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Objective@#Hair loss has been reported to occur during dopaminergic therapy in patients with Parkinson’s disease. The mechanism by which dopaminergic therapy induces hair loss is not well understood. Dopamine receptors are present in the hair follicle, where they regulate melanin production. However, the role of dopamine receptors in hair growth is still not well understood. This study aimed to evaluate the prevalence of hair loss and identify factors associated with complaints of hair loss in patients with Parkinson’s disease. @*Methods@#A cross-sectional design involving 495 Parkinson’s disease patients was applied to evaluate hair loss status. Patients completed a questionnaire, and scalp/hair examinations were performed. Patients with underlying conditions that could affect hair loss and those prescribed medications known to increase the risk of hair loss were excluded. Finally, 291 patients (58.8%) were included for analysis. @*Results@#Among the 495 patients, 138 (27.9%) reported hair loss. Interestingly, more than half of the patients who complained of hair loss (79 out of 138) did not utilize treatments such as hair products, massage, dietary modifications, or alopecia medications. Hair inspection by a single investigator revealed objective hair loss in 263 patients (53.1%). An analysis of factors associated with hair loss complaints showed that the intake of dopaminergic medications with a levodopa-equivalent daily dose > 448 mg was associated with complaints of hair loss. @*Conclusion@#Dopaminergic medication is associated with hair loss complaints in Parkinson’s disease patients.
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Erosive adenomatosis of the nipple (EAN) is a rare benign entity that involves abnormal proliferation of the lactiferous ducts of the nipple and often presents with visible erosive lesions, erythema, or discharge. A 34-year-old female patient visited our clinic with erythematous patches and bloody discharge from the right nipple.Ultrasonography revealed a hypervascular lesion. A punch biopsy was performed, and histopathological examination confirmed the diagnosis of EAN. A 22-year-old female patient presented with a 4-year history of itchy erythematous eczematous patches with telangiectasia, crust, and bloody discharge in the areolar region. The punch biopsy results were consistent with those of EAN. The patient underwent total excision surgery. Herein, we report cases of EAN, which were difficult to differentiate from Paget's disease or nipple eczema, highlighting the need for clinicians to pay close attention.
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Cutaneous papillomas or acrochorda usually appear after the 4th decade of life in areas with skin folds. Conventional methods of removal are associated with bleeding problems, pain and prolonged sequelae. Thus, acrochorda removal with lasers has gained attention. In this study, we compared the efficacy of two popular laser types with different wavelengths and pulse widths for removal of skin tags. A 60-year-old Korean male noticed skin tags on his neck bilaterally. All tags were treated in a single session, on one side with a picosecond (ps)-domain 532 nm Nd:YAG laser and on the contralateral side with a long-pulsed (LP) 755 nm alexandrite laser. The endpoint for the ps-532 laser was immediate whitening, while that for the LP and quasi-LP (QLP) 755 lasers were visible changes on the surface of the lesion. Antibiotic ointment was applied, dressing was done and clinical photographs were taken. Both lasers effectively removed the skin tags at all settings in a single session without bleeding and with minimal discomfort. Crust formation occurred on both sides with natural shedding within 1 to 2 weeks. Transient erythema lasted longer in the tags treated with the ps-532 laser. At the 5th month of follow-up, residual lesions were detected on the field treated with the ps-532 laser. No persistent side effects such as scarring or postinflammatory hyperpigmentation (PIH) were observed. In conclusion, both the ps-532 nm Nd:YAG and the 755 nm alexandrite lasers ensured safe and effective removal of skin tags in a single session without adverse sequelae.
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Background@#Acne is a complex inflammatory disorder affecting the pilosebaceous follicles of the skin. In the search for effective acne treatments, patients frequently turn to various social media platforms, including Instagram.Notably, diverse occupational groups contribute to Instagram on acne treatment, showcasing significant variations depending on the specific group. @*Objective@#This study investigated the impact and accuracy of acne treatment posts on the Korean Instagram platform. @*Methods@#We systematically examined the “top posts” with the hashtag #acne treatment, and 107 posts were included for analysis. Posts were excluded if they were not Korean, had other medical conditions, or were duplicates. @*Results@#The distribution of posts and their respective proportions were as follows: dermatologists (n=12, 11.2%), non-dermatologists (n=17, 15.9%), skin care centers (n=54, 50.5%), influencers (n=22, 20.6%), and retailers (n=2, 1.9%). Notably, dermatologists’ posts demonstrated a significantly lower number of followers and likes compared to those of skin care centers or influencer (p＜0.001, each). The similar trend was observed for the assessment of total engagement power (calculated as likes×1＋comments×1). Additionally, we evaluated the treatment accuracy of each post using the DISCERN criteria. The average DISCERN score of dermatologists’ posts was significantly higher than that of skin care centers or influencers (p＜0.001). @*Conclusion@#Our findings underscore that, despite possessing a greater level of accuracy in their information, dermatologists exert comparatively less influence on the Korean Instagram platform. Considering the recent increase in medical content on Instagram and the growing interest among patients, the role of dermatologists in providing reliable and informed guidance has become increasingly important.
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Background@#The periorbital area plays an important role cosmetically. Periorbital wrinkles are attributed to long-term, repeated use of orbicularis oris muscles and UV-induced dermal collagen degeneration. Fractional microneedle radiofrequency (RF) treats scars and laxity by creating vertical channels of injury in the dermis, triggering a scarless healing cascade and neocollagenesis. @*Objective@#To evaluate the effect and safety of a novel fractional microneedle RF device on periorbital wrinkles based on several objective indicators. @*Methods@#Eleven healthy Korean patients aged 30 to 75 years with periorbital wrinkles were included in this study. Wrinkle grades were evaluated using the Fitzpatrick wrinkle assessment scale (WAS). The melanin and erythema index, transepidermal water loss (TEWL), and three parameters for elasticity were recorded. Skin biopsies were obtained in patients who consented. @*Results@#All patients exhibited wrinkle improvement in the lateral periorbital area, and two patients also showed efficacy in the lower eyelid area. There was a statistically significant decrease in WAS and a significant improvement in the melanin index of V4 and V5. TEWL also showed a considerable decline on V4 and V5, suggesting that the water content of the skin increased with repeated laser sessions. A peak increase in viscoelasticity and a decrease in retraction time following the first laser application were observed. In the histopathologic examination, the dermis had a denser collagen and elastin content. @*Conclusion@#Microneedle fractional RF resulted in statistically significant long-term clinical improvement of periorbital wrinkles and enhanced pigmentation and skin hydration.
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Background@#Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize; however, in some cases, it is difficult to differentiate it from atypical dermatofibroma. Atypical dermatofibroma is a rare variant of a more aggressive nature and requires complete excision due to its tendency to recur. @*Objective@#To describe the clinical and dermoscopic features of dermatofibromas with special emphasis on the characteristics of atypical subtypes and to differentiate them from typical subtypes on the basis of results. @*Methods@#We retrospectively searched the databases of patients of Korea University Ansan Hospital from January 2010 to December 2019 who underwent skin biopsies or excision surgeries and had pathological reports of dermatofibroma. Analyses of the clinical characteristics (age, sex, number of lesions, anatomical site) and dermoscopic patterns were performed. @*Results@#Dermoscopic patterns were analyzed in 148 cases of dermatofibroma; peripheral delicate pigment networks and central white scar-like patches were the most common patterns found in 45 cases (30.4%). In eight cases of atypical dermatofibroma, three cases (37.5%) showed peripheral homogenous areas and central white networks, followed by multiple white scar-like patches in 2 cases (25.0%), peripheral delicate pigment networks, and central white scar-like patches in 2 cases (25.0%). Dermoscopy revealed a statistically significant difference in the peripheral homogenous area and the central white network pattern between the two groups. @*Conclusion@#In this study, we analyzed the dermoscopic findings of 148 patients with dermatofibroma and found that the peripheral homogenous area and central white network patterns were significantly more in atypical dermatofibroma.
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Background@#Pigmented purpuric dermatosis (PPD) is known as a chronic recurrent eruption which usually presents with petechiae and pigmented macules on the lower extremities.Dermoscopy is a noninvasive diagnostic tool in identifying pigmented and vascular lesions, which can also be beneficial in the evaluation of PPD. @*Objective@#We aimed to analyze the common dermoscopic characteristics of PPD, and correlate those findings with the histopathologic features. Additionally, dermoscopic and pathological findings in this study population were compared with other similar studies from the literature review. @*Methods@#A retrospective analysis was performed using data of 60 patients who were diagnosed as PPD by skin biopsy and had dermoscopic examination. The pathologic analysis was performed by categorizing the pattern into lichenoid, perivascular, interface, and spongiotic subtype, and the dermoscopic assessment was performed by the three authors independently. @*Results@#In dermoscopy, 96.7% of the patients showed red globules and dots, followed by brownish patch, coppery-red pigmentation, and annular comma-like vessels. The pathologic pattern analysis revealed statistically significant association of lichenoid pattern with coppery red pigmentation, perivascular pattern with annular/comma-like vessels, and spongiosis pattern with reticular pigmented network and linear vessels. The interrater similarity test showed total kappa value of 0.811which referred to “very good”. @*Conclusion@#In this study, the prevalence of dermoscopic features in Asian PPD patients was identified, which was similar with previous studies. The dermoscopic-pathologic correlation was found in four dermoscopic features. We suggest that dermoscopic examination is helpful in clinical diagnosis and pathological prediction of PPD.
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Background@#Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize; however, in some cases, it is difficult to differentiate it from atypical dermatofibroma. Atypical dermatofibroma is a rare variant of a more aggressive nature and requires complete excision due to its tendency to recur. @*Objective@#To describe the clinical and dermoscopic features of dermatofibromas with special emphasis on the characteristics of atypical subtypes and to differentiate them from typical subtypes on the basis of results. @*Methods@#We retrospectively searched the databases of patients of Korea University Ansan Hospital from January 2010 to December 2019 who underwent skin biopsies or excision surgeries and had pathological reports of dermatofibroma. Analyses of the clinical characteristics (age, sex, number of lesions, anatomical site) and dermoscopic patterns were performed. @*Results@#Dermoscopic patterns were analyzed in 148 cases of dermatofibroma; peripheral delicate pigment networks and central white scar-like patches were the most common patterns found in 45 cases (30.4%). In eight cases of atypical dermatofibroma, three cases (37.5%) showed peripheral homogenous areas and central white networks, followed by multiple white scar-like patches in 2 cases (25.0%), peripheral delicate pigment networks, and central white scar-like patches in 2 cases (25.0%). Dermoscopy revealed a statistically significant difference in the peripheral homogenous area and the central white network pattern between the two groups. @*Conclusion@#In this study, we analyzed the dermoscopic findings of 148 patients with dermatofibroma and found that the peripheral homogenous area and central white network patterns were significantly more in atypical dermatofibroma.
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Background@#Pigmented purpuric dermatosis (PPD) is known as a chronic recurrent eruption which usually presents with petechiae and pigmented macules on the lower extremities.Dermoscopy is a noninvasive diagnostic tool in identifying pigmented and vascular lesions, which can also be beneficial in the evaluation of PPD. @*Objective@#We aimed to analyze the common dermoscopic characteristics of PPD, and correlate those findings with the histopathologic features. Additionally, dermoscopic and pathological findings in this study population were compared with other similar studies from the literature review. @*Methods@#A retrospective analysis was performed using data of 60 patients who were diagnosed as PPD by skin biopsy and had dermoscopic examination. The pathologic analysis was performed by categorizing the pattern into lichenoid, perivascular, interface, and spongiotic subtype, and the dermoscopic assessment was performed by the three authors independently. @*Results@#In dermoscopy, 96.7% of the patients showed red globules and dots, followed by brownish patch, coppery-red pigmentation, and annular comma-like vessels. The pathologic pattern analysis revealed statistically significant association of lichenoid pattern with coppery red pigmentation, perivascular pattern with annular/comma-like vessels, and spongiosis pattern with reticular pigmented network and linear vessels. The interrater similarity test showed total kappa value of 0.811which referred to “very good”. @*Conclusion@#In this study, the prevalence of dermoscopic features in Asian PPD patients was identified, which was similar with previous studies. The dermoscopic-pathologic correlation was found in four dermoscopic features. We suggest that dermoscopic examination is helpful in clinical diagnosis and pathological prediction of PPD.
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Basal cell carcinoma is a common cancer and has been reported to account for approximately 80% of non-melanoma skin cancers. Superficial basal cell carcinoma occurs mainly in the trunk or limbs and is characterized by clinical features of scaly erythema with or without epidermal atrophy. These clinical features require differentiation from those of other benign and malignant skin diseases. Recently, specific dermoscopic findings of basal cell carcinoma have been helpful for diagnosis. Common dermoscopic findings of superficial basal cell carcinoma include superficial telangiectasia and maple leaf-like areas. Herein, we report a case of superficial basal cell carcinoma that was not diagnosed by punch biopsy but by dermoscopy.
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Background@#Pulsed dye laser treatment is a proven effective treatment for capillary malformation. Previous studies have shown different responses to pulsed dye laser depending on the anatomical location of the capillary malformation. @*Objective@#This retrospective study assessed the potential differences in treatment response depending on anatomical location and the factors affecting pulsed dye laser treatment response. @*Methods@#We retrospectively investigated 88 patients with capillary malformation (nevus flammeus or port-wine stain) in the head and neck area treated with pulsed dye laser between November 2005 and January 2019. Dermatologists evaluated the effect of treatment from photographs taken before and after treatment. The anatomical location in the head and neck, lesion size, number of treatments, and the presence of proliferative lesion were analyzed from medical records and photographs. @*Results@#The analyzed 88 patients included 121 lesions. The lesion size and the presence of proliferative lesions significantly affected the treatment effect; however, the location of the lesion in the head and neck did not. @*Conclusion@#Smaller lesion size and the absence of proliferative lesion showed better effects of pulsed dye laser treatment. Unlike previous studies, the lesion location did not significantly affect the treatment effect.
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No abstract available.
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Erythema ab igne (EAI) is a persistent chronic skin condition that is characterized by reticulated macular hyperpigmented lesions caused by repeated exposure to infrared radiation. EAI has reemerged in recent years because of the increasing infrared exposure due to the use of new technologies, such as portable computers and automobile seat heaters. We report a case of a 54-year-old female patient presenting with asymptomatic mottled brownish plaque on both sides of her neck for 1 month prior to the visit. Patient history revealed that she had used a home skincare device for skin rejuvenation and relaxation. The clinicopathological features suggested a diagnosis of EAI. To our knowledge, there has only been one reported case of EAI on the neck related to a thermal pillow, and this was the first case of EAI related to the self-skincare devices. Herein, we report a rare case of EAI presenting on both sides of the neck due to the use of a modern home skincare device.
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Femenino , Humanos , Persona de Mediana Edad , Automóviles , Diagnóstico , Eritema , Cuello , Rejuvenecimiento , Relajación , PielRESUMEN
Idiopathic neutrophilic eccrine hidradenitis is usually observed in healthy children with tender erythematous nodules on the soles or palms. We report a case of a 26-year-old man with a painful erythematous swollen patch on both hands and feet. His symptom recurred once monthly over 2 years; thus, he visited Orthopedics. However, no bony abnormality was identified. We performed a skin biopsy on an erythematous indurated patch on his right sole. Histopathological findings indicated neutrophilic eccrine hidradenitis. After 2 weeks of treatment with oral colchicine, his symptom resolved, and no relapses were observed during follow-up. Only a few case reports describe idiopathic neutrophilic eccrine hidradenitis in adults, which is not associated with malignant hematological disease, solid cancer, and chemotherapy. Conventional treatment comprises bed-rest and the administration of topical steroids. Colchicine can be a good treatment option for adults with severe or recurrent idiopathic neutrophilic eccrine hidradenitis.
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Adulto , Niño , Humanos , Biopsia , Colchicina , Quimioterapia , Estudios de Seguimiento , Pie , Mano , Enfermedades Hematológicas , Hidradenitis , Neutrófilos , Ortopedia , Recurrencia , Piel , EsteroidesRESUMEN
BACKGROUND: Recently, the pulse-in-pulse mode of intense pulsed light (IPL) has been used increasingly for the treatment of melasma. OBJECTIVE: To observe the morphologic changes in the melanophore in adult zebrafish after irradiation with conventional and pulse-in-pulse IPL and Q-switched Nd:YAG (QSNY) laser. METHODS: Adult zebrafish were irradiated with conventional and pulse-in-pulse mode of IPL. The conditions for conventional IPL were 3 mJ/cm², 560 nm filter, and pulse widths of 7, 20, and 35 msec. The pulse-in-pulse conditions were 3 mJ/cm² and on-time 1/off-time 2. The QSNY laser was used with the settings of 1,064 nm, 0.4 J/cm², a 7 mm spot size, and one shot. Specimens were observed using a light microscope, a transmission electron microscope (TEM), a scanning electron microscope (SEM) and a confocal microscope. RESULTS: After conventional IPL irradiation with a 7 msec pulse width, melanophore breakage was observed using light microscopy. Under TEM, irradiation with conventional IPL for 7 msec and pulse-in-pulse IPL induced melanophore thermolysis with vacuolization. However, changes in the melanophore were not observed with 35 msec IPL. Under SEM, unlike the control and QSNY groups, IPL-irradiated zebrafish showed finger-like fusion in the protein structure of scales. Specimens examined by a confocal microscope after conventional IPL irradiation showed a larger green-stained area on TUNEL staining than that after pulse-in-pulse mode IPL irradiation. CONCLUSION: Zebrafish irradiated with long pulse-IPL showed no morphologic changes using light microscopy, while morphological changes in melanophores were evident with use of TEM. Pulse-in-pulse mode IPL caused less damage than conventional IPL.