Photosensitive psoriasis is a rare disease defined as psoriasis in which the lesions deteriorate or new lesions develop after sun exposure. It should be differentiated from other photosensitive conditions that may be a vated or confused on sun-exposure. Half of the patients have a history of polymorphic light eruption(PMLE), whieh several weeks later develops into psoriasis lesions and the others have no history of preceding PMLE reaction. PUVA therapy is recommended for the treatment of choice. In this report, we describe two cases of photosensitive psoriasis. A 51-year-old woman without underlying psoriasis suffered from erythemato-squamous papular lesions on the face, neck and dorsum of hands after sun-exposure. She revealed a lowered minimal erythema dose(MED) for UVA which was confused with a photosensitive disease. But characteristic psariatic plaques on the elbow, knee and palm and histologic findings made the diagnosis photosensitive psoriasis. She showed a good result to cyclosporine therapy. The other patient, a 44-year-old woman with underlying psoriasis, experienced an exacerbation with preceding PMLE and showed a lowered erythema threshold for UVB. She was treated with sun-screen and topical corticosteroids.
Adrenal Cortex Hormones ; Adult ; Cyclosporine ; Diagnosis ; Elbow ; Erythema ; Female ; Hand ; Humans ; Knee ; Middle Aged ; Neck ; Psoriasis ; PUVA Therapy ; Rare Diseases ; Solar System

There have been several reports in the literature of coexistent psoriasis and bullous pemphigoid. In most cases, the bullous pemphigoid lesions have been considered to be induced by antipsoriatic treatments. We describe a patient with psoriasis in whom bullous pemphigoid developed during psoriasis treatment, but the exact etiologic factor was not identified. Recently, some reports have suggested that an immunologic or biochemical association between the two diseases plays a role in the pathogenesis.
Humans ; Pemphigoid, Bullous* ; Psoriasis*

No abstract available.
Extremities*

BACKGROUND: PUVA photochemotherapy has been accepted as an effective treatment modality in the treatment of psoriasis. Many combination therapies have been tried to reduce the long-term side effects of UV radiation. OBJECTIVE: We performed conventional PUVA and calcipotriol-PUVA combination therapy to compare the effectiveness between two treatment modalities. METHODS: We treated 38 Korean patients with conventional PUVA and 54 with D-PUVA. We compared the total number, duration and total UVA dose of PUVA therapy to reach grade 4 between two groups. We categorized each patient into clearing, improvement, or failure groups based on the therapeutic efficacy, and evaluated PASI score at patient`s visits. RESULTS: The irradiation number and total cumulative dose of D-PUVA phototherapy to achieve grade 4 were significantly smaller than PUVA phototherapy. CONCLUSION: Combining PUVA with a vitamin D analogue, calcipotriol, in the treatment of psoriasis may lead to lowering the risk of long-term exposure to UV radiation with higher efficacy.
Humans ; Photochemotherapy ; Phototherapy ; Psoriasis* ; PUVA Therapy ; Vitamin D

No abstract available.
Slipped Capital Femoral Epiphyses*

BACKGROUND: Narrow-band UVB phototherapy using 311+-2nm wavelength is in widespread use due to its greater efficacy and, possibly, safety compared with broad-band UVB sources. OBJECTIVE: We performed emollient narrow-band UVB(NBUVB) phototherapy to evaluate the clinical efficacy and safety in Korean psoriasis patients. METHODS: Fifteen psoriasis patients received narrow-band UVB phototherapy. We categorized each patient into clearing, improvement, or failure groups based on the therapeutic efficacy, and measured the PASI score every two weeks. RESULTS: 1. Among patients who received narrow-band UVB phototherapy, clearing was shown in 40.0% and improvement in 27.7%, and failure in 33.3%. 2. The total number, duration, final and cumulative doses to achieve grade IV were 16.3, 39 days, 1,050mJ/cm2 and 12,125mJ/cm2 respectively. 3. There were some side effects of NBUVB phototherapy such as pruritus(53.3%) and mild burning(13.3%). CONCLUSION: Narrow-band UVB phototherapy is a effective treatment modality which is convenient and less erythemogenic in psoriasis. It will be used more and more and play an important role in the treatment of psoriasis.
Humans ; Phototherapy* ; Psoriasis*

OBJECTIVES: The root barks of Periploca sepium Bge. (P. sepium) has been used in traditional Chinese medicine for healing wounds and treating rheumatoid arthritis. However, toxicity in high-doses was often diagnosed by the presence of many glycosides. The potential mutagenicity of P. sepium was investigated both in vitro and in vivo. METHODS: This was examined by the bacterial reverse mutation (Ames) test using Escherichia coli WP2uvrA and Salmonella typhimurium strains, such as TA98, TA100, TA1535, and TA1537. Chromosomal aberrations were investigated using Chinese hamster lung cells, and the micronucleus test using mice. RESULTS: P. sepium did not induce mutagenicity in the bacterial test or chromosomal aberrations in Chinese hamster lung cells, although metabolic activation and micronucleated polychromatic erythrocytes were seen in the mice bone marrow cells. CONCLUSIONS: Considering these results, it is suggested that P. sepium does not have mutagenic potential under the conditions examined in each study.
Animals ; Arthritis, Rheumatoid ; Biotransformation ; Bone Marrow ; Chromosome Aberrations ; Cricetinae ; Cricetulus ; Erythrocytes ; Escherichia coli ; Glycosides ; Lung ; Medicine, Chinese Traditional ; Mice ; Micronucleus Tests ; Periploca ; Salmonella typhimurium

Beta-fluoroethylacetate has been extensively used as the rodenticide in Korea. In some patients with acute poisoning, beta-fluoroethylacetate caused cerebellar dysfunction as a single and persistent neurologic sequela after a period of an acute neurological disorder which is characterized by mental deterioration, seizures, and respiratory failure. But there has been no report of pathological findings to explain neurological deficit. We tried to verify the histologic changes of the central nervous systems in beta-fluoroethylacetate poisoned rats. Silver staining(Gallyas) was used to evaluate the histology. In acute intoxication experiment with LD50(7mg/Kg), beta-fluoroethylacetate elicited acute onset of consciousness deterioration, generalized tonic-clonic seizures and large amplitude tremulous activity involving whole body with full recovery after 24 hours. There was no discernible pathologic change in CNS in acutely poisoned rats. However, when poisoned with sublethal dose(5mg/Kg) daily for five days, a moderate degree of nerve cell degeneration was found selectively in dentate nucleus, Purkinie cell layer, vestibulo-cochlear nucleus and striatum. This change was not seen in hippocampus, cerebral cortex or cerebellar cortex. These findings were well correlated with the previous reports of selective pathology in human 5-FU intoxication cases. Our preliminary results suggest that beta-fluoroethylacetate, a kind of cellular metabolism inhibitor may induce selective neuropathology mainly involving cerebellar output pathway in rats.
Humans ; Rats ; Animals ; Poisons

BACKGROUND: Although retinoid and PUVA monotherapy is effective for psoriasis, both treatment regimens have some limitations because of the risk of long-term toxicity. OBJECTIVE: We performed Re-PUVA combination therapy to evaluate the clinical efficacy and safety in comparison with retinoid and PUVA monotherapy. METHODS: Seventy-eight psoriasis patients received Re-PUVA combination therapy as well as conventional retinoid and PUVA monotherapy. Pretreatment with etretinate for 1 week was followed by PUVA therapy in combination with etretinate. RESULTS: 1. Among patients who received Re-PUVA combination therapy, clearing was shown in 77.3% and improvement in 13.6%, which were higher than retinoid, 27.8%/61.1%, and PUVA monotherapy, 65.8%/21.0%.2. In patients who reached grade 4 with Re-PUVA therapy, the duration and total dose of etretinate were 56.4 days and 1616mg. These were significantly lower than retinoid monotherapy, 107.5 days and 2577.5mg.3. In patients who reached grade 4 with Re-PUVA therapy, the number and total dose of UVA were 13.3 and 82.8 J/cm2, which showed no difference compared with those of PUVA monotherapy, 16.2 and 120.2 J/cm2. However, excluding the cases who did not respond to previous monotherapy, the number and total dose of UVA in Re-PUVA were 10.4 and 49.0J/cm2, which were significantly lower than those of PUVA4. The side effects of Re-PUVA were reported in 54.5%, which were similar to PUVA monotherapy, 52.6%, and lower than retinoid monotherapy, 83.3%. There were some side effects of retinoid, such as cheilitis, dry mouth, elevation of sGOT/sGPT and triglycerides, and side effects of PUVA, such as itching, erythema, anorexia, nausea and vomiting. CONCLUSION: Our study suggests that Re-PUVA combination therapy is more effective and tolerable than retinoid and PUVA monotherapy in the treatment of psoriasis, especially in severe and recalcitrant cases.
Acitretin ; Anorexia ; Cheilitis ; Erythema ; Etretinate ; Humans ; Mouth ; Nausea ; Pruritus ; Psoriasis* ; PUVA Therapy ; Triglycerides ; Vomiting

A survey with self-administered questionnaire method to examine the association of Pap Smear health screening tests and health promotion activities for 500 women who visited OPD of Obstetrics and Gynecology. The compliance of pap smear of the rich, married, house wife and self employed women was higher than others. Women who received Pap smears were significantly more likely to receive breast examiniations, mammograms, gastrofibroscopy and regular blood pressure check-up. The Pap smear was associated with health promotion activities such as own private physician, no cooling beverage intake, milk intake and heptitis B vaccination. In conclusion, health care providers may use the Pap smear as a marker of whether a woman has received screening for several other medical problems. Thus, the Pap smear can be considered a "sentinel" test for health screening in women.
Beverages ; Blood Pressure ; Breast ; Compliance ; Female ; Gynecology ; Health Personnel ; Health Promotion* ; Humans ; Mass Screening* ; Milk ; Obstetrics ; Surveys and Questionnaire ; Spouses ; Vaccination