A Survey of the Awareness, Knowledge, and Behavior of Topical Steroid Use in Dermatologic Outpatients of the University Hospital / 대한피부과학회지

BACKGROUND: Topical steroids are a widely used therapeutic agent in dermatology. However, little objective data has been collected in order to assess the awareness, knowledge and behavior of patients regarding the use of topical steroids. OBJECTIVE: The goal of this study was to investigate the current state of awareness, knowledge, and behavior of patients regarding topical steroid use. METHODS: A written questionnaire was distributed to 570 outpatients who visited the dermatologic clinics of the University Hospital. Of these, 504 were appropriate and thus were included in this study for further statistical analysis. The questionnaire consisted of 26 items concerning the overall evaluation of the awareness, and behavior of outpatients regarding their use of topical steroids. RESULTS: The results demonstrated that of 504 patients included in the analysis, 53.8% bought topical steroids with a dermatologist's prescription, whereas 33.6% obtained their topical steroids without prescription. The patient recognition rate of brand name, therapeutic effects, and side effects of topical steroids was 58%, 77% and 26%, respectively. Twenty percent of patients who have used topical steroids complained of side effects, the most common of which being pruritus (7.5% of cases). More than half of the patients said they obtained their information about topical steroids from sources other than the dermatologist. More than three quarters of patients (77%) applied topical steroids 1-2 times per day, whereas the overusers (4%) and the long-term users (16%) were applying topical steroids more than 5 times a day and longer than 16 weeks, respectively. CONCLUSION: The results indicate that topical steroids have been used without sufficient information and guidelines. Taken together, it is suggested that dermatologists should more thoroughly explain the therapeutic effects, indications, and side effects of topical steroids to their patients.

A Case of Atypical Tinea Faciale Accompanying Tinea Capitis and Tinea Corporis / 대한의진균학회지

Tinea faciale is a dermatophyte infection of glabrous skin of the face except bearded areas of the adult male. Tinea faciale usually has been classified as tinea corporis but recently recognized as a separate disease entity. The age distribution of patients was highest in the age group of 10 years or under. The most common pathogens are Trichophyton rubrum, Microsporum canis, T. mentagrophytes. We present an atypical case of Tinea faciale with Tinea capitis & Tinea corporis caused by Microsporum canis in a 75-year-old woman.

Three Cases of Wells' Syndrome / 대한피부과학회지

Wells' syndrome was first described by Wells in 1971 as a recurrent granulomatous dermatitis with eosinophilia and was later named eosinophilic cellulitis. It is defined by the following criteria: sudden onset of annular or circinate erythematous-edematous patches that rapidly evolve to morphea-like blue-slate-colored plaques; a histological feature characterized usually by the presence of 'flame figures'; non-constant blood hypereosinophilia. We present clinical and histopathologic features of three cases of eosinophilic cellulitis.

A Case of Recurrent Generalized Pustular Psoriasis Treated with a Combination of Infliximab with Methotrexate and Retinoid / 대한피부과학회지

Tumor necrosis factor (TNF)-alpha is suggested to play a major role in the pathophysiology of psoriasis. Excellent clinical responses of psoriasis to anti-TNF-alpha-based therapies have recently been demonstrated. We studied the effect of combination therapy of infliximab, methotrexate, and retinoid in recalcitrant pustular psoriasis. A 34-year-old woman with a 1-year history of severe pustular psoriasis, who had not responded to conventional therapies, responded rapidly to combination treatment with infliximab, methotrexate, and retinoid. The clinical response was ascertained by the PASI gap (Psoriasis area and severity index) and the VAS gap (Visual affected sign). The findings showed that all the pustular lesions faded away after a single combination therapy treatment, and there has been no recurrence of pustular psoriasis for 8 months since initial injection. Thus, we conclude that the combination therapy of infliximab, methotrexate, and retinoid is an effective therapy for severe recalcitrant pustular psoriasis which does not respond to conventional therapies.

A Case of Cutaneous Neurofibroma Intimately Contacted with Intrathoracic and Chest Wall Plexiform Neurofibroma in Von Recklinghausen's Disease

Congenital neurofibromatosis type 1, or Von Recklinghausen's disease is an autosomal dominant disorder characterized by neurofibroma, pigmented skin lesions (Cafe-au-lait macules), iris hamartomas and meningeal tumors, but rarely, by autonomic ganglia tumors, such as pheochromocytomas. We have experienced an intrathoracic and chest wall plexiform neurofibroma intimately contacted with collagenoma-like, dome-shaped skin lesions of type 1 neurofibromatosis, which are relatively rare and interesting, but can be regarded as typical findings in neurofibromatosis. Although intrathoracic neurogenic tumors are not uncommon, cases like ours are interesting, as the feature of collagenoma-like skin neurofibroma was very closely apposited with chest wall neurofibroma. Our case had no aypical features of malignancy and the patient was clinically followed up without recurrence.

A Case of Nevus Sebaceus, Accompanied by Syringocystadenoma Papilliferum, a Basal Cell Carcinoma-like Tumor, Sebaceous Epithelioma, Apocrine Adenoma and Tumor of Follicular Infundibulum, with Repair by Subgaleal-periosteal Fixation / 대한피부과학회지

Nevus sebaceus is well-known for its potential to develop both benign and malignant neoplasms of epidermal and adnexal origin. We found 5 tumors including syringocystadenoma papilliferum, a basal cell carcinoma-like tumor, sebaceous epithelioma, a tumor of follicular infundibulum and apocrine adenoma within a single nevus sebaceus lesion in a 37-year-old man. This is a rarely reported case of a nevus sebaceus lesion containing a basal carcinoma-like, trichoblastoma-like skin tumor and tumors of follicular infundibulum. The lesion was treated by wide excision and repaired with subgaleal-periosteal fixation which resulted in good wound healing.

Analysis of Amelogenin Gene & Short Tandem Repeat(STR) Locus F13A01, LPL from Pulpless Teeth Dentin / 대한법의학회지

Theoretically, if the odontoblastic layer on the pulpal surface of the dentin is removed, it is impossible to find nucleus after the teeth has undergone endodontic therapy. So dentin does not contain genomic DNA. But it is in existence the possibility that blood permeates into the dentin by endodontic therapy and trauma. Therefore DNA in blood can be detected from the dentin layer. The purpose of this investigation is to evaluate the possibility of individual identification after detection of DNA in the dentin of endodontic created teeth. The authors isolated the human DNA from 40 endodontic treated teeth, performed AmpFLPs by PCR and electrophoresed for detection of STR loci F13A01, LPL gene and X-Y homologous amelogenin gene. The following results were obtained: 1) DNA extraction was possible in 19 endodontic treated teeth out of 40. 2) Sex determination was possible in 12 endodontic treated teeth out of 40 by detection of X-Y homologous amelogenin gene 3) F13A01 locus was detected in 6 endodontic treated teeth out of 40, observed 4 alleles(3.2, 4, 5, 6) and 5 genotypes(3.2-3.2, 3.2-4, 3.2-5, 4-5, 6-6). 4) LPL locus was detected in 7 endodontic treated teeth out of 40, observed 3 alleles(10, 11, 12) and 3 genotypes(10-10, 10-12, 11-12). From the above results DNA extraction, sex determination, amplification of STR locus F13A01, and LPL gene were possible in the endodontic treated teeth and it was suggested that endodontic treated teeth were useful and applicatable as molecular biological samples for individual identification.