We report a case of a photosensitivity reaction in a 76-year-old inale induced by chlorpropamide ingestion. The patient had erythematous scaly patches on the sur. -exposed areas, A phototest revealed the decreased minimal erythemal dose(MED) to UVA(5J/cm). A photopatch test and photo-scartch test with 1% chlorpropamide ointment and 0.1% chlorpropamic!e .olution were all negative. An oral provocation test was performed, which showed a positive result with marked decrease of MED to UVA (5J/cm). After the cessation of chlorpropamide, his skin lesions were improved markedly with complete loss of photosensitivity. Macular hypopigmentations (leukcme.anoderma) appeared on the previous erythematous patchy ereas, but disappeared during the follow-up period.
Aged ; Chlorpropamide ; Eating ; Follow-Up Studies ; Humans ; Skin

No abstract available.

A 49-year-old male had erythematous to rusky red papules, indurated plaques and lichenified patches with hyperpigmentation on sun-exposed areas for 6 years. Phototest revealed the decreased rninimal erythemal dose to UVA(10J/cm. Photopatch test with 5% Trandate ointment, 5% hydrochlorthiazide ointment and vaselin. as a control were all negative. Two weeks after cessation of Trandate, an oral challenge of hydrochlorthiazide followed by phototest was perfrirmed resulting in exacerbation of skin lesions and photosensitivity with a decreased MED to UVA(10J/cm) again. After the cesation of Trandate containing hydrochlorthiazide, the skin lesions were improved with complete loss of photosensitivity. But, improvement of the infiltrated or licheified plaques were delayed. Presenile cataract previously noted in the patient seemed to be related to his longstanding intake of hydrochlorthiazide.
Cataract ; Humans ; Hyperpigmentation ; Labetalol ; Male ; Middle Aged ; Skin

We report a case of a phototoxic reaction in a 48-year-old female induced by griseofulvin ingestion. The patient hac! erythematous papules, vesicles and patches on the sun-exposed areas. Phototest revealed a decreased minimal erythemal dose to UVA (10J/cm). Photopatch tests with 1%, 5%, 10% Griseofulvin ointment and vaseline as a control and photoingestion tests with Griseofulvin (50mg b.i.d.) were all negative. After the cessation of Griseofulvin, her skin lesions were markedly improved with complete loss of photosensitivity.
Eating ; Female ; Griseofulvin ; Humans ; Middle Aged ; Petrolatum ; Skin

Erythromelalgia is a rare disorder characterized by intense hun ing pain in the distal extremities associated with erythema and increased skin temperature. The patient was a 42- year-old woman with a 5 year history of burning pain, erythema, and warmth of the skin on both hands and feet. She had been suffering from bronchiali astalima since childhood. The onset of the symptoms were temporally related to the attacks of hei bronchial asthma. Physical examination revealed mottled dusky red patches on her both ha ids and feet, and purplish acrocyanosis on the finger and toe tips. We present a case of secondary erythromelalgia associated with bronchial asthma and acrocyanosis.
Asthma* ; Burns ; Erythema ; Erythromelalgia ; Extremities ; Female ; Fingers ; Foot ; Hand ; Humans ; Physical Examination ; Skin ; Skin Temperature ; Toes

We report two cases of Darier's disease improved with Etretmate in the 44-year-old father and his 18-year-old son. Clinically, multiple dirty brownish, verrucous, discrete or confluent papules and plaques were noted on their back, abdomen, and face. Histopathologically, both of them demonstrated hyperkeratosis, suprabasal acantholysis, acantholytic cells in the lacunae, corpsronds, grains, and dyskeratotic cells. Oral Etretinate 30mg daily was given in both cases with remakable improvement 3 weeks after treatment. Six months later, they showed almost total clearin, of their skin lesions. No specific adverse effect was noted. There has been no evidence of recurrence for 6 months follow up period.
Abdomen ; Acantholysis ; Acitretin* ; Adolescent ; Adult ; Edible Grain ; Darier Disease* ; Etretinate* ; Fathers ; Follow-Up Studies ; Humans ; Recurrence ; Skin

A 29-year-old woman had multiple, umbilicated papules on her fingers for 2 months. Skin biopsy specimen showed transepidermal perforation filled with plug of cellular debris, degenerated collagen and mucinous material. In the dermis, there were necrobiosis and peripheral palisading of mononuclear cells. Special stainings including masson's trichrome, alcian blue, acid orcein, and PAS showed necrobiotic collagen fibers and acid mucopolysaccharides on the necrobiotic zone and trasepidermal elimination canal. Topical application of 0.05% Clobetasol-17-propionate ointment improved her lesion.
Adult ; Alcian Blue ; Biopsy ; Collagen ; Dermis ; Female ; Fingers ; Glycosaminoglycans ; Granuloma Annulare* ; Granuloma* ; Humans ; Mucins ; Necrobiotic Disorders ; Skin

New Cervicography, a Pap smear adjunct test, is an innovative cervical cancer surveillance system. It is a relatively new technique in which a photograph of the cervix is obtained without the aid of colposcope after application of 5% acetic acid. The purpose of this study was to investigate the role of New Cervicography in diagnosis of cervical cancer. Pap smear and cervicogram data were obtained from 143 patients who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from September 1996 to May 1997. Histologic specimens were obtained from patients in whom abnormalities were detected by either Pap smear or cervicogram. Specimens were taken either by colposcopically directed biopsy or large loop excision af the transformation zone. (continue)
Acetic Acid ; Biopsy ; Cervix Uteri ; Chungcheongnam-do ; Colposcopes ; Diagnosis* ; Female ; Gynecology ; Humans ; Mass Screening ; Obstetrics ; Uterine Cervical Neoplasms*

Our aim was to identify histologic changes in cervical carcinoma tumor cells due to chemotherapy,by electron microscopic examination. Cisplatin and 5-fluorouracil were used between March 1, 1994 and February 28, 1995 on a total of 16 patients. The treatment schedule consisted of 75 mg/m2 cisplatin via iv with hyperhydration on Day 1, in combination with 1000 mg/m2 5-fluorouracil via continuous iv on Day 1 to 5. The treatment was repeated every 4 weeks with a maxinum of 3 courses. Ultrastructurally, chemotherapy induced apoptosis,indicated by condensation of nucleus and cytoplasm,fragmentation of nuclei, and apoptotic bodies. Due to repeat chemotherapy, increased levels of desmosomes were noted and parts of tumor nests were replaced by mature squamous cells. Tumor nests were reduced in size, mitochondria exhibited swelling, the endoplasmic reticulum was dilated, and infiltration of inflammatory cells increased after chemotherapy. These results suggest that chemotherapy induces apoptosis and injury to the cytoplasm and nuclei of tumor cells. However, the exact selection mechanism of the biochemical pathway of cell death is not fuUy understood. Further study of the molecular biologic actions of cell death after chemotherapy is warranted.
Apoptosis ; Appointments and Schedules ; Cell Death ; Cisplatin ; Cytoplasm ; Desmosomes ; Drug Therapy* ; Endoplasmic Reticulum ; Fluorouracil ; Humans ; Mitochondrial Size

BACKGROUND: Solar ultraviolet (UV) radiation induces sunburn, immune suppression, and various pigmentary disorders. Sunscreens are widely used to protect those untoward effects by UV but there are reports of phototoxicity or stability problems of sunscreens after exposure to UV. OBJECTIVE: We tried to compare sunscreens with different photostability in terms of their protection against various biologic responses like sunburn, immune suppression or pigmentation. METHODS: Three different sunscreens with SPF around 30 were used; Sunscreen-A (Sc-A) was photochemically inert, sunscreen-B (Sc-B) showed intermediate level of photostability, and sunscreen-C (Sc-C) was the least stable. To observe their in vivo effects, we measured sunscreen-protection against sunburn by back-skin swelling and sunburn cell formation, against immune suppression measured by depletion of Langerhans cells, local and systemic suppression of contact hypersensitivity (CHS), and against pigmentation by irradiation with mixed light source with UVA and UVB lamps that mimic solar UV spectrum. RESULTS: Back skin swellings by 5 kJ/m2 of UVB were protected well by sunscreens, but protection of Sc-C against 50 kJ/m2 of UVB was worse than Sc-A or Sc-B. Sunburn cells were increased significantly in mice irradiated with 5 kJ/m2 of UVB and it was protected by sunscreens, and the effect of photostability was minimal. Depletion of epidermal Langerhans cells by 5 kJ/m2 of UVB was protected completely by sunscreens. Local suppression of CHS by 5 kJ/m2 of UVB was protected by sunscreens, and Sc-A had better protection. But, in the experiment with 50 kJ/m2 of UVB, the protective efficacy was reversed; Sc-A showed worse protection. Systemic suppression of CHS by 10 kJ/m2 of UVB was protected well by sunscreens, and Sc-A had better protection and Sc-C had worse protection. In the experiment irradiated with 100 kJ/m2 of UVB, the protection of sunscreens was decreased, and Sc-B showed better protection, whereas Sc-C showed worse protection. In UV-induced pigmentation, all three sunscreens showed significant protection both by L* value and individual topographic angle (ITA) with the best protection by Sc-A and the worst protection by Sc-B. CONCLUSION: These data showed sunscreens can protect various in vivo responses and photostability of sunscreens played important roles particularly in the back-skin swelling and systemic suppression of CHS by high dose of UVB.
Animals ; Dermatitis, Contact ; Dermatitis, Phototoxic ; Langerhans Cells ; Mice ; Pigmentation ; Skin ; Sunburn ; Sunscreening Agents*