Oral Allergy Syndrome to Hazelnuts / 대한피부과학회지

No abstract available.

Infantile Scabies Masquerading as Langerhans Cell Histiocytosis

No abstract available.

Bedbug Bite / 대한피부과학회지

No abstract available.

Dietary Pattern and Nutrient Intake of Korean Children with Atopic Dermatitis

BACKGROUND: Atopic dermatitis (AD) is characterized by itching and eczema-like skin lesions, and its symptoms alleviate with age. Recently, the prevalence of AD has increased among adolescents and adults. The increasing prevalence of AD seems to be related to westernized lifestyles and dietary patterns. OBJECTIVE: The aim of this study was to evaluate the dietary patterns and nutrient intake of patients with AD. METHODS: The study population consisted of 50 children with AD who visited the Department of Dermatology at Kangnam Sacred Heart Hospital, Seoul, Korea from May 2008 to May 2009. Physical condition and calorie intake were evaluated using the Eczema Area and Severity Index score and Food Record Questionnaire completed by the subjects, and the data were analyzed using the Nutritional Assessment Program Can-pro 3.0 (The Korean Nutrition Society, 2005) program to determine the gap between the actual ingestion and average requirements of 3 major nutrients (i.e. carbohydrates, proteins, and lipids), vitamins (i.e. A, B, C, and E), niacin, folic acid, calcium, iron, phosphorus, and zinc in all subjects. RESULTS: The intake rate of proteins was 18.02% (recommended dietary allowance [RDA], 7%~20%), of carbohydrates was 67.7% (RDA, 55%~70%), and of lipids was 14.24% (RDA, 15%~30%). Thirty-one subjects (62%) showed deficiency of folic acid, and 21 subjects (42%), of iron supplements. CONCLUSION: Essential nutrient intake tends to be lower in AD patients than in healthy subjects, and this low intake is closely related to the severity of AD.

Induction of a Hardening Phenomenon and Quantitative Changes of Ceramides in Stratum Corneum

BACKGROUND: Hardening phenomenon of human skin after repeated exposure to the irritants is well-known, but the precise mechanism remains elusive. OBJECTIVE: To modify the previous experimental model of hardening phenomenon by repeated applications of two different concentrations of sodium lauryl sulfate (SLS) solutions to Korean healthy volunteers and to investigate the quantitative changes of ceramides in stratum corneum before and after chronic repeated irritation. METHODS: Eight hundred microliters of distilled water containing 0.1% and 2% SLS was applied for 10 minutes on the forearm of 41 healthy volunteers for 3 weeks. After an intervening 3-week rest, 24-hour patch tests with 1% SLS were conducted on previously irritated sites. Transepidermal water loss (TEWL), erythema index and quantity of ceramide were measured in the stratum corneum before and after irritation. RESULTS: TEWL values on the sites preirritated with 2% SLS were lower than those with 0.1% SLS. Hardening phenomenon occurred in 24 volunteers at day 44. The changes in ceramide levels were not significantly higher in the hardened skin than in the non-hardened skin. CONCLUSION: Repetitive stimulation with a higher concentration of SLS can more easily trigger skin hardening.

Hyperkeratotic Hand Eczema due to Use of Rubber Gloves While Driving

No abstract available.

Bilateral Tibialis Anterior Muscle Herniation / 대한피부과학회지

Muscle herniation is defined as a protrusion of a portion of a muscle through a defect of the muscle fascia. The anterior tibialis muscle is the most common site of herniation. This condition is a relatively common complaint among athletes, and it has been frequently reported in the orthopedic surgery literature, whereas it has received little attention in the dermatological literature. Clinical findings include the presence of soft, compressible nodules that vary in size depending on their position. Usually, herniation is asymptomatic and the main concern is cosmetic, but the patient may seek medical treatment because of pain. Here we report a 65-year-old woman who visited our hospital for an evaluation of two asymptomatic nodules that were on her lower legs, and was diagnosed with bilateral tibialis anterior muscle herniation.

Dose-Dependent Effects of Evening Primrose Oil in Children and Adolescents with Atopic Dermatitis

BACKGROUND: Previous clinical trials with evening primrose oil in atopic dermatitis (AD) treatment have shown different results. In addition, the optimal dose and duration of treatment with evening primrose oil have not yet been determined. OBJECTIVE: The aim of this study is to investigate the dose-response treatment effects of evening primrose oil on clinical symptoms of AD and serum concentrations of polyunsaturated fatty acids. METHODS: Forty AD patients were enrolled for the study and randomly divided into 2 groups: those who received evening primrose oil 160 mg daily for 8 weeks and those who received 320 mg of evening primrose oil twice daily for 8 weeks. We evaluated the Eczema Area Severity Index (EASI) scores of all AD patients at weeks 0, 2, 4 and 8. In addition, we measured the levels of serum fatty acids, including C16 : 0 (palmitic), C18 : 2n (linoleic), C18 : 3n (linolenic) and C20 : 4 (arachidonic acid) using gas chromatography. RESULTS: The serum fatty acid levels C18 : 3n and C20 : 4 were higher in the 320 mg group than in the 160 mg group, with statistical significance. After evening primrose oil treatment, EASI scores were reduced in the 2 groups. The improvement in EASI scores was greater in the 320 mg group than in the 160 mg group. There were no side effects seen in either group during the study in the 2 groups. CONCLUSION: The results of this study suggest that the 320 mg and 160 mg groups may be equally effective in treating AD patients and show dose-dependent effects on serum fatty acid levels and EASI scores.

Improvement of Atopic Dermatitis Severity after Reducing Indoor Air Pollutants

BACKGROUND: Recent epidemiologic studies have shown that environmental contaminants such as air pollution and tobacco smoke play an important role in the pathophysiology of atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the relationship between the severity of AD and indoor air pollution. METHODS: The study population consisted of 425 children from 9 kindergartens, Korea. The authors surveyed the prevalence of AD and evaluated disease severity by the eczema area and severity index (EASI) score and investigator's global assessment (IGA). After measuring indoor air pollution, a program to improve indoor air quality was conducted in 9 kindergartens. Seven months later, the prevalence and disease severity were evaluated. RESULTS: The initial prevalence of AD was 8% and the mean EASI score was 2.37. The levels of particulate material 10 (PM10) and carbon dioxide (CO2) were higher in some kindergartens compared to the normal values. Subsequent to the completion of the indoor air quality improvement program, the mean PM10 level was significantly decreased from 182.7 to 73.4 microg/m3. After the completion of the program, the prevalence of AD and the mean EASI were decreased, and the changes were both statistically significant. The mean number of hospital visits decreased from 1.3 per month during the first survey to 0.7 per month during the second survey, which was statistically significant. CONCLUSION: Indoor air pollution could be related to AD. The reduction of PM10 through improving indoor air quality should be considered in kindergartens and schools in order to prevent and relieve AD in children.

Dose-Dependent Effects of Evening Primrose Oil in Children and Adolescents with Atopic Dermatitis

BACKGROUND: Previous clinical trials with evening primrose oil in atopic dermatitis (AD) treatment have shown different results. In addition, the optimal dose and duration of treatment with evening primrose oil have not yet been determined. OBJECTIVE: The aim of this study is to investigate the dose-response treatment effects of evening primrose oil on clinical symptoms of AD and serum concentrations of polyunsaturated fatty acids. METHODS: Forty AD patients were enrolled for the study and randomly divided into 2 groups: those who received evening primrose oil 160 mg daily for 8 weeks and those who received 320 mg of evening primrose oil twice daily for 8 weeks. We evaluated the Eczema Area Severity Index (EASI) scores of all AD patients at weeks 0, 2, 4 and 8. In addition, we measured the levels of serum fatty acids, including C16 : 0 (palmitic), C18 : 2n (linoleic), C18 : 3n (linolenic) and C20 : 4 (arachidonic acid) using gas chromatography. RESULTS: The serum fatty acid levels C18 : 3n and C20 : 4 were higher in the 320 mg group than in the 160 mg group, with statistical significance. After evening primrose oil treatment, EASI scores were reduced in the 2 groups. The improvement in EASI scores was greater in the 320 mg group than in the 160 mg group. There were no side effects seen in either group during the study in the 2 groups. CONCLUSION: The results of this study suggest that the 320 mg and 160 mg groups may be equally effective in treating AD patients and show dose-dependent effects on serum fatty acid levels and EASI scores.

Improvement of Atopic Dermatitis Severity after Reducing Indoor Air Pollutants

BACKGROUND: Recent epidemiologic studies have shown that environmental contaminants such as air pollution and tobacco smoke play an important role in the pathophysiology of atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the relationship between the severity of AD and indoor air pollution. METHODS: The study population consisted of 425 children from 9 kindergartens, Korea. The authors surveyed the prevalence of AD and evaluated disease severity by the eczema area and severity index (EASI) score and investigator's global assessment (IGA). After measuring indoor air pollution, a program to improve indoor air quality was conducted in 9 kindergartens. Seven months later, the prevalence and disease severity were evaluated. RESULTS: The initial prevalence of AD was 8% and the mean EASI score was 2.37. The levels of particulate material 10 (PM10) and carbon dioxide (CO2) were higher in some kindergartens compared to the normal values. Subsequent to the completion of the indoor air quality improvement program, the mean PM10 level was significantly decreased from 182.7 to 73.4 microg/m3. After the completion of the program, the prevalence of AD and the mean EASI were decreased, and the changes were both statistically significant. The mean number of hospital visits decreased from 1.3 per month during the first survey to 0.7 per month during the second survey, which was statistically significant. CONCLUSION: Indoor air pollution could be related to AD. The reduction of PM10 through improving indoor air quality should be considered in kindergartens and schools in order to prevent and relieve AD in children.

Food Hypersensitivity in Patients with Childhood Atopic Dermatitis in Korea

BACKGROUND: It is well known that atopic dermatitis (AD) is related to food hypersensitivity, although its prevalence varies among several studies according to age group, severity, country, survey time, and test method. OBJECTIVE: To examine the prevalence and status of food hypersensitivity among childhood AD patients in Korea. METHODS: A total of 95 patients were enrolled in the study. The history of food hypersensitivity was collected by interviews. The severity of AD was evaluated by eczema area and severity index (EASI). We took blood samples to measure serum total and food-specific immunoglobulin E (IgE) levels. Based on the histories and serum IgE levels, open oral food challenge (OFC) testing was performed to confirm food hypersensitivity. RESULTS: Forty-two (44.2%) of the 95 AD patients had histories of food hypersensitivity. They reported that the most common suspicious foods were egg (n=13, 13.7%), pork (n=9, 9.5%) and cow milk (n=8, 8.4%). The mean EASI score was 16.05+/-9.76. Thirty-nine (41.1%) of the 95 patients showed elevated serum food-specific IgE levels. The specific IgE levels were elevated for egg (n=17, 17.9%), milk (n=12, 12.6%), peanut (n=10, 10.5%) and wheat (n=8, 8.4%). Fifty-one (53.8%) of 95 patients underwent open OFC, and only 7 (13.7%) of these patients showed positive reactions. CONCLUSION: The overall prevalence of food hypersensitivity in patients with childhood AD in Korea was 8.3% (7/84). The most common foods causing food hypersensitivity were egg and milk. Among the foods causing hypersensitivity, AD patients in Korea often underestimated peanut, while they overestimated pork.

A Acquired Lymphangioma Circumscriptum of the Nipple Areola / 대한피부과학회지

Lymphangioma is an uncommon, benign hamartomatous malformation that consists of dilated lymphatic channels lined by normal, single-cell lymphatic endothelia. The lymphangiomas are divided into cavernous lymphangioma, cystic hygroma, lymphangioma circumscriptum, and acquired progressive lymphangioma. Acquired lymphangioma circumscriptum usually occurs due to surgery, infection or radiotherapy, which leads to obstruction of lymphatic vessels. Clinically, the lesions appear as thick-walled, 2~5 mm translucent vesicles. Spontaneous drainage of straw-colored to milky-white fluids may occur. Herein, we report an acquired lymphangioma circumscriptum of the nipple areola without preceding causes.

Oral Allergy Syndrome to Watermelon and Melon / 대한피부과학회지

Oral allergy syndrome (OAS) usually presents as an immediate swelling and itching sensation of the mouth and throat after ingestion of a food allergen. OAS may be the most common food allergy-related manifestation. Watermelon and melon belong to the Cucurbitaceae family and often show allergenic cross reactivity. Profilin is a 13 kda protein that is identified as a relevant pollen allergen in airborne pollen and related plant food allergies. Profilin is found in both watermelon and melon. Here we report a case of OAS to watermelon and melon in an 11 year-old boy. He was positive to the skin prick test, patch test and oral challenge test with watermelon and melon.

Palisaded Encapsulated Neuroma with Unusual Clinical Features: 1 Case / 대한피부과학회지

Palisaded encapsulated neuroma (PEN) is a rare, benign, cutaneous nerve sheath tumor, which usually appears as a solitary asymptomatic skin-colored papule, which usually affects the face of middle-aged adults. Here, we report a case of PEN with unusual clinical features in a 23-year-old female, developed on the back, accompanied with pain sensation. Histopathologically, it appeared as a well-circumscribed, encapsulated round nodule, consisted of uniform, broad, and interlacing fascicles of the spindle cells in the dermis. On immunohistochemical staining, the tumor cells of nodule were positive for S-100 protein and neural filaments, while the capsule of the nodule was focally positive for the epithelial membrane antigen.

Quality of Life in Adults with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: The symptoms of atopic dermatitis (AD) may lead to the impairment of overall quality of life (QOL). Many international studies have addressed the effects of AD on the QOL of patients and their families'. However, studies from Korea are few and insufficient. OBJECTIVE: The purpose of this study was to identify the correlation between the QOL and clinical disease severity in adults with AD. METHODS: Thirty-one AD patients ranging in age from 19~43 years were included. Dermatology Life Quality Index (DLQI) and the shorter version of World Health Organization QOL assessment instrument (WHOQOL-BREF) were used to determine the QOL. Eczema area and severity index (EASI) was examined to evaluate the severity of AD. RESULTS: The mean DLQI, QOL and EASI score was 19.74+/-6.93, 3.77+/-0.76 and 9.42+/-11.12, respectively. DLQI and QOL scores significantly correlated with EASI score (p0.05). Each domain of the WHOQOL-BREF and EASI score did not show meaningful correlation (p>0.05). However, for DLQI, categories of emotion, daily life, work and school work showed a high correlation with the EASI score (all p<0.05). Both DLQI and QOL score showed significant correlation with the EASI score in females (p<0.05), but only QOL score showed high correlation in male (p<0.05). CONCLUSION: AD affects QOL of adults with AD as the disease severity increases. In managing the AD patients, evaluating the clinical severity and evaluating QOL of patients would be necessary and emotional support will be helpful.

Quality of Life in Children and Adolescents with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: The symptoms of atopic dermatitis (AD) can limit a patient's physical and psychosocial development as well as lower their overall quality of life (QOL). These problems may have a greater effect on patients during childhood and adolescence, whose physical and psychosocial developments are vigorously ongoing. OBJECTIVE: The purpose of this study was to identify the correlation between the QOL and clinical disease severity in children and adolescents with AD. METHODS: Forty-six AD patients aged from 7 to 18 years were included in this study. A questionnaire based on Children's Dermatology Life Quality Index (CDLQI) was used to determine QOL. Eczema area and severity index (EASI) were examined to evaluate the severity of AD. RESULTS: The mean score of CDLQI was 12.83+/-6.52. Among the 10 categories, itching, treatment, and sleep showed the highest scores, whereas teasing, friendships, and school or holiday work had the lowest scores (p<0.01). The mean EASI score was 8.51+/-8.64. CDLQI and EASI scores showed significant correlation (p<0.001). Among the 10 categories of CDLQI and EASI score, the sleep, itching, and clothes categories displayed high correlation with the EASI score (p<0.001). There was no statistically significant difference between the different age groups or between boys and girls. Patients with head and neck skin lesions showed problems with personal relationships and treatment (p<0.05). CONCLUSION: AD affects the QOL of children and adolescents with AD as the severity of the disease increases. In managing AD patients, not only evaluating the clinical severity of the disease but also evaluating QOL is necessary, and emotional support could be helpful to increase the QOL of childhood and adolescent AD patients.