Treatment and Classification of Nevus of Ota: A Seven-Year Review of a Single Institution's Experience

BACKGROUND: Nevus of Ota (NO) is a relatively common pigmentary disorder in Asians. Tanino's classification is an old but tacit consensus to delineate the disease. Various treatment options have been presented. However, a few studies have been conducted on available laser options and current treatment strategies or the classification of NO. OBJECTIVE: To investigate current laser options and their effectiveness for the treatment of NO, contributing factors to clinical outcomes, and verification of classification. METHODS: A retrospective study of NO was conducted by reviewing medical charts and photographs of sixty-seven patients. Statistical analysis was used to compare excellent and poor outcomes and determine contributing factors. RESULTS: The median age of onset was below the age of 1 (interquartile range [IQR], 0~1). Tanino's and PUMCH classification systems failed to classify patients in 24 (35.8%) and 6 (9.0%) of patients, respectively. A 1,064 nm Q-switched Nd:YAG laser without additional lasers was used most frequently in 42 patients (62.7%). The frequency of treatment was 19.0 (IQR, 10.0~23.0) in the cured group defined as subjects showing 95% improvement or above, compared to 10.0 (IQR, 6.25~13.75) in the unattained group defined as subjects showing less than 95% improvement (p=0.001). CONCLUSION: A 1,064 nm Q-switched Nd:YAG laser is a reliable treatment armamentarium, functioning as a single infallible modality as well as a combination treatment modality for NO. Repetitive laser treatments without interruption seems to be the most suitable in clearing NO. The current classification systems of NO are defective. Thus, a new classification should be developed.

Erratum: Treatment and Classification of Nevus of Ota: A Seven-Year Review of a Single Institution's Experience

In the originally published version of this article, the last line of footnotes was omitted in Table 2.

Cutaneous Metastasis of Small Cell Lung Cancer Masquerading as Lipomatosis / 대한피부과학회지

No abstract available.

A Case of Local and Generalized Skin Adverse Reactions after Pneumococcal Vaccination / 대한피부과학회지

Pneumococcus is the most frequently encountered causative pathogen in community-acquired pneumonia in elderly patients. The pneumococcal polysaccharide vaccine (PPV23) is widely used for preventing pneumococcal diseases in adults. PPV23 is relatively safe; however, some cutaneous adverse reactions, including localized mild inflammation associated with erythema, a sensation of heat, and tenderness, have been reported. Systemic reactions such as myalgia, arthralgia, and headache have also been reported, though severe adverse reactions are rare. In the Korean literature, a case of localized toxic reaction near the injection site after pneumococcal conjugate vaccine (PCV13) administration was previously reported. However, there are no published reports of a generalized skin rash after PPV23. Herein, we report a case of PPV23-induced generalized skin rash on the face, neck, upper trunk, and both arms with a local adverse reaction at the injection site after vaccination.

A Case of Xanthoma Dissemiantum with Laryngeal and Stomach Mucosal Involvement / 대한피부과학회지

No abstract available.

Identifying Skin Type using the Baumann Skin Type Questionnaire in Korean Women Who Visited a Dermatologic Clinic / 대한피부과학회지

BACKGROUND: Skin types vary, making it difficult to identify them at a glance. To effectively understand skin type, analysis based on a questionnaire could be helpful. OBJECTIVE: The purpose of this study was to identify the accuracy and effectiveness of the Baumann skin type questionnaire (BSTQ) compared with an interview with a dermatologic specialist. In addition, we aimed to identify differences in skin type proportions according to age and develop a modified BSTQ. METHODS: Subjects included 202 women (19~64 years of age) who visited the dermatologic clinic of our hospital. They completed both the BSTQ and an interview with a dermatologic specialist. A modified BSTQ was developed by removing similar and racial questions and adjusting grading scores. RESULTS: The agreement between skin type proportions analyzed by the BSTQ and an interview was not reasonable (κ=0.428, 95% confidence interval [CI]: 0.363~0.493). There was a correlation between the proportion of dryness and age (R2=0.029, p<0.05). However, other skin type proportions (sensitivity, pigmentation, and wrinkles) were not significantly correlated with age. The modified BSTQ showed substantial agreement with the BSTQ in skin type proportions (κ=0.691, 95% CI: 0.641~0.740). CONCLUSION: We identified the skin types of Korean women of various ages using the BSTQ and an interview. Furthermore, the modified BSTQ might be helpful for accurately recognizing skin types.

Representative Trichoscopic Findings of Outpatients with Androgenetic Alopecia and Alopecia Areata / 대한피부과학회지

BACKGROUND: By magnifying the scalp and structure of hair, trichoscopy enables easy differentiation among various hair loss diseases. OBJECTIVE: To measure the frequency of representative trichoscopic findings in outpatients with androgenetic alopecia and alopecia areata and the frequency of various trichoscopic findings depending on the disease severity of androgenetic alopecia. METHODS: This cross-sectional study included 87 patients with androgenetic alopecia (n=57) and alopecia areata (n=30) treated over a year (2014∼2015). Three dermatologists assessed the trichoscopic findings (hair shaft, hair follicle opening, and perifollicular epidermis) in these patients. RESULTS: Vellus hair was observed in 21 of the 30 patients (70%) with alopecia areata and 20 of the 57 patients (35%) with androgenetic alopecia. Among the patients with androgenetic alopecia, as the disease severity increased, the portion of patients with vellus hair, thickness heterogeneity, and honeycomb pigmentation also increased (p<0.05). CONCLUSION: Trichoscopy is very useful for the diagnosis of androgenetic alopecia and alopecia areata. Additionally, the severity of androgenetic alopecia can be assessed using trichoscopy.

Representative Trichoscopic Findings of Outpatients with Androgenetic Alopecia and Alopecia Areata / 대한피부과학회지

BACKGROUND: By magnifying the scalp and structure of hair, trichoscopy enables easy differentiation among various hair loss diseases. OBJECTIVE: To measure the frequency of representative trichoscopic findings in outpatients with androgenetic alopecia and alopecia areata and the frequency of various trichoscopic findings depending on the disease severity of androgenetic alopecia. METHODS: This cross-sectional study included 87 patients with androgenetic alopecia (n=57) and alopecia areata (n=30) treated over a year (2014∼2015). Three dermatologists assessed the trichoscopic findings (hair shaft, hair follicle opening, and perifollicular epidermis) in these patients. RESULTS: Vellus hair was observed in 21 of the 30 patients (70%) with alopecia areata and 20 of the 57 patients (35%) with androgenetic alopecia. Among the patients with androgenetic alopecia, as the disease severity increased, the portion of patients with vellus hair, thickness heterogeneity, and honeycomb pigmentation also increased (p<0.05). CONCLUSION: Trichoscopy is very useful for the diagnosis of androgenetic alopecia and alopecia areata. Additionally, the severity of androgenetic alopecia can be assessed using trichoscopy.

A Statistical Analysis of Dermatology Patients Visiting the Emergency Department in the Recent 3 Years (2010~2012) / 대한피부과학회지

BACKGROUND: An increasing number of patients visit the emergency department (ED) for dermatological complaints. However, there is a paucity of data regarding the skin conditions presenting to the ED. OBJECTIVE: This study aimed to describe the characteristics of skin complaints seen in the ED of a tertiary hospital in Korea. METHODS: We retrospectively reviewed 1,663 new dermatological emergency patients who visited the ED of our hospital from January 2010 to December 2012. All skin conditions were diagnosed by a dermatologist and not by an emergency medicine specialist. RESULTS: A total of 1,663 patients with skin problem were seen, corresponding to 1.5% of total ED visits. The mean age was 41.8 years and there was a slight female predominance (61.2%). The peak arrival time was between 9 pm and midnight. In terms of visit length, 68.9% of patients stayed less than 2 hours. Patients most commonly presented with urticaria/angioedema (53.8%) followed by herpes zoster (14.0%), contact dermatitis (7.2%), drug eruption (6.5%), and cellulitis/erysipelas (4.0%). Urticaria/angioedema patients were most commonly aged 21 to 40 years and herpes zoster patients were most commonly aged 51 to 70 years. Admissions occurred in 8.1% of cases, most frequently for herpes zoster. CONCLUSION: This retrospective study provides insight into the types of cases being evaluated by dermatologists in the ED of a tertiary hospital. An awareness of these characteristics may assist physicians working in the ED in evaluating patients who present to the ED with skin disease.

A Case of Primary Cutaneous CD30+ Anaplastic Large Cell Lymphoma, Small Cell Variant / 대한피부과학회지

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare cutaneous T-cell lymphoma. Most cases are composed of large anaplastic cells. However, it presents a wide spectrum of histologic patterns. In the small cell variant, a small-sized pleomorphic cell morphology can be seen. A 74-year-old woman presented with an 8-month history of asymptomatic ulcerative plaque and satellite nodule on the right calf. Her past medical history was not specific. The histologic findings on punch biopsy specimens showed a malignant small round cell tumor on both lesions. The tumor cells had large pleomorphic nuclei with multinucleation and some eosinophilic cytoplasm. We performed immunohistochemical staining to rule out neuroectodermal tumor, neuroendocrine tumor, melanoma, lymphoma, and so on. However, the staining results were negative for pancytokeratin, CD3, CD20, CD99, chromogranin A, synaptophysin, CD56, ALK, HMB45, desmin, kappa, lambda, myoglobin, and S-100 protein. CT, MRI, and PET-CT were negative for extracutaneous involvement. Total excision was done, and additional immunohistochemical staining was performed to confirm the origin of the tumor. Staining results for vimentin, LCA, CD4, and CD30 were positive. We concluded that these findings were consistent with the small cell variant CD30+ PCALCL, which occurs rarely.