Oral lichen planus (OLP) is a painful chronic inflammatory condition, that is often resistant to many therapeutic approaches, including immunosuppressive agents. Topical tacrolimus has recently been recognized as a safe and effective remedy in the treatment of OLP. We, rerein, describe 3 patients with oral lichen planus, who showed a substantial improvement after the use of topical tacrolimus ointment (0.1%). This topical agent was well tolerated in all 3 patients and could be used an effective medicine in controlling oral lesions of lichen planus.
Humans ; Immunosuppressive Agents ; Lichen Planus ; Lichen Planus, Oral* ; Tacrolimus*

Intravenous immunoglobulin therapy has been used to treat various immune-mediated diseases. Its utility in dermatology continues to expand, including treatment for autoimmune blistering disease, graft-versus-host disease, and dermatomyositis. It is generally considered safe, and serious adverse effects such as anaphylaxis, renal tubular necrosis or aseptic meningitis rarely occur. Furthermore, adverse skin reactions very rarely occur, but can include urticaria, pruritus, eczema, alopecia, lichenoid dermatitis or pompholyx. We describe a case of a 48-year-old man who developed vesicular eczema on his palms and soles after administration of intravenous immunoglobulin therapy for encephalomyelopathy.
Alopecia ; Anaphylaxis ; Blister ; Dermatitis ; Dermatology ; Dermatomyositis ; Eczema ; Eczema, Dyshidrotic* ; Graft vs Host Disease ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Meningitis, Aseptic ; Middle Aged ; Necrosis ; Pruritus ; Skin ; Urticaria

BACKGROUND: 'Tight junctions (TJ)' have recently been identified in the granular cell layer of the human epidermis, where they contribute to the normal adhesion between keratinocytes and to the physiologic barrier function of the epidermis. Among the TJ proteins in the epidermis, occludin is an important transmembrane protein, which is considered as a major component among the TJ. OBJECTIVE: The purpose of this study is to investigate whether regional variation exists in the expression of tight junction protein occludin in normal human epidermis. METHODS: The immunofluorescence staining for occludin was performed with specimens taken from different areas of normal skin (4 from each of 7 different anatomical sites, including the scalp, face, posterior neck, upper arm, abdomen, lower back, and inner thigh). The degrees of the expression-intensity in each specimen were estimated with the reciprocals of positive end-point titer of occludin in an immunofluorescence study. RESULTS: The highest degree expression-intensity of the TJ protein occludin among the different areas of normal epidermis was observed on the face and abdomen with a titer of 600. The lowest intensity of expression of occludin was seen in the epidermis from the upper arm. Skin specimens from the scalp, neck, back, and leg demonstrated intermediate degrees of the expression in intensity. CONCLUSION: The expression of occludin in the skin samples obtained from different locations of the body showed a statistically significant variation. This suggests that there is a certain degree of regional variation in the expression-intensity of TJ protein 'occludin' in the human epidermis.
Abdomen ; Arm ; Epidermis ; Fluorescent Antibody Technique ; Humans ; Keratinocytes ; Leg ; Neck ; Occludin ; Proteins ; Scalp ; Skin ; Tight Junctions

BACKGROUND: Nano-sized water particles have been thought to moisturize the skin more effectively. However, clear benefits of humidifier generating nano-sized water particles on the skin have not been studied. OBJECTIVE: The aim of this study is to examine the effects of humidifier generating nano-sized water particles on the skin by measuring the levels of the skin hydration state and skin barrier function with an objective, quantifiable method. METHODS: A 4-week, randomized, case-control study was conducted in 40 healthy Korean women, aged between 20 and 39, and they were divided into two groups, the experimental and control groups. The experimental group used humidifier generating nano-sized water particles for 8 hours every night, during 4 weeks. Skin hydration and transepidermal water loss (TEWL) were measured every week on the forehead and cheek using corneometer and tewameter, respectively. Safety evaluations were also performed at each visit. RESULTS: The baseline skin hydration and TEWL values showed no significant differences between the two groups. After 1 week of use, the experimental group showed significantly increased skin hydration values (p<0.001, p<0.0001) and decreased levels of TEWL values (p=0.017, p=0.025) as compared to the control group. During a 4-week study period, increased skin hydration and decreased TEWL were sustained in the experimental group. No adverse effects were observed in all the volunteers. CONCLUSION: These results show that humidifier, which generates nano-sized water particles, seems to positively affect skin hydration and skin barrier function. More studies and sufficient follow-up time are needed for the assessment of the humidifier generating nano-sized water particles.
Aged ; Case-Control Studies ; Cheek ; Female ; Follow-Up Studies ; Forehead ; Humans ; Skin ; Water

Periumbilical perforating pseudoxanthoma elasticum is a rare acquired disorder that usually occurs in obese, middle-aged, multiparous women. It is considered as a separate entity from the hereditary pseudoxanthoma elasticum due to lack of hereditary transmission and association with systemic disease. A 70-year-old multiparous woman presented with a 2-year history of a gradually enlarging, yellowish ulcerated plaque in the periumbilical region. The biopsy specimen showed irregularly altered elastic fibers with encrusted calcium salts that underwent transepidermal elimination. We report a rare case of periumbilical perforating pseudoxanthoma elasticum with no signs of hereditary pseudoxanthoma elasticum.
Aged ; Biopsy ; Calcium ; Elastic Tissue ; Female ; Humans ; Pseudoxanthoma Elasticum* ; Salts ; Ulcer

Atrophic dermatofibrosarcoma protuberans (DFSP) is a rare variant of DFSP, which presents as a depressed scar-like lesion with atrophic patch. Although atrophic DFSP is identical to classical DFSP in biologic and histologic features, such atrophic lesions can be difficult to diagnose clinically. Better knowledge of atrophic DFSP is important for making an early diagnosis and for proper surgical treatment. We report the case of a 33-year-old female presented with a gray depressed atrophic patch with a skin-colored, pea-sized nodule on the left lateral rim, and an erythematous indurated plaque on her upper back. Histopathologically, the atrophic patch showed densely packed, monomorphous, plump spindle cells arranged in a storiform pattern, infiltrating the dermis and subcutaneous tissue, producing a characteristic honeycomb pattern. The tumor cells exhibited strong and diffuse positivity with CD34, establishing the diagnosis of DFSP.
Adult ; Dermatofibrosarcoma* ; Dermis ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Subcutaneous Tissue

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.