Clinicoepidemiological Features of Melasma in Korean Patients at Five University Hospitals: A Cross-sectional Multicenter Study / 대한피부과학회지

BACKGROUND: Melasma is a common acquired hyperpigmentation disorder that predominantly affects the face. It frequently occurs in women with darker skin types and severely impacts quality of life. OBJECTIVE: To characterize the clinicoepidemiological features and triggering or aggravating factors of melasma in Korean patients. METHODS: This cross-sectional study was conducted at the dermatology clinics of five university hospitals in Korea. Between January 2011 and August 2012, 411 patients with melasma completed a questionnaire about the clinical and aggravating factors associated with their melasma. RESULTS: The study population consisted of 400 women and 11 men aged 22~73 years (mean age, 42.8±9.92 years). Triggering or aggravating factors were sun exposure (68.4%), pregnancy (27.0%), and emotional stress (24.8%). Interestingly, 61.1% of patients complained of sensitive/inflammatory features such as erythema, itching, and a stinging sensation. Dryness was the most common aggravating factor, followed by erythema/redness and itching/stinging. Concomitant pigmentary disorders included post-inflammatory hyperpigmentation in 15.1% of patients, followed by pigmented contact dermatitis, and acquired bilateral nevus of Ota-like macules. CONCLUSION: It is well known that sun exposure and hormonal changes are the most common triggers of melasma; however, sensitive/inflammatory features may aggravate melasma in East Asian patients. Therefore, these individual and racial differences should be considered in the prevention and treatment of melasma.

Analytic Study of the Patients Registered at Seoul National University Hospital Acne Clinic / 대한피부과학회지

BACKGROUND: Acne is a common skin disorder which affects both adolescents and adults. However, there have been few Korean epidemiological studies conducted. OBJECTIVE: The purpose of this study was to analyze the prevalence, demographic factors, clinical features and aggravating factors of acne. We also investigated the relationship of these factors. METHODS: Epidemiological and clinical data was obtained by interviewing 657 acne patients, newly enrolled at Seoul National University Hospital Acne Clinic between 1996 and 2004. RESULTS: Most patients were found to have facial acne, and the forehead and cheeks were the most common sites where acne first developed. Males tended to visit the hospital because of social problems compared to females. We identified some significant correlations with sex, age of onset, disease duration, first affected site, seborrhea, and family history. Acne lesions developed earlier and disease duration was longer in the group with a family history of acne or severe seborrhea. More than 80% of patients were found to have subjective symptoms, including pain and itching which were most frequent. The degree of seborrhea was higher and the aggravation after sun exposure was more frequent in the group where complete remission of acne had not been achieved. Aggravation of acne was most frequent in summer, followed by winter. CONCLUSION: We could investigate the epidemiological and clinical features of acne patients, including the age of onset, motive of treatment, subjective symptoms, plus outcome of treatment according to remission history of acne, as these factors have never been reported in the Korean literature before.

Factors Relevant to Aggravation of Skin Lesions in Pemphigus Foliaceus / 대한피부과학회지

There may be some exacerbating factors which aggravate skin lesions of pemphigus foliaceus, including exposure to sun and/or heat. However, the degree of aggravation induced by these factors varies in individuals. We examined possible aggravating factors of skin lesions in a 47-years-old woman with pemphigus foliaceus who had managed her disease with topical and/or sublesional use of corticosteroids for 20 years. The lesion- provoking or exacerbating factors recognized in the patient were sleeplessness/fatigue, emotional stress, menstruation, mechanical trauma, external heat and alcohol.

Report from ADRG: A Study on the Clinical Manifestations of Childhood Atopic Dermatitis in Korea / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing disease with genetic and environmental background. Many factors may act as triggers and affect the course of the disease. However, little is known about the factors affecting the disease severities in Korean childhood AD. OBJECTIVE: The aim was to document the distinct characteristics of childhood AD in Korea and to determine which manifestations are prone to be present in the settings of different severity of the disease. METHOD: The clinical manifestations, past medical and family history, and inducing or aggravating factors were studied in patients, who participated in the open lectures for childhood AD patients in three provinces of Korea. The severity of the disease was evaluated using the Eczema Area and Severity Index (EASI) and the factors affecting the severity of the disease were determined. Skin prick tests with four allergens, Dermatophagoides pteronyssinus, milk, peanut and egg, were also carried out. RESULTS: Of the 93 patients, 38.7% had the disease onset between the age of three and six, while 17.2% had it between the age of seven and fifteen. Sixty-five percent of the patients had family members with a history of atopic diseases, such as AD, asthma, allergic rhinitis and allergic conjunctivitis. In order of frequency, the patients either had a history of or presently accompanying infantile eczema, allergic rhinitis, asthma or allergic conjunctivitis. Among the patients, 27% took herbal medication. The most frequently involved site was the flexural area. The most common aggravating factors were sweating in hot environment, wool fabric and stress. When AD patients were categorized into mild, moderate and severe groups by EASI, the older onset age, the longer duration, facial distribution, history of taking herbal medication, cholinergic condition, wool fabric and stress were found to be significant factors influencing the severity of the disease. Skin prick test with the four major allergens revealed the highest prevalence in Dermatophagoides pteronyssinus. CONCLUSION: The age of onset of AD was higher than that has been reported. Many suffered from infantile dermatitis and had other accompanying atopic diseases. Aggravating factors should be avoided to minimize the risk of disease aggravation. Based on the fact that late onset age, duration, facial distribution, history of taking herbal medication, cholinergic condition, wool and stress were the statistically significant factors, we may predict the severity or the course of the disease.