The Efficacy of Oral Isotretinoin (Roaccutane(R)) in the Treatment of Acne by Using the Korean Acne Grading System / 대한피부과학회지

BACKGROUND: Although oral isotretinoin is an effective established therapy for acne, Korean data related with this therapy is very limited. Moreover, there is no published data available on the efficacy of this drug that uses a grading system suitable for Korean acne patients. OBJECTIVE: The purpose of this study is to evaluate the efficacy of oral isotretinoin (Roaccutane?) by using the Korean Acne Grading System (KAGS) and the general satisfaction of patients in treating acne. METHODS: In this multicenter and prospective clinical study, 499 patients with acne, who visited at 5 dermatologic clinics during 11 months, were enrolled. The drug dosage was 0.2~1.0 mg/kg/day over 4 months. The efficacy assessment was performed at baseline and monthly after, with an acne grading based on the KAGS and the patient satisfaction questionnaire. RESULTS: Out of the 499 patients, 435 and 371 have completed the 3-month and 4-month treatments, respectively. After the 4-month treatment, the mean acne grades significantly decreased from 2.71 to 0.68, thus showing a 75.9% reduction in pretreatment scores. The mean patient satisfaction scores improved at the end of 4-month treatment, showing a 4.42 out of 5. CONCLUSION: In this paper, we describe the efficacy of oral isotretinoin by using the KAGS, which has not been previously reported in the Korean literature. Our results show that oral isotretinoin is an effective and satisfactory treatment modality for acnes of all grades in Korean patients, regardless of the dosage.

Giant Vascular Eccrine Spiradenoma: Report of a Case with Immunohistochemical Study

We report a rare case of giant vascular eccrine spiradenoma (GVES) which developed in 56-yr-old Korean woman. It is a rare variant of eccrine spiradenoma (ES), which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic features. Histogenesis of GVES is not clearly elucidated although it is known that ES presumably originates in the eccrine glands. To clarify the histogenesis of GVES, immunohistochemical stainings using various monoclonal antibodies were also performed. The tumor was composed of three types of cells, namely pale epithelial cells, small basal cells, and myoepithelial cells. Therefore, we conclude that GVES originated from eccrine gland and mainly differentiates toward secretory portion of secretory coil.

The Effects of Topical Glycolic Acid on the Expression of Epidermal Cytokines and Epidermal Calcium Gradient of Hairless Mice / 대한피부과학회지

BACKGROUND: Although the topical application of glycolic acid (GA) could possibly exert some effects on the normal epidermal permeability function, the exact effects and its mechanism of action have not been well documented. OBJECTIVE: This study was conducted to investigate the effects of GA on the expression of epidermal cytokines and to clarify its chelation effect on the epidermal calcium ions, which are known to control the secretion of lamellar bodies. METHODS: After topical application of 70% GA aqueous solution on the flank of hairless mice, the expression of epidermal IL-1alpha and TNF-alpha was assessed and the change of epidermal calcium ions was evaluated. RESULTS: The results could be summarized as the following: (1) real time reverse transcriptase polymerase chain reaction and immunohistochemical staining studies showed increases in mRNA and protein expression of epidermal IL-1alpha and TNF-alpha; (2) the GA reduced intracellular calcium ion concentrations in vitro and resulted in the loss of epidermal calcium gradient in vivo. CONCLUSION: These results suggest that, like iontophoresis or sonophoresis, GA could influence the skin's barrier homeostasis, possibly by lowering the epidermal calcium ions.

A Case of Multiple Cafe-au-lait Spots with Nevus Depigmentosus and Hemangioma / 대한피부과학회지

When 6 or more Cafe-au-lait spots(CALS) tend to be randomly and widely distributed, we must rule out neurofibromatosis(NF). Nevus depigmentosus is a congenital nonprogressive hypopigmented patch that shows histologically decreased pigmentation while CALS shows increased pigmentation. We report a case of a 16-month-old girl showing generalized multiple cafe-au-lait spots with segmental nevus depigmentosus and capillary hemangioma on her right upper back. A possible explanation for the co-occurrence of CALS and nevus depigmentosus could be the concept of mosaicism.

A Case of Scar Sarcoidosis Treated with Doxycyline / 대한피부과학회지

Scar sarcoidosis is a rarely encountering variant of cutaneous sarcoidosis and its pathogenesis is still unknown. When inactive scars that have been quiescent for years develop a red or purple hue with induration, we should doubt whether they become infiltrated with sarcoid granuloma or not. We report herein a 45-year-old patient with recurrent scar sarcoid, who shows indurated plaques on the right chin and raised serum level of angiotensin converting enzyme, although there was no evidence of systemic involvement. She was treated with oral doxycycline of moderate doses and skin lesions were cleared after 9 months of treatment.

Treatment of Anogenital Condyloma Acuminata in Two Children with 5% Imiquimod Cream / 대한피부과학회지

Condyloma acuminatum, an infection caused by human papilloma virus, is one of the most common sexually transmitted diseases involving the anogenital area. Although it has been more common in adults, the incidence in children has been increasing recently. Although several treatment options are available for condyloma in adults, children's treatment options are limited because non-painful alternatives should be considered as first-line therapy. Imiquimod cream is an immunomodulating agent that has been demonstrated to be a potent inducer of several cytokines promoting an antiviral cell-mediated immune response. Herein, we report two cases of condyloma acuminata in children which showed an excellent response to 5% imiquimod cream without any adverse reactions.

A Case of Drug Eruption Induced by Celecoxib / 대한피부과학회지

A drug eruption is any adverse skin reaction caused by a drug used in a normal dose. Celecoxib(Celebrex(R)), a cyclooxygenase(COX) 2 inhibitor, is a new generation non-steroidal anti- inflammatory drug, recently introduced in Korea. It is increasingly used because of significantly lower rate of gastrointestinal injury than typically seen with most other NSAIDs. Cutaneous reactions related to celecoxib are rare and there have been no previous reports in Korea. We report a case of drug eruption probably due to this drug with positive skin tests and wish to underline the possible cutaneous reactions with this new drug.