Sleep Pattern and Factors Causing Sleep Disturbance in Adolescents with Cancer before and after Hospital Admission

PURPOSE: This is a descriptive study conducted in order to survey sleep patterns and factors responsible for sleep disturbance among adolescent cancer patients after hospital admission. METHODS: The study group included 46 adolescent cancer patients aged 10 to 19 who received admission care in multi-bed hospital rooms from March to June 2016. Data on patterns and quality of sleep, and factors causing sleep disturbance were recorded using the Verran and Snyder-Halpern (VSH) Sleep Scale, the Pittsburgh Sleep Quality Index (PSQI), and a sleep disturbance questionnaire. RESULTS: There was no difference in patterns and quality of sleep prior to and after hospital admission in the study group. However, patients experienced sleep disturbance, as defined by PSQI > 5, both before (5.43) and after (6.30) admission. The most important physical, emotional and environmental factors causing sleep disturbance after admission were nocturnal diuresis, monotony of admission care, and crying of younger patients respectively. CONCLUSION: This study focused on sleep patterns and factors causing sleep disturbance after hospital admission for adolescent cancer patients. Future studies should aim to develop nursing interventions resulting in an environment that improves sleep quality. Additional studies should focus on developing daytime programs to determine the impact of admission care on other quality of life parameters.

A Case of Primary Cutaneous Perivascular Epithelioid Cell Tumor / 대한피부과학회지

Perivascular epithelioid cell tumors (PEComas) are a rare, recently described group of mesenchymal tumors, which is composed of distinctive perivascular epithelioid cells. Primary cutaneous PEComas are composed of focally nested or trabecularly arranged groups of epithelioid cells with clear to eosinophilic cytoplasm and round to oval nuclei with obvious nucleoli. Here, we describe the case of a 27-year-old Korean man who was presented with a solitary, cutaneous nodule on his left popliteal fossa. Physical examination revealed a solitary, 1.2x1.0 cm-sized erythematous protruding nodule on his left popliteal fossa. Immunohistochemical evaluation showed that the epithelioid tumor cells were positive for HMB-45 and desmin. These clinical and histological findings were consistent with a diagnosis of primary cutaneous PEComa.

Infantile Hemangioma Presenting as Perianal Ulcers / 대한피부과학회지

Infantile hemangiomas are the most common benign tumors of infancy and they can occur on any part of the body. However, their presentation as a perianal ulcer prior to the development of a clinical hemangioma is extremely rare. A 5-week-old girl presented with painful ulcerated lesions on the perianal area, which developed about 10 days after her birth. Histopathologic examination showed the proliferation of dilated vessels in the upper dermis. The patient was treated with combined approach using topical steroid, 5% imiquimod cream and triamcinolone intralesional injection. Clinical improvement was observed. We herein report on a case of infantile hemangioma that presented with perianal ulcers.

Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO2 Fractional Laser: A Randomized Controlled Trial

BACKGROUND: Striae distensae are atrophic dermal scars with overlying epidermal atrophy causing significant cosmetic concern. Although a variety of laser and light sources have been used for the treatment of striae distensae, to date no definite 'gold standard' treatment modality has been determined. OBJECTIVE: To assess and compare the efficacy and safety of nonablative fractional photothermolysis and ablative CO2 fractional laser resurfacing in the treatment of striae distensae. METHODS: Twenty-four ethnic South Korean patients with varying degrees of atrophic striae alba in the abdomen were enrolled in a randomized blind split study. The patients were treated with 1,550 nm fractional Er:Glass laser and ablative fractional CO2 laser resurfacing. Each half of the abdominal lesion was randomly selected and treated three times at intervals of 4-weeks using the same parameters. Digital photography was conducted and skin elasticity and the width of the widest striae in each subject were measured at the baseline and 4 weeks after the final treatment. Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs by two blinded physicians and participant satisfaction rates were evaluated. Skin biopsies were taken from three participants. All adverse effects were reported during the study. RESULTS: Although they do not statistically differ, both treatments with nonablative fractional laser and ablative CO2 fractional laser showed a significant clinical and histopathologic improvement of striae distensae over pretreatment sites. CONCLUSION: These results support the use of nonablative fractional laser and ablative CO2 fractional laser as effective and safe treatment modalities for striae distensae of Asian skin. However, neither treatment showed any greater clinical improvement than the other treatment.

Congenital Melanocytic Nevus Showing an Unusual Clinical Manifestation / 대한피부과학회지

Completely neurotized melanocytic nevi are often clinically and histologically indistinguishable from neurofibromas. We report a 23-year-old female who presented with a dark brown plaque with an underlying soft blue subcutaneous nodule in the left infra-axillary area. The skin biopsy revealed markedly increased melanocytic proliferation and nests of nevus cells within dermo-epidermal junction and upper dermis. Circumscribed, non-encapsulated tumor of the dermis was composed of loosely-spaced spindle cells and wavy stroma. Spindle cells in the lower dermis showed staining for S-100, but failed to express glial fibrillary acidic protein and Leu-7. We present an interesting case because the lesion presented as a soft blue subcutaneous nodule suggested an underlying hemangioma or neurofibroma initially, but was shown to be a neurotized melanocytic nevus based on immunohistochemical examination.

A Case of Congenital Melanocytic Nevus Clinically Improved by Fractional Carbon Dioxide Laser Treatment / 대한피부과학회지

Congenital melanocytic nevi are cosmetically disfiguring, pigmented skin lesions that are present at birth. A 61-year-old man presented with an asymptomatic 3x2 cm sized black-colored patch involving the helix, antihelix and triangular fossa of the left auricle, and the lesion had been there since birth. The patient refused surgical removal and so we tried fractional carbon dioxide laser treatment for cosmetic improvement only. Clinical improvement was observed after 18 treatment sessions. We report a case of congenital melanocytic nevus within the auricle, and this was treated with fractional carbon dioxide laser.

Facial Angioleiomyoma Mimicking a Hemangioma / 대한피부과학회지

Angioleiomyoma is a deep dermal or subcutaneous, benign tumor that originates from the vascular smooth muscle. It commonly presents between the third and sixth decades of life and it has a female preponderance. It mainly develops on the limbs and especially the lower legs. We experienced a case of angioleiomyoma that occurred on the chin, and this clinically mimicked hemangioma.