Disseminated superficial actinic porokeratosis (DSAP) has an autosomal dominant mode of inheritance with reduced penetration at young age, characterized by multiple superficial keratotic lesions surrounded by a slightly raised border. The aggrevation of the lesion by exposing UV light indicates that phenotypic expression of gene regluating DSAP is related to sun light. We observed a family of which 13 members had DSAP in 3 successive generations. They were grandrnother, two sons of her 3 offsprings, 2 grandsons and 8 granddaughters. Lesions of all cases were found on the sun exposed areas, especially, face, extremities and upper trunk but exceptionally one had a lesion on the unex posed area, abdomen below the iliac crest. The number of lesions of the individual patient were 12-116, and there appeared to be increasing number of lesions with age.
Abdomen ; Extremities ; Family Characteristics* ; Humans ; Porokeratosis* ; Solar System ; Ultraviolet Rays ; Wills

The globus symptom is a condition in which a patient, often middle aged women, complains of a lump andchocking sensation in the throat, Functional disturbance of the cricopharyngeal muscle, rendering it incapable ofrelaxing during swallowing, has long been recognized as a cause of globus symptom and dysphagia. We wanted to findout how often and to what extent distrubed relaxation of the cricopharyngeal muscle can be seen in patients withglobus symptom with routine examination and video esophagogram. The results were as follows: 1. Male : femaleratio was 1:2.4. 2. Globus symptom was most frequent in the age group between 30-39 of female. 3. Organic lesionswere seen in 43.6%(24 Pts) of globus patients. 4. Cricopharyngeal muscle was visualized in 29.1%(16Pts), esophageal diverticulum in 3.6%(2 Pts) and degenerative spondylosis in 3.6%(2 Pts). 5. Incidence of visualizationof cricopharyngeal muscle were higher in male group (50%) than female one (20.5%). 6. Cricopharyngeal muscle wasmost frequently visualized on early swallowing phase(12/16 Pts).
Deglutition ; Deglutition Disorders ; Diverticulum, Esophageal ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pharynx ; Relaxation ; Sensation ; Spondylosis

BACKGROUND: Herpes recurrences coincide with changes in the immunologic status of the patient, particularly in respect of cell mediated immunity (CMI),, and it has been represented that thymopentin(TP) induces a wide range of immunoregulatory effects. OBJECTIVE: Relapses of herpes simplex seem to depend on the relationship between the cellular immune mechanisms and the virus in its latent phase, therefore immunomodulatory therapy may represent an alternative approach. In this respect, thymopentin may have the potential to become a valuable drug for prophylactic use in patients with recurrent herpes simplex. METHODS: Patients with moderate to severe herpes simplex(a relapse rate of at least 6 times/year) were treated with subcutaneous injection of thymopentin 50mg three times weekly for 6 consecutive weeks. The study consisted of a 6-week therapy and a subsequent 1 year follow-up on average. RESULTS: Fourteen of sixteen patients with herpes simplex improved as demonstrated by a reduction in the relapse rate, shorter duration of episodes and improvement in symptoms such as itching or pain. Four patients did not experience a relapse for more than 1 year after cessation of therapy. In this study, the duration of the symptom-free period increased and the average number of relapses per year was reduced. CONCLUSION: Thymopentin is a highly effective drug, capable of positively influencing recurrent herpetic episodes and reducing the relapse rate.
Follow-Up Studies ; Herpes Simplex* ; Humans ; Immunity, Cellular ; Immunomodulation ; Injections, Subcutaneous ; Pruritus ; Recurrence ; Simplexvirus* ; Thymopentin*

BACKGROUND: Stratum corneum lipids serve as a water retainer as well as permeability barrier by forming a multi-lamellae structure in the stratum corneum. The major constituent of these lipids, ceramides, have been shown to be predominantly associated with both functions. OBJECTIVE: Exposure of human epidermis to ultraviolet(UV) irradiation leads to changes in the physiologic and biochemical features of the skin. In order to investigate the effect of UVB irradiation on the skin barrier function in hairless mice, transepidermal water loss (TEWL) and lipid composition of stratum corneum were evaluated in hairless mice. METHODS: Hairless mice were irradiated 3 times weekly for 3 weeks with suberythemal dose (0.6MED, Group I) and minimal erythemal dose(MED), Group II) of UB. The mice of Group III received high dose of UVB(3MED) on the back in a single exposure. The control was Group IV. TEWL measured by evaporimeter and lipid composition of stratum corneum appraised by high performance thin layer chromatography(HPTLC) were evaluated weekly for 3 weeks. RESULTS: 1. Each time it was measured, the values of TEWL in group I were lower than group IV, but the difference was not significant. The peak value of TEWL in group II was 8.2+/-1.56 g/cm/h on the 7th day. The increase in TEWL was markedly significant at this point(P<0.001). Although the values of TEWL on the 14th and 21th day in group E increased compared with those of the control group, the significance of the values decreased (P<0.05). 2. The peak value of TEWL in group III was 9.88+/-1.13 g/cm/h on the 2nd day, showed a markedly significant increase compared with that of the control group(P<0.001). The values of TEWL decreased to the level of the control group on the 14th day. 3. The lipid(cholesterol sulfate, ceramide and neutral lipid) and total lipid mass in group 1 were insignificantly larger than that of the group IV measured each time. On the 7th and 14th day, the amount of each three lipid and total lipid mass significantly increased (P<0.05). On the 21th day, the amount of ceramide and neutral lipid showed a significant increase(P<0.05), furthermore the total lipid mass increased pronouncedly(P<0.01) in group II. 4. The amount of the 3 kinds of lipid and total lipid mass in group III significantly increased compared with those of the control group on the 2nd day(P<0.05). After the 7th day, no significant difference of the lipid mass except neutral lipid compared with that of the control group was seen. Comparing the 2nd and 14th day, there was a significant decrease in the amount of ceramide and total lipid mass(P<0.05) CONCLUSION: These results results suggest that considerable amount of UVB irradiation given in single or repeated exposure causes the disruption of skin barrier function, but a compensatory increase of skin lipid, especially ceramide, protests it from further damage and also improves skin barrier function.
Animals ; Ceramides ; Epidermis ; Humans ; Mice ; Mice, Hairless* ; Permeability ; Skin*

This study was performed to investigate the clinical efficacy of intralesional recombinant interferon-γ (IFN-γ) in the treatments of warts, using a placebo comparison. Warts of each groups were injected with INF-γ containing 5×10⁶ IU/ml (high dose), 1×10⁶ IU/ml (low dose), or distilled water for injection as placebo, respectively, twice weekly for three weeks. The final therapeutic efficacy was determined on the fourth week after the beginning of therapy. Among the 74 patients with periungual warts, plantar warts, or warts of other sites, complete clearing of the treated warts at week four occurred in 56% of the 36 patients receiving the high dose IFN-γ compared to 30% of the 53 receiving the low dose IFN-γ and 17% of the 36 receiving the placebo. Marked improvement showing 75% or greater regression of wart lesions was noted as 89% of patients receiving the high dose INE compared with 55% receiving the low dose IFN and 50% receiving the placebo. The group of patients with warts of other sites showed the best response. The group receiving the high dose IFN experienced some adverse effects more frequently or more severely than the group receiving low dose IFN. However, the effects were relatively tolerable to the patients. Therefore, intralesional injection of the high dose IFN-γ may be more useful in treating warts than a low dose IFN-γ.
Humans ; Injections, Intralesional ; Interferon-gamma* ; Treatment Outcome ; Warts* ; Water

We report a case of familial benign chroinic pemphigus in a 47 year old man. We had tried various treatments but no effect had been noted with systemic steroids, tetracycline, cephalosporin, rifampin, dapsone, and local application with antibiotic ar..d eteroid ointment. Thus the patient was started on 50mg of etretinate(Tigason) daily and almost complete resolution of the skin lesions was noted two moths after treatment. He was maintained on 15mg of etretinate daily and follow up evaluations for six months revealed no recurrence and no exacerbation of the lesions.
Acitretin* ; Dapsone ; Etretinate* ; Follow-Up Studies ; Humans ; Middle Aged ; Moths ; Pemphigus ; Pemphigus, Benign Familial* ; Recurrence ; Rifampin ; Skin ; Steroids ; Tetracycline

A 51-year-old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 6 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy, The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Female ; Humans ; Hypertrophy ; Middle Aged ; Pigmentation

We experienced a case of generalized granuloma annular e in a 68-year-old man. Many factors have been implicated in the genesis of this disease, but in this case no etiologic factors were identified. He was treated successfully with systemic corticosteroid for about l year.
Aged ; Granuloma Annulare* ; Granuloma* ; Humans

Great difficulty may be encountered in the differentiation of basal cell carcinoma from trichoepithelioma snd, in some cases, it may even be irnpossible. Immunohistochemical methods using peanut agglutinin(PNA) which is glycoprotein of non-immune origin selectively binding to galactose-N-acetyl-galactosa-mine are increasingly used in dermatopathology to improve the diagnosis and differential diagnosis. Using PNA, anti-PNA antibody, and peroxidase antiperoxi-dase(PAP) technique, normal skin specimens, basal cell carcinomas, trichoepitheliiomas, and a variety of different skin tumors were studied, and different PNA Ibinding sites between basal cell carcinomas and trichoepitheliomas were observed. The results were as follows : l. In normal skin, except the basement membrane, epidermis and hair follicle epithelium showed a cell membrane staining of PNA, which stained weakly in the Ibssal cell layer. Sebaceous glands revealed membranous and cytoplasmic staining of PNA, but sweat ducts and duct coi1s were mostly negative. 2. 34 of 36(94.4%) basal cell carcinoma sections demonstrated peritumorous PNA-positive bands, and none of 5 trichoepithelioma sections showed peritumorous PNA-binding. 3. Peritumorous PNA-positive bands were strongly positive in solid and keratotic basal cell carcinomas, but decreased or absent in the vicinity of the ulceration or the dense inflammatory infiltration. 4. None of the other skin tumors(squamous cell carcinoms, keratoscanthoma, Bowens disesse and actinic keratosis} showed a periturnorous PNA-positive band. Therefore, we believe that the PNA staining on paraffin-embedded sections using PAP technique can be a useful probe for the differentiation of basal cell carcinoma from trichoepithelioma.
Actins ; Basement Membrane ; Carcinoma, Basal Cell* ; Cell Membrane ; Cytoplasm ; Diagnosis ; Diagnosis, Differential ; Epidermis ; Epithelium ; Glycoproteins ; Hair Follicle ; Peanut Agglutinin* ; Peroxidase ; Sebaceous Glands ; Skin ; Sweat ; Ulcer

A case of hepatocellular carcinoma (HCC) complicating with secondary biliary cirrhosis due to intrahepatic bile duct growth of the tumor is presented. The patient was 34 years-old male who had been suffered from right upper quadrant pain with intermittent fluctuating jaundice for 4 months. Left lobectomy specimen contained a single, 4 cm sized, relatively well circumscribed and partly protruding nodular HCC in the medial seqment of left lobe. It compressed the left hepatic duct, and the intra and extra-hepatic ducts were completely plugged with tumor casts (extending to the common bile duct at the operating table). Remaining hepatic parenclyma was the seat of advanced secondary biliary cirrhosis in which were abundance of HBsAg-containing hepatocytes possibily representing a HBsAg carrier status. Biliary cirrhosis in HCC is an extremely rare manifestation, reflecting the delayed adequate clinical procedure by unusual pattern of obstructive jaundice. In such a case presenting as persisting and fluctuating obstructive jaundice in HCC, an intrabile duct tumor growth should be suspected.
Male ; Humans ; Carcinoma, Hepatocellular