Association between Smoking and Unintentional Injuries among Korean Adults / 전남의대학술지

Using a cross-sectional representative national survey, we evaluated the relationship between cigarette smoking and unintentional injuries among Korean adults. We used data from the 2009 Korean Community Health Survey. Smoking status was defined as never smokers, ex-smokers, and current smokers. Current smokers were categorized into light daily smokers (1–10 cigarettes/day), moderate daily smokers (11–20 cigarettes/day), or heavy daily smokers (≥21 cigarettes/day). We used the Poisson regression model with a robust variance estimation to estimate prevalence rate ratios (PRR) and corresponding 95% confidence interval (95% CI). After adjusting for demographic characteristics, socioeconomic variables, lifestyle variables, and health status variables, former smokers (PRR, 1.19, 95% CI 1.11–1.28), light daily smokers (PRR 1.22, 95% CI 1.13–1.32), moderate daily smokers (PRR 1.33, 95% CI 1.24–1.42), and heavy daily smokers (PRR 1.40, 95% CI 1.25–1.57) had an increased risk for unintentional injuries compared with non-smokers. In conclusion, cigarette smoking is associated with unintentional injuries in a dose-response manner in Korean adults. The findings suggest that community smoking cessation programs may reduce morbidity and mortality from unintentional injuries.

Recurrent Milia-Like Idiopathic Calcinosis Cutis on the Upper Eyelid

No abstract available.

A Case of Defects Reconstruction Using Burow's Graft after Total Excision of Skin Tumor on the Scalp / 대한피부과학회지

Burow's graft, obtained from the excised Burow's triangle, is a sort of full-thickness skin graft and can provide outstanding results because the skin used is immediately adjacent to the defects. This procedure is a suitable reconstruction method of surgical defects which are too large for primary closure or within an anatomic subunit with insufficient skin elasticity. Reconstruction of the scalp is not simple owing to lack of elasticity, inflexibility, and hair-bearing feature. We report a case of large sized eccrine poroma on the scalp that was reconstructed with Burow's graft, producing an aesthetically satisfactory result.

Papuloerythroderma of Ofuji

Papuloerythroderma of Ofuji is a rare type of erythroderma of the elderly and consists of flat-topped erythematous papules that coalesce, forming diffuse sheets that characteristically spare skin folds (so called 'deck-chair' sign). The etiopathogenesis of the disease remains unknown, but a number of cases have demonstrated the connection of this disorder with malignancy, mainly cutaneous T cell lymphoma. We report a case of papuloerythroderma of Ofuji unassociated with underlying malignancy, with the biopsy specimen showing nonspecific eczematous findings. There are cases of papuloerythroderma of Ofuji associated with malignancy, and one needs to be mindful of such in examinations.

A Case of Pigmented Eccrine Poroma on the Scalp / 대한피부과학회지

Eccrine poroma is a benign tumor, which is thought to originate from the epidermal eccrine sweat duct unit. It occurs primarily on the hairless acral surface. However, there have been some cases occurring in atypical area like scalp and face. In general, eccrine poroma lacks melanin pigment clinically and melanocytes on microscopic examination. However, in either black or yellow skin, melanin granules and melanocytes can occasionally be found dispersed within the tumor. We report a case of pigmented eccrine poroma occurring on the scalp. The lesion was located on an unusual occurring site as well as contained melanocyte and melanin.

A Case of Eruptive Collagenoma / 대한피부과학회지

Eruptive collagenoma is an acquired connective tissue nevus composed predominantly of collagen. We present a case of eruptive collagenoma in a 13-years-old female who had asymptomatic multiple 3 to 9 mm sized flesh colored scattered papules on both limbs. In addition, the differential diagnosis and other types of cutaneous collagenomas are briefly discussed.

Epidermal Cyst-like Skin Metastasis in Ovarian Cancer Patient / 대한피부과학회지

Cutaneous metastasis from the ovarian cancer has been found to be exceedingly rare. We report a case of a metastatic ovarian mucinous cystadenocarcinoma, which clinically manifested as the epidermal cyst-like skin nodule on the right upper quadrant of abdomen.

Immunohistochemical Study for the Syndecan-1, E-cadher in and Beta-catenin Expressions in Epidermal Tumors / 대한피부과학회지

BACKGROUND: Syndecan-1, E-cadherin and beta-catenin are cell adhesion molecules that are primarily expressed on the surface of adult epithelial cells. The expressions of them appear to be inversely correlated with tumor aggressiveness and invasiveness. OBJECTIVE: The purpose of this study was to investigate the expressions of syndecan-1, E-cadherin and beta-catenin in tissue sections of normal sun-damaged skin, cutaneous premalignant lesions and squamous cell carcinoma in all stages of the evolution of lesions associated with sun exposure. METHODS: Ten normal skins from patients with actinic keratosis, 10 cases of seborrheic keratosis, 5 cases of actinic keratosis, 5 cases of Bowen's disease, 5 cases of keratoacanthoma without dysplatic cells, 5 cases of keratoacanthoma with dysplastic cells in an invasive margin, 5 cases of poor-differentiated squqmous cell carcinoma and 5 cases of acantholytic squamous cell carcinoma were investigated. The specimens were assessed for the syndecan-1, E-cadherin and beta-catenin expressions using a semi-quantitative method in which the intensity of membranous staining was evaluated. RESULTS: In almost all the cases the expression of the E-cadherin and beta-catenin was very similar. These adhesion molecules were progressively reduced in the epidermis of normal sun-damaged skin through premalignant lesions to squamous cell carcinoma. Also, the expression of syndecan-1 was similar to the E-cadherin and beta-catenin expressions except for a normal expression in premalignant lesions. But all three adhesion molecules were diminished with decreasing cell differentiation. CONCLUSION: Our results suggest that syndecan-1, E-cadherin and beta-catenin are expressed similarly in the epithelium, and that the decreased expression of these adhesion molecules is associated with malignant transformation.

Immunohistochemical Study for the Syndecan-1, E-cadher in and Beta-catenin Expressions in Epidermal Tumors / 대한피부과학회지

BACKGROUND: Syndecan-1, E-cadherin and beta-catenin are cell adhesion molecules that are primarily expressed on the surface of adult epithelial cells. The expressions of them appear to be inversely correlated with tumor aggressiveness and invasiveness. OBJECTIVE: The purpose of this study was to investigate the expressions of syndecan-1, E-cadherin and beta-catenin in tissue sections of normal sun-damaged skin, cutaneous premalignant lesions and squamous cell carcinoma in all stages of the evolution of lesions associated with sun exposure. METHODS: Ten normal skins from patients with actinic keratosis, 10 cases of seborrheic keratosis, 5 cases of actinic keratosis, 5 cases of Bowen's disease, 5 cases of keratoacanthoma without dysplatic cells, 5 cases of keratoacanthoma with dysplastic cells in an invasive margin, 5 cases of poor-differentiated squqmous cell carcinoma and 5 cases of acantholytic squamous cell carcinoma were investigated. The specimens were assessed for the syndecan-1, E-cadherin and beta-catenin expressions using a semi-quantitative method in which the intensity of membranous staining was evaluated. RESULTS: In almost all the cases the expression of the E-cadherin and beta-catenin was very similar. These adhesion molecules were progressively reduced in the epidermis of normal sun-damaged skin through premalignant lesions to squamous cell carcinoma. Also, the expression of syndecan-1 was similar to the E-cadherin and beta-catenin expressions except for a normal expression in premalignant lesions. But all three adhesion molecules were diminished with decreasing cell differentiation. CONCLUSION: Our results suggest that syndecan-1, E-cadherin and beta-catenin are expressed similarly in the epithelium, and that the decreased expression of these adhesion molecules is associated with malignant transformation.

Genetic Study in a Case of Birt-Hogg-Dube Syndrome

Birt-Hogg-Dube syndrome (BHDS) is an autosomal dominantly inherited disorder characterized by multiple trichodiscomas, fibrofolliculomas, and acrocordons. There is also an increased risk of developing renal neoplasms and lung cysts/spontaneous pneumothorax. We present a 43-year-old man with multiple, 2~4 mm sized, dome-shaped, and skin-colored papules on his cheek and neck. On the basis of clinical finding and histopathologic examination on the cheek lesion, it was diagnosed as multiple trichodiscomas. Subsequently, molecular analysis revealed a mutation in the folliculin gene. We report a rare case of BHDS with a proved gene mutation.

Epidermal Necrolysis due to Methazolamide Treatment in Glaucomatous Patients / 대한피부과학회지

Epidermal necrolysis (EN) is a rare, but potentially life threatening disease, characterized by epidermal necrosis and sub-epidermal detatchment, and is predominantly medication-induced. Methazolamide is a sulfonamide derivative and carbonic anhydrase inhibitor used for lowering of intraocular pressure in glucomatous patients. Common side effects of methazolamide include metabolic acidosis, hypokalemia, tinnitus, transient myopia, and renal calculi; however, EN caused by methazolamide is very rare. We report on two cases of EN induced by methazolamide treatment and review previously published cases.

A Statistical Study of Cutaneous Basal Cell Carcinoma and Squamous Cell Carcinoma in Gwangju City and Chonnam Province (2006~2010) / 대한피부과학회지

BACKGROUND: The incidence of cutaneous malignant tumors has been continuously increasing worldwide. OBJECTIVE: The purpose of this study was to analyze recent trends in the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in patients from Gwangju City and Chonnam Province. METHODS: We reviewed clinical data and histopathological reports of 82 cases of BCC and 60 cases of SCC in outpatients who had visited the department of dermatology at Chosun University Hospital between 2006 and 2010. RESULTS: The male-female ratio was 0.61:1 in patients with BCC and 0.87:1 in patients with SCC. The most frequent age group was the eighth decade (42% BCC and 67% SCC). Mean patient ages were 65.1 years and 67.8 years, respectively. The most common involved site was the face (90.2% BCC and 78.3% SCC), particularly the cheek. More skin cancers were found on the left than the right side of head and neck area in male automobile drivers only. The most frequent histological BCC subtype was the nodulocystic type (59.7%), followed by the pigmented (12.1%), and adenoid type (9.7%). The most frequent histological pattern of SCC was the well-differentiated type (66.6%). Development of BCC (61.3%) was more frequent than that of SCC in sun-exposed areas. CONCLUSION: Our data were similar to those previously reported. In our study, no difference in demographic variables such as age, gender or residence were found between patients with BCC and SCC. Additionally, no differences were observed in the incidence of BCC or SCC among the other variables. Further cohort studies that include cumulative lifetime sun exposure and a large sample size are needed.

Study of Complications of Ear Piercing / 대한피부과학회지

BACKGROUND: Ear piercing is widely and easily practiced by medical personnel as well as nonmedical personnel, but it has been associated with many complications. Epidermal cyst may develop after ear piercing and result in permanent deformity of ear. However, there have been few studies to investigate the complications of ear piercing, and especially epidermal cyst. OBJECTIVE: We wanted to evaluate the epidemiology of epidermal cyst that developed due to ear piercing. METHODS: A written questionnaire was distributed to 236 students at Chosun University. It consisted of 17 items concerning the overall evaluation of the complications of ear piercing, the treatments for the complications and the epidemiology of epidermal cyst after ear piercing. RESULTS: Of 236 students included in the survey, 132 students (56%) already had pierced ears. Among them, 80 students (60.6%) experienced one or more complications such as contact dermatitis (41.5%), infection (39.2%), cyst formation (13.7%) and bleeding (5.9%). In 14 students who experienced epidermal cyst after ear piercing, the ratio of male to female patients was 1:3.7 and the mean age when they first underwent ear piercing was 18.7 years. An asymptomatic cystic mass was the most common clinical symptom. Half of them received medical treatment such as dressing (50%), medication (25%), drainage (12.5%) and a surgical procedure (12.5%). CONCLUSION: Our data indicates that ear piercing is not easy and simple, but rather, it is a dangerous procedure due to its frequent complications. Therefore, dermatologists should warn patients about the complications of ear piercing and play a major role to prevent them.

Miliary Osteoma Cutis of the Face in Middle-aged Women / 대한피부과학회지

Miliary osteoma cutis of the face is a variant of osteoma cutis, and this malady occurs in middle-aged to older women with or without a previous history of acne vulgaris. Case 1 is a 54-year-old woman who presented with asymptomatic, multiple, 2~3 mm-diameter, skin-colored, firm papules on both cheeks and she'd had these lesions for 10 years. Case 2 is a 61-year-old woman who showed the same type of skin lesions on both cheeks and temporal areas for 10 years. Histopathological examinations for the two cases revealed compact bone formation in the dermis. We report here on 2 rare cases of miliary osteoma cutis of the face.

A Case of Human Immunodeficiency Virus Infection Initially Presented with Disseminated Herpes Zoster

Herpes zoster is characterized by unilateral grouped vesicles along the distribution of a single dermatome. Disseminated herpes zoster usually is defined as a generalized eruption of more than 20 extra-dermatomal vesicles occurring within a week of the onset of classic dermatomal herpes zoster. It occurs chiefly in old or debilitated individuals, and especially in patients with underlying malignancy, immunosuppressive therapy, or human immunodeficiency virus (HIV) infection. A 51-year-old man presented with segmental grouped vesicles on the left upper trunk and arm, and a varicella-like eruption over the entire body. Tzanck smear preparation and punch biopsy done on the vesicles of the trunk indicated a herpetic infection. Later, he was found to be HIV-positive. We report a rare case of HIV infection initially presenting with disseminated herpes zoster.

Recent Trends in Clinical Observation of Syphilis and Consideration for Laboratory Tests

Syphilis is an infectious and sexually transmitted chronic disease caused by Treponema pallidum. The progression of syphilis is classified into early symptomatic (primary, secondary, early latent) and late asymptomatic (late latent, tertiary) stage. Since the late 20th century, resurgence of infectious syphilis have been occuring among hetero- and homosexual males with HIV co-infection over the world, and similar trend can also be observed in Korea. In order to contain the current spread of syphilis, clinical presentation and diagnostic approach must first become available, and in particular, the peculiarity in HIV co-infection should also be considered. Serology remains the mainstay of laboratory testing for syphilis, except for during the very early stage of infection. If syphilis patients are not diagnosed properly, it may lead to a serious public health problem. Based on the review of literatures, RPR/VDRL test is not reliable as a single screening test, and a new syphilis test algorithm of treponemal antibody test needs to be established as a primary screening test.

A Comparative Study of the Clinical Findings Associated with Herpes Zoster and According to Age / 대한피부과학회지

BACKGROUND: Patients with herpes zoster generally complain typical manifestations, including prodromal pain, a grouped vesicular rash and prickling pain on unilateral dermatomes. However, there have been a few reports showing clinical differences by age. OBJECTIVE: The purpose of this study was to evaluate the clinical differences among the various aged populations that suffer with herpes zoster. METHODS: The medical records of 921 patients who were diagnosed with herpes zoster at our institution between January 2002 and December 2008 were reviewed, and if necessary, telephone interviews were done. According to the age groups as classified with a decade-scale, the data was assessed with respect to gender, seasonal occurrence, the dermatomal distribution, prodromal pain, the chief symptom, the range of lesion, underlying diseases and postherpetic neuralgia. RESULTS: The mean age of the subjects was 57.7 and the ratio of males to females was 1:1.4. The proportions of female patients gradually increased in the over 40 year-old group (p<0.001). As one grows older, there is a trend for a higher occurrence of herpes zoster in winter (p=0.011). The likelihood of attacks on the trigeminal dermatome appeared to increase with age, but that of the spinal dermatomes, including the cervical, thoracic and lumbosacral area, showed a decrease with age (p=0.01). The rate of prodromal pain was higher with age (p=0.004). The rate of prickling pain increased with age, but that of pruritus decreased with age (p=0.001). The presence of widely involved lesion (p=0.013), an underlying disease (p<0.001) and postherpetic neuralgia (p<0.001) increased with age. CONCLUSION: The results of this study demonstrated that the clinical findings associated with herpes zoster were not always consistent in different aged populations. The rate of female patients, occurrence in winter, an attack on the trigeminal dermatome, prodromal pain, prickling pain, larger lesion, underlying disease and postherpetic neuralgia showed a tendency to increase with age.

A Case of Myxoid Liposarcoma / 대한피부과학회지

Liposarcomas are one of the most common soft-tissue sarcomas in adults. They usually arise in the deep soft tissues, and patients present with large painless masses. Four major types of liposarcomas are generally recognized and have epidemiologic and prognostic differences: atypical lipomatous neoplasm/well-differentiated; myxoid/round- cell; dedifferentiated; pleomorphic variants. Myxoid liposarcoma is the second most common type of liposarcoma, representing 30~40% of all liposarcomas in the extremities. We report a case of myxoid liposarcoma in a 78-year-old man who presented with an asymptomatic, firm, deep-seated mass in the lateral aspect of his left upper arm.

A Case of Kerion Celsi Caused by Trichophyton tonsurans in Adult Female Patient / 대한피부과학회지

Trichophyton (T.) tonsurans is an anthrophophilic dermatophyte and children are the primary target population. The "seborrheic" type is the most common clinical type of tinea capitis caused by T. tonsurans but kerion celsi is much less common. We report a case of kerion celsi caused by T. tonsurans in a 21-year-old woman. The patient had various-sized, erythematous nodules and pustules with irregular alopecia on the scalp. On mycological investigation, T. tonsurans was identified within the lesion. The patient did not respond to itraconazole therapy but was successfully treated with ultramicronized griseofulvin.

A Study of Antibiotic Susceptibility of Staphylococcus aureus in Bacterial Skin Infections / 대한피부과학회지

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. It can also cause community-acquired infection. However, there are few reports on MRSA in community-acquired infections. OBJECTIVE: To evaluate the prevalence and antibiotic susceptibility of Staphylococcus aureus (S. aureus) in community-acquired bacterial skin infections. METHODS: Bacterial cultures and antimicrobial susceptibility tests were performed on out-patients with bacterial skin infection from January 2004 to October 2005. RESULTS: Of 252 pyoderma cases, bacteria were cultured from 145 (57.5%) cases. Among them, S. aureus was isolated from 85 (33.7%) patients. Eight (9.4%) S. aureus isolates were MRSA. The others were coagulase-negative Streptococcus (10.3%), Streptococcus (5.6%) and gram-negative bacilli (12.3%). The resistant rates of S. aureus against antibiotics were as follows: penicilin 97.6%, tetracycline 29.7%, gentamycin 23.5%, tobramycin 16.2%, fusidic acid 13.5%, oxacillin 9.4%, erythromycin 8.1%, aberkacin 5%, ciprofloxacin 4.7%, rifampin 2.7%, clindamycin 2.4%, trimethoprim/sulfameth-oxazole 2.4%, amoxicillin/clavulanic acid 0%, teicoplanin 0% and vancomycin 0%. The effective antibiotics for the treatment of MRSA were amoxicillin/clavulanic acid (0%), teicoplanin (0%) and vancomycin (0%). CONCLUSION: S. aureus was the most predominent pathogen in community-acquired pyoderma, and was sensitive to oxacillin, erythromycin, aberkacin, ciprofloxacin, rifampin, clindamycin, trimethoprim/sulfametho-xazole, amoxicillin/clavulanic acid, teicoplanin and vancomycin. Among these, amoxicillin/clavulanic acid, teicoplanin and vancomycin were also effective in the treatment of MRSA.