BACKGROUND: Although the main features of psoriasis consist of abnormal epidermal proliferation and T cell infiltration, which of these is the initial abnormality has been a longstanding unresolved question. Recently there has been definite evidence that activated T cells produce the cytokines that induce keratinocyte abnormalities. OBJECTIVE: We investigated the distributions and relative numbers of T lymphocyte subpopulations, that is, CD4+ and CD8+ T cells, to verify the more important T cell subtype and its infiltrating site in the formation of psoriatic lesions. METHODS: Paired psoriatic lesional and non-lesional skin tissues were obtained from eight typical psoriatic patients. Immunohistochemical staining was done on the frozen sections using a labelled streptavidin-biotin peroxidase complex method with DAKO LSAB kit. The primary antibodies used in this study were monoclonal or polyclonal antibodies against CD3, CD4, CD8, HLA-DR, and ICAM-1. RESULTS: In lesional psoriatic skin, the epidermis was mainly infiltrated by CD8+ T cells. There were little or no T cells in non-lesional epidermis. In both lesional and non-lesional dermis, CD4+ T cells were the main ones. In lesional skin, anti-ICAM-1 antibody positively stained diffusely in the endothelial cells of papillary and subpapillary plexuses and focally in epidermal keratinocytes, but in non-lesional skin only the endothelial cells in the subpapillary plexus were stained. There were many HLA-DR+T lymphocytes in lesional and non-lesional dermis. In the epidermis, HLA DR was detected only in lesional keratinocytes and T lymphocytes. CONCLUSION: These results suggest (1) participation of activated epidermal CD8+ T lymphocytes in the formation of psoriatic plaques, and (2) a pathogenetic role of ICAM-1 expression on papillary microvessels.
Antibodies ; Cytokines ; Dermis ; Endothelial Cells ; Epidermis ; Frozen Sections ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Subsets* ; Lymphocytes* ; Microvessels ; Peroxidase ; Psoriasis ; Skin* ; T-Lymphocytes

The purpose of this study was to examine the frequency of eutaneous disorders in patients with chronie renal failure presently on hemodialysis(HD). The results were as follows. 1. Cutaneous lesions were present in all 78(100% ) patients with chronic renal failure. 2. The frequency of msjor cutaneous problems associated with chronic renal failure was as follows: xerosis(82.1%), pruritus(74.4%), nail changes(74.4%), hyperpigmentation(70.5 % ), xerostomia(42.3'Yo), poor wound healing(37.2%), easy bruisability(30,8%), hypotrichosis(21.896), and purpura(14.1 % ). 3. Cutaneous problems which appeared after the initiation of HD were. appearance of new pigmented nevi or lentigines(9 patients), appearance or aggravation of acne(6), contact dermatitis at AV fistula site(2), gynecomastia(1), extensive flat warts(1), extensive tinea versicolor(1), and extensive vitiligo(1). 4. Among 55 patients with hyperpigmentation, 11 patients reported decreased pigmentation following HD. In 15 patients, hyperpigmentation worsened following HD, and in 9 patients hyperpigmentation first appeared after HD was initiated. 5. Cutaneous disorders favorably affected by HD were as follows: easy bruisability(3/ 24), xerostomia(3/33), gingival friability(2/7), and hypotrichosis(5/17). 6. Poor wound healing and xerosis were not improved by HD. 7. Among 58 pruritic patients, 7 patients were improved after HD, 7 patients became worse during each HD, and 3 patients were not pruritic only for 2 to 3 days after each HD. Four patients experinced pruritus only during each HD. 8. There was no significant statistical difference between the frequency of pruritus and xerosis and the levels of blood urea nitrogen, calcium, phosphorus, and parathyroid hormone.
Blood Urea Nitrogen ; Calcium ; Dermatitis, Contact ; Fistula ; Humans ; Hyperpigmentation ; Kidney Failure, Chronic* ; Nevus, Pigmented ; Parathyroid Hormone ; Phosphorus ; Pigmentation ; Pruritus ; Renal Dialysis* ; Renal Insufficiency ; Tinea ; Wound Healing ; Wounds and Injuries

No abstract available.

Neutrophilic eccrine hidradenitis(NEH) was originally described in 1982 by Harrist et al. in a patient with myelogenous leukemia receiving chemotherapy. Clinically NEH represents various cutaneous manifestations with or without tenderness and pruritus. Histologic examination demonstrates a neutrophilic infiltrate within and around the eccrine gland and degeneration of the eccrine gland structures. Although the pathogenesis and possible cause of NEH remain unknown, it is probably an unusual cutaneous reaction to chemotherapeutic agents. A few cases of infection associated eccrine hidradenitis are found in the literature. We report three cases of neutrophilic eccrine hidradenitis. Two cases were associated with hematologic malignancy. The third case was associated with an infection of Vibrio vulnificus.
Drug Therapy ; Eccrine Glands ; Hematologic Neoplasms ; Hidradenitis* ; Humans ; Leukemia, Myeloid ; Neutrophils* ; Pruritus ; Vibrio vulnificus

PURPOSE: Insulin-like growth factor I(IGF-I) is a polypeptide mitogen and mediates growth effect of growth hormone(GH). The lack of daily variation of IGF-2 allows their measurements to be reliable in screening for growth disorders. The aims of this study are to evaluate the mean levels of IGF-I and also to evaluate whether IGF-I has diagnostic significance as a screening test in short stature children. METHODS: We studied 71 short stature children(Male 43, Female 28)whose test results were normal after GH provocation test(L-dopa and/clonidine). Control group was 13 children with GH deficiency(complete GH deficiency 6 cases, partial GH deficiency 7 cases). Serum GH level was measured with radioimmunoassay(RIA, Diagnostic system laboratories, USA) kit. and serum IGF-I level was measured with RIA kit(Nichols co., USA). RESULTS : 1) Study group included 71 short stature children(male 43, female 28) without GH deficiency and 13 short stature children with GH deficiency(complete GH deficiency 6, partial GH deficiency 7). 2) The height of 43 male children was below 50 percentile except in 3 cases. And 28 female children was below 50 percentile except 1 case. In Tanner standard growth curve. But, 7 male chidren with GH deficiency was below -1SD and 6 female children with GH deficiency was below -2SD. 3) Serum IGF-I level in short stature children without GH deficiency was seen to increase with age and serum IGF-1 level of female was higher than that of male. 4) Serum IGF-I level was correlated with height percentile in study group(male: Y=0.017X+0.243, r=0.294, P=0.03, female: Y=1.248X+0.716, r=0.384, P=0.01). 5) Serum IGF-I level was -2SD in most GH deficient children. Conclusions: The height was mostly below 50 percentile of the Tanner growth curve in short stature children without GH deficiency. Serum IGF-I level was weakly correlated with the height percentile in both male and female study group. But, serum IGF-I level has limited value of screening test in diagnosis of short stature. However, if serum IGF-I level below -2SD, it could be anti pate the sign for further evaluation of GH deficiency.
Child* ; Diagnosis ; Female ; Growth Disorders ; Humans ; Insulin-Like Growth Factor I* ; Insulin-Like Growth Factor II ; Male ; Mass Screening

Alternaria species are common plant pathogens, but rare causes of human infection. We present a case of primary cutaneous alternariosis with iatrogenic Cushing syndrome. A 59-year-old woman presented with a spreading erythematous ulcerative patch containing chocolate-colored pus draining sinuses. Histopathology and culture of lesional skin were consistent with alternariosis. The cutaneous lesion cleared following treatment with itraconazole, 200mg daily, for 7 months without significant side effect and there was no evidence of relapse for 4 months.
Alternaria ; Alternariosis* ; Cushing Syndrome* ; Female ; Humans ; Itraconazole ; Middle Aged ; Plants ; Recurrence ; Skin ; Suppuration ; Ulcer

PURPOSE: We wanted to determine the differential points between craniopharyngioma and pituitary macroadenoma on MRI. MATERIALS AND METHODS: The MRI findings in twenty seven patients (age range: 14-67 years, mean age: 46 years, 17 males and 10 females) with pathologically proven craniopharyngioma and twenty four patients (age range: 23-64 years, mean age: 54 years, 8 males and 16 females) with pathologically proven pituitary macroadenoma were analyzed retrospectively by two radiologists. We analyzed the location, the contour of the mass, the presence of high signal intensity on the T1 weighted images, the thickness of the enhancing wall, separation between the mass and the pituitary gland, and the presence of attachment or compression to the midbrain. RESULTS: On MRI, craniopharyngiomas showed a suprasellar location, high signal intensity on the T1 weighted images and a larger suprasellar portion. After contrast enhancement, the separation of the mass from the pituitary gland is more distinct than that of the pituitary macroadenomas. The craniopharyngiomas showed the presence of attachment or compression to the midbrain. The pituitary macroadenomas had a larger intra- or infrasellar portion than that of the craniopharyngiomas, and they also showed a thicker enhancing wall after contrast enhancement. CONCLUSION: The location, contour of the mass, presence of high signal intensity on T1 weighted images, thickness of the enhancing wall, separation of the mass from the pituitary gland and the presence of attachment or compression to midbrain are useful differential points between craniophayngioma and pituitary macroadenoma on MRI.
Craniopharyngioma* ; Humans ; Magnetic Resonance Imaging ; Male ; Mesencephalon ; Pituitary Gland ; Retrospective Studies

BACKGROUND: The abuse, misuse, and adverse effects to topical drugs have been widespread in Korea due to lack of awareness of seriousness of drug abuse and misuse, and improper designation of prescription and non-prescription drugs. OBJECTIVE: This study was conducted to bring Korean people to an awareness of the abuse, misuse, and adverse effects of topical drugs, and to stress the importance of proper designation of non-prescription drugs. METHODS: A multicenter, prospective, clinico-epidemiologic evaluation was made from patients with adverse effects to topical drugs who visited 31 dermatologic departments in university hospitals or private clinics nationwide from march, 2002 to December, 2002. RESULTS: The diagnostic incidence of adverse effects from topical drugs are abuse and misuse (40%), dermatophytosis incognito (29%), bacterial infection (14%), contact dermatitis (9%), acne (2.5%), skin atrophy (1.4%), telangiectasia (1%). Erghty three percent of adverse effects are caused by topical corticosteroids, and betamethasone valerate, prednicarbate and triamcinolone acetonide are commonly used topical corticosteroids that induce adverse effects frequently. The most common way to obtain topical drugs is purchase directly from pharmacist without prescriptions. CONCLUSION: From this study, we confirmed that adverse effects to topical corticosteroids are very common even after the enforcement of designation of prescription drugs and non-prescription drugs. The proper designation of prescripton drugs should be reevaluated and based on the safety of patients to protect people from adverse effects of topical drugs.
Acne Vulgaris ; Adrenal Cortex Hormones ; Atrophy ; Bacterial Infections ; Betamethasone Valerate ; Dermatitis, Contact ; Hospitals, University ; Humans ; Incidence ; Korea ; Nonprescription Drugs ; Pharmacists ; Prescription Drugs ; Prescriptions ; Prospective Studies ; Skin ; Substance-Related Disorders ; Telangiectasis ; Tinea ; Triamcinolone Acetonide

PURPOSE: Magnetic Resonance Imaging (MRI) is widely used for the preoperative staging of breast cancer. In this study, we investigated a role of preoperative breast MRI for detecting the extent of disease and predicting the prognosis of ductal carcinoma in situ (DCIS). METHODS: From January 2002 to April 2008, preoperative MRI was performed for evaluating the extent of disease in 26 patients with DCIS. The MRI findings, the modified Van Nuys scores and the clinicopathological results were reviewed. The accuracy of breast MRI was analyzed with respect to the detection of tumor multiplicity and disease extending into the nipple, and this was compared with that of mammography. RESULTS: For detecting multiple lesions, the sensitivity and specificity of breast MRI were 25.0% and 86.4%, respectively, and the results of mammography were 0.0% and 86.4%, respectively. The accuracy of breast MRI was 76.9% and that of mammography was 73.1%. For detecting tumor extension into the nipple, the sensitivity and specificity of breast MRI was 100.0% and 80.0%, respectively, and that for mammography was 0.0% and 92.0%. respectively. The accuracy of MRI was 80.8% and that for mammography was 88.5%. The MRI final assessment was not associated with the modified Van Nuys score (p=0.474). CONCLUSION: For detecting the disease extent of DCIS, preoperative breast MRI is not superior to mammography due to the low specificity and accuracy of MRI. MRI did not show a definite ability to predict the prognosis of DCIS in this study.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Mammography ; Nipples ; Prognosis ; Sensitivity and Specificity

PURPOSE: To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. MATERIALS AND METHODS: Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: 0.66x0.66x1.1 or 1.2 mm3), and CTA on 64-slice CT scanners (voxel dimension: 0.42x0.42x0.63 mm3). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. RESULTS: A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n=19) and intracranial (n=15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity, specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1% on CTA, with DSA as the standard of reference. CONCLUSION: Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.
Angiography ; Angiography, Digital Subtraction ; Constriction, Pathologic ; Female ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Male ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity