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

This clinical study of nine patients presented Disseminated Superficial Actinic Porokeratosis (DSAP) as a distinctive and recognizable entity characterized by multiple uniformly small, irregular marginated, keratotic plug with atrophic center developing during second or third decade of life on sun exposed area of skin. Six of nine patients had DSAP, which was inherited as autosomal dominant trait. The patient's father, two brothers and two sisters were known to have same skin lesions. Of nine patients, five were female and four were male. Eight patients were developed DSAP lesions during second decade of life and other one was third dcade of life. Three patients had pruritus. In alI patients, lesions were developed bilaterally over sun exposed area but was not always symmetrical. The number of lesion was multiple in all patients. The greatest number of lesions were found on distal part of extremities, neck, face, upper portion of anterior chest and back.
Extremities ; Fathers ; Female ; Humans ; Male ; Neck ; Porokeratosis* ; Pruritus ; Siblings ; Skin ; Solar System ; Thorax

The case of a 30 year old man is described, in whom mycosis Fungoides was originating from nose and followed by tumor stage of Mycosis Fungoides on skin. In January 1970, the patient leveloped nasal tumor, when he was n at E.N.T. department of Severance Hospital. At that time a biopsy of nasal tumor demonstrated only a non-specific inflammatory cell infiltrated mass. He received radiation therapy (Co 60) with satisfadory suppression of mass and resulted in right nasal septal deviation. Jn December 1970, thumb sized painful non-tender, movable mass developed on right supraclaviular area. In August 1971, thumb sized painful, tender, movable mass appeared at right posterolateral aspect of neck, which was excied and removed at local clinic. But excised wound was not healed and the mass was enlarged. One month after above lesion, pea sized same mass developed. On physical examination, there were 4*5cm round, erythematous, painful, tender, granulomatous ulceration mass on right postero-lateral aspect of neck and also same mass on postero-inferior site of above lesion. Two times of biopsy was done and it interpreted as tumor stage of Mycosis Fungoids. Treatment included radiation therapy with Co 60 (200r/day, total 6,000r), prednisolone 40mg/day and antibiotics. There has been good response 1 month after radiation therapy and mass is diminished in size and would begin to heal.
Adult ; Anti-Bacterial Agents ; Biopsy ; Humans ; Mycosis Fungoides* ; Neck ; Nose* ; Peas ; Physical Examination ; Prednisolone ; Skin ; Thumb ; Ulcer ; Wounds and Injuries

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

No abstract available.
Mucocutaneous Lymph Node Syndrome*

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
Amyloid ; Amyloidosis ; Congo Red ; Eosinophils ; Female ; Humans ; Hyalin ; Light ; Lymph Nodes ; Mediastinum ; Middle Aged ; Thorax ; Thymoma ; Thymus Gland

No abstract available.
Lasers, Gas*

Among 130 cholera patients treated in Seohae Hospital in 1991, 86 were cholera bacilli positive and remaining 44 were negative. All cholera bacilli 'positive' patients were confirmed bacteriologically by National Institute for Health team. Cholera related symptoms and laboratory findings were gathered by interviews and medical records surveys. Symptoms and some serological laboratory findings are compared between cholera bacilli 'positive' and 'negative' patients in 1991 cholera epidemic. Results are as follows: 1. There were no differences in symptoms distribution and in mean values of all serological laboratory tests done between two groups. These facts support that both cholera bacilli 'positive' and 'negative' patients are persons who have cholera bacilli infection. 2. The age distribution of the cholera bacilli 'negative' group tended to be much younger than that of 'positive' group. The infection source of this group is believed to be the environmental reservoir. This findings suggests that cholera bacilli 'negative' patients have the possibility of endemic characteristics. We think it is worth investigating Vibrio cholera antibody titers of people in area with frequent cholera epidemics in Korea.
Age Distribution ; Cholera* ; Humans ; Korea ; Medical Records ; Vibrio

BACKGROUND: The purpose of this study is to obtain the accurate information on the obesity indices, such as body mass index(BMI), relative weight and waist-hip ratio(WHR) and to investigate their relationship in order to assess the childhood and adolescent obesity more appropriately. METHODS: In May, 1995, a total of 6943(male; 3469, female; 3474) students from primary, middle and high schools in Seoul were selected and each students height, weight, waist and hip circumference data were collected. RESULTS: The BMI increased with age in both sexes. From age 12 to 16, values of BMI 50th percentiles for females exceeded those for males. And the BMI 95th percentiles at the age of 13 to 14 years were higher for females than for males. The prevalence of obesity by relative weight was higher in males than in females(male ; 17.9%, female ; 13.1%). The WHR was higher in males than females in all age group and decreased with age in both sexes, showing more sharp reduction in females. Strong correlations were observed between the BMI and the relative weight, and the BMI and the relative weight correlated closely with WHR. The WHR was significanly higher in obese group' than in non-obese group. In the female obese group aged 6 to 11 years, no significant correlation was found between the relative weight and the WHR. CONCLUSIONS: There were significant relationships between the indices of obesity and body fat distribution. This study suggests that WHR as well as BMI and relative weight might be useful in assessing the childhood and adolescent obesity.
Adolescent* ; Body Fat Distribution ; Body Mass Index* ; Child* ; Female ; Hip ; Humans ; Male ; Obesity ; Pediatric Obesity ; Prevalence ; Seoul* ; Waist-Hip Ratio*

PURPOSE: Cataract and refractive surgical procedures which are one of the most common and successful surgeries in modern medicine. The purpose of this study is clear understanding of the current situation and future trends in cataract and refractive surgery. METHODS: Sixth annual survey forms consisted of 88 multiple-choice questions mailed to 281 ophthalmologists of the KSCRS in January 2001. Approximately 32% of the questionnaires were returned. The current data were compared with previous annual surveys and data of Japan and USA. RESULT: The hospitalized period is decreased annually, but the rate of topical anesthesia (44%) increases steadily. Self sealing wound construction was the main wound closure technique in phacoemulsification (48%). The most preferred intraocular lenses for small incision cataract surgery are silicone (48%), acrylic (40%), and polymethyl methacrylate (PMMA, 11%). 72% of the respondents were performing excimer laser keratectomy for refractive surgery, and its most common complication is the regression of visual acuity (35%). Most respondents preferred laser in situ keratomileusis (LASIK) without regard to diopter range and there is decreasing tendency of legal problems after refractive surgery. CONCLUSIONS: From this survey, we found that the current trend and changes in cataract and refractive surgery in Korea are similar to those of Japan and USA.
Anesthesia ; Cataract* ; Surveys and Questionnaires ; History, Modern 1601- ; Japan ; Keratomileusis, Laser In Situ ; Korea* ; Lasers, Excimer ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Postal Service ; Refractive Surgical Procedures* ; Silicones ; Visual Acuity ; Wound Closure Techniques ; Wounds and Injuries