The technique of plssma exchange has been applied to a number of immune disorders in which c4eulating antibodies are present. We observed a patient with bullous pemphigoid and serious side effects of longterm use of steroid therspy. We applied ten times of plasmapheresis to him over six months period. After the plasmapheresis, clinical symptoms have greatly improved and steroid maintenance doses have been decreased. We have not observed any side effect of plasmapheresis such as thrambotopenia or hypogarnrnaglobulinemia during the whole therapeutic period.
Antibodies ; Humans ; Immune System Diseases ; Pemphigoid, Bullous* ; Plasmapheresis*

BACKGROUND: Primary targit injured from the immunologic mechanism of alopecia areata is not definitely confirmed although alopecia areata is regarded as a disease occuring from certain im munologic process. Recently, par ticular interest has been focused on the follicular keratinocytes which show morphologic and anigenic alterations in active lesions. Another important point is the subclinical state hypothesi. It is based upon the observation that the patterns of T lymphocytes infiltration and ultrastructural changes of dermal papilla cells are nearly identical in active lesions and in non-lesional areas of alopecia areata. OBJECTIVE: The purpose of this study is to determine and to compare the aberrant expression of HLA-DR, CD1 and ICAM-1 on the follicular keratinocytes from the active alopecia areata lesion, stationary lesion and non-lesional scalp. METHODS: We performed a n immunohistochemical study, using the streptavidin system to compare the patterns of HLA-DR, CD1 and ICAM-1 immunoreactivity in the follicular keratinocytes in five active alopecia lesions two stationary lesions and non-lesional scalp specimens among four active and two stationary patients, and two normal control scalp specimens. RESULTS: In the active aloecia lesions, the HLA-DR and ICAM-1 immunoreactivity was observed in some patients while CD1 immunoreactivity was observed in all the patients. In the sta tionary alopecia lesions, none of the HLA-DR or CD1 or ICAM-1 immunoreactivity was observed as was the case in the norrial control scalp specimens. In the non-lesional normal scalp specimens, the HLA-DR, CD1 and ICAM-1 immunoreactivity showed nearly the same patterns as those in the acute alopecia leions. CONCLUSION: The aberrant antigenic alterations, especially CD1 expression of follicular keratinocytes are likely to be asociated with the active progress of alopecia areata lesions. These antigenic alterations were also observed in non-lesional scalp as well as alopecia areata lesions in the very similar patterns.
Alopecia Areata* ; Alopecia* ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Scalp* ; Streptavidin ; T-Lymphocytes

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

This study was done with 5,980 cases of dermatomycosis of dermatological patients in Chnnnam University Hospital for 10 years(1976~1985). And the literatures concerning all fungal diseases reported in Korea were reviewed. The results were summarized as follows ; Among total dermatological patients, the average annual incidence of dermatomycosis was about 15+3%. Dermatophytosis was the most prevalent(77.34%), followed by candicliaais(14.38%), tinea versicolor(7.78%), sporotrichosis(0.45%). Of dermatophytosis, the decreasing orders of clinical localization by the incidence were T.pedis(42.2%), T.cruris(25.9%), T. manum(10.3% ), T. corporis(10.0%), T. ungium (6.2%), T.facialis(4.2%), and T. capitis(2.2%). The organisms identified from dermato phytoses were generally 9 species ; the decreasing orders of frequency were Trichophyton rubrum(59.4%), T. mentagrophyte(27.9%), Microsporum canis(8.5%), Epidermophyton floccosum(2.4%), T. ferrugineum(0.9%), and others(M. gypseum, T. schonleinii, T. violaceum, T. verrucosum). The most common causative organism was T. rubrum, but that of T. corporis and T. capitis was M. canis, which showed a continuous increase on the annual variation of dermatophytes. Of candidiasis, the most common clinical form was cutaneous candidiasis, which was prevalent under 10 years old. But vulvo-vaginitis and paronychia highly developed between 3rd and 5th decades. The occasion with precipitating faetors was 10.4% of total candidiasis, of which tuberculosis and diabetes mellitus were prevalent. Of T. versicolor patients, the peak age was 3rd decades but some cases were infant and child. Of sporotrichosis, the most common clinical location and form were hand and lym phatic respectively. The peak age was between 4th and 5th decades, and the most prevalent occupation was farmer. Of other deep mycosis, there were each case of cryptococcosis, systernic candidiasis, and Wangiella derm,atitidies infection.
Arthrodermataceae ; Candidiasis ; Candidiasis, Cutaneous ; Child ; Cryptococcosis ; Dermatomycoses* ; Diabetes Mellitus ; Epidermophyton ; Exophiala ; Hand ; Humans ; Incidence ; Infant ; Korea ; Microsporum ; Occupations ; Paronychia ; Sporotrichosis ; Tinea ; Trichophyton ; Tuberculosis

No abstract available.
Carbon Dioxide* ; Carbon* ; Lasers, Gas* ; Vulva*

In a previous communication, we described a relatively simpli. method for assaying quantities of sweat using the skin surface hydrometer. In order to evaluate the pharmacologic response of weat glands in psoriasis, vitiligo and loalized scleroderma, we measured the basal skin conductance and the quantity of sweat induced by intradermal injections of pilocarpine nitrate in the lesional and per ilesional skin. The results were as follows : 1. In psoriatic plaques, based skin surface hydration and the sweat response to pilocarpine was markedly reduced (p<0.05), but there were no significant differences in normal perilesional skin. 2. In generalized vitiligo, basal skin surface hydration and the sweat gland response was normal. In the case of the segmental type, there was a slightly decreased sweat response in the lesion but, not significant statistically. 3. In the morphea plaque, basal skin surface hydration and the sw.at response to pilocarpine was markedly reduced but was normal in perilesional skin. This study presents evidence of the functional changes in the development of sweat secretion and surface hydration in the lesions of psoriasis, morphec and segmental type of vitiligo. The demonstration of ahnormalities in the pharmacolopic response to pilocarpine induction led us to suggest the possibility that some degree of sweat gland involvement is induced by the pathogenetic mechanisms of these diseases.
Injections, Intradermal ; Pilocarpine ; Psoriasis* ; Scleroderma, Localized ; Skin ; Sweat Glands* ; Sweat* ; Vitiligo*

17,966 new outpatients who visited the Department of Dermatology of Wonju Christian Hospital from 1985 to 1989 were analyzed statistically. The study results are summarized as follws : 1. Among the 17,966 outpatients, the total number of male patients were 8358 (46.5%) and female patients were 9608 (53.5%). 2. In age distribution, the most frequent age groups were lst decade (24.0), 2nd decade (16.5), and 3 rd decade (25.5) amounting to 66% of the total outpatients. 3. The 15 most common dermatoses were dermatophytosis, atopic dermatitis, urticaria, acne, seborrheic dermatitis, allergic contact dermatitis, other eczema, hypopigmentary disorder, bacterial infection, psoriasis, insect bites, and herpes zoster. 4. Those dermatoses which showed increasing tendency were other eczema, hypopigmentary disorder, herpes zoster, and those of decreasing tendency were scabies, bacterial infection. psoriasis, insect bites. 5. Seasonal distribution. showed those diseases occurring most frequently during the summer season were dermatophytosis, insect bites. urticaria, acne, eczema, contact dermatitis. hypopigmentary disorder, bacterial infection. and herpes zoster. The incidence of atopic deratitis. and psoriasis were incfreased during the winter season. 6. In sexual distribution sebourrheic dermatitis. and scabies were more frequent in the males. whereas with urticaria. acne, contact dermatitis, and other eczema the females were more commonly affected. 7. In age distribution, atopic dermatitis, bacterial infection, and insect bites were the most frequent in the Ist decade. Dermatophytosis. urticaria, acne, seborrheic dermatitis, contact dermatitis, other eczema, hypopigmentary disorder, drug eruption, and psoriasis were most frequent in the 3 rd decade, with scabies in the 2nd decade, and herpes zoster in the 6th decade. 8. The distributions of dermatoses as disease groups, were eczema (23.8%), dermatophytosis (13.9%), urticaria-drug eruption (12.2%), skin appendage disorder (11.2%), and viral infection (8.1%), which constituted 69.2% of the total.
Acne Vulgaris ; Age Distribution ; Bacterial Infections ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Dermatology ; Drug Eruptions ; Eczema ; Epidemiology ; Female ; Gangwon-do* ; Herpes Zoster ; Humans ; Incidence ; Insect Bites and Stings ; Male ; Outpatients ; Psoriasis ; Scabies ; Seasons ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria

No abstract available.
Purpura, Thrombocytopenic* ; Rifampin*

We present a case of venous hemangioma which is seen beneath a clavus (corn) developed in the interdigital area of the foot. Clinically, a violaceous papule was located on the third and fourth interdigital spaces under an overlying corn. Histopathologic examination showed a non-encapsulated dermal mass composed of thick-walled and thin walled vessels lined by a single layer of endothelial cells. Some thick-walled vessels had protruding endothelial cells into the lumen and through Verhoeff-van Gieson and Masson-trichrome stain of the tissue section, we found that the vascular mass was composed of vein.
Endothelial Cells ; Foot ; Hemangioma* ; Veins ; Zea mays

We present a case of systemic lupus erythematosus(SLE) asseci ted with vitiligo in a 57 year-old male patient. Physical examination revealed two distinct skin lesions those of itiligo showed as centrally located depigmented patches surrounded by erythernatous patch on the right cheek, scalp and left dorsurn of hand and those of SLE showed as erythematous papules and patchs with partial adherent scales on the face, scalp, neck, both extensor surface of arm, and left dorsun of hand. Their coexistence lends credence to the contention that altered autoimrnunity may play a role in the pathogenesis of each of these diseases. In Western countries and Japen, patients with lupus erythema osis have been observed to develop vitiligo or depigmented spots on the skin, while in Korea, its has not been previously observed.
Arm ; Cheek ; Erythema ; Hand ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Male ; Middle Aged ; Neck ; Physical Examination ; Scalp ; Skin ; Vitiligo* ; Weights and Measures