BACKGROUND: The incidence of skin diseases in the university hospital may not truely indicate their province in the population, nevertheless it offers the only available source of information.Objective and Method: To study the prevalence of common dermatoses and compare this with previous reports, we reviewed 20, 000 new outpatients who visited the Department of Dermatology at Wonju Christian Hospital from 2000 to 2004, and have statistically analyzed the findings. RESULTS: The study results are summarized as follows: 1. Of the 20, 000 outpatients, the total number of male patients was 9, 871 (49.4%), and the numbers of female patients was 10, 129 (50.6%). 2. As for age distribution, the most frequent age group was the first decade (15.3%), fifth decade (15.1%), fourth decade (13.9%) and sixth decade (13.7%), comprising 58% of the total outpatients. 3. The 19 most common dermatoses were found to be dermatophytosis, atopic dermatitis, allergic contact dermatitis, other eczema, urticaria, alopecia, herpes zoster, seborrheic dermatitis, psoriasis, bacterial infection, pruritus, drug eruption, vitiligo, acne, verruca, irritant contact dermatitis, benign epidermal tumors, nevocellular nevus and hyperpigmentary disorders. 4. Those dermatoses which showed a decreasing tendency to be treated by medicine included allergic contact dermatitis, other eczema, bacterial infections, acne, and irritant contact dermatitis. An increasing tendency was noted in dermatophytosis, urticaria, alopecia, herpes zoster, seborrheic dermatitis, psoriasis, pruritus, drug eruption, vitiligo, verruca, benign epidermal tumors and nevocellular nevus. There was no significant annual difference in incidences of hyperpigmentory disorders compared to atopic dermatitis. 5. Diseases with high seasonal distribution in summer were dermatophytosis and verruca. However, atopic dermatitis, alopecia, herpes zoster and pruritus showed high incidence in the winter period. Acne showed a peak incidence in both summer and winter. 6. As for gender distribution, dermatophytosis, alopecia, seborrheic dermatitis, bacterial infection and vitiligo showed a high frequency in males, whereas allergic contact dermatitis, urticaria, herpes zoster, psoriasis, pruritus, drug eruption, acne, epidermal benign tumors, nevocellular nevus and hyperpigmentary disorders showed a high freguency in female. 7. In age distribution, atopic dermatitis, bacterial infection, vitiligo, verruca and nevocellular nevus were found to be the most frequent in the first decade, and acne and alopecia in the second decade. Urticaria and psoriasis were most frequent in the third decade; dermatophytoses, allergic contact dermatitis, irritant contact dermatitis and hyperpigmentary disorders in the fifth decade; other eczema, seborrheic dermatitis and pruritus in the sixth decade; herpes zoster and drug eruption in the seventh decade; and epidermal benign tumors in the eighth decade. 8. In the distribution of dermatoses as disease groups, eczema (25.5%), diseases of the skin appendages (10.8%), dermatophytosis (10.0%), erythema, urticaria and drug eruption(10.2%), viral infections (8.4%), papulosquamous disease (4.1%), and pruritus and neurocutaneous disease (3.9%) constituted 72.5% of the total. CONCLUSION: The distribution of skin disease in our hospital was similar to studies wnducted in other provinces. Comparing the alone results with earlier studies carried out in the same area by Lee (3), Won (2) and Song (1), there was a relatively low incidence of dermatoses caused by animal parasites. However, a predominently high incidence of age related dermatoses was found.
Acne Vulgaris ; Age Distribution ; Alopecia ; Animals ; Bacterial Infections ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Dermatology ; Drug Eruptions ; Eczema ; Epidemiology ; Erythema ; Female ; Gangwon-do ; Herpes Zoster ; Humans ; Incidence ; Male ; Music ; Nevus ; Outpatients ; Parasites ; Prevalence ; Pruritus ; Psoriasis ; Seasons ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Vitiligo ; Warts

Tethered cord syndrome is a kind of spinal dysraphism with low-lying conus frequently associated with intraspinal lipoma, diastematomelia or fibrous band. The clinical manifestations varies from long periods of no overt symptoms to back pain, scoliosis, progressive neurological deficit of legs and incontinence. Therefore the diagnosis requires a strong clinical suspicion and aggressive investigation. It shows various cutaneous manifestations including hyperpigmentation, skin dimple, dermal sinus or hypertrichosis. This 34-year-old female patient has had a lozenge shaped hair tuft with terminal hair on the lumbosacral area since her birth. Her MRI scan showed dermal sinus and a low-lying conus at the lower border of L5. The filum terminale was also thickened. These findings are compatible for tethered cord syndrome.
Adult ; Back Pain ; Cauda Equina ; Conus Snail ; Diagnosis ; Female ; Hair ; Humans ; Hyperpigmentation ; Hypertrichosis ; Leg ; Lipoma ; Magnetic Resonance Imaging ; Neural Tube Defects* ; Parturition ; Scoliosis ; Skin ; Spina Bifida Occulta ; Spinal Dysraphism

The sign of Leser-Trelat refers to the sudden appearance and rapid increase in size and number of seborrheic keratosis. It is considered to be a sign of internal malignant tumors. A 60-year-old male who had received chemotherapy for bladder cancer showed multiple rice to bean-sized dark brownish papules on the scalp and trunk. Skin lesions had suddenly appeared 4 months ago, and he had been diagnosed with transitional cell carcinoma of bladder cancer. The lesions had rapidly increased in number and size. The histopathologic finding of the skin lesions revealed seborrheic keratosis.
Carcinoma, Transitional Cell ; Drug Therapy ; Humans ; Keratosis, Seborrheic ; Male ; Middle Aged ; Scalp ; Skin ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Acupuncture* ; Metals*

A 7 year-old boy visited our hospital with a 2 week history of inflammatory, pustular, tender patches and plaques on the right scalp and face area. He had been treated with topical steroid and antibiotics in a private clinic. In a KOH smear mount, multiple hyphaes and spores appeared on stratum corneum of the outer root sheath layer of his hair. The diagnosis of kerion celsi induced by dermatophytes was made. The patient was treated with oral griseofulvin, and on the 2nd day after starting treatment, multiple erythematous and tendered subcutaneous nodules occurred on his shin. A photosensitive dermatitis like lesion also occurred on his periorbital area. Griseofulvin changed to terbinafine. On the 6th day after treatment, the skin lesions on his face and scalp had improved, as had his shin lesions. The interest of this case lies in the unusual association of kerion and erythema nodosum, of which only eleven cases have been reported in dermatologic literature, and all cases were kerion induced Trichophyton species.
Anti-Bacterial Agents ; Arthrodermataceae ; Child* ; Dermatitis ; Diagnosis ; Erythema Nodosum* ; Erythema* ; Griseofulvin ; Hair ; Humans ; Hyphae ; Male ; Scalp ; Skin ; Spores ; Tinea Capitis* ; Trichophyton

BACKGROUND: Prolonged exposure of topical and systemic corticosteroid to skin can result in well-recognized cutaneous abnormalities including cutaneous atrophy, easy bruisibility, increased skin fragility, and increased risk of infection. Skin barrier impairment is also reported as a steroid-induced side effect. A major function of the skin is the formation of a permeability barrier between the external milieu and the organism. Recent studies have shown that chronic corticosteroid negatively impacts epidermal barrier function. As well as this topical corticosteroid not only has antiproliferative actions but also inhibits the differentiation of the epidermis, resulting in structural defects in the epidermis. OBJECT: We wanted to determine whether high dose systemic steroid injection would display adverse effects, specifically on; epidermal functions, permeability barrier homeostasis and stratum corneum integrity and cohesion. The basis for such changes was also to be determined. MATERIAL AND METHODS: Systemic steroid was administered by injecting each hairless mouse, 8-10 week of age, intraperitoneally with 0.3 mg triamcinolone acetonide, two times per week for five weeks. For the controlled hairless mice, 0.9% normal saline was administered by the same method of injection. Every week, transepidermal water loss (TEWL) was checked and skin biopsies were taken. Skin specimens were prepared for electron microscopy using both 0.25% ruthenium tetroxide and 4% osmium tetroxide postfixation. For light microscopy staining hematoxylin-eosin and ion capture cytochemistry was used. RESULTS: The results were as follows; 1. From about 1 week onwards, high dose systemic steroid usage produced visible cutaneous changes and significantly increased the TEWL in the group of 0.3 mg triamcinolone acetate injected hairless mice compared with the control. 2. Light microscopic observations of the steroid-injected hairless mice showed gradual thinning of the epidermis from about 2 weeks onwards, compared with the control. Loss of stratum corneum was also observed in the steroid injected hairless mice. 3. The ruthenium tetroxide staining of high dose systemic steroid treated specimens revealed that the lipid bilayer was impaired and fragmented from about 3 weeks. Intercellular spaces were widened and the lipid bilayer either disappeared or showed damage when compared with the control. 4. From about 3weeks onwards. electron microscopic studies revealed, not only a marked decrease in the number of lamellar bodies, but also an abnormal transformation of lamellar bodies in the steroid injected hairless mice compared with the control. 5. Throughout the five weeks, the calcium gradient gradually disappeared in the 0.3mg triamcinolone injected hairless mice compared with the control. Consequently, high dose systemic steroid use results in barrier dysfunction and morphological abnormalities.
Animals ; Atrophy ; Biopsy ; Calcium ; Epidermis ; Extracellular Space ; Histocytochemistry ; Homeostasis ; Lipid Bilayers ; Mice ; Mice, Hairless* ; Microscopy ; Microscopy, Electron ; Osmium Tetroxide ; Permeability ; Ruthenium ; Skin* ; Triamcinolone ; Triamcinolone Acetonide

BACKGROUND: The pathogenesis of melasma has not yet been clearly demonstrated. But, clinical manifestations such as remarkable lesional symmetry and the distribution related to trigeminal nerves, suggest that the neural system could play a pathogenic role in melasma. OBJECTIVE: This study was carried out to examine the expression of some neuropeptides and their receptors, which are well known to be major contributors of neuroinflammation in many dermatoses, in melasma lesions. METHODS: Skin biopsies were obtained from the lesional and non-lesional facial skin of 6 Korean women with melasma. Immunofluorecence staining and confocal laser scanning microscopy were performed. RESULTS: In our results, no difference could be detected with regard to the intensity of immunoreactivity for vasoactive intestinal peptide (VIP), calcitonin gene-related peptide (CGRP), calcitonin gene-related peptide receptor (CGRPR), substance P (SP), substance P receptor (SPR), somatostatin (SOM), pituitary adenylate cyclase activating peptide (PACAP) and pituitary adenylate cyclase activating peptide receptor (PACAPR) in the lesional skins compared with the non-lesional skins. CONCLUSION: These results suggest that neuroinflammation induced by neuropeptides such as substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and somatostatin and their receptors included in this study, are not directly associated with melasma pathogenesis.
Adenylyl Cyclases ; Biopsy ; Calcitonin Gene-Related Peptide ; Female ; Humans ; Melanosis ; Microscopy, Confocal ; Neuropeptides ; Receptors, Neurokinin-1 ; Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide ; Skin ; Skin Diseases ; Somatostatin ; Substance P ; Trigeminal Nerve ; Vasoactive Intestinal Peptide

BACKGROUND: Although there are no known gender-related differences in permeability barrier function in adults, estrogen accelerates whereas testosterone retards barrier development in fetal skin. However, there have been few studies concerning the effects of testosterone on the skin barrier. OBJECT: We evaluated the effects and mechanisms of testosterone on the skin barrier. METHODS: In this experiment, hairless mice were divided into three groups; sham-operated, castrated and testosterone-replacement castrated group. Testosterone was administered subcutaneously once a day for 7 days. We performed a skin biopsy at 7 days and performed hematoxyline-eosin staining, calcium-ion capture cytometry and the immunohistochemical examination of involucrin, loricrin, filaggrin and proliferating cell nuclear antigen (PCNA). The specimens were prepared for electron microscopy using RuO4 and OsO4 postfixation. RESULTS: The results were summarized as follows 1. Light microscopic findings of the testosterone-replacement castrated group showed apparent hyperkeratosis and acanthosis, not present in the sham-operated and castrated group. 2. Whereas the expression of involucrin, loricrin and filaggrin of immunohistochemical staining and in situ hybridization of the sham-operated and castrated group were normal, it was abnormal in the testosterone-replacement castrated group. 3. Labelling indices for PCNA in the sham-operated and castrated group were not statistically different, but the testosterone-replacement castrated group showed a marked increase of PCNA labeling index. 4. Wherease the calcium gradient was normal in the sham-operated and castrated group, it was distorted in the testosterone-replacement castrated group. Calcium deposition was increased through all layers of the epidermis and the calcium gradient disappeared in the testosterone-replacement castrated group. 5. Normal looking membrane structure was observed in the sham-operated and castrated group, but a membrane structure which appeared fragmented, incomplete lipid bilayer structures and prominent dilatation of lacunar domains were observed only in the testosterone-replacement castrated group. CONCLUSION: From the above results, it is concluded that there is a functional alteration of the epidermal barrier induced by testosterone, including the formation of an abnormal cornified envelope and also incomplete lipid synthesis.
Adult ; Animals ; Biopsy ; Calcium ; Dilatation ; Epidermis ; Estrogens ; Humans ; In Situ Hybridization ; Lipid Bilayers ; Membranes ; Mice ; Mice, Hairless ; Microscopy, Electron ; Permeability ; Proliferating Cell Nuclear Antigen ; Skin* ; Testosterone*

No abstract available.
Skin*

We report a case of intratumoral fat in neurofibroma and coexistance of eccrine hidrocystoma on the occipital area of the scalp for one year duration. There are several diseases showing fatty change histopathologically. Among them, few cases of neurofibroma showing fatty change had been reported. The mechanism of fatty change is unclear, but several hypotheses are proposed. Here we report a case of neurofibroma showing fatty change and coexistence of eccrine hidrocystoma, and discuss the pathomechanism of fatty change and its relationship with disease.
Hidrocystoma* ; Neurofibroma* ; Scalp