Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 281
Filter
1.
Article in English | WPRIM | ID: wpr-917654

ABSTRACT

Background@#The incidence of atopic dermatitis has been increasing and the condition is known to present with different phenotypes. As response to treatment varies from patient to patient, many attempts have been made to classify atopic dermatitis into different clinical phenotypes and endophenotypes to personalize treatment. @*Objective@#This is a pilot study that aims to classify atopic dermatitis into common clinical phenotypes and associate each of the phenotypes with clinical characteristics and laboratory findings. @*Methods@#A total of 186 adult atopic dermatitis patients were classified into four clinical phenotypes: lichenoid/exudative, nummular, prurigo-nodularis, and erythrodermic. We compared baseline characteristics, disease severity, laboratory test results, associated symptoms, and lesional location between the phenotypes. @*Results@#The age was lower, and proportion of very early onset group was higher in lichenoid/exudative type. Eczema Area and Severity Index score was significantly lower in nummular type patients. Total immunoglobulin E and eosinophilic cationic protein values were higher in lichenoid/exudative type patients and total immunoglobulin E and eosinophil (%) were lower in nummular type patients. In prurigo-nodularis type patients, eosinophilic cationic protein and vitamin D deficiency were frequent. Vitamin D deficiency was infrequent in erythrodermic type patients. @*Conclusion@#Lichenoid/exudative type patients showed classical characteristics of atopic dermatitis, and related to extrinsic type. In nummular type, patients tend to be more intrinsic and less severe. In prurigo-nodularis type, patients would be related to frequent vitamin D deficiency. Erythrodermic type patients showed more extensive atopic dermatitis lesions and less frequent vitamin D deficiency.

2.
The Korean Journal of Pain ; : 288-303, 2021.
Article in English | WPRIM | ID: wpr-903818

ABSTRACT

Background@#Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. @*Methods@#CRPS patients from 37 university hospitals in South Korea were surveyed.The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. @*Results@#A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. @*Conclusions@#Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

3.
Article in English | WPRIM | ID: wpr-902026

ABSTRACT

Background@#Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal acute hypersensitivity reactions that involve the skin and mucous membranes. Because they are relatively rare diseases, it is difficult to obtain well-organized epidemiological data. The clinicodemographic characteristics, culprit drugs, and factors related to disease prognosis may vary. @*Objective@#To identify the characteristics of SJS/TEN by investigating patient clinicopathological characteristics, laboratory findings, suspected drugs, and mortality through a retrospective study using medical record data. @*Methods@#The clinical records of patients diagnosed with SJS/TEN between February 2009 and February 2019 at three medical institutions of Soonchunhyang University were retrospectively reviewed. Data pertaining to sex, age, history, suspected drugs, latent period, laboratory findings, and mortality were collected, and their correlations were analyzed. @*Results@#We identified SJS/TEN in 88 patients. Among the probable causative agents, antibiotics were the most common (29 cases, 33.0%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) in 20 cases (22.7%). The period between drug administration and symptom onset varied with the causative agent. Patients who died had high SCORTEN scores. In addition, hypertension, diabetes, renal failure, and cardiac disease had a statistically significant association with high SCORTEN. @*Conclusion@#Antibiotics, NSAIDs, antiepileptics and allopurinol were the most commonly implicated drugs in our retrospective study. There was a significant correlation between comorbidities. Because SJS/TEN is a life-threatening condition, early recognition of the suspected drug are important. The results of this study may provide insights that aid in the early diagnosis and prediction of disease outcomes of SJS/TEN in the Korean population.

4.
Article in English | WPRIM | ID: wpr-902012

ABSTRACT

Background@#Ceramide offers an important barrier function to the epidermis. It can reduce epidermal water loss and inhibit the production of dandruff. Ceramide is essential in protecting hair and can be used as a cosmetic ingredient to improve seborrheic dermatitis and uncomfortable symptoms. @*Objective@#We aimed to evaluate the efficacy of synthetic ceramide on dandruff, erythema, sebum secretion, and scalp water loss. @*Methods@#We enrolled 20 subjects. Ten were randomly assigned to a group using a synthetic ceramide containing shampoo and the other 10 were assigned to the control group. The subjects underwent evaluation of the scalp before the trial and after using the shampoo for 4 weeks. Scores were given for dandruff and scalp erythema. Sebum secretions were evaluated using a sebumeter and were checked at four different scalp sites. The water content of the scalp was measured using a corneometer at the same sites. @*Results@#After 4 weeks, 8 patients showed favorable outcomes in dandruff in the ceramide group compared to 4 patients in the control group. Four patients displayed favorable outcomes in erythema in the ceramide group compared to 3 patients in the control group. Sebum secretion increased in the ceramide group and decreased in the control group, but the difference was not statistically significant. The water content showed a tendency to increase in the ceramide group, whereas the water content significantly decreased in the control group. @*Conclusion@#These results indicate that synthetic ceramide is effective at improving dandruff, erythema, and reducing scalp water loss.

5.
Article in English | WPRIM | ID: wpr-902007

ABSTRACT

Eruptive xanthomatosis is a condition of extensive yellowish papules and nodules with fat deposits which can spread systemically. Although eruptive xanthomatosis is usually related to abnormal lipid metabolism, few cases have been reported in patients with normal lipid levels. The current treatment option is treatment of dyslipidemia by lifestyle modification and lipid-lowering agents. But treatment strategies in normolipidemia patients have not been established. Herein, we report an unusual case of eruptive xanthomatosis in normolipidemia patient showing clinical improvement after narrow-band ultraviolet B therapy

6.
Article in English | WPRIM | ID: wpr-901977

ABSTRACT

There have been a few cases of alopecia areata (AA) patients with pityriasis rubra pilaris (PRP), but the relationship between them is unclear. To the best of our knowledge, there have been no cases of co-occurrence reported in Korea. A 58-year-old male presented with multiple erythematous follicular papules and scaly plaques on the both legs with diffuse keratotic thickening on both palms and soles for several months. After skin biopsy, he was diagnosed with type I PRP. After treatment with oral and topical steroid, vitamin D3 analogue, oral alitretinoin, and urea cream for one week, multiple, diffuse alopecic patches appeared. He was diagnosed with AA after skin biopsy and we added topical minoxidil. Herein, we report a case of AA in a patient with type I PRP.

7.
Infection and Chemotherapy ; : 489-502, 2021.
Article in English | WPRIM | ID: wpr-898643

ABSTRACT

Background@#The latent reservoir of Human Immunodificiency Virus-1 (HIV-1) has been a major barrier to the complete eradication of HIV-1 and the development of HIV therapy. Longterm non-progressors (LTNPs) are a rare group of patients with HIV-1 who can spontaneously control HIV-1 replication without antiretroviral therapy. Transcriptome analysis is necessary to predict the pathways involved in the natural control of HIV-1, elucidate the mechanisms involved in LTNPs, and find biomarkers for HIV-1 reservoir therapy. @*Materials and Methods@#In this study, we obtained peripheral blood mononuclear cells from two LTNP subjects at multiple time points and performed RNA-sequencing analyses. @*Results@#We found that LTNPs and normal subjects had different transcriptome profiles. Functional annotation analysis identified that differentially expressed genes in LTNPs were enriched in several biological pathways such as cell cycle-related pathways and the transforming growth factor-beta signaling pathway. However, genes that were downregulated in LTNPs were associated with immune responses such as the interferon response and IL2-STAT5 signaling. Protein-protein interaction network analysis showed that CD8A, KLRD1, ASGR1, and MLKL, whose gene expression was upregulated in LTNPs, directly interacted with HIV-1 proteins. The network analysis also found that viral proteins potentially regulated host genes that were associated with immune system processes, metabolic processes, and gene expression regulation. @*Conclusion@#Our longitudinal transcriptome analysis of the LTNPs identified multiple previously undescribed pathways and genes that may be useful in the discovery of novel therapeutic targets and biomarkers.

8.
The Korean Journal of Pain ; : 288-303, 2021.
Article in English | WPRIM | ID: wpr-896114

ABSTRACT

Background@#Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. @*Methods@#CRPS patients from 37 university hospitals in South Korea were surveyed.The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. @*Results@#A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. @*Conclusions@#Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

9.
Article in English | WPRIM | ID: wpr-894322

ABSTRACT

Background@#Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal acute hypersensitivity reactions that involve the skin and mucous membranes. Because they are relatively rare diseases, it is difficult to obtain well-organized epidemiological data. The clinicodemographic characteristics, culprit drugs, and factors related to disease prognosis may vary. @*Objective@#To identify the characteristics of SJS/TEN by investigating patient clinicopathological characteristics, laboratory findings, suspected drugs, and mortality through a retrospective study using medical record data. @*Methods@#The clinical records of patients diagnosed with SJS/TEN between February 2009 and February 2019 at three medical institutions of Soonchunhyang University were retrospectively reviewed. Data pertaining to sex, age, history, suspected drugs, latent period, laboratory findings, and mortality were collected, and their correlations were analyzed. @*Results@#We identified SJS/TEN in 88 patients. Among the probable causative agents, antibiotics were the most common (29 cases, 33.0%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) in 20 cases (22.7%). The period between drug administration and symptom onset varied with the causative agent. Patients who died had high SCORTEN scores. In addition, hypertension, diabetes, renal failure, and cardiac disease had a statistically significant association with high SCORTEN. @*Conclusion@#Antibiotics, NSAIDs, antiepileptics and allopurinol were the most commonly implicated drugs in our retrospective study. There was a significant correlation between comorbidities. Because SJS/TEN is a life-threatening condition, early recognition of the suspected drug are important. The results of this study may provide insights that aid in the early diagnosis and prediction of disease outcomes of SJS/TEN in the Korean population.

10.
Article in English | WPRIM | ID: wpr-894308

ABSTRACT

Background@#Ceramide offers an important barrier function to the epidermis. It can reduce epidermal water loss and inhibit the production of dandruff. Ceramide is essential in protecting hair and can be used as a cosmetic ingredient to improve seborrheic dermatitis and uncomfortable symptoms. @*Objective@#We aimed to evaluate the efficacy of synthetic ceramide on dandruff, erythema, sebum secretion, and scalp water loss. @*Methods@#We enrolled 20 subjects. Ten were randomly assigned to a group using a synthetic ceramide containing shampoo and the other 10 were assigned to the control group. The subjects underwent evaluation of the scalp before the trial and after using the shampoo for 4 weeks. Scores were given for dandruff and scalp erythema. Sebum secretions were evaluated using a sebumeter and were checked at four different scalp sites. The water content of the scalp was measured using a corneometer at the same sites. @*Results@#After 4 weeks, 8 patients showed favorable outcomes in dandruff in the ceramide group compared to 4 patients in the control group. Four patients displayed favorable outcomes in erythema in the ceramide group compared to 3 patients in the control group. Sebum secretion increased in the ceramide group and decreased in the control group, but the difference was not statistically significant. The water content showed a tendency to increase in the ceramide group, whereas the water content significantly decreased in the control group. @*Conclusion@#These results indicate that synthetic ceramide is effective at improving dandruff, erythema, and reducing scalp water loss.

11.
Article in English | WPRIM | ID: wpr-894303

ABSTRACT

Eruptive xanthomatosis is a condition of extensive yellowish papules and nodules with fat deposits which can spread systemically. Although eruptive xanthomatosis is usually related to abnormal lipid metabolism, few cases have been reported in patients with normal lipid levels. The current treatment option is treatment of dyslipidemia by lifestyle modification and lipid-lowering agents. But treatment strategies in normolipidemia patients have not been established. Herein, we report an unusual case of eruptive xanthomatosis in normolipidemia patient showing clinical improvement after narrow-band ultraviolet B therapy

12.
Article in English | WPRIM | ID: wpr-894273

ABSTRACT

There have been a few cases of alopecia areata (AA) patients with pityriasis rubra pilaris (PRP), but the relationship between them is unclear. To the best of our knowledge, there have been no cases of co-occurrence reported in Korea. A 58-year-old male presented with multiple erythematous follicular papules and scaly plaques on the both legs with diffuse keratotic thickening on both palms and soles for several months. After skin biopsy, he was diagnosed with type I PRP. After treatment with oral and topical steroid, vitamin D3 analogue, oral alitretinoin, and urea cream for one week, multiple, diffuse alopecic patches appeared. He was diagnosed with AA after skin biopsy and we added topical minoxidil. Herein, we report a case of AA in a patient with type I PRP.

13.
Infection and Chemotherapy ; : 489-502, 2021.
Article in English | WPRIM | ID: wpr-890939

ABSTRACT

Background@#The latent reservoir of Human Immunodificiency Virus-1 (HIV-1) has been a major barrier to the complete eradication of HIV-1 and the development of HIV therapy. Longterm non-progressors (LTNPs) are a rare group of patients with HIV-1 who can spontaneously control HIV-1 replication without antiretroviral therapy. Transcriptome analysis is necessary to predict the pathways involved in the natural control of HIV-1, elucidate the mechanisms involved in LTNPs, and find biomarkers for HIV-1 reservoir therapy. @*Materials and Methods@#In this study, we obtained peripheral blood mononuclear cells from two LTNP subjects at multiple time points and performed RNA-sequencing analyses. @*Results@#We found that LTNPs and normal subjects had different transcriptome profiles. Functional annotation analysis identified that differentially expressed genes in LTNPs were enriched in several biological pathways such as cell cycle-related pathways and the transforming growth factor-beta signaling pathway. However, genes that were downregulated in LTNPs were associated with immune responses such as the interferon response and IL2-STAT5 signaling. Protein-protein interaction network analysis showed that CD8A, KLRD1, ASGR1, and MLKL, whose gene expression was upregulated in LTNPs, directly interacted with HIV-1 proteins. The network analysis also found that viral proteins potentially regulated host genes that were associated with immune system processes, metabolic processes, and gene expression regulation. @*Conclusion@#Our longitudinal transcriptome analysis of the LTNPs identified multiple previously undescribed pathways and genes that may be useful in the discovery of novel therapeutic targets and biomarkers.

14.
Annals of Dermatology ; : 497-514, 2021.
Article in English | WPRIM | ID: wpr-913456

ABSTRACT

Background@#In 2015, the Korean Atopic Dermatitis Association (KADA) working group published consensus guidelines for treating atopic dermatitis (AD). @*Objective@#We aimed to provide updated consensus recommendations for systemic treatment of AD in South Korea based on recent evidence and experience. @*Methods@#We compiled a database of references from relevant systematic reviews and guidelines on the systemic management of AD. Evidence for each statement was graded and classified based on thestrength of the recommendation. Forty-two council members from the KADA participated in three rounds of voting to establish a consensus on expert recommendations. @*Results@#We do not recommend long-term treatment with systemic steroids forpatients with moderate-to-severe AD due to the risk of adverse effects. We recommend treatment with cyclosporine or dupilumab and selective treatment with methotrexate or azathioprine for patients with moderate-to-severe AD. We suggest treatment with antihistamines as an option for alleviating clinical symptoms of AD. We recommend selective treatment with narrowband ultraviolet B for patients with chronic moderate-to-severe AD. We do not recommend treatment with oral antibiotics for patients with moderate-to-severe AD but who have no signs of infection. We did not reach a consensus on recommendations for treatment with allergen-specific immunotherapy, probiotics, evening primrose oil, orvitamin D for patients with moderate-to-severe AD. We also recommend educational interventions and counselling for patients with AD and caregivers to improve the treatment success rate. @*Conclusion@#We look forward to implementing a new and updated consensus of systemic therapy in controlling patients with moderate-to-severe AD.

16.
Annals of Dermatology ; : 138-146, 2021.
Article in English | WPRIM | ID: wpr-874102

ABSTRACT

Background@#The aryl hydrocarbon receptor (AHR) and autophagy are both important to maintain skin homeostasis.However, they are also involved in skin disorders. So far, their roles in psoriasis pathogenesis are unknown. @*Objective@#We studied the immunohistochemical and gene expression of AHR, CYP1A1, and microtubule-associated protein light chain 3 (LC3) in lesional skin of psoriasis patients to determine correlations among them. @*Methods@#We included 24psoriasis patients and ten healthy volunteers. Skin biopsies were collected. AHR, CYP1A1, and LC3 protein expression was examined by immunohistochemistry, immunofluorescence, and western blotting. AHR, CYP1A1, LC3, ATG5, BECN1 and Nrf2 mRNA levels were measured by quantitative polymerase chain reaction. @*Results@#AHR and CYP1A1 protein expression were higher in psoriasis lesional skin than in normal skin. LC3 protein expression was lower in psoriasis lesions than in normal controls. AHR and CYP1A1 protein expression in psoriasis lesions showed significant positive correlations with mean epidermal thickness and inflammatory cell density. Significant negative correlations were noted between LC3 protein expression in psoriasis lesions and the mean epidermal thickness or inflammatory cell density. A significant negative correlation was found between AHR and LC3 expression in psoriatic skin. AHR, CYP1A1 and Nrf2 mRNA expression were upregulated while LC3, ATG5, and BECN1 mRNA were down-regulated, in psoriatic lesional skin compared with normal controls. @*Conclusion@#AHR and autophagy could play a role in psoriasis pathogenesis by modifying epidermal hyperproliferation and inflammation. AHR and autophagy regulation are potential therapeutic targets in chronic inflammatory skin diseases.

18.
The Korean Journal of Pain ; : 234-244, 2020.
Article | WPRIM | ID: wpr-835229

ABSTRACT

Background@#Chronic pain affects approximately 22% of the world’s population. Opioids can be useful in chronic pain management. However, some patients have negative perception of opioids. The purpose of this research was to evaluate patients’ perception about opioids and investigate problems associated with prescribing and taking opioids in South Korea. @*Methods@#Patients who visited a pain clinic in 14 university hospitals of South Korea from September through October 2018 were asked to complete anonymous questionnaires about taking opioids. @*Results@#Of the 368 patients that were surveyed (female 53.3%, male 46.7%), 56.8% were prescribed opioids. In the opioid group, 92.8% patients had heard of opioids from their doctor and 72.6% of them had a positive perception about opioids. The side effects associated with opioid use were constipation (35.4%), dizziness (24.6%), nausea and vomiting (17.4%), dysuria (6.2%), and addiction (2.0%). In the no opioid group, the primary sources of information about opioids were doctors (49.2%), mass media (30.8%), and the internet (16.2%). The main reasons why 39.0% patients did not take opioids were fear of addiction (57.7%) and side effects (38.5%). There were 71.5% and 60.9% patients in the opioid and no opioid group, respectively, who wished to take opioids when their numeric rating scale pain score was ≥ 7. @*Conclusions@#Perception of opioids among patients who take them was either neutral or positive. However, 39.0% patients who have not been prescribed opioids did not want an opioid prescription, citing fear of addiction and side effects as the primary reasons.

19.
Article | WPRIM | ID: wpr-835164

ABSTRACT

Objective@#To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). @*Methods@#The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. @*Results@#Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNSVRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNSadenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. @*Conclusions@#FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.

20.
Article | WPRIM | ID: wpr-832688

ABSTRACT

Fixed drug eruption (FDE) is a drug-induced disorder that may appear as patches or bullae. It recurs at the same sites as those involved in exposure to the same drug (causative drug). We encountered two cases of generalized FDE, and both patients had a history of diclofenac exposure before the onset of skin lesions. In the first case, an 82-year-old female patient presented with multiple erythematous patches on the trunk and lower extremities. In the second case, a 71-year-old male patient developed multiple bullae on violaceous patches on the trunk and extremities. The findings of histopathologic examinations were indicative of the diagnosis of FDEs. Although diclofenac is commonly used as a non-steroidal inflammatory drug, diclofenac-induced generalized FDE occurs rarely and has not been reported in Korea. With reuse of causative drugs, the size and number of lesions tend to increase. Therefore, early diagnosis of FDE is important, and avoidance of repeated exposure to drugs should be educated.

SELECTION OF CITATIONS
SEARCH DETAIL