Vitiligo in a Patient with Systemic Lupus Erythematosus: A Case Report / 대한피부과학회지

Vitiligo is a multifactorial disorder. Neural, biochemical, and autoimmune mechanisms have been hypothetically suggested as etiopathological contributors to this condition. Autoimmunity focuses primarily on genetic factors and the association between vitiligo and other autoimmune disorders including autoimmune thyroid disease, rheumatoid arthritis, psoriasis, type 1 diabetes, pernicious anemia, and Addison's disease. We describe a 35-year-old man with systemic lupus erythematosus who developed concurrent vitiligo and discoid lupus erythematosus suggesting the possible autoimmune association between these 2 different diseases.

Granuloma Annulare Successfully Treated with a Combined Regimen of Excimer Laser and Topical Tacrolimus / 대한피부과학회지

Granuloma annulare is a relatively common benign dermatosis of unknown etiology. It is typically characterized by skin-colored to violaceous annular or arcuate lesions. The localized form of the disease usually resolves spontaneously, but treatment may be required in cases of intractable symptoms such as pruritus, or for cosmetic purposes. Herein, we report the case of a 65-year-old man diagnosed with a localized form of granuloma annulare that was refractory to various treatments but showed clinical improvement with a combined regimen of excimer laser and topical tacrolimus.

Levofloxacin-induced Fixed Drug Eruption: A Case Report / 대한피부과학회지

Fixed drug eruptions (FDEs) are characterized by the presence of site-specific recurrence of a solitary or multiple, well-circumscribed, erythematous macules or patches that recur with each exposure to a particular medication. Several drugs including non-steroidal anti-inflammatory drugs, non-opioid analgesics, sedatives, anticonvulsants, sulfonamides, and tetracycline have been associated with an increased risk of inducing FDE. A 45-year-old woman with known history of levofloxacin use presented with erythematous patches on her face and left forearm. Although a patch test to levofloxacin showed a negative reaction, intradermal tests to assess hypersensitivity to levofloxacin were positive, and she was diagnosed with levofloxacin-induced FDE. Her antibiotic was switched to moxifloxacin, which she tolerated well. Moxifloxacin did not show cross-reactivity. Because of the widespread use of fluoroquinolones, it is important to consider these as possible etiological agents in cases of FDE. We describe a case of FDE diagnosed using positive intradermal tests to detect sensitivity to levofloxacin.

A Comparison of the Clinical Features and Comorbidities of Psoriasis and Psoriatic Arthritis: A Retrospective Study / 대한피부과학회지

BACKGROUND: Psoriatic arthritis (PsA) is one of the inflammatory arthritis associated with psoriasis. Several studies have described the clinical difference between psoriatic patients with PsA and those without PsA. OBJECTIVE: The purpose of this study was to examine the difference in clinical features and prevalence of comorbidities between psoriatic patients with and without PsA in Korea. METHODS: We retrospectively evaluated 173 patients diagnosed with psoriasis. Patients were subdivided based on the presence or absence of PsA. We analyzed clinical manifestations including comorbidities and laboratory tests such as total cholesterol, triglyceride, C-reactive protein, erythrocyte sedimentation rate (ESR), and fasting glucose. RESULTS: Among 173 patients with psoriasis, 29 patients (16.8%) were diagnosed with PsA. The mean age of psoriasis onset for patients with PsA was 7.6 years earlier (p=0.017) than for those without PsA. The duration of psoriasis was 4.6 years longer (p<0.001) in patients with PsA than in patients without PsA. Nail involvement was more common in patients with PsA (p<0.001). There were statistically significant differences between the two groups regarding ESR levels (p=0.003) and the prevalence of diabetes mellitus (p=0.032). CONCLUSION: We found several differences in the prevalence of comorbidities, levels of inflammatory markers, and epidemiologic characteristics between psoriatic patients with and without PsA. This study may help improve strategies for the clinical approach for treating psoriasis in dermatology.

Clinical Analysis of Nail Involvement in Psoriasis and Psoriatic Arthritis / 대한피부과학회지

BACKGROUND: It has been reported that nail psoriasis is common in psoriatic arthritis (PsA) patients, however, studies on the prevalence of PsA with nail psoriasis and the relationship between the severity of the diseases has not previously been reported in Korea. OBJECTIVE: The aim of this study was to investigate nail psoriasis and its relation to psoriasis and PsA. METHODS: After researching past medical records, 48 patients with nail psoriasis and 247 patients without nail psoriasis were enrolled in this study. Nail psoriasis was classified according to the morphologic types of nails and severity was evaluated using the modified nail psoriasis severity score index (mNAPSI). We assessed the severity of psoriasis and PsA by psoriasis area and severity index (PASI), and swollen and tender joint counts (STJC), respectively. Finally, we analyzed the relationship between mNAPSI, PASI, and STJC. RESULTS: Nail involvement was observed in 48 (16.3%) of 295 patients. Prevalence of PsA was higher in nail psoriasis (31.3%) than in uncomplicated psoriasis (9.3%, p<0.001). mNAPSI showed a positive correlation with STJC (p=0.002, Pearson correlation=0.427), but not with PASI (p=0.094, Pearson correlation=0.202). CONCLUSION: The results show that PsA is more common and severe in psoriatic patients with nail involvement than in uncomplicated psoriasis. Clinicians should be alert to nail involvement in psoriatic patients, as it could be related to the disease course and prognosis of PsA.

A Case of Multiple Desmoplastic Trichoepithelioma

No abstract available.

Efficacy and Safety of Alitretinoin for Chronic Hand Eczema in Korean Patients

BACKGROUND: Chronic hand eczema (CHE) tends to be refractory to conventional therapy. Previous clinical trials have found that a 24-week treatment course of oral alitretinoin is effective and well tolerated for CHE treatment. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of oral alitretinoin in Korean CHE patients. METHODS: A total of 27 patients with moderate to severe CHE took 30 mg of alitretinoin daily for 12 weeks. The primary efficacy parameter was the physician's global assessment (PGA). The response was defined as a patient being "clear" or "almost clear" of disease. The secondary efficacy parameters were the modified total lesion symptom score (mTLSS) and the patients' global assessment (PaGA). All adverse events and laboratory abnormalities were recorded during the treatment period. RESULTS: Alitretinoin led to CHE symptom improvement in 44.4% of patients. The PGA, mTLSS, and PaGA scores correlated well with each other. Reported adverse events were typical retinoid class effects and headache was the most common. CONCLUSION: Taking 30 mg of oral alitretinoin daily for 12 weeks was found to be effective in treating Korean patients with CHE, compared with the 24 week-treatment shown in previous studies.

Linear Morphea Progressed to Generalized Morphea with Lichen Sclerosus / 대한피부과학회지

Morphea is an autoimmune condition characterized by excessive accumulation of collagen in the skin and underlying tissues. Lichen sclerosus (LS) is another connective tissue disease for which an autoimmune cause has been proposed, given the high association with other autoimmune diseases. The coexistence of morphea and lichen sclerosus has been sometimes reported in the literature, and is suggestive of a common pathogenic background between the two diseases. Among various types of morphea, generalized morphea has been associated with an increased rate of autoimmune disease, including LS. We report a case of extragenital LS during the progression of linear morphea into generalized morphea.

A Case of Lichen Nitidus Treated with Adapalene-benzoyl Peroxide Fixed-dose Combination Gel / 대한피부과학회지

No abstract available.

Pachydermoperiostosis Associated with Peptic Ulcer and Hyperplastic Polyp of Stomach / 대한피부과학회지

No abstract available.

Assessment of the Quality of Life in Autoimmune Blistering Skin Disease Patients / 대한피부과학회지

BACKGROUND: Autoimmune blistering skin diseases such as pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid and epidermolysis bullosa acquisita substantially affect patients' daily life and psychosocial well-being. OBJECTIVE: The aim of this study was to evaluate the quality of life (QOL) in patients with autoimmune blistering diseases and to identify the factors that can influence their QOL by comparing them to healthy controls. METHODS: Forty patients with autoimmune blistering skin diseases and 40 healthy controls were interviewed using the Korean version of Skindex-29. The study assessed the clinical severity of the disease. RESULTS: The total, symptom, function, and emotion scores of Skindex-29 were significantly higher in patients with autoimmune blistering skin diseases (35.28, 40.78, 30.57, and 36.67, respectively) than in the healthy controls (6.90, 9.38, 5.47, and 6.60, respectively) (p<0.001). Higher disease severity had a negative correlation with QOL in patients with blistering skin diseases, and QOL was lower when patients had low levels of satisfaction with treatment. CONCLUSION: The results show that autoimmune blistering skin diseases can affect patients' QOL. In addition, disease severity and low satisfaction with treatment are important factors that reduce QOL. Development of new treatments should improve treatment efficacy and the QOL of patients with autoimmune blistering diseases.