BACKGROUND: It is traditiqnally considered that the non-bullous fonn of impetigo is primarily of streptococcal origin and the bullous form is of staphylococcal origin. However, recent reports have shown that Staphylococcus aureus (SA) has become the predominant cauative pathogen of non-bullous impetigo as well as of bullous impetigo. Objective. Our purpose was to evaluate the predominant causativi. pathogen, and to establish a therapeutic guideline for impetigo. METHOD: We described the characteristics of lesions and gerformed bacterial culture and susceptibility tests in patients with impetigo. Patients were treatecl by one of three frequently used antibiotics(erythromycin, cefuroxime, fusidic acid). RESULTS: Of 77 patients, there were 47 cases of crusted type(61.9%), 18 cases of mixed type with crusted and bullous lesiona(23.3%), 7 cases of mixed type with crusted and pustular lesions(9.1%) and 5 cases of bullous type(6.6%). SA was grown from 90.1% af the cases, in 83.1% of cases it was the only organism to be foind and no gowth of streptococcus was faund even in mixed infections. An antimicrobial susceptibility test of 63 strains of SA demonstrated high susceptibility to vancomycin(98.4%), cefuroxime(97.1%), oxacillin(96.4%), cephalothin(95.2%), fusidic acid(91.7%) etc, and high resistance to penicillin(93.7%), gentamicin(90.5%), tobramycin(88.9%) and erythromicin(80.9%). Of 19 patients treated with erythrornycin, 12(63.1% ) showed treatment failure at a weeks, while no treatment failure occured in groups treated with cefuroxime and usidic acid. There were statistically significant differences iri therapeutic effect between cefuroxirne and erythromycin(P=0.005 by two tailedy test), and betweer fusidic acid and erythromycin(P=0.0040. But there was no significant difference between cefuroxime and fusidic acid. CONCLUSION: The predominant pathogen of non-bullous impetigo a well as bullous impetigo was SA which were highly resistant to erythromycin and highly sensitive to efuroxime and fusidic acid. In the clinical response, cefuroxinie and fusidic acid treatment were most effective and erythromycin was inadequate for treatment of impetigo.
Cefuroxime ; Coinfection ; Erythromycin ; Furosemide ; Fusidic Acid ; Humans ; Impetigo* ; Staphylococcus aureus ; Streptococcus ; Treatment Failure

Epidermolytic hyperkeratosis, previously called bullous congenital ichthyosiform erythroderma is a dominantly inherited disorcler and usually manifested by blisters at or shortly after birth. We report a case of epidermolytic hyperkeratosis in 9 year old girl vrho developed generalized erythema &: easily eroded vesicles at birth. Later the skin lesions progresed to characteristic thick, grayish-dark brown verruform cais, affecting predominantly flexural and intertriginous areas. Fiistologic findings show typical granular degeneration.
Blister ; Child ; Cytochrome P-450 CYP1A1 ; Erythema ; Female ; Humans ; Hyperkeratosis, Epidermolytic* ; Parturition ; Skin

We measured serum 1gE by using IgE 'Eiken' radioirnrnunoassay Kit and delayed cutaneous hypersensitivity responsiveness by the Multitest CMI Kit (Institut Merieux) that simultaneously administrates 7 standardized recall antigens(tetanus, diphtheria, streptococcus, tuberculin, candida, trichophyton, proteus) and 70% W/V glycerin diluent control by multiple prick puncture. We studied 40 cases comprising 20 patients with atopic dermatitis (AD) and 20 healthy children as control. The results were obtained as follows; 1) The mean serum level of IgE in AD(63.3+/-395.2 1U/ml) was higher than in control(155.6+/-67.1IU/ml) (p<0.0l), but the intensity of reaction (IR) & rate of reaction (RR) in AD (l.34+/-1.06, 0.38+/-0.23) was not significantly decreased than in control (1.70+/-0.87,0.44+/-0.16). 2) 1n both AD & control group, tuberculin showed highest IR R RR. 3) Anergic state was found in only one patient with disseminated cutaneous lesions Sc 4) serum IgE, but rate of hypoergy was significantly increased in AD(65%) than in control (30%) (p<0.05). 4) Serum IgE was not statistically correlated with IR and RR, but IR was statistically correlated with RR (p<0.001, r=0.9504). 5) IgE level in severe AD (generalized skin lesion) was significantly increased than in both mild AD 8c control group (p<0. 001). but IR & RR were not statistically correlated with disease severity.
Candida ; Child ; Dermatitis, Atopic* ; Diphtheria ; Glycerol ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed* ; Immunoglobulin E* ; Punctures ; Skin ; Streptococcus ; Trichophyton ; Tuberculin

BACKGROUND: Pityriasis versicolor(PV) is a superficial mycosis, theoretically unusual in children. Epidemiologic and clinical data for children with PV under 14 years were collected. OBJECTIVE: The purpose of this study was to evaluate the clinical features of PV in the young. METHOD: We included all cases of PV in patients under 14 years of age observed in our department from 1981 to 1995. All cases were diagnosed on the basis of clinical criteria and were confirmed by microscopic examination. RESULTS: From 1981 to 1995 we encountered 32 cases of PV in children, compared with 637 cases in adults; thus children represented 4.7% of all cases. The ratio of male to female was l. 7:1. Among the age groups, the incidence was the highest in the 10-14 years(43%). The monthly prevalence was the highest in August. Distribution of the lesions were the face(40.9%), neck (25%), chest(13.6%), back(11.3%), extremities(6.8%) and abdomen(2.2%). The incidence of hypopigmented lesions was 70.4% and that of hyperpigmented lesions was 29.6%. CONCLUSION: This study confirms that the face is a predilectionl site for PV in children and all facial lesions are hypopigmented. Other clinical features are variable and similar to those of adults.
Adult ; Child ; Female ; Humans ; Incidence ; Male ; Neck ; Pityriasis* ; Prevalence ; Tinea Versicolor*

We report a case of nevus sebaceus associated with sebaceous epithelioma and basal cell epithelioma in a 48-year-old male patient. A 2.6 x 2.0cm orange-yellow erosive tumor and 1.5 x 1.0cm, l.0 x 0.8cm dark blue-yellow varigated nodules were intimately associated with a 4 x 3cm sized yellowish verrucous plaque on the parieto-occipital area of the scalp. Biopsy revealed sebaccous epithelioma, basal cell epithelioma and nevus sebaceus, respectively.
Biopsy ; Carcinoma* ; Carcinoma, Basal Cell* ; Humans ; Male ; Middle Aged ; Nevus* ; Scalp

We report two cases of vulvar syringorna in a 40-year-old women and a 28-year-old woman who had 2-3mm sized, brownish papules on both valvar areas an l-3rnm sized, yellow-brownish papules on both vulvar ares with yellowish milia-like lesion the surface, respectively. Microscopically the lesions revealed characteristic findings of syrinzoiza However the second case showed a small cystic duct in the papillary dermis, which is lineilly a stratified epithelium and filled with concenteric lamellae of keratin.
Adult ; Cystic Duct ; Dermis ; Epithelium ; Female ; Humans ; Syringoma* ; Vulva

Bowens disease is a precaicerous lesion and may transform into in asive squamous cell carcinoma. We present a case of a 67 year-old male with Bowens disease on the buttock from which squamous cell carcinoma developed. He had anerythematous, scaly and crusted slaque with a nodule on the left buttock. Skin biopsy specimen taken from the plaque and nodule revealed typical histopathological findings of Bowens disease and squlamous cell carcinoma, respectieels. The patient was treated with excision and skin graft under general anesthesia.
Aged ; Anesthesia, General ; Biopsy ; Bowen's Disease ; Buttocks ; Carcinoma, Squamous Cell ; Humans ; Male ; Skin ; Transplants

We report a case of 68-year-old male patient who was confirmed as d'emblee type of mycosis fungoides. The skin lesions showed sharply rnargined multiple reddish brown coIarcd papules, ndules, and tumors on the groin, thign, abdomen, and neck. The microscopic findings showed the epidermotropism and pautrier's micruabscess in the epidermis, and the infiltration of atypical cells in the dermis. The electron micrascopic findings showed irregular contour of the nuclear mernbrane within atypical lymphocytes. Thc lesions were gradually diminished by superficial radiation therapy.
Abdomen ; Aged ; Dermis ; Dronabinol ; Epidermis ; Groin ; Humans ; Lymphocytes ; Male ; Mycosis Fungoides* ; Neck ; Skin

Phakomatosis pigmentovascularis characterized by the association of cutaneous hemangioma and pigmentary nevi was first recognized as a syndrome by Ota in 1947. We describe herein a case of phakomatosis pigmentovascularis alsoiated with ocular abnormalities in a 22-year-old female. According to Hasegawas criteria, this case is lassified as type lIb.
Female ; Hemangioma ; Humans ; Neurocutaneous Syndromes* ; Nevus ; Stomach Neoplasms ; Young Adult

No abstract available.
Liver Transplantation* ; Liver*