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

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*

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

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

No abstract available.
Acupuncture* ; Metals*

BACKGROUND: Cold is considered an important environmental factor on the skin's barrier function. It is also known that cold can disrupt the barrier's permeability function. Historically irritant contact dermatitis develops frequently amongst fish processing workers. This means that cold may disrupt the skin barrier function. However, there are only a few studies of the effect of cold on the skin barrier. OBJECTIVE: The aim of our study was to investigate the effects of exposure to the cold on the skin's barrier permeability, calcium gradient and cornified enveloped proteins. METHODS: Hairless mice were classified into four groups as follows; tape-stripping and exposure to cold (4degrees C) for 5 hours group (Group 1), exposure to cold (4degrees C) for 5 hours after tape-stripping and occlusion with Gore-Tex group (Group 2), exposure to cold (4degrees C) for 5 hours after tape-stripping and applying with petrolatum group (Group 3), and tape-stripping and exposure at room temperature (25degrees C) for 5 hours group (Group 4). Next, rate of barrier recovery was measured, and skin of cold exposure site was taken for immunohistochemistry of cornified enveloped protein, calcium inon capture chemistry and in situ hybridization. RESULTS: Rate of barrier recovery of Group 1 was measured at -56.33%, the most delayed rate of all groups. Rate of barrier recovery of other groups were measured as follows; Group 2 (20%), Group 3 (55%) and Group 4 (41.78%). In calcium-ion capture cytochemistry, Group 1 appeared to absent calcium deposit in the entire epidermis. Group 3 appeared to the highest density of calcium in entire epidermis. In immunohistochemical staining of cornified enveloped proteins including involucrin, loricrin and filaggrin, Group 1 resulted in the lowest expression of cornified enveloped proteins. Of all groups, Group 3 appeared to have the highest expressionof cornified enveloped proteins. In situ hybridization of loricrin and filaggrin, expression were similar with results of immunohistochemical staining. CONCLUSION: Our results provide that cold impairs the skin's barrier permeability by having a negative effect on recovery of calcium gradient and differentiation of cornifed enveloped proteins. But occlusion with vapor permeable membranes such as Gore-Tex or petrolatum could improve conditions of skin barrier impaired by cold by restoring the recovery rate of calcium gradient and differentiation of cornified enveloped protein.
Animals ; Calcium ; Cold Temperature ; Dermatitis, Contact ; Epidermis ; Histocytochemistry ; Immunohistochemistry ; In Situ Hybridization ; Intermediate Filament Proteins ; Membrane Proteins ; Membranes ; Mice ; Mice, Hairless ; Permeability ; Petrolatum ; Polytetrafluoroethylene ; Protein Precursors ; Proteins ; Skin

BACKGROUND: Laser treatment in melasma has previously failed because of the resulting inflammation and consequent pigmentation and excessive thermal damage caused by the use of high fluence. OBJECTIVE: This study is aimed at establishing the concept of the collimated low fluence Q-switched Nd : YAG laser as a treatment for melasma by investigating its therapeutic effects clinically as well as histopathologically. METHODS: 27 patients were treated weekly with Q-switched Nd : YAG laser (1,064 nm wavelength, 7 mm spot size, 1.6~2.5 J/cm2 fluence) for 8 weeks. The results were evaluated based on standardized clinical images that used Robo skin analyzer, spectrophotometer, MASI score and general severity. RESULTS: 17 (58.8%) patients showed "GOOD" (50~75% improvement) and no case of full recurrence was examined and partial recurrence was detected in 12/17 patients. Common adverse effects include pain, erythema, and temporary edema. Rarely partial hypopigmented macules and diffuse hyperpigmentation appeared. Additional studies, such as immunohistochemical examination and electron microscopic examination, are also currently in progress. CONCLUSION: The collimated low fluence Q-switched Nd : YAG Laser is effective in melasma treatment. This treatment method is a new concept that can be described as selective photothermolysis with minimal thermal damage and inflammation reaction to affected tissues by pigmentation. We consider this treatment method should be regarded as Minimized Selective Photothermolysis (MSP) that will provide a new effective treatment for melasma.
Edema ; Electrons ; Erythema ; Humans ; Hyperpigmentation ; Inflammation ; Lasers, Solid-State ; Melanosis ; Pigmentation ; Recurrence ; Skin

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

A 9-year-old girl presented with fever, conjunctival injection, desquamation following erythema and edema of the fingers and toes, strawberry tongue, polymorphous rash and cervical lymphadenopathy. She showed palpable purpura on the lower extremities after 7 days of the onset of the above symptoms. She showed typical Henoch-Schonlein purpura concurrent with Kawasaki disease. There is no known report of a case of Henoch-Schonlein purpura concurrent with Kawasaki disease and evaluation of the same pathogenesis of the two diseases. We've got a clue from the facts that human parvovirus B19 could develope both of the diseases. But Human parvovirus B19 PCR was negative. We, herein, report an unusual case of Henoch-Schonlein purpura concurrent with Kawasaki disease.
Child ; Edema ; Erythema ; Exanthema ; Female ; Fever ; Fingers ; Fragaria ; Humans ; Lower Extremity ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome* ; Parvovirus B19, Human ; Polymerase Chain Reaction ; Purpura ; Purpura, Schoenlein-Henoch* ; Toes ; Tongue

Dermatofibroma is a small, firm, red to purple-brown colored dome-shaped or flat papule or nodule, occurring more commonly in women. Majority of dermatofibromas are solitary, but multiple lesions can sometimes occur. The etiology is unclear, but an association with various immunosuppressed conditions has been proposed. We report a case of multiple eruptive dermatofibromas on the lower extremities in a patient with AIDS.
Female ; Histiocytoma, Benign Fibrous* ; Humans ; Lower Extremity