BACKGROUND: Photodynamic therapy (PDT) is a treatment modality involving the use of a photosensitizer, oxygen and a light source to induce selective targeted cell death. It is used for various skin conditions, including actinic keratosis (AK). Both 5-aminolevulinic acid and methyl aminolevulinic acid (MAL) are currently available as photosensitizers. Although there are several studies on the treatment of AK using 5-aminolevulinic acid-PDT in Korea, there are few studies on using MAL-PDT for the treatment of AK. OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of MAL-PDT for the treatment of AK. METHODS: We performed a retrospective study and reviewed 64 AK lesions from 28 patients who were treated by MAL-PDT between January 2008 and April 2010. The data was collected through the medical records, the clinical photographs and the biopsy specimens. RESULTS: The patients were treated with either a single treatment or double treatments 1 week apart. The treatment results were assessed after 12 weeks. Overall, complete remission was achieved in 42/64 lesions (65.6%). Although a single treatment was effective for thin lesions, the complete response rates were significantly lower for the moderately thick and severely thick lesions (100% vs 71.3% vs 22.2%, respectively). Repeated treatment tended to improve the complete response rate of the severely thick lesions. A favorable cosmetic outcome was achieved and only tolerable local side effects were reported after MAL-PDT. The patients were followed up for an average period of 6 months and 4 lesions recurred. CONCLUSION: MAL-PDT is an effective and well-tolerated treatment option for thin and moderately thick AK. However, further study is required for determining the optimal regimen for thicker lesions and the long-term treatment results of MAL-PDT.
Actins ; Aminolevulinic Acid ; Biopsy ; Cell Death ; Cosmetics ; Humans ; Keratosis, Actinic ; Korea ; Light ; Medical Records ; Oxygen ; Photochemotherapy ; Photosensitizing Agents ; Retrospective Studies ; Skin

No abstract available.
Humans ; Skin

No abstract available.
Biopsy ; Warts

BACKGROUND: Urticaria and atopic dermatitis are representative allergic skin diseases that can be mediated by IgE. Measuring levels of specific IgE can be used to confirm causative agents of these skin diseases. OBJECTIVE: To analyze results from the multiple allergosorbent test chemiluminescent assay (MAST-CLA), which measures specific IgE in the presence of a causative agent/allergen, in IgE-mediated skin diseases. METHODS: A total of 404 patients with urticaria, atopic dermatitis or pruritus were enrolled in the present study. Positive rates of specific IgE as well as total serum IgE from the MAST-CLA were compared. RESULTS: Positive rates of specific IgE were highest in atopic dermatitis patients, followed by urticaria, and then pruritus, with 57.0%, 37.1%, and 20.8%, respectively (p<0.05). House dust mite species were the most common allergens in both atopic dermatitis and urticaria skin diseases. There were no differences in the overall MAST-CLA results between acute and chronic urticaria. The relative positive rate of inhalant allergen was significantly higher in adult than in child atopic dermatitis patients. CONCLUSION: Results from the MAST-CLA showed diversity among the three disease groups, and within each disease group, with different positive rates of specific IgE, a different mean allergen number per patient, and so on. Therefore, we concluded that MAST-CLA could be a useful diagnostic tool for various allergic skin diseases.
Adult ; Allergens ; Child ; Dermatitis, Atopic ; Humans ; Immunoglobulin E ; Luminescent Measurements ; Pruritus ; Pyroglyphidae ; Skin ; Skin Diseases ; Urticaria

No abstract available.
Melanoma ; Nevus ; Nevus, Pigmented ; Warts

Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta (PLEVA), or febrile ulcerative Mucha-Haberman disease (FUMHD) is very rare, but potentially lethal variants of PLEVA. This subtype is characterized by rapidly progressive ulceronecrotic lesions and systemic manifestations, such as high fever, gastrointestinal, neurological, cardiologic and pulmonary involvement, and rheumatologic manifestations. Several treatments with variable response have been challenged, such as systemic steroid, antibiotics, methotrexate, dapsone, cyclosporine and ultraviolet therapy. But there is no standard therapy for FUMHD to date. We report a 59-year-old woman with FUMHD, who recurred after discontinuation of systemic steroid, but successfully treated with oral cyclosporine.
Anti-Bacterial Agents ; Cyclosporine ; Dapsone ; Female ; Fever ; Humans ; Methotrexate ; Middle Aged ; Pityriasis ; Pityriasis Lichenoides ; Ulcer ; Ultraviolet Therapy

Transcatheter arterial chemoembolization (TACE) is the mainstay of treatment for unresectable hepatocellular carcinoma (HCC). Although various complications of TACE have been reported, cerebral lipiodol embolism after TACE is rare. We report a 67-year-old man, who had patent foramen ovale and developed cerebral lipiodol embolism after TACE via the inferior phrenic artery. At 20 months after third TACE of 3 cm sized HCC in the left hepatic lobe, computed tomography (CT) revealed about 1.6 cm newly developed HCC in the anterior superior segment of right hepatic lobe. The angiogram revealed the HCC was supplied from the right inferior phrenic artery. Toward the end of TACE, there were accumulations of the iodized oil in the pulmonary vasculature. Immediately after TACE, he complained of weakness in right upper and lower limbs and sensory decrease in right limbs and right hemitrunk. Magnetic resonance imaging revealed a cerebral lipiodol embolism. Transesophageal echocardiography revealed no visible thrombi but contrast-echocardiography using hand agitated saline revealed an intracardiac right to left shunt consistent with patent foramen ovale. Motor weakness and sensory decrease were gradually improved, and all neurological symptoms disappeared over 4 weeks.
Aged ; Carcinoma, Hepatocellular/complications/diagnosis/*therapy ; *Chemoembolization, Therapeutic ; Contrast Media/*adverse effects/diagnostic use ; Humans ; Intracranial Embolism/*diagnosis/*etiology/ultrasonography ; Iodized Oil/*adverse effects/diagnostic use ; Liver Neoplasms/complications/diagnosis/*therapy ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

Diagnosis of scabies in young children can be challenging since the morphology and distribution of skin lesions may differ from adults. Therefore, clinicians should keep scabies in mind in their differential diagnosis in a child who presents with severe pruritic, polymorphic skin lesions. Regarding the treatment of scabies, the reported clinical experience with gamma benzene hexachloride (lindane) in young children is quite limited because of its neurotoxicity. However, a recent review suggests that lindane is an excellent alternative drug with minimal risk. We report the case of a 2-month-old male infant with pruritic, erythematous macules, papules, nodules, vesicles, and pustules from the top of the head to the tip of the toes. Initially, he was thought to have impetigo and antibiotics were prescribed. After obtaining a careful history and with the use of skin scraping, he was diagnosed with scabies. He was successfully treated with lindane with no adverse reactions.
Adult ; Anti-Bacterial Agents ; Child ; Diagnosis, Differential ; Head ; Humans ; Impetigo ; Infant ; Lindane ; Male ; Scabies ; Skin ; Toes

Fibroma of the tendon sheath is an uncommon soft tissue tumor presenting as a solitary, slow-growing, firm, painless, small nodule, which shows strong attachment to the tendon or tendon sheath. It is usually localized on fingers and hand tendons in adults between the age of 20 and 40 years old. This case concerns a 61-year-old man presenting with a 5-year history of multiple cutaneous nodules on both palms and soles. Skin biopsy confirmed fibroma of the tendon sheath. Blood tests showed a high titer of rheumatoid factor and positivity to anti-nuclear antibody. No case of fibroma of the tendon sheath occurring multifocally on both palms and soles has been previously reported. Herein, we report on a very rare case of multiple fibromas of the tendon sheath arising from palms and soles, which supports the pathogenetic hypothesis that this tumor may be a reactive process rather than a true neoplasm.
Adult ; Biopsy ; Fibroma ; Fingers ; Hand ; Hematologic Tests ; Humans ; Middle Aged ; Rheumatoid Factor ; Skin ; Tendons

Seborrheic keratosis is one of the most common benign epithelial tumors, especially in elderly patients. Squamous cell carcinoma is the second most common malignant tumor of the skin. Despite the fact that both tumors are common, malignant transformation of seborrheic keratosis rarely occurs. Herein we report a case of squamous cell carcinoma arising in a patient with pre-existing seborrheic keratosis.
Aged ; Carcinoma, Squamous Cell ; Humans ; Keratosis, Seborrheic ; Skin