Ji Hwan Hwang

Periauricular eczematization in childhood atopic dermatitis

Abstract: We investigated the prevalence of periauricular eczematization (PAE) in children with atopic dermatitis (AD) in Korea, and evaluated the clinical significance of the lesion in terms of Its treatment in relation to a possible pathogenetic role for Staphylococcus aureus. Tentatively, PAE was classified as infraauricular and postauricular fissuring, which were observed in 62 (57,9%) and 37 (34.6%) of 107 patients, respectively. Sixty eight patients (64.5%) had infraauricular or postauricular fissures, or both, and this prevalence was significantly (p < 0.01) higher than that in controls (1.3%). Staphylococcus aureus was cultured from oozing material from infraauricular fissures in 12 of 14 patients, and topical application of erythromycin cream to the ear lesions led to faster and more definite improvement. Our study shows that PAE is a characteristic clinical manifestation of AD, probably induced by S. aureus. Topical antibiotics are worth trying for effective management of this disorder.

Halo-like disappearance of mongolian spot combined with café au lait spot.

To the Editors: The halo phenomenon surrounding the caf6 au lait spot has been very rarely reported. We describe a patient with neurofibromatosis who had a halo-like disappearance of mongolian spot surrounding cafe au lait spots. A 10-month-old baby was seen for evaluation of multiple skin lesions on the whole body. At birth he was found to have mongolian spots over the lumbosacral region and buttocks. About 1 month later, multiple brownish macules appeared and gradually increased in size and number on the trunk and extremities. With the appearance of these macules, the mongolian spots, which on the areas surrounding the macules of the lumbosacral region, buttocks, and back had a halo nevus-like appearance, disappeared (Fig. 1). Three Punch biopsy specimens were obtained from the caf6 au lait spot, the whitish halo-like zone surrounding this spot, and the mongolian spot, respectively. DenFigure 1. Multiple whitish halo-like zones on the areas surrounding the cafe au lait spots of the lumbosacral region and buttock combined with mongolian spot.

The changes of serum soluble intercellular adhesion molecule-1 after systemic steroid treatment in vitiligo.

Cell surface adhesion molecules are thought to play an important role in establishing intercellular contacts that are necessary for immunological reactions. Intercellular adhesion molecule-1 (ICAM-1, CD54) is a crucial adhesion molecule in mediating cell to cell adhesion during inflammatory responses, including non-MHC-restricted cytotoxicity. In this study, the sICAM-1 levels of ten healthy control subjects and seven generalized active vitiligo patients were measured by ELISA. The sICAM-1 levels were also correlated with the clinical courses in 33 patients with active vitiligo, who received systemic steroid treatment for 3 months. The average serum level of sICAM-1 was significantly higher in patients with active vitiligo than in the healthy control subjects. The sICAM-1 levels significantly decreased after systemic steroid treatment in the clinically improved group. These results suggest that immune activation is involved in active vitiligo and that changes of sICAM-1 levels can be a marker in the course of vitiliginous lesions.