Clinical Practice Guidelines for the Diagnosis and Treatment of Scabies in Korea:Part 1. Epidemiology, Clinical Manifestations, and Diagnosis / 대한피부과학회지

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 people/yr in 2010 to approximately 30,000 people/yr in 2021. However, outbreaks have been consistently observed in residential facilities, such as nursing facilities, particularly among the older population. The clinical manifestations of scabies vary depending on a patient’s age, health status, number of mites, and transmission route. Typical clinical presentations of classic scabies include intense nocturnal pruritus and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. Unlike classic scabies, older adults with immunodeficiency or neurological disorders exhibit hyperkeratotic scaly lesions or an atypical distribution with mild-to-non pruritus (crusted scabies). Diagnosis of scabies is based on clinical symptoms and results of diagnostic tests aimed at identifying the presence of the parasite. Although a close contact history and characteristic clinical findings are suggestive of scabies, confirmation of diagnosis requires detection of scabies mites, eggs, or scybala.This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution in vivo imaging techniques.

Clinical Practice Guidelines for the Diagnosis and Treatment of Scabies in Korea:Part 2. Treatment and Prevention / 대한피부과학회지

For all suspected, clinical, or confirmed cases of scabies, treatment should be initiated. Affected patients should be adequately isolated, and high-risk groups with close contact histories should be treated irrespective of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and patient’s health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments are topical 10% crotamiton and oral ivermectin. Following treatment completion, a follow-up visit at 2 and 4 weeks is recommended to monitor therapeutic response. Treatment failure is considered when scabies mites or burrows are detected, upon development of new clinical characteristics, or upon aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control should be rendered to reduce the transmission of scabies.

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.

Effective Treatment of Suspicious Riehl's Melanosis Using Low Fluence 1,064 nm Q-switched Nd:YAG Laser and 595 nm Pulsed Dye Laser / 대한피부과학회지

No abstract available.

A Case of Congenital Smooth Muscle Hamartoma Presenting as a Human Tail / 대한피부과학회지

A human tail is a rare congenital anomaly, and is characterised by a prominent lesion from the lumbosacrococcygeal region. Human tails are classified into 'true tails' and 'pseudotails'. True tails are comprised of only mesenchymal tissue. They are presumed to be remnants of the embryologic tail. All other lumbosacrococcygeal protrusions are summarized as pseudotails. Congenital smooth muscle hamartoma usually presents as a well-circumscribed, hypertrichotic, hyperpigmented or skin-colored patch or plaque on the trunk or an extremity at birth. Histologically, numerous thick, long, well-defined bundles of smooth muscle fibers are scattered throughout the dermis in various directions. We report a case of congenital smooth muscle hamartoma in a 15-year-old male patient who presented with a tail-like protruding mass accompanied by hypertrichosis and underlying soft tissue deviation.

A Case of Recurrent Atypical Fibroxanthoma Treated with Mohs Micrographic Surgery / 대한피부과학회지

Atypical fibroxnathoma (AFX) is a pleomorphic spindle cell neoplasm of the dermis, and is a clinically-benign reactive lesion, despite apparently malignant histologic features. We describe a case of 16-year-old female with recurrent AFX which developed on the occipital scalp. The lesion was totally excised by Mohs micrographic surgery and no recurrence was observed during one year follow up period. It is uncommon for AFX, such as the present case, to develop on a non-sun-exposed area and in adolescence.

A Case of Oral Focal Mucinosis / 대한피부과학회지

Oral focal mucinosis (OFM) is an uncommon clinicopathologic entity which is considered to be the oral counterpart of cutaneous focal mucinosis. It is comprised of a clinically-elevated mass with a histological feature of localized areas of myxomatous connective tissue. We herein report a case of oral focal mucinosis in a child, plus a review of the literature.

A Case of Oral Focal Mucinosis / 대한피부과학회지

Oral focal mucinosis (OFM) is an uncommon clinicopathologic entity which is considered to be the oral counterpart of cutaneous focal mucinosis. It is comprised of a clinically-elevated mass with a histological feature of localized areas of myxomatous connective tissue. We herein report a case of oral focal mucinosis in a child, plus a review of the literature.

A Case of Extramammary Paget's Disease Treated with 5% Imiquimod Cream / 대한피부과학회지

Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma. Mohs micrographic surgery is considered the standard treatment. Other treatment modalities such as surgical excision, radiotherapy, topical chemotherapy, and photodynamic therapy are associated with varying degrees of effectiveness, and possible loss of tissue function and disease recurrence are seen. The search for an effective, safe treatment with minimal side effects proves to be challenging. Imiquimod is the first representative of a new class of immunomodulating drugs demonstrating potent antiviral and antitumor activity, and has been approved by the FDA for treating anogenital warts, actinic keratosis and basal cell carcinoma. Recent research has demonstrated its effective usage as a 5% cream in the management of EMPD. We report a case of EMPD of the scrotum successfully treated with topical 5% imiquimod cream. This has never been published in the Korea dermatologic literature.

A Case of Extramammary Paget's Disease Treated with 5% Imiquimod Cream / 대한피부과학회지

Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma. Mohs micrographic surgery is considered the standard treatment. Other treatment modalities such as surgical excision, radiotherapy, topical chemotherapy, and photodynamic therapy are associated with varying degrees of effectiveness, and possible loss of tissue function and disease recurrence are seen. The search for an effective, safe treatment with minimal side effects proves to be challenging. Imiquimod is the first representative of a new class of immunomodulating drugs demonstrating potent antiviral and antitumor activity, and has been approved by the FDA for treating anogenital warts, actinic keratosis and basal cell carcinoma. Recent research has demonstrated its effective usage as a 5% cream in the management of EMPD. We report a case of EMPD of the scrotum successfully treated with topical 5% imiquimod cream. This has never been published in the Korea dermatologic literature.

Reconstruction of Defect on the Nasal Dorsum with Modified Bilateral Rhombic Flap / 대한피부과학회지

The skin over the nose is less mobile for primary closure of defects. In addition to skin graft and secondary intention healing, there are various local flap techniques and their modifications for the reconstruction of nasal defects. Imprecise engineering of wound repair methods and contracture can lead to twisting of the nose and distortion of surrounding anatomic structures such as the nasal ala and paranasal sulcus. The skin defects on the nasal dorsum were reconstructed with a modified bilateral rombic flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that the modified bilateral rhombic flap can reconstruct defects on the center area of the nasal dorsum effectively and in a single stage.

Henoch-Schonlein Purpura Presenting as Hemorrhagic Vesicles and Bullae with Gastrointestinal Hemorrhage / 대한피부과학회지

No abstract available.

The Development of an Illuminator with High Brightness LED for Super-Macro Mode of Digital Camera / 대한피부과학회지

BACKGROUND: With increasing use of digital cameras, it is needed to develop a better method of taking photographs that meet the dermatologists' demand. Recent digital cameras have super-macro mode capability, but that mode is only available in very bright conditions such as sun shining locations because flashing is unavailable. OBJECTIVE: To develop a better method of taking delicate and reproducible super-macro mode photographs using digital cameras under ordinary hospital or clinic settings. METHODS: We planned to develop an illuminator with a high brightness light emitting diode for the super-macro mode of a digital camera. To be economical, convenient, and lightweight, the illuminator was designed to plug into the USB port of a personal computer for the power source. We have applied the illuminator to three different camera models. The light emitting diodes were arranged in some different ways for better results. RESULTS: When we took super-macro photographs with this device, patients felt no discomfort, such as dazzling, which they have experienced with a camera flash. And, the photographs showed more delicate zoomed-in images and were reproducible. The image quality was enhanced with the more optimal arrangement of diodes. We named the small space in front of the camera lens, `micro studio', because we can modify the lighting method for better illumination. The users may maximize the capability of the digital camera using this device. CONCLUSION: We developed an economically appealing and flexible digital camera device that enables us to take super-macro mode images of a much more enhanced quality. It may be useful for many dermatologists who use digital cameras.

Sudden Death Associated With Hypothyroidism / 대한법의학회지

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.

Sudden Death Associated With Hypothyroidism / 대한법의학회지

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.