ABSTRACT
Because nail psoriasis is difficult to treat, therapy with many biological drugs has been attempted. Ustekinumab is approved for chronic plaque psoriasis and psoriatic arthritis (PsA), with some trials reporting nail improvement using this agent. A 51-year-old man with severe chronic plaque psoriasis had severe involvement of all fingernails and toenails, with accompanying nail fold psoriasis. He also had PsA of the small joints of the fingers. Despite multiple conventional therapies, the nail lesions did not improve, and his nail psoriasis severity index score was 97. After a fourth ustekinumab injection, most of the fingernail psoriasis was resolved, and only hyperkeratosis remained on both large toenails. Because the nail plate, nail fold, and small joints of the fingers are closely apposed structures within a small area, cytokines produced from the nail units overflow to the nail fold and small joints and can induce nail fold psoriasis and PsA.
Subject(s)
Humans , Middle Aged , Arthritis , Arthritis, Psoriatic , Cytokines , Fingers , Joints , Nail Diseases , Nails , Psoriasis , Severity of Illness Index , UstekinumabABSTRACT
Venous leg ulcers, the most common form of leg ulcers, are relevant to the pathogenicity of pericapillary fibrin cuff. Sarcoidosis, a multiorgan granulomatous disease, causes fibrin deposition in tissues. We report a case of a 50-year-old man with venous leg ulcers coexisting with sarcoidosis. On the basis of the histologic findings, we propose the hypothesis that sarcoidosis patients are prone to the development of venous leg ulcers.
Subject(s)
Humans , Middle Aged , Capillaries , Fibrin , Leg Ulcer , Leg , Sarcoidosis , VirulenceABSTRACT
BACKGROUND: Cellulite is a 'cottage cheese-like' cutaneous change caused by subcutaneous fat bulging into the dermis that usually leads to cosmetic problems. Slimming cream containing 3.5% water-soluble caffeine and xanthenes exhibits a lipolytic effect with penetration into the dermis. OBJECTIVE: To evaluate the efficacy and safety of slimming cream for the treatment of cellulite. METHODS: Fifteen subjects with cellulite applied slimming cream to the thighs and inner side of the upper arms twice daily for 6 weeks. Efficacy was assessed using a standard visual scale, changes in the circumferences of the thighs and upper arms, and patient satisfaction by a questionnaire at baseline, week 3, and week 6. Safety was assessed by inquiring about adverse events through questionnaires. RESULTS: The standard visual scale score improved significantly by 0.49 points (19.8%) at week 6. Thigh and upper-arm circumferences decreased by 0.7 cm (1.7%) and 0.8 cm (2.3%), respectively, at week 6. Slight itching and transient flushing were commonly reported, but no serious adverse event occurred. CONCLUSION: The slimming cream tested appears to be effective for the treatment of cellulitis without serious adverse effects. However, additional large clinical trials are required to confirm the efficacy and safety of slimming cream for the treatment of cellulitis.
Subject(s)
Arm , Caffeine , Cellulitis , Dermis , Flushing , Patient Satisfaction , Pruritus , Subcutaneous Fat , Thigh , Xanthenes , Surveys and QuestionnairesABSTRACT
Oral lichen planus (OLP) is a relatively common chronic inflammatory disease of uncertain etiology. OLP lesions rarely undergo spontaneous remission and have the potential to undergo malignant transformation. The risk of malignant transformation in OLP is estimated to be between 0.4% and 5.3%; two clinical studies in Korea reported the frequency of malignant change as 2.9% and 2.85%. However, to the best of our knowledge, there has been no individual case report in the Korean dermatological literature to date regarding the malignant transformation of OLP. Herein, we report the case of a 77-year-old Korean woman with long-standing OLP that underwent transformation to oral squamous cell carcinoma. This is the first well-documented case report of squamous cell carcinoma that developed from OLP.
Subject(s)
Aged , Female , Humans , Biopsy , Carcinoma, Squamous Cell , Korea , Lichen Planus , Lichen Planus, Oral , Remission, SpontaneousABSTRACT
BACKGROUND: Formaldehyde (FA) and other volatile organic compounds (VOCs) are considered among the main causes of atopic aggravation. Their main sources include wallpapers, paints, adhesives, and flooring materials. OBJECTIVE: To assess the effects of environmentally friendly wallpaper and flooring material on indoor air quality and atopic dermatitis severity. METHODS: Thirty patients with atopic dermatitis were enrolled in this study. To improve air quality, the wallpaper and flooring in the homes of the subjects were replaced with plant- or silica-based materials. The indoor air concentration of FA and the total VOCs (TVOCs) were measured before remodeling and 2, 6, and 10 weeks thereafter. Pruritus and the severity of atopic eczema were evaluated by using a questionnaire and the eczema area and severity index (EASI) score before and at 4, 8, and 12 weeks after remodeling. The subjects were instructed to continue their therapy for atopic dermatitis. RESULTS: The houses of 24 subjects were remodeled; all subjects completed the study. The concentration of FA in ambient air significantly decreased within 2 weeks after remodeling. The TVOC level showed a decrease at week 2 but increased again at weeks 6 and 10. The reduction of pruritus and EASI score was statistically significant in patients whose baseline EASI score was >3. CONCLUSION: Replacing the wallpaper and flooring of houses with environmentally friendly material reduced FA in ambient air and improved pruritus and the severity of atopic eczema. The improvement of pruritus and eczema was statistically significant in patients whose baseline EASI score was >3.
Subject(s)
Humans , Adhesives , Air Pollution, Indoor , Dermatitis, Atopic , Eczema , Formaldehyde , Housing , Paint , Pilot Projects , Pruritus , Volatile Organic Compounds , Surveys and QuestionnairesABSTRACT
No abstract available.
Subject(s)
Carbon Dioxide , Carbon , Foreign Bodies , Foreign-Body Reaction , Granuloma , Lasers, Gas , LipABSTRACT
No abstract available.
ABSTRACT
BACKGROUND: Computer-aided image analysis (CAIA) has been suggested as an effective diagnostic tool for pigmented skin lesions (PSLs), especially melanoma. However, few studies on benign PSLs have been reported. OBJECTIVE: The purpose of this study was to evaluate benign PSLs with our CAIA software and analyze the differences between the parameters of those lesions. METHODS: By using homegrown CAIA software, we analyzed 3 kinds of PSLs-nevus, lentigo, and seborrheic keratosis. The group of seborrheic keratosis was divided into pigmented seborrheic keratosis, sebolentigine, and hyperkeratotic seborrheic keratosis. The CAIA was used to extract the color, as well as the morphological, textural, and topological features from each image. RESULTS: In line with clinical observations, the objective parameters indicated that nevus was dark and round, lentigo was small and bright, and seborrheic keratosis was large and spiky. The surface of nevus showed the highest contrast and correlation. In topological analysis, the concentricity clearly separated melanocytic lesions from seborrheic keratosis. The parameters of pigmented seborrheic keratosis were between those of typical nevus and seborrheic keratosis. CONCLUSION: We confirmed that definite correlations exist between the subjective differentiation by experts' examination and the objective evaluation by using CAIA. We also found that the morphological differences observed in CAIA were greatly influenced by the composition ratios of keratinocytes and melanocytes, which are already known histopathological characteristics of each PSL.
Subject(s)
Bioengineering , Keratinocytes , Keratosis, Seborrheic , Lentigo , Melanocytes , Melanoma , Nevus , SkinABSTRACT
BACKGROUND: The differential diagnosis of common pigmented skin lesions is important in cosmetic dermatology. The computer aided image analysis would be a potent ancillary diagnostic tool when patients are hesitant to undergo a skin biopsy. OBJECTIVE: We investigated the numerical parameters discriminating each pigmented skin lesion from another with statistical significance. METHODS: For each of the five magnified digital images containing clinically diagnosed nevus, lentigo and seborrheic keratosis, a total of 23 parameters describing the morphological, color, texture and topological features were calculated with the aid of a self-developed image analysis software. A novel concept of concentricity was proposed, which represents how closely the color segmentation resembles a concentric circle. RESULTS: Morphologically, seborrheic keratosis was bigger and spikier than nevus and lentigo. The color histogram revealed that nevus was the darkest and had the widest variation in tone. In the aspect of texture, the surface of the nevus showed the highest contrast and correlation. Finally, the color segmented pattern of the nevus and lentigo was far more concentric than that of seborrheic keratosis. CONCLUSION: We found that the subtle distinctions between nevus, lentigo and seborrheic keratosis, which are likely to be unrecognized by ocular inspection, are well emphasized and detected with the aid of software.
Subject(s)
Humans , Bioengineering , Cosmetics , Dermatology , Diagnosis, Differential , Image Processing, Computer-Assisted , Keratosis, Seborrheic , Lentigo , Nevus , SkinABSTRACT
BACKGROUND: The differential diagnosis of common pigmented skin lesions is important in cosmetic dermatology. The computer aided image analysis would be a potent ancillary diagnostic tool when patients are hesitant to undergo a skin biopsy. OBJECTIVE: We investigated the numerical parameters discriminating each pigmented skin lesion from another with statistical significance. METHODS: For each of the five magnified digital images containing clinically diagnosed nevus, lentigo and seborrheic keratosis, a total of 23 parameters describing the morphological, color, texture and topological features were calculated with the aid of a self-developed image analysis software. A novel concept of concentricity was proposed, which represents how closely the color segmentation resembles a concentric circle. RESULTS: Morphologically, seborrheic keratosis was bigger and spikier than nevus and lentigo. The color histogram revealed that nevus was the darkest and had the widest variation in tone. In the aspect of texture, the surface of the nevus showed the highest contrast and correlation. Finally, the color segmented pattern of the nevus and lentigo was far more concentric than that of seborrheic keratosis. CONCLUSION: We found that the subtle distinctions between nevus, lentigo and seborrheic keratosis, which are likely to be unrecognized by ocular inspection, are well emphasized and detected with the aid of software.