Cutaneous tuberculids are relatively rare hypersensitivity reactions to Mycobacterium tuberculosis, characterized by erythematous eruption on the skin of a tuberculosis patient. Papulonecrotic tuberculid, lichen scrofulosorum, erythema induratum and nodular tuberculid were originally included in tuberculids. However, some cases are difficult to classify into the subtypes because of their broad spectrum of cutaneous manifestations and various histopathologies. This is particularly true in immunocompromised patients. We report a case of atypical cutaneous tuberculid in an immunocompromised patient in whom mycobacterical DNA was not demonstrated by PCR. However, the diagnosis of latent tuberculous infection was supported by IFN-gamma assay (QuantiFERON(R)-TB Gold test) and tuberculous lymphadenitis was diagnosed. The skin lesions responded dramatically to anti-tuberculous therapy, and there has been no evidence of recurrence.
DNA ; Erythema Induratum ; Humans ; Hypersensitivity ; Immunocompromised Host ; Lichens ; Mycobacterium tuberculosis ; Polymerase Chain Reaction ; Recurrence ; Skin ; Tuberculosis ; Tuberculosis, Cutaneous ; Tuberculosis, Lymph Node

BACKGROUND: Recently, propranolol has been found to be an effective treatment agent for infantile hemangiomas. Several studies have documented the effectiveness of propranolol in involution of infantile hemangiomas. The known side effects of propranolol include bronchospasm, hypoglycemia, bradycardia, hypotension, hyperkalemia, cool extremities, sleep disturbance, etc. However, the exact prevalence of adverse effects of this drug in Korean infants is unclear. OBJECTIVE: The purpose of this study was to evaluate the efficacy and side effects of propranolol treatment in Korean patients with infantile hemangiomas. METHODS: A total of 29 patients diagnosed with infantile hemangioma were treated with propranolol ranging from 1.5 to 2.5 mg/kg/day given either 2 or 3 times per day. Echocardiography and vital signs, blood glucose levels, and serum electrolytes were checked before and after each additional increased dose thereafter, and also during or at the end of the treatment period. All patients with IH took photographs and their parents were asked questions regarding their side effects at intervals of two months. RESULTS: The mean age at treatment initiation was 3.9 months, and the average duration of treatment was 10.4 months. Most of the patients (82.98%) showed good response with a clearance of 75% or more. Three (10.34%) patients had sleep disturbance and one (3.45%) had hyperkalemia. No patient was reported to have severe side effects such as symptomatic hypoglycemia, bradycardia, and hypotension. CONCLUSION: Based on these results, propranolol therapy is a very safe and highly effective modality for the treatment of Korean infants with infantile hemangiomas.
Blood Glucose ; Bradycardia ; Bronchial Spasm ; Echocardiography ; Electrolytes ; Extremities ; Hemangioma ; Humans ; Hyperkalemia ; Hypoglycemia ; Hypotension ; Infant ; Parents ; Prevalence ; Propranolol ; Vital Signs

BACKGROUND: Intertrigo is a form of contact dermatitis of skin folds of the body, for which a large variety of topical medications may be recommended. Application of a suitable barrier preparation is the cornerstone for the prevention and treatment for the intertrigo. OBJECTIVE: There is a notable absence of controlled trials to support and guide the use of barrier preparations for intertrigo. METHODS: We evaluated the effect of powders and moisturizers with non-invasive measuring methods on irritated skin reactions induced by sodium lauryl sulphate in the sintertriginous skin of 21 healthy volunteers. After skin irritation for 24 hours with patch test of 1% sodium lauryl sulphate on both axilla, we applied a powder and a moisturizer respectively. Evaluation was done at 2 weeks by transepidermal water loss, electrical capacitance. RESULTS: TEWL values of the moisturizer treated side were significantly lower than that of the powder treated side. Water holding capacity values of the moisturizer treated side were significantly higher than that of the powder treated side. CONCLUSION: These results suggest that topical application of a moisturizer might improve the disruption of permeability barrier function of intertrigo. We suggest this experimental model for further barrier preparation efficacy testing of intertrigo.
Axilla ; Dermatitis, Contact ; Intertrigo ; Models, Theoretical ; Patch Tests ; Permeability ; Powders ; Skin ; Sodium

BACKGROUND: The clinical presentation of lichen planus varies depending on the area involved. It occurs in less than 1% of the world's population: also, the prevalence in Korea is relatively low. However, the number of our outpatients has been increasing rapidly. OBJECTIVE: We studied the clinical characteristics of 100 patients with biopsy proven lichen planus. METHODS: We reviewed the medical records and clinical photographs of 100 patients who had been diagnosed with lichen planus during the last 10 years, from January 2002 to December 2011. RESULTS: Over the past 10 years, patients with Lichen Planus accounted for 0.196% among the new outpatients of this dermatology. The rate of Lichen Planus increased when it occurred on the skin, except for the Mucosal area. Of the 100 outpatients, 62% were men and 38% were women. The mean age at diagnosis was 54 years, and more than half of the patients were between 40 and 60 years of age. The most common site of lichen planus was the lip, which was found in 44% of the patients. Oral lesions were the second most commonly involved site at 28%, followed by the body at 20% and the genital area at 8%. The patients complained of various symptoms such as pain, burning sensation, pruritus, and irritation. Various treatments had been tried by all patients. CONCLUSION: This study of domestic patients with Lichen Planus is the biggest clinical research performed at a single center. The clinical features of patients in this survey share many similarities with those reported previously, but showed some differences too.
Biopsy ; Burns ; Dermatology ; Female ; Humans ; Korea ; Lichen Planus ; Lichens ; Lip ; Male ; Medical Records ; Outpatients ; Prevalence ; Pruritus ; Sensation ; Skin

BACKGROUND: Scabies is one of the common skin diseases observed in developing countries. The incidence of scabies has decreased dramatically since the late 1980s in Korea. However, recent outbreaks in nursing homes or hospitals have been raising public health concerns. OBJECTIVE: We intended to evaluate the epidemiological and clinical aspects of patients diagnosed with scabies in Korea. In particular, we tried to investigate the changing trend of contact sources in our society. METHODS: A multi-center cross sectional study was performed at 25 hospitals in Korea. We included 1,539 patients who were diagnosed with scabies. These patients showed scabies mites or eggs under microscopic examination, or clinical improvement after treatment. Their medical records with information of contact sources were reviewed. RESULTS: Six hundred and ninety-three patients were males and 826 were females. Patients' age from 70 to 79 was the most common followed by patients below 10 years of age. More patients were found in the fall and winter months. 66.7% of patients were thought to be infected at their homes which were situated next to nursing homes or hospitals (23.1%). Place of infection could not be verified in 39.3% of patients. 25.8% of patients were suggested to be infected through contact with medical staff or patients from hospitals or nursing homes. CONCLUSION: We confirmed that the contact sources of scabies are changing in our society; nursing homes and hospitals are emerging sources of infection. The majority of patients are old or very young who are vulnerable to many diseases. Therefore, dermatologists should pay attention to new contact sources and appropriate care of patients.
Developing Countries ; Disease Outbreaks ; Eggs ; Female ; Humans ; Hypogonadism ; Incidence ; Korea ; Male ; Medical Records ; Medical Staff ; Mites ; Mitochondrial Diseases ; Nursing Homes ; Ophthalmoplegia ; Ovum ; Public Health ; Retrospective Studies ; Scabies ; Skin Diseases

BACKGROUND: Scabies is an ectoparasite caused by the mite Sarcoptes scabiei var. hominis, an obligate human parasite. Although its incidence has been decreasing, it is not a rare dermatologic disease and is difficult to diagnosis. OBJECTIVE: To evaluate the clinical characteristics of scabies patients and find out etiologic factors in transmission. METHODS: Two hundred and ninety-five patients who were diagnosed with scabies at the Dermatologic Department, Myongji Hospital, Goyang city, Korea were enrolled. Medical records were evaluated in a retrospective manner. RESULTS: We studied 295 scabies patients who were diagnosed by the mineral oil test or skin biopsy. The mean age of the patients was 58.2 (male: 56.7/female: 61.2), and 74% of patients were over 60 years. There was seasonal variation in occurrence, and scabies was found to be most common in winter. The majority of suspected routes of infection were transmission through convalescent hospitals (38.1%) and caregivers (15.2%). Nosocomial infection and communal living were the major causes. 73.8% of scabies patients had underlying medical disease, such as hypertension (32.2%) and dementia (11.9%). CONCLUSION: Currently, scabies prevalence is still increasing in Goyang city, because of the increased number of convalescent hospitals.
Biopsy ; Caregivers ; Cross Infection ; Dementia ; Hospitals, Convalescent ; Humans ; Hypertension ; Incidence ; Korea ; Medical Records ; Mineral Oil ; Mites ; Parasites ; Prevalence ; Retrospective Studies ; Sarcoptes scabiei ; Scabies ; Seasons ; Skin

BACKGROUND: A number of skin manifestations in patients with allergic contact dermatitis result from sensitization with specific allergens, and patch testing is used as a diagnostic means of identifying theses allergens. In Korea, the commercial patch test panel, the TRUE-test, has been available since 2005. However, there have been few reports regarding the results of the TRUE-test. OBJECTIVE: The purpose of this study was to analyze the type, frequency, and changes in common contact allergens in Korea using the TRUE test. METHODS: A total of 311 patients with allergic contact dermatitis were evaluated by the TRUE test between January 2007 and December 2011 at Soonchunhyang hospital. Patch test reading was performed on day 2 and day 4. RESULTS: A total of 311 cases of TRUE test records (male 79, female 232) were compiled and analyzed. The highest age distribution was the 4th decade in females. The face, with exception of the lips, was the most frequently affected site (40.2%). Overall, 58.8% of patients had at least on positive reaction, and the most common allergens were nickel sulfate (31.8%), p-phenylenediamine (13.5%), cobalt chloride (10.0%), thiomersal (7.4%), and carba mix (5.5%). Nickel allergen displayed higher positive rates than the rates in other countries. CONCLUSION: There was no significant difference in the overall positive rate of patch test results compared with recent studies. However, we confirmed that metal-related allergens remain the most common, and that the results provide the basis for the use of the TRUE test in patients with contact dermatitis in Korea.
Age Distribution ; Allergens ; Cobalt ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Ditiocarb ; Female ; Guanidines ; Humans ; Korea ; Lip ; Nickel ; Patch Tests ; Phenylenediamines ; Skin Manifestations ; Thimerosal

Angioma serpiginosum is a rare acquired naevoid disorder, characterized by minute red or purple punta that are frequently arranged in serpiginous patterns in the lower extremities and buttocks. It usually begins in childhood and is more common in females. Histopathologically, thin-walled capillaries in the dermal papillae and the superficial reticular dermis are widely dilated without extravasation of red blood cells. We report a case of angioma serpiginosum on the lateral aspect of the right arm along the lines of Blaschko in a 36-year-old woman.
Adult ; Arm ; Buttocks ; Capillaries ; Dermis ; Erythrocytes ; Female ; Hemangioma* ; Humans ; Lower Extremity

Necrotizing fasciitis is a life-threatening, invasive soft-tissue infection that is characterized by widespread, rapidly developing necrosis of the subcutaneous tissue and fascia with relative sparing of the skin and underlying muscle. In type I necrotizing fasciitis, anaerobes and gram negative bacteria are predominant; in the type II form, Group A p-hemolytic streptococcus is a major etiologic agent. It needs immediate surgical intervention for a favorable outcome. A 64-year-old male presented with extremely painful, erythematous, symmetric, tense swelling with yellowish or hemorrhagic blisters on his right upper extremity. Two weeks before the admission, pain on his elbow made him take acupuncture therapy, There was severe tenderness, pitting edema, and his right elbow showed limited flexibility. The patient underwent wide debridement and drainage immediately. Liquefactive necrosis was seen in the subcutaneous fat and superficial fascia without muscular involvement. Group A B-hemolytic streptococci were grown from the tissue culture specimen.
Acupuncture Therapy ; Blister ; Debridement ; Drainage ; Edema ; Elbow ; Fascia ; Fasciitis, Necrotizing* ; Gram-Negative Bacteria ; Humans ; Male ; Middle Aged ; Necrosis ; Pliability ; Skin ; Streptococcus ; Subcutaneous Fat ; Subcutaneous Tissue ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity

Generalized pustular skin eruptions as a form of drug eruption is a rare entity. Recently this unique pustular dermatosis has been termed as acute generalized exanthematous pustulosis. We report on a 19-year-old man with acute generalized exanthematous pustulosis probably induced by ampicillin. The patient presented with erythematous and pinhead-sized subcorneal pustules after taking ampicillin for abdomimal pain. The patient complained of high fever and malaise. On further review of his history, generalized skin eruptions had been noted on at least three other occasions. Each episode occured following oral administration of antibiotics. A histological examination of a skin biposy specimen showed a subcorneal pustules with a few neutrophils, dermal edema and necrotic keratinocytes. After discontinuation of ampicillin, the eruption cleared within 4 days.
Acute Generalized Exanthematous Pustulosis* ; Administration, Oral ; Ampicillin* ; Anti-Bacterial Agents ; Drug Eruptions ; Edema ; Fever ; Humans ; Keratinocytes ; Neutrophils ; Skin ; Skin Diseases ; Young Adult