RESUMO
Exophiala species are dark pigmented fungi associated with phaeohyphomycosis that exhibit yeast-like or hyphal forms of the fungus in superficial subcutaneous locations or systemic disease. The incidence of subcutaneous tissue infection of Exophiala species has recently increased, particularly in immunocompromised hosts. In Korea, E. jeanselmei, E. dermatitidis, and E. salmonis were isolated from patients with phaeohyphomycosis. However, there have been no case reports of phaeohyphomycosis caused by E. oligosperma. Here we report the first case of phaeohyphomycosis caused by E. oligosperma in Korea. An 82-year-old female with competent immune function presented with multiple subcutaneous masses on the dorsum of the left hand and wrist. A histopathological examination of the skin specimen revealed granulomatous inflammation with fungal hyphae and yeast. Molecular identification was performed using internal transcribed spacer sequences analysis. The sequence showed 100% identity with the E. oligosperma strains. She was treated with oral itraconazole and showed improvement.
Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Exophiala , Fungos , Mãos , Hifas , Hospedeiro Imunocomprometido , Incidência , Inflamação , Itraconazol , Coreia (Geográfico) , Feoifomicose , Pele , Tela Subcutânea , Punho , LevedurasRESUMO
BACKGROUND: Skin laser treatment has improved significantly and has become an effective treatment approach for many skin diseases while also having applications for beauty treatments. However, since skin laser transfers energy directly to the skin, the misuse of such treatment may result in permanent damage to skin tissues. OBJECTIVE: This survey of Korean adults, conducted to obtain their perspectives on and their treatment experience with skin laser treatment, will be used to determine the current status of skin laser treatment and to identify necessary changes to ensure proper and safe conduct of skin laser treatment. METHODS: From April 5th to April 12th, 2016, a survey was conducted to obtain information regarding the perspectives and the treatment experience of adults aged 20~59 years. RESULTS: Approximately 50% of the participants had experience with skin laser treatment, and among these, 24.7% had not received treatment at a dermatology clinic. Compared to treatment at a dermatology clinic, the danger of side effects was 1.7 times higher at a non-dermatology clinic, 2 times higher at a skin care shop, and 5.3 times higher at an Oriental medical clinic. Among patients who received skin laser treatment, 16.1% experienced side effects, and among these, 1 out of 4 patients visited a non-dermatologist for treatment of these side effects. CONCLUSION: The results of the survey showed that in order for the public to receive safe and effective skin laser treatment based on professional diagnosis, there is a definitive need to provide correct information to the public and to implement changes to ensure proper understanding of skin laser treatment among this population.
Assuntos
Adulto , Humanos , Beleza , Dermatologia , Diagnóstico , Higiene da Pele , Dermatopatias , PeleRESUMO
BACKGROUND: Parallel-polarized light (PPL) photography evaluates skin characteristics by analyzing light reflections from the skin surface. OBJECTIVE: The aim of this study was to determine the significance of quantitative analysis of PPL images in rosacea patients, and to provide a new objective evaluation method for use in clinical research and practice. METHODS: A total of 49 rosacea patients were enrolled. PPL images using green and white light emitting diodes (LEDs) were taken of the lesion and an adjacent normal area. The values from the PPL images were converted to CIELAB coordinates: L* corresponding to the brightness, a* to the red and green intensities, and b* to the yellow and blue intensities. RESULTS: A standard grading system showed negative correlations with L* (r=−0.67862, p=0.0108) and b* (r=−0.67862, p=0.0108), and a positive correlation with a* (r=0.64194, p=0.0180) with the green LEDs for papulopustular rosacea (PPR) types. The xerosis severity scale showed a positive correlation with L* (r=0.36709, p=0.0276) and a negative correlation with b* (r=−0.33068, p=0.0489) with the white LEDs for erythematotelangiectatic rosacea (ETR) types. In the ETR types, there was brighter lesional and normal skin with white LEDs and a higher score on the xerosis severity scale than the PPR types. CONCLUSION: This technique using PPL images is applicable to the quantitative and objective assessment of rosacea in clinical settings. In addition, the two main subtypes of ETR and PPR are distinct entities visually and optically.
Assuntos
Humanos , Métodos , Óptica e Fotônica , Fotografação , Rosácea , PeleRESUMO
No abstract available.
Assuntos
Mama , Líquen Escleroso e Atrófico , Líquens , Vitiligo , VulvaRESUMO
Tinea incognito is a dermatophytic infection induced by immunosuppressive agents that lacks the classic features of a typical fungal infection. Although the treatment of tinea incognito is simple and relatively easy, its clinical manifestation varies and can masquerade as various skin disorders, causing misdiagnosis and thus preventing prompt and appropriate treatment. Here, we report an interesting case of tinea incognito occurring after topical steroid administration in an immunosuppressed patient with dermatitis artefacta. A 40-year-old female patient who had been taking systemic glucocorticoid for 4 years for chronic inflammatory demyelinating polyneuropathy presented with itching multiple erythematous erosive lesions on the face and upper chest for 2 months. Initial biopsy produced nonspecific findings. The skin lesion was aggravated and became polycyclic and erythematous; after azathioprine was added, her chronic inflammatory demyelinating polyneuropathy became aggravated. A second biopsy confirmed hyphae in the cornified layer. Complete remission was achieved after admonishing oral terbinafine and topical amorolfine.
Assuntos
Adulto , Feminino , Humanos , Azatioprina , Biópsia , Dermatite , Erros de Diagnóstico , Hifas , Imunossupressores , Polineuropatias , Prurido , Pele , Tórax , TinhaRESUMO
BACKGROUND: Pigmented purpuric dermatoses (PPD) are a spectrum of disorders characterized by a distinct purpuric rash. Although PPD can be easily diagnosed, the disease entity remains an enigma and a therapeutic challenge. OBJECTIVE: The purpose of this study was to investigate the characteristics and clinical manifestations of PPD and to elucidate the relationship between assumed etiologic factors and the clinical manifestations of PPD and treatment responses. METHODS: Retrograde analyses were performed to identify appropriate PPD patients who visited Korea University Medical Center Anam Hospital from 2002 to 2012. RESULTS: Information on 113 patients with PPD was analyzed, and 38 subjects with skin biopsy were included for this study. Schamberg's disease was the most frequent clinical type (60.5%). Concomitant diseases included hypertension (15.8%), diabetes (10.5%), and others. Associated medication histories included statins (13.2%), beta blockers (10.5%), and others. Possibly associated etiologic factors were recent upper respiratory infection (5.3%), high orthostatic pressure due to prolonged standing (2.6%), and strenuous exercise (2.6%). A total of 36 patients (94.7%) were treated with one or more treatment methods, including oral antihistamines, pentoxifylline, topical steroids, and/or phototherapy. There was no significant difference in disease progress according to underlying diseases, medications, or association factors (p>0.05). CONCLUSION: Our overall results were grossly consistent with the existing literature, excluding several findings. Although a possible relationship between PPD and cardiovascular disease or cardiovascular medication was proposed at the beginning of the study, no statistically significant correlations were found according to the specific clinical types and treatment responses (p>0.05).
Assuntos
Humanos , Centros Médicos Acadêmicos , Biópsia , Doenças Cardiovasculares , Classificação , Exantema , Antagonistas dos Receptores Histamínicos , Inibidores de Hidroximetilglutaril-CoA Redutases , Hipertensão , Coreia (Geográfico) , Pentoxifilina , Fototerapia , Transtornos da Pigmentação , Pele , Dermatopatias , EsteroidesRESUMO
BACKGROUND: The rapid development of information and communication technology has replaced traditional books by electronic versions. Most print dermatology journals have been replaced with electronic journals (e-journals), which are readily used by clinicians and medical students. OBJECTIVE: The objectives of this study were to determine whether e-readers are appropriate for reading dermatology journals, to conduct an attitude study of both medical personnel and students, and to find a way of improving e-book use in the field of dermatology. METHODS: All articles in the Korean Journal of Dermatology published from January 2010 to December 2010 were utilized in this study. Dermatology house officers, student trainees in their fourth year of medical school, and interns at Korea University Medical Center participated in the study. After reading the articles with Kindle 2, their impressions and evaluations were recorded using a questionnaire with a 5-point Likert scale. RESULTS: The results demonstrated that gray-scale e-readers might not be suitable for reading dermatology journals, especially for case reports compared to the original articles. Only three of the thirty-one respondents preferred e-readers to printed papers. The most common suggestions from respondents to encourage usage of e-books in the field of dermatology were the introduction of a color display, followed by the use of a touch screen system, a cheaper price, and ready-to-print capabilities. CONCLUSION: In conclusion, our study demonstrated that current e-readers might not be suitable for reading dermatology journals. However, they may be utilized in selected situations according to the type and topic of the papers.
Assuntos
Humanos , Centros Médicos Acadêmicos , Inquéritos e Questionários , Dermatologia , Coreia (Geográfico) , Faculdades de Medicina , Estudantes de Medicina , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Tacrolimus ointment is a topical immunomodulator. Preliminary studies suggest that 0.1% tacrolimus is effective and has a proactive effect on atopic dermatitis with fewer complications than topical corticosteroids. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of tapering treatment with 0.1% tacrolimus ointment and its impact on quality of life in adult patients with atopic dermatitis in Korea. Korean adults with atopic dermatitis. METHODS: A total of 53 patients aged 15 to 54 years with moderate to severe atopic dermatitis applied 0.1% tacrolimus ointment for 12 weeks. The 0.1% tacrolimus ointment was applied along with a topical corticosteroid once daily during the 2-week induction phase and twice daily during the 2-week transitional phase. During the 8-week maintenance phase, the corticosteroid was discontinued and the 0.1% tacrolimus ointment alone was applied twice daily for 2 weeks and twice weekly for 6 weeks. Efficacy and quality of life were evaluated by the SCORAD and the Dermatology Life Quality Index (DLQI), respectively. RESULTS: SCORAD and DLQI values were significantly improved after 12 weeks of treatment. Symptoms were markedly improved after 2 weeks of applying the 0.1% tacrolimus ointment and the improvements were well maintained after tapering. Continuous improvement was observed throughout the study. Transient skin burning and itching occurred in about 43% of the patients, but gradually decreased in about 30% after continuous application. CONCLUSION: Tapering treatment with 0.1% tacrolimus ointment is safe and effective, and may replace the long-term use of topical corticosteroids, avoiding corticosteroid-associated adverse effects while maintaining clinical control and improving the quality of life of adult atopic dermatitis patients.
Assuntos
Adulto , Humanos , Corticosteroides , Queimaduras , Dermatite Atópica , Dermatologia , Coreia (Geográfico) , Prurido , Qualidade de Vida , Pele , Tacrolimo , Resultado do TratamentoRESUMO
BACKGROUND: Scabies is an old and common contagious skin disease. The incidence of scabies has decreased through the economic growth of Korea. However, recent outbreaks in medical facilities have created a suspicion that the infection of scabies is an emerging public health problem. OBJECTIVE: We evaluated the epidemiological and clinical aspects of patients diagnosed with scabies in Korea. This prospective study follows the retrospective study already performed by the same authors in 2011. METHODS: A multicenter, prospective study of scabies was performed at 25 hospitals in Korea. We included 914 patients who were diagnosed with scabies. Microscopic examination revealed scabies mites or eggs, or clinical improvement after treatment. Patients were asked to provide information on scabies, especially regarding the contact source, and the physicians examined them. RESULTS: Of the participants, 432 patients were men and 482 were women. Patients aged younger than 10 years and 60~69 years were the most common groups. Scabies more commonly affected patients during the fall and winter. Of the patients, 68.0% were thought to be infected at their homes, followed by nursing homes or hospitals (25.7%), and 31.6% through contact with other patients or, occasionally, staff members, including caregivers. CONCLUSION: We confirmed that scabies is an emerging threat in institutions, especially medical facilities. In addition, we suggest that public and in-hospital education is essential to minimize the problems associated with scabies.