No abstract available.
Thyroid Gland* ; Thyroid Nodule*

No abstract available.
Cutaneous Fistula ; Fistula*

BACKGROUND: Diphencyclopropenone (DPCP) has recently been reported to be a potent contact sensitizer in the treatment of alopecia areata. However, the concentration for sensitization and optimal treatment method has not been standardized. In addition, highly variable results of DPCP use have been reported to date. OBJECTIVE: The purpose of our study was to find the optimal concentration for sensitization and to evaluate efficacy, prognostic factors and side effects of DPCP in the treatment of AA. METHODS: A total of 33 healthy people were enrolled in an open-label clinical trial to ascertain the concentration of DPCP needed for sensitization. The patients were sensitized with 0.1%, 0.5%, 1.0%, 1.5% of DPCP on a 2 cm2 area of each extremity (both arms and legs). We also reviewed the medical records of 48 alopecia areata patients who had been treated with DPCP. We evaluated both therapeutic efficacy and prognostic factors influencing the therapeutic effect of DPCP immunotherapy. RESULTS: Sensitization of 1.0% DPCP in 91% of patients. This concentration showed a higher sensitization rate than 0.5% DPCP, but a lower irritation rate than 1.5% DPCP. 56.3% (27/48) of patients showed terminal hair growth and 33.3% (16/48) completely responded with a cosmetically-acceptable result. The prognostic factor which influenced the result of therapy was the extent of alopecia areata. CONCLUSION: Topical DPCP treatment for alopecia is quite effective and well-tolerated. This therapy also provides safe therapeutic benefits if it is carried out with the correct sensitization concentration and treatment procedure.
Alopecia Areata* ; Alopecia* ; Arm ; Extremities ; Hair ; Humans ; Immunotherapy ; Medical Records

BACKGROUND: Acute diffuse alopecia areata (AA) was described as a unique AA which mimics anagen effluvium, or in which the initial hair loss is diffuse and followed by total denudation of scalp within several weeks or months. In spite of its peculiar clinical feature, there was neither further characterization nor known effective treatment for this form of AA. OBJECTIVE: To evaluate the characteristic clinical findings of acute diffuse AA and confirm the effect of high dose methyl prednisolone therapy. METHODS: The medical records of 13 patients with acute diffuse AA between January 2002 and April 2006 at the Department of Dermatology, Chungnam National University Hospital were reviewed. All patients were treated with high dose methylprednisolone therapy. RESULTS: Of the 13 patients who completed the study, 8 patients (61.5%) were male and 5 patients (38.5%) were female. The mean age was 29.6 years old. The progress of hair loss stopped 2.4 weeks on average after initial treatment and newly emerging hairs were recognized 4.1 weeks on average after initial treatment. 84.6% (11/13) of patients showed terminal hair growth, and 46.2% (6/13) of patients completely responded to this therapy. CONCLUSION: Acute diffuse alopecia areata can occur in male as well as in female patients. High dose methylprednisolone therapy appears to be effective in patients with rapidly progressing acute diffuse alopecia areata to prevent the progression of the disease.
Alopecia Areata* ; Alopecia* ; Chungcheongnam-do ; Dermatology ; Female ; Hair ; Humans ; Male ; Medical Records ; Methylprednisolone ; Prednisolone ; Scalp

BACKGROUND: The clinical presentation of lichen planus varies depending on the area involved. It occurs in less than 1% of the world's population: also, the prevalence in Korea is relatively low. However, the number of our outpatients has been increasing rapidly. OBJECTIVE: We studied the clinical characteristics of 100 patients with biopsy proven lichen planus. METHODS: We reviewed the medical records and clinical photographs of 100 patients who had been diagnosed with lichen planus during the last 10 years, from January 2002 to December 2011. RESULTS: Over the past 10 years, patients with Lichen Planus accounted for 0.196% among the new outpatients of this dermatology. The rate of Lichen Planus increased when it occurred on the skin, except for the Mucosal area. Of the 100 outpatients, 62% were men and 38% were women. The mean age at diagnosis was 54 years, and more than half of the patients were between 40 and 60 years of age. The most common site of lichen planus was the lip, which was found in 44% of the patients. Oral lesions were the second most commonly involved site at 28%, followed by the body at 20% and the genital area at 8%. The patients complained of various symptoms such as pain, burning sensation, pruritus, and irritation. Various treatments had been tried by all patients. CONCLUSION: This study of domestic patients with Lichen Planus is the biggest clinical research performed at a single center. The clinical features of patients in this survey share many similarities with those reported previously, but showed some differences too.
Biopsy ; Burns ; Dermatology ; Female ; Humans ; Korea ; Lichen Planus ; Lichens ; Lip ; Male ; Medical Records ; Outpatients ; Prevalence ; Pruritus ; Sensation ; Skin

Nail psoriasis is a common finding in psoriatic patients and is associated with substantial adverse effects on the patient's quality of life. Although several treatment options are available, nail psoriasis tends to be persistent and refractory to therapy. Pulse dye laser (PDL) has been demonstrated to be effective for plaque-type psoriasis, but there are no reports on nail psoriasis being successfully treated with PDL in the Korean literature. We here report on a 46-year-old woman presenting with nail psoriasis recalcitrant to conventional treatment modalities, showing pitting, nail bed discoloration, and crumbling. We successfully treated the symptoms with 595 nm PDL, supporting the hypothesis that PDL may be a safe and effective therapeutic option in patients with recalcitrant nail psoriasis.
Female ; Humans ; Lasers, Dye* ; Middle Aged ; Psoriasis* ; Quality of Life

PURPOSE: Human bronchial smooth muscle cell(HBSMC) plays an important role in the remodeling of the airways in asthma. Vascular endothelial growth factor(VEGF) is a multifunctional cytokine, which induces edema, angiogenesis, vascular remodeling, mucus metaplasia, subepithelial fibrosis, and antigen-induced Th2 inflammation. Transforming growth factor-beta(TGF-beta) is a growth modulator of HBSMC and an important cytokine in airway remodeling. We investigated the effect of dexamethasone on the release of VEGF from HBSMC stimulated with platelet-derived growth factor(PDGF) and TGF-beta. METHODS: HBSMC cultured in 10 percent FCS-DMEM media was growth-arrested in serum-deprived medium for 48 hours. Dexamethasone and TGF-beta were added and incubated for 16 hours before stimulation with PDGF. After 24 hours of stimulation, culture medium was harvested and stored at -80 degrees C until ELISA for VEGF was performed. RESULTS: The release of VEGF was significantly increased after stimulation with PDGF (P<0.01). The production of VEGF pretreated with TGF-beta before stimulation with PDGF was higher than those without TGF-beta pretreatment(P<0.01). Dexamethasone suppressed the release of VEGF in HBSMC stimulated with PDGF(P<0.01), TGF-beta and PDGF(P<0.01). CONCLUSION: PDGF and TGF-beta may be one of the key mediators in inducing airway remodeling and glucocorticoid, and can be used as useful therapies to prevent airway vascular remodeling by modulating the VEGF on airway smooth muscle cells.
Airway Remodeling ; Asthma ; Dexamethasone* ; Edema ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Humans* ; Inflammation ; Metaplasia ; Mucus ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Transforming Growth Factor beta ; Vascular Endothelial Growth Factor A*

BACKGROUND: Keratinocytes are the major cells in epidermis, providing barrier components such as cornified cells through the sophisticated differentiation process. In addition, keratinocytes exerts their role as the defense cells via activation of innate immunity. It has been known that pathogen-associated molecular patterns (PAMPs) including double-strand RNA and nucleotides can provoke inflammatory reaction in keratinocytes. OBJECTIVE: The aim of this study is to evaluate the effect of Ampelopsis japonica Makino extract (AE) on PAMPs-induced inflammatory reaction of keratinocytes. METHODS: The effects of AE were determined using poly (I:C)-induced inflammation and imiquimod-induced psoriasiform dermatitis models. RESULTS: In cultured keratinocytes, AE significantly inhibited poly(I:C)-induced expression of inflammatory cytokines, such as interleukin (IL)-1β, IL-6, IL-8 and tumor necrosis factor-α. AE significantly inhibited poly(I:C)-induced release of caspase-1 active form (p20), and down-regulated nuclear factor-κB signaling pathway. In imiquimod-induced psoriasiform dermatitis model, topical application of AE resulted in significant reduction of epidermal hyperplasia. CONCLUSION: These results suggest that AE may be a potential candidate for the treatment of skin inflammation.
Ampelopsis* ; Cytokines ; Dermatitis ; Epidermis ; Hyperplasia ; Immunity, Innate ; Inflammation ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Keratinocytes* ; Necrosis ; Nucleotides ; Pathogen-Associated Molecular Pattern Molecules* ; RNA ; Skin

BACKGROUND: Epigenetic modulation of gene expression occurs by various methods, including DNA methylation and histone modification. DNA methylation of specific genes may affect the chromatin structure, preventing access by the transcriptional machinery. Although gene expression is dramatically changed during keratinocyte differentiation, there is no evidence of epigenetic modulation during the process of epidermal stratification. OBJECTIVE: We investigated whether epigenetic modulation is involved in keratinocyte differentiation-specific gene regulation. METHODS: We used trypsin to produce epidermal fragmentation (named T1-T4) and performed a morphological analysis using hematoxylin-eosin stain and cytokeratin expression based on reverse transcription polymerase chain reaction. We then constructed a DNA methylation microarray. RESULTS: Each epidermal fragment showed morphological features of the epithelial layer. T1 represented the basal layer, T2 was the spinous layer, T3 was the granular layer, and T4 was the cornified layer. The level of the K14 proliferation marker was increased in the T1 fraction, and the level of K10 differentiation marker was increased in the T2-T4 fractions. Using a methylation microarray with the T1 and T4 fractions, we obtained many hypermethylated and hypomethylated genes from differentiated keratinocytes. CONCLUSION: The importance of epigenetic modulation in target gene expression during keratinocyte differentiation is identified.
Cell Differentiation ; Chromatin ; DNA Methylation ; Epigenomics ; Gene Expression ; Histones ; Keratinocytes ; Keratins ; Methylation ; Polymerase Chain Reaction ; Reverse Transcription ; Trypsin

Nodular vasculitis was introduced by Montgomery for cases of erythema induratum-like lesions that were not associated with tuberculosis. Nodular vasculitis has been associated with both nontuberculous infections and noninfectious conditions. However, there has been no report on the development of nodular vasculitis during tumor necrosis factor-alpha inhibitor treatment. A 28-year-old man visited our clinic for the treatment of severe psoriasis with a 20-year history. Subcutaneous injection of etanercept (25 mg, twice weekly) was started. One year later, erythematous nodules developed on his lower leg. A skin biopsy showed lobular panniculitis with extensive necrosis and vasculitis. To exclude latent tuberculosis, an assay specific for Mycobacterium tuberculosis antigens was performed, with a negative result. After stopping etanercept under the diagnosis of nodular vasculitis associated with etanercept, the lesions gradually disappeared, leaving depressed scars in 3 months. There has been no recurrence after 6 months of follow-up.
Adult ; Biopsy ; Cicatrix ; Diagnosis ; Erythema ; Follow-Up Studies ; Humans ; Injections, Subcutaneous ; Latent Tuberculosis ; Leg ; Mycobacterium tuberculosis ; Necrosis ; Panniculitis ; Psoriasis* ; Recurrence ; Skin ; Tuberculosis ; Tumor Necrosis Factor-alpha ; Vasculitis* ; Etanercept