Comparisons of the Clinical Variables between High and Low Self-Stigma Group in the Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The purpose of this research was to investigate the differences of clinical variables between high and low self-stigma group in the outpatients with schizophrenia. METHODS: 209 schizophrenic outpatients were assigned to high self stigma group (n=76) and low self stigma group (n=133) based on the scores of perceived stigma, and compared age, sex, education, age of onset, duration of illness, number of hospitalization, symptom, social functioning, insight, self-esteem, empowerment between two groups. RESULTS: 1) The high self-stigma group had significantly lower age of onset, higher duration of illness and number of hospitalizations compared to the low self-stigma group. 2) In the PANSS, the high self-stigma group showed significantly higher score in the total score and general symptoms compared to the low self-stigma group. No significant difference was found in the positive symptoms and negative symptoms between two groups. 3) The high self-stigma group had significantly lower empowerment and self-esteem compared to the low self-stigma group. 4) The high self-stigma group had significantly higher insight compared to the low self-stigma group. CONCLUSION: Self-stigma in patients with schizophrenia directly reduces self-esteem and empowerment, and may cause depression and a lower quality of life. Therefore, identifying self-stigma and its degree is one of the important factors for good outcome.

Erythema Multiforme after Radiotherapy with 5-fluorouracil Chemotherapy in a Rectal Cancer Patient

No abstract available.

A Case of Chronic Bullous Disease of Childhood That Was Reactive to the Antigen of 120 kDa (LAD-1)

Chronic bullous disease of childhood (CBDC) is an autoimmune blistering disease that is characterized by Immunoglobulin A (IgA) deposits at the basement membrane zone. IgA autoantibodies (aAbs) from the serum of patients with CBDC react with antigens of 97 kDa (LABD97) and 120 kDa (LAD-1), and both of which are fragments of the extracellular domain of bullous pemphigoid 180 (BP180, type XVII collagen). The CBDC sera reacts with the immunodominant NC16a domain of BP180, which is the major region recognized by IgG aAbs in patients with bullous pemphigoid. A five-year-old boy presented with multiple pruritic tense blisters on the umbilical and inguinal areas for six weeks. The direct immunofluorescence of the perilesional area demonstrated linear deposits of IgA at the basement membrane zone. Using immunoblotting and an enzyme linked immunosorbent assay (ELISA), we identified the IgA aAbs reactive to antigens with a molecular weight of 120 kDa (LAD-1), which is a fragment of the extracellular domain of BP180.

Extramammary Paget's Disease of the Scalp / 대한피부과학회지

Extramammary Paget's disease (EMPD) is an unusual neoplasm that affects apocrine gland-bearing skin, such as the vulva, perianal region, scrotum, and penis. However, EMPD has been rarely observed in the non-apocrine, gland-bearing regions; such cases are referred to as "ectopic" EMPD. We present a case involving a 46-year-old man in whom ectopic EMPD affected the scalp. Although the clinical appearance was suggestive of pagetoid Bowen's disease, EMPD was confirmed by biopsy and immunohistochemical studies. In Korea, there has been only one report of EMPD occurring in the scalp. EMPD of the scalp is extremely rare, with few reported cases. We report a case EMPD of the scalp with a review of the literature.

The Clinical and Histopathologic Features of 30 Cases of Lupus Miliaris Disseminatus Faciei / 대한피부과학회지

BACKGROUND: Lupus miliaris disseminatus faciei (LMDF) is a rare granulomatous disease characterized by eruption of discrete red-brown, dome-shaped papules, predominantly in the lower eyelid. Histopathologically, LMDF could present as caseous necrosis in the central area with granulomas composed of epithelioid cells and giant cells. The pathogenesis of LMDF remains controversial. Some suspect LMDF as a kind of cutanoeus tuberculosis, but others believe LMDF to be a variant of granulomatous rosacea or sarcoidosis. OBJECTIVE: This study aimed to investigate the clinical and histopathologic features of LMDF. METHODS: We reviewed the medical records, clinical photographs, and histopathologic slides of 30 cases of LMDF that were evaluated in our department between February 1991 and May 2009. RESULTS: The average age of the affected patient was 34.6+/-10.9 years and the ratio of male-to-female patients was 3.3 : 1. The most common sites of involvement with LMDF was the eyelid (86.7%). cheek (76.7%), philtrum (60.0%), and glabella (56.7%). On histopathologic examination, the epithelioid granulomas had a connection to pilosebaceous structures in 66.7% of the cases. Follicular rupture (33.3%), perifollicular granulomas composed of naked tubercles (53.2%), and sarcoidal granulomas with abscesses (23.3%) were noted. Characteristic caseous necrosis occurred in 7 cases (23.3%). The duration of LMDF was 2 years in 26 cases (86.7%) and the lesion improved leaving scar in 21 cases (70%). CONCLUSION: We identified the histopathologic changes of LMDF as a function of disease duration. Connections of pilosebaceous units with granulomas were commonly observed. It will be helpful to understand the pathophysiology of LMDF.

Facial Reticular Veins Treated with Phlebectomy / 대한피부과학회지

Ambulatory phlebectomy is a procedure for the removal of superficial veins through small incisions. It is commonly used to treat varicose veins in the legs. Compared with alternative procedures such as sclerotherapy and laser therapy, phlebectomy is less likely to cause conditions such as hyperpigmentation, cutaneous necrosis, superficial phlebitis and deep vein thrombosis. Phlebotomy is cosmetically effective for the removal of facial reticular veins, which are currently cosmetic issues. The first patient, a 42-year-old woman, presented with a 3 cm sized bluish linear patch on her right lower eyelid. Color-flow duplex ultrasonography confirmed that it was dilated superficial vein. The second patient, a 51-year-old woman, came to our clinic with reticular vessels on the nasal dorsum and left lower eyelid. Both patients were treated with phlebectomy and they showed a cosmetically satisfactory outcome. This paper reports on two cases of facial reticular vessels that were treated with phlebectomy and the course of the procedure.

Analysis and Clinical Correlation of Bacteria Cultured from Patients with Inflammatory Acne / 대한피부과학회지

BACKGROUND: Acne is a common follicular inflammatory dermatosis affecting the pilosebaceous unit. The representative organism isolated from the acne lesion is Propionibacterium acnes, but other aerobic organisms, such as Staphylococcus epidermidis have also been isolated. The exact role of aerobic bacteria in the pathogenesis of acne remains controversial, but several reports have shown that these microorganisms are important in the development of acne lesions and affect acne severity by their involvement in the inflammatory process. OBJECTIVE: The purpose of this study was to investigate the clinical features associated with aerobic microorganisms isolated from inflammatory acne and to identify antibiotic resistance. METHODS: We examined the species of bacteria aerobically and anaerobically isolated from patients with inflammatory acne and determined the relationship between antimicrobial resistance of the isolated aerobic organisms and clinical characteristics in 186 patients. RESULTS: P. acnes was cultured in 40.86% of the patients. Enterobacter aerogenes (4.30%), S. capitis species (6.45%), S. aureus (3.76%), S. hominis (2.15%), Serraita marcescens (1.08%), Klebsiella oxitoca (1.08%), S. lugdunensis (1.08%), S. auricularis (0.54%), S. hyicus (0.54%), S. simulans (0.54%), and S. saprophyticus (0.54%) were also cultured. Among the aerobes isolated from lesions, S. epidermidis was the most common (43.0%) and showed higher resistance to gentamicin (57.5%), ampicilin (45.0%), erythromycin (40.0%), and clindamycin (30.0%) than previous reports. The disease duration in the S. epidermidis group resistant to gentamicin, erythromycin, ampicilin, and clindamycin was longer than that in the susceptible group. CONCLUSION: These results revealed the recent increase in antibiotic resistance of S. epidermidis in patients with acne. Antibiotic resistance of aerobes in patients with acne have a tendency to increase based on disease duration.

Generalized Annular Lichen Planus / 대한피부과학회지

Generalized annular lichen planus is rarely described and is characterized by generalized flexural eruptions without involvement of oral mucosa. A 43-year-old male presented with mildly pruritic erythematous to brownish annular macules, confluent patches with peripheral elevated rim for 5 months. The annular lesions involved abdomen, back, upper and lower extremities, predominantly distributed on flexural areas such as both axillae, inguinal areas and popliteal fossae. Histopathologic features from abdomen lesion were compatible with lichen planus. The patient was treated with methylprednisolone, hydrochloroquine and dapsone for 8 weeks and all erythematous lesions disappeared with remaining marked hyperpigmentation.

Standard Patch Test Results in Patients with Contact Dermatitis / 대한피부과학회지

BACKGROUND: A number of skin manifestations in patients with allergic contact dermatitis result from sensitization with specific allergens. The patch test is a primary diagnostic tool for identifying allergens causing allergic contact dermatitis. OBJECTIVE: We identified the results of patch test with Korean standard series in patients with clinically diagnosed with contact dermatitis, and evaluated the specific relationship with each allergen. METHODS: During a 5-year period, 743 patients were examined with patch test of standard Korean series. The results of patch test were then evaluated. Location of the skin lesion, age, sex, and occupation of the patients were completely reviewed. RESULTS: Overall, 68.5% of patients had at least one positive reaction and 43.6% of patients had two or more positive reactions. Allergens most frequently causing positive reactions were nickel sulfate (27.1%), cobalt chloride (22.1%), potassium dichromate (17.9%), mercuric ammonium chloride (13.8%), and 4-phenyledediamine base (10.2%). Those patients in their 10s and 40s showed the highest rate of positive reaction. Metal allergens displayed higher positive rates than any other standard allergens. Of 201 patients who showed positive reaction to nickel, 37.8% and 27.3% of them also showed positive reaction to cobalt and chromium, respectively, representing concomitant reactions between metal-related antigens. In addition, polysensitization to cosmetics-related antigens including balsam peru and fragnance mix was evident. CONCLUSION: There was no significant difference in overall positive rate in patch test results compared with recent studies. However, we confirmed that metal-related allergens remain most common, and that multiple contact allergy were relatively common.