The accuracy and sensitivity of both direct and indirect immunofluorescence microseopy in diagnosing chronic bullous dermatoses were evaluated and compared in 11 cases of six different disease entities(pemphigus vulgaris, pemphigus vegetans, bullous pemphigoid, linear IgA bullous dermatosis, familial benign chronic pemphigus), which had been diagnosed clinically and by routine histopa thological studies. And the results obtained were as follows: 1) In 4 cases of bullous pemphigod, the direct IF of perilesional skin showed linear deposition of IgG and C2 along basement membrane zone(BMZ), whereas the indirect IF revealed negetive findings. 2) In 2 cases of pemphigus vulgaris, the direct IF showed deposition of IgG and C2 in intercellular substance(ICS) of perilesional epidermal tissue, and the indirect IF revealed auto-antibody to ICS(1:320) in one case. 3) In 2 cases of linear IgA bullous dermatosis, which were diagnosed as dermatitis herpetiformis by clinical and routine hisopathological findings, the direct IF of perilesional and uninvolved skin manifested linear deposition of IgA, IgM, C3 and F along BMZ, However, no immunofluorescence was detected by the indirect IF. 4) In a case of chronic bullous dermatosis of childhood, the direct IF of perilesional skin showed linear deplosition of IgA and IgM along BMZ. 5) In a case of pemphigus vegetans, the direct IF revealed no specific findings, while the inderect IF disclosed auto antibody positive to ICS(1:40). 6) In a case of familial benign chronic permphigus, no immunofluorescence was found by direct IF. These results indicate that both direct and indirect immunofluorescence micros-copy are valuable in diagnosing chronic bullous dermatoses and in understanding their immune pathogenesis.
Basement Membrane ; Dermatitis Herpetiformis ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Linear IgA Bullous Dermatosis ; Pemphigoid, Bullous ; Pemphigus ; Skin ; Skin Diseases ; Skin Diseases, Vesiculobullous*

No abstract available.
Diagnosis* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

This study was done with 5,980 cases of dermatomycosis of dermatological patients in Chnnnam University Hospital for 10 years(1976~1985). And the literatures concerning all fungal diseases reported in Korea were reviewed. The results were summarized as follows ; Among total dermatological patients, the average annual incidence of dermatomycosis was about 15+3%. Dermatophytosis was the most prevalent(77.34%), followed by candicliaais(14.38%), tinea versicolor(7.78%), sporotrichosis(0.45%). Of dermatophytosis, the decreasing orders of clinical localization by the incidence were T.pedis(42.2%), T.cruris(25.9%), T. manum(10.3% ), T. corporis(10.0%), T. ungium (6.2%), T.facialis(4.2%), and T. capitis(2.2%). The organisms identified from dermato phytoses were generally 9 species ; the decreasing orders of frequency were Trichophyton rubrum(59.4%), T. mentagrophyte(27.9%), Microsporum canis(8.5%), Epidermophyton floccosum(2.4%), T. ferrugineum(0.9%), and others(M. gypseum, T. schonleinii, T. violaceum, T. verrucosum). The most common causative organism was T. rubrum, but that of T. corporis and T. capitis was M. canis, which showed a continuous increase on the annual variation of dermatophytes. Of candidiasis, the most common clinical form was cutaneous candidiasis, which was prevalent under 10 years old. But vulvo-vaginitis and paronychia highly developed between 3rd and 5th decades. The occasion with precipitating faetors was 10.4% of total candidiasis, of which tuberculosis and diabetes mellitus were prevalent. Of T. versicolor patients, the peak age was 3rd decades but some cases were infant and child. Of sporotrichosis, the most common clinical location and form were hand and lym phatic respectively. The peak age was between 4th and 5th decades, and the most prevalent occupation was farmer. Of other deep mycosis, there were each case of cryptococcosis, systernic candidiasis, and Wangiella derm,atitidies infection.
Arthrodermataceae ; Candidiasis ; Candidiasis, Cutaneous ; Child ; Cryptococcosis ; Dermatomycoses* ; Diabetes Mellitus ; Epidermophyton ; Exophiala ; Hand ; Humans ; Incidence ; Infant ; Korea ; Microsporum ; Occupations ; Paronychia ; Sporotrichosis ; Tinea ; Trichophyton ; Tuberculosis

Skin floras were taken from forehead, sternal area, lower margin of axillae, and interscapular space of 50 healthy Koreans(M 30, F 20) between 18 year and 40 years old using Williamson and Kligman's method and modified Pilsburg and .Nichols method. After incubating these floras for 3-5 days aerobically and anaerobically, we identified them using various stains and biochemical tests. The most common flora was Corynebucterium acne(84%), followed by aerobic diphtheroids(14%), coagulase negative staphylococcus, Micrococcus in orders. Although transient floras including Staphylococcus aareas, Pseudomonas, Listeria monocytogenes, and other Gram negative bacilli were isolated, they were rare and did mainly from axilla. The most common resident site of Corynebacteirium acne was forehead (l. 67 x 10/cm), but in aerobic diphtheroids and Micrococcaceae was the lower margin of axilla(2.70x16/cm, 2.34x10/cm), in which aerobic floras were more than anaerobics. The incidence rate of lipophilic diphtheroid was 27%, however it was 35% in axilla. The aerobic diphtheroid capable of nitrate reduction was 26%, which was very common in forehead. Among Propionibacterium species, Propionibacterim(P) acne was isolated 100% from all sites, but P. grandulosum was only in 2-7% and P. avidum was not.
Acne Vulgaris ; Adult ; Axilla ; Coagulase ; Coloring Agents ; Forehead ; Humans ; Incidence ; Listeria monocytogenes ; Micrococcaceae ; Micrococcus ; Propionibacterium ; Pseudomonas ; Skin* ; Staphylococcus

We experienced a 54-year-old female patient who had multiple vegetaing plaques and, peripherally, a few pustules in her both axillae. On the skin biopsy specimen of the vegetating plaque, it showed acanthosis, suprabasal acsntholysis, papillo-matosis, downward proliferation of the epidermis, and eosinophilic microroabscess in the epidermis. The indirect immunofluorescence study disclosed anto-antibody positive to intercellular substance of the lip of guinea pig, while direct. immuno-fluorescence of the perilesional skin reealed no specific findings. The skin lesion had improved with topical and systemic steroid therapy.
Animals ; Axilla ; Biopsy ; Eosinophils ; Epidermis ; Female ; Fluorescent Antibody Technique, Indirect ; Guinea Pigs ; Humans ; Lip ; Middle Aged ; Pemphigus* ; Skin

We reported a case of 22 years old male with perifolliculitis capitis abscedens et suffodiens. He had multiple fistular tracts, abscess, and cicatrized alopecia on the vertex and occiput. Compressing the abscess lesion, pus discharge was shown. Also he had acne conglobata and acne vulgaris on the face and nuchal area. On the bacterial culture, coagulase positive Staphylococcus aureus was isolated. These lesions were persistent in spite of frequent incision and drainage and antibiotic therapy. Considering it having a pathogenesis like acne conglobata, we tried him 13-cis-retinoic acid that had good effect in the treatment of cystic or conglobate acne. Three months after treatment, the lesions disappeared completely.
Abscess ; Acne Vulgaris ; Alopecia ; Coagulase ; Drainage ; Humans ; Isotretinoin ; Male ; Staphylococcus aureus ; Suppuration ; Tretinoin* ; Young Adult

Trichophyton(T.) verrucosum had not been reported until now in Korea. We report herein a case of kerion celsi caused by T. verrucosum considered the first case in Korea and its epidemiologic enviroment. She was a 10 years old girl living in cattle country. Three weeks ago, three small erythematous nodules were developed and rapidly progressed to be large boggy mass like tumefactions. Histopathologically, fungal hyphae and spores were found in hair follicles in H & E and PAS stain. In fungal study, characteristic features of T. verrucosum were found as chains of chlamidospores et als. With above results, we could diagnose these lesions as kerion celsi caused by T. verrucosum which were transmitted from a cattle. After 4 weeks-administration of ketoconazole, lesions were healed completely.
Animals ; Cattle ; Child ; Epidemiologic Studies* ; Female ; Hair Follicle ; Humans ; Hyphae ; Ketoconazole ; Korea ; Spores ; Tinea Capitis* ; Trichophyton*

Gangrenous skin disease is characterized by rapidly progressive necrosis of the subcutaneoua tissue. It is mainly caused by Group A b-hemolytic Streptococcus. We are now reporting three cases of gangrenous skin diseases including gangrene due to Vibrio vulnificus, streptococcal gangrene, and ecthyma gangrenosum. Their treatment was as follows: early surgical debridment, the correction of fluidelectrolyte depletion, and antibiotics. When fresh granulation tissues were seen on the wound base, we performed so called Island skin graft. 3 to 5 weeks later, there were good cosmetic and functional results. These results reveals that among several curative measures of gangrenous skin diseases early surgical debridment is the most important one. We belive many dermatologists should be concerned about skin surgery progressively.
Anti-Bacterial Agents ; Dermatologic Surgical Procedures ; Ecthyma ; Gangrene ; Granulation Tissue ; Necrosis ; Skin Diseases* ; Skin* ; Streptococcus ; Transplants* ; Vibrio vulnificus ; Wounds and Injuries

Superior mesenteric artery (SMA) injuries remain a challenge to most trauma surgeons and continue to result in significant mortality despite aggressive management. We report successful management of a proximal SMA injury through endovascular treatment in a 56-year-old man. The patient presented with hypotension due to a stab wound after the epigastrium. He underwent emergency laparotomy and repair of the penetrated wall of the stomach. Right retroperitoneal hematoma at the initial laparotomy expanded and ruptured, requiring a massive transfusion. At the second laparotomy, we performed lateral arteriorrhaphy of the proximal SMA. Follow-up abdominal computed tomography angiography on post-injury day 7 showed a pseudoaneurysm on the left side of the SMA trunk. The patient was treated successfully with an endovascular stent graft.
Aneurysm, False* ; Angiography ; Blood Vessel Prosthesis ; Emergencies ; Endovascular Procedures ; Follow-Up Studies ; Hematoma ; Humans ; Hypotension ; Laparotomy ; Mesenteric Artery, Superior* ; Middle Aged ; Mortality ; Stomach ; Wounds, Stab

The V-to-T plasty was developed by Field(1985), of which purposes are to place scars in natural wrinkle lines, be hidden by natural anatomic landmarks, and, if possible, attain symmetry. The authors reported a case of basal cell carcinoma arising at the upper lip of 66 years old male, We treated him with V-T plasty using the natural landmarka and wrinkle lines around the upper lip and the nose, Two weeks after operation, we attained excellent funtional and cosmetic results. So we recommended its method to operate tumors arising at forehead, upper & lower evelid, upper and lower lip, both preauricular area, etc.
Aged ; Anatomic Landmarks ; Carcinoma, Basal Cell* ; Cicatrix ; Forehead ; Humans ; Lip ; Male ; Nose