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Background@#Vitiligo is an acquired depigmentary disorder characterized by the destruction of melanocytes via an autoimmune-mediated process. Treatments can be categorized into nonsurgical and surgical methods. Prognostic factors of surgical management in vitiligo have not been widely studied in the Korean population. @*Objective@#To investigate the prognostic factors of tissue grafts in vitiligo. @*Methods@#We retrospectively analyzed patients who underwent tissue grafting for vitiligo between January 2010 and December 2020. Medical records and clinical photographs were reviewed, and demographics, disease characteristics, and treatment outcomes were collected. @*Results@#A total of 195 cases were evaluated, and among them, 86 (44.1%) showed 75% improvement, and 49 (25.1%) showed 50% to 74% improvements 3 months after surgery. Statistical analyses showed that the prognosis of tissue grafting was significantly different according to vitiligo subtype, recipient site, and grafting method. The focal and segmental type, head and neck sites, and suction blister grafting showed favorable results compared with the non-segmental type, sites other than the head and neck, and punch grafting. Age and adjuvant phototherapy did not affect the clinical outcomes. @*Conclusion@#This study proposes several clinical factors that affect the outcomes of skin grafting in vitiligo.
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Vitiligo is a relatively common, acquired hypopigmentary disorder caused by the loss of epidermal melanocytes. It is characterized by asymptomatic, well-circumscribed round to oval-shaped whitish patches that vary in size. Depending on various clinical features, vitiligo is classified into several types, that is, non-segmental, segmental, and undetermined/unclassified vitiligo. The uniform classification of vitiligo is very important in predicting its clinical course and prognosis and communication among researchers. In particular, segmental vitiligo is a highly distinctive subtype of vitiligo considering its clinical features and prognosis. It usually has an onset early in life and spreads rapidly within the affected area limited to one segment of the integument. Signs of vitiligo activity such as Koebnerʼs phenomenon, trichrome vitiligo, inflammatory vitiligo, and confetti-like lesions give useful information to start treatments to block the progression of the disease. Lastly, other hypopigmentary disorders should be distinguished from vitiligo to make the correct diagnosis and prescribe the right treatment. In this report, I review the clinical features of vitiligo, various subtypes according to classification, and the importance for differential diagnosis of hypopigmentary disorders from vitiligo.
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Background@#Chronic actinic dermatitis is a rare, acquired, persistent eczematous eruption of photo-distributed areas.There are limited data available on the clinical characteristics of Korean patients diagnosed with chronic actinic dermatitis. @*Objective@#To evaluate the clinical features and prognosis of chronic actinic dermatitis patients in Korea. @*Methods@#Sixty-two Korean patients diagnosed with chronic actinic dermatitis through clinical findings, phototesting, and skin biopsy from six hospitals were included in this study, and their clinical characteristics were evaluated. @*Results@#Among the 62 patients, 51 were men, and the mean age at diagnosis was 60.3±12.8 years. Phototesting was performed for 27 patients, with results available for 18 patients. Patch tests were performed for only 4.8% of the patients. Skin pathology tests were performed for 47 patients and showed the following: spongiosis, acanthosis, actinic elastosis, and pseudo-lymphomatous change. Twelve patients were clinically diagnosed without using diagnostic tools such as phototesting, patch testing, and skin biopsy. The most commonly used systemic treatments were antihistamine, cyclosporine, steroid, and azathioprine. Although avoiding ultraviolet irradiation and outdoor activities are critical, only 22.6% of patients used sunscreen. @*Conclusion@#Although phototesting is highly recommended for diagnosing chronic actinic dermatitis, phototesting was performed for less than half of the patients to diagnose chronic actinic dermatitis. Patch tests and photopatch tests are also recommended to disclose a causative agent.
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Vitiligo is a relatively common, acquired hypopigmentary disorder caused by the loss of epidermal melanocytes. It is characterized by asymptomatic, well-circumscribed round to oval-shaped whitish patches that vary in size. Depending on various clinical features, vitiligo is classified into several types, that is, non-segmental, segmental, and undetermined/unclassified vitiligo. The uniform classification of vitiligo is very important in predicting its clinical course and prognosis and communication among researchers. In particular, segmental vitiligo is a highly distinctive subtype of vitiligo considering its clinical features and prognosis. It usually has an onset early in life and spreads rapidly within the affected area limited to one segment of the integument. Signs of vitiligo activity such as Koebnerʼs phenomenon, trichrome vitiligo, inflammatory vitiligo, and confetti-like lesions give useful information to start treatments to block the progression of the disease. Lastly, other hypopigmentary disorders should be distinguished from vitiligo to make the correct diagnosis and prescribe the right treatment. In this report, I review the clinical features of vitiligo, various subtypes according to classification, and the importance for differential diagnosis of hypopigmentary disorders from vitiligo.
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A 74-year-old man visited our department with complaints of multiple asymptomatic erythematous scaly crusted patches on the scalp. He had non-segmental vitiligo with the extent of over 20% of the body surface area for 30 years. Biopsies showed hyperkeratosis, foci of atypical, pleomorphic keratinocytes along the basal cell layer, and marked solar elastosis, consistent with actinic keratosis (AK). Melan-A and Fontana-Masson staining showed absence of melanin and melanocytes. Despite conflicting data on the prevalence of skin cancers in patients with vitiligo, it is known that vitiligo does not increase nor decrease the risk of skin cancer. Recent studies have reported that patients with vitiligo lesions show increased epidermal expression of wild-type p53 protein than healthy controls. However, a few cases of skin cancer have been reported in patients with vitiligo. Here, we report a case of AK developing in vitiligo lesions. Dermatologists should not overlook the possible occurrence of AK or skin cancers in sun-exposed vitiliginous skin.
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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.
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Background@#Chronic actinic dermatitis is a rare, acquired, persistent eczematous eruption of photo-distributed areas.There are limited data available on the clinical characteristics of Korean patients diagnosed with chronic actinic dermatitis. @*Objective@#To evaluate the clinical features and prognosis of chronic actinic dermatitis patients in Korea. @*Methods@#Sixty-two Korean patients diagnosed with chronic actinic dermatitis through clinical findings, phototesting, and skin biopsy from six hospitals were included in this study, and their clinical characteristics were evaluated. @*Results@#Among the 62 patients, 51 were men, and the mean age at diagnosis was 60.3±12.8 years. Phototesting was performed for 27 patients, with results available for 18 patients. Patch tests were performed for only 4.8% of the patients. Skin pathology tests were performed for 47 patients and showed the following: spongiosis, acanthosis, actinic elastosis, and pseudo-lymphomatous change. Twelve patients were clinically diagnosed without using diagnostic tools such as phototesting, patch testing, and skin biopsy. The most commonly used systemic treatments were antihistamine, cyclosporine, steroid, and azathioprine. Although avoiding ultraviolet irradiation and outdoor activities are critical, only 22.6% of patients used sunscreen. @*Conclusion@#Although phototesting is highly recommended for diagnosing chronic actinic dermatitis, phototesting was performed for less than half of the patients to diagnose chronic actinic dermatitis. Patch tests and photopatch tests are also recommended to disclose a causative agent.
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Yonsei Dermatology celebrated its centennial in 2017, marking 100 years since Kung Sun Oh established the first Department of Dermatology and Urology in Korea in 1917. Following the footsteps of Kung Sun Oh, a pioneer of Korean dermatology, its members united and worked to provide the best medical service and achieve academic milestones in dermatology. Over the past hundred years, Yonsei Dermatology has played a pivotal role in the advancement of medical science and academia in Korea. The main activities of the department include medical care, education, and dermatologic research. Its research activities have encompassed a wide spectrum of dermatologic manifestations from skin immunology and pathology to introduction of newly developed treatment technologies. As Kung Sun Oh was the first Korean professor of dermatology at Severance Medical School and a passionate educator, we continue to serve his will by nurturing medical students and dermatology specialists to serve as global medical leaders. The Kung Sun Oh Memorial Lecture, first hosted in 1977, was the beginning of mutual international academic exchange in the field of dermatology in Korea. The memorial lecture has played a major role in advancing the academic status of Korean dermatological science by inviting distinguished dermatologists from around the world as guest lecturers. Yonsei Dermatology has played a key role in the history of modern medicine and dermatology in Korea over the last 100 years and continues to make an impact.
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Humanos , Alergia e Inmunología , Dermatología , Educación , Historia Moderna 1601- , Corea (Geográfico) , Patología , Facultades de Medicina , Piel , Sistema Solar , Especialización , Estudiantes de Medicina , UrologíaRESUMEN
Primary ductal adenocarcinoma of the lacrimal gland (PDALG) is a rare tumor accounting for less than 2% of all tumors arising within the orbit. It is classified as a high-grade malignant epithelial tumor due to its variable biologic behavior and aggressive clinical course. Due to its rare incidence, the clinicopathologic profile is poorly identified and generally dependent on the few available reports and case series. Metastatic lesion of PDALG presenting as a skin lesion is very rare with only one previously reported case. We report here a case of metastatic PDALG that presented with cutaneous features. This case illustrates that such a rare malignant tumor may present to dermatologists, requiring prompt diagnosis and management with a multidisciplinary approach.
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Adenocarcinoma , Carcinoma , Diagnóstico , Incidencia , Aparato Lagrimal , Órbita , PielRESUMEN
PURPOSE: Vitiligo prevalence and its associated comorbidities rate have been reported variably among different populations. We aimed to determine the prevalence of vitiligo in Korea along with the baseline rate of comorbidities and compared the risks to the general population using hospital visit information of the total population in Korea. MATERIALS AND METHODS: We assessed demographic characteristics of vitiligo patients in Korean population from 2009 to 2011 in a nationwide data from Health Insurance Review Assessment Service. Patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with International Classification of Diseases, 10th Revision, Clinical Modification diagnosis code for vitiligo were identified. As a supplementary study, comorbidities associated with vitiligo were selected for further review to calculate relative risks compared to the general population. RESULTS: The annual prevalence of vitiligo determined by hospital-visiting rate in Korea was 0.12% to 0.13% over a three year period. In sync with other previous epidemiological studies, there was bimodal distribution among the age groups and no difference between genders. Also, vitiligo in Korean population was associated with various autoimmune/non-autoimmune diseases such as thyroiditis, atopic dermatitis, and psoriasis. CONCLUSION: This study was by far the most comprehensive review on prevalence of vitiligo using a data of total population in Korea. The prevalence is within a range of those reported in previous literatures, and increased risk of comorbidities such as thyroid diseases and psoriasis in vitiligo might aid clinicians in the initial work up of vitiligo patients and concurrent follow ups.
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Autoinmunes/epidemiología , Comorbilidad , Diabetes Mellitus Tipo 1/epidemiología , Vigilancia de la Población , Prevalencia , República de Corea/epidemiología , Factores Socioeconómicos , Enfermedades de la Tiroides/epidemiología , Vitíligo/epidemiologíaRESUMEN
Lupus miliaris disseminatus faciei (LMDF) is a chronic inflammatory disorder primarily affecting the face. A 22-year-old man presented with facial skin lesions. Physical examination revealed scattered pin-head sized erythematous to yellowish papules. Skin biopsy from the erythematous papule showed keratinous material in the layers of the thin epithelium and caseous necrosis with adjacent epitheloid granuloma and giant cells. After mechanical extractions of milium-like inflamed papules, skin lesions improved leaving an atrophic scar. LMDF was initially thought to be associated with tuberculosis infection but today it is considered a variant of rosacea. However, there have been reports of LMDF in association with epidermal cysts or milium, suggesting an abnormal immune response to the pilosebaceous unit may play a role. Damage to the pilosebaceous unit that is further complicated by milium rupture may induce inflammation resulting in LMDF. We suggest that milium or epidermal cysts may also attribute to the pathogenesis of LMDF although further studies are needed.