Calcipotriol, a synthetic analogue of calcitriol(1,25-dihydroxyvitamin D) is as active as calcitriol in inducing cell differentiation and inhibiting cell pralifiration but at least 100 times less active than calcitriol in its effect on calcium metabolism. We report a case of psoriasis in a 28 year old male who was treated with calcipotriol ointment on the right forearm. The therapeutic effect of calcinoipotriol ointment was compared with desoxymethason, cream applied on the left forearm. Both topical agents reduced equally the degrees of scale, erythema and thickness of the lesions. We observed that the calcipotriol ointment was effective in the treatment of psoriasis n this case.
Adult ; Calcitriol ; Calcium ; Cell Differentiation ; Erythema ; Forearm ; Humans ; Male ; Metabolism ; Psoriasis*

BACKGROUND: Although treament with PUVA or etretinate is effective for psoriasis, both treatment regimens have limitation because of the risk of long-term toxicity. OBJECTIVE: The present study was performed to compare the clinical effects of PUVA and retinoid-PUVA. METHODS: Twenty five chronic plaque psoriasis patients with more than 20% involvement of the skin suface were included in this study. Sixteen patiens were treated with the PUVA therapy and nine patients were treated with retinoid-PUVA. RESULTS: the number of phototherapy and cumulative UVA doses of retinoid-PUVA were significantly smaller than those of PUVA therapy. CONCLUSION: Combining PUVA with etretinate in the tretment of psoriasis may lead to lowering of total number of PUVA treatments and the cumulative dosage and it may be possible to shorten the duration of using etretinate.
Acitretin ; Etretinate ; Humans ; Phototherapy ; Psoriasis* ; PUVA Therapy ; Skin

Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

BACKGROUND: Topical vitamine D analogues have been reported to bean effective treatment in patients with psoriasis. Calcipotriol, a new vitamin D analogue, is effect ve and at least 100 times less calcemic than calcitriol. OBJECTIVE: Our purpose was to study the clinical efficacy, safety and tolerability of calcipotriol ointment in the treatment of psoriasis. METHODS: Twenty five patients with chronic poriasis were treated with calcipotriol ointment(50pg/g) twice daily. Efficacy as meaaured by the clinical degree of erythcimor, scale and thickness of the lesions, and safety were assessecl every 2 weeks. RESULTS: The total score of erythema, scale and thickness of the lesions decreased in 6 weeks from 8.52+0.76 to 3.80+1.7 with calcipotriol. Some patients developed mild and transient local side effects. The laboratory tests including serum calcium remained unchanged. CONCLUSION: Topical applicalion of calcipotriol ointment for 6 week was found to bean effective and safe treatment of psoriasis vulgaris.
Calcitriol ; Calcium ; Erythema ; Humans ; Psoriasis* ; Vitamin D ; Vitamins

BACKGROUND: Topical vitamine D analogues have been reported to bean effective treatment in patients with psoriasis. Calcipotriol, a new vitamin D analogue, is effect ve and at least 100 times less calcemic than calcitriol. OBJECTIVE: Our purpose was to study the clinical efficacy, safety and tolerability of calcipotriol ointment in the treatment of psoriasis. METHODS: Twenty five patients with chronic poriasis were treated with calcipotriol ointment(50pg/g) twice daily. Efficacy as meaaured by the clinical degree of erythcimor, scale and thickness of the lesions, and safety were assessecl every 2 weeks. RESULTS: The total score of erythema, scale and thickness of the lesions decreased in 6 weeks from 8.52+0.76 to 3.80+1.7 with calcipotriol. Some patients developed mild and transient local side effects. The laboratory tests including serum calcium remained unchanged. CONCLUSION: Topical applicalion of calcipotriol ointment for 6 week was found to bean effective and safe treatment of psoriasis vulgaris.
Calcitriol ; Calcium ; Erythema ; Humans ; Psoriasis* ; Vitamin D ; Vitamins

BACKGROUND: Recentliy copper vapor laser(CVL) has been applied with encouraging results in the treatment of port wine stain. The CVL emits yellow light(578nm) in a sequence of about 10,000 to 15,000 pulses/second(10-15kHz) with a pulse duration of 15-50 cases. One of the basic methods of evaluationg the effects of laser lights is to study histologic changes after laser irradiation. OBJECTIVE: The effects of power output and energy density on the histologic change of guinea pig skin following CVL irradiation was evaluted to suggest a way of deciding parameters of CVL to achieve the best clinical results. METHODS: After setting the power output for one of 0.8W, 1.6W and 2.4W, the laser was irradiated with an energy density of 10, 12, 14, 16, 18, 20J/cm. A biopsy was done 15 minutes after irradiation and the biopsy specimens was stained with H&E and NBTC histocberr ical method. RESULTS: 1. At the power of 0.8W, specimens irradiated with an energy density above 14J/cm showed diffuse nonspecific coagulation necrosis of the epidermis and upper dermis. 2. At the power of 1.6W, specimens irradiated with energy density of 14, 16J/cm showed coagulation necrosis of dermal vessel and perivascular collagen. With energe density of 18, 20J/cm, diffuse nonspecific coagulat,ion necrosis of epidermis and upper dermis were observed. 3. At the power of 2.4W, specimens irradiated with an anergy density of 12, 14, 16, 18J/cm showed coagulation necrosis of the dermal vessel and perivascular collagen. With an energy density of 20J/cm, diffuse nonspecific coagulation necrosis of the epidermis and upper dermis was observed. CONCLUSIONS : With the above results it was found that t,he higher power output of CVL enlarged the range of energy density confining thermal damage to the dermal v-ssels and perivascular collagen. Additionally the higher power raised the upper limit of energy density with which t,he epidermis was viable.
Animals ; Biopsy ; Collagen ; Copper* ; Dermis ; Epidermis ; Guinea Pigs* ; Guinea* ; Herpes Zoster ; Humans ; Inpatients ; Lasers, Gas* ; Necrosis ; Port-Wine Stain ; Skin*

BACKGROUND: Recentliy copper vapor laser(CVL) has been applied with encouraging results in the treatment of port wine stain. The CVL emits yellow light(578nm) in a sequence of about 10,000 to 15,000 pulses/second(10-15kHz) with a pulse duration of 15-50 cases. One of the basic methods of evaluationg the effects of laser lights is to study histologic changes after laser irradiation. OBJECTIVE: The effects of power output and energy density on the histologic change of guinea pig skin following CVL irradiation was evaluted to suggest a way of deciding parameters of CVL to achieve the best clinical results. METHODS: After setting the power output for one of 0.8W, 1.6W and 2.4W, the laser was irradiated with an energy density of 10, 12, 14, 16, 18, 20J/cm. A biopsy was done 15 minutes after irradiation and the biopsy specimens was stained with H&E and NBTC histocberr ical method. RESULTS: 1. At the power of 0.8W, specimens irradiated with an energy density above 14J/cm showed diffuse nonspecific coagulation necrosis of the epidermis and upper dermis. 2. At the power of 1.6W, specimens irradiated with energy density of 14, 16J/cm showed coagulation necrosis of dermal vessel and perivascular collagen. With energe density of 18, 20J/cm, diffuse nonspecific coagulat,ion necrosis of epidermis and upper dermis were observed. 3. At the power of 2.4W, specimens irradiated with an anergy density of 12, 14, 16, 18J/cm showed coagulation necrosis of the dermal vessel and perivascular collagen. With an energy density of 20J/cm, diffuse nonspecific coagulation necrosis of the epidermis and upper dermis was observed. CONCLUSIONS : With the above results it was found that t,he higher power output of CVL enlarged the range of energy density confining thermal damage to the dermal v-ssels and perivascular collagen. Additionally the higher power raised the upper limit of energy density with which t,he epidermis was viable.
Animals ; Biopsy ; Collagen ; Copper* ; Dermis ; Epidermis ; Guinea Pigs* ; Guinea* ; Herpes Zoster ; Humans ; Inpatients ; Lasers, Gas* ; Necrosis ; Port-Wine Stain ; Skin*

BACKGROUND: The erythemal response and delayed tanning of the skin to UV radiations which are used as diagnostic phototest and guideline of phototherapy are different according to the races and light sources. OBJECTIVE: The MED and MMD induced by UVB radiation were measured in 130 normal young adult Koreans. METHODS: In this study, a high pressure mercury are lamp(Burdick UV-800) and a sunlight fluorescent lamp(Waldmann UV 800) were used as UVB light sources. Multiple sites of the lower baek or buttock skin were irradiated with an increasing dose by a constant, anount. The minimal doses of erythema response and delayed tanning of the skin were assessed visaually at 24 hours and 7 days after irradiation, respectively. RESULTS: MED and MMD of Burdick UV-800 are 18.0+/-9.8mJ/cm2 (mean+/-S.D.), 29.7+/-12.5mJ/cm2, respectively. MED and MMD of Waldmann UV 800 are 70.8+/-28.5mJ/cm2 and 91.2+/-33.1mJ/cm2, respecively. The most frequent MED by Burdick UV-800 is 10mJ/cm2 and those by Waldmann UV 800 are 50m J/cm2 and 60m J/cm2. CONCLUSION: In this study MED and MMD of young adult Koreans by two kinds of UVB light sources were assessed. The RESULTS: how that MED is less than MMD and the levels of MED under which the photosensitivity is suggested are 5.6mJ/cm2 by Burdick UV-800 anr 32.4mJ/cm2 by Waldmann UV 800.
Buttocks ; Continental Population Groups ; Erythema* ; Humans ; Phototherapy ; Skin ; Sunlight ; Tanning ; Triacetoneamine-N-Oxyl ; Young Adult*

Hydrochlorothiazide is a diuretic drug used in the treatement of edema and hypertension. We report a case of hydrochlorothiazide induced photosensitivity in a 54 year old woman who had taken hydrochlorothiazide for 3 years for hypertension. She complained of itching and burning sensation with erythematous papules and lichenified plaques on light-exposed areas. Fhototest showed marked decrease of the minimal erythema dose(MED) for UVA. The symptoms subsided after the use of topical steroid and the substitution atenolol for hydrochlorothiazide.
Atenolol ; Burns ; Edema ; Erythema ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Middle Aged ; Pruritus ; Sensation

Proper education about dermatology in medical college would have physicians appropriately diagnose and treat common dermatoses without referring patients to dermatologists. However, physicians who are not dermatologists have difficulty in diagnosing and treating common dermatoses. We have made up a questionnaire about treatment and a slide test for clinical diagnosis of common dermatoses in order to evaluate the knowledge of physicians about common dermatoses, which reflects indirectly the current status of medical education of dermatology in Korea and can be used as a basic data for modifying directions for education in medical college. Total 654 physicians answered the questionnaire, including 125 just graduated general physicians, 111 general physicians who had just finished internship and 418 medical specialists. 11 data from dermatologists were analyzed as a control for evaluation. The result showed that 84%(545) of them have difficulty in diagnosing dermatologic diseases. The probable causes answered by them are lack of easy illustrative textbook for general physician(48%), inadequate education of dermatology in their medical colleges(27%) and so on. In the field of therapy in the questionnaire, only 53% of them had proper knowledge about indication of topical steroids, 56% about acne therapy, 22% about treatment of tinea pedis, 35% about scabies and 41% about urticaria. The average score was 53%. The score of family medicine group and urologist group was 69% and 66% each, which were significantly higher than that of other major groups except 98% of dermatologist group. In the slide test for clinical diagnosis, the average score was 71%. The score of family medicine group which had received postgraduate education on dermatology in their resident training was 84%, also significantly higher than that of other major groups except 100% of dermatologist group. The percentage of correct responders about tinea faciei is only 13%, tinea versicolor 42%, tinea cruris 49%, impetigo 53%, pityriasis rosea 60%, atopic dermatitis 67%, psoriasis 72% and fixed drug eruption 74%, etc. The average score was 71%. In conclusion, this study showed that physicians who are not dermatologists have difficulty in diagnosing and treating even common dermatoses. We think it is important to put stress on the common dermatoses in the field of dermatologic education in medical college. Moreover we could find the importance and need of postgraduate education on dermatology in the resident training of primary care physicians such as not only family medicine doctors but also internists and pediatricians.
Acne Vulgaris ; Dermatitis, Atopic ; Dermatology ; Diagnosis ; Drug Eruptions ; Education ; Education, Medical ; Humans ; Impetigo ; Internship and Residency ; Korea ; Physicians, Primary Care ; Pityriasis Rosea ; Psoriasis ; Scabies ; Skin Diseases* ; Specialization ; Steroids ; Tinea ; Tinea Pedis ; Tinea Versicolor ; Urticaria ; Surveys and Questionnaires