Effects of Lactic Acid and Sodium Pyrrolidone Carboxylic Acid on the Irritated Skin Reaction Induced by Sodium Lauryl Sulphate Patch Testing of Normal Persons and Atopic Dermatitis Patients / 대한피부과학회지

BACKGROUND: Natural moisturizing factors such as sodium pyrrolidone carboxylic acid and lactic acid may play an important role in increasing the moisture retention of isolated stratum corneum and reducing the incidence of dry and flaky skin in vivo. Although the precise mechanism of surfactant irritancy is not fully understood, it has been suggested that barrier dysfunction of stratum corneum by surfactants results in skin changes such as scaling, erythema, and even fissuring. OBJECTIVE: We evaluated the effect of sodium pyrrolidone carboxylic acid(NaPCA) and lactic acid(LA) with several non-invasive measuring methods in the irritated skin reaction induced by sodium lauryl sulphate (SLS) in normal persons and atopic dermatitis patients. METHODS: After skin irritation for 24 hours with patch test of 1% SLS on five volar sites of right forearm, we applied nothing(A), 3% LA+3% NaPCA(B), 3% LA(C), 3% NaPCA(D), and vehi cle(E) twice a day respectively. Visual score, transepidermal water loss(TEWL), water holding capa city(WHC), and erythema index were measured at 30 min, 24hr, 48hr and 72hr after patch removal. RESULTS: 1. After 72hr, the visual scores of B and C were significantly lower than that of A(control) in atopic dermatitis patients, and that of C in normal persons was significantly lower than that of A, D, and E. 2. TEWL values of B and C in both the normal (after 72hr) and atopic dermatitis group (after 48hr and 72hr) were significantly lower than that of A. 3. WHC values of B, C, D in both the normal and atopic dermatitis group were significantly higher than that of A after 48hr and 72hr. 4. After 72hr, erythema indices by Mexameter of B, C, and D in both the normal and atopic dermatitis group were significantly lower than that of A and values of C were significantly lower than that of E. In the atopic dermatitis group, values of D were also significantly lower than that of E. 5. The mean visual score was significantly correlated with TEWL value and erythema index of Mexameter (r=0.58, r=0.64) and the TEWL value was significantly correlated with erythema index of Mexameter (r=0.64). CONCLUSION: These results suggest that topical application of a moisturizing factor might improve the surfactant-induced disruption of permeability barrier with improvement of the water holding capacity of the stratum corneum.

Tick Bites / 대한피부과학회지

Tick bites are dermatoses not commonly encountered in Korea. Identification of causative ticks as well as recognition of clinical signs and histopathologic findings are important in making a diagnosis in tick-related dermatoses. Hard ticks which belong to the Family Ixodidae are responsible for most tick-related diseases. Since the first human case of tick bite in Korea was reported in 1982, seventeen cases have been reported up to the present. All the inflicted ticks belonged to the genus Ixodes except a case by Haemaphysalis flava. Among 16 ticks, collected from 16 cases of tick bites caused by the genus Ixodes, nine I. nipponenses, an I. ovatus and I. persulcatus were identified. Recently we experienced 8 cases of tick bites, 6 of them were caused by the genus Ixodes including 4 I. nipponenses. One of them, whose essential complaint was fever and chills, showed the clinical course of tick bite pyrexia which had not been reported in Korea. The clinical and epidemiological findings of tick bites reported in Korea were reviewed, including these 8 cases.

Skin Characteristics of Normal Korean Subjects According to Sex and Site using Non-Invasive Bioengineering Methods / 대한피부과학회지

BACKGROUND: During the last few years, the in vivo study of the physiological parameters of the skin by non-invasive methods has been considerably developed. So far, there have been some reports on the skin characteristics only in parts, but there has not been any criteria to classify those of normal subjects. OBJECTIVE: The aim of the present study was to investigate the skin characteristics of healthy Korean subjects according to sex and sites using non-invasive methods. METHODS: To determine normal levels of sebum, skin hydration, transepidermal water loss (TEWL), skin elasticity and skin color according to sex, 163 subjects (male; 124, female; 39) were used to investigate 5 different anatomical sites. 6 different instruments were used: The Sebummeter SM 410, Corneometer CM 820, Evaporimeter EP1, Cutometer SEM 474, Chromameter CR-121, and Mexameter MX 16, for evaluating sebum excretion rate, capacitance, TEWL, mechanical property and skin color respectively. RESULTS: Differences were noticed depending on the anatomical sites and sex. Most of the measuring parameters were significantly different according to sites and sex. The values of sebum levels, capacitance and TEWL were higher in the males on the cheek, forehead and crows foot, whereas in the females, higher values were observed on the dorsum of the hand. The skin elasticity varied considerably among the nine-parameters but, for the elastic ratio (R2, R5), the females showed significantly higher values than the males in all sites except the forehead. Skin lightness (L* value) was higher in the females, whereas the males showed lugher values in the category of redness (a* value) and yellowness (b* value). The values of the eqrthema index (EI) and melanin index (MI) were also higher in the males on all sites. Correlations between the skin parameters mentioned above were calculated. A negative, correlation between capacitance and TEWL was observed only on the cheek (male/female, r =-0.2/ r =-0.4, p<0.05). The L* value correlated negatively with MI. Mioreover the values between a* and El also showed sipificant correlations in the male (cheek and dorsum of hand, y =0.2, forehead and crows foot, r =0.3, p<0.05). There were considerably significant correlations between the visual pigmentation score and instrumental skin parameters in the males (visual pigmentation score vs. L* value measured by Chromameter ; cheek/crows foot, r = -0.3/y =-0.4, visual pigmentation score vs. MI by Mexameter ; cheek/crows foot, r =0.2/ r =0.4, viisual winkle score vs. sebum excretion rate measured by Sebumeter ; cheek, r=0.2, visual winkle score vs. elasticity parameters measured by Cutometer ; cheek, R2/R5/R7, r =-0.3/ r =-0.2/ r =-0.3, p<0.05). CONCLUSION: Skin physiological parameters can be evaluated by non-invasive skin bioengineering methods which show quantitative modifications in physiological conditions in relation to sites and sex.

A Case of Diffuse Biphasic Cutaneous Amyloidosis

We described a case of diffuse biphasic cutaneous amyloidosis, a unique form of localized cutaneous amyloidosis. A 41-year-old man has gradually developed a lichenoid papular and a grouped spotted pigmented macular eruption on the trunk and upper extremities over the past 15 years. Histopathologic examination revealed that amyloid deposits were present in the papillary dermis. It was confirmed by Congo red staining, immunohistochemistry and electron microscopy. There was no evidence of systemic amyloidosis.

A Case of Juvenile Spring Eruption of the Ears

Juvenile spring eruption(JSE) of the ears is an unusual type of photodermatosis, which develops on the light exposed areas of the ears of boys and young male adults in the early spring months. JSE has received little attention in the literature, and to our knowledge no cases have been reported in Korea until now. Herein we report a case of JSE occurring in a 17-year-old man who has suffered from a recurrent pruritic erythematous papulovesicular eruption of both helix, followed by crusting and healing without scarring within one to two months early each spring for six years.

Milia en Plaque

Milia en plaque is characterixed by multiple milia-like lesions within an erythematous edematous plaque in the postauricular area. The histopathological findings are those of milia. We report a case of milia en plaque occurring on the scapha's fossa of the left auricle in a 3-year-old boy.

A case of Malassezia (Pityrosporum) Folliculitis Associated with Pityriasis(Tinea) Versicolor / 대한의진균학회지

We report a case of Malassezia folliculitis associated with pityriasis versicolor in a 16-year-old man. He had asymptomatic multiple erythematous papulopustular eruptions and scaly confluent hypopigmented maculas on the anterior chest for 2 months. The diagnosis of Malassezia folliculitis was established with the mycological and histological examinations from the specimen of papulopustules on the chest. Pityriasis versicolor was confirmed by KOH examination with the scales of the hypopigmented macules on the chest. Although the association of these two dermatoses is not common, they are generally accepted as being caused by the same organism of the genus Afafaffgfio, which has different pathogenic stages. In our case, both types of skin lesions were improved after 3 weeks of antifungal therapy with systemic itraconazole (200 mg/day) and topical 1% isoconazole nitrate cream.

Two Cases of Congenital Preauricular Fistula / 대한피부과학회지

The auricle develops from six auricular tubercles which originate from the mesenchyme of the first and second branchial arch. If a defective fusion of these tubercles occur, a preauricular fistula may be formed. We report two cases of congenital preauricular fistula manifested by soft nodules with external openings on the left preauricular area. Histologically, the fistulas are lined by stratified squamous epithelium, and elastic cartilage. and chronic inflammatory cell infiltration are also present.