Distribution and Recognition of Skin Diseases in Rural Areas / 대한피부과학회지

BACKGROUND: In many epidemiologic reports of distribution of skin diseases, the outpatients of university hospitals have been the target groups of the analysis. But there has been no epidemiologic study of dermatoses in the field of rural area. OBJECTIVE: The purposes of this study were to investigate the distribution of skin diseases in rural areas and to evaluate the rural population's concept of skin disease and the attitude to their skin problems. METHOD: We analysed the results of interview and responses of questionnaires from 481 residents who visited the local public health centers and the free clinics in the rural areas of Kyonggi-Do and Ulsan city. RESULTS: The results of the study are summarized as follows : 1. Of 481 residents, there were 328 females and 153 males. The mean age was 56.6 years old. The residents over 50 years old formed 73.2 percent of total population. 2. The common dermatoses were tinea pedis, onychomycosis, xerosis, seborrheic keratosis, chloasma, pruritus, hand eczema, contact dermatitis, lentigo, seborrheic dermatitis in order of frequency. 3. The cutaneous fungal infection was the most common dermatoses in each study population. 4. To treat skin diseases, 51.2% of the residents visited the drug store initially. 5. The major reason of not taking dermatological care in the rural population was customary habit. 6. The 39.5% of 238 respondents have used self-treatments, and 15.5% of 90 respondents have experienced side effects of self-treatments. 7. On the question about the negative concepts of dermatoses, 61.7% of 462 respondents agreed to the statement that dermatoses look unclean. 8. Half of the 463 respondents thought that dermatologic medicine was harmful. The 50.6% of the 328 respondents had no specific reason, and 34.1% experienced gastrointestinal trouble. 9. The most favorite type of dermatologic medicine was topical agent, which was preferred especially by the group of respondents using nonmedical service including drug store. CONCLUSION: The distribution of the skin diseases in rural areas was similar to other reported results except the high frequency of cutaneous fungal infection. This research could be a basis on the following epidemiologic studies of the skin diseases in rural areas. It is also suggested that the educational program to improve understanding of skin diseases should be performed in the rural areas.

A Case of Primary Cutaneous Sporotrichoid Nocardiosis Caused by Nocardia asteroides

We report a case of a 42-year-old woman who suffered from recurrent nodular skin lesions on her left foot. Sporotrichoid fungal infection was suspected and two linear nodular skin lesions that had occurred after trauma in a public pool were treated with itraconazole for 4 months. These nodular skin lesions were completely flattened. However, four months after complete flattening, a new lesion developed in the scar of a previous nodule. N. asteroides, which is extremely rare for sporotrichoid cutaneous nocardiosis, was cultured from the relapsed lesion. We treated this case with trimethoprim-sulfamethoxazole for 6 months under an emperical basis and this resulted in complete healing, and sensitivity of N. asteroide to trimethoprim-sulfamethoxazole was confirmed later. There has been no recurrence for 3 years. To our knowledge, our case is the first report in the english literature of primary sporotrichoid cutaneous nocardiosis caused by N. asteroides in terms of anatomic location below the knee and host immunocompetency.

A Case of Trichoblastic Fibroma

Trichoblastic fibroma is a rare, benign trichogenic tumor that has both an epithelial and mesenchymal component. This tumor may be confused clinically and/or histologically with basal cell carcinoma and other tumors with hair follicle differentiation. We describe here a patient with trichoblastic fibroma on the nose. For further characterization of the tumor, we studied the bcl-2 expression in this case and compared it with those of trichoepitheliomas and basal cell carcinomas. The bcl-2 expression in this case and trichoepitheliomas were positive at the periphery of the tumor nest only, whereas those of basal cell carcinomas were positive diffusely throughout the tumor nest.

Congenital self-healing Reticulohistiocytosis / 대한피부과학회지

Congenital self-healing reticulohistiocytosis (CSHRH) is a rare Langerhans cell disorder showing spontaneous resolution within 3-4 months. By electron microscopy, the identification of many Birbeck granules and laminated dense bodies in the infiltrated cells is mandatory for the diagnosis of CSHRH. We describe a case of congenital self-healing reticulohistiocyt~osis in a 4-month-old male infant.

Job's Syndrome: Suspected Case / 대한피부과학회지

Job's syndrome is an inflammatory skin disease characterized by (1) severe eczema, (2) recurrent staphylococcal infections of the skin and sinopulmonary tract, (3) cold subcutaneous abscesses, and (4) high serum IgE levels. We describe a 55-year-old woman with long-standing atopic dermatitis-like eczema, recurrent abscesses, and a high level of serum IgE. We suspected this case as Job's syndrome.

The Role of Nitric Oxide (NO) in UVB-induced Apoptosis in HaCaT Keratinocytes / 대한피부과학회지

BACKGROUND: According to target cells, apoptosis-inducing agents, and NO concentration, NO concentration, NO shows both pro- and antiapoptotic effects. OBJECTS: Our study was perfermed to verify the role of NO in UVB-induced apoptosis in HaCaT cells. METHODS: After UVB irradiation, FACS using propidium iodide, LDH cytotoxicity assay, and nitrite assay based on Griess reaction were done in HaCaT cells. These procedures were repeated after UVB irradiation and NG-monomethyl-arginine (L-NMMA), a NO synthase (NOS) inhibitor, addition. RESULTS: 1) UVB irradiation (5-80mJ/cm2) induced apoptosis in HaCaT cells dose-dependently. 2) UVB irradiation (80mJ/cm2) stimulated NO production 30-50% more over baseline level, and this was inhibited by 500 micrometer L-NMMA. 3) 500 micrometer L-NMMA did not inhibit UVB-induced apoptosis. CONCLUSION: UVB irradiation evokes apoptosis in HaCaT keratinocytes through NO-independent mechanism.

The Effects of Immunosuppressants Rapamycin and Cyclosporin A on the Proliferation, Cell Cycle, and Cyclin Expression of Cultured Human Keratinocyte Cell Line HaCaT Cells / 대한피부과학회지

BACKGROUND: Rapamycin and cyclosporin A display an immunosuppressive effect by inhibiting the proliferation of T lymphocytes. Both immunosuppressants are effective in the treatment of psoriasis which is considered to be a T-cell mediated immunological disease. The inhibition of helper T-cells by immunosuppressants is considered to be a therapeutic mechanism on psoriasis. Recent studies have demonstrated that rapamycin and cyclosporin A can directly inhibit the proliferation of many non-hematopoietic cells other than T lymphocytes direct inhibitory effect of two immunosuppressants on keratinocyte proliferation may be another anti-psoriatic mechanism. OBJECTIVE: We investigated the direct inhibitory effects of rapamycin and cyclosporin A on the proliferation of cultured human keratinocyte cell line HaCaT cells without T-cell involvement, and also compared the effects of the two immunosuppressants on the cell cycle and cyclic expression of HaCaT cells. METHODS: The effects of rapamycin and cyclosporin A on the proliferation of cultured human keratinocytes were examined by using the MTS {3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxy phenyl)-2-(4-sulfophenyl)-2H-tetrazolium} method and we also performed a flow cytometric study to determine whether the two immunosuppressants could affect the cell cycle and cyclic expression of HaCaT cells. RESULTS: The results are summarized as follows: 1. Rapamycin and cyclosporin A significantly inhibited the proliferation of cultured human normal keratinocytes and HaCaT cells in a dose-dependent fashion(p<0.05), and the degree of suppression was more evident in normal keratinocytes than in HaCaT cells. 2. Both immunosuppressants reduced the number of HaCaT cells in the S phase and the number of S phase cells was decreased early (Dl) by cyclosporin 4, while rapamycin reduced S phase cells more slowly. 3. The expression of cyclic D2 was significantly inhibited after 16 hours of rapamycin treatment and after 2 hours of cyclosporin A treatment(p<0.05). The expression of cyclic A was significantly suppressed after 2 hours of both immunosuppressant treatments(p<0.05). CONCLUSION: We have shown that rapamycin and cyclosporin A can directly inhibit the proliferation of keratinocytes without T-cell involvement by blocking cell cycle progression in the G1 phase through reducing the number of S phase cells and inhibition of cyclic D2 expression.