ABSTRACT
Nontuberculous mycobacteria are ubiquitous environmental organisms that are rare pathogens in immunocompetent individuals. However, cutaneous nontuberculous mycobacteria infections have been increasingly associated with invasive procedures, including surgery, liposuction, filler injection, intramuscular injection, mesotherapy, piercing, acupuncture, and cupping therapy. Herein, we report the first case of cutaneous nontuberculous mycobacteria infection caused by the East-Asian traditional treatment ‘Gua Sha’, also known as scraping, coining or spooning in English. A 35-year-old healthy female presented with widespread, painful skin nodules and pustules on her upper and lower extremities that had developed after Gua Sha treatment for body contouring. Histopathologic examination of the lesions revealed granulomatous inflammation in the dermis and the culture isolates were identified as Mycobacterium massiliense with molecular identification. The patient was successfully treated with intermittent incision and drainage of persistent nodules and oral clarithromycin based on antimicrobial susceptibility testing. We recommend implementation of a standard safety protocol for Gua Sha practitioners to minimize the risk of infection transmission.
ABSTRACT
BACKGROUND: This study aimed to analyze correlations between depression, cognitive function, oral health state, ability to perform activities of daily living, oral dryness symptoms, and oral health-related quality of life, and determine factors influencing the latter.METHODS: This was a cross-sectional study based on questionnaires completed by 260 participants with suspected dementia, residing in South Korea. Psychiatrists, psychiatric nurses, and dental hygienists visited clinics in the participating regions for examination and questionnaire administration. General characteristics, the geriatric depression scale, ability to perform activities of daily living, cognitive function, oral health state, and oral health-related quality of life were analyzed. Independent t-tests, one-way analysis of variance (ANOVA), correlation analysis and multiple regression analysis were conducted, identifying factors affecting oral health-related quality of life. Data analysis was performed using SPSS ver. 20.0 (IBM Corp., USA), and the significance was set at p<0.05.RESULTS: Approximately 65.0% of participants were female, 63.5% were in their 70s, and 90.0% had health insurance. About 21.5%, 42.0%, and 36.5% were normal, slightly impaired, and had dementia, respectively. High cognitive impairment was associated with poor oral health. Sex, education levels, marital status, and living arrangements influenced oral health-related quality of life. According to the regression analysis, geriatric depression and oral dryness affected the Geriatric Oral Health Assessment Index scores.CONCLUSION: In conclusion, oral dryness and depression levels among elders influenced oral health-related quality of life. The results showed that to enhance elders' oral health-related quality of life, it is essential to not only improve their oral health state, but also relieve oral health problems, especially oral dryness, and take into consideration their psychological aspects.
Subject(s)
Aged , Female , Humans , Activities of Daily Living , Cognition , Cognition Disorders , Cross-Sectional Studies , Dementia , Dental Hygienists , Depression , Education , Insurance, Health , Korea , Marital Status , Oral Health , Psychiatry , Quality of Life , Residence Characteristics , Statistics as TopicABSTRACT
No abstract available.
Subject(s)
Humans , Keratoderma, Palmoplantar , Pityriasis Rubra Pilaris , Pityriasis , SiblingsABSTRACT
The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into ‘dental hygiene job relevance’, ‘dental hygiene competency relevance’, ‘timeliness’, and ‘value discrimination of educational goal setting’ to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.
Subject(s)
Humans , Cross-Sectional Studies , Data Collection , Dental Hygienists , Discrimination, Psychological , Education , Expert Testimony , Hygiene , Learning , Medical Assistance , Oral Health , Oral Hygiene , Social SecurityABSTRACT
No abstract available.
Subject(s)
Humans , Alopecia Areata , Alopecia , Hair , Prostheses and ImplantsABSTRACT
No abstract available.
Subject(s)
Humans , Male , Male , Breast Neoplasms, Male , Neoplasm MetastasisABSTRACT
OBJECTIVES: To evaluate the Community-Based Participatory Research (CBPR) professional periodontal care program model for patients with hypertension and diabetes. METHODS: This descriptive case study included 151 participants of the professional periodontal care program. The CBPR-based professional periodontal care program consists of 5-steps: ‘Issue identification and prioritization’ (Step 1), ‘Strategy development’ (Step 2), ‘Entry into community’ (Step 3), ‘Implementation’ (Step 4), and ‘Transition’ (Step 5). Quantitative data were analyzed using frequency analysis, and descriptive data with PASW 23.0 (SPSS Inc., Chicago, IL, USA). The results of the Focus group interview (FGI) were classified as ‘general opinions regarding the program planning and operation receptiveness’, ‘sustainability’, ‘potential spread of the program’, and ‘improvement of program’. The interviews were qualitative research involving seven people. RESULTS: 1. Participants increased their interest in health and oral health by managing their hypertension, diabetes, and periodontal disease using community resources. Through this, healthy practices and improved awareness helped to prevent complications and manage periodontal diseases. 2. Community organizations actively cooperated, resulting in positive changes in oral health practices (increased registration of patients in education centers for hypertension and diabetes, and increased number of patients visiting the local dental clinic). In the future, it was positive to participate in the program continuously. CONCLUSIONS: The most important step is ‘Entry into community’, which has led to active participation and cooperation of community organizations and participants. Therefore, community organizations and strategy development should be discussed, and the role of community leaders should be emphasized to build cooperative relationships. In addition, participation in and collaboration with health-based projects should be achieved through a search of various community organizations.
Subject(s)
Humans , Chronic Disease , Community-Based Participatory Research , Community Participation , Cooperative Behavior , Education , Focus Groups , Hypertension , Oral Health , Periodontal Diseases , Qualitative ResearchABSTRACT
The development of cutaneous sarcoidosis as a paradoxical adverse event of tumor necrosis factor alpha (TNF-α) blockers has been reported in the literature; however, an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy has not yet been reported. Herein, we report the first case of an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy and review previous studies of cutaneous sarcoidosis. A 6-year-old Korean girl who had been suffering from juvenile rheumatoid arthritis presented with generalized erythematous skin eruption involving more than about 90% of her body surface area. After 14 months of etanercept treatment, the new erythematous skin eruption had developed and progressed into generalized erythroderma. Exclusion of suspected co-medication had been performed based on medication history. She had no other systemic symptoms, and ophthalmologic and neurologic examinations were normal. Histopathologic findings of the skin lesion revealed diffuse non-caseating granulomatous infiltrates composed of epithelioid histiocytes with sparse lymphocytes involving the entire dermis. Periodic-acid-Schiff and acid-fast stains were negative, and acid-fast bacilli was not detected by polymerase chain reaction of the skin biopsy. Based on clinicopathologic findings, she was diagnosed with etanercept-induced sarcoidal granuloma. After discontinuation of the suspected agent, the lesions spontaneously disappeared.
Subject(s)
Child , Female , Humans , Arthritis, Juvenile , Biopsy , Body Surface Area , Coloring Agents , Dermatitis, Exfoliative , Dermis , Etanercept , Granuloma , Histiocytes , Lymphocytes , Neurologic Examination , Polymerase Chain Reaction , Sarcoidosis , Skin , Tumor Necrosis Factor-alphaABSTRACT
The development of cutaneous sarcoidosis as a paradoxical adverse event of tumor necrosis factor alpha (TNF-α) blockers has been reported in the literature; however, an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy has not yet been reported. Herein, we report the first case of an erythrodermic form of cutaneous sarcoidosis during anti-TNF-α therapy and review previous studies of cutaneous sarcoidosis. A 6-year-old Korean girl who had been suffering from juvenile rheumatoid arthritis presented with generalized erythematous skin eruption involving more than about 90% of her body surface area. After 14 months of etanercept treatment, the new erythematous skin eruption had developed and progressed into generalized erythroderma. Exclusion of suspected co-medication had been performed based on medication history. She had no other systemic symptoms, and ophthalmologic and neurologic examinations were normal. Histopathologic findings of the skin lesion revealed diffuse non-caseating granulomatous infiltrates composed of epithelioid histiocytes with sparse lymphocytes involving the entire dermis. Periodic-acid-Schiff and acid-fast stains were negative, and acid-fast bacilli was not detected by polymerase chain reaction of the skin biopsy. Based on clinicopathologic findings, she was diagnosed with etanercept-induced sarcoidal granuloma. After discontinuation of the suspected agent, the lesions spontaneously disappeared.
Subject(s)
Child , Female , Humans , Arthritis, Juvenile , Biopsy , Body Surface Area , Coloring Agents , Dermatitis, Exfoliative , Dermis , Etanercept , Granuloma , Histiocytes , Lymphocytes , Neurologic Examination , Polymerase Chain Reaction , Sarcoidosis , Skin , Tumor Necrosis Factor-alphaABSTRACT
It is well recognized that the deposition of mucin occurs in areas of eruption in patients with lupus erythematosus. However, nodular cutaneous mucinosis is regarded as a rare distinctive cutaneous mucinosis in which the mucin deposition occurs in areas other than the sites of eruption in patients with systemic lupus erythematosus and manifests as a clinically specific lesion. Although several cases have been described in the literature, there have been only two reported cases in Korean literature. Thus, we report an interesting case of nodular cutaneous mucinosis that occurred in a young man. A 16-year-old man visited our clinic presenting with multiple soft subcutaneous nodules on his back for 6 months. He denied any other symptoms. Histological examination showed diffuse mucin deposition throughout the superficial and mid-reticular dermis. The abnormal laboratory values were as follows: a positive antinuclear antibody, increased anti-dsDNA, and reduced WBC count and C3 levels. He was diagnosed with nodular cutaneous mucinosis with systemic lupus erythematosus and treated with oral hydroxychloroquine and methylprednisolone. Our report is of interest owing to the rarity of developing nodular cutaneous mucinosis as an initial presentation of systemic lupus erythematosus.
Subject(s)
Adolescent , Humans , Antibodies, Antinuclear , Dermis , Hydroxychloroquine , Lupus Erythematosus, Systemic , Methylprednisolone , Mucinoses , MucinsABSTRACT
Angiomyxolipoma is a recently described and rare variant of lipoma that is characterized by the proliferation of adipose tissue with a myxoid stroma and multiple thick and thin-walled blood vessels. A 51-year-old man presented with a tender subcutaneous nodule on his right arm. The tumor was completely removed by excisional biopsy, and the histopathologic features revealed a thin fibrous capsule with incomplete fibrous septa extending into the lesion, dividing it into lobules of different sizes. The fat cells were mature, with a single vacuole and an eccentric nucleus. The vascular component consisted of groups of capillaries and occasional vessels of larger caliber. Erythrocytes were present within the lumen, and myxoid stroma was found. He was diagnosed as having angiomyxolipoma. Herein, we report a rare case of subcutaneous angiomyxolipoma of the arm. We also review and discuss such cases in the literature.
Subject(s)
Humans , Middle Aged , Adipocytes , Adipose Tissue , Arm , Biopsy , Blood Vessels , Capillaries , Erythrocytes , Lipoma , VacuolesABSTRACT
Sebaceous carcinoma (SC) is a neoplasm derived from the adnexal epithelium of the sebaceous glands, and most studies on this neoplasm have been conducted in Caucasians. We retrospectively reviewed the records of 29 patients with SC (16 extraocular and 13 ocular lesions) who were diagnosed from 2001 to 2014 to analyze the clinical and histopathological features of SC in the Korean population. Sixteen of the patients were women and 13 were men. There was an equal sex distribution for extraocular lesions, and a female predilection (M:F = 1:1.6) for ocular lesions. The mean ages at presentation of extraocular and ocular lesions were 69.19 ± 37.19 (range, 32–87) and 67.46 ± 24.46 (range, 43–85) years, respectively. Most lesions occurred in the eyelid (13/29, 44.83%), and most extraocular lesions occurred in the head and neck area (13/16, 81.25%). There was no recurrence or death during the follow-up period. Most lesions were poorly differentiated (extraocular, 43.75%; ocular, 38.46%), had a lobular infiltrative growth pattern (extraocular, 68.75%; ocular, 76.92%), and were basaloid (extraocular, 56.25%; ocular, 61.54%). Only 5 cases (2 extraocular and 3 ocular lesions) showed pagetoid spread. Extraocular lesions were marginally more common than the ocular form. There were higher incidences in elderly patients, who also had the highest incidence of eyelid lesions. The proportion of cells with sebaceous differentiation and prominent growth patterns were variable. Our results show that SC may not be very aggressive in Koreans.
Subject(s)
Aged , Female , Humans , Male , Epithelium , Eyelids , Follow-Up Studies , Head , Incidence , Korea , Neck , Pathology , Recurrence , Retrospective Studies , Sebaceous Glands , Sex Distribution , Tertiary Care CentersABSTRACT
Purpureocillium lilacinum, formerly Paecilomyces lilacinus, is a saprophytic fungus found in soil and rotting vegetation and rarely pathogenic to humans. Only 4 cases of cutaneous infection caused by Purpureocillium lilacinum have been reported in the name of Paecilomyces lilacinus. Herein, we report a case of localized cutaneous infection due to Purpureocillium lilacinum. A healthy 81-year-old immunocompetent male presented with an erythematous scaly and pustular plaque on his left dorsal hand that had begun 3 months ago. Histopathologic examination showed suppurative granulomatous inflammation with hyphae and round spores in the dermis. Periodic acid-Schiff and methenamine silver stain revealed fungal spores. Fungus culture from the biopsy specimen revealed velvety pink to white colonies after 15 day-incubation period. The slide culture stained with lactophenol-cotton blue showed typical long hyphae and flask-shaped phialides with oval conidia in chains. The result of DNA sequencing from the colony was identical to that of Purpureocillium lilacinum.
Subject(s)
Aged, 80 and over , Humans , Male , Biopsy , Dermis , Fungi , Hand , Hyphae , Inflammation , Methenamine , Paecilomyces , Sequence Analysis, DNA , Skin , Soil , Spores , Spores, FungalABSTRACT
Dermatophytosis of the palm of the hands (tinea manus) tends to involve one hand. We encountered a case of bilateral tinea manus in a patient with type 1 diabetes mellitus and bilateral tinea pedis. A 57-year-old man presented for evaluation of hyperkeratotic lesions on both his palms and soles. Skin examination revealed hyperkeratotic scaly lesions on the palmar surfaces of his hands and plantar surfaces of his feet. Yellow discoloration and thickening were observed on both his nails. Fasting venous plasma glucose concentration and hemoglobin A1c levels were 332 mg/dL and 7.5%, respectively. Fungus cultures revealed white colonies with brown color on the reverse side in a 14-day incubation period. Trichophyton rubrum infection was identified using polymerase chain reaction with amplified internal transcribed spacer regions. He was treated with oral fluconazole (150 mg/week) and topical flutrimazole spray. In addition, we examined the frequency of 77 superficial fungal hand infections (age, sex, seasonal distributions and coexisting fungal infections) among patients who visited the dermatologic clinic of Chonbuk University Hospital between January 1997 and December 2016.