No abstract available.
Bowen's Disease ; Fingers

Advertising as Topic ; Health Knowledge, Attitudes, Practice ; Health Promotion ; Humans ; Singapore ; Smoking Cessation ; methods ; Smoking Prevention ; Social Marketing ; Television

Breast feeding can play a very important role in the development of strong, healthy children. Many studies over the years have shown that breast milk provides defense against common ailments of childhood such as otitis media, gastrointestinal distress, and atopic diseases (allergies). For these reasons the American Academy of Pediatrics recommends breast feeding for at least the first twelve months of an infant's life. Goals of the Health People 2010 Initiative include that at least 75% of mothers will be breast feeding upon discharge from the hospital and at least 50% will be still nursing at six months post-partum. Currently, about 60% of new mothers initiate breast feeding and about 26% are still breast feeding at six months. However, research has shown that breast feeding trends are below these averages in rural areas of the United States. This may be due in part to lack of breast feeding knowledge and teaching in rural areas. Rural hospitals and birthing centers have not initiated many of the breast feeding promotional programs, such as the Baby Friendly Hospital Initiative and Best Start, that have been successful in improving breast feeding trends in urban areas. Often new mothers who live in rural areas do not have access to a lactation consultant to help them with proper follow up. This paper will examine these concerns and propose recommendations to improve breast feeding in rural areas.
Americas* ; Birthing Centers ; Breast Feeding* ; Breast* ; Child ; Consultants ; Female ; Follow-Up Studies ; Hospitals, Rural ; Humans ; Lactation ; Milk, Human ; Mothers ; Nursing ; Otitis Media ; Pediatrics ; United States

BACKGROUND: Cutaneous adverse reactions are often observed during chemotherapy with epidermal growth factor receptor (EGFR) inhibitors including papulopustular eruptions, xerosis and paronychia. OBJECTIVE: To investigate and compare the cutaneous adverse reactions induced by EGFR inhibitors including erlotinib, gefitinib and cetuximab which have commonly been used as chemotherapeutic agents in Korea. METHODS: We reviewed cutaneous adverse effects through the medical records and clinical photographs of 43 Korean patients who had been treated with erlotinib, gefitinib or cetuximab at Pusan Paik Hospital between June 2003 and January 2010. RESULTS: Papulopustular eruptions occurred in 28 patients (65.1%); they were easily controlled by topical benzoyl peroxide, clindamycin and a retinoid, or by oral minocycline and tetracycline. There were no significant differences in incidence, duration and severity grades of papulopustular eruptions among EGFR inhibitors. In contrast to previous studies, the frequency and severity of papulopustular eruptions were not significantly correlated with treatment responses to EGFR inhibitors. Xerosis appeared in 14 patients (41%), and was easily controlled by topical emollients and steroids, and by systemic steroids and antihistamines. Paronychia occurred in 8 patients (18.6%) and were controlled by conservative treatments. CONCLUSION: Papulopustular eruptions, xerosis and paronychia are common cutaneous adverse reactions associated with EGFR inhibitors and there are no significant differences in adverse cutaneous reactions among EGFR inhibitors. As these cutaneous adverse reactions are relatively easily controlled with treatment, it will be helpful to detect and treat these adverse reactions early, including reassuring the patients, which should increase compliance of patients during treatment with EGFR inhibitors.
Antibodies, Monoclonal, Humanized ; Benzoyl Peroxide ; Clindamycin ; Compliance ; Emollients ; Epidermal Growth Factor ; Histamine Antagonists ; Humans ; Incidence ; Medical Records ; Minocycline ; Paronychia ; Quinazolines ; Receptor, Epidermal Growth Factor ; Steroids ; Tetracycline ; Cetuximab ; Erlotinib Hydrochloride

Methotrexate (MTX) is an antimetabolite which interferes with DNA synthesis, and it is used for the treatment of moderate to severe psoriasis, atopic dermatitis and a wide variety of cutaneous diseases. Although many adverse effects of MTX, including cutaneous ulcerations, have been documented, multifocal mucosal ulceration mimicking Behcet's disease has not been reported. In our case, a 63-year-old female presented with oral, vaginal ulcer and multiple purpuric patches on both legs. Considering patient's clinical course and histopathologic findings, we presumed that these reactions may be the side effect of MTX administered for treatment of necrotizing scleritis. Herein we report the cutaneous side effect of MTX that manifested clinically like Behcet's disease.
Dermatitis, Atopic ; DNA ; Female ; Humans ; Leg ; Methotrexate ; Middle Aged ; Psoriasis ; Scleritis ; Ulcer

Lichen planus pigmentosus (LPP) is chronic pigmentary disorder that shows diffuse or reticulated hyperpigmented, dark brown macules on the sun-exposed areas such as the face, neck and other flexural folds. Clinically, it is different from classical lichen planus because LPP has a longer clinical course and it manifests with dark brown macules. In case of LPP, involvement of the scalp, nail or mucosal area is rare. The histopathological findings of the lesions show an atrophic epidermis, the presence of melanophages and a vacuolar alteration of the basal cell layer with a sparse lymphohistiocytic lichenoid infiltration. Although there have been a few reports of LPP, there have only 3 cases of linear LPP along the lines of Blaschko in the Korean dermatologic literature. Our patient had lesions on the neck and chin with a linear pattern. In this report, we describe a very rare case of LPP with a linear distribution related to Blaschko's lines on the neck and chin areas.
Chin ; Epidermis ; Humans ; Lichen Planus ; Lichens ; Nails ; Neck ; Scalp

BACKGROUND: Pressure alopecia is the loss of hair following a prolonged immobilization, probably due to pressure-induced local ischemia. It is most commonly observed after surgical procedures under general anesthesia. Most of the studies or reports of pressure alopecia deal with postoperative cases. OBJECTIVE: This study was undertaken to investigate and understand the clinical manifestations, course and histopathological characteristics of pressure alopecia in various circumstances. METHOD: 27 patients with pressure alopecia, who had visited the Department of Dermatology at Busan Paik Hospital between 1998 and 2004, were examined clinically and histopathologically. RESULTS: The ratio of males to females was 4: 5, and the mean age of patients was 36+/-22 years. The cause of pressure alopecia were classified into 5 groups: open heart surgery, craniectomy, other surgeries, long-term bed rest, and the miscellaneous causes including wearing of hair prosthesis and group punishment. The most commonly involved site was the occipito-parietal area. Histopathological examination showed upper dermal edema and fibrosis, follicular fibrosis, melanin pigments, hair follicles in telogen and catagen stages, perifollicular lymphocytic infiltration and vascular change. The mean operation time was 8.1+/-7.2 hours in the patients with temporary alopecia and 17.8+/-7.6 hours in those with permanent alopecia. The mean operation time of the patients with temporary alopecia was shorter than those with permanent alopecia (p<0.05). CONCLUSION: This study revealed several causative factors of pressure alopecia including surgery, long-term bed rest, and miscellaneous causes. Therefore, close observation of the pressure site and changing the position of the patient's head at regular intervals are essential during the various surgical and nonsurgical treatments to prevent pressure alopecia.
Alopecia* ; Anesthesia, General ; Bed Rest ; Busan ; Dermatology ; Edema ; Female ; Fibrosis ; Hair ; Hair Follicle ; Head ; Humans ; Immobilization ; Ischemia ; Male ; Melanins ; Prostheses and Implants ; Punishment ; Thoracic Surgery

Allergic reaction to different fruits and vegetables has frequently been described, but an allergic reaction to mango fruit, including its sap, pericarp, stems and leaves, has rarely reported in the literature. Mango dermatitis, although not common, is the term for allergic contact dermatitis caused by mango. The Mango plant is found worldwide, and the plant shares chemical compounds that are similar to other substances of the Anacardiaceae plant. The substances uroshiol and cardol cause the allergic contact dermatitis. Any case of allergic contact dermatitis with eating mango fruit has not been reported in the Korean dermatologic literature. Here we report the first case of mango contact dermatitis in a 20-years-old female and this happened when she drank mango juice.
Anacardiaceae ; Bandages ; Bandages, Hydrocolloid ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Eating ; Female ; Fruit ; Humans ; Hypersensitivity ; Mangifera ; Plants ; Resorcinols ; Vegetables

BACKGROUND: Pruritic urticarial papules and plaques of pregnancy is a common benign dermatosis of pregnancy. It occurs mainly in primigravidas in the third trimester, it resolves spontaneously or with delivery, and it is usually responsive to topical treatment. The morphological spectrum of pruritic urticarial papules and plaques of pregnancy includes (1) urticarial papules and plaque (type I), (2) non-urticarial erythematous patches that are discrete or confluent and they are surrounded by tiny papules or vesicles, or clusters or sheets of 1-mm to 2-mm erythematous papules (type II) and (3) a combination of these features (type III). OBJECTIVE: This study evaluated our clinical experience with 22 Korean patients with pruritic urticarial papules and plaques of pregnancy. METHODS: From June 1997 to August 2008, 22 patients with pruritic urticarial papules and plaques of pregnancy were evaluated. The clinical manifestations, the lesion distribution and the obstetric and pediatric findings were retrospectively investigated with using the patients' medical records and clinical photographs. RESULTS: There were 9, 11 and 2 patients with types I to III, respectively. Many patients (n=14) were primigravida and the mean time of onset was a gestational age of 29.8 weeks. There were no pediatric problems such as intra-uterine growth retardation, or a small or large size for the gestational age.Most of the patients (n=20) were treated with topical corticosteroid or antihistamine; there was one case of recurrent pruritic urticarial papules and plaques of pregnancy. CONCLUSION: Pruritic urticarial papules and plaques of pregnancy usually occur in primigravidas, but this can also occur in multigravida patients. The number of patients with pruritic urticarial papules and plaques of pregnancy and who had obstetric obesity, a multiple pregnancy or pregnancy-induced hypertension was fewer than we expected. Pruritic urticarial papules and plaques of pregnancy can be divided into three categories, although this is rather redundant because the disease prognosis and treatments are not different according to the type.
Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Medical Records ; Obesity ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, Third ; Pregnancy, Multiple ; Prognosis ; Pruritus ; Retrospective Studies ; Skin Diseases

Pseudoxanthoma elasticum is a rare, heritable disorder of elastic fibers characterized by yellowish, coalescing papules on the loose and wrinkled flexural skin. An 18-year-old man presented cutis laxa-like marked wrinkling on the axillae, trunk and thighs for about 10 years. There was no similar skin lesion on his family members and no other systemic involvement was found. Histopathological examination of the abdomen revealed fragmentation and calcification of elastic fibers in the middle and lower dermis. Von Kossa staining showed calcium deposition along the altered elastic fibers. Herein, we report a rare case of autosomal recessive pseudoxanthoma elasticum presenting generalized cutaneous laxity.
Abdomen ; Adolescent ; Axilla ; Calcium ; Dermis ; Elastic Tissue ; Humans ; Pseudoxanthoma Elasticum* ; Skin ; Thigh