Association of food intake with serum levels of phosphorus and potassium in hemodialysis patients / 한국영양학회지

PURPOSE: Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium. METHODS: This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items. RESULTS: The mean body mass index (BMI) was 22.2 +/- 3.0 kg/m2, mean serum phosphorus level was 4.50 +/- 1.52 mg/dl, and mean serum potassium level was 4.74 +/- 0.73 mEq/l. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (> 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p < 0.05). Mean duration of HD was 7.9 +/- 7.3 years and it showed positive correlation with serum potassium levels (p < 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p < 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p < 0.01), potatoes, fish, and high-potassium vegetables (p < 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p < 0.05). CONCLUSION: The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.

A Case of Segmental Neurofibromatosis / 대한피부과학회지

A 30-year-old woman had localized several cutaneous neurofibromas on the scalp in a dermatomal distribution(C2). Family history was negative, and evaluation for other signs such as cafe-au-lait spots, axillary frecklings, or Lisch nodules were not revealed. Biopsy specimen showed a well-circumscribed encapsulated tumor which consists of spindle cells with elongated, wavy nuclei and thin wavy collagenous strands loosely spaced in a clear matrix as seen in the neurofibroma. The diagnosis of bilateral segmental neurofibromatosis was made on the basis of the clinical features including the distribution of the neurofibromas and the absence of the family history and the histology consistent with a neurofibroma.

A Case of Perioral Dermatitis Involving the Eyelids / 대한피부과학회지

Perioral dermatitis is a facial dermatoses affecting the nasolabial folds, the chin, and the upper lip with sparing of a rim of skin at the vermilion border. The classic distribution is of the perioral area, but the glabella, eyelids and even forehead may be affected. In the patients with the periocular variety, the history, course, and response to treatment are exactly the same as in those with classic perioral dermatits. Herein, we report a case of perioral dermatitis involving the eyelids in a 23-year-old man who had used topical corticosteroids but experienced symptom aggravation and improvement after doxycycline treatment.

Prevalence of Latex Sensitization in Atopic Dermatitis Patients: Results of Skin Prick Test and RAST to Latex / 대한피부과학회지

BACKGROUND: Natural rubber latex has become an important health concern in recent years, particularly in risk groups. Atopic dermatitis is well known risk factor for latex allergy, but there is no data or study of latex allergy in Korea. OBJECTIVE: The purpose of this study was to investigate the prevalence of latex sensitization in atopic dermatitis patients. METHODS: A total of 154 patients presenting with various diseases for allergologic evaluation was studied. A questionnaire-based history was taken, skin prick tests(SPT) with latex glove extract were done. In SPT positive patients, serum total IgE and latex-specific IgE by radioallergosorbent test(RAST) were measured, and a use test was also performed. RESULTS: A total of 77 subjects(50%) was atopic. There were positive SPT reactions to latex in 13/77(16.9%). There were only 7 positive to the latex RAST in SPT positive patients. Except one patient, there were no clinically relevant latex allergy by history and challenge tests. CONCLUSION: The results of this study suggest that the prevalence of latex sensitization in atopic dermatitis patients is quite high(16.9%), and in latex allergy diagnosis, SPT is more sensitive than RAST.

A Case of Speckled Lentiginous Nevus combined with Spitz Nevi / 대한피부과학회지

Speckled lentiginous nevus(SLN) is characterized by a tan background patch on which more darkly pigmented macules and papules are randomly distributed. The presence of agminated Spitz nevi with SLN is well known, but a solitary Spitz nevus arising on a SLN is rare. We herein report a case of SLN with two Spitz nevi developed individually and congenital melanocytic nevus in a 9-year-old boy.

Effects of Lactic Acid and Sodium Pyrrolidone Carboxylic Acid on the Irritated Skin Reaction Induced by Sodium Lauryl Sulphate Patch Testing of Normal Persons and Atopic Dermatitis Patients / 대한피부과학회지

BACKGROUND: Natural moisturizing factors such as sodium pyrrolidone carboxylic acid and lactic acid may play an important role in increasing the moisture retention of isolated stratum corneum and reducing the incidence of dry and flaky skin in vivo. Although the precise mechanism of surfactant irritancy is not fully understood, it has been suggested that barrier dysfunction of stratum corneum by surfactants results in skin changes such as scaling, erythema, and even fissuring. OBJECTIVE: We evaluated the effect of sodium pyrrolidone carboxylic acid(NaPCA) and lactic acid(LA) with several non-invasive measuring methods in the irritated skin reaction induced by sodium lauryl sulphate (SLS) in normal persons and atopic dermatitis patients. METHODS: After skin irritation for 24 hours with patch test of 1% SLS on five volar sites of right forearm, we applied nothing(A), 3% LA+3% NaPCA(B), 3% LA(C), 3% NaPCA(D), and vehi cle(E) twice a day respectively. Visual score, transepidermal water loss(TEWL), water holding capa city(WHC), and erythema index were measured at 30 min, 24hr, 48hr and 72hr after patch removal. RESULTS: 1. After 72hr, the visual scores of B and C were significantly lower than that of A(control) in atopic dermatitis patients, and that of C in normal persons was significantly lower than that of A, D, and E. 2. TEWL values of B and C in both the normal (after 72hr) and atopic dermatitis group (after 48hr and 72hr) were significantly lower than that of A. 3. WHC values of B, C, D in both the normal and atopic dermatitis group were significantly higher than that of A after 48hr and 72hr. 4. After 72hr, erythema indices by Mexameter of B, C, and D in both the normal and atopic dermatitis group were significantly lower than that of A and values of C were significantly lower than that of E. In the atopic dermatitis group, values of D were also significantly lower than that of E. 5. The mean visual score was significantly correlated with TEWL value and erythema index of Mexameter (r=0.58, r=0.64) and the TEWL value was significantly correlated with erythema index of Mexameter (r=0.64). CONCLUSION: These results suggest that topical application of a moisturizing factor might improve the surfactant-induced disruption of permeability barrier with improvement of the water holding capacity of the stratum corneum.

A Case of Primary Anetoderma / 대한피부과학회지

Anetoderma is a rare cutaneous disorder characterized by circumscribed loss of skin elasticity. This has been historically divided into inflammatory(Jadassohn-Pellizzari) and non-inflammatory(Schw eninger-Buzzi) type. We herein, report a case of Schweninger-Buzzi type anetoderma occurring on a 6 year-old girl. The lesions did not have an inflammatory onset. Histologically, the focal loss of elastic fibers was seen on the lesion.

A Case of Acral Lentiginous Nevus / 대한피부과학회지

Acral lentiginous nevus(ALN) is a new disease entity recently proposed by Clemente et al in 1995. The main histopathological features of ALN are characterized by elongation of the rete ridges, lentiginous proliferation of melanocytes at the dermo-epidermal junction, the presence of melanocytes within the upper epidermis, poor or absent lateral circumscription of the intraepithelial melanocytes and, in the dermis, fibroplasia, vascular neogenesis, and lymphoid infiltration, which enable clinicians to distinguish these nevi from ordinary nevi and melanoma. We, herein, report a case of ALN of plantar skin with unique histopathological characteristics.

A Case of Ocular Rosacea / 대한피부과학회지

Ocular rosacea is the eye manifestations of rosacea, which involves the lids, conjunctiva, and cornea. A recent study revealed that all patients with cutaneous rosacea had some degree of ocular involvement which is often undiagnosed. It is difficult to make a diagnosis of ocular rosacea because it lacks clinical or pathological hallmarks. However, early diagnosis and treatment are emphasized to decrease morbidity and prevent potential blindness. We report a case of ocular rosacea in a 49 year-old man who showed blepharoconjunctivitis, keratitis, and cutaneous manifestations of persistent erythema, telangiectasia, and papules. The ocular symptoms and signs had improved significantly with tetracycline therapy.