A Case of Linear Exacerbation of Atopic Dermatitis with Secondary Prurigo Nodularis

Inflammatory acquired Blaschko-linear dermatoses (IABLD) are a continuous concept involving diseases such as lichen striatus, blaschkitis, and atopic dermatitis. However, atopic dermatitis that showed increase in severity along Blaschko lines is rarely reported on its own. Herein, we report a rare case of atopic dermatitis with secondary prurigo nodularis along Blaschko lines, which may be valuable in broadening the concept of IABLD. A 28-year-old male presented with multiple, pruritic, brownish nodules on the left lower extremity along Blaschko lines for 3 to 4 years. The patient had atopic dermatitis since childhood. Histopathologic findings revealed compact orthohyperkeratosis, hypergranulosis, spongiosis, and irregular acanthosis in the epidermis. Fibrosis with vertically arranged collagen fibers and perivascular lymphohistiocytic infiltration were shown in the upper dermis. We diagnosed the case as secondary prurigo nodularis along Blaschko lines, accompanied by the preceding atopic dermatitis. We hypothesized that the patient’s underlying atopic dermatitis increased in severity along Blaschko lines, and prurigo nodularis occurred due to frequent scratching. The lesions improved with topical methylprednisolone cream, oral antihistamines and intralesional triamcinolone injection.

Recurrent Cellulitis Associated with Acupuncture with Migratory Gold Threads

In Asian countries, acupuncture with gold threads has been widely used in the treatment of pain. However, several reports have suggested that the implanted gold threads can become fragmented and migrate to other parts of the body, damaging surrounding tissues. A 75-year-old female presented with diffuse erythematous edema with multiple vesicles on the right lower leg for 3 days. She had previously suffered from cellulitis on the same region twice for the last 1year. Her past medical history included acupuncture with gold threads on the back due to lumbar herniated nucleus pulposus (HNP) about 10 years ago. Histopathological examination demonstrated marked subepithelial edema and diffuse perivascular infiltrate of inflammatory cells in the dermis. Simple radiography of the leg revealed numerous radiodense threads in the soft tissue. Since the patient did not receive acupuncture on any other sites except on the back, we hypothesized that the gold threads injected on the back may have migrated through the vessels to the leg. These metal fragments can cause inflammatory reaction and make the tissues more susceptible to secondary infections. The lesion gradually improved after treatment with systemic steroid and antibiotics for 1 week.

Hypersensitivity Reactions to Contrast Media Used in Computed Tomography in Korea / 대한피부과학회지

Background@#Contrast media have been widely used for the diagnosis of numerous diseases. Although they are generally safe, the reported number of hypersensitivity reactions to contrast media has increased annually. @*Objective@#We aimed to investigate the incidence of hypersensitivity reactions due to intravenous nonionic contrast media. Also, we investigated whether the risk of contrast media-associated hypersensitivity was increased by specific types of contrast agents. @*Methods@#We performed a retrospective review of patients who had hypersensitivity reactions after enhanced computed tomography scans at Bucheon St. Mary’s Hospital, Bucheon, Korea from January 2016 to December 2019.We classified the hypersensitivity reactions into immediate (＜1 hour) or delayed (≥1 hour) reactions. All demographic data and information regarding the hypersensitivity reactions were obtained from the electronic medical records. @*Results@#The overall incidence of hypersensitivity reactions to contrast media was 0.49% (262 cases resulting from 53,733 exposures). The incidence increased annually from 0.19% in 2016 to 0.86% in 2019. Among the 262 cases, 199 cases (76.0%) were immediate-type while the delayed-type accounted for 63 cases (24.0%). The immediate hypersensitivity reaction incidence was not significantly different among contrast agents. However, the incidence of the delayed-type was significantly different (ranging from 0.02% for iomeprol to 0.25% for iodixanol, p＜0.05). @*Conclusion@#This study found that the hypersensitivity reaction incidence has increased annually. Immediate hypersensitivity reactions occurred at a higher rate than delayed hypersensitivity reactions. The incidence of delayed hypersensitivity reactions was significantly greater in patients who received iodixanol than in those who received the other types.

Recurrent Cellulitis Associated with Acupuncture with Migratory Gold Threads

In Asian countries, acupuncture with gold threads has been widely used in the treatment of pain. However, several reports have suggested that the implanted gold threads can become fragmented and migrate to other parts of the body, damaging surrounding tissues. A 75-year-old female presented with diffuse erythematous edema with multiple vesicles on the right lower leg for 3 days. She had previously suffered from cellulitis on the same region twice for the last 1year. Her past medical history included acupuncture with gold threads on the back due to lumbar herniated nucleus pulposus (HNP) about 10 years ago. Histopathological examination demonstrated marked subepithelial edema and diffuse perivascular infiltrate of inflammatory cells in the dermis. Simple radiography of the leg revealed numerous radiodense threads in the soft tissue. Since the patient did not receive acupuncture on any other sites except on the back, we hypothesized that the gold threads injected on the back may have migrated through the vessels to the leg. These metal fragments can cause inflammatory reaction and make the tissues more susceptible to secondary infections. The lesion gradually improved after treatment with systemic steroid and antibiotics for 1 week.

Abrupt Development of Esophageal Candidiasis after Secukinumab Treatment in a Psoriatic Patient

no abstract available.

Hypersensitivity Reactions to Contrast Media Used in Computed Tomography in Korea / 대한피부과학회지

Background@#Contrast media have been widely used for the diagnosis of numerous diseases. Although they are generally safe, the reported number of hypersensitivity reactions to contrast media has increased annually. @*Objective@#We aimed to investigate the incidence of hypersensitivity reactions due to intravenous nonionic contrast media. Also, we investigated whether the risk of contrast media-associated hypersensitivity was increased by specific types of contrast agents. @*Methods@#We performed a retrospective review of patients who had hypersensitivity reactions after enhanced computed tomography scans at Bucheon St. Mary’s Hospital, Bucheon, Korea from January 2016 to December 2019.We classified the hypersensitivity reactions into immediate (＜1 hour) or delayed (≥1 hour) reactions. All demographic data and information regarding the hypersensitivity reactions were obtained from the electronic medical records. @*Results@#The overall incidence of hypersensitivity reactions to contrast media was 0.49% (262 cases resulting from 53,733 exposures). The incidence increased annually from 0.19% in 2016 to 0.86% in 2019. Among the 262 cases, 199 cases (76.0%) were immediate-type while the delayed-type accounted for 63 cases (24.0%). The immediate hypersensitivity reaction incidence was not significantly different among contrast agents. However, the incidence of the delayed-type was significantly different (ranging from 0.02% for iomeprol to 0.25% for iodixanol, p＜0.05). @*Conclusion@#This study found that the hypersensitivity reaction incidence has increased annually. Immediate hypersensitivity reactions occurred at a higher rate than delayed hypersensitivity reactions. The incidence of delayed hypersensitivity reactions was significantly greater in patients who received iodixanol than in those who received the other types.

Factors Influencing Family's Organ Donation Decision / 대한이식학회지

BACKGROUND: The main factor limiting the increase in brain dead organ donors is low consent rates for organ donation. METHODS: This study is a retrospective analysis of donor records of Korea Organ Donation Agency from 2013 to 2015. Factors related before providing information about organ donation and process of explaining organ donation were analyzed. RESULTS: Donor gender, marital status, religious affiliation, residence area, knowledge of patients' wishes, understanding of brain death status, and the referring system, providing initial information about donation and initial medical staff providing information about donation had a significant influence on decision to donate. Organ donation greatly increased when the donor family knew the patient's intent to donate. As the degree of family understanding of brain death status and the referring system increased, organ donation rate significantly increased. CONCLUSIONS: Providing sufficient information about brain death during the period of delivering medical services as well as activating campaign and public education are essential to improving the positive attitude toward organ donation.

Significance of Peritoneal Albumin Excretion in New Peritoneal Dialysis Patients / 대한신장학회지

PURPOSE: High peritoneal transport status is known to be related with the cardiovascular risk. One of the hypotheses that explain the relationship between peritoneal permeability and atherosclerosis is chronic inflammation and endothelial dysfunction. Microalbuminuria is a well-known marker of endothelial dysfunction and a predictor of cardiovascular disease (CVD). We hypothesized that peritoneal albumin excretion, like microalbuminuria, may be related to the cardiovascular events and chronic inflammation in peritoneal dialysis (PD) patients. METHODS: We enrolled eighty-five patients who started PD. Pre-existing CVD was defined as angina, history of MI, cerebrovascular disease, or peripheral arterial disease. Modified peritoneal equilibration test was performed within 2 months. At that time, peritoneal albumin excretion, serum and dialysate IL-6, CRP were measured. RESULTS: The age was 49.5+/-14 years and male-to-female ratio was 1 to 3. Diabetes mellitus and CVD were present in 40% and 28%, respectively. The dialysate-to-plasma albumin (D/Palb) was correlated with D/P4 Cr (r= 0.552, p<0.001), and was higher in HA/H group than in LA/L group (0.19+/-0.008 vs. 0.12+/-0.005, p<0.001). D/Palb was closely correlated with the dialysate IL-6 (r=0.432, p< 0.001), but not with the serum IL-6 and CRP. There were no differences in the peritoneal albumin excretion with respect to the diabetic status or pre-existing CVD. CONCLUSION: The peritoneal albumin excretion was associated with peritoneal small solute transport and dialysate IL-6 in the new PD patients. Prospective studies will follow in order to verify the role of peritoneal albumin excretion as a predictor of cardiovascular events.

The Factors Associated with Weight Control Experiences among Adolescents: Based on Self-esteem, Body-cathexis, Attitudes toward the Body, Anthropometric Characteristics and Perceptions of Body Shape / 대한지역사회영양학회지

This study was carried out to investigate among adolescents (total = 729) the relationship between their self-esteem, body-cathexis, their attitudes toward the importance of their bodies, their anthropometric characteristics, their perceptions of their body shapes and their experiences with weight control. The results are summarized as follows: The mean values for self-esteem and body-cathexis were generally low, but these values were significantly higher among boys than girls (p < 0.01 - 0.001). However the mean values for their attitudes toward the importance of their bodies were relatively high and were significantly higher among girls than boys (p < 0.01). The mean values for Percent Ideal Body Weight (PIBW) and Body Mass Index (BMI) were normal and no significant differences between the genders were observed. The distribution of the PIBW and the BMI values showed a higher rate for normal weights among the girlsand a higher rate for underweightedness and obesity among the boys (p < 0.01). With regard to their perception of their body image, among the boys, their current figures were almost identical with their idea of an ideal figure, but among the girls, their idea of an ideal figure was thinner than their current figure. The girls were more dissatisfied with their own body image than the boys (p < 0.001). Fifty-four percent of the subjects had previous weight control experience, and the girls had significantly more experience than the boys (p < 0.001). Their main reason for practising weight control was to lose weight (65.3%). Those who had more weight control experience had lower satisfaction with their body shapes, higher PIBW, higher BMIs or currently had fatter figures. Their standard image of their figures was influenced by TV (40.3%) and friends (36.9%). There was a weakly positive correlation between their self-esteem and their satisfaction with their body shapes, and a weakly negative correlation between their satisfaction with their body shapes and their attitudes toward the importance of their bodies. These results suggest the necessity for an educational program for adolescents as to foster a positive body image. Such a program should consider psychological factors such as selfesteem, satisfaction with body shape and attitudes toward the importance of the body