Effect of Trans-4-Aminomethylcyclohexanecarboxylic Acid on the Proliferation and Melanization in Cultured Normal Human Melanocytes

BACKGROUND: Trans-4-aminomethylcyclohexanecarboxylic acid (tranexamic acid) has recently been reported to inhibit prostaglandin synthesis and hinder the pigmentation caused after UV radiation. OBJECTIVE: we evaluated the influence of tranexamic acid on the viability, morphogenesis and melanization of cultured normal human melanocytes. METHOD: The cultured melanocytes from neonatal foreskin were exposed to UVB 20mJ/cm2, then treated with tranexamic acid [0.05microgram/ml, 0.05microgram/ml, and 0.5microgram/ml]. After 24 hours, the viability of melanocytes and the melanin concentration was measured. The number and length of the melanocytes' dendrites, and the expression level of tyrosinase, TRP-1 and TRP-2 were also evaluated. RESULTS: The viability of the melanocytes was decreased by tranexamic acid in a dose dependent manner (p<0.05). The increased melanin synthesis by UVB irradiation was decreased by tranexamic acid in a dose dependent manner (p<0.05). Also, the increased expressions of TRP-1, TRP-2 and tyrosinase after exposure to UV were statistically decreased by tranexamic acid in a dose dependent manner (p<0.05). CONCLUSION: tranexamic acid may prevents UVB induced pigmentation.

A Clinical Study of Androgenetic Alopecia (III)

BACKGROUND: Androgenetic alopecia is considered to be a genetically determined disorder influenced by age and androgen. The proportion of patients with androgenetic alopecia among the total number of patients with alopecia seems to be gradually increasing. OBJECTIVES: The purpose of this study is to evaluate the family history,clinical and endocrine status of the patients with androgenetic alopecia. METHODS: 1113 patients with androgenetic alopecia who had visited the Department of Dermatology, Yongsan Hospital, College of Medicine,Chung-Ang University during the 3 years (1995.1-1998. 12) have been examined. RESULTS: The results are summarized as follows 1) The incidence of androgenetic alopecia among the total number of alopecia patients was 64.5%, showing recent increment. 2) There were 855 male and 258 female patients being most prevalent in the third decade in both sexes and the patients younger than 30 years old with premature androgenetic alopecia,made up 70.3% of the male patients and 48.8% of the female patients with androgenetic alopecia. 3) While Norwood's type Iia was the most common and following type II, III vertex,and IV in the male AGA, Ludwig's type II was the most common in female AGA 4) There was a family history of baldness in 53.5% of first degree relatives in male patients and 51.6%in female patients. 5)Associated diseases were observed in 565(66.8%) of the male patients and 219 (84.8%) of the female patients:diseases associated with androgen such as seborrheic dermatitis and acne vulgaris occupied 39.1%. CONCLUSION: Based on our findings, those who want to treat androgenetic alopecia at the earlier ages are gradually increasing and it seems to be reasonable to believe that the age, genetic factors, localized effects of androgens on the scalp and the density and/or functional activity of androgen receptors may influence the pathogenesis of androgenetic alopecia.

UVB-induced Apoptosis and p53 Expression in Cultured Normal Human Keratinocyte / 대한피부과학회지

Cutaneous absorption of ultraviolet B(UVB) in the skin occurs primarily in keratinocyte, causing DNA and protein damage. p53 tumor suppressor gene appeared in the epidermis after UVB irradiation, and the wild type has been known to be responsible for apoptosis and plays an important role in excluding abnormal cells with significant DNA damage. While p53 has been implicated in both DNA repair and apoptosis, it is unclear whether the p53 protein is involved in both of these processes within the same cell. Therefore, UVB-induced apoptosis and changes in p53 expression were studied in cultured normal human keratinocyte to determine that the cellular response to UVB induced DNA damage(DNA repair or apoptosis) correlated with p53 expression. The cultured normal human keratinocytes were irradiated with the doses of UVB(25-150 mJ/cm2) and incubated for various times(3, 6, 12, 24 hour) after radiation. At UVB doses of 100 and 150 mJ/cm2, acridine orange/ethidium bromide(Ao/Eb) staining-positive cells and TUNEL (TdT mediated dUTP-biotin nick end labeling) staining-positive cells increased significantly after 3 hours and 6 hours postirradiation respectively. Twelve hour postirradiation, staining-positive cells increased at each level of UVB-radiation exposure. These results suggest that there were significant influences of UVB doses and time course after irradiation to the number of Ao/Eb and TUNEL staining-positive cells. To determine whether all Ao/Eb and TUNEL-positive cells were actually undergoing apoptosis, cellular DNA was extracted from keratinocytes at 12 hours after UVB irradiation and seperated by electrophoresis on an 2.5% agarose gel to detect the internucleosomal DNA fragmentation(DNA ladder). 'DNA ladder' occurred at every dose of UVB 12 hour after irradiation, but did not appear early after irradiation, suggesting that whether Ao/Eb and TUNEL-positive cells observed early after irradiation were not undergoing apoptosis. Activation of p53 and the response to DNA damage is not observed universally, but is dependent on tissue specificity, species specificity and type of genotoxic damage. To correlate p53 level with UVB-induced apoptosis at the dose of 100mJ/cm2 UVB, p53 levels were determined by western blot analysis. The accumulation of p53 protein was apparent after 6 hours postirradiation, and UVB irradiation caused a dramatic increase in p53 levels at 12 and 24 hours. These results demonstrate that p53 is required for UVB-induced apoptosis in cultured normal human keratinocyte and p53 has a time-dependent effect in the initiation of apoptosis. In this study, the results indicated that a low dose(25mJ/cm2) of UVB irradiation could induce apoptosis in human keratinocyte in vitro and UVB exerts a time-dependent effect on inducing apoptosis. And the results also give support to increasing evidence that p53 may play a role in UVB-induced DNA damage and the induction of apoptosis in cultured normal human keratinocyte and that p53 is involved in the decision process which determines the fate of keratinocyte after UVB -induced DNA damage.

Three Cases of Generalized Lichen Nitidus

Lichen nitidus(LN) is an uncommon chronic inflammatory disease of shiny, flat-topped, flesh-colored uniform papules most commonly located on the penis, forearms and wrists, lower abdomen, and thighs. LN almost has localized distribution, but in rare cases, it may become generalized. In Korea, three cases of generalized LN were reported. We report here three cases of generalized lichen nitidus in 31-year-old man, 8-year-old boy, and 6-year-old girl who had generalized numerous pinhead-sized, erythematous to flesh-colored, shiny papules. Microscopically, they had typical appearance of LN.

Life Event Stress and Coping Strategies in Patients with Alopecia Areata and Androgenetic Alopecia / 대한피부과학회지

BACKGROUND: Psychosocial stress and stressful events in life have been reported to be closely related to the onset and acute exacerbation of some dermatologic disorders, such as alopecia areata, psoriasis, seborrheic dermatitis and atopic dermatitis. However, the nature of the association between stress and dermatologic disorders remains unclear. OBJECTIVE: The purpose of this study is to determine the relation of stress and the onset and exacerbation of dermatologic disorders. Furthermore we studied whether the coping strategies to stress are related to dermatologic disorders. METHOD: We examined 30 patients with alopecia areata, 30 patients with androgenetic alopecia who visited Dept. of Dermatology, Chung-Ang University Hospital and a control group of 30 who visited our clinic at the same time for tinea pedis and onychomycosis, which are supposed not to be related to stress. For the evaluation of stress we used questionares of 'Scale of Life Events' and 'Multidimensional Coping Scale'. RESULT: 1) The score of life event stress in the alopecia areata group was significantly higher than that of the normal control group. The score of life event stress in androgenetic alopecia was higher than that of the normal control group with no statistical significance. 2) In the aspect of coping strategies, the alopecia areata group was significantly higher than the normal control group at the passive withdrawal and fatalism, while in the normal control group, emotional pacification, positive comparison and religious seeking tended to be higher than the alopecia areata group. In the androgenetic alopecia group, no significant pathologic coping strategies were found compared with the control. CONCLUSION: These findings suggest that the psychosocial stress may play a role in the pathogenesis of alopecia areata and androgenetic alopecia. But to clarify the exact role of stress, further studies about biological parameters of physiologic changes to stress are needed in the future.

A Case of Bleomycin induced Streaky Pigmentation and Scleroderma

Bleomycin, a tumoricidal antibiotic agent, may produce unusual cutaneous manifestations such as pigmentation scleroderma, and gangrene. We report a case of the development of linear streaky pigmentation and cutaneous scleroderma in a patient treated with bleomycin for choriocarcinoma of undescented testis. The patient was 45-year-old male presented with linear brown and slate gray streaking over the trunk and extremities after three cycles of chemotherapy(bleomycin, etoposide, cisplatine). After the fourth cycle of the same chemotherapy, 18 weeks after initiation of bleomycin, the development of cutaneous scleroderma-like conditions was observed involving the same sites. Histopathologic examination showed increased basal pigmentation and thick collagen bundles through the entire dermis, extending to the subcutis. Herein, we describe a case of streaky pigmentation and scleroderma in association with bleomycin anticancer chemotherapy simultaneously in a patient.

A Case of Cutaneous Diffuse Large B-Cell Lymphoma / 대한피부과학회지

We report a case of cutaneous B cell lymphoma in a 65-year-old male who had several bizarre shaped erythematous to brownish plaques on the both shins for 2 months. An abdominal CT scan revealed gastrohepatic ligament, retroperitoneal, mesenteric and bilateral external iliac lymphadenopathies. Histologic examinations revealed diffuse dense infiltration of the large atypical cells with vesicular nucleus and prominent nucleoli in the entire dermis. They showed a positive reaction to the LCA, CD20 and kappa light chain in the immunohistochemical study, suggesting that these neoplastic lymphoid cells are B cell lineage. We treated him with COPBLAM-V regimen. In the course of treatment, new skin lesions developed on both upper arms and herpes zoster on the left thigh. So we changed the regimen into IMVP-16. No relapses have been found up to the present date for 9 months.

A Case of Acquired Digital Fibrokeratoma Occurring on the Sole / 대한피부과학회지

Acquired digital fibrokeratomas are unusual benign solitary tumors of fibrous tissue that usually occur on the fingers and toes. We report a case of acquired digital fibrokeratoma with unusual involvement of the sole, a previously traumatic site, in a 57-year-old male. We treated it with a total surgical excision.

A Case of Henoch-Schoenlein Purpura with Necrotizing Vasculitis in the G-I Tract / 대한피부과학회지

Henoch-Schoenlein purpura is a syndrome of acute systemic allergic vasculitis involving the small vessels of skin and multiple organs, characterized by a symmetrical, non-thrombocytopenic, painless purpura, nephritis and gastrointestinal manifestations. Although GI involvement is about 70%, endoscopic and histopathological finding of the GI tract in Henoch-Schoenlein purpura is rarely reported and necrotizing vasculitis in GI tract biopsy has not been reported yet. We report a case of a 16-year-old male patient, who complained of palpable purpura, vomiting and epigastric pain with necrotizing vasculitis of the duodenum on histopathological examination.