Latex Allergy in Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Allergy against natural rubber latex is an increasing problem in recent years, especially in health care workers, children with spina bifida. Many studies reported atopic dermatitis could be also one of risk factors of latex allergy. OBJECTIVE: Purposes of this study were not only to access the prevalence of latex sensitization in patients with atopic dermatitis, but to evaluate the relationship between latex sensitization and clinical allergy. METHODS: Of the total of 110 patients, 80 patients were atopic dematitis and 30 patients were controls. A questionaire-based history was taken, skin prick tests (SPTs) with latex glove extract and commercial latex allergen and several commercial fruit extracts were done. If SPT to latex was positive, use test performed. Patch tests for delayed type hypersensitivity were carried out with a small piece of latex glove, commercial latex allergens and rubber additives. RESULTS: Eighteens (22.5%) of 80 atopic dermatitis reported symptoms whenever they used rubber products. In skin prick test, 3 of 80 (3.8%) patients with atopic dermatitis were positive to latex glove extration solutions and also the commercial latex antigens. Reactions to fruit extracts including mixed nuts, potato, tomato, banana were 8.8%, 6.3%, 6.3%, 5.0%, respectively. Use test was done with all of 4 patients positive to SPT, and only one of them showed positive reaction. There is no positive result in latex glove or latex extraction in patch tests. CONCLUSION: There were no differences in latex sensitivities between patients with atopic dermatitis and healthy people. In patch tests, ZnBDC and mercapto mix were the highst rate of reaction addictives of NRLs.

A Retrospective Clinical Epidemiological Study of the Health Care Utilization of the Outpatients in the Dermatologic Field after 1 year's Separation of Dispensary from Medical Practice / 대한피부과학회지

BACKGROUND: Despite 2 years' separation of dispensary from medical practice since year of 2000, many outpatients in Korea have a lack of understanding this separation. In addition, the illegal practices of pharmacists such as medical examination have contributed to the recent problematic situation. OBJECTIVE: We performed this study to evaluate the actual situation of the separation of dispensary from medical practice in the dermatologic field. METHODS: The clinico-epidemiologic analysis of 17 months' data of 18, 230 outpatients was conducted through the available medical records and serial questionnaires. RESULTS: The medical or non-medical institutions that 18, 230 outpatients with skin diseases had chosen at first, were as follows by the order of frequency; pharmacy(78.5%), folk remedies or self-medication(9.8%), dermatologic institutions(5.5%), non-dermatologic medical clinics(3.4%), herb clinics(2.8%). Accordingly, most(94.5%, 17, 223) of the new patients did not select a dermatologic institution for the care of their skin diseases. The patterns of health care utilization of the patients mostly(72.9%) showed a fixed tendency to visit the one particular institution or formula continuously prior to final visit to the research hospitals. Most of the patients(62.8%) firstly visited a pharmacy for their disease care and did not revisit another institution. Since the first visit to a pharmacy, 9.6% of the patients repetitively utilized one or more herb clinic(s) or folk remedies in addition to one or more medical institution(s). The patients utilizing non-dermatologic measures for skin disease care at first, were mostly in their fifties(25.3%). The patients seeking herb medicine or non-dermatologic medical clinics, were in their teens(27.3% and 24.3%, respectively). Of the cases misdiagnosed as another disease or aggravated in the patients choosing non-dermatologic care, fungal infections are most common(24.0%). In front of 97.1% of the patients seeking pharmacy at first, the pharmacists practiced medicine like a physician in a wrong way instead of dispensing a prescription. CONCLUSION: In Korea, the majority of dermatologic clinics has been deprived of a position as an institution for primary care of skin diseases. It is imperative that dermatologists should be granted independent and unconstrained authority in the medical profession for the benefit of their patients.

A Case of Secondary Syphilis Showing Clinical Features of Annular Pustular Psoriasis Following the Acupuncture and Venous Drainage in a Herb Clinic / 대한피부과학회지

Secondary syphilis has a myriad of clinical presentations as "the great imitator". However, syphilid mimicking annular pustular psoriasis has been rarely reported in the Korean literature. Although the incidence of syphilis has been declining in recent years, serologic testing for syphilis might be mandatory in all types of the unestablished psoriasiform dermatoses, in that failure to diagnose early syphilis correctly can have potentially serious legal ramifications. Though the risk of non-sexual transmission of syphilis has been extremely low, the probability of transmission following needle-stick injury or acupuncture can not be excluded. We herein report a rare case of secondary syphilis with clinical features of annular pustular psoriasis following the repeated acupuncture and venous drainage by a herb doctor.

Use of Alternative Medicine by Patients with Psoriasis

BACKGROUND: Psoriasis is a disabling and intractable disease influencing the psychosocial life of the patients. Patients who are frustrated with orthodox medicine may explore alternative therapies. OBJECTIVE: This study was done to research on the actual condition of the use of alternative medicine in the patients with psoriasis. METHODS: A self-administered questionnaire was constructed, and was given to the patients to answer our questions. RESULTS: Among 128 patients with psoriasis, 61 (47.7%) reported previous use of one or more forms of alternative medicine. The absence of satisfactory long-term effects of physician-provided therapy was the main reason for patients trying alternative medicine. Persons without skin s disease and the mass media were the main sources of information on alternative medicine. CONCLUSION: Alternative therapies were widely utilized by subjects participating in this study, and dermatologists need to be aware of alternative treatments employed by their patients.