Kakkonkokato is a special formula used for the treatment of rosacea-like dermatitis lesions in the nasal region, but very few cases treated with this formulation have been reported so far. Here, we report three patients with refractory facial eruptions of rosacea-like dermatitis treated successfully with kakkonkokato. Case1was a 39-year-old man who presented with a 15-year history of rosacea-like dermatitis lesions in the nasal region. After 3 weeks' treatment with kakkonkokato, a marked improvement of his lesions was seen, with disappearance of the redness of his face. Case 2 was a 56-year-old woman who presented with a prolonged history of itchy eruptions around her mouth and nasal region. After 8 weeks' treatment with kakkonkokato, an almost complete disappearance of her eruptions was observed. Case 3 was a 26-year-old woman who presented with atopic dermatitis and intractable erythema under her nose, which was refractory to treatment with steroid ointments and antiallergic agents. After 2 months' treatment with kakkonkokato, her erythema completely resolved, along with improvement of the systemic lesions of atopic dermatitis. The observations in these three cases suggest that kakkonkokato may be a useful formula for the treatment of not only rosacea-like dermatitis in the nasal region, but also of refractory facial eruptions of other causes.
therapeutic aspects ; seconds ; Lesion, NOS ; Nasal ; Acne Rosacea

BACKGROUND: Demodicosis is a parasitic skin disease caused by Demodex mites, and the determination of mite density per square centimeter is important to diagnose demodicosis. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd). However, no study has previously compared these two methods with respect to clinical types and distribution patterns of demodicosis. OBJECTIVE: The aim of this study was to compare the value of SSSB and DME findings in reference to the clinical types and distribution patterns of demodicosis. METHODS: The medical records of 35 patients diagnosed with demodicosis between December 2011 and June 2015 were retrospectively reviewed. Demodicosis was classified according to four clinical types (pityriasis folliculorum, rosacea type, acne type, and perioral type) and three distribution patterns (diffuse pattern, U-zone pattern, and T-zone pattern). Two samples, one for SSSB and one for DME, were obtained from a lesion of each patient. RESULTS: In all patients, mean Dd and the proportion with a high Dd (>5D/cm²) by DME (14.5±3.3, 80.0%, respectively) were higher than by SSSB (5.5±1.3, 37.1%, respectively; p<0.01, p=0.02, respectively). In terms of clinical types, for rosacea type, mean Dd and proportion with a high Dd by DME (12.4±3.5, 84.6%, respectively) were significantly greater than those determined by SSSB (3.6±1.2, 23.1%; p=0.04, p=0.04, respectively). In terms of distribution pattern, for the diffuse pattern, mean Dd and the proportion with a high Dd by DME (17.5±3.7, 100%, respectively) were significantly higher than those determined by SSSB (6.0±2.7, 26.7%; p<0.01, p<0.01, respectively). CONCLUSION: The results of our study revealed that DME is a more sensitive method for detecting Demodex than SSSB, especially in patients with diffuse pattern and suspected rosacea type. Further research is needed to confirm this finding.
Acne Vulgaris ; Biopsy* ; Humans ; Medical Records ; Methods ; Mites* ; Retrospective Studies ; Rosacea ; Skin Diseases, Parasitic ; Skin*

Bokbunja (Rubus Coreanus Miquel) is a wild berry to Rosaceae genus of which application areas have been expanded due to many health effects. Bokbunja contains carbohydrates, protein, fats and dietary fibers as major components and various flavonoids such as tannins, volatile components including organic acids, alcohols and hydrocarbons as minor ones. Those active compounds attribute to increase in immune function, antioxidant and anti-inflammatory activity. Recently pure compounds have been isolated from the extracts for the development of medicines. We report here on two cases of acne vulgaris that was successfully treated with Rubus Coreanus Miquel extracts.
Acne Vulgaris ; Alcohols ; Carbohydrates ; Dietary Fiber ; Fats ; Flavonoids ; Fruit ; Hydrocarbons ; Propionibacterium acnes ; Rosacea ; Rosaceae ; Tannins

BACKGROUND: The prevalence of patients over the age of 25 years with acne has significantly increased over the past 10 years. Several etiologic factors such as genetic factor, hyperandrogenism, stress, and cosmetics have been studied. OBJECTIVES: The purpose of this study is to evaluate the differences between adolescent acne and post-adolescent acne, based on the clinical features, asoociated diseased and aggravating factors of 327 acne patients. METHODS: 327 consective patients, first visited to our hospital with clinical facial acne between March 2000 and February 2001, were enrolled. 220 adolescent patients(AP) were under the age of 25 and post-adolescent patients(PP) were over age of 25. RESULTS: 1. In the face, cheeks and forehead in adolescents, chin and cheeks in post-adolescents were predilection sites. The predominant type was a comedonal type in adolescents and a papulopustular type in post-adolescents(P<0.05). Severity of inflammatory type was not different between two groups. Familial factors were important in both groups, but more frequently found in post-adolescents with persistent acne(P<0.05). 2. Rosacea, chloasma, and hyperandrogenic features such as hirsutism and androgenetic alopecia were more frequently observed in post-adolescents. Seborrheic and atopic dermatitis were more frequent in adolescents. Four patients had all the features of chloasma, acne, rosacea, seborrheic dermatitis and hirsutism. 3. Aggravation by weason especially summer, sweating, stress, and cosmetics was more frequent in adolescents. In PP, acne was more frequently aggravated by sunlight, foods and menstrual period. CONCLUSION: Post-adolescent acne was mainly a papulopustular type predominantly located on the chin and cheeks with mild to moderated severity, and family history and hyperandrogenism were strong etiologic factors in persistent acne. Aggravating factors were not significantly different between two group, which suggested cosmetics and stress might not be important in post adolescent acne.
Acne Vulgaris* ; Adolescent* ; Alopecia ; Cheek ; Chin ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Forehead ; Hirsutism ; Humans ; Hyperandrogenism ; Melanosis ; Prevalence ; Rosacea ; Sunlight ; Sweat ; Sweating

The pathogenicity of Demodex folliculorum (DF) is not well established, becausc this cutaneous parasite can be found very often not only from acneic skin lesions but also on healthy human skin, surface, particularly on sebaceous gland-rich and functionaIly active areas of the skin, i.e. on face, and therefore, the mite has been generally considered as normal inhabitant of human skin. However, as is the case with candidiasis, the parasite could also be pathogenic in the state of disturbed host-para-site relationship. To find out the pathogenicity of the mite, the authors studied the incidence of finding DF from different sites of face in several groups of 60 acneic patients (various types of acne vulgaris and rosacea) and 30 normal subjects as control. And the results obtained were as follows: the mite was found in 33 cases out of the acnei patients (55%), in male patients 67% (12 out of l8) were positive and in fernales 50% (21 out of 42). In the control group of 3O (15 each sex), 17 cases (9 males and 8 females) had thc mite, the incidence rate being 57%, The incidence rate of DF in various types of acneic skin lesions were: 85% in rosacea. 80% in pustular acne 71% in cvstic acne and 32% in papular acne. The distribution of the mite in various sites of the face differed markedly in the acneic and normal groups. In the control group 17 (57 %) were positive on nose, 3 (10%) on cheek, 2 (7%) on chin, and none on the forehead. Among 60 acneic patients, however, 18 (30%) were positive on cheek, 17 (28%) on nose, 15 (25%) on chin 12 (20 %) on forehead. In addition, the acuthors observed two cases of demodicidosis in the dogs. These two dogs were siblings and lived together with other dogs of the same lineage, but the other dogs were not affected. In spite of vigorous treatment with 15 % benzyl benzoate aqueous emulsion and 10 % crotamiton ointment applied topically for two to three weeks, the dogs died within one to two months. Slight improvement only was noted in the first week of the treatment, but the dogs were gradually emaciated, leading to death. At the onset of the disease, both dogs were two to three months old. Histopathological studies of the affected skin revealed dense patchy lymphocytic infiltration predominantly in perifollicular area, follicular keratotic plugging and egg-like materials in the Iumen of hair follicle. Histopathology of the affected canine skin appeared similar to that of human demodicidosis except that the mitelike material was observed lodged in the lumen of hair follicle. The morphology of demodex folliculorum canis seemed slightly different from that of the human strain (DF hominis). It is generally smaller in size and has narrower and shorter stunted abdomen than human strain, otherwise it is almost alike. The human demo3icrdosis can be effectively treated with 15% benzyl benzoate aqueous emulsion, 1% gamma benzene hexachlrode cream and 10 % crotamiton ointment, and it seems to be most effective agent being crotamiton ointment among them. It is suggested that demodex folliculorum, which has been hitherto thought to be harmless, can be pathogenic in certain individuals and that some immunologic factors might be implicated in the process of the demodicidosis.
Abdomen ; Acne Vulgaris ; Animals ; Benzene ; Benzoates ; Candidiasis ; Cheek ; Chin ; Dogs ; Dronabinol ; Forehead ; Hair Follicle ; Humans ; Immunologic Factors ; Incidence ; Male ; Mites ; Nose ; Parasites ; Rosacea ; Siblings ; Skin ; Virulence*

BACKGROUND: Rosacea is a very common affection but so far there are no reliable figures for its true prevalence. Symptoms are usually progressive, but early diagnosis and appropriate management can alleviate patient discomfort and psychological distress as well as prevent serious long term complications. OBJECTIVE: The purpose of this study was to elucidate the clinical observations of rosacea. METHOD: During 1-year-period from feb. 1999 to feb. 2000, 112 patients were evaluated with regard to age, sex, location of skin lesions, clinical type, duration, aggravating and relieving factors, family history, and smoking history. RESULTS: 1. Of the 112 cases were diagnosed with rosacea, 60 were male patients and 52 females. The incidence was peaked in the fifth decades of life. 2. The most common type of rosacea was erythematotelangiectatic rosacea(81.3%) and the average initial severity score of rosacea was 5.55. 3. The average duration of rosacea was 7.9 years. 4. The predilection sites of the rosacea were: nose(48.2%), cheek(27.7%), entire face(24.1%). 5. Associated diseases with rosacea were: seborrheic dermatitis(59.8%), acne(42%), migraine(28.6%), chloasma(22.3%). 6. Associated symptoms with rosacea were: eye symptoms(58.0%), irritating symptoms(60.7%). 7. The aggravating factors of rosacea were: hot bath(58.9%), sun exposure(53.6%), alcohol(48.2%), spicy food(40.2%), emotional stress(36.6%), hot beverages or food(36.6%), coffee and tea(10.7%), summer season(33.0%), and winter season(28.6%). However in summer and on sun exposure 9.8% and 4.5% of the patients were relieved respectively. 8. The relieving factors of rosacea were: rest and relax(55.4%), cooling(34.8%), winter season(15.2%). 9. The family history of rosacea was detected in 20.5% and the smoking history 38.4%.
Acne Vulgaris ; Beverages ; Coffee ; Dermatitis, Seborrheic ; Early Diagnosis ; Female ; Humans ; Incidence ; Male ; Melanosis ; Migraine Disorders ; Prevalence ; Rosacea* ; Skin ; Smoke ; Smoking ; Solar System

BACKGROUND: Tinea faciale usually has been classified as tinea corgoris. Recently it has often been classified as a seperate disease recently because of its various clinicel pesentations. OBJECTIVE: Our purpose was to evaluate the clinical characteristics and mycological findings of tinea faciale, METHODS: Clinieal and mycological study was done with 42 eases of tinea faciale among out-patients examined for eight years from January 1985 to December 1992 at Yeungnam University Hospital, Taegu, Korea. RESULTS & CONCLUSION: 1. The average of annual distribution of patients was five and there a as no significant difference according to year. The age distribution of patients was highest under age 10(33.4%). The ratio of male to female patient was 3.1: 1. Monthly or seasonal distribution if patients was not significantly different. 2. Of 42 cases, causative organisms were isolated in 31 cases. They are Trichophyton(T.) rubrum in 19 cases (61.3%), Microsporum(M.) canis in 6 cases (19.4%), T. mentcgrophytes in 5 cases (16.1%) and M. gypseum in 1 case(3.7%) in tbe order of decreasing frequncd M. canis was the main causative organisrn in children under age 10. In the age group after 10, T. rubrum was predominated. T. rubrum infection was most frequently seen in spring, T. mentagrphates infection was seen more in winter and M. canis infectior in autumn. 3. Classic annular types were seen most frequently in the cases caused by T. rubrum and T. mentagrophytes. Papular types were seen most commonly in the case caused by M. canis. Multiple facial lesions were seen in T. rubrum infection (2 cases) and Of canis infection (1 case). Tinea faciale simulated several other dermatoses. These were contact, dermatitis, lupus erythematosus, photosensitive dermatosis, rosacea, granuloma annulare and acne. Of these, tinea faciale simulated contact dermatitis most frequently. Coexisting fungal infections were found in 7 patients and tinea corporis was most frequently present. Topical antifungsl agent was tried alone in 22 cases, and topical and systemic antifungal agent were combined in 20 cases.
Acne Vulgaris ; Age Distribution ; Child ; Daegu ; Dermatitis ; Dermatitis, Contact ; Female ; Granuloma Annulare ; Humans ; Korea ; Male ; Outpatients ; Rosacea ; Seasons ; Skin Diseases ; Tinea*

BACKGROUND: Tinea faciale usually has been classified as tinea corgoris. Recently it has often been classified as a seperate disease recently because of its various clinicel pesentations. OBJECTIVE: Our purpose was to evaluate the clinical characteristics and mycological findings of tinea faciale, METHODS: Clinieal and mycological study was done with 42 eases of tinea faciale among out-patients examined for eight years from January 1985 to December 1992 at Yeungnam University Hospital, Taegu, Korea. RESULTS & CONCLUSION: 1. The average of annual distribution of patients was five and there a as no significant difference according to year. The age distribution of patients was highest under age 10(33.4%). The ratio of male to female patient was 3.1: 1. Monthly or seasonal distribution if patients was not significantly different. 2. Of 42 cases, causative organisms were isolated in 31 cases. They are Trichophyton(T.) rubrum in 19 cases (61.3%), Microsporum(M.) canis in 6 cases (19.4%), T. mentcgrophytes in 5 cases (16.1%) and M. gypseum in 1 case(3.7%) in tbe order of decreasing frequncd M. canis was the main causative organisrn in children under age 10. In the age group after 10, T. rubrum was predominated. T. rubrum infection was most frequently seen in spring, T. mentagrphates infection was seen more in winter and M. canis infectior in autumn. 3. Classic annular types were seen most frequently in the cases caused by T. rubrum and T. mentagrophytes. Papular types were seen most commonly in the case caused by M. canis. Multiple facial lesions were seen in T. rubrum infection (2 cases) and Of canis infection (1 case). Tinea faciale simulated several other dermatoses. These were contact, dermatitis, lupus erythematosus, photosensitive dermatosis, rosacea, granuloma annulare and acne. Of these, tinea faciale simulated contact dermatitis most frequently. Coexisting fungal infections were found in 7 patients and tinea corporis was most frequently present. Topical antifungsl agent was tried alone in 22 cases, and topical and systemic antifungal agent were combined in 20 cases.
Acne Vulgaris ; Age Distribution ; Child ; Daegu ; Dermatitis ; Dermatitis, Contact ; Female ; Granuloma Annulare ; Humans ; Korea ; Male ; Outpatients ; Rosacea ; Seasons ; Skin Diseases ; Tinea*

Gram-negative folliculitis is an infection with Gram-negative bacteria that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne or rosacea. A 21-year-old male soldier with acne vulvaris had been treated with broad-spectrum antibiotics for two months because of severe pyoderma on the soles. While the plantar lesions improved significantly, prolonged use of the systemic antibiotics resulted in widespread follicular pustules on his face, scalp, and back of the neck. A skin biopsy showed features of superficial pustular folliculitis. Klebsiella species were identified from the pus culture. A diagnosis of gram-negative folliculitis was made. The lesions almost disappeared after 4 weeks of treatment with oral isotretinoin (0.5 mg/kg/day).
Acne Vulgaris ; Anti-Bacterial Agents* ; Biopsy ; Diagnosis ; Folliculitis* ; Gram-Negative Bacteria ; Humans ; Isotretinoin ; Klebsiella ; Male ; Military Personnel ; Neck ; Pyoderma ; Rosacea ; Scalp ; Skin ; Suppuration ; Young Adult

Gram-negative folliculitis is an infection with Gram-negative bacteria that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne or rosacea. A 21-year-old male soldier with acne vulvaris had been treated with broad-spectrum antibiotics for two months because of severe pyoderma on the soles. While the plantar lesions improved significantly, prolonged use of the systemic antibiotics resulted in widespread follicular pustules on his face, scalp, and back of the neck. A skin biopsy showed features of superficial pustular folliculitis. Klebsiella species were identified from the pus culture. A diagnosis of gram-negative folliculitis was made. The lesions almost disappeared after 4 weeks of treatment with oral isotretinoin (0.5 mg/kg/day).
Acne Vulgaris ; Anti-Bacterial Agents* ; Biopsy ; Diagnosis ; Folliculitis* ; Gram-Negative Bacteria ; Humans ; Isotretinoin ; Klebsiella ; Male ; Military Personnel ; Neck ; Pyoderma ; Rosacea ; Scalp ; Skin ; Suppuration ; Young Adult