Anti-T cell monoclonal antibodies(OKT series. OKT4a, OKTSA, OKT)1) immunoperoxidase technique study for the presence of T cells in cutaneous lesions from four patients with erythema multiforme showed that most dermal and epidermal lymphoid cells were reactive with monoclonal antibodies to anti-pan T cell (l3KT11) in this semiquantitative assay. In the dermis most of the perivascular lirmphoid infiltrates were reactive with anti-helper/inducer T cell antibody, but in the epidermis and in the derrnopidermal interface the predominant cells were identified as suppressor/cytotoxic T cells. The histologic and immunopathologic changes in erythema multiforme appear to be due in part to cellular immune rnechanisms with the lyrnphocyte as the predominant effector cell. But complex interplays with other humoral immune mechanisms might be in work for the development of erythema multiforme.
Antibodies, Monoclonal ; Dermatology* ; Dermis ; Epidermis ; Erythema Multiforme ; Humans ; Immunoenzyme Techniques ; Lymphocytes ; T-Lymphocytes

Mycobacteriosis cutis is largely classified to localized forms and exanthematous forms and it is subdivded into five diseases in detail, each. They are 1) primary tuberculous complex, 2) lupus vulgaris, 3) tuberculous verrucosa cutis 4) scrofulo derma, and 5) tuberculosis cutis orificialis in localized ferms and 1) tuberculous miliaris disseminata, 2) lupus miliaris disserninaia faciei, 3) papulonecrotic tuberculid, 4) lichen scrofulosorom and 5) ervthema induratum in exanthematous forms.Rich(1944) insisted on that, the pathogenesis of cutaneous tuberuculosis was essen tially the sarne as that for tuberculosis in general. He said that aII forms of cutaneous tuberculosis were produced by the local action of the bacilus of tuberculosis. In the formerly termed true tuberculosis such as lupus vulgaris, the microorganisrns were found in varing numbers in the lesions, and animal inoculations of tissue were successful, In other forms represented by the tuberculids, the bacillus of tuberculosis was found only in the earilest stages before the true clinical and histological picture had developed, Its short lived existence in this forms was explained by the allergic statc of the tissues and this fact exnlained the failure to find the microorganisms in the lesions, or reproduced the affection by inoculations in animals, in cases sufficiently developed to be recognizable clinically and histologically. The other generally accepted view is that the mycobacteriosis cutis, especially the types in the category of tuberculids are caused by the hematogenous dissemination of tubercle bacilli from a focus, often extrapulmonary in location, into the skin, where they are rapidly destoryed. spiet and Roeckie(1960) agreed with above menitioned plausible theories with the background of their hypothesis, that was the skin was hyperegic, And Miescher(1951) also insisted that, skin had a decreased immunologic resistance. But according to Flegel(1957), if the skin was in a state of hyperegic reaction, the focus from which the dissemination was taking place was also should be in a hyperegic state and vice versa should be right, And moreover, Suizberger(1940) declared that whenever microorganisms or their products were being overcome or neutralized by local lmmunologic reactions, tubercles or tubercles or tuberculoid structures had a tendency to appear. So the theories of different immunologic state between the skin and focus were discarded. After that many authors proposed three factors against a tuberculous etiology of tuberculids. First, inoculation of tissue from lesion into guinea pigs and culturing of such tissue have given no evidence for tuberculosis. Second, active tuberculosis occurs no greater frequency in patients with tuberculids than in the general population. Third, tuberculids does not respond to antituberculous treatment but responds to the adminiatration of corticosteroids. According to Eberhartinger(1963), Schneider and Undeutsch(1965), in erytbema induraturn the primary event is a vasculitis of subcutaneous arteries and veins. And any fat necrosis following vascular damage can develop a tubereuloid appea- rance. Lever(1967) declared with self confidence that it was a relic of the times- when a tuberculoid histology was tantamount to tuberculosis. In this condition we decided to clarify that whether the mycobacteriosis cutis, especially the disease in the category of tuberculids, could be originated from mycobacteria tuberculosis in fact or not. Eleven patients, whose clinical diagnosis were skin tuberculosis or very similar to those diseases such as erythema. nodosum, were biopsied by 5mm puncher after 2% procaine injection on their two of skin lesions, the early one for the culture of tubercle bacilli and the oId one for histopathological study, on the O.P.D. of dermatologic department in Severance Hospital. Those biopsied material of early lesion was digested with proper amount of 4% NaOH and fragmented in tissue grinder about 10 minutes. After that, it was centrifuged in rotating speed of 3,500 r.p.m. for 30minutes, and neutralized by 8% HCl after adding phenol red drop by drop. Again it was centrifuged by same as previous method and its supernatant was discarded. The remnants of precipitin was inoculated on Ogawa's nutrient tuberculous media in incubator at 37C. Finally the acid-fast tubercle bacilli have been grown on the Ogawa's media three months after its first inoculation. The inoculation material was biopsied from the patient of eighteen year-old girl, whose clinical and histopathological diagnosis was erythema induratum. From the result of this study, we got the strong confidence that in spite of many authors powerful countertheories and the extremely poor harvesting of its culture, the erythema induratum can be or in evidently caused from mycobacterium tuberculosis. It may be early days yet to say that erythema induratum is originated fromtubercle bacilli but it is considered to be a truth in Korea, with the result of this study.
Adrenal Cortex Hormones ; Animals ; Arteries ; Bacillus ; Diagnosis ; Erythema ; Erythema Induratum ; Fat Necrosis ; Female ; Guinea Pigs ; Humans ; Incubators ; Korea ; Lichens ; Lupus Vulgaris ; Mycobacterium tuberculosis ; Phenolsulfonphthalein ; Procaine ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous* ; Vasculitis ; Veins

On the basis of stastistical awlysis trend of increase in syphilis patients in Korea closely resembles that reported in other countries. Among these patients, it should be noticed that thy were highly infectious, showing early latent syphilis. Nevertheless, the available diagnstic test for syphilis has only been limited to the Non-treponemal antigen test. Moreover not only schedules employing in the treatment f disease have been different among physicians but the follow up test for each patient bas been quite impossible. In these respects, the author strongly suggests that the effective measures for the prevention and treatment of syphilis will be required as a national policy.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Korea* ; Syphilis* ; Syphilis, Latent

Xeroderma pigmentosum is characterized by sunlight sensitivit.y, autosomal recessive inheritance, and multiple cutaneous malignancies, usually basal and squamous cell carcinomas. In this work the effects of bleomycin and topical 5-fluorouracil on basal and squamous cell careinomas appearing in the patient of xeroderma pigmentosum were studied and followed up for two years. The material was a 50 year old female patient of xeroderma pigmentosum associated with basal and squamous cell carrinomas occuring in the exposed area, and its mixed tumor in the nose for thirty years. Duringfirst admission blecmycin was given intravenously in a dosage of 15 mg every other day or twice a week for basal cell carcinomas in the exposed area and mixed tumor in the nose. The total amount of bleomycin given was 315 mg. A year later another squamous cell carcinomas developed on the exposed area. She was treated with topical application of 5% 5-fluorouracil cream daily for 40 days during second admission. The results obtained are summarized as follows: l. The effect of bleomycin is more effective in the squamous cell carcinoma than in the basal cell carcinoma which recurred after 2 years. 2. Topical therapy of 5% 5-fluorouracil cream appeared almost complete effectiveness to the squamous cell carcinoma.
Bleomycin ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Female ; Fluorouracil ; Humans ; Ichthyosis* ; Middle Aged ; Nose ; Skin Neoplasms* ; Skin* ; Sunlight ; Wills ; Xeroderma Pigmentosum*

One of the most interesting subjects in the field of dermatology has become the clarifying of the action mechanism of various drugs in promoting skin permeability in regard to their usefulness or harmfulness to various skin diseases. Although dimethyl sulfoxide (DMSO) detergents and propylene glycol were well known as having a promoting effect on the skin permeability, but the exact action mechanism of them was still unknown because of difficulty in methodology. So an attempt to clarify the action mechanism and find out the differences in the mode of action between them have been made by using frog skin, which has been used in research for the 'membrane transport', during past but having complex structures i.e. soley as 'skin' in this study was done. Abdominal skin was removed from frogs, Rana nigromaculata, captured on the area of Kyung Ki Do. In a series of experimental procedures about effect of experimental agents, short circuit current (SCC) as an estimate of net flux of sodium transport and potential difference (PD) was measured by the method of Ussing and Zerahn(1951). And changes of SCC and PD was observed during treatment with bathing mediums which contained agents and maintained iso-osmorality by varying amount of sodium chloride. These were compared including the effect of concentration of each experimental agent. The experimental agents used were DMSO and various detergent, i.e., sodium lauryl sulphate(SLS): anionic detergent, benzalkonium chloride (BAC): cationic detergents, and 'Tween-80: nonionic detergents. Results obtained are summarized on the followings. 1. The promoting effect of the sodium lauryl sulphate on the active sodium transport was reached to maximum within 10 to 20 min and was present until 40 min. after bathing with it, and thereafter, sodium transport was inhibited irreversibly at the both sides of the frog skin. And the maximal promoting effect of the SLS induced by increasing concentration had relationship in such a way on the saturation curve. 2. The active sodium transport was always increased on the inside of the frog skin after bathing with benzalkonium chloride (BAC) and in spite of changing of bathing medium with Ringer's solution, the active sodium transport was steadiIy increased even beyond the effect of BAC except temporally decreasing just after the bathing with Riger's solution. But the frog skin died within 20 min. at the outside after bathing with BAC. 3. Tween-80 brought about reversible reaction increasing the active sodium transport across the frog skin at the inside after bathing. And it seemed to be parallel to the degree of tle coneentration of it. 4. The effect of dimethyl sulfoxide (DMSO) on the active sodium transport across the frog skin was altered seasonaly, i.e., promoting sodium transport during the summer months hut inhibiting it during the winter months. So it was suggested that the action of DMSO on the sodium transport depends on the metabolic rates of the frog skin and the action differed from that of ADH hormone which promotes the sodium transports only in winter months. Also the effect of the DMSO differed from various detergents in view of seasonal variation and reversibility of the action of it. From the above resu]ts, this experimental method should be used more preferably using isolated frog skin in the research for clarifying the action mechanisms of the various other drugs in skin permeability.
Baths ; Benzalkonium Compounds ; Dermatology ; Detergents ; Dimethyl Sulfoxide ; Permeability* ; Propylene Glycol ; Ranidae ; Seasons ; Skin Diseases ; Skin* ; Sodium ; Sodium Chloride

A case of malignant melanoma developed from giant congenital pigmented nevus in a seven year old girl was reported. Since the identification of benign juvenile melanoma, the distinct rarity of true cutaneous malignant melanoma in infants and children has become generally recognized. In giant congenital pigmented nevus, the malignant melanoma as a rule arises deep in the dermis. In this case, the histopathologic finding shows no junctional activity in epidermodermal juction other than ordinary nevocellular nevi, but some nevus cell nests and mild inflammatary cell infiltration in the upper dermis. And in the deep dermis, well marginated but not encapsuIated huge tumor mass, in which variable sized, pleomorphic, several vigorous mitotic figures in predominantly cuboidal cells and bizarre giant cells, which was thought to be developed from giant congenital pigmented nevus. The few recorded cases of fatal cutaneous malignant melanoma in early life are of two types: those arising in giant congenital pigmented nevi and ordinary small nevi, de novo including small nevus. The former account for between 22% and 40% of the total. This case is one of the reported 20 cases in the world.
Child ; Dermis ; Female ; Giant Cells ; Humans ; Infant ; Melanoma* ; Nevus ; Nevus, Pigmented*

Dermatitis Herpetiformis rarely in childhood, and certain features of the disease in children differ from its manifestations in adults. Juvenile dermatitis herpetiformis appears not to be the same disease as the typical dermatitis herpetiformis of adults. Juvenile dermatitis herpetiformis has been described as a predomimantly bullous disease, but rarely papulovesicular eruptions. This bullous eruption in children must be considered in the several entities such as bullous pemphigoid and erythema multiforme. Juvenile bullous dermatitis herpetiformis has not responded routinely to sulfapyridine and sulfone therapy. A 15-month-old child whose skin lesions fulfilled clinical, histologic, and therapeutic criteria for Juvenile dermatitis hepetiformis is reported. The skin lesions showed bullous eruptions and also complained of severe itching sensation different from bullous Juvenile dermatitis herpetiformis.
Adult ; Child ; Dermatitis Herpetiformis* ; Dermatitis* ; Erythema Multiforme ; Humans ; Infant ; Pemphigoid, Bullous ; Pruritus ; Sensation ; Skin ; Sulfapyridine

The clinical findings in the Vogt-Koyanagi-Harada syndrome ae reviewed and eight cases reported emphasizing the cutaneaus changes. The syndrome consists of symptoms of poliosis, vitiligo, alopecia, meningeal irritation sign, nontraumatic uveitis, and dysacousia. Meningeal or ocular symptons usually appear first, but in some patients thc cutanious changes have been observed beforc the uveitis. The etiology rernains unsettied, but an allergic mechanism or a virus infection is favaveci by most observers. Early diagnosis is important because ocular mobidity can be reduced significantly in some patients if treated in the early stages. During the course of treatment of our patients, corticosteroid is appeared to be the most effective drug for this uncertain etiologic syndrome and this fact may eventually support. the theory nf autoimmue mechanisn. The daily does of corticosteroid is prednisolone 60mg and the duration of administration is from 15 days to 2 months, after that the dose is graclually decreased in relation with the degree of symptoms. The ophthalrnologic symptoms were markedly improved 10 days after the administvation of prednisolonc. The purpose of this report is to emphasize the cutaneous findings in this syndrome, to point out that the cutaneous manifestations may lead to establishing tne diagnosis and on the basis of that, those patients can be received prompt, suitable treatment to avoid the grave ocular morbidity.
Alopecia ; Diagnosis ; Dronabinol ; Early Diagnosis ; Humans ; Prednisolone ; Uveitis ; Uveomeningoencephalitic Syndrome ; Vitiligo

It has been well known for a long time that Rhus species are belonged botanically to same family called family Anacardacea and their allergenic components are identical because it contains 3-pentadecyl catechol. However, Mason (1954) and some investigators suggest the possibility that some individuals may be sensitive to a component of the oleoresin other than 3-pentadecyl catechol. By this suggestion, author performed the patch test on 138 individuals with 4 species of Korean Rhus tree (Rhus verniciflua, Rhus trichocarpa, Rhus javanica, and Rhus sylvestris.) and observed the incidence of latent sensitivity to dry leaves of Rhus trees and urushiol, The patch test results on sensitivity to Rhus verniciflua, Rhus trichocarpa, Rhus javanica, and Rhus sylvestris showed 35.50%, 27.53%, 21.01%. 28. 26%, and 29. 71% respectively and these results could make the suggestion that cross sensitivity between each Rhus trees are few and a certain specific antigenic component may be contained in every Rhus tree leaves. On animal experiment concerning the basic study for the extraction of Rhus tree antigen, author could easily sensitize the guinea pig with urushiol but couldn't challenge these animal with methanol aceton extract of Rhus leaves. From these findings, author proposed that Korean Rhus trees are different immunologically to poison ivy tree antigen and a certain specificities of antigeniciy contain in each Korean Rhus. But this postulation will need further experimental study as multiple step fractionation with Rhus tree.
Animal Experimentation ; Animals ; Guinea Pigs ; Humans ; Incidence ; Methanol ; Patch Tests ; Research Personnel ; Rhus* ; Toxicodendron ; Trees*

In 1933 Shope described an infectious papilloma of wild cattontail rabbits. Shope rabbit papilloma is a virus-induced epidermal neopIasm indigenous to western cottontail rabbits and readily transmissible to domestic rabbits by inocuiation with an cell-free extract of wild cottontail papilloma. Shope papilloma induced in the domestic rabbits may spoataneously, remain benign, or progress to carcinoma. Kidd et al. (1936) noted that the regression is not correlated with the titer of virus neutralizing antibody. The possibility that papilloma regression is brought about by a mechanism anaIogous to that operating in allograft rejection was suggested by kidd et al. (1938) with the view of the histological resemblance between papilloma regression and rejection of allografted tissue. That regression is mediated by an immune mechanism is strongly indicated by the findings of Evans et al.(1962) that the proportion of rabbits showing regression is substantially increased by vaccination of rabbits with their own papilloma tissue or with papilloma tissue from another rabbits. McMichael (1967) demonstrated that suppression of regression was achieved by use of large doses of corticosteroid. The effect of 5-fluorouracil on human warts was mentioned as being effective by Goldman et al. (1963). In Korea resinous extract from Paulownia coreana has long been used empirically in the treatment of human warts. In this investigation effects of dexamethasone administration on the development and the spontaneous regression of Shope papillomas in domestic rabbits were studied. At the same time, observations were made to evaluate the comparative effectiveness of topical application of 5% 5-fluorouracil ointment and resinous extract from Paulownia coreana on Shope papilloma in the domestic rabbit. The results are summarized as follows: l. Administration of dexamethasone significantly reduced the spontaneous regression of Shope papillomas in domestic rabbits by 12 weeks after virus inoculation. 2. Topical application of 5% 5-fluorouracil ointment on Shope papillomas cured the tumors by 4 weeks of drug application. However, similar treament with resinous extract from Paulownia coreana was without any demonstrable effects. 3. Marked losses of body weights became manifest in dexamethasone treated rabbits. 4. Reinoculation of Shope papilloma virus into 2 rabbits whose papillomas had regressed 3 months ago failed to produce papillomas.
Allografts ; Antibodies, Neutralizing ; Body Weight ; Cottontail rabbit papillomavirus ; Dexamethasone* ; Fluorouracil ; Humans ; Korea ; Papilloma* ; Rabbits ; Tumor Virus Infections ; Vaccination ; Warts