A nationwide study of acne treatment patterns in Korea: analysis of patient preconceived notions and dermatologist suggestion for treatment.

Patients often have preconceived notions about acne treatments before visiting dermatologists. The aim of this study was to explore the association between patients' beliefs regarding acne and physicians' suggestion for treatment modality in dermatology clinics. A cross-sectional, nationwide multicentre study was conducted. A total of 1,370 patients completed questionnaires about beliefs about acne treatment before seeking medical care, and 101 dermatologists assessed their acne severity and proposed treatment methods. We found that patients had preconceptions in understanding disease characteristics, assessing subjective acne severity and preferring specific treatment modalities. Dermatologists' determination of topical agents as first-line treatment was affected by disease severity and patients' preferences. They were also more likely to prescribe isotretinoin even in moderate acne compared to oral antibiotics and topical agents. Selections of physical treatments and light-based therapies were affected by patients' preferences, subjective self-evaluation and dermatologists' assessments. Thus, we suggest that acne treatment strategies should incorporate both patients' subjective perceptions and objective clinical practices into a management paradigm.

Sphingosine may have cytotoxic effects via apoptosis on the growth of keloid fibroblasts.

Keloids are often resistant to treatment, causing much suffering to the patient. Our previous work found that ceramide (Cer) inhibits growth of fibroblasts via apoptosis. However, when compared to normal fibroblasts (NFs), which are quiescent, keloid fibroblasts (KFs) rapidly proliferate and are reported to be resistant to apoptosis via Cer. Sphingosine (Sph) is a metabolite product of ceramide that has some different biochemical properties. Thereofore, we investigated the cytotoxic effects of Sph on cultured fibroblasts from keloid lesions and normal skin in order to evaluate the possibility of using Sph in the treatment of keloid. We used the lactic dehydrogenase (LDH) method, MTT method, and propidium iodide (PI) method. Sph had cytotoxic effects via apoptosis on both the KFs and NFs. Our results indicate that Sph may be applicable to the future treatment of keloid.

A case of congenital mucinous nevus: a connective tissue nevus of the proteoglycan type.

Mucinous nevus is a very rare entity and can be classified as both a cutaneous mucinosis (CM) and a connective tissue nevus (CTN). We describe the clinicopathologic features of an unusual case of mucinous nevus in a 14-year-old Korean boy who presented with zosteriform plaques of congenital onset.

Microvenular hemangioma in a boy with acute myelogenous leukemia.

Microvenular hemangioma (MVH) is a rare, benign, acquired vascular tumor. We report a case that shows the characteristic histopathologic features of this disorder in a boy with acute myelogenous leukemia (AML), suggesting an association with systemic immunosuppression.

Generalized perforating granuloma annulare in an infant.

Generalized perforating granuloma annulare presents with flesh- to red-colored, 1-5 mm papules with a central umbilicated crust or scale that usually involves the extremities, face, neck, and trunk. Perforating granulomas are demonstrated on histopathology. Our patient is a 68-day-old girl with generalized perforating granuloma annulare.

Relative frequency of the different types of cutaneous T cell and natural killer cell lymphomas in Korea based on the proposed WHO classification and the EORTC classification.

The R.E.A.L. classification was largely adopted recently by the proposed WHO classification. The usefulness of this classification in cutaneous T cell and natural killer (NK) cell lymphomas in Korea was evaluated compared to that of the European Organization for Research and Treatment of Cancer (EORTC) classification. Overall, 78 patients with cutaneous T cell and NK cell lymphomas were diagnosed in Asan Medical Center in the 1990's. The clinical records, slides of H&E and immunohistochemical stainings were reviewed. By the proposed WHO classification, mycosis fungoides (20 cases), lymphomatoid papulosis (13 cases), nasal type NK/T-cell lymphoma (10 cases), CD30+ anaplastic large cell lymphoma (8 cases), subcutaneous panniculitis-like T-cell lymphoma (6 cases), peripheral T-cell lymphoma, unspecified (3 cases), Sézary syndrome (1 case) and blastic NK cell lymphoma (1 case) comprised the primary cases. Secondary or undetermined cases included peripheral T-cell lymphoma, unspecified (10 cases), nasal type NK/T-cell lymphoma (5 cases), and angioimmunoblastic T-cell lymphoma (1 case). EORTC classification for cutaneous T cell and NK cell lymphomas did not include nasal and nasal type NK/T-cell lymphomas, unspecified non-pleomorphic T-cell lymphoma, undetermined cases among primary or secondary ones and some rare types of skin lymphomas which can be classified by WHO. The WHO classification is more useful for skin lymphomas in Korea since it encompassed all the various types of skin T cell and NK cell lymphomas in Korea.

A case of infantile acne due to pityrosporum.

We report a case of infantile acne. The lesion on the forehead resembled infantile acne clinically, but histologically it contained yeasts of Pityrosporum. The lesion was treated with topical ketoconazole cream and improved. We suggest that Pityrosporum is associated with infantile acne.

Scabies incognito presenting as urticaria pigmentosa in an infant.

Misdiagnosis is frequent in scabies of infants and children because of a low index of suspicion, secondary eczematous changes, and inappropriate therapy. Topical or systemic corticosteroids may modify the clinical presentation of scabies and that situation is referred to as scabies incognito. We describe a 10-month-old infant with scabies incognito mimicking urticaria pigmentosa.

Tinea capitis due to Trichophyton rubrum in a neonate.

Tinea capitis is a common infection of school-aged children, but there have been only a few reports of tinea capitis in newborns. Furthermore, Trichophyton rubrum as a causative organism of tinea capitis is documented very rarely. We report herein a neonate in whom T. rubrum was the causative agent. This boy was successfully treated with three pulses of oral itraconazole solution.