ABSTRACT
Lipedematous alopecia (LA) is a rare disease entity that manifests as increased thickness of subcutaneous fatty tissue in the scalp with a variable degree of acquired, non-scarring alopecia. Although the pathogenesis of alopecia in LA is not clear, it is assumed that the increased thickness of subcutaneous fat retards hair growth by disturbing the peripheral microenvironment of the hair bulb. LA is clinically distinguishable from lipedematous scalp (LS) in that LS is not associated with any hair abnormalities, while LA is characterized by variable degree of hair loss. However, both LA and LS share increased scalp thickness. Here, we describe a rare case of LA on the frontal scalp of an Asian woman, further characterize the clinical and histologic features, and suggest applying an integrated diagnosis as lipedematous diseases of the scalp.
Subject(s)
Female , Humans , Adipose Tissue , Alopecia , Asian People , Diagnosis , Hair , Lipomatosis , Rare Diseases , Scalp , Subcutaneous FatABSTRACT
BACKGROUND: Onychomycosis is one of the most prevalent fungal diseases in the general population. However, treatment is of limited effectiveness and must be administered for long periods of time. Systemic antifungal agents are associated with adverse effects. OBJECTIVE: We evaluated the clinical efficacy and safety of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with amorolfine nail lacquer to treat onychomycosis. METHODS: The 128 patients were randomly divided to 2 groups: 64 in the experimental group were treated with 1,064-nm Nd:YAG laser therapy and amorolfine nail lacquer; the other 64 were in a control group treated with topical amorolfine lacquer monotherapy. The laser treatment was 4 sessions at 4-week intervals and amorolfine lacquer was applied once a week for 16 weeks. Efficacy was assessed as response rate from standardized photographs with ImagePro®Plus (Media Cybernetics, Inc., USA) analysis, microscopic examination, and subjective evaluation. RESULTS: At 16 weeks, the experimental group showed a significantly higher cumulative cure rate than the control group (71.88% vs. 20.31%, p<0.0001). Clinical therapeutic effects were linked to patient satisfaction. The percent of “very satisfied” or “satisfied” responses was higher in the test group than the control group (81.25% vs. 23.44%). The treatment regimen was well tolerated, with transient discomfort observed in the test group. CONCLUSION: The 1,064-nm Nd:YAG laser with amorolfine nail lacquer was effective and safe for treating onychomycosis. This therapy should be considered an alternative treatment, especially for patients with contraindications to systemic antifungal agents.
Subject(s)
Humans , Antifungal Agents , Cybernetics , Lacquer , Laser Therapy , Onychomycosis , Patient Satisfaction , Therapeutic Uses , Treatment Outcome , YttriumABSTRACT
BACKGROUND: Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. OBJECTIVE: To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. METHODS: To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. RESULTS: The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. CONCLUSION: Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.
Subject(s)
Female , Humans , Activities of Daily Living , Dermatitis, Contact , Eczema , Hand , Health Personnel , Korea , Medical Records , Occupations , Prevalence , Quality of Life , Seasons , Skin , Surveys and QuestionnairesABSTRACT
Neck wrinkles commonly develop owing to the aging process. However, recently, the number of patients with neck wrinkles has been increasing. Also, an increasing number of young patients have presented with this condition, possibly because of the effect of the head-down posture that they adopt when using their computer or smartphone. We report two cases of young adults with a prominent neck wrinkle. In case 1, a 29-year-old woman with a neck wrinkle was treated with six intradermal radiofrequency (RF) procedures. Her neck wrinkle was significantly improved with the RF treatment. In case 2, a 32-year-old woman with a wrinkle and generalized light brownish tiny papules on the neck was treated with three intradermal RF procedures simultaneously with 30% glycolic acid peeling. Her wrinkle and skin tone were improved dramatically. We conclude that intradermal RF has a considerable efficacy for reducing neck wrinkles.
Subject(s)
Adult , Female , Humans , Young Adult , Aging , Neck , Posture , SkinABSTRACT
BACKGROUND: Severe alopecia areata (AA) is resistant to conventional treatment. Although systemic oral corticosteroids are an effective treatment for patients with severe AA, those drugs have many adverse effects. Corticosteroid pulse therapy has been introduced to increase therapeutic effects and reduce adverse effects. However, the treatment modality in severe AA is still controversial. OBJECTIVE: To evaluate the effectiveness of corticosteroid pulse therapy in patients with severe AA compared with treatment with oral cyclosporine with corticosteroid. METHODS: A total of 82 patients with severe AA were treated with corticosteroid pulse therapy, and 60 patients were treated with oral cyclosporine with corticosteroid. Both groups were retrospectively evaluated for therapeutic efficacy according to AA type and disease duration. RESULTS: In 82 patients treated with corticosteroid pulse therapy, 53 (64.6%) were good responders (>50% hair regrowth). Patients with the plurifocal (PF) type of AA and those with a short disease duration (< or =3 months) showed better responses. In 60 patients treated with oral cyclosporine with corticosteroid, 30 (50.0%) patients showed a good response. The AA type or disease duration, however, did not significantly affect the response to treatment. CONCLUSION: Corticosteroid pulse therapy may be a better treatment option than combination therapy in severe AA patients with the PF type.
Subject(s)
Humans , Adrenal Cortex Hormones , Alopecia Areata , Alopecia , Cyclosporine , Hair , Retrospective StudiesABSTRACT
Sorafenib is an oral multi-kinase inhibitor with effects on tumor cell proliferation and tumor angiogenesis. The drug is associated with a relatively high incidence of dermatologic adverse events. Frequently observed clinical presentations include skin rash, a hand-foot skin reaction, alopecia, splinter subungual hemorrhages, and xerosis. There have been few reports of erythema multiforme or leukocytoclastic vasculitis related to sorafenib use. We report a case of a 72 year-old male diagnosed with renal cell carcinoma with distant metastasis, who developed an erythema multiforme-like drug eruption on his trunk and extremities after use of sorafenib.
Subject(s)
Humans , Male , Alopecia , Carcinoma, Renal Cell , Cell Proliferation , Drug Eruptions , Erythema Multiforme , Erythema , Exanthema , Extremities , Hemorrhage , Incidence , Neoplasm Metastasis , Skin , VasculitisABSTRACT
BACKGROUND: The most common adverse effects of oral isotretinoin are cheilitis, skin dryness, dry eyes, and conjunctivitis, whereas evening primrose oil (EPO) is known to improve skin moisture and transepidermal water loss (TEWL) in healthy adults and atopic patients. OBJECTIVE: To evaluate the clinical efficacy and safety of EPO in preventing xerotic cheilitis in acne patients being treated with oral isotretinoin. METHODS: Forty Korean volunteers of Fitzpatrick skin types III and IV, having moderate acne, were enrolled and randomized to receive either isotretinoin with or without EPO for 8 weeks. The efficacy of treatment was evaluated on the basis of global acne grading system scores, number of inflammatory and noninflammatory lesions, TEWL, corneometry, physician's global assessment, and patient satisfaction. RESULTS: The results after 8 weeks of treatment showed that the TEWL of the lip increased significantly during isotretinoin treatment, whereas the TEWL of the hand dorsum showed no significant change. The increase of the TEWL of the lip was more definite in the control group than in the experimental group. The number of acne lesions decreased significantly in both groups, and there were no differences between them. CONCLUSION: Our study suggests that the addition of EPO improved xerotic cheilitis in acne patients being treated with oral isotretinoin. However, besides TEWL and corneometry assessments, additional studies are required for a complete understanding of the role of EPO in xerotic cheilitis in acne patients being treated with oral isotretinoin.
Subject(s)
Adult , Humans , Acne Vulgaris , Cheilitis , Conjunctivitis , Hand , Isotretinoin , Lip , Oenothera biennis , Patient Satisfaction , Pilot Projects , Skin , Volunteers , Water Loss, InsensibleABSTRACT
No abstract available.
ABSTRACT
BACKGROUND: Pores are the openings of the pilosebaceous unit or the apocrine gland. Increase in pore size or in the number of dilated pores may be a cosmetic problem. To date, epidemiological studies on the numbers of dilated pores have been rarely reported. OBJECTIVE: To analyze the distribution of pores and the factors affecting pores. METHODS: We compared the number of dilated facial pores on the face according to site, age group, and sex. The relations of pore counts to wrinkle severity and to the amount of hydration were also analyzed. Dermavision(TM), a device that can take cross-polarization, parallel polarization, and ultraviolet light images, was used. Parameters were measured at three points: the forehead, cheek, and nose. RESULTS: The results revealed that dilated pores were more common on the nose and forehead. The pore counts were increased with age, and the increment was significant between participants in their 30s and 40s. Moreover, dilated pore counts were affected by wrinkle severity. The amount of hydration did not affect the counts of dilated pores. CONCLUSION: In this study, the number of dilated pores differed depending on the location. Moreover, it was confirmed that pore counts were higher in older persons. The pore counts showed a correlation with wrinkle severity.
Subject(s)
Humans , Aging , Apocrine Glands , Cheek , Epidemiologic Studies , Forehead , Nose , Ultraviolet RaysABSTRACT
BACKGROUND: Scabies is an old and common contagious skin disease. The incidence of scabies has decreased through the economic growth of Korea. However, recent outbreaks in medical facilities have created a suspicion that the infection of scabies is an emerging public health problem. OBJECTIVE: We evaluated the epidemiological and clinical aspects of patients diagnosed with scabies in Korea. This prospective study follows the retrospective study already performed by the same authors in 2011. METHODS: A multicenter, prospective study of scabies was performed at 25 hospitals in Korea. We included 914 patients who were diagnosed with scabies. Microscopic examination revealed scabies mites or eggs, or clinical improvement after treatment. Patients were asked to provide information on scabies, especially regarding the contact source, and the physicians examined them. RESULTS: Of the participants, 432 patients were men and 482 were women. Patients aged younger than 10 years and 60~69 years were the most common groups. Scabies more commonly affected patients during the fall and winter. Of the patients, 68.0% were thought to be infected at their homes, followed by nursing homes or hospitals (25.7%), and 31.6% through contact with other patients or, occasionally, staff members, including caregivers. CONCLUSION: We confirmed that scabies is an emerging threat in institutions, especially medical facilities. In addition, we suggest that public and in-hospital education is essential to minimize the problems associated with scabies.
Subject(s)
Female , Humans , Male , Caregivers , Disease Outbreaks , Economic Development , Education , Eggs , Epidemiologic Studies , Epidemiology , Incidence , Korea , Mites , Nursing Homes , Ovum , Prospective Studies , Public Health , Scabies , Skin DiseasesABSTRACT
BACKGROUND: Androgenetic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. There are no studies that analyze annual changes in age, patterns, family history, and associated disease. OBJECTIVE: We investigated the severity of hair loss, age of onset, the frequency of family history, and past medical histories in Korean patients with AGA. METHODS: A retrospective chart review was performed to identify all patients with AGA referred to the Dermatology Clinic at Chung-Ang University Hospital from January 2006 to December 2010. RESULTS: The age of onset was also gradually decreased from 34.1+/-10.1 years to 31.6+/-10.9 years between 2006 and 2010. In female patients, specific annual changes were not observed. Hamilton-Norwood Type IIIv AGA was most common in male patients and Ludwig Type I AGA was most common in female patients at all times between 2006 and 2010. The majority of patients with AGA had a family history of baldness and was most commonly associated with a paternal pattern of inheritance. Seborrheic dermatitis was the most common associated disease in male and female patients. CONCLUSION: Our results show the possibilities that the average age of onset is decreasing. The period of the present study was only 5 years, which is not sufficient for the precise determination of onset age for AGA. Clearly, a long-term study is needed.
Subject(s)
Female , Humans , Male , Age of Onset , Alopecia , Dermatitis, Seborrheic , Dermatology , Hair , Retrospective Studies , Scalp , WillsABSTRACT
BACKGROUND: Scabies is one of the common skin diseases observed in developing countries. The incidence of scabies has decreased dramatically since the late 1980s in Korea. However, recent outbreaks in nursing homes or hospitals have been raising public health concerns. OBJECTIVE: We intended to evaluate the epidemiological and clinical aspects of patients diagnosed with scabies in Korea. In particular, we tried to investigate the changing trend of contact sources in our society. METHODS: A multi-center cross sectional study was performed at 25 hospitals in Korea. We included 1,539 patients who were diagnosed with scabies. These patients showed scabies mites or eggs under microscopic examination, or clinical improvement after treatment. Their medical records with information of contact sources were reviewed. RESULTS: Six hundred and ninety-three patients were males and 826 were females. Patients' age from 70 to 79 was the most common followed by patients below 10 years of age. More patients were found in the fall and winter months. 66.7% of patients were thought to be infected at their homes which were situated next to nursing homes or hospitals (23.1%). Place of infection could not be verified in 39.3% of patients. 25.8% of patients were suggested to be infected through contact with medical staff or patients from hospitals or nursing homes. CONCLUSION: We confirmed that the contact sources of scabies are changing in our society; nursing homes and hospitals are emerging sources of infection. The majority of patients are old or very young who are vulnerable to many diseases. Therefore, dermatologists should pay attention to new contact sources and appropriate care of patients.