An Overview of the Package Insert and Contraindications of Filler Products in Korea / 대한피부과학회지

Filler injection is an extremely popular cosmetic procedure in Korea, but surprisingly few dermatologists are aware of the package inserts in filler products. In the era of legal dispute, it is important that we fully understand the indications, contraindications, and side effects of the individual filler products. The purpose of this paper is to provide a general overview of the contents of package inserts of filler products that are commercially available in Korea, especially in terms of the contraindications of filler injection. The authors emphasize that greater improvement in the Korean package inserts of filler products can be expected. Currently, practicing physicians are usually blamed for filler complications. We also found many significant translational errors. We hope that dermatologists take more interest in filler package inserts by reading this overview.

The Incidences of Malassezia in Steroid Acne and Other Acneiform Eruptions / 대한의진균학회지

BACKGROUND: Steroid acne is a folliculitis that can result from a systemic or topical administration of steroid and has been described as showing similar clinical pictures to Malassezia folliculitis, but there have been few reports about the incidence of Malassezia in steroid acne and other acneiform eruptions. OBJECTIVE: Our purpose was to describe the incidences of Malassezia in acneiform eruptions and to discuss about the relationship between clinical steroid acne and Malassezia folliculitis. METHODS: The history, clinical features, direct microscopy, histopathological analysis, and therapeutic results of 125 cases with steroid acne or other acneiform eruptions were described and compared. RESULTS: Over 80% of patients with acneiform eruption receiving systemic steroid revealed significant numbers of Malassezia in the lesional follicle. CONCLUSION: Steroid acne and other acneiform eruptions showing discrete follicular papules and/or pustules localized to the upper trunk or acneiform facial skin lesions associated with multiple acneiform lesions on the body in the summer period should be suspected as Malassezia folliculitis.

Three Cases of Acne Keloidalis Nuchae / 대한피부과학회지

We report three cases of acne keloidalis nuchae which showing typical clinical and histopathological findings. A 61-year-old man showed well-defined child-fist sized erythematous to skin-colored hard plaque on his posterior scalp since two years ago and was treated by surgical excision and skin graft(STSG). A 22-year-old man showed discrete pinkish to erythematous pea sized follicular papules and pustules on his occiput since seven years ago and was treated by intralesional injection of triamcinolone for several times with fair response. Finally, a 38-year-old black man showed variable sized hard round follicular papules on his posterior scalp with several grouped hairs on the center of papules and was treated by intralesional injection of triamcinolone effectively. Histopathologically, common findings were follicular and perifollicular inflammation with the infiltration of plasma cells, neutrophils, lymphohistiocytes, massive dermal fibrosis resembling scar tissue, and diminished sebaceous glands.

The Pathergy Test in Behcet' s Disease and Recurrent Aphthous Stomatitis / 대한피부과학회지

BACKGROUND: Pathergy, or skin hypersensitivity to needle puncture has been reported as a diagnostic test for Behcets ciisease. But the positivity of pathergy test in recurrent aphthous stomatitis which can be a comporent of Behcets disease is obscure. In recent years it has been noted that the positivity of the test has decreased. It is possible to say that the disposable needles used nowadays are less trauniatic to initiate the reaction than are the nondisposable ones used in the preAIDS ara by some uthors. OBJECTIVE: It is the porpose of this study to clarify the value of pathergy test in differentiating Behcets disease from recurrent aphthous stomatitis and to evaluate the difference of positivity using various kinds of needles, and finally to suggest the most profitable one. METHODS: 34 patients with Behcets disease according to the diagnostic criteria of Shimizu(revisecl) 25 ones in case of applying that of International study group for Behcets disease(ISG) and 21 ones with recurrent aphthous stomatitis, and 25 normal controls were selected. A pathergy test, i.e., intradermal injection of 0.1 ml physiological saline by using 26 gauge & 20 gauge disposable needles and 26 gauge & 20 gauge nondisposable ones were given and the evaluation was made after 24 hours and 48 hours. RESULTS: 1. The positive rates of pathergy test using all kinds of needles in Behcets disease were significantly higher than thoen recurrent aphthous stomatitis and normal controls(p=0.00000-0.03600). The sensitivity were 29.4% 64.7% (Shimizu) and 32.0% 76.0% (ISG), respectively, and the specificity were 91.3%-100.0% for all of them. 2. In Behcets disease, the positive rates of the pathergy test using 26 gauge disposable needles were not significantly different from that of using ZO gauge disposable needles in total and active patients after 24 and 4.3 hours and so were 26 gauge R 20 gauge nondisposable ones(p=0.40134 -0.80603(Shimizu), 0.37551-0.77078(ISG) ). 3. In Behcets disease, the positive rates of pathergy test using 26 gauge nondisposable needles were 59%-68%(Shimiu) and 64% 79% (ISG), which were significantly different, from the test using 20 gauge disposable needles, i.e. 29%-36%(Shimizu), 40%-46%(ISG) in total and active patients(p==0.00753-0.01512) after 24 and 48 hours except for those by the criteria of ISG after 24 hours(p=0.14573-0.15597). CONCLUSION: This study shows that the pathergy test is obviously useful in differentiating Behcets disease from ecurrent aphthous stomatitis and we recommend the intradermal injection of 0.1 ml physiological saline by using 26 gauge nondisposable needle and the evaluation after 48 hours as a standard mithod of pathergy test.

Cutaneous Infection by Fusarium solani in a Patient with Burger's Disease

Fusarium species are known as ubiquitous soil saprophytes and human skin comtaminants. Occasionally, however, they have been reported to cause a variety of infections in humans. We report herein a case of cutaneous infection by Fusarium sokmi in a patient with Burger's disease involving his right lower leg. He was treated with itraconazole 200 mg p.o. per day for 5 weeks and the skin lesion resolved without any noticeable side effects. Furthermore, there has been no evidence of recurrence of the disease 9 months after discontinuing the itraconazole. This is the first reported case of cutaneous infection by Fusarium sokmi in a patient with Burger's disease and itraconazole was an effective drug in our case.

A Case of Trichophyton rubrum Infection showing Unusual Clinical Manifestation / 대한피부과학회지

Trichophyton rnbrum is a.nthropophilic, and the most common and widely distributed dermato phyte of man. Characterisic lions are circular, usually sharplyn ginated, slightly erythematous, dry, scaly patches with a raised edge. Progressive central clearin produces annular outlines. Other variants are reported, such as granulomatous, bullous or verucius. We reported a case of Trichophyton rubrum infection showing an unusual clinical manifest tin. The skin leison showed multiple discrete brownishouni macules with a fine scale on both hi lower legs, dorsum of feet and buttocks. Central clearing and inflammed border were not not. On KOH mount, fungal hyphae were noted and Techophyton rubrum was isolated on the funu culture.

A Case of Symmetrical Peripheral Gangrene Associated with Disseminated Intravascular Coagulation / 대한피부과학회지

We report a case of symmei.rical peripheral gangrene in a 22-day-old female associated with dissem-inated intravascular coagulation, which probably occured from septicmia of Enterobacter aerogenes. The skin lesions showed well-defined blackish gangrene surrounded by purpuric patches on the whole fingertips and toes except the loft thumb. Histopathologically, there were epidermal necrosis, diffuse extravasation of RBCs, mild petivascular inflammatory infiltrates and delated and RBC-filled vessels in the dermis. But, there was no definite evidence of vasculitis. In spit,e of aggressive antibictics therapy and other supportive measrres, she died at 39th day after birth.