A Case of Pressure Blister after Using Air Mesh Mat / 대한피부과학회지

No abstract available.

The Clinical Profile of Patients with Psoriasis in Korea: A Nationwide Cross-Sectional Study (EPI-PSODE)

BACKGROUND: Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. OBJECTIVE: To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. METHODS: This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. RESULTS: A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m²; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. CONCLUSION: This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population.

Introduction of the Reliable Estimation of Atopic Dermatitis in ChildHood: Novel, Diagnostic Criteria for Childhood Atopic Dermatitis

PURPOSE: Questionnaire-based diagnostic criteria for atopic dermatitis (AD) have been proposed to detect the major group of AD with flexural dermatitis. We aimed to develop novel, questionnaire-based diagnostic criteria for childhood AD, which can detect more comprehensive AD including non-flexural type. METHODS: The draft version of questionnaire to detect childhood AD was prepared to be used for preliminary hospital- (n=1,756) and community-based (n=1,320) surveys. From analysis, the Reliable Estimation of Atopic dermatitis of ChildHood (REACH) was derived and verified in derivation (n=1,129) and validation (n=1,191) sets by community-based surveys. RESULTS: The REACH consists of 11 questions including 2 major and 9 minor criteria. AD is diagnosed as the major group of 'eczema on the antecubital or popliteal fossa' to fulfill the 2 major criteria (2M), and the minor group of 'eczema on the non-antecubital or popliteal fossa' to fulfill the 1 major plus 4 or more minor criteria (1M+4m). In the validation set, the overall 1-year AD prevalence by the REACH was estimated as 12.3% (95% CI, 10.5%-14.2%), and the REACH showed a sensitivity of 75.2%, a specificity of 96.1%, and an error rate of 6.4%. The REACH demonstrated better diagnostic performance than the ISAAC in terms of the number of misclassification (10.0%). CONCLUSIONS: We propose the REACH as new full, questionnaire-based diagnostic criteria for childhood AD in epidemiological surveys. Further studies are warranted to validate the REACH in different populations or countries in the context of large-scale, epidemiological surveys.

Subcorneal Pustular Dermatosis Caused by Darbepoetin-α in Hemodialysis Patients / 대한피부과학회지

Subcorneal pustular dermatosis is a pustular eruption that shows subcorneal pustules containing polymorphonuclear leukocytes and chronic progression. It most commonly affects the trunk, inguinal region, and axilla of middle-aged women, and the pustules are distributed bilaterally. Cultures of the pustules consistently do not reveal bacterial growth. Subcorneal pustular dermatosis rarely happens, and no specific etiology and pathogenesis are known. Thus, we present this case to provide dermatologists with information on its adequate diagnosis and treatment and to inform them of the risk of subcorneal pustular dermatosis in kidney dialysis patients who use darbepoetin-α.

Use of Q-switched Nd:YAG Laser in the Treatment of Longitudinal Melanonychia / 대한피부과학회지

No abstract available.

Increased Expression of Type I Collagen, MMP-1, and MMP-2 in Platelet-rich Plasma-treated Human Skin Fibroblasts / 대한피부과학회지

BACKGROUND: Platelet-rich plasma (PRP) treatment is a promising tool for dermal tissue regeneration. PRP combined with subcision can synergistically induce dermal tissue regeneration. OBJECTIVE: The purpose of this study was to investigate the effects of PRP on the proliferation and migration of skin fibroblasts, as well as on the type I collagen, matrix metalloproteinase (MMP)-1, and MMP-2 expression in these skin cells. The effect of PRP with subcision on the expression of TGF-beta1 was also investigated in an animal model. METHODS: Human skin fibroblasts were treated with various concentrations of PRP. The proliferation and migration rate of the cells were evaluated by the trypan blue exclusion method and scratch assay, respectively. The expression levels of type I collagen, MMP-1, and MMP-2 were analyzed by western blot or RT-PCR. In addition, the activity levels of MMP-1 and MMP-2 were studied by zymography. Finally, we treated the animal back with PRP, subcision, or PRP with subcision. The specimens were evaluated by H&E, Masson-trichrome, and TGF-beta1 immunohistochemical staining. RESULTS: Data from this study showed that PRP more effectively promoted the migration and proliferation of cells in a dose-dependent manner. The expression levels of type I collagen, MMP-1, and MMP-2 were increased in PRP-treated fibroblasts at the protein and mRNA levels. The in vivo study revealed that the expression of TGF-beta1 was prominently increased by co-treatment with PRP and subcision rather than by treatment with either PRP or subcision alone. CONCLUSION: PRP treatment promoted fibroblast migration and proliferation, and increased the expression of type I collagen, MMP-1, MMP-2, and TGF-beta1. Therefore, PRP co-application with subcision is an effective method for dermal remodeling and can be a good treatment option for depressed acne scars.

Increased Expression of Type I Collagen, MMP-1, and MMP-2 in Platelet-rich Plasma-treated Human Skin Fibroblasts / 대한피부과학회지

BACKGROUND: Platelet-rich plasma (PRP) treatment is a promising tool for dermal tissue regeneration. PRP combined with subcision can synergistically induce dermal tissue regeneration. OBJECTIVE: The purpose of this study was to investigate the effects of PRP on the proliferation and migration of skin fibroblasts, as well as on the type I collagen, matrix metalloproteinase (MMP)-1, and MMP-2 expression in these skin cells. The effect of PRP with subcision on the expression of TGF-beta1 was also investigated in an animal model. METHODS: Human skin fibroblasts were treated with various concentrations of PRP. The proliferation and migration rate of the cells were evaluated by the trypan blue exclusion method and scratch assay, respectively. The expression levels of type I collagen, MMP-1, and MMP-2 were analyzed by western blot or RT-PCR. In addition, the activity levels of MMP-1 and MMP-2 were studied by zymography. Finally, we treated the animal back with PRP, subcision, or PRP with subcision. The specimens were evaluated by H&E, Masson-trichrome, and TGF-beta1 immunohistochemical staining. RESULTS: Data from this study showed that PRP more effectively promoted the migration and proliferation of cells in a dose-dependent manner. The expression levels of type I collagen, MMP-1, and MMP-2 were increased in PRP-treated fibroblasts at the protein and mRNA levels. The in vivo study revealed that the expression of TGF-beta1 was prominently increased by co-treatment with PRP and subcision rather than by treatment with either PRP or subcision alone. CONCLUSION: PRP treatment promoted fibroblast migration and proliferation, and increased the expression of type I collagen, MMP-1, MMP-2, and TGF-beta1. Therefore, PRP co-application with subcision is an effective method for dermal remodeling and can be a good treatment option for depressed acne scars.

Adalimumab-induced Lupus Erythematosus Profundus in a Rheumatoid Arthritis Patient / 대한피부과학회지

The clinical manifestations and immunohistologic findings of drug-induced lupus erythematosus (DILE) are similar to those of idiopathic lupus. However, DILE is different from idiopathic lupus because it is induced after continuous drug exposure and resolves after discontinuation of the causative drug. DILE can be divided into systemic lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus (CCLE). Lupus erythematosus profundus is a subtype of CCLE, and drug-induced CCLE is very rarely reported in the literature. Herein, we report a rare case of adalimumab-induced lupus erythematosus profundus developed in a rheumatoid arthritis patient. The patient is a 43-year-old Korean woman who had multiple tender nodules and plaques on her face, trunk, and both extremities after using adalimumab for rheumatoid arthritis. She was diagnosed with adalimumab-induced lupus erythematosus profundus, and her condition improved after discontinuation of adalimumab.

Adalimumab-induced Lupus Erythematosus Profundus in a Rheumatoid Arthritis Patient / 대한피부과학회지

The clinical manifestations and immunohistologic findings of drug-induced lupus erythematosus (DILE) are similar to those of idiopathic lupus. However, DILE is different from idiopathic lupus because it is induced after continuous drug exposure and resolves after discontinuation of the causative drug. DILE can be divided into systemic lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus (CCLE). Lupus erythematosus profundus is a subtype of CCLE, and drug-induced CCLE is very rarely reported in the literature. Herein, we report a rare case of adalimumab-induced lupus erythematosus profundus developed in a rheumatoid arthritis patient. The patient is a 43-year-old Korean woman who had multiple tender nodules and plaques on her face, trunk, and both extremities after using adalimumab for rheumatoid arthritis. She was diagnosed with adalimumab-induced lupus erythematosus profundus, and her condition improved after discontinuation of adalimumab.

Prurigo Pigmentosa Triggered by Contact Dermatitis / 대한피부과학회지

No abstract available.

A Family-Engaged Educational Program for Atopic Dermatitis: A Seven-Year, Multicenter Experience in Daegu-Gyeongbuk, South Korea

BACKGROUND: It is important to educate families of pediatric patients with atopic dermatitis (AD) so that they have a correct understanding of AD. OBJECTIVE: The purpose of this study is to introduce, evaluate, and improve our family-engaged educational program. METHODS: Children suffering from AD and their families have participated in a half-day educational program called "AD school" with catchy slogans such as "Enjoy with AD Families!" every year since 2005. Educational lectures were conducted for parents. For children with AD, various entertaining programs were provided. A feedback survey about AD school was administered for the purpose of evaluation. RESULTS: A total of 827 people (376 patients and 451 family members) participated in this program over 7 years. On-site surveys showed a positive response (i.e., "excellent" or "good") for the prick test (95.1%), emollient education (78.4%), educational lecture (97.0%), drawing contest and games (90.2%), and recreation (magic show; 99.0%) respectively. Telephone surveys one year later also elicited a positive response. CONCLUSION: We herein introduce the experience of a half-day, family-engaged educational program for AD. Family-engaged education programs for AD such as this AD school encourage and validate family participation in the treatment of their children's AD.

Giant Infantile Hemangioma Treated with Beta-blocker with Intermittent Triamcinolone Intralesional Injection / 대한피부과학회지

No abstract available.

Anti-fibrotic Effect of Silibinin in Keloid Fibroblasts and a Bleomycin-induced, Scleroderma-like Animal Model / 대한피부과학회지

BACKGROUND: Silibinin reduces the expression of Type I collagen in normal skin fibroblasts through down-regulation of the TGF-beta/smad pathway. However, it is largely unknown whether silibinin can reduce the expression of Type I collagen in vivo sclerotic animal models, as well as in keloid fibroblasts. OBJECTIVE: The purpose of this study was to investigate the effect of silibinin on the expressions of type I collagen, matrix metalloproteinase-1 (MMP-1), MMP-2, smad2/3, and TGF-b1 receptor in keloid fibroblasts in vitro, and to evaluate the anti-fibrotic effect of silibinin in a bleomycin-induced, scleroderma-like animal model in vivo. METHODS: Keloid and normal skin fibroblasts were treated with silibinin (20~100 mM), and the expressions of type I collagen, MMP-1, MMP-2, and TGF-b1 receptor were analyzed with western blot. The animal model was established by bleomycin treatment (1.0 mg/mL) for 2 weeks in C57/BL9 mice. Then silibinin was injected on one side of the back and the same volume of normal saline was injected on the other side of the back. The specimen was evaluated with H&E, Masson-trichrome, and TGF-beta1 immunohistochemical staining. RESULTS: Expressions of Type I collagen, MMP-1, and MMP-2 decreased, but the expression of TGF-beta1 receptor increased in keloid fibroblasts after silibinin treatment. Thickened dermis with dense extracellular matrix and inflammatory cell infiltration of the bleomycin-induced, scleroderma-like animal model improved after silibinin treatment. Expression of TGF-beta1 decreased after silibinin treatment in the bleomycin-induced, scleroderma-like animal model. CONCLUSION: Silibinin treatment decreased the expression of Type I collagen in keloid fibroblasts in vitro. In addition, silibinin decreased the expression of Type I collagen by inhibiting TGF-beta1 expression in the bleomycin-induced, scleroderma-like animal model. These results indicate that silibinin has the potential to be an effective antifibrotic agent.

Effect of Horse Oil on Anti-bacterial, Inflammatory Cytokines, and Type I Collagen Expressions in Human HaCaT Keratinocytes and Fibroblasts / 대한피부과학회지

BACKGROUND: Anti-inflammation, anti-bactericidal, and collagen synthesis are important for health skin conditions. However, the effect of horse oil on anti-inflammation, anti-bactericidal, and collagen synthesis is largely unknown. OBJECTIVE: The aim of this study was to evaluate the anti-bactericidal, anti-inflammatory, and synthesis of type I collagen of horse oil. METHODS: Anti-bacterial effect was evaluated by disc diffusion test. Expressions of inflammatory cytokines were studied by RT-PCR analysis, real time PCR. Type I collagen expression was evaluated by Western blot in human HaCaT kertinocytes and fibroblasts. RESULTS: Our data showed that horse oil exerted anti-bacterial effect on P.acnes and S.aureus. Expression of IL-10 was increased by horse oil-treated HaCaT cells. In addition, increased expression of type I collagen was observed in horse oil-treated human skin fibroblasts. CONCLUSION: Horse oil exerts an anti-bactericidal effect against P.acnes and S.aureus. In addition, anti-inflammatory and anti-aging effects of horse oil will be mediated by up-regulation of IL-10 and type I collagen, respectively.

Erratum: Author's Name Correction. Dapsone Hypersensitivity Syndrome with EBV Reactivation / 대한피부과학회지

Author list should be corrected.

Erythema Multiforme-like Eruptions Caused by Accidental Exposure to Glufosinate Ammonium / 대한피부과학회지

Glufosinate ammonium herbicide is a nonselective herbicide used worldwide because it is less toxic than paraquat. Acute glufosinate ammonium intoxications manifest as injuries of the intestinal mucosa, abdominal pain, vomiting, diarrhea, convulsions, respiratory distress, and death resulting from human abuse. We present a case of irritant contact dermatitis on the back caused by accidental exposure to glufosinate ammonium and followed by erythema multiforme-like eruptions without systemic intoxication, which has not been documented previously in Korea.

Dapsone Hypersensitivity Syndrome with EBV Reactivation / 대한피부과학회지

No abstract available.

Pneumococcal Vaccination-Induced Localized Cutaneous Toxic Reaction Mimicking Fixed Drug Eruption on a Nearby Vaccination Injection Site in an Infant / 대한피부과학회지

Pneumococcus is a very important pathogen for children and elderly people, and causes considerable morbidity and mortality in these groups. Pneumococcal vaccination is relatively safe, and is being increasingly used for the prevention of pneumococcal disease, such as meningitis, pneumonia, otitis media, and bacteremia. Mild adverse reactions of pneumococcal vaccination are relatively common, and include erythema, pain, fever, myalgia, and headaches. However, adverse skin reactions are very rare. Here, we present a case of pneumococcal vaccination-induced localized toxic reaction mimicking fixed drug eruption on a nearby vaccination injection site in an infant, which has not previously been documented in Korea.

Weber-Cockayne Type Epidermolysis Bullosa Simplex Resulting from a Novel Mutation (c. 608T>C) in the Keratin 5 Gene

Epidermolysis bullosa simplex (EBS), an inherited genetic disorder, is most often caused by a dominant-negative mutation in either the keratin 5 (KRT5) or the keratin 14 (KRT14) gene. These keratin mutants result in a weakened cytoskeleton and cause extensive cytolysis. It is important to analyze the KRT5 or KRT14 genes of the patient and their family members by mutational analysis in order to identify genetic defects as well as the need for genetic counseling. In this study, we present a 5-year-old Korean boy who had been developing blisters and erosions on the palms of his hands and soles of his feet since infancy. In addition, while his younger sister and father showed similar clinical manifestation, his mother did not. The patient was diagnosed with EBS based on clinical manifestation, which is characterized by the presence of blisters restricted to the palms and soles, histological findings, and mutational analysis. Mutational analysis of the patient's DNA revealed a thymine-to-cytosine transition at codon 608 in the KRT-5 gene, resulting in a leucine-to-proline substitution in the keratin 5 protein. The same mutation was identified in the paternal, but not maternal, DNA. Here, we report a case of Weber-Cockayne type EBS with vesicles and bullae restricted to the palms and soles with a novel, paternally inherited mutation in KRT5 gene (exon2, c.608T>C).

Effect of Botulinum Toxin A on Acute and Chronic Pain in Herpes Zoster Patients / 대한피부과학회지

BACKGROUND: Many strategies are currently used to reduce herpes zoster pain, such as opioid analgesic administration and transcutaneous electrical nerve stimulation. However, a more effective and convenient method to reduce herpes zoster pain is needed. OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of botulinum toxin A in patients with herpes zoster pain. METHODS: Seventy-five patients with herpes zoster pain were enrolled. We reviewed the medical records and divided the patients into three groups according to the treatment they received: standard treatment with botulinum toxin A, standard treatment only, and standard treatment with normal saline injection. Data on patients' age, sex, involved dermatome, and the duration and severity of pain evaluated with the visual analogue scale (VAS) were collected. Botulinum toxin A (1 unit/1 cm2, total 10~20 units) was injected intradermally, and the patients were evaluated on initial visit, and at 1 and 28 days after injection. RESULTS: In concordance with previous studies, this study showed that botulinum toxin A had a rapid and considerable effect on reducing both acute and postherpetic pain. The mean VAS was 6.96 on initial visit, 2.90 after 1 day, and 2.03 after 28 days in the botulinum toxin injection group. This result was statistically significant (p<0.001) when compared with the standard treatment group and the standard treatment with normal saline injection group. Few adverse effects were observed. CONCLUSION: Intradermal injection of botulinum toxin A is an effective and safe method for reducing pain in patients with herpes zoster.