Clinical Features and Awareness of Hand Eczema in Korea.

BACKGROUND: Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. OBJECTIVE: To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. METHODS: To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. RESULTS: The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. CONCLUSION: Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.

Preceding Annular Skin Lesions in a Patient with Hemophagocytic Lymphohistiocytosis.

The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.

A case of acquired idiopathic pterygium inversum unguis.

Pterygium inversum unguis (PIU) is a rare nail abnormality in which the distal nail bed adheres to the ventral surface of the nail plate, with obliteration of the distal groove. Because of the rarity of this condition, its exact origin is unknown. This disorder can be either congenital or acquired, with or without a family history. The acquired forms may be idiopathic or secondary to systemic connective tissue diseases or other causes such as stroke, neurofibromatosis, leprosy, or the use of nail fortifiers. We present an unusual case of acquired idiopathic PIU of the 10 fingernails in a 22-year-old man.

Phototrichogram analysis of normal scalp hair characteristics with aging.

BACKGROUND: Phototrichogram analysis of normal scalp hair characteristics in Asian populations is not well characterized. OBJECTIVE: To investigate the normal hair characteristics of South Koreans using a phototrichogram. METHODS: We enrolled 674 males and 683 females between the ages of 10 and 69. Hair density, thickness and the white hair percentage were measured via phototrichogram. Six scalp sites, including front, top, the peak between top and back, back, and the right and left sides were targeted. RESULTS: The mean hair density, hair thickness, and the white hair percentages were not significantly different between genders at any scalp site. The mean hair density and thickness were significantly different according to scalp sites. Hair density declined with age, especially at the peak between the top and back. Males and females showed different patterns of aging in hair density. Hair thickness changed little with age. Mean hair thickness generally tended to increase until the 20s, reach a plateau between the 20s and 50s, and decrease after the 50s. The mean white hair percentages were 1.84 ± 4.24% in males and 1.66 ± 4.21% in females. The mean white hair percentages were significantly increased in subjects over 40 years of age. CONCLUSION: We described the normal characteristics and aging patterns of scalp hair in a Korean population.

Prevalence and risk factors of depression in geriatric patients with dermatological diseases.

BACKGROUND: Although rarely life threatening, dermatological diseases may have a considerable influence on a patient's quality of life and psychological well-being. As with morbidity and mental distress from other chronic diseases, a skin disorder can be the one of the main causes of depression in the geriatric population. OBJECTIVE: To determine the prevalence of depression in elderly patients with dermatological disease in Korea and to identify factors associated with depression. METHODS: Patients over the age of 60 years with dermatologic diseases were solicited for a questionnaire survey. The Geriatric Depression Scale (GDS) was used to obtain a patient-based measurement of depression. Additionally, demographic information and medical history were collected. RESULTS: The questionnaire was completed by 313 patients (39.94% men, mean age 69.04 years, mean disease duration 3.23 years). Dermatological disease overall had a significant effect on patients' depression (χ(2)=177.13, p<0.0001), with a mean GDS score of 12.35 (out of 30). The patients who had a GDS score greater than 10 was 62.3% which indicated increased prevalence of mild to severe depression when compared to the general population among whom only 22.22% percent have GDS score greater than 10. In the univariate analysis, physical health, education level, and the presence of concurrent diseases were risk factors for geriatric depression. However, we did not find any demographic or disease related variables that were independent predictors of depression. CONCLUSION: Geriatric patients with dermatological disease experience an increase burden of depression. Thus, it is important for clinicians to evaluate geriatric patients with dermatologic diseases for depression.

Recent trends (1991-2010) of metastatic skin cancers in Korea.

The incidence of overall cancer has increased over time. The incidence of top-ranking cancers has changed in the 1990s and the 2000s. However, few studies have evaluated the trends in metastatic skin cancers during this period. We evaluated the recent trends in incidence, peak age and location of metastatic skin cancers from 1991 to 2010. This 20-yr survey was divided into two decades to determine the trends by comparing the statistics. Out of 694,466 outpatients (1991-2010), 174 (0.025%) were diagnosed with metastatic skin cancer. The incidence of metastatic skin cancer increased significantly from 20.64 per 100,000 outpatients in the 1990s to 28.70 per 100,000 outpatients in the 2000s (P = 0.030). The peak age of skin metastasis shifted from the 40s to the 50s in women, and from the 50s to the 60s in men. The percentage of metastatic skin cancers originating from intra-abdominal organs increased from 10% in the 1990s to 23.1% in the 2000s (P = 0.027). The percentage of metastatic skin cancers located on the abdomen increased from 7.1% in the 1990s to 15.4% in the 2000s (P = 0.011). The higher proportion of metastatic skin cancers located on the abdomen may be related to the increase in skin metastases from intra-abdominal organs.

A split-face comparison of low-fluence Q-switched Nd: YAG laser plus 1550 nm fractional photothermolysis vs. Q-switched Nd: YAG monotherapy for facial melasma in Asian skin.

BACKGROUND: Melasma is a common pigmentary disorder which poses substantial therapeutic challenge. Combined therapy may be beneficial in Asians, where mixed type melasma is dominant. OBJECTIVE: We sought to assess the efficacy and safety of a 1064 nm Q-switched Nd: YAG (1064 QSNY) and a nonablative 1550 nm erbium-doped fractional photothermolysis (NFP) treatment in Asian melasma. METHODS: This was a split face study, in which 26 patients were treated with the 1064 QSNY (6 mm spot size, 1.2-1.4 J/cm(2) fluence) for 10 sessions at 2-week intervals to the entire face, and with the NFP (dynamic mode, pulse energy 6-8 mJ/microthermal zone (MTZ); total density 300 MTZs/cm(2)) for five sessions at 4-week intervals to the experimental side of the face. Efficacy variables were modified Melasma Area and Severity Index (mMASI), the physician's global assessment (PhGA), and patient's subjective global assessment (PGA). Safety was evaluated through the reporting of adverse events. RESULTS: The percentage of subjective improvement was virtually identical on both sides. The mMASI corroborated the patients' subjective estimate, both in terms of the degree of improvement and the lack of difference between the 1064 QSNY + NFP and the 1064 QSNY treated sides. No serious side effects were reported in either side. CONCLUSIONS: Our findings do not support the hypothesis of NFP providing a substantial benefit in treating the melasma when compared with the lone treatment of the 1064 QSNY.

Clinical characteristics of 75 patients with leukemia cutis.

Leukemia cutis (LC) is defined as a neoplastic leukocytic infiltration of the skin. Few clinical studies are available on recent trends of LC in Korea. The purpose of this study was to analyze the clinical features and prognosis of LC in Korea and to compare findings with previous studies. We performed a retrospective study of 75 patients with LC and evaluated the patients' age and sex, clinical features and skin lesion distribution according to the type of leukemia, interval between the diagnosis of leukemia and the development of LC, and prognosis. The male to female ratio was 2:1, and the mean age at diagnosis was 37.6 yr. The most common cutaneous lesions were nodules. The most commonly affected site was the extremities in acute myelocytic leukemia and chronic myelocytic leukemia except for acute lymphocytic leukemia. Compared with previous studies, there was an increasing tendency in the proportion of males and nodular lesions, and LC most often occurred in the extremities. The prognosis of LC was still poor within 1 yr, which was similar to the results of previous studies. These results suggest that there is a difference in the clinical characteristics and predilection sites according to type of leukemia.

Eccrine poroma on the postauricular area: a rare presentation.

An eccrine poroma is a benign neoplasm that originates from the intraepidermal ductal portion of the eccrine sweat duct. Although eccrine poromas are most commonly found on the sole or side of the foot, eccrine poromas have been observed on other areas of the skin, such as the scalp, neck, and chest. We report an interesting case of an eccrine poroma, which presented as a 1×1 cm protruding dome-shaped, skin-colored-to-black nodule on the right postauricular area. The patient denied a previous history of trauma to this area. The histopathologic diagnosis was consistent with an eccrine poroma. There has been no local recurrence 5 months after complete excision.