A Clinical Study of Prevalence of Telogen Effluvium after Childbirth / 대한피부과학회지

BACKGROUND: Telogen effluvium (TE) is a form of nonscarring alopecia, characterized by diffuse scalp hair thinning in response to some form of physiologic stress. It is commonly described in women subsequent to childbirth. OBJECTIVE: The purpose of this study was to evaluate the prevalence of TE after childbirth. METHODS: Medical records from January 2006 to June 2007 of 240 postpartum patients from our obstetric department were reviewed. Telephone interviews with TE patients were conducted to investigate the initial occurrence time, restoration time, and treatment history. RESULTS: Prevalence of TE according to parity is higher in multiparas than primiparas (p=0.026). In addition, the prevalence of TE after a cesarean section delivery is higher than that after non-surgical delivery (p=0.014). Prevalence of TE with respect to weight gain is higher in the groups displaying agreater increase in weight (p=0.014). Finally, prevalence of TE according to gestational age is higher in groups giving birth after 38 weeks gestational age (p=0.015). CONCLUSION: Prevalence of telogen effluvium may be associated with multiparity, cesarean section, marked weight gain, and high gestational age.

A Case of Lupus Enteritis That Developed during the Treatment of Systemic Lupus Erythematosus / 대한피부과학회지

Systemic lupus erythematosus is a multisystemic autoimmune inflammatory disease with a variety of presenting features and manifestations. Gastrointestinal complications are common in patients with systemic lupus erythematosus, and lupus enteritis is a major cause of acute abdominal pain in the patients suffering with systemic lupus erythematosus. We report here on a 41-year-old-woman with systemic lupus erythematosus and who had developed an acute abdomen during treatment with systemic glucocorticoid and antimalarial drugs. Lupus enteritis was strongly suspected according to the clinical manifestations and the findings of the abdominal computerized tomography scan. She recovered after being treated with intravenous high dose glucocorticoid and conservative therapy.

A Clinical Study of Cases of Syphilis Referred to Our Dermatologic Clinic (2002~2007): Clinical Presentation and Changes in Symptomatic Stage / 대한피부과학회지

BACKGROUND: There are many differences in the prevalence of syphilis according to the objects and districts. Recently, the incidence of syphilis increased in the world because of various factors. OBJECTIVE: The purpose of this study is to investigate the changes of the epidemiological, clinical characteristics, and stages of syphilis. METHODS: We selected 357 patients with reactive results on VDRL among 79,991 cases who visited in our hospital, between January 2002 and December 2007. We assessed the age, gender, skin lesion, serologic result, clinical stage, treatment history, and underlying disease. RESULTS: During the 7-year period under study, the reactive rate of serum VDRL test was 4.5% in 79,991 people (preoperation or admission examinees: 35.0%. physical examinees: 30.8%, skin lesion: 21.3%, partner's (+): 9.0%, pregnant women: 3.7%). The annual incidence of syphilis had increased from 3.5% in 2002 to 6.3% in 2007. On a total 357 sera with reactive results on VDRL, the symptomatic syphilis rate was 21.3%, increased from 13.6% in 2002 to 26.8% in 2007 (p=0.001). Statistically, there are differences in age distribution between both sexes. The male:female ratio was 1:3.3 in 0~19 years and 1.9:1 in 60~69 years (p=0.029). The incidence of symptomatic syphilis cases was 8 (66.7%) in 0~19 years, 22 (39.3%) in 20~29 years, while latent syphilis was 53 (74.6%) in 50~59 years and 35 (60.3%) in 60~69 years (p<0.001). CONCLUSION: This study suggests that the incidence of symptomatic syphilis may be increasing. Further observation, analysis, and continued vigilance in the general population are required.

A 5-Year Period Clinical Observation on Herpes Zoster and the Incidence of Postherpetic Neuralgia (2002~2006); A Comparative Analysis with the Historical Control Group of a Previous Study (1995~1999) / 대한피부과학회지

BACKGROUND: Herpes zoster is a commom dermatologic disease characterized by acute unilateral neuritis, vesicular eruption and a persistent pain after the rash has healed- a complication known as postherpetic neuralgia. Recently, the incidence of herpes zoster seems to be increased due to various factors. OBJECTIVE: The purpose of this study was to investigate the change of the epidemiological and clinical characteristics, starting on the first day of antiviral therapy, and the incidence rate of postherpetic neuralgia. METHODS: During the 5 years from January 2002 to December 2006, 177 patients (Group A) with herpes zoster were assessed with age, sex, dermatomal distribution, starting day of antiviral therapy and postherpetic neuralgia. The data was compared with the historical control group of a previous study (1995~1999, Group B). RESULTS: There was no statistical difference between the two groups in clinical characteristics. Thoracic dermatome involvement was most common in both groups. But the incidence of trigeminal involvement was higher in group A than group B (p=0.040). Based on the starting day of antiviral therapy, the percentage of 3rd day group is higher than other groups. In group A, the percentage of 2nd, 3rd, 4th day group was increased and mean starting day was faster than group B (p=0.043). The prevalence of postherpetic neuralgia was decreased from group B to group A. In group A, incidence of postherpetic neuralgia according to age or delaying therapy increases (p=0.001). But, sex, underlying disease and dermatomal distribution were not predictor of postherpetic neuralgia. CONCLUSION: In group A, the starting day of antiviral therapy shows a tendency to be shortened, and the incidence of postherpetic neuralgia had decreased.

A Case of Post-traumatic Pyoderma Gangrenosum Associated with Ulcerative Colitis / 대한피부과학회지

Pyoderma gangrenosum is a painful, chronic, ulcerating skin disease associated with a wide variety of disorders, including Crohn's disease, ulcerative colitis, and Behcet's disease. Etiology of pyoderma gangrenosum is unknown but the lesions frequently appear at points of trauma and it is related with pathergy. We report a case of post-traumatic pyoderma gangrenosum occurring in ulcerative colitis with a review of the literature.

A Case of Juvenile Xanthogranuloma Developed in a Neurofibromatosis Child with Family History / 대한피부과학회지

Juvenile xanthogranuloma (JXG) is a fibrohistiocytic proliferative disorder predominant in infancy and childhood. It is a benign and transient skin lesion that usually appears in the cephalic area. Recently, the concurrent finding of neurofibromatosis (NF), juvenile chronic myelogenous leukemia (JCML), and JXG has been repeatedly reported. Especially, the family history of NF may represent a risk factor for the development of JCML in patients with NF and in patients with NF and JXG. So, a finding of JXG and NF in infants should alert the physician to a possible development of JCML. We report a case of JXG developed in a neurofibromatosis child with family history.

A Case of a Surviving Male Infant with Incontinentia Pigmenti

Incontinentia pigmenti (Bloch-Sulzberger's disease) is an X-linked dominantly inherited disorder which is usually lethal in hemizygous males, but rarely found in male infants. It can be explained by the presence of an extra X chromosome (Klinefelter's syndrome), hypomorphic mutations, and somatic mosaicism. We herein report a rare case of incontinentia pigmenti with typical course of skin manifestation in normal karyotype (46, XY) male infant.

A Case of Lichenoid Drug Eruption with Whole Body and Oral Mucosal Involvement Caused by Antituberculosis Drugs / 대한피부과학회지

Lichenoid drug eruption can arise as a result of exogenous compound exoposures and closely mimic idiopathic lichen planus. A 45-year-old man who had taken antituberculosis drugs (isoniazid, rifampin, ethambutol, pyrazinamide) for 2 months developed pruritic violaceous papules and plaques with silvery scales on the whole body. On close inspection, he had superficial erosions on the lips and reticulate white papules on the buccal mucosa. Histopathologic findings were hyperkeratosis, parakeratosis, and hypergranulosis in the epidermis and band-like lymphohistiocytic infiltration, numerous eosinophils, and perivascular lymphohistiocytic infiltration in the dermis. The skin lesions improved leaving hyperpigmentation after cessation of the antituberculosis drugs and application of topical corticosteroid.

A Case of Jessner's Lymphocytic Infiltration / 대한피부과학회지

Jessner's lymphocytic infiltration of the skin (JLIS) is a well-known but poorly understood disorder. Some doubt still exists about whether it is a distinct disease or a variant of lupus erythematosus or, less commonly, polymorphous light eruption, cutaneous lymphoid hyperplasia. An effective therapy is still unavailable for JLIS. We report a patient with JLIS which was successfully treated with dapsone and intermittent systemic glucocorticoid therapy.

Langerhans Cells and Cytokines in UV-irradiated Melanocytic Nevi / 대한피부과학회지

BACKGROUND: It is well established that UV-induced DNA damage is involved in the mutation of oncogenes and tumor suppressor genes, and the subsequent development of skin cancers. Langerhans cells (LC) are thought to play an important role in the presentation of tumor antigens for the induction of anti-tumor immunity. Cytokines may have a key role in the UV-induced modulation of the skin's immune system. OBJECTIVE: To clarify the role of Langerhans cells, cytokines in UV-irradiated Melanocytic Nevi vs non-irradiated melanocytic nevi. METHODS: Skin biopsies from 10 melanocytic nevi, taken from partially covered melanocytic navi and irradiated part with a defined UV dose, were examined. Immunohistochemical staining was used for the quantitative distribution of LC and the expression of cytokines which are related to LC migration and maturation (TNF-alpha and GM-CSF), Th1 response (IL-12), and Th2 response (IL-10). RESULTS: LC number increased in non-irradiated neoplastic epithelium compared to control skin. In UV-exposed nevi, LC density decreased significantly but a constant number was still maintained. TNF-alpha and GM-CSF were predominently expressed in lesional epithelium and some nevus cells, 2 days after irradiation. GM-CSF expression in nevus cells was maintained up to 7 days after exposure. IL-10 was expressed in epidermis 2 days after exposure. While IL-12 was weakly positive and maintained up to 7 days in unexposed lesional epidermis, it was not detected after 2 days but reappeared in an exposed lesion after 7 days. CONCLUSION: Langerhans cells (LC) modulated by cytokines in UV-exposed skin may have a functional role in UV-induced carcinogenesis.

A Case of Poroid Hidradenoma / 대한피부과학회지

Poroid hidradenoma is a benign soft-tissue neoplasm with eccrine differentiation. It is a recent variant of the eccrine poroma group. It is made up of poroid and cuticular cells and has both solid and cystic components contained entirely within the dermis. We report a case of poroid hidradenoma in a 55-year-old female who presented with a solitary, bluish nodule on the lateral aspect of her left shin.

A Study of Antibiotic Susceptibility of Staphylococcus aureus in Bacterial Skin Infections / 대한피부과학회지

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. It can also cause community-acquired infection. However, there are few reports on MRSA in community-acquired infections. OBJECTIVE: To evaluate the prevalence and antibiotic susceptibility of Staphylococcus aureus (S. aureus) in community-acquired bacterial skin infections. METHODS: Bacterial cultures and antimicrobial susceptibility tests were performed on out-patients with bacterial skin infection from January 2004 to October 2005. RESULTS: Of 252 pyoderma cases, bacteria were cultured from 145 (57.5%) cases. Among them, S. aureus was isolated from 85 (33.7%) patients. Eight (9.4%) S. aureus isolates were MRSA. The others were coagulase-negative Streptococcus (10.3%), Streptococcus (5.6%) and gram-negative bacilli (12.3%). The resistant rates of S. aureus against antibiotics were as follows: penicilin 97.6%, tetracycline 29.7%, gentamycin 23.5%, tobramycin 16.2%, fusidic acid 13.5%, oxacillin 9.4%, erythromycin 8.1%, aberkacin 5%, ciprofloxacin 4.7%, rifampin 2.7%, clindamycin 2.4%, trimethoprim/sulfameth-oxazole 2.4%, amoxicillin/clavulanic acid 0%, teicoplanin 0% and vancomycin 0%. The effective antibiotics for the treatment of MRSA were amoxicillin/clavulanic acid (0%), teicoplanin (0%) and vancomycin (0%). CONCLUSION: S. aureus was the most predominent pathogen in community-acquired pyoderma, and was sensitive to oxacillin, erythromycin, aberkacin, ciprofloxacin, rifampin, clindamycin, trimethoprim/sulfametho-xazole, amoxicillin/clavulanic acid, teicoplanin and vancomycin. Among these, amoxicillin/clavulanic acid, teicoplanin and vancomycin were also effective in the treatment of MRSA.

A Case of Palisaded Encapsulated Neuroma of the Lower Lip

Palisaded encapsulated neuroma (PEN) is a clinically-distinctive, benign, cutaneous nerve sheath tumor. It usually occurs as a solitary, asymptomatic, skin-colored papule, and commonly affects the face of middle-aged adults. We report a case of PEN which developed on the lower lip of a 44-year-old Korean man. It was a 5mm-sized skin colored papule. Histopathologically, it consisted of uniform, broad, interlacing fascicles of spindle cells and was surrounded by a complete capsule in the dermis. On immunohistochemical staining, the tumor cells of the nodule were positive for S-100 protein and neural filaments, whil the capsule of the nodule was positive for epithelial antigen.

A Case of Hemorrhagic Cellulitis / 대한피부과학회지

Hemorrhagic cellulitis consists of an acute onset of extremely painful erythema which affects dependent areas, followed by dermal hemorrhaging and sloughing of the overlying epidermis. Hemorrhagic cellulitis in the initial stage is frequently misdiagnosed as bacterial cellulitis. The disease differs from cellulitis because of it's large area of hemorrhaging, which is an unusual feature in bacterial cellulitis. Failure to recognize and treat the early stage of the disease results in necrosis of the skin and sometimes gangrene down to the deep fascia. Treatment in the early stages consists of corticosteroids in combination with antibiotics. We report a case of hemorrhagic cellulitis in the right lower leg of a 66-year-old male with diabetes mellitus. Begining as a tender erythematous streak, the lesions became hemorrhagic and evolved progressively through the hemorrhagic vesicobullous stage, to necrotic crusts in about 2 weeks. Cultural isolation showed Enterobacter cloacea.

Immunohistochemical Study for MAPK Expression in UV Irradiated Melanocytic Nevi / 대한피부과학회지

BACKGROUND: In contrast to the relationship between UV exposure and nonmelanoma skin cancers, molecular evidence for the involvement of UV radiation in melanocytic tumorigenesis is quite limited. Mitogen-activated protein kinase (MAPK) is an important molecule in transducing extracellular signals from the cell surface to the nucleus. The MAPK family includes ERK (extracellular signal- regulated protein kinase), JNK (stress-activated c-Jun N-terminal kinase), and p38 kinases. Various growth factors and cytokines, as well as other signals such as UV light are able to activate MAPK, resulting in a variety of cellular responses including proliferation, differentiation and apoptosis. OBJECTIVE: The purpose of our study was to investigate the effect of UV irradiation on the expression of MAPK in melanocytic nevi. METHOD: Melanocytic nevi from ten healthy volunteers were partially covered, irradiated with a defined UV dose, and excised after 1 week. healthy The irradiated and non-irradiated area were examined separateted by immunohistochemistry using p-ERK, p-JNK, and p-p38 monoclonal antibodies. RESULTS: In the non-irradiated area of melanocytic nevus, p-ERK, p-JNK, and p-p38 were undetectable in nevus cells. After irradiation, p-ERK expression was observed in nevus cells in 7 cases, and p-p38 was stained diffusely in the cytoplasm of nevus cells in 6 cases, but there was no immunoreactivity of p-JNK. CONCLUSION: We suggest that a single UV irradiation of melanocytic nevi can stimulate both p-ERK and cytoplasmic p-p38 expression, but not p-JNK.

Acanthosis Nigricans Associated with Vitiligo

No abstract available.

The Effect of Amniotic Membrane Patch in Wound Healing of Skin Defect / 대한피부과학회지

BACKGROUND: Amniotic membrane contains basement membrane components and several growth factor proteins. Therefore, transplantation of amniotic membrane might help epithelialization. OBJECTIVE: The purpose of this study was to compare efficacies of amniotic membrane patches (amniotic group), polyurethane film (TegadermTM, 3M, USA: wet group), and nonadherent dressing (dry group) in wound healing. METHOD: Six rabbits were included in this study. We made wound defects on the back of each rabbit. Amniotic membrane patches (amniotic group) was applied to each wound defect in the first group, polyurethane film (TegadermTM, 3M, USA: wet group) to the second group, and nonadherent dressings (dry group) to the third group. We compared the time taken for each wound defect to heal, and the gross and histopathologic change of the wound defect from baseline, over time. RESULTS: The results were as follows: 1. In the early phase, the amniotic membrane patch (amniotic group) resulted in a faster healing time than either the polyurethane film (TegadermTM, 3M, USA: wet group) or the nonadherent dressing (dry group). 2. On day 10, all groups achieved histological epithelialization. 3. In the late phase, the amniotic membrane patch (amniotic group) might inhibit collagen fiber arrangement and development of skin appendages. CONCLUSION: The amniotic membrane patch is effective in the treatment of rabbit wound defects. It can serve as a biological dressing in the early phase of wound defects.

Report from ADRG: A Study on the Clinical Manifestations of Childhood Atopic Dermatitis in Korea / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing disease with genetic and environmental background. Many factors may act as triggers and affect the course of the disease. However, little is known about the factors affecting the disease severities in Korean childhood AD. OBJECTIVE: The aim was to document the distinct characteristics of childhood AD in Korea and to determine which manifestations are prone to be present in the settings of different severity of the disease. METHOD: The clinical manifestations, past medical and family history, and inducing or aggravating factors were studied in patients, who participated in the open lectures for childhood AD patients in three provinces of Korea. The severity of the disease was evaluated using the Eczema Area and Severity Index (EASI) and the factors affecting the severity of the disease were determined. Skin prick tests with four allergens, Dermatophagoides pteronyssinus, milk, peanut and egg, were also carried out. RESULTS: Of the 93 patients, 38.7% had the disease onset between the age of three and six, while 17.2% had it between the age of seven and fifteen. Sixty-five percent of the patients had family members with a history of atopic diseases, such as AD, asthma, allergic rhinitis and allergic conjunctivitis. In order of frequency, the patients either had a history of or presently accompanying infantile eczema, allergic rhinitis, asthma or allergic conjunctivitis. Among the patients, 27% took herbal medication. The most frequently involved site was the flexural area. The most common aggravating factors were sweating in hot environment, wool fabric and stress. When AD patients were categorized into mild, moderate and severe groups by EASI, the older onset age, the longer duration, facial distribution, history of taking herbal medication, cholinergic condition, wool fabric and stress were found to be significant factors influencing the severity of the disease. Skin prick test with the four major allergens revealed the highest prevalence in Dermatophagoides pteronyssinus. CONCLUSION: The age of onset of AD was higher than that has been reported. Many suffered from infantile dermatitis and had other accompanying atopic diseases. Aggravating factors should be avoided to minimize the risk of disease aggravation. Based on the fact that late onset age, duration, facial distribution, history of taking herbal medication, cholinergic condition, wool and stress were the statistically significant factors, we may predict the severity or the course of the disease.

A Case of Spindle Cell Lipoma / 대한피부과학회지

Spindle cell lipoma is an unusual and benign neoplasm, which normally occurs in middle age to older individuals oh the posterior neck, shoulders, and upper part of the back in the form of a solitary, slowly growing, painless, and subcutaneous nodule. We report a case of spindle cell lipoma on the right forearm of a 49-year-old female. Histopathologic examination revealed that the subcutaneous tumor was composed of mature fat cells and uniform spindle cells within a mucinous matrix. In some areas, the spindle cell proliferation was dominant due to variation in the ratio of spindle cells to mature fat cells. Vascularity was prominent in many parts of the tumor, and there were numerous mast cells scattered throughout the tumor. Immunohistochemically, the spindle cells were positive for vimentin and CD34, while S-100 protein and actin were not expressed.

The Immunohistochemical Study of MAPKs Expression in Psoriatic Epidermis

No abstract available.