No abstract available.
Schools, Medical*

We report a 55-year-old male, who has had erythematous, scaly, verrucous plaque on the left lower leg. About 1 year ago, rice sized erythematous papule on the left lower leg was developed. The lesion had been aggravated abruptly and rapidly in size since about one month ago. Histopathologic finding showed clusters of fungal spores in the upper dermis and intraepidermal microabscesses. The patient had been treated with wide excision and intravenous injection of amphotericin B. We observed a good response without evidence of recurrence.
Amphotericin B ; Chromoblastomycosis ; Dermis ; Humans ; Injections, Intravenous ; Leg ; Male ; Middle Aged ; Recurrence ; Spores, Fungal

In 1932, Harris, et al., reported that vitamin A had an anti-keratinizing effect on acne vulgaris, and in 1948, Straumfjord, somewhat over-enthusiastically reported that oral use of vitamin A also had a beneficial effect on acne. In spite of studies by Lynch and Cook (1947), and Andrew and Stokoe (1963), which questioned its effectiveness, the original enthusiasm for this regimen has not been completely dampened. Kligman (1969) reported that vitamin A acid (VAA), a metabolic end-product of vitamin A metabolism, produced a peeling effect and when applied topical was effective in tbe treatment of acne. The mechanism of action of VAA is incompletely understood, however, it is observed to cause, arnong other things, an increase in the speed of proliferation of the cells of the epidermis; dissolution of the intracellular lysosomes; increase in the rate of keratin formation and the conversion of hard keratin to soft keratin; and an increase in the secretion of the sebaceous glands. The effect of VAA in acne treatment is due to the increase in the secretion of the sebaceous glands which prevents the formation of comedones. It is believed that the increased spced of cell division, increased keratinization and softening of the keratin cause a weakening of the intercellular adhesion. These processes cause an acceleration of the flow of cells out of the sebaceoua glands which prevents the formation of comed.ones and forces existing comedones to the surface of the skin. For this study, thirty eight patients with acne vulgaris were selected from among the outpatients of Severance Hospital. They were divided into two groups. The first group was treated with application of vitamin A acid alone. The second group was treated concurrently with topical vitamin A acid and oral tetracycline. The results were a.s folIows: l. The group treated for three weeks with VAA alone showed significant improvement in up to 70 of the cases. 2. The group treated with VAA and oral tetracycline showed results which were sirnilar to the group on VAA alone. 3. In both groups. closed cornedones and papules gradually disappeared, however, the number of open com.dones increased in the first week, but decreased threafter, In combined therapy, pustules disappeared grad.ually just like the papules, but in therapy with VAA alone, the number of pustules increased during tbe first week and decreasd. thereafter. 4. In the group which was treated with VAA alone, undesirable side effects such as scaling, erythema, tightness, itching and burning sensation were seen, and also occasionally fissures, edema, pain and oozing were noted. In the group treated with combined therapy, similar findings were recorded.
Acceleration ; Acne Vulgaris* ; Burns ; Cell Division ; Edema ; Epidermis ; Erythema ; Humans ; Lysosomes ; Metabolism ; Outpatients ; Pruritus ; Sebaceous Glands ; Sensation ; Skin ; Tetracycline ; Tretinoin* ; Vitamin A* ; Vitamins*

A case of toxic epidermal necrolysis(TEN) in 20 years old female was presente d. The characteristic skin lesions of toxic epidermal necrolyais developed after oral administration of Aspirin for common cold. The cause of the disease. was probably due to Aspirin, but on the microscopic pathologic findings intraepithelial and subcorneal bullae which is characteristic in the staphylococcal induced TEN were noticed. She was treated with a massive systemic corticosteroids(Dexamethasone 12mg/d), antibiotics(Lincocin l.5grn/d), Fluids with electrolytes, sedatives and topical measures. So she was discharged with excellent results in a week of admission.
Administration, Oral ; Aspirin ; Common Cold ; Electrolytes ; Female ; Humans ; Hypnotics and Sedatives ; Skin ; Young Adult

A 54-year-old man had a 1.0 *0.8cm sized, reddish, slightly firm tumor mass on the right side of his tongue. Some 30 years ago, he bit his tongue with considerable bleeding. Since then, he has experienced irritation at the previous bit site, particularly after eating irritaible foods or smoking. About 5 years ago, he felt a pea sized mass exactly at the bit site which gradually increased in size. The histopathologic findings of skin biopsy specimen show typical features of neurilemmoma consisted of Antony type A and type B tissue.
Biopsy ; Eating ; Hemorrhage ; Humans ; Middle Aged ; Neurilemmoma* ; Peas ; Skin ; Smoke ; Smoking ; Tongue*

A black pigmented ulcerative, 1cm x 3cm nodule was developed in a 43 year old woman since 5 years ago. Clinically, it resembled the malignant melanoma and histopathological study revealed the combination of pigmented and morphea like basal cell epithelioma. Wide and deep excision down to oral mucosa with frozen section of free margin and primary closure had performed to bring the excellent cosmetic outlook, Both the pigmented basal cell epithelioma and morphea like basal cell epithelioma are reported rarely, however, to the best of our review of the English literature, this is the first of reported case of combinated type of pigmented and morphea like basal cell epitheliorna. We are now on close observation of the patient for recurrence and metastasis of the tumor.
Adult ; Carcinoma, Basal Cell ; Female ; Frozen Sections ; Humans ; Melanoma ; Mouth Mucosa ; Neoplasm Metastasis ; Recurrence ; Scleroderma, Localized* ; Ulcer

Although many regimens for the acne therapy were proposed and vere used upto date, there is, no ideal choice of treatment. Since a certain relationship between the vitamin A and some dermatoses accompanied, with dyskeratoses had been proposed by Harris in 1932. many studies have been reported for the acne treatment with vitamin A topical or oral administration. (Straumfjord 1943, Lynch & Cook 1947, Anderson & Stokoe 1968). In 1969, Kligman observed the peeling effect of vitamin A acid (VAA), a metabolite of vitamin A, on the human skin and he experienced very good effect of VAA topical application on acne patients. Tbereafter, many authors studied about the VAA and reported the excellent effect on acne (McGills et al. 197l, Mills R Plewig 1972, Juhlin 1975). Moxeover, in 1976, Kim & Lee observed similar results with the authors mentioned above in its cure rate and side effects. In contrast to their high cure rate in those studies, however, its untoward side effects were freqvently elicited with severe intensity. So, author studied the effectiveness and side effects of VAAD which was changed in its chemical structure to diminish the side effects of VAA. Thirty-seven patients (M:F=4:33) were studied, and the results obtained were as follows. 1. The total number of lesions decreased significantly from third week and decreased by half in 4th. week. 2. The number of closed comedones decreased significantly from second week but the number of open comedones temporarily increased in 1st. week and decreased thereafter. 3. pustules and papul s continually decreased but new pustule formation developed in 3 patients and also disappeared in 4 weeks of treatment. 4. Allergic contact dermatitis was developed in 1 patient among 37 patients in 4th. week. 5. There were some undesirable side effects of scaling, pruritus, buming sensation in about 80% respectively, but its intensity was mild or moderate, and fissure, edema and exudation which appeared in VAA treatment were not observed. only a few patients complained tightness, erythema and pain. In comparison with VAA, the duration of treatment with VAAD was delayed about 1-2 weeks and the effectiveness in acne therapy with VAAD was almost equal to VAA therapy, and the side effects were markedly diminished.
Acne Vulgaris* ; Administration, Oral ; Dermatitis, Allergic Contact ; Edema ; Erythema ; Humans ; Pruritus ; Sensation ; Skin ; Skin Diseases ; Tretinoin* ; Vitamin A* ; Vitamins*

Our present knowledge of impetigo contagiosa extends from its first description as a separate clinical entity by Fox in I864, and the proof of its bacterial etiology by Radcliffe-Crocker in 1881. Both staphylococci and streptococci have been discovered from the lesions, but the relative preponderance of each varies greatly, and reports are contradictory. Seventy-eight patients with impetigo contagiosa were studied bacteriologically in order to ascertain the primary etiologic agent. Also, a susceptibility test (Bauer- Kirby method) was done on the isolated organisms with 7 antibiotics which are used frequently in the clinical field. Specimens obtained from the skin lesions were cultured and organisms were isolated. They were identified by various biochemical and serological tests. A DN ase test, a carbohydrate fermentation test, and a coagulase test were done for the isolated staphylococci. A bacitracin disc method and a precipitin test(Lancefield method) were done for the isolated B-hemolytic streptococci. The results were as follows: Fifty-six cases(71.8%) were infected by staphylococcus only. Twenty cases(25.6%) were infected by a mixture of staphylococcus and p-hemo- lytic streptococcus. Only 2 cases(2.6%) were infected by B-hemolytic streptococcus alone. All 76 strains of staphylococci were identified as coagulase positive staphylococci. Among the 22 strains of B-hemolytic streptococci, 15 strains were identified as group A and remaining 7 strains were identified as group B. Coagulnse negative sta,phylococcus was not found. In the susceptibility test to 7 antibiotics, staphylococci showed susceptibility to lincomycin, erythromycin, cloxacillin, and chloramphenicol, and resistance to tetra-cycline, penicillin, and ampicillin. Streptococci showed susc.ptibility to all of the above antibiotics except tetracycline. From the results of this experiment, it was concluded that the primary etiologic agent of impetigo contagiosa was coagulase positive staphylococcus and streptococcus for the most part can be considered as a secondarily infecting agent. Coagulase negative staphylococcus apparently is not implicated as an etiologic agent of impetigo contagiosa. The results of the antibiotic susceptibility tests would seem to indicate that the use of such antibiotics as tetracycline, penicillin, and ampicillin is not indicated in the treatment of impetigo contagiosa.
Ampicillin ; Anti-Bacterial Agents ; Bacitracin ; Chloramphenicol ; Cloxacillin ; Coagulase ; Erythromycin ; Fermentation ; Humans ; Impetigo ; Lincomycin ; Penicillins ; Serologic Tests ; Skin ; Staphylococcus ; Streptococcus ; Tetracycline

No abstract available.
Carcinoma, Squamous Cell* ; Epidermolysis Bullosa*

A 50-year-old man developed 3cm sized, well-marginated, subcutaneous mass on the right upper back. Histopathologic finding showed the lipomatous tissue was replaced by a mixture of uniform spindle cells and mature fat cells that were closely associated with a mucoid matrix and a varying number of collagen fibers. The patient had been treated with excision and showed no evidence of recurrence.
Adipocytes ; Collagen ; Humans ; Lipoma* ; Middle Aged ; Recurrence