A Case of Unilesional Mycosis Fungoides Treated with Photodynamic Therapy Using Methyl-Aminolevulinate / 대한피부과학회지

Various treatment modalities are available for mycosis fungoides including topical steroids, topical chemotherapy, phototherapy, and spot radiation therapy. However, these modalities do not always result in optimal effects, with efficacy depending on lesion size, number, and location. Photodynamic therapy (PDT) is a recently introduced therapeutic modality that proved effective in patients with unilesional mycosis fungoides. A 58-year-old woman presented with a seven-year history of a pruritic erythematous scaly patch on her right thigh. Through skin biopsy, we verified the lesion as mycosis fungoides. The lesion did not respond well to a topical steroid. We opted for topical PDT with methyl-aminolevulinate (MAL). MAL cream was applied for 4 hours following irradiation with a red light. Four sessions were administered, separated by five weeks. The lesion clinically improved after treatment without severe side effects. PDT using MAL could be considered an effective and tolerable treatment for mycosis fungoides.

A Case of Opitz G/BBB Syndrome / 대한피부과학회지

No abstract available.

Differences in the Known Cellular Composition of Benign Pigmented Skin Lesions Reflected in Computer-Aided Image Analysis

BACKGROUND: Computer-aided image analysis (CAIA) has been suggested as an effective diagnostic tool for pigmented skin lesions (PSLs), especially melanoma. However, few studies on benign PSLs have been reported. OBJECTIVE: The purpose of this study was to evaluate benign PSLs with our CAIA software and analyze the differences between the parameters of those lesions. METHODS: By using homegrown CAIA software, we analyzed 3 kinds of PSLs-nevus, lentigo, and seborrheic keratosis. The group of seborrheic keratosis was divided into pigmented seborrheic keratosis, sebolentigine, and hyperkeratotic seborrheic keratosis. The CAIA was used to extract the color, as well as the morphological, textural, and topological features from each image. RESULTS: In line with clinical observations, the objective parameters indicated that nevus was dark and round, lentigo was small and bright, and seborrheic keratosis was large and spiky. The surface of nevus showed the highest contrast and correlation. In topological analysis, the concentricity clearly separated melanocytic lesions from seborrheic keratosis. The parameters of pigmented seborrheic keratosis were between those of typical nevus and seborrheic keratosis. CONCLUSION: We confirmed that definite correlations exist between the subjective differentiation by experts' examination and the objective evaluation by using CAIA. We also found that the morphological differences observed in CAIA were greatly influenced by the composition ratios of keratinocytes and melanocytes, which are already known histopathological characteristics of each PSL.

An Open-Label, Single-Arm, Multicenter Trial of Tacrolimus Ointment 0.1% for the Treatment of Atopic Dermatitis in the Head and Neck / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is a chronic or chronically relapsing, inflammatory, pruritic skin disease. Because tacrolimus ointment does not induce skin atrophy, it is especially indicated in delicate areas such as the face, intertriginous areas and anogenital region. OBJECTIVE: With the aim of investigating the differences between the established clinical guidelines and actual treatment response, an open-label, non-comparative, multicenter clinical observational study was undertaken. METHODS: One hundred and fifty-three patients with AD in the head and neck area were treated with topical tacrolimus 0.1% twice daily. Clinical evaluations were conducted at baseline, week 4 and week 8. Efficacy was assessed through the investigator's evaluation of the patients' individual signs (erythema, edema, oozing, excoriation, scaling, lichenification and fissuring) and symptoms (burning, pruritus and telangiectasia) using a 4-point grading system. The physician's and patient's global assessments and quality of sleep were also evaluated. RESULTS: Among 153 enrolled patients, 25 (16.3%) were lost to follow-up, and 6 (3.9%) dropped out due to adverse events, leaving 79.7% of the population who completed the trial. Head and neck dermatitis was improved or cleared in 93.6% (week 4) and 94.4% (week 8) by physicians and in 92.1% (week 4) and 90.8% (week 8) by patients. Tacrolimus treatment improved the quality of sleep in head and neck dermatitis patients. Eighty-seven percent of the subjects were compliant, applying it at least 3 days per week. Burning sensation was the most frequently reported adverse event, followed by pruritus and aggravation of the lesion. CONCLUSION: Tacrolimus ointment 0.1% is a safe and effective treatment option for atopic dermatitis of head and neck including eyelids.

Pseudomonas Folliculitis Suggestively Caused by Water from Bathing Tub: A Case Report / 대한피부과학회지

Pseudomonas infections can occur from inadequate chemical treatment of water, prolonged exposure to the water source and excessive numbers of bathers in the pool or hot tub. Therefore, pseudomonas folliculitis is also called 'hot tub folliculitis'. We report a 3-year-old boy with Pseudomonas aeruginosa folliculitis suggestively caused by water from the bathing tub of a Hotel. According to the sanitary code of the United States of America, pool staff should regularly check both chlorine and pH levels to prevent swimmers from recreational water infection. However, in Korea, there is no definite regulation regarding chlorine or pH level of recreational water. Thus, we report this issue with a review of the literature.