Analysis of Serum Zinc and Copper Concentrations in Hair Loss

BACKGROUND: It is well known that some trace elements such as zinc and copper play a significant role in many forms of hair loss. However, the effect of zinc and copper in the pathogenesis of hair loss is still unknown. OBJECTIVE: The purpose of this study is to evaluate the zinc and copper status in each of four types of hair loss. METHODS: A study was carried out with 30 health controls and 312 patients who were diagnosed with alopecia areata (AA), male pattern hair loss, female pattern hair loss and telogen effluvium (TE) (2008 to 2011; Hallym University Kangdong Sacred Heart Hospital). Zinc and copper serum concentrations were evaluated between controls and each of four types of hair loss patients. RESULTS: In all of the hair loss patients, the mean serum zinc was 84.33+/-22.88, significantly lower than the control group (97.94+/-21.05 microg/dl) (p=0.002), whereas the serum copper was 96.44+/-22.62, which was not significantly different (p=0.975). The analysis of each group showed that all groups of hair loss had statistically lower zinc concentration, but not copper concentrations. However, the ratio of the patients with serum zinc concentration lower than 70 microg/dl was significantly high in only the AA group (odds ratio, OR 4.02; confidence interval, CI 1.13 to 14.31) and the TE group (OR 1.12; CI 1.12 to 17.68). CONCLUSION: The data led to the hypothesis of zinc metabolism disturbances playing a key role in hair loss, especially AA and TE, whereas the effect of copper on hair growth and shedding cycles still needs more study.

A Case of Zosteriform Cutaneous Metastasis from Lung Cancer / 대한피부과학회지

Cutaneous metastasis is a relatively rare complication of internal malignancy and has been reported in 0.7% to 9% of all malignant cancers. It may be an important clue for undiagnosed malignancies or even the prognosis of primary cancers. Cutaneous metastatic cancers vary in type and are rarely presented with zosteriform distribution. The lung is one of the most common primary sites of zosteriform cutaneous metastasis. We describe a 52-year-old man with a prior history of lung cancer in whom zosteriform cutaneous metastasis developed along the right T4-5 dermatome on his trunk. This case highlights the importance of the differential diagnosis of cutaneous metastasis with zosteriform distribution and the need of skin biopsy in order to confirm the early diagnosis.

Cutaneous Lymphoid Hyperplasia Which Developed after Allergy Skin Test of Antibiotics / 대한피부과학회지

Cutaneous lymphoid hyperplasia (CLH, pseudolymphoma) refers to a heterogeneous group of benign reactive T- and/or B-cell lymphoproliferative diseases of the skin, that resemble cutaneous lymphoma both clinically and histologically. Despite the unknown causes of CLH development, various stimuli can induce CLH, such as medications, infections, insect bites, photosensitivity and foreign agents. To date, there has been no reported case of CLH development after an allergy skin test of antibiotics. Thus, we report a patient who developed CLH following an allergy skin test of antibiotics. He was a 21-year-old man who presented with 1.5x1.5 cm sized erythematous plaque with yellowish crusts on his right forearm that showed features of a CLH, based on histopathologic assessment.

Multiple Lichen Striatus in an Adult / 대한피부과학회지

Lichen striatus is an uncommon, self-limiting dermatosis that is characterized by linearly distributed eruptions that follow Blaschko's lines. It usually occurs unilaterally, but few cases of bilateral or multilinear eruptions have also been reported. In addition, lichenstriatus is commonly seen in children and rarely affects adults. We report a case of 29-year-old woman with multiple, unilateral lichen striatus on the right abdomen and right chest that was treated successfully with topical tacrolimus.

A Case of Motor Paralysis of the Limb Caused by Herpes Zoster / 대한피부과학회지

Herpes zoster is a common viral disease that accompanies segmental, painful vesicular eruptions along the dermatome. Motor involvement can also occasionally occur in this disease entity and its reported incidence is between 0.5% and 5%. However, the impairment of motor function often goes unrecognized, probably because of severe pain that is a more prominent feature than motor weakness. We experienced an 83-year-old female patient with herpes zoster infection of the right C5-7 dermatomes, who showed right upper extremity paralysis. We examined the limb using motor nerve conduction velocity (MNCV) test and concluded that herpes zoster caused patient's motor paralysis. After 4 months, her motor paralysis was completely recovered spontaneously.

A Case of Chronic Mucocutaneous Candidiasis Occurring in a Patient with Scrofuloderma-like BCGitis / 대한의진균학회지

Chronic mucocutaneous candidiasis (CMC) consists of several clinical syndrome characterized by chronic, treatment-resistant, superficial candidal infections of skin, nails and oropharynx. The patients with CMC usually have other manifestations including non-candidal infections, endocrinopathies and autoimmune diseases. These findings suggest that patients with CMC have multiple or complex abnormalities in their immune systems, especially of cell mediated immunity. The scrofuloderma or scrofuloderma-like BCGitis is used to describe the skin reaction and enlargement of regional lymph node with suppuration. In contrast to chronic mucocutaneous candidiasis, BCGitis does not suggest underlying host immune defect in most cases. In our knowledge, there is no report about scrofuloderma-like BCGitis and chronic mucocutaneous candidiasis occurring in the same patient. Herein, we report a case of chronic mucocutaneous candidiasis associated with scrofuloderma-like BCGitis.

Chondroid Syringoma Occurring in an Adolescent Girl / 대한피부과학회지

Chondroid syringoma is a myxoid tumor of the skin and the reported incidence of this is 0.098% among all the primary skin tumors. This tumor generally occurs in middle or old aged patients. A 15-year-old woman presented with a 2-year history of a 0.4x0.4 cm sized whitish papule on her nasolabial fold. The tumor was diagnosed as chondroid syringoma by histologic examinations. We present here a case of chondroid syringoma in an adolescent girl, and such a case has not been previously reported in the Korean medical literature.

A Case of Transient Acrodermatitis Enteropathica with a Normal Serum Zinc Level Localized on the Anogenital Area / 대한피부과학회지

A male full-term infant who had been breast-fed since birth developed an erythematous eroded eruption involving the anogenital area at 1 month of age, and this lesion did not respond to treatment with topical corticosteroids and antimicrobials. He was first seen at our office at 9 months of age. At that time, he had continuous diarrhea, but he had no alopecia, nail dystrophy or acral skin lesions. His serum zinc level was normal and his mother's breast milk zinc level was also normal, but it was not enough for his zinc metabolism. His clinical symptoms and skin lesions were dramatically improved with administering zinc.

Acute Generalized Exanthematous Pustulosis in a 10-month-old Infant / 대한피부과학회지

Acute generalized exanthematous pustulosis (AGEP) is an uncommon aseptic pustular eruption that usually follows recent administration of oral or parenteral drugs. Characteristic AGEP features include the sudden onset of fever with widespread erythematous eruption, rapidly progressing to a fine, non-follicular, micropustular rash. The illness usually resolves spontaneously with fever and pustulation clearing within 15 days, sometimes followed by desquamation. Histopathology shows non-follicular spongiotic pustules in the epidermis filled with neutrophils, a mixed perivascular infiltrate of neutrophils and occasional eosinophils with papillary dermal edema. We describe a 10-month-old boy with AGEP secondary to exposure to amoxicillin. This is an uncommon condition in children.