Quality of Life Assessment in Male Patients with Androgenetic Alopecia: Result of a Prospective, Multicenter Study

BACKGROUND: Androgenetic alopecia (AGA) is a common hair loss disease with genetic predisposition among men and women, and it may commence at any age after puberty. It may significantly affect a variety of psychological and social aspects of one's life and the individual's overall quality of life (QoL). OBJECTIVE: This study aimed to investigate the QoL of AGA patients and discover the factors that can influence the QoL of AGA patients, including previous experience in non-medical hair care, reasons for hospital visits, age, duration, and the severity of AGA. METHODS: A total of 998 male patients with AGA were interviewed, using the Hair Specific Skindex-29 to evaluate the QoL of AGA patients. RESULTS: The results of the Hair Specific Skindex-29 on patients with AGA were as follows: symptom scale: 26.3+/-19.5, function scale: 24.0+/-20.1, emotion scale: 32.1+/-21.8, and global score: 27.3+/-19.1. According to this assessment, QoL was more damaged if the patient had severe alopecia, a longer duration of AGA, younger age, had received previous non-medical hair care, and visited the hospital for AGA treatment. CONCLUSION: This study showed that AGA could harmfully affect the patients' QoL. These findings indicate that dermatologists should address these QoL issues when treating patients with alopecia.

Cutaneous Granulomas Associated with Common Variable Immunodeficiency / 대한피부과학회지

Common variable immunodeficiency (CVID) is one of the primary immunodeficiency disorders, which is characterized by hypogammaglobulinemia, defect in antibody synthesis and recurrent sinorespiratory bacterial infections. Granuloma is an uncommon skin manifestation in primary immunodeficiency disorders. Here we present a 5-year-old girl who had asymptomatic erythematous plaques on the face and legs. She had a past medical history of recurrent sinorespiratory and gastrointestical bacterial infections since 2 years old. The histopathologic findings of the skin lesions showed sarcoid-like granulomas with focal necrobiosis. No specific organism was found with evaluation. Cells forming granulomas were strongly positive for CD3 or CD68. CD4/CD8 ratio was estimated less than 1. Laboratory examination showed low hemoglobin, low B cell and normal T cell number, low IgA and IgG levels.

Inflammatory Disseminated Superficial Porokeratosis Successfully Managed by Oral Isotretinoin / 대한피부과학회지

Disseminated superficial porokeratosis is a keratinization disorder characterized by multiple brown, atrophic patches with sharply demarcated and hypertrophic ridges. Atypical cases of disseminated superficial porokeratosis with acute exacerbation accompanied by severe pruritus have been reported as "eruptive pruritic papular porokeratosis" or "inflammatory disseminated superficial porokeratosis." We report a case of inflammatory disseminated superficial porokeratosis in a 53-year-old man who was successfully treated with oral isotretinoin.

Photodistributed Telangiectasia Induced by Amlodipine

Calcium channel blockers are widely used antihypertensive drugs, which are uncommonly associated with cutaneous reactions, such as pruritus, urticaria, or alopecia. Photosensitivity presenting with telangiectasia has rarely been described. We present here a case of photodistributed telangiectasia induced clinically by amlodipine and histologically by enlarged capillaries in the upper dermis without signs of vasculitis.

Acromegaloid Facial Appearance Syndrome with Generalized Hypertrichosis Terminalis / 대한피부과학회지

Acromegaloid facial appearance (AFA) syndrome is a rare autosomal dominant disease, consisting of an acromegaloid face, a bulbous nose, and narrowing of the palpaebral fissure. In 1996, Irvin first reported a case of a combination of acromegaloid facial appearance syndrome and congenital hypertrichosis, and reported this case as a new disease of acromegaloid facial appearance with generalized hypertrichosis terminalis, which is differentiated from both AFA syndrome and congenital hypertrichosis/gingival hyperplasia. We report herein the first Korean case of acromegaloid facial appearance with generalized hypertrichosis terminalis.

Acantholytic Squamous Cell Carcinoma on the Right Foot / 대한피부과학회지

Acantholytic squamous cell carcinoma is a well-defined, rare variant of squamous cell carcinoma in which significant portions of the neoplastic tissue show, on microscopy, a pseudoglandular or tubular pattern. It usually presents in aged patients as an erythematous nodule with scales, crust, and ulceration on sun-exposed areas. Herein we report a case of acantholytic squamous cell carcinoma that occurred on the Rt 4th toeweb of a 70-year-old man.

A Case of Cicatricial Alopecia Associated with Erlotinib

Erlotinib is a small-molecule tyrosine kinase inhibitor (TKI) of the epidermal growth factor receptor (EGFR). Erlotinib has been used primarily to treat non-small cell lung cancer. In addition to its role in tumor cells, EGFR is also an important regulator of growth and differentiation in the skin and hair. Therefore, EGFR-TKIs have been associated with a number of cutaneous side effects including follicular acneiform eruptions, cutaneous xerosis, chronic paronychia, desquamation, seborrheic dermatitis, and hair texture changes. Herein, we report a rare case of a 61-year-old woman who was treated with erlotinib and experienced cicatricial alopecia.

Chromoblastomycosis Caused by Fonsecaea pedrosoi

We report herein a case of chromoblastomycosis caused by Fonsecaea (F.) pedrosoi in a 39-year-old male, who showed multiple, asymptomatic, scaly erythematous plaques on the left shin for 12 months. Histopathologically, chronic granulomatous inflammation and either sclerotic or muriform cells were observed. The fungal culture produced typical black colonies of F. pedrosoi. The DNA sequence of the internal transcribed spacer (ITS) region of the clinical sample was 100% match to that of F. pedrosoi IFM 47061 (GenBank accession number AB240943). The patient was treated with 200 mg of itraconazole daily, for 3 months. Skin lesions were improved. In Korea, only 9 cases of chromoblastomycosis, including this case, have been reported until now. The etiologic agent was F. pedrosoi in the majority of cases (6/9;67%). The incidence of chromoblastomycosis was slightly higher in female, and the upper limbs were more affected than the lower limbs in patients.

A Case of Neutrophilic Dermatosis of the Dorsal Hands with Concomitant Involvement of the Lips

Neutrophilic dermatosis of the dorsal hands (NDDH) is a localized, pustular variant of acute febrile neutrophilic dermatosis (Sweet syndrome). The lesions of NDDH clinically resemble those of Sweet syndrome (SS), but they differ from classic SS according to their locations (NDDH is predominantly restricted to the dorsal hands) and the smaller number of accompanying systemic symptoms. The histology of the NDDH lesion shows a dense dermal neutrophilic infiltration. The lesions rapidly resolve after systemic corticosteroid and/or dapsone therapy. We herein report on a case of neutrophilic dermatosis of the dorsal hands in a 34-year-old woman. The patient also had skin changes with erythematous plaque on the right lips.

Two Cases of Pruritic Urticarial Papules and Plaques of Pregnancy in the Postpartum / 대한피부과학회지

Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as a polymorphic eruption of pregnancy, is the most common dermatosis of pregnancy. Typically, PUPPP starts with erythema and urticarial papular eruption in the abdominal striae and may extend to the buttocks and thighs. It usually evolves in the third trimester and resolves rapidly in the postpartum. It is not usually recurrent in subsequent pregnancies. We report herein two patients with postpartum PUPPP.

A Clinicopathological Study on Skin Manifestations of Adult-onset Still's Disease (AOSD) / 대한피부과학회지

BACKGROUND: Adult-onset Still's disease (AOSD), one of the causes of fever of unknown origin, is accompanied by skin rash. This is the reason why the clinical significance of skin lesions has been of interest. However, its skin manifestations and the histopathological findings are not clearly documented. OBJECTIVE: This study aimed to identify characteristic clinical and histopathological features of skin manifestation of AOSD. METHODS: We evaluated the medical records and histopathologic slides of five patients who had been diagnosed with AOSD in the rheumatology department and referred to our department between 1996 and 2009. RESULTS: An asymptomatic evanescent salmon colored macular rash was seen in three patients (60%). A persistent brown plaque was seen in two patients (40%). Histopathologically, superficial perivascular infiltrates of neutrophils and lymphocytes were observed in all patients (100%) and necrotic keratinocytes were observed in the upper epidermis in three patients (60%). CONCLUSION: In addition to typical Still's rash, atypical cutaneous findings such as persistent plaque lesions were found in AOSD patients. The results of this study may help clinicians to diagnose this rare disease more easily.

Surgical Treatment for Acquired Malalignment of the Toenail / 대한피부과학회지

Malalignment of the toenail is a rare deformity that is characterized by lateral deviation of the nail plate with respect to the longitudinal axis of the distal phalanx. The condition may be congenital or acquired. The acquired forms of malalignment may result from trauma or surgical intervention. However, there are only a few reports that have focused on surgical treatment for this condition. We present here a case of a 24-year-old woman who had this nail problem for 1 year and she was successfully treated with the surgical approach. We also discuss the probable mechanism of iatrogenic malalignment.

A Case of Sister Mary Joseph's Nodule / 대한피부과학회지

Metastatic cancer of the umbilicus is very rare and is called Sister Mary Joseph's nodule. Metastasis to the umbilicus usually presents as diffuse spreading of primary cancer or recurrence after treatment of primary cancer, carries very poor prognosis, and is generally inoperable. However, umbilical metastasis presents rarely as a first sign of primary cancer and can lead to its diagnosis. The diagnosis is usually made with the histologic examination and the most common primary cancer is an adenocarcinoma of the stomach. We report a case of umbilical metastasis as a first sign of gastric cancer which leads to its diagnosis. This report emphasizes the need for careful evaluation of any umbilical lesion.

A Case of Lichenoid Drug Eruption Caused by Allopurinol / 대한피부과학회지

Lichenoid drug eruption is a lichenoid skin eruption caused by certain drugs and compounds, and can be similar to lichen planus. A 51-year-old man who had taken antihypertensive drugs (enalapril, dilazep dihydrochloride) and cholesterol lowering drug (atorvastatin) for 4 years had received allopurinol for asymptomatic hyperuricemia for 4 months. He developed pruritic erythematous papules and plaques with silvery scales on the face, trunk and extremities after taking allopurinol for 3 months. He had no fever, no eosinophilia and no systemic abnormalities. Histopathologic findings showed hyperkeratosis, parakeratosis, hypergranulosis, band-like lymphohistiocytic infiltration and perivascular lymphohistiocytic infiltration in the dermis, which were compatible with lichenoid drug eruption. The skin rashes disappeared after he stopped taking allopurinol and was treated with steroids.

A Case of Rheumatoid Neutrophilic Dermatitis / 대한피부과학회지

Rheumatoid neutrophilic dermatitis (RND) is a rare distinctive complication of rheumatoid arthritis (RA). Clinically, RND is characterized by slightly tender erythematous patches and papules, often associated with vesicles or pustules, which are symmetrically distributed on the extensor surfaces of the extremities. Histopathological findings revealed a dermal neutrophilic infiltration with leukocytoclasia without vasculitis. We report a case of rheumatoid neutrophilic dermatitis associated with seronegative RA.