In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.
Asian Continental Ancestry Group ; Austria ; Canada ; Denmark ; Employment ; Finland ; France ; Germany ; Great Britain ; Humans ; Hungary ; Israel ; Japan ; Jurisprudence ; Korea ; Netherlands ; New Zealand ; Norway ; Organization and Administration ; Portugal ; Questionnaires ; Singapore ; Skin ; Skin Care ; Slovakia ; Social Control, Formal ; Spain ; Switzerland ; Turkey ; United States

Hand-foot syndrome, also known as acral erythema, is a distinctive and relatively common toxic reaction due to some anticancer drugs. It is characterized by a painful erythema on the palms and soles during chemotherapy, which is often preceeded by paresthesia. We report two cases of hand-foot syndrome induced by capecitabine, which is a relatively brand-new oral anticancer agent. Hand-foot syndrome is one of the most common complications of capecitabine, and is on the increase. Therefore, dermatologists should be aware of it.
Drug Therapy ; Erythema ; Hand-Foot Syndrome* ; Paresthesia ; Capecitabine

PURPOSE: This study was attempted to investigate the prevalence of the expression of c-fos protein, TGF-alpha and -beta, PCNA , DNA ploidy pattern and histopathological parameters of giant cell tumor (GCT) of bone and to correlate with prognosis and to extend our understanding on tumorigenesis of GCT. MATERIALS AND METHODS: Twenty eight cases of paraffin-embedded tissue were studied, classified as recurrent (5 cases) and non-recurrent group (12cases) within the limits of the cases which afforded surgical material on first operation. RESULTS: No significant difference was observed in cellularity of stromal cells, atypia of stromal and giant cells, presence of hemorrhage and necrosis between recurrent and non-recurrent group. However, presence of more than 10 mitotic figures in 10 high power fields in recurrent group was significantly higher than non-recurrent group (p<0.05). The immunoreactivity for PCNA was seen only in nuclei of stromal cells, whereas nuclei of giant cells showed negative staining. The positivity of PCNA revealed no significant difference between non-recurrent (mean; 40.9%) and recurrent group (34.4%). The expression of c-fos oncogene was seen in 5 cases (100%) in recurrent group, and 8 cases (66.7%) in non-recurrent group, and no significant difference was seen. No significant difference of expression of TGF-alpha was seen in 5 cases (100%) in recurrent group and in 11 cases (91.7%) in non-recurrent group. The expression of TGF-beta in stromal cells was significantly higher in non-recurrent group (80%) compared to recurrent group (100%) (p<0.05). In DNA analysis out of 18 cases, 4 cases (22.2%) were aneuploidy and 14 cases (77.8%) were diploidy. Among 4 aneuploidy cases, 3 cases (75%) had no recurrence, and 1 case (25%) had metastasis to lung and expired. No significant difference of DNA ploidy pattern was seen between the recurrent and non-recurrent group. CONCLUSION: Presence of more than 10 mitotic figures in 10 high power fields and less expression of TGF-beta are related to higher possibility of recurrence and it is suggested that the number of mitotic figure (more than 10/10HPF) and expression of TGF-beta could be helpful parameters in predicting recurrence of GCT.
Aneuploidy ; Carcinogenesis ; Diploidy ; DNA* ; Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells* ; Hemorrhage ; Lung ; Necrosis ; Negative Staining ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prevalence ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Stromal Cells ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors*

We present a patient who developed a pseudolymphoma after ear piercing. A patch test showed gold sensitivity. Therefore, long standing dermal exposure to gold from a pierced-type earring might have produced the patient's disease. This patient did not respond to an intralesional steroid injection and was finally treated with a complete resection of the lesion. It is proposed that every patient with a hyperplastic lesion in the ear lobe should be taken a biopsy in order to rule out the possibility of a pseudolymphoma. When a pseudolymphoma develops in the ear lobe, a complete surgical excision could be the treatment of choice, especially for the prevention of recurrence.
Biopsy ; Body Piercing* ; Ear* ; Humans ; Patch Tests ; Pseudolymphoma* ; Recurrence

BACKGROUND: Photodynamic therapy (PDT) using topical aminolevulinic acid (ALA) has increasingly been used for the treatment of acne vulgaris and several studies have shown its clinical efficacy. However, ALA-PDT needs a relatively long incubation period and is frequently associated with adverse effects. Indole-3-acetic acid (IAA) has been introduced as a new photosensitizer for the treatment of acne in recent study. IAA-PDT requires only a short incubation period and the procedure is relatively painless in contrast to ALA-PDT. OBJECTIVE: To investigate the efficacy and safety of IAA- PDT in the treatment of acne. METHODS: Twenty-five patients with facial acne lesions were enrolled in this study. IAA-PDT was performed for five sessions at 1-week intervals (week 0~4). IAA was treated with 15 minute occlusion, and green light was given for 15 minutes. Clinical efficacy was determined by evaluating acne lesion counts, severity grading, and the Dermatology Life Quality Index (DLQI) at week 0, 2, 4, and 5. Sebum secretion and erythema index was measured by Sebumeter and Mexameter, respectively, at baseline and one week after each treatment session (week 1~5). Histopathological examination was performed at baseline and week 5. Adverse effects were recorded throughout the study. RESULTS: All the patients completed the study. Numbers of both inflammatory and non-inflammatory acne lesions were significantly decreased. Acne severity grade and the DLQI showed significant reduction. Sebum secretion and erythema were also reduced. Histopathological examination showed a reduction in inflammatory reactions. No adverse effects were observed except for transient pruritus in one patient. CONCLUSION: PDT using IAA and green light was an effective, simple and safe treatment for acne.
Acne Vulgaris ; Aminolevulinic Acid ; Dermatology ; Erythema ; Humans ; Indoleacetic Acids ; Light ; Photochemotherapy ; Pruritus ; Quality of Life ; Sebum ; Triazenes

BACKGROUND: Trichophyton rubrum is one of the major pathogens causing dermatophytoses on human. The identification of this species by mycological methods are sometimes difficult and time-consuming. Moreover, suitable methods for subtyping of this species are not established yet. OBJECTIVE: This study was performed to identify and subtype T. rubrum by molecular biological methods. METHODS: Total 65 clinical isolates of T. rubrum were included and classified according to the results of 8 mycological tests. Their identification were done by random amplified polymorphic DNA (RAPD) analysis. Subtyping of this species was performed by analyzing the DNA band patterns produced by amplifying the non-transcribed spacer (NTS) area of ribosomal DNA. RESULTS: The 65 strains of T. rubrum could be classified into 5 phenotypic varieties according to the results of mycological tests. All clinical isolates produced identical band pattern with those of standard strains of T. rubrum by RAPD analysis. Amplification of NTS area produced 13 PCR patterns. CONCLUSION: The confirmative identification of T. rubrum could be done by RAPD analysis regardless of their phenotypic variations. Subtyping of T. rubrum was successfully performed by amplifying NTS area but these PCR patterns were not correlated with their phenotypic characteristics.
DNA ; DNA, Ribosomal ; Humans ; Polymerase Chain Reaction ; Tinea ; Trichophyton*

Reconstruction of partial ear defects presents a unique and notable challenge to the dermatologist. This is due to the complex architecture of the external ear which is difficult to duplicate surgically. Several procedures are available for correction of defects to the external ear. However, the diversity of external ear shapes shows how difficult it is to achieve a certain solution to this problem. We report a case of auricular squamous cell carcinoma in which the skin defect is reconstructed by a staged supra-auricular interpolation pedicle flap.
Carcinoma, Squamous Cell ; Ear* ; Ear, External ; Skin

BACKGROUND: Surgery of the nasolabial area is susceptible to the distortion of lips, commissure and nasal ala. A subcutaneous pedicle flap is suitable for surgical treatment of mid-size facial defects. OBJECTIVE: To evaluate the effectiveness of a subcutaneous pedicle flap for surgical defects of the nasolabial area. METHOD: We reviewed the medical records and evaluated clinical aspects and surgical treatment outcomes. RESULTS: Total number of patients was 13, including 8 males and 5 females. Mean age was 67.7years-old. Surgical defects were present on the alar crease in 9 cases, and upper lip in 4 cases. Mean size of defects was 1.6 by 1.3 cm. Flaps were well adopted, and no surgical scars were visible. No distortion of the adjacent structures were left. However, the alar crease was slightly blunted in one patient. CONCLUSION: A subcutaneous pedicle flap is suitable for reconstruction of nasolabial area defects.
Cicatrix ; Female ; Humans ; Lip ; Male ; Medical Records

Many treatments for perianal squamous cell carcinoma in situ have been used. Surgery and cryotherapy, which are known to be the most effective treatment for this disease, may have high risk of cosmetic and functional deformity. We have treated squamous cell carcinoma in situ in renal transplant patient with 5% imiquimod successfully. With the experience of our treatment for squamous cell carcinoma in situ, 5% imiquimod cream can be an alternative treatment option of squamous cell carcinoma in situ of anus.
Anal Canal ; Carcinoma, Squamous Cell* ; Congenital Abnormalities ; Cryotherapy ; Humans

rcinoma (SCC) is the second most common skin cancer. In particular, invasive SCC has a high risk of metastasis and sometimes, this can be fatal. At present, the treatment of choice for invasive SCC is complete excision with a proper surgical margin, but most cases of SCC develop on cosmetically-sensitive areas, so sometimes significant scarring or deformities can lead to an unhappy result. An 80 year-old female presented with a 4x1.5cm sized SCC on her lower lip. Although surgery was the first line therapy for this invasive SCC, a cosmetically poor outcome was expected. Thus the patient did not want to undergo a surgical operation, so we had to explore other treatment options. Recently there have been many reports that show imiquimod 5% cream is effective in the treatment of invasive SCC. Therefore we started topical therapy with imiquimod 5% cream five times a week. After 6 months, the lesion size was reduced to 2x1.5cm and we could remove the remnant tumor by wedge resection with cosmetically acceptable result. We suggest this neo-adjuvant immunotherapy can be an alternative for the treatment of cosmetically-critical SCC and present this case as a good example that has shown successful size-reductive neoadjuvant immunotherapy using imiquimod in invasive SCC.
Aged, 80 and over ; Carcinoma, Squamous Cell* ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Immunotherapy* ; Lip* ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Skin Neoplasms