BACKGROUND: Trichloroacetic acid chemexfoliation has gained popularity and is widely used cosmetically. The depth of the wound caused by the various dilutions of TCA is paramount to the therapeutic efficacy. Therfore rational use of TCA chemexfoliation requires a clear understanding of the expected depth of destruction caused by a given dilution. OBJECTIVE: The purpose of this stuely is to quantitate the wound deptlw produced by varying concentrations of TCA. We have stirdied takie effects of consecutive applications, occlusion and tretinoin pretreatment on wound depth in TCA clinimical peeling. METHODS: Various concentrations of TCA and distilled water were aplied to two pairs of test sites of a guinea pigs back in a uniform fashion with cotton-tip applicators and then we have measured the mean depth of epidermal necrtsis mieroscopically by using Visual Imagc Data Analysis System. RESULTS: 1. Depths of wounds createdly threre consecutive applications of 20, 35% and 50% TCA were deeper than those of wounds by a single application of TCA. 2. Depths of wounds created by application of TCA with the occlusive method were deeper than those of the open method. Therefore the effect of occlusion is to enhance the penetration of TCA. 3. Depths of wounds pretreatwi with 0.05 % tretinoin daily for 7 days are deeper than those of the control in 50% TCA chemical peeling. Therefore the effect of 0.05% retinoin pretreatment is to enhance the penetration of TCA. CONCLUSION: This study showed that consecutive applications, oeclusion and tretinoin pretreatment in TCA chemexfoliation enhance the peietration of TCA.
Animals ; Chemexfoliation* ; Guinea Pigs ; Statistics as Topic ; Tretinoin ; Trichloroacetic Acid* ; Water ; Wounds and Injuries

We report a typical case of Hunters syndrr me in a 9 year old boy, who presented with firm skin colored nodules that coalesce to form a reticular pattern on a symmetrical rea between the angles of the scapulas, which is regarded as the pathognornonic cutaneous rnarker, for Hunters syndrome. He also showed growth retardation, clear corneas, hepatomegaly, attertich deficit and mild mental deterioration. The skin biopsy specimen taken frorn a typical nodule shows loosely arranged collagen fibers with massive mucinous material which stains positively with aliar blue at both pH 2.5 and 0.5, metachromatic granules within fibroblast stained with toluidine blue.
Biopsy ; Child ; Collagen ; Coloring Agents ; Cornea ; Fibroblasts ; Hepatomegaly ; Humans ; Hydrogen-Ion Concentration ; Male ; Mucins ; Mucopolysaccharidosis II* ; Scapula ; Skin* ; Tolonium Chloride

Basal cell carcinoma(BCC) is the most common human malignancy. It involves the face and neck most frequently. However, BCC can very rarely occur on external glenitalia such as scrotum and vulva. We report two cases of serotal and vulvar BCCs in a 67 year old imale and a 43 year old female. He suffered from well defineril erythematous to violet colored plaque with central erosion on the left scrotum for 5 years. She had a brown black colored plaque on the left vulva for 8 years. They did not show any metastatic foci from g!rimary cutaneous lesions, and underwent surgical excision and curettage respectively.
Adult ; Aged ; Carcinoma, Basal Cell* ; Curettage ; Female* ; Genitalia* ; Humans ; Male* ; Neck ; Scrotum ; Viola ; Vulva

No abstract available.
Humans ; Pityriasis* ; Tinea Versicolor* ; Treatment Outcome*

Letterer-Siwe disease is one of Langerhans cell histiocytosis, with Hand-Schuller-Christian disease and eosinophilic granuloma, characterized by proliferation of Langevha is cell. The clinical course of Letterer-Siwe disease is acute fulmunant of casionally fatal, involving skin and many other internal organs, such as the lymph node, liver, spleen, ung and bone. We present 3 cases of Letterer-Siwe disease with characteristic cutaneous findings and revealed Langerhans granules by imrriunohistochemical stain and electronmicrc scopic examination. All patients died in spite of combined chernotherapy.
Eosinophilic Granuloma ; Histiocytosis, Langerhans-Cell ; Humans ; Liver ; Lymph Nodes ; Skin ; Spleen

A 51-year-old female developed a distinctive perioral rash, conisting of discrete or confluent erythematous papules for one and a half years. Histopathologic examiriation revealed upper dermal granulomas admixed with lymphoytes. Pieces of hair shaft were staincd peri-dish by AFB in the center of granuloma, which might play a role in the formation of the granuloma She also had used corticosteroid ointment intermittently duririg this time. There were no associated systemic abnormalities. The lesions resolved after two month treatment with oral corticosteroid and tetrac cline.
Dermatitis, Perioral* ; Exanthema ; Female ; Granuloma ; Hair ; Humans ; Middle Aged

Acrodermatitis continua (AC) of Hallopeau is one of the chronic relapsing pustular eruptions of the extremities. Generalization of AC sometimes occurred spontaneously, or induced by withdrawl of drugs such as corticosteroid, or pregnancy. We report a case of generalized AC in a 50-year-old woman who has been treated intermittently with various medications other than systemic retinoids. The histopathologic findings of the pustules on the fingertips and trunk revealed subcomeal abscesses and/or spongiform pustules. The patient was treated with etretinate in the dose of 50mg/day, and UVB exposure. Two months after treatment, skin lesions were markedly improved.
Abscess ; Acitretin ; Acrodermatitis* ; Etretinate ; Extremities ; Female ; Generalization (Psychology) ; Humans ; Middle Aged ; Pregnancy ; Retinoids ; Skin

Vaginitis is one of the most common disease in gynecologic field in recent days. About 90% of these patients suffer from the infection of the vagina caused by Gardnerella vaginalis, Candida, or Trichomonas, either alone or in combination. For the effective diagnosis and management, it is essential to get an accurate identification of the causative agent. Applying simple and easy diagnostic methods such as pH of vaginal discharge, amine test and microscopic examination of wet mount preparation of normal saline and 10% KOH to 549 cases of randomly selected patients visiting Out-patient Department of Obstetrics and Gynecology of Yeungnam University Hospital through May 1st to Sept. 31st, 1987, the following results were obtained. 1. In the Gardnerella vaginitis vaginal pH was more than 5.0 in 81.0% of total cases, positive amine test in 62.8%, decreased lactobacilli in 77.4% & decreased WBC counts in 70.1%, In the Trichomonas vaginitis vaginal pH more than 5.0 was noted in 93.3% of the cases, negative amine test in 90%, decreased showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 90%, decreased lactobacilli in 90% & increased WBC counts in 93.3%, whereas Candida vaginitis and normal groups showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 100%, normal distribution of lactobacilli in 89.7%, normal WBC counts in 72.4%. 2. The accuracy rates of physical diagnosis by wet mount preparation of normal saline and 10% KOH revealed 26.3%, 47.5%, 70.0% in Gardnerella vaginitis, Candida vaginitis, and Trichomonas vaginitis, respectively. The vaginal pH and amine test showed 83.2% of accuracy rate in Candida vaginitis group, 60.6% in Gardnerella vaginitis group and 83.3% in Trichomonas vaginitis group. 3. In 23 cases of Gardnerella vaginitis showing vaginal pH of 3.0 or 4.0 and positive amine test, the clue cells were observed in 10% or less in 12 cases, 30% in 5 cases, 50% in 4 cases and 50% or more in 2 cases. In summary vaginal pH and amine test could be useful in screening and differentiating the different types of infectious vaginitis. Furthermore by adding microscopic examination of normal saline and 10% KOH wet mount preparation to them, they not only could obtain higher diagnostic accuracy rate but would be more valuable in selecting the patients requiring cultures to confirm the diagnoses.
Candida ; Diagnosis ; Gardnerella ; Gardnerella vaginalis ; Gynecology ; Humans ; Hydrogen-Ion Concentration* ; Mass Screening ; Obstetrics ; Outpatients ; Trichomonas ; Trichomonas Vaginitis ; Vagina ; Vaginal Discharge* ; Vaginitis*

We report a case of Mycobacterium(M.) fortuitum infection in a 65-year-old female who presented with erythematous to purplish colored tender nodules and plaques with curst and purulent discharge on both upper and lower extremities along the sites of acupuncture. The culture of surgically excised specimen in 3% Ogawa media yielded slightly yellowish colored colonies within 2 days. Several tests for identification of the species were performed and growth on 5% NaCl, negative niacin test, positive results in nitrate reduction, catalase, urease and iron uptake tests were noted. Excision of the lesions followed by administration of minocycline and ciprofloxacin showed no sign of relapse to data a year after treatment.
Acupuncture* ; Aged ; Catalase ; Ciprofloxacin ; Female ; Humans ; Iron ; Lower Extremity ; Minocycline ; Mycobacterium fortuitum* ; Mycobacterium* ; Niacin ; Recurrence ; Urease

BACKGROUND: Previous studies have suggested that pityrosporurr yeasts, normal resident flora of skin, may be important in the pathogenesis of dandruff seborrheic dermatitis and confluent and reticulated papillomatosis. OBJECTIVE: We investigated the incidence and distribution of pityiosorum yeasts on clinically normal skin as a more reasonable method for providing the basic data or proving the relationship of pityrosporum and pathogenesi, of the diseases. MEHTODS: A total of 350 subjects were studied. Skin scrapings were stained with 20% Parker ink-KOH(P-KOH) solution. The numbers of pityrosporum spores and hyphe per high power field( x 400) were counted and designated according to a new grading method using bacterial index(BI) of lepra bacilli. RESULTS: The incidence rates of pityrosporum orbiculare(p. orbiculare) and pityrosporum ovale(p. ovale) were 60-70% and 20-50% of subjects respectively on seborrheic area., The incidence of p. orbicilare was highter than that of p. ovale on all examined sites except for the iterior scalp. And pityrosporal hyphae was present on anteriand posterior scalp and earwax in 24-25% of subjects respectively. The incidence of pityrosporum was higher in summer than other seasons The incidence rate of p. orbiculare and hyphae in the group aged below 9 (except neonates) and above 60, were lower than that of other age groups. The inciderice rates and distribution of grades of pityrosporum of neonates were lower than those of older subjects. CONCLUSION: The results of this study showed that the incidence and distribution of pityrosporum spores were similar to previoureports and hyphal forms were found 25% approximately on clinically normal skin of the scalp and carwax. The significance of the presenet of pityosporal hyphae and the relationship between normal skin and pityrosporal hyphae are to be firther elucidated.
Dandruff ; Dermatitis, Seborrheic ; Humans ; Hyphae ; Incidence* ; Infant, Newborn ; Malassezia ; Papilloma ; Scalp ; Seasons ; Skin* ; Spores ; Yeasts