Type B Pigmentary Demarcation Lines of Pregnancy Involving the Anterior Thighs and Knees

Pigmentary demarcation lines are abrupt transition lines between the areas of deeper pigmentation and the areas of lighter, normal pigmentation. Type B pigmentary demarcation lines involve the posterior medial portion of the lower extremities and are more commonly associated with pregnancy. We present a case of pigmentary demarcation lines of pregnancy with erythematous changes, involving both the anterior and posterior aspects of the lower extremities.

A Case of Chromium Contact Dermatitis due to Exposure from a Golf Glove

Chromium is a transition metal and has been shown to elicit contact dermatitis. Although leather products have been known to be the most significant source of chromium exposure these days, the majority of reports have been related to exposure from shoe products. We herein report a professional golfer who became allergic to golf gloves made of chromium-tanned leather. A 27-year-old woman golfer presented with recurrent, pruritic, erythematous plaques that had been occurring on both hands for several years. The lesions developed whenever she had worn golf gloves for an extended period of time, especially during tournament season. To identify the causative agent, patch tests were performed and the results demonstrated a strong positive reaction to potassium dichromate 0.5% and to her own glove. The amount of chromium in her golf glove was analyzed to be 308.91 ppm and based on this, a diagnosis of allergic contact dermatitis due to a chromium-tanned leather glove was made. She was treated with oral antihistamines combined with topical steroids and advised to wear chromium-free leather gloves. There has been no evidence of recurrence during a six month follow-up period.

Two Cases of Areolar Sebaceous Hyperplasia / 대한피부과학회지

Sebaceous hyperplasia is a common benign disorder of the face, mainly on the forehead and cheeks, in the elderly. Clinically, these lesions present as multiple yellow umbilicated papules. Occasionally, sebaceous hyperplasia can occur in sites such as the vermilion of the lips, buccal mucosa, or the mucocutaneous surfaces of the genitalia. However, diffuse areolar involvement is rare and only a few cases have been reported. We herein report two cases of sebaceous hyperplasia in the areolae of the breast in a 29-year-old and a 44-year-old woman.

A Case of Aplasia Cutis Congenita in Two Siblings / 대한피부과학회지

Aplasia cutis congenita (ACC) is a rare congenital disorder, which was first described by Cordon in 1767. It is characterized by a defect of epidermis, dermis, subcutaneous tissues and sometimes even bone, and occurs predominantly on the scalp. Non-scalp locations are involved in 15% of all cases and are often bilaterally symmetrical. Most cases of ACC appear sporadically. Intrauterine trauma, vascular accidents or genetic factors are postulated as initial steps in the pathogenesis. However, the aetiology of this condition remains unknown. Familial cases have been reported and are suggestive of either an autosomal dominant or autosomal recessive inheritance with variable expression. We herein report on a 10-day-old female infant and her 8-year-old sister with aplasia cutis congenita on their legs.

A Study on the Quality of Life and the Economic Burden of Korean Patients with Viral Warts / 대한피부과학회지

BACKGROUND: Although warts are common viral infections of the skin, no single optimal treatment has been determined and most warts are resistant to the current treatment modalities. As a result, many patients suffer from viral warts. Nevertheless, there have been few studies on the patients' quality of life and the economic burden associated with viral warts. Objective: The purpose of this study is to assess the quality of life and the economic burden in the population affected by viral warts by administering a survey questionnaire. METHODS: A questionnaire quoted from the Dermatology life Quality Index was administered to one hundred twenty patients who had viral warts. RESULTS: The data for the quality of life revealed that warts do not particularly affect the patient's daily living activities nor their psychological status. However, the data indicated that the treatment of warts had significantly negative effects on the quality of life of our patients. With regard to treatment satisfaction, many were unsatisfied with 'the pain associated with treatment'. The estimated cost for the treatment of warts was 45,900 won per treatment and the estimated total treatment expenditure of each patient was 236,800 won. CONCLUSION: These results suggest that warts significantly affect the patients' quality of life and especially due to its resistance to treatment and the pain associated with the treatment. Moreover, warts can impose a considerable economic burden.

A Study on the Quality of Life and the Economic Burden of Korean Patients with Viral Warts / 대한피부과학회지

BACKGROUND: Although warts are common viral infections of the skin, no single optimal treatment has been determined and most warts are resistant to the current treatment modalities. As a result, many patients suffer from viral warts. Nevertheless, there have been few studies on the patients' quality of life and the economic burden associated with viral warts. Objective: The purpose of this study is to assess the quality of life and the economic burden in the population affected by viral warts by administering a survey questionnaire. METHODS: A questionnaire quoted from the Dermatology life Quality Index was administered to one hundred twenty patients who had viral warts. RESULTS: The data for the quality of life revealed that warts do not particularly affect the patient's daily living activities nor their psychological status. However, the data indicated that the treatment of warts had significantly negative effects on the quality of life of our patients. With regard to treatment satisfaction, many were unsatisfied with 'the pain associated with treatment'. The estimated cost for the treatment of warts was 45,900 won per treatment and the estimated total treatment expenditure of each patient was 236,800 won. CONCLUSION: These results suggest that warts significantly affect the patients' quality of life and especially due to its resistance to treatment and the pain associated with the treatment. Moreover, warts can impose a considerable economic burden.

Tinea Manus Caused by Trichophyton mentagrophytes var. erinacei Transferred from a Hedgehog / 대한피부과학회지

The hedgehog has recently become a fashionable pet in South Korea, especially among the younger persons. However, hedgehogs have been rarely reported to carry fungus that can cause human dermatomycosis. We report such a case. A 12-year-old boy was bitten by his hedgehog one week prior to presentation; he developed two clearly defined erythematous plaques with some pustules on the fingers. Periodic acid-Schiff stain of the biopsy specimen showed long, septated fungal hyphae in the keratin layer. KOH examination and fungus culture showed Trichophyton(T.) mentagrophytes. The subtype was identified as T. mentagrophytes var. erinacei by sequence analysis of the internal transcribed spacer regions of theribosomal DNA. The patient was treated with oral itraconazole (3.3 mg/kg, twice a day for 4 weeks) and topical ketoconazole cream with potassium permanganate wet dressings twice a day, resulting in complete resolution of the skin lesions.

Role of NF- kappaB binding sites in the regulation of inducible nitric oxide synthase by tyrosine kinase

In macrophages, lipopolysaccharide (LPS) alone or in combination with interferon- gamma (IFN- gamma) has been shown to release a nitric oxide (NO) through the increase of the transcription of the inducible nitric oxide synthase (iNOS) gene. To investigate the exact intracellular signaling pathway of the regulation of iNOS gene transcription by LPS plus IFN- gamma, the effects of protein tyrosine kinase (PTK) inhibitor and protein kinase C (PKC) inhibitors on NO production, iNOS mRNA expression, nuclear factor- kappaB (NF- kappaB) binding activity and the promoter activity of iNOS gene containing two NF- kappaB sites have been examined in a mouse macrophage RAW 264.7 cells. LPS or IFN- gamma, stimulated NO production, and their effect was enhanced synergistically by mixture of LPS and IFN- gamma. The PTK inhibitor such as tyrphostin reduced LPS plus IFN- gamma-induced NO production, iNOS mRNA expression and NF- kappaB binding activity. In contrast, PKC inhibitors such as H-7, Ro-318220 and staurosporine did not show any effect on them. In addition, transfection of RAW 264.7 cells with iNOS promoter linked to a CAT reporter gene revealed that tyrphostin inhibited the iNOS promoter activity through the NF- kappaB binding site, whereas PKC inhibitors did not. Taken together, these suggest that PTK, but not PKC pathway, is involved in the regulation of the iNOS gene transcription through the NF- kappaB sites of iNOS promoter in RAW 264.7 macrophages by LPS plus IFN- gamma.