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Background@#Atopic dermatitis (AD) patients usually wonder if their condition will worsen after vaccination or if they should continue with the treatment they are receiving. Considering that many patients treated with dupilumab had previously experienced severe AD symptoms and flares, the concerns are more understandable. @*Objective@#This study aimed to investigate the safety of the coronavirus disease 2019 (COVID-19) vaccination in patients with AD treated with dupilumab. @*Methods@#We enrolled 133 patients (101 dupilumab-treated and 32 systemic oral agentstreated as control group) with AD from six hospitals. Patients were asked about worsening pruritus and AD (5-point Likert scale) after vaccination. AD variables (eczema area and severity index [EASI], investigator’s global assessment [IGA], itch numerical rating scale [NRS], sleep NRS, and patient-oriented eczema measure [POEM]) were compared pre- and postvaccination. Adverse reactions to the COVID-19 vaccination were observed. @*Results@#The incidence of adverse reactions to COVID-19 vaccines and worsening AD symptoms in dupilumab-treated patients were not significantly different compared with that in the control group. The itch NRS score increased significantly after vaccination (p<0.001).However, there were no statistically significant differences between the pre-and post-EASI, IGA, and POEM scores. Eight patients (7.9%) had worse EASI scores and required rescue therapy; however, most were easily managed with low-dose steroids or topical agents. None of the patients discontinued dupilumab treatment. @*Conclusion@#No serious adverse reactions were observed in patients with AD after COVID-19 vaccination. Exacerbation of pruritus and AD symptoms was observed but was mostly mild and transient.
ABSTRACT
For all suspected, clinical, or confirmed cases of scabies, treatment should be initiated. Affected patients should be adequately isolated, and high-risk groups with close contact histories should be treated irrespective of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and patient’s health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments are topical 10% crotamiton and oral ivermectin. Following treatment completion, a follow-up visit at 2 and 4 weeks is recommended to monitor therapeutic response. Treatment failure is considered when scabies mites or burrows are detected, upon development of new clinical characteristics, or upon aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control should be rendered to reduce the transmission of scabies.
ABSTRACT
Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 people/yr in 2010 to approximately 30,000 people/yr in 2021. However, outbreaks have been consistently observed in residential facilities, such as nursing facilities, particularly among the older population. The clinical manifestations of scabies vary depending on a patient’s age, health status, number of mites, and transmission route. Typical clinical presentations of classic scabies include intense nocturnal pruritus and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. Unlike classic scabies, older adults with immunodeficiency or neurological disorders exhibit hyperkeratotic scaly lesions or an atypical distribution with mild-to-non pruritus (crusted scabies). Diagnosis of scabies is based on clinical symptoms and results of diagnostic tests aimed at identifying the presence of the parasite. Although a close contact history and characteristic clinical findings are suggestive of scabies, confirmation of diagnosis requires detection of scabies mites, eggs, or scybala.This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution in vivo imaging techniques.
ABSTRACT
Background@#In psoriasis treatment, not all body regions improve simultaneously after clinical interventions. @*Objective@#This study was aimed at evaluating clinical responses across body regions, which may differentially influence patient treatment plans. @*Methods@#This prospective, observational, and multi-center study was conducted in Koreans who adhered to ustekinumab treatment based on criteria per local label and reimbursement guidelines. A total of 581 were included in this analysis. @*Results@#The mean (±standard deviation) psoriasis area severity index (PASI) score at baseline, age, disease duration, and body surface area (%) were 18.9±9.69, 44.2±13.29 years, 11.3±9.65 years, and 27.8±17.83, respectively. Across the head and neck, upper extremities, trunk, and lower extremities, the correlation between the PASI sub-scores for the upper and lower extremities was the highest (r=0.680). The mean PASI sub-score for the lower extremities was the highest at baseline. PASI90 and PASI100 scores were the highest for the head and neck region, indicating the highest response rates, while those for the lower extremities were consistently low at all visits. @*Conclusion@#We found differences in regional ustekinumab responses, with the lower extremities being the most difficult to treat. These findings should be considered in psoriasis treatment.
ABSTRACT
Background@#Patients with atopic dermatitis (AD) have an impaired quality of life (QoL). To our knowledge, impairments in mental health status and health-related QoL (HRQoL) have not yet been evaluated in adult-onset and child-onset AD in a large-scale study. @*Objective@#This study compared the mental health status and HRQoL (using the EuroQoL [EQ] five-dimensional [5D] questionnaire) in child-onset AD and adult-onset AD to those in normal controls. @*Methods@#We used nationwide, population-based, cross-sectional data from the Korean National Health and Nutrition Examination Survey conducted from 2008 to 2013. We performed multiple logistic regression analyses with adjustments for age, sex, body mass index, income, education level, drinking status, current smoking, regular exercise, diabetes mellitus, hypertension, and dyslipidemia, and analyzed odds ratios (OR) for factors associated with impaired QoL. @*Results@#The OR for strong psychological stress, depressed mood, and suicidal ideation were significantly increased in adult-onset AD patients compared to in normal controls.In addition, the OR (95% confidence interval [CI]) values for the EQ-5D questionnaire responses (for physical activity, self-control, daily activities, pain/discomfort, and anxiety/ depression) were significantly high in adult-onset AD compared to in normal controls after adjustments for covariates. However, patients with child-onset AD showed a significantly increased OR (95% CI) only for problems in pain/discomfort in the EQ-5D questionnaire. @*Conclusion@#Adult-onset AD patients suffer from impaired HRQoL and significant mental problems compared to normal controls. Dermatologists should focus not only on the clinical phenotype but also patients’ psychological health status to ensure a better treatment outcome.
ABSTRACT
Background@#Ultraviolet radiation causes skin damage due to increased production of reactive oxygen species (ROS) and inflammatory intermediates and direct attack of DNA of skin cells. Astaxanthin is a reddish pigment that belongs to a group of chemicals called carotenoids and has protective effects as an antioxidant. @*Objective@#To determine the beneficial effects of astaxanthin on damaged human skin after exposure to ultraviolet radiation. @*Methods@#Normal human epidermal keratinocytes (NHEKs) were pre-treated with astaxanthin for 24 hours and exposed to ultraviolet B (UVB) irradiation. After 24 hours, the Cell Counting Kit-8 (CCK-8) assay measured cell viability, ROS assay and flow cytometry analysis assessed apoptosis, and western blotting was performed to determine expression of apoptosis-related proteins. @*Results@#Astaxanthin significantly inhibited UVB-induced NHEKs cytotoxicity. Pretreatment of NHEKs with astaxanthin reduced UVB-induced ROS production. Astaxanthin caused significant inhibition of UVB-induced apoptosis, as evidenced by flow cytometry analysis and western blotting. @*Conclusion@#These results suggest that astaxanthine has a beneficial effect of reducing damage caused by UVB by effectively inhibiting cell death and reducing ROS production in keratinocytes.
ABSTRACT
Background@#Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. @*Objective@#The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. @*Methods@#We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. @*Results@#A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. @*Conclusion@#These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.
ABSTRACT
Background@#Hot springs have been traditionally used as an alternative treatment for a wide range of diseases, including rheumatoid arthritis, bronchial asthma, diabetes, hypertension, psoriasis and atopic dermatitis. However, the clinical effects and therapeutic mechanisms associated with hot springs remain poorly defined. @*Objective@#The purpose of this study was to demonstrate the different effects of hot springs on cellular viability and secretion of inflammatory cytokines on keratinocyte in two geographically representative types of hot springs: NaHCO3 -type and NaCl-type, which are the most common types in South Korea. @*Methods@#We performed WST-1, BrdU measurements, human inflammatory cytokine arrays and enzyme-linked immunosorbent assay in HaCaT cells stimulated with toll-like receptor 3 by polyinosinic-polycytidylic acid. @*Results@#The interaction effects of cell viability and cell proliferation were not significantly different regardless of polyinosinic-polycytidylic acid stimulation and cultured hot springs type. Cytokine array and enzyme-linked immunosorbent assay analysis showed increased expression of inflammatory cytokines such as interleukin-6 and granulocyte-macrophage colony-stimulating factor by polyinosinic-polycytidylic acid stimulation, with expression levels differing according to hot springs hydrochemical composition. Cytokine reduction was not significant. @*Conclusion@#The effects and mechanisms of hot springs treatment in keratinocytes were partially elucidated.
ABSTRACT
Background@#Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. @*Objective@#The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. @*Methods@#We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. @*Results@#A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. @*Conclusion@#These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.
ABSTRACT
Background@#Hot springs have been traditionally used as an alternative treatment for a wide range of diseases, including rheumatoid arthritis, bronchial asthma, diabetes, hypertension, psoriasis and atopic dermatitis. However, the clinical effects and therapeutic mechanisms associated with hot springs remain poorly defined. @*Objective@#The purpose of this study was to demonstrate the different effects of hot springs on cellular viability and secretion of inflammatory cytokines on keratinocyte in two geographically representative types of hot springs: NaHCO3 -type and NaCl-type, which are the most common types in South Korea. @*Methods@#We performed WST-1, BrdU measurements, human inflammatory cytokine arrays and enzyme-linked immunosorbent assay in HaCaT cells stimulated with toll-like receptor 3 by polyinosinic-polycytidylic acid. @*Results@#The interaction effects of cell viability and cell proliferation were not significantly different regardless of polyinosinic-polycytidylic acid stimulation and cultured hot springs type. Cytokine array and enzyme-linked immunosorbent assay analysis showed increased expression of inflammatory cytokines such as interleukin-6 and granulocyte-macrophage colony-stimulating factor by polyinosinic-polycytidylic acid stimulation, with expression levels differing according to hot springs hydrochemical composition. Cytokine reduction was not significant. @*Conclusion@#The effects and mechanisms of hot springs treatment in keratinocytes were partially elucidated.
ABSTRACT
A 57-year-old man presented with a tender, solitary, 0.3 cm-sized, subdermal nodule on the left periocular area for several months. He had surgery three times for recurrent primary mucinous eccrine adenocarcinoma on the right periocular area. Skin biopsy showed a tumor separated by strands of fibrous tissue and small compartments of tumor cells were surrounded by pale-staining mucin. The cluster of tumor cells contained atypical epithelial cells. The mucin stained with periodic acid-Schiff (PAS) and alcian blue at pH 2.5. Cytokeratin-7 (CK7) was positive for tumor cells, but cytokeratin-20 (CK20) and S-100 were negative. For evaluation of local metastasis, computed tomography was performed and there was no evidence of regional lymph node metastasis. The lesion was removed by local excision and the patient was under close follow up without any sign of recurrence. To our knowledge, double primary mucinous eccrine adenocarcinomas in the opposite body site has never been reported.
ABSTRACT
Background@#Social standards for skin health have changed and have led to a rise in the general population’s interest to achieve flawless skin. @*Objective@#To survey the Korean public’s perception of skin health and dermatologists and skinhealth-related behaviors. @*Methods@#A total of 355 participants of the Skin Health Expo 2018, held by the Dermatological Research Foundation of the Korean Dermatological Association from September 14 to 16, 2018, completed a questionnaire that assessed demographics, status, and behaviors regarding skin health. The questionnaire also included lifestyle characteristics, satisfaction, behavioral factors, and perceptions regarding skin-care products. @*Results@#Participants were using various skin-care products including toners, lotions, hydrating or nutrition creams, sunscreens, essences, serums, facial masks and packs, body, hand, and foot moisturizers, eye creams, and hair products. The participants believed that the most reliable source of information on skin-care product recommendations was the dermatologist (41.55%). However, purchases were also being made at skin-care product stores (27.64%) based on the recommendation of a friend or acquaintance (40.11%). The results also revealed that 23.8% of participants experienced side effects from using skin-care and cosmetic products, and about 40% of participants could not yet distinguish hospitals run by dermatologists. @*Conclusion@#Demand for skin-care products has been increasing, and dermatologists should provide proper information about skin health to prevent adverse effects from skin-care products. Educational and informative activities, such as the expo planned by dermatologists, are necessary to improve skin health in the general population.
ABSTRACT
An eccrine poroma (EP) is a benign adnexal tumor that typically presents as a single lesion. Eccrine poromatosis defined as multiple EPs is an uncommon presentation. A 54-year-old male had undergone operation for stomach cancer 10 years prior and insisted that he had also taken adjuvant chemotherapy. The patient presented with six reddish papules and nodules scattered on the trunk and extremities for 3 years. The histopathologic findings from all six lesions were consistent with EP. No local recurrence was observed after complete removal through punch biopsies. We report a rare case of eccrine poromatosis in the patient with gastric cancer, suspected of being caused by chemotherapy.
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Purpose@#We investigated the relationship between optic nerve damage and peripapillary choroidal thickness in patients with treatment-naïve primary open-angle glaucoma. @*Methods@#Peripapillary choroidal thicknesses of 78 eyes of 39 patients with primary open-angle glaucoma were measured on 360° scans of enhanced-depth optical coherence tomography images using the inbuilt manual segmentation function. Inter-eye peripapillary choroidal thicknesses were compared and factors associated with glaucoma were analyzed. @*Results@#Eyes with primary open-angle glaucoma exhibited thinner peripapillary choroidal thickness (133.2 ± 52.1 vs. 144.1 ± 53.0 μm; p < 0.001), higher intraocular pressure (16.7 ± 3.9 vs. 15.4 ± 2.6 mmHg; p = 0.005), thinner corneal thickness (523.8 ± 32.5 vs. 527.6 ± 35.0 μm; p = 0.030), and thinner retinal nerve fiber layer (72.2 ± 13.7 vs. 89.3 ± 13.1 μm; p < 0.001), compared with healthy fellow eyes. On multivariate, conditional, logistic regression analysis, thinner peripapillary choroidal thickness (odds ratio [OR] 0.910, 95% confidence interval [CI] 0.834-0.993; p = 0.035) and higher intraocular pressure (OR 3.368, 95% CI 1.285-8.828; p = 0.014) were significantly associated with glaucoma. @*Conclusions@#Thinner peripapillary choroid and higher intraocular pressure were significantly associated with glaucoma in patients with unilateral primary open-angle glaucoma, suggesting that poor perfusion around the optic nerve head may be associated with glaucoma pathogenesis.
ABSTRACT
Chronic spontaneous urticaria (CSU) is defined as the occurrence of spontaneous wheals, angioedema, or both for >6 weeks in the absence of specific causes. It is a common condition associated with substantial disease burden both for affected individuals and societies in many countries, including Korea. CSU frequently persists for several years and requires high-intensity treatment; therefore, patients experience deteriorations in quality of life and medication-associated complications. During the last decade, there have been major advances in the pharmacological treatment of CSU and there is an outstanding need for evidence-based guidelines that reflect clinical practice in Korea. The guidelines reported here represent a joint initiative of the Korean Academy of Asthma, Allergy and Clinical Immunology and the Korean Dermatological Association, and aim to provide evidence-based guidance for the management of CSU in Korean adults and children. In Part 1, disease definition, guideline scope and development methodology as well as evidence-based recommendations on the use of antihistamines and corticosteroids are summarized.
ABSTRACT
Purpose@#We investigated the relationship between optic nerve damage and peripapillary choroidal thickness in patients with treatment-naïve primary open-angle glaucoma. @*Methods@#Peripapillary choroidal thicknesses of 78 eyes of 39 patients with primary open-angle glaucoma were measured on 360° scans of enhanced-depth optical coherence tomography images using the inbuilt manual segmentation function. Inter-eye peripapillary choroidal thicknesses were compared and factors associated with glaucoma were analyzed. @*Results@#Eyes with primary open-angle glaucoma exhibited thinner peripapillary choroidal thickness (133.2 ± 52.1 vs. 144.1 ± 53.0 μm; p < 0.001), higher intraocular pressure (16.7 ± 3.9 vs. 15.4 ± 2.6 mmHg; p = 0.005), thinner corneal thickness (523.8 ± 32.5 vs. 527.6 ± 35.0 μm; p = 0.030), and thinner retinal nerve fiber layer (72.2 ± 13.7 vs. 89.3 ± 13.1 μm; p < 0.001), compared with healthy fellow eyes. On multivariate, conditional, logistic regression analysis, thinner peripapillary choroidal thickness (odds ratio [OR] 0.910, 95% confidence interval [CI] 0.834-0.993; p = 0.035) and higher intraocular pressure (OR 3.368, 95% CI 1.285-8.828; p = 0.014) were significantly associated with glaucoma. @*Conclusions@#Thinner peripapillary choroid and higher intraocular pressure were significantly associated with glaucoma in patients with unilateral primary open-angle glaucoma, suggesting that poor perfusion around the optic nerve head may be associated with glaucoma pathogenesis.
ABSTRACT
Chronic spontaneous urticaria (CSU) is defined as the occurrence of spontaneous wheals, angioedema, or both for >6 weeks in the absence of specific causes. It is a common condition associated with substantial disease burden both for affected individuals and societies in many countries, including Korea. CSU frequently persists for several years and requires high-intensity treatment; therefore, patients experience deteriorations in quality of life and medication-associated complications. During the last decade, there have been major advances in the pharmacological treatment of CSU and there is an outstanding need for evidence-based guidelines that reflect clinical practice in Korea. The guidelines reported here represent a joint initiative of the Korean Academy of Asthma, Allergy and Clinical Immunology and the Korean Dermatological Association, and aim to provide evidence-based guidance for the management of CSU in Korean adults and children. In Part 1, disease definition, guideline scope and development methodology as well as evidence-based recommendations on the use of antihistamines and corticosteroids are summarized.
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No abstract available.
Subject(s)
Female , Humans , Aged , Candidiasis, Oral , Candida , Candida albicans , Diabetes Mellitus , Antifungal AgentsABSTRACT
To date, hundreds of fungal genomes have been sequenced, and many more are underway. Recently developed cutting-edge techniques generate very large amounts of data, and the field of fungal genomics in dermatology has consequently evolved substantially. Methodological improvements have broadened the scope of large-scale ecological studies in dermatology, including biodiversity assessments and genomic identification of fungi. Here, we aimed to provide a brief introduction to bioinformatic approaches to fungal genomics in the field of dermatology. We described the history and basic concepts of fungal genomics and presented sequencing-based techniques for fungal identification, including a list of the revised taxa of dermatophytes, as determined by current phylogenetic analysis. Finally, we discussed the emerging trends in fungal genomics in dermatology, such as next-generation sequencing.