BACKGROUND: The role of dietary factors in atopic dermatitis has been the subject of debate for several decades. Recently it has received convincing support from a double-blind controlled trial of an exclusion diet, showing benefit from careful avoidance of egg and milk in a group of atopic children. OBJECT: The purpose of this study was to determine the prevalence of specific food allergies in Korean atopic dermatitis and the potential utility of the Pharmacia CAP-RAST FEIA in the diagnosis of food allergy. METHODS: One hundred ten patients with atopic dermatitis were evaluated for food hypersensitivity by history, skin prick test, CAP-RAST FEIA, and open food challenge test(OFCT). RESULTS: The prevalence of specific food allergies in the study population was 28.2% in history and 18.2% in CAP-RAST FEIA and OFCT. The frequent food allergens were milk, egg, peanut, and wheat. There was no correlation between the clinical severity of atopic dermatitis and CAP-RAST FEIA and OFCT results. Plasma eosinophil and IgE levels were correlated with CAP-RAST FEIA results, but not OFCT results. According to the history, 31 atopic dermatitis patients answered that their dermatitis was related to food, and of the 31 patients, positive reactions to prick test and CAP-RAST FEIA were observed in 8 and 22 patients, respectively. Among the other 79 patients who answered that there was no relation between atopic dermatitis and food, 14 patients reacted positively to prick test and 47 patients showed positive result to CAP-RAST FEIA. CONCLUSION: The CAP-RAST FEIA provides standardized measurement of food specific IgE antibodies which may be useful to diagnose food allergy in atopic dermatitis.
Allergens ; Antibodies ; Child ; Dermatitis ; Dermatitis, Atopic* ; Diagnosis ; Diet ; Eosinophils ; Food Hypersensitivity* ; Humans ; Immunoglobulin E ; Milk ; Ovum ; Plasma ; Prevalence ; Skin ; Triticum

Allopurinol is a xanthine oxidase inhibitor widely used to control plasma uric acid levels. Serious and life threatening adverse effects such as the allopurinol hypersensitivity syndrome(AHS) are rare. We describe a 32-year-old female patient who was treated with allopurinol and developed fever, rash, and renal and liver dysfunction.
Adult ; Allopurinol* ; Exanthema ; Female ; Fever ; Humans ; Hypersensitivity* ; Liver Diseases ; Plasma ; Uric Acid ; Xanthine Oxidase

Male breast cancer is a rare disease, accounting for approximately 1% of all breast cancer. We report a case of cutaneous, osteolytic, pulmonary, and hepatic metastases of male breast cancer in a 40-year-old male who presented 4x2.5 cm erythematous plaque with ulceration and bloody discharge on the areolar area of the left anterior chest. The histopathologic findings of the lesion showed nests and strands of invasive carcinoma forming ductlike structures and cellular arrangement in single-row line, referred to as Indian filing, between collagen bundles. The tumor cell showed positive reaction for estrogen receptor, but negative reaction for progesterone receptor. He was treated with tamoxifen, 5-fluouracil, adriamycin, and cyclophosphamide. Six months after initiation of the treatment, skin lesion was improved. Also, number and size of the metastatic cancer nodules decreased in the computer tomographic imaging.
Adult ; Breast Neoplasms ; Breast Neoplasms, Male* ; Collagen ; Cyclophosphamide ; Doxorubicin ; Estrogens ; Humans ; Male ; Male* ; Neoplasm Metastasis* ; Rare Diseases ; Receptors, Progesterone ; Skin ; Tamoxifen ; Thorax ; Ulcer

A review of the literature indicates that the simultaneous occurrence of two or more neoplasms in one specimen is a relatively infrequent finding. The finding of nevocellular nevi in close association with seborrheic keratosis, desmoplastic trichoepithelioma, syringoma, basal cell carcinoma, trichilemmal cyst, and epidermoid cyst raises interesting points about the histogenesis of these lesions. The combined occurrence of nevus with other epithelial neoplasms may indicate that changes in the microenvironment produced by nevus result in the induction of growth of the ectodermal origin neoplasms. We report a case of simultaneous occurrence of intradermal nevus and seborrheic keratosis.
Carcinoma, Basal Cell ; Ectoderm ; Epidermal Cyst ; Keratosis, Seborrheic* ; Neoplasms, Glandular and Epithelial ; Nevus ; Nevus, Intradermal* ; Syringoma

Despite abundant blood supply, metastatic tumors of the penis are rare. We report herein a case of metastatic cancer of the penis from urinary bladder carcinoma in a 80-year-old man. He presented with 1 month history of erythematous tender mass on the penis which developed 16 months later after the diagnosis of carcinoma of the urinary bladder had been made. Skin biopsy from this lesion revealed variable sized atypical cells with hyperchromatic and pleomorphic nuclei similar to those of the urinary bladder. On immunohistochemical staining, infiltrating cells of both bladder and penis showed positive reaction to thrombomodulin and carcinoembryonic antigen(CEA), but negative reaction to cytokeratin20 and C-erB-2 oncogene.
Aged, 80 and over ; Biopsy ; Diagnosis ; Humans ; Male ; Neoplasm Metastasis ; Oncogenes ; Penile Neoplasms* ; Penis ; Skin ; Thrombomodulin ; Urinary Bladder*

Ramsay Hunt syndrome or herpes zoster oticus is a viral disease associated with otalgia, vesicular eruption, facial paralysis, hearing disturbance, tinnitus, vertigo and other symptoms. Rarely it can be associated with involvement of IV, V, IX, X, XI, XII cranial nerves, cervical plexus, and diffuse encephalitis. We report a case of Ramsay Hunt syndrome with vocal cord paralysis which developed prior to facial nerve paralysis.
Cervical Plexus ; Cranial Nerves ; Earache ; Encephalitis ; Facial Nerve ; Facial Paralysis ; Hearing ; Herpes Zoster Oticus* ; Paralysis ; Tinnitus ; Vertigo ; Virus Diseases ; Vocal Cord Paralysis* ; Vocal Cords*

Juvenile xanthogranuloma(JXG) is a disorder of histiocytes usually associated with cutaneous lesions. JXG developing in soft tissue is rare and receives little attention. Therefore deeply located JXG may present a diagnostic difficulty in the absence of cutaneous lesions. Clinically, deep JXG seems to occur as solitary lesions on the trunk rather than on the head and neck region and tends to be composed of a monotonous population of histiocytic cells, with rare, if any, foamy macrophages or Touton-type multinucleated giant cells. We report an unusual case of JXG in a 4-month-old male infant who had a deep-seated mass located on the subcutaneous and muscle layer of the left forearm.
Forearm ; Giant Cells ; Head ; Histiocytes ; Humans ; Infant ; Macrophages ; Male ; Neck ; Xanthogranuloma, Juvenile*

BACKGROUND: Specific serum IgE determination is widely used in the diagnosis of IgE-mediated allergic diseases. House dust mite allergens are known to show good sensitivity on in vitro tests. We report the results of specific IgE against house dust allergen by Pharmacia CAP system FEIA and compared them with those of in vivo test. OBJECTIVE: The aim of this study is to find out the clinical application of Pharmacia CAP system FEIA in atopic dermatitis. METHODS: In 46 atopic dermatitis patients, skin prick test and Pharmacia CAP system FEIA were performed for Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens. For all patients, atopy and family histories were taken. RESULTS: The positive results were more frequent in adult patients(over 16 years old, 73.3%) than in child patients(below 15 years old, 38.7%) in skin prick test for both Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens. When skin prick tests were used as a reference standard, the sensitivity of Pharmacia CAP system FEIA was 89.5% for Dermatophagoides pteronyssinus and 90.0% for Dermatophagoides farinae, and the specificity of Pharmacia CAP system FEIA was 77.8% for Dermatophagoides pteronyssinus and 80.8% for Dermatophagoides farinae. Correlations were found between Pharmacia CAP system FEIA results and serum total IgE (r=0.574 for Dermatophagoides pteronyssinus and r=0.534 for Dermatophagoides farinae). CONCLUSION: Our results suggest that Pharmacia CAP system FEIA offers high sensitivity and can be an effective method of screening for allergies to Dermatophagoides pteronyssinus and Dermatophagoides farinae in atopic dermatitis.
Adolescent ; Adult ; Allergens ; Antigens, Dermatophagoides ; Child ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Dust* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mass Screening ; Pyroglyphidae* ; Sensitivity and Specificity ; Skin

Generalized pustular psoriasis(GPP) is an uncommon and severe form of psoriasis. The possible provocative factors such as steroid therapy, infection, stress, drugs, pregnancy, sun exposure, and metabolic disorders were reported. Among them, corticosteroid therapy is thought to be the most common factor. Although the cause of psoriasis remain obscure, the coexistence of psoriasis and autoimmune disease and cyclosporin accepted for the treament of psoriasis emphasize the importance of immunologic mechanism in the pathogenesis of psoriasis. We present a case of GPP in a 48-year-old male, who has had a history of myasthenia gravis since the age of 34 years and managed with long-term corticosteroid therapy. With the administration of acitretin and cyclosporin, generalized pustular eruptions nearly cleared and clinical improvement was achieved.
Acitretin ; Autoimmune Diseases ; Cyclosporine ; Humans ; Male ; Middle Aged ; Myasthenia Gravis* ; Pregnancy ; Psoriasis* ; Solar System

Calcinosis cutis is the deposition of calcium phosphate into the skin. It is classified as dystrophic if the calcium is deposited in previously damaged tissue and serum calcium and phosphorous levels are normal. We report a case of dystrophic calcinosis cutis in a 35-year-old man. About 2 months ago, he developed an ulcer in the left thigh that was treated by grafting. Histopathologically, amorphous basophilic materials that stained with von Kossa were deposited in the dermis.
Adult ; Basophils ; Calcinosis* ; Calcium ; Dermis ; Humans ; Skin* ; Thigh ; Transplants* ; Ulcer