered immune status may be a factor in the initiation and growth of cutaneous malignancies. Authors experienced a typical case of xeroderma pigmentosum in a 6 year-old girl, who has been suffered from hyper and hypopigmented macules on sun-exposed area, photophobia and also noted eroded lesion on the lower lip. The biopsy finding of the hyperpigmented macule showed that of freckle and the finding of actinic cheilitis was observed from the specimen of eroded 1esion on the lower lip. We performed immunologic test and obtained some evidences of immunologic defect; such as decreased numbers of total T cells, T-suppressor cell and B cell in our patient.
Actins ; Biopsy ; Cheilitis ; Child ; Cytochrome P-450 CYP1A1 ; Female ; Humans ; Ichthyosis* ; Immune System ; Immunologic Tests ; Lip ; Melanosis ; Photophobia ; Skin Neoplasms ; T-Lymphocytes ; Xeroderma Pigmentosum*

Hematogenous contact dermatitis may be produced by the systemic administrationof a drug to an individeal who has been previously sensitized by the topical application of the drug or related chemicals. 37 year-old male patient had frequent rhus dermatitis. He took rhus with chicken for treatment of peptic ulcer, on next day generalized skin rashes with itching sensation were developed. the aptient was diagnosed as hematogenous contact dermatitis or systemic exzematous contact dermatitis according to the history, symptoms and the result of patch test.
Adult ; Chickens ; Dermatitis, Contact ; Dermatitis, Toxicodendron ; Eating* ; Exanthema ; Humans ; Male ; Patch Tests ; Peptic Ulcer ; Pruritus ; Rhus* ; Sensation

Gougerost-Blum syndrome is a rare disease and characterized by lichenoid papules in association with purpuric lesions. So far as we know there has been no report of, in literatures, Gougerot-Blum syndrome with leukemia. We experienced a case of typical Gougerrot_Blum syndrome with acute myeloblastic leukemia in a 30 year-old female patient. This patient complained of rashes on whole body for 2 months, and frequent epistaxis and gum bleeding for 20 days. The skin revealed miliary to rice sized rusty colored lichenoid papules on whole body especially on legs and arms. Histopathologically the skin showed the picture of Gougerot-Blum syndrome. On peripheral blood examination and bone marrow aspiration myeloblastic leukemia was confirmed. The patient was treated with 6-mercaptopurine, cytoxan and prednisolone with slight improvement of skin lesions, but no improvement of leukumia itselt.
6-Mercaptopurine ; Adult ; Arm ; Bone Marrow ; Cyclophosphamide ; Epistaxis ; Exanthema ; Female ; Gingiva ; Granulocyte Precursor Cells ; Hemorrhage ; Humans ; Leg ; Leukemia* ; Leukemia, Myeloid, Acute ; Prednisolone ; Rare Diseases ; Skin