Clinical and Mycological Features of Tinea Capitis in Korea: Analysis of 61 Cases from 1990 to 2018 / 대한피부과학회지

Background@#Tinea capitis, a superficial dermatomycosis, is caused by a dermatophyte infection on the scalp and hair. Recently, the number of adult patients with tinea capitis have been increasing; therefore, the clinical and mycological features of tinea capitis may be different from those of previous reports. However, only a few studies on adult tinea capitis have been conducted in Korea. Objective: This study aimed to analyze the clinical and mycological features of Korean adult patients with tinea capitis. @*Methods@#A retrospective review of 61 adult patients with tinea capitis was conducted. Clinical features including age, sex, clinical type, and treatment outcome were obtained from medical records and images. The mycological features, including the result of KOH smear and fungal culture, were also analyzed. @*Results@#The mean onset age was 61.3 years, and the male-to-female ratio was 1:4.1. Two patients (3.3%) had a family history of developing the same symptoms, and 17 (27.9%) had a history of close contact with animals. The most predilection site was the vertex, followed by the frontal and parietal areas. Microsporum canis was cultured in 66.7% patients, and Trichophyton rubrum was cultured in 28.6% patients. The number of adult patients with tinea capitis has been increasing constantly. The proportion of patients infected by T. rubrum has been increasing since 2000. Of the 51 patients who received treatments, 42 showed improvements. No significant difference was observed between patients treated with terbinafine and itraconazole. @*Conclusion@#This is the large-scale study that analyzed the clinical and mycological features of Korean adult patients with tinea capitis.

A Case of Recalcitrant Erythema Nodosum Associated with Pancreatic Cancer

No abstract available.

The Difference in Sebum Secretion Affecting Development of Acne

BACKGROUND: Although sebum secretion is crucial for acne development, acne lesion distribution is not always similar to the topographic differences of sebum secretion. OBJECTIVE: To analyze whether sebum secretion affects acne development and distribution and to assess other factors possibly influencing the relationship between acne and sebum secretion. METHODS: This single-center retrospective study included 67 acne patients and 50 controls. Acne patients were divided into 3 groups based on acne lesion distribution: T-zone dominant, U-zone dominant, and mixed groups. The secreted sebum level in each zone of acne patients was compared with that of controls. We also conducted correlation analysis between secreted sebum level and acne number, depending on the facial zone. RESULTS: No significant difference was found between acne patients and controls regarding age and sex ratio. The U-zone dominant group showed increased sebum levels compared with controls in the U-zone and whole face, but a similar result was not obtained in the T-zone dominant group. Moreover, there was a significant correlation between the number of lesions and secreted sebum level in the U-zone, but not in the T-zone. Further, there was a more significant relation in the U-zone of male and young patients. CONCLUSION: We found that increased sebum secretion compared with the condition may affect acne development, especially in the U-zone. Sex and age may also influence the relationship between acne and increased sebum secretion. Acne lesion distribution may vary from patient to patient because sebum secretion affects acne differently depending on multiple factors.

Clinicopathological Analysis of Patients with Acute Generalized Exanthematous Pustulosis / 대한피부과학회지

BACKGROUND: Acute generalized exanthematous pustulosis (AGEP) is typically a medication-induced acute febrile eruption. Few large-scale studies have reported clinical data regarding AGEP in Korea. OBJECTIVE: This study analyzed the clinical and histopathological features of AGEP in Koreans to identify recent trends in this context. METHODS: This study retrospectively reviewed 31 patients with AGEP. Age, sex, clinical features, etiologies, laboratory findings, histopathological features, and treatment outcomes were obtained from patients' medical records and photographs. RESULTS: The mean age of onset was 43.6 years, and the male:female ratio was 2.1:1. All patients showed non-follicular tiny pustules and erythema. Fever was reported in 13 patients and neutrophilia in 17 patients. Medications were considered the most common etiological contributors. Twenty patients showed drug-induced AGEP, and 11 of 20 patients showed antibiotic-induced AGEP. Serum C-reactive protein and lactate dehydrogenase levels increased in 93.8% and 77.8% of the patients, respectively. Histopathologically, all patients showed subcorneal or intraepidermal pustules, followed by exocytosis and neutrophilic dermal infiltrate. Twenty-five patients improved within a mean period of 7.5 days after the onset of the skin rash. The percentage of women in the drug-induced AGEP group was significantly higher than that in the non-drug-induced AGEP group. CONCLUSION: This report describes a large-scale study that analyzed the clinical and histopathological features of AGEP in Koreans and seems to accurately reflect the recent trends in this context. Clinically, it is important to note that the percentage of women in the drug-induced AGEP group was higher than that in groups showing other etiologies of AGEP.

Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward / 한국호스피스완화의료학회지

PURPOSE: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. METHODS: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. RESULTS: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. CONCLUSION: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.