Background/Aims: To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods: This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results: The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

OBJECTIVE: The 2010 New American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for rheumatoid arthritis (RA) was raised to identify patients with early RA and replaced the 1987 ACR classification criteria. The aims of this study are to assess the availability of new classification criteria and to evaluate its potential limitation. METHODS: A total of 408 patients with newly diagnosed RA were included from 13 secondary or tertiary hospitals in South Korea. The symptom duration was less than 12 months before the diagnosis of RA. RA was defined as either 1987 ACR classification criteria or new 2010 ACR/EULAR criteria. We compared the full details of both classification criteria. RESULTS: The mean symptom duration was 5.1 months. The majority (76.2%) of the patients were female. Two hundred and seventy three patients (66.9%) fulfilled both of the 2010 and 1987 classification criteria. Forty-seven (14.7%) of the 320 patients fulfilling the 1987 criteria did not fulfill the new classification criteria. On the other hand, eighty-eight (24.4%) of the 361 patients fulfilling the 2010 ACR/EULAR classification criteria did not fulfill the 1987 ACR criteria. Thirty-six (55.4%) of the 65 patient with seronegative RA failed to meet the 2010 classification criteria. In case of seropositive RA (n=343), 85 additional patients (24.8%) could be diagnosed as RA using new classification criteria. CONCLUSION: The new 2010 ACR/EULAR classification criteria enable physicians to diagnose more patients with early RA via the help of serology. However, the sensitivity for the diagnosis of seronegative RA is projected to decrease.
Arthritis, Rheumatoid ; Female ; Hand ; Humans ; Republic of Korea ; Rheumatic Diseases ; Tertiary Care Centers

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.
Dermatitis, Atopic ; Erythema ; Humans ; Light ; Pruritus ; Salicylamides ; Skin ; Weights and Measures

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.
Dermatitis, Atopic ; Erythema ; Humans ; Light ; Pruritus ; Salicylamides ; Skin ; Weights and Measures

BACKGROUND: Atopic dermatitis is a chronic inflammatory skin disease. It is caused by immunological abnormalities, abnormalities of the skin barrier, environmental factors and genetic factors. Atopic dermatitis destroys the skin barrier and passes through the skin, triggering an immune response. To treat atopic dermatitis, we anticipate use of hypoallergenic cures to hydrate skin that has been dried by destruction of the skin barrier. OBJECTIVE: We did a preclinical trial to identify inhibitory effects of the StoneTouch(R) infrared scanner on atopic dermatitis. We conducted skin safety tests, comparing the use of infrared energy to drug treatment. We then confirmed the effects of the StoneTouch(R) infrared scanner through animal tests using Nc/Nga mice as a model of atopic dermatitis in order to identify any inhibition of the immune response in atopic dermatitis. METHODS: We irradiated Nc/Nga mice using a StoneTouch(R) infrared scanner under a variety of conditions. During skin safety tests of the StoneTouch(R) infrared scanner on hairless mice, we assessed immune response and burn risk in irradiated mouse skin. We identified any inhibitory effects on atopic dermatitis using Dermoscope assessments, measurements of transepidermal water loss (TEWL) and IgE levels, measurements of pro-inflammatory cytokines, H&E staining and immunofluorescence staining (IF) of substance P and CGRP as neurotransmitters on the backs and ears of Nc/Nga mice irradiated by the StoneTouch(R) infrared scanner. RESULTS: We did not observe any skin abnormalities after using the StoneTouch(R) infrared scanner on Nc/Nga mice. We confirmed the inhibitory effect of the StoneTouch(R) infrared scanner irradiation on atopic dermatitis. We found that irradiated epidermis was thinner than that of the epidermis in Nc/Nga mice in which atopic dermatitis was induced. We observed no significant between groups differences in expression level of substance P. The expression of CGRP in mice with atopic dermatitis was decreased, but, the increased irradiation led to greater expression of CGRP in irradiated skin. CONCLUSION: The StoneTouch(R) infrared scanner does not as a function of irradiation dosage. It inhibits the development of atopic dermatitis.
Animals ; Burns ; Cytokines ; Dermatitis, Atopic ; Ear ; Epidermis ; Fluorescent Antibody Technique ; Immunoglobulin E ; Mice ; Mice, Hairless ; Neurotransmitter Agents ; Skin ; Skin Abnormalities ; Skin Diseases ; Substance P

BACKGROUND: Inflammatory response on LPS and IFN-gamma induced Macrophage Raw 264.7 cells was secreted NO (nitric oxide) and PGE2 (prostaglandin E2) though expression of iNOS and COX-2. And many pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6 etc.) was secreted on LPS and IFN-gamma induced Macrophage Raw 264.7 cells, too. Atopy dermatitis was inflammatory skin disease with pruritus, xeroderma and specific eczema. OBJECTIVE: We sought to effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. METHODS: The immune response of Raw 264.7 cells were induced by LPS and IFN-gamma. Then LPS and IFN-gamma induced Raw 264.7 cells was measured NO, PGE2 production after treatment of different concentrations for AF-343. The related genes (iNOS, COX-2) for NO, PGE2 production were detected using Western blot in LPS and IFN-gamma induced Raw 264.7 cells after treatment of different concentrations for AF-343. Pro-inflammatory cytokines were detected, too. NC/Nga mice as Atopy dermatitis model was induced atopy dermatitis. Then NC/Nga mice with atopy dermatitis were performed oral administration of AF-343 for 1weeks. After oral administration of AF-343, TEWL was measured on skin tissues of NC/Nga mice with atopy dermatitis according to whether were performed oral administration of AF-343 or not. And pro-inflammatory cytokines and IgE was measured in serum, protein of skin tissues of NC/Nga mice. Skin tissues of NC/Nga mice were performed H&E staining, immunohistochemical staining for PCNA, Involucrin and filaggrin. RESULTS: LPS and IFN-gamma induced Raw 264.7 cells was decreased NO, PGE2 production in dose-dependent after treatment of different concentrations for AF-343. The expression level of iNOS, COX-2 protein was decreased in dose-dependent, too. The related pro-inflammatory cytokines in media with LPS and IFN-gamma induced Raw 264.7 cells were decreased after treatment of different concentrations for AF-343. TEWL level of NC/Nga mice skin (back, ear) with atopy dermatitis according to whether were performed oral administration of AF-343 or not was decreased in NC/Nga mice with atopy dermatitis group was performed oral administration by AF-343. When NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343, induced pro-inflammatory cytokines and IgE expression in serum, protein of back, ear skin tissues of each NC/Nga mice group was decreased. H&E stained Skin tissues of NC/Nga mice was confirmed that thickness of epidermis, dermis were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis. The expression of PCNA, involucrin and filaggrin were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis as results of immunihistochemical staining using specific antibodies such as PCNA as cell proliferation marker, involucrin and filaggrin as keratinocytes differentiation markers for skin tissues (back, ear) of NC/Nga mice. CONCLUSION: We confirmed effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. In conclusion, AF-343 is expecting as therapeutics for atopic dermatitis.
Administration, Oral ; Animals ; Antibodies ; Antigens, Differentiation ; Blotting, Western ; Cell Proliferation ; Cytokines ; Dermatitis ; Dermatitis, Atopic ; Dermis ; Dinoprostone ; Ear ; Eczema ; Epidermis ; Ichthyosis ; Immunoglobulin E ; Inflammation ; Interleukin-6 ; Intermediate Filament Proteins ; Keratinocytes ; Macrophages ; Mice ; Proliferating Cell Nuclear Antigen ; Protein Precursors ; Pruritus ; Skin ; Skin Diseases ; Taraxacum

BACKGROUND: Dermatological diseases can occur with atopic dermatitis. OBJECTIVE: The purpose of this study was to analyze diseases associated with atopic dermatitis in Koreans. METHODS: From November, 2007, to May, 2008, 948 patients with atopic dermatitis who visited the department of dermatology at 19 hospitals were evaluated for associated diseases. RESULTS: Of 948 patients, 53.8% (510) had symptoms associated with other dermatological diseases. In order of frequency, diseases associated with atopic dermatitis included acne, hand/foot eczema, seborrheic dermatitis, urticaria, warts, and recurrent herpes simplex. The number of associated diseases did not change significantly with the severity of atopic dermatitis. However, the incidence of hand/foot eczema and eczema herpeticum correlated significantly with the severity of atopic dermatitis. CONCLUSION: There is a distinct pattern of diseases associated with atopic dermatitis in Koreans.
Acne Vulgaris ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Dermatology ; Eczema ; Herpes Simplex ; Humans ; Incidence ; Kaposi Varicelliform Eruption ; Methylmethacrylates ; Polystyrenes ; Urticaria ; Warts

Sphingosine 1-phosphate (S1P) is a bioactive lipid molecule that mediates cell proliferation, differentiation, migration, and angiogenesis in vivo. However, the roles of S1P on pathogenesis of arthritis have been not completely understood. This study was designed to determine the effects of S1P modulation on collageninduced arthritis (CIA) model. DBA/1J mice were injected with collagen into the tail for induction of CIA model. S1P was administered into the peritoneal cavity every other days from day 1 to day 42 after collagen injection. To determine the degree of damage in CIA, we examined macroscopic findings of CIA. The inflammation and bone destruction of CIA mice were evaluated by histo-patholigy and radiography (CT and microradiography). The expressions of TNF-alpha, IL-6, and RANKL which have important roles in pathogenesis of rheumatoid arthritis and bone destruction were observed by immuno-histochemical staining. After injection with collagen in the DBA/1J mice, CIA was induced by swelling in the knee and ankle joint. Administration of S1P suppressed damages and incidence of arthritis elicited by collagen. In histologic and radiographic studies, S1P strongly suppressed the infiltration of inflammatory cells, the swelling of synovial membrane, erosion, and the destruction of bone on CIA mice. Injection of S1P resulted in down-regulation of the expression of the pro-inflammatory and bone destruction mediators such as TNF-alpha, IL-6, and RANKL on CIA mice. Furthermore, S1P suppressed the differentiation of bone marrow cells into osteoclasts by RANKL. In conclusion, this study suggest that S1P has protective effects on inflammation and bone destruction during pathogenesis of CIA, which indicates S1P can be a new possible therapeutic strategy for rheumatoid arthritis
Animals ; Ankle Joint ; Arthritis ; Arthritis, Rheumatoid* ; Bone Marrow Cells ; Cell Proliferation ; Collagen ; Down-Regulation ; Incidence ; Inflammation* ; Interleukin-6 ; Knee ; Mice* ; Osteoclasts ; Peritoneal Cavity ; Radiography ; Sphingosine ; Synovial Membrane ; Tail ; Tumor Necrosis Factor-alpha

The skin over the nose is less mobile for primary closure of defects. In addition to skin graft and secondary intention healing, there are various local flap techniques and their modifications for the reconstruction of nasal defects. Imprecise engineering of wound repair methods and contracture can lead to twisting of the nose and distortion of surrounding anatomic structures such as the nasal ala and paranasal sulcus. The skin defects on the nasal dorsum were reconstructed with a modified bilateral rombic flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that the modified bilateral rhombic flap can reconstruct defects on the center area of the nasal dorsum effectively and in a single stage.
Contracture ; Intention ; Nose ; Skin ; Transplants ; Wounds and Injuries

BACKGROUND: Pitted keratolysis is a superficial bacterial infection which usually affects the pressure bearing areas of the feet. Some bacterial organisms were identified as etiologic agents, including Corynebacterium species, Micrococcus species and Dermatophilus congolensis. However, in Korea, studies to prove the causative organisms have not been performed. OBJECTIVE: We performed this study to identify causative organisms of pitted keratolysis in Korea. METHOD: Twelve normal healthy men and 27 pitted keratolysis patients were enrolled. We cultured the scraped specimens of the stratum corneum and identified the cultured organisms. We compared the cultured organisms of pitted keratolysis group with those of control group. We also compared the distribution of cultured organisms in pitted keratolysis with and without tinea pedis. RESULT: Micrococcus species and Corynebacterium species were identified in pitted keratolysis group much more frequently than in normal control group. In most cases of pitted keratolysis combined with tinea pedis, the identified organisms were Micrococcus species. CONCLUSION: Micrococcus species and Corynebacterium species are thought to be the major causative organisms of pitted keratolysis in Korea. Micrococcus species might play a certain antagonistic role, especially in patients of pitted keratolysis with tinea pedis.
Bacterial Infections ; Corynebacterium ; Foot ; Humans ; Korea ; Male ; Micrococcus ; Tinea Pedis