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Background@#Dapsone has been used for a long time to treat skin diseases. Although various drug-related side effects and adverse reactions to dapsone have been reported, most studies have addressed only one or two specific reactions to dapsone. @*Objective@#This study aimed to investigate the overall adverse reactions to dapsone in Koreans and their relationship with patient demographics. @*Methods@#A retrospective analysis was conducted by reviewing the electronic medical records from 2005 to 2020. The association between adverse drug reactions and dapsone use was assessed using the Naranjo scale. Correlations between variables and adverse reactions were analyzed using univariate and logistic regression analyses. @*Results@#The overall incidence of adverse drug reactions to dapsone was 7.7% (41 of 533 patients). The incidence was significantly higher in female than in male, and predictable adverse reactions were significantly higher (6.8%, 36 of 533 patients) than in unpredictable cases (0.9%, 5 of 533 patients). The most common adverse event was methemoglobinemia/anemia (3.0%, 16 of 533 patients), and the least common was hypersensitivity syndrome, which occurred in only one case (0.2%, 1 of 533 patients). With the exception of hypersensitivity syndrome, which is a severe drug-related side effects and adverse reactions, most patients recovered after drug discontinuation. @*Conclusion@#Dapsone can be used relatively safely for various chronic diseases if medical personnel are aware of its adverse reactions.
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Background@#Differentiating between verruca plana (VP) and VP-like seborrheic keratosis (SK) is difficult and little research has been performed on the topic. @*Objective@#The aim of this study was to elucidate clinical differences between these two diseases. @*Methods@#We conducted a retrospective review of cases of VP and VP-like SK identified by biopsy. Demographics (age and gender) and clinical information (location, color, distribution, and shape) were collected. @*Results@#A total of 224 cases were identified. Thirty-nine cases were finally diagnosed with VP (17.4%) and 159 cases with VP-like SK (71.0%). The rest of the diagnoses accounted for 26 cases. On multivariate analysis, extremities (odds ratio [OR] 7.91, confidence interval [CI] 2.61∼23.93), flesh color (OR 3.69, CI 1.43∼9.49), erythematous color (OR 36.83, CI 7.50∼180.84), and clustered distribution (OR 4.73, CI 1.66∼13.46) were significantly associated with VP. Shape is not predictive in VP occurence. @*Conclusion@#We provide clinical information regarding the differentiation of VP and VP-like SK, which should prove useful in clinical dermatological practice.
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Background@#Causative antigens in allergic contact dermatitis (ACD) can be changed by several variables, including time and place. Change in antigens over a period of time in the same institution is one way to reduce the variables; however, these investigations have rarely been performed in Korea. @*Objective@#To investigate the change in patch test results by comparing with the results obtained 10 years ago at the same hospital. @*Methods@#Patch test results were analyzed retrospectively through the medical records of patients with suspected ACD who underwent the patch test using Korean standard series between September 2015 and September 2018. The institutional Review Board of the Dongguk University Ilsan Hospital approved this study. The results of the patch test were compared with those obtained 10 years ago. @*Results@#A total of 360 patients (males: 142, females: 218) were included. Compared with the results obtained 10 years ago, the positivity rates of metal-related allergens (nickel sulfate, cobalt chloride, and potassium dichromate), fragrance allergens, and 4-phenylenediamine base were increased, whereas the positivity rates of mercury ammonium chloride, thimerosal, and formaldehyde were decreased. @*Conclusion@#The patch test results obtained at the same hospital over a 10-year interval suggest that causative allergens in ACD could change with time lapse. In the future, collaborative studies including a number of participating hospitals are needed for obtaining more reliable results.
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Background@#Despite the numerous treatment options for cutaneous warts, choosing the appropriate method for optimum results can be challenging. Treatment strategies should be individualized according to the patient and lesion characteristics. However, there is a paucity of research on the clinical factors predicting treatment response. @*Objective@#To investigate the efficacy of diphenylcyclopropenone immunotherapy for warts, based on anatomical location @*Methods@#This retrospective study included 262 wart lesions from 99 patients treated with diphenylcyclopropenone immunotherapy for warts between 2007 and 2018. The lesions were divided into three groups−periungual wart, palmoplantar wart, or hair-bearing skin wart−according to anatomical location. Periungual warts were divided into hyponychium, proximal nail fold, and lateral nail fold-type subgroups. Treatment success rates were compared between the groups. @*Results@#The treatment success rate of periungual warts (75.3%) was significantly higher than those of palmoplantar (60.4%) and hair-bearing skin (60.3%) warts. No significant differences were observed between the treatment success rates of the periungual wart subgroups. @*Conclusion@#Diphenylcyclopropenone immunotherapy is an effective treatment modality for periungual warts.
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No abstract available.
Subject(s)
Diagnosis , Emergencies , Emergency Service, Hospital , KoreaABSTRACT
Rhus is a common cause of allergic contact dermatitis (ACD), particularly in East Asia. Rhus can cause localized contact dermatitis following direct contact with the skin, and systemic contact dermatitis following its ingestion, causing pruritus, erythema, and occasionally blistering. Bullous pemphigoid (BP) is an acquired subepidermal autoimmune bullous disease that typically occurs in the elderly. Although BP usually occurs sporadically, some precipitating factors of BP have been suggested, such as other autoimmune diseases, drugs, and malignancies. We report a rare case of BP induced by ingestion of Rhus in a 54-year-old man who presented with itchy erythematous rash and blisters on the whole body, initially misdiagnosed as ACD, and treated with systemic steroids.
ABSTRACT
Rhus is a common cause of allergic contact dermatitis (ACD), particularly in East Asia. Rhus can cause localized contact dermatitis following direct contact with the skin, and systemic contact dermatitis following its ingestion, causing pruritus, erythema, and occasionally blistering. Bullous pemphigoid (BP) is an acquired subepidermal autoimmune bullous disease that typically occurs in the elderly. Although BP usually occurs sporadically, some precipitating factors of BP have been suggested, such as other autoimmune diseases, drugs, and malignancies. We report a rare case of BP induced by ingestion of Rhus in a 54-year-old man who presented with itchy erythematous rash and blisters on the whole body, initially misdiagnosed as ACD, and treated with systemic steroids.
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Orofacial granulomatosis is a rare granulomatous inflammatory disease, characterized by recurrent orofacial swelling. Infectious, genetic, and immunologic etiologies are suggested, but not fully understood. Herein, we report a case of synchronous orofacial granulomatosis with brain cavernous hemangioma in a 44-year-old female patient, which may be considered paraneoplastic syndrome.
Subject(s)
Adult , Female , Humans , Brain , Granulomatosis, Orofacial , Hemangioma, Cavernous , Hemangioma, Cavernous, Central Nervous System , Paraneoplastic SyndromesABSTRACT
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.
Subject(s)
Female , Humans , Male , Developing Countries , Disease Outbreaks , Eggs , Hypogonadism , Incidence , Korea , Medical Records , Medical Staff , Mites , Mitochondrial Diseases , Nursing Homes , Ophthalmoplegia , Ovum , Public Health , Retrospective Studies , Scabies , Skin DiseasesABSTRACT
No abstract available.
Subject(s)
Carcinoma, Squamous Cell , Esophageal Neoplasms , Neoplasm MetastasisABSTRACT
Erythema multiforme (EM) is an extremely rare condition in infancy. To the best of our knowledge, there have been only three cases of neonatal EM described in the literature, and no such cases have been reported in Korea. A preterm neonate born at 35 weeks and six days of gestation presented with multiple annular erythematous patches with a targetoid shape over his entire body at 36 days of age (corrected age of 7 days). He had no systemic symptoms except for transient mild fever. No triggering factor except for hepatitis B and BCG vaccination was found. Neutropenia was noted upon laboratory analysis. Skin biopsy specimens showed findings suggestive of erythema multiforme. The skin lesions improved rapidly upon administration of intravenous methylprednisolone; however, neutropenia continued for a much longer period. The significance of neutropenia with respect to the development of EM was not clarified. There has been no recurrence of skin lesions over a one-year follow-up period.
Subject(s)
Humans , Infant, Newborn , Pregnancy , Biopsy , Erythema , Erythema Multiforme , Fever , Follow-Up Studies , Hepatitis B , Korea , Mycobacterium bovis , Neutropenia , Recurrence , Skin , VaccinationABSTRACT
Leukocytoclastic vasculitis (LV) is characterized by neutrophilic invasion and fibrinoid necrosis along with endothelial enlargement in postcapillary venules. Annular appearance of LV (ALV) is rare, but it can be accompanied by several systemic diseases. One of these systemic diseases is ulcerative colitis (UC), a subgroup of inflammatory bowel disease. Only one case was previously reported in which ALV was associated with UC, and herein we present one more case. A 66-year-old woman presented with painful polycyclic erythema on both palms, which had been present for 4 days. She had suffered from UC for 5 years. The patient had no fever or other systemic symptoms, and histological examination demonstrated typical LV. 200 mg of oral dapsone was taken daily to rapidly reduce her symptoms and signs, and after 1 week all lesions resolved completely without any adverse events. ALV is not a distinct condition and it can appear in a broad range of small vessel vasculitides. Although ALV in patients with UC is a very rare combination, clinicians need to be aware of this possible association.
Subject(s)
Aged , Female , Humans , Colitis, Ulcerative , Dapsone , Erythema , Fever , Glycosaminoglycans , Inflammatory Bowel Diseases , Necrosis , Neutrophils , Ulcer , Vasculitis , Vasculitis, Leukocytoclastic, Cutaneous , VenulesABSTRACT
BACKGROUND: Preservatives are important contact allergens. However, any reports that have focused on them are relatively scanty in Korea. OBJECTIVE: The aim of this study is to investigate the prevalence of preservative allergy in patients with suspected cosmetic contact dermatitis. METHODS: We retrospectively reviewed the patch test results and medical recordings of the patients who were suspected of having cosmetic contact dermatitis from January 2003 to December 2008 and who visited Seoul National University Hospital. A total of 330 patients (males: 69, females: 261) were enrolled in our study and the medical records included the patients' demographic information, the site of contact dermatitis, the past dermatologic diseases and the duration of the disease. We used 30 cosmetic preservative antigens. RESULTS: The mean age of the patients was 42.5 years and the most common age of the group with contact dermatitis was in the forties. The most prevalent site for contact dermatitis was the face (60.3%). Forty nine patients (14.8%) had a past history of atopic dermatitis. A hundred thirty nine patients (42.1%) showed at least one positive patch test result. Thiomerosal showed the highest patch test rate (10.6%), followed by cocamidopropylbetaine (8.1%), Euxyl K400 (7.8%), Dodecyl gallate (6.9%) and Octyl gallate (6.6%). CONCLUSION: As the positive rate of a patch test with preservative antigens was relatively high, certain preservative antigens contained in the cosmetic series should be included in the patch test for patients with suspected cosmetic contact dermatitis.
Subject(s)
Humans , Allergens , Betaine , Cosmetics , Dermatitis, Atopic , Dermatitis, Contact , Gallic Acid , Hypersensitivity , Medical Records , Patch Tests , Prevalence , Retrospective StudiesABSTRACT
Trichogerminoma is a rare neoplasm which was first described in 1992 and there is still controversy over its inclusion into the spectrum of trichoblastoma. A 79-year-old woman presented with a 5-year history of an asymptomatic nodule on the left posterior neck. Histologically, the lesion revealed a well-demarcated deep dermal nodule surrounded by a pseudocapsule. The tumor was composed of lobules with basophilic cells and some of the lobules displayed a distinctive pattern of densely packed 'cell balls' with peripheral condensation. Immunohistochemically, the tumor cells showed zonal CK5/6 immunoactivity in contrast with the negatively stained 'cell balls'. These characteristics were compatible with the diagnosis of trichogerminoma. We report here on a rare case of a hair germ tumor called trichogerminoma.
Subject(s)
Aged , Female , Humans , Basophils , Fluconazole , Hair , NeckABSTRACT
BACKGROUND: Little information exists concerning the amount of information patients aspects from physicians as to the risk for an adverse reaction of medication. The present study was designed to determine such opinions in a population sample and to determine whether patients believe Physicians should use discretion in the amount of such information given. METHODS: Five hundred fifty sequential adults visiting outpatient clinics filled out a 9-item questionnaire. The percentage of subjects desiring information about varying degrees of risk and those believing physicians should and should not use discretion in the amount of such information provided were recorded. The results were correlated with demographic variables and Previous experience of adverse effects. RESULTS: Among the respondents, 56.6% desired to be told of all possible adverse effects; 13.8% only if an adverse effect occurred in 1 out of 100,000; and 26.3% only if such occurrence was 1 in 100, 3.3% were not interested in any information. The Percentages were closely similar to those for the same question that restricted opinion to serious adverse effects. The opinion that physicians should give the same information to all patients comprised 41.8% of the sample, and 83.4% opinioned that physicians were never justified in withholding any information. CONCLUSIONS: Many individuals desire all information concerning possible adverse effects of prescribed medication from physicians and agree that the Physician use judgement on the amount of information given, but do not consider the physician to be justified in withholding information.