A Mechanism for the Up-regulation of the IL-8 Gene Expression in Keratinocytes by All-trans Retinoic Acid / 대한피부과학회지

BACKGROUND: Retinoic acid (RA) has been reported to induce the up-regulation of inflammatory cytokines such as IL-1, TNF-alpha and IL-8 in dermal fibroblasts and keratinocytes. There is no evidence to support a direct interaction between the RA-mediated transcriptional machinery and IL-8 gene transcription. OBJECTIVE: The aim of this study is to clarify the mechanism of the up-regulation of IL-8 in keratinocytes by RA. METHODS: The IL-1, IL-8, TNF-alpha and MCP-1 mRNA expressions in HaCaT cells stimulated by RA were measured by quantitative RT-PCR. The effects of a NF-kappaB inhibitor and IL-1 receptor antagonist (ra) on the IL-8 mRNA expression were measured by quantitative RT-PCR. Electrophoretic motility shift assay (EMSA) was conducted on the RA-stimulated HaCaT cells that were or were not treated with NF-kappaB inhibitor to measure the NF-kappaB binding activity in each group. The phospho-IkappaB activity in the HaCaT cells after stimulation with RA was also measured by Western blotting. RESULTS: An up-regulation of the IL-8 gene expression by RA was demonstrated in the HaCaT cells. The inhibition assay revealed the involvement of the NF-kappaB binding site of the IL-8 gene in the RA-enhanced promoter activity. EMSA demonstrated that RA enhanced the formation of the DNA-NF-kappaB complex. There was no evidence to support IL-1 as an intermediate stimulus between the RA-mediated transcriptional machinery and IL-8 gene transcription. Western blot analysis revealed increased phospho-IkappaB activity in the HaCaT cells after stimulation with RA. CONCLUSION: Our result suggested that the IL-8 gene expression of HaCaT cells after RA stimulation is caused by the activation of IKK and the dissociation of IkappaB from NF-kappaB and the transcription of NF-kappaB in the nucleus.

Quality of Life of Acne Patients / 대한피부과학회지

BACKGROUND: Although acne is extremely prevalent, few studies have focused on what the patient with acne vulgaris experiences. Furthermore, despite recent advances in the accurate measurement of health outcomes, few studies have discussed the influence of acne on discrete aspects of patients' experiences such as their quality of life. OBJECT: To determine the influence of acne vulgaris on the quality of life of adult dermatology outpatients, we performed cross-sectional and longitudinal questionnaire study. METHOD: Sixty patients with acne vulgaris attending appointments with their dermatologists. Findings using Skindex, a validated 29-item instrument to measure the effects of skin disease on patients' quality of life. Results are reported as 3 scale scores (functioning, emotions, and symptoms) and a composite score (average scale score). In addition, dermatologists rated the clinical severity of patients' skin disease. Higher Skindex scores indicate greater effects on quality of life. RESULTS: Patients with acne experienced functioning and emotional effects from their skin disease comparable with those of patients with psoriasis, but experienced fewer symptoms (for patients with acne and psoriasis, respectively, Skindex functioning scores of 14.9 and 22.8 [p=0.08]; emotion scores, 39.2 and 38.9 [p=0.95]; and symptoms scores, 29.5 and 42.1 [p<0.05]). Skindex scores were higher in older patients than in younger patients, and patients aged 40 years or older were less likely to report improvement in their acne after 3 months (43% vs 85%; p<0.05). Among patients reporting no improvement in their acne, older patients reported greater effects of their acne on their quality of life. Furthermore, in multivariate analyses, older adults reported more effects of acne on their quality of life than younger adults, even after controlling for sex and acne severity as judged by the dermatologist. CONCLUSIONS: Acne vulgaris significantly affects patients' quality of life. Sex, age, severity of acne and duration of acne can effect on quality of life of acne patients.

The Korean Version of Skindex-29 / 대한피부과학회지

BACKGROUND: Most available dermatologic quality-of-life measures were written in English. So these must be translated for use in Korea. Our purpose was to translate and adapt culturally into Korean a skin-related quality-of-life measure Skindex-29, and to begin preliminary assessments of its reliability and validity. METHODS: Cross-cultural adaptation questionnaire studies were performed. Two hundred and sixty adult outpatients and healthy people responded to the Korean version of Skindex-29. Evaluations of the semantic equivalence of back-translated items, reliability, construct validity, and content validity of the Korean version were the main outcome measures. Comparison between the Korean version and other versions of Skindex-29 (Spanish and American) responses was also performed. RESULTS: Five problematic items required a second translation and back-translation to achieve satisfactory agreement with the original instrument. The final Korean version of Skindex-29 was internally reliable. The instrument demonstrated both construct and content validity. As hypothesized, scores for dermatologic patients were higher than those of healthy persons and scores for patients with inflammatory diseases were higher than those of persons with isolated skin lesions. Skindex scale scores of the Korean version and other versions of Skindex-29 were similar. CONCLUSIONS: We have developed a semantically equivalent translation of Skindex-29 in Korean. Our preliminary evaluation of its measurement properties suggests that it is a reliable and valid measure of the effects of skin disease on the quality of life in Korean patients.

A Case of Muir-Torre Syndrome / 대한피부과학회지

Muir-Torre syndrome (MTS) is an autosomal dominant genodermatosis first described in 1967 by Muir and in 1968 by Torre. It is characterized by the presence of at least one sebaceous gland tumor and the presence of a low-grade internal malignancy. The sebaceous neoplasia are typically adenomas, sebaceomas/sebaceous epitheliomas, or carcinomas. Most common internal malignancy is colorectal adenocarcinoma, but also neoplasia of the uterus, ovary and kidney may occur. Recent studies about genetic defect revealed MTS was caused by germline mutations in DNA mismatch repair genes and microsatellite instability. We report a case of MTS, multiple sebaceous adenomas with colorectal cancer in a 67-year-old male.

A Case of Faun Tail associated with Tethered Cord Syndrome / 대한피부과학회지

Tethered cord syndrome is a kind of spinal dysraphism with low-lying conus frequently associated with intraspinal lipoma, diastematomelia or fibrous band. The clinical manifestations varies from long periods of no overt symptoms to back pain, scoliosis, progressive neurological deficit of legs and incontinence. Therefore the diagnosis requires a strong clinical suspicion and aggressive investigation. It shows various cutaneous manifestations including hyperpigmentation, skin dimple, dermal sinus or hypertrichosis. This 34-year-old female patient has had a lozenge shaped hair tuft with terminal hair on the lumbosacral area since her birth. Her MRI scan showed dermal sinus and a low-lying conus at the lower border of L5. The filum terminale was also thickened. These findings are compatible for tethered cord syndrome.

Behcet's Disease: The First Mongolian Case in Literature Showing HLA B51, MICA Gene Type *5/*6

Behcet's disease is a chronic multi-systemic disease of unknown origin that includes mucocutaneous, ocular, cardiac, vascular, renal, gastrointestinal, neurologic and cutaneous involvement. The disease is spread throughout the world, but it is most prevalent in the eastern Mediterranean region-along the Silk Road-, and in Japan, China, and Korea. Recently, we treated a Mongolian patient who had complete-type Behcet's disease. As far as we know, this case is the first report of a Mongolian with Behcet's disease in the English literature. HLA typing in this patient revealed A2, A24; B51, B35; Cw4, Cw7; DR9, DR11. Study of the MICA genetype showed *5, *6 positive. Our data provided adequate evidence, from an epidemiological aspect, to support the belief that Behcet's disease is most prevalent along the old Silk Road.

A Case of Progressive Macular Hypomelanosis Treated with Narrow Band UVB / 대한피부과학회지

Progressive macular hypomelanosis is an idiopathic acquired hypopigmentary disorder first described in 1988. The disorder is characterized by ill-defined, non-scaly, round to oval, hypopigmented patches symmetrically localized on the trunk. No clinical symptoms have been observed. Currently, diagnosis is made on clinical grounds and any histological, laboratory investigations are not diagnostic. This disorder does not respond to conventional treatment and its clinical course is variable. We experienced a case of progressive macular hypomelanosis that was successfully treated with narrow band UVB phototherapy.

Proliferating Nodules Within a Congenital Melanocytic Nevus: Proper criteriae for surgical removal in infantile periods

Congenital melanocytic nevus(CMN) constitute a well-known risk factor in the development of malignant melanoma, but melanoma developing in newborn and infants are extremely rare. We describe a case of proliferating nodules within CMN at the age of 13 months. Like our case it is difficult to manage the proliferating lesions within CMN in infants. So we carefully suggest the indications of preventive excision when proliferating lesions occur within CMN as follows; 1) preventive excision is postponed until the age of two when the proliferating lesions are slowly growing, 2) surgical excision is needed when the lesions are rapidly growing exceeding 1 cm in size even though it is before the age of two.

Angiokeratoma Circumscriptum with Transepidermal Elimination / 대한피부과학회지

Transepidermal elimination is a mechanism whereby foreign or altered constituents can be removed from the dermis. The phenomenon of transepidermal elimination may occur as a primary process characterizing disorders such as elastosis perforans serpiginosa, reactive perforating collagenosis and chondrodermatitis nodularis chronica helicis; as well as a secondary process characterizing disorders such as granuloma annulare, necrobiosis lipoidica diabeticorum, calcinosis cutis, pseudoxanthoma elasticum, spitz nevi, pimented nevi, porokeratosis plantaris discreta and metastatic tumors. A 17-year-old man presented with a 2X2 cm sized well-circumscribed slightly erythematous plaque with some black colored papules on the left dorsum of his hand. The histopathology of the lesion indicated angiokeratoma circumscriptum with transepidermal elimination.

A Case of Cicatricial Pemphigoid with Autoantibodies Against the BP180 and BP230 Antigens / 대한피부과학회지

Cicatricial pemphigoid is a chronic autoimmune subepithelial blistering disease that predominantly involves mucous membrane with resultant scar formation. It may involve oral, ocular, nasal, pharyngeal, laryngeal, esophageal, and anogenital mucous membranes. Cicatricial pemphigoid is a heterogenous group of diseases with respect to the autoimmune target antigens including BP180(type XVII collagen), BP230, laminin 5(epiligrin), laminin 6, type VII collagen and other newly described antigen. We describe a patient with cicatricial pemphigoid in whom circulating IgA and IgG autoantobodies against BP180 and BP230 antigens were detected simunltaneously.

Langerhans Cell Histiocytosis in Children: Report of six cases with clinicopathological observation / 대한피부과학회지

BACKGROUND: Langerhans cell histiocytosis (LCH) is a broad spectrum of clinical diseases having proliferation of Langerhans cells in common. LCH may be manifested in a variety of ways, ranging from a spontaneously regressing skin lesion to a multisystemic life-threatening disorder. Congenital self-healing reticulohistiocytosis is widely regarded as a limited form of LCH. It is present at birth or shortly thereafter and involute spontaneously. OBJECTIVE: Our purpose was to investigate the relationship between clinicopathologic characteristics and prognosis of LCH in children. METHODS: Six children with LCH were investigated clinically and histopathologically. Immunostains were performed with CD1a and S100 antibodies in 5 cases using paraffin-embedded sections and an electron microscopic examination was done in 1 case. RESULTS: Among the 6 cases of LCH, 4 cases were confined to the skin, and 2 cases showed internal organ involvement. All LCH confined to the skin showed resolution of the skin lesion in 1 year, and 2 cases involving internal organ showed bad prognosis. Histopathological findings showed large histiocytes with eosinophilic cytoplasm in common. Immunohistochemical stains (5 cases) showed positive reactions with CD1a and S-100, and electron- microscopical observation in one case demonstrated laminated dense bodies. There was no significant histopathological or immunohistochemical difference between LCH confined to the skin which showed resolution of lesions and LCH involving internal organs with grave prognosis. CONCLUSIONS: Clinical types of Langerhans cell histiocytosis could not be differentiated only from the histopathological findings of the skin. The distinction between Langerhans cell histiocytosis confined to the skin showing spontaneous resolution and congenital self-healing reticulohistiocytosis remains to be clarified.

Spontaneously Healed Primary Cutaneous Alternariosis: Reports of 2 Cases / 대한의진균학회지

No abstract available.