No abstract available.

BACKGROUND: Steroids are used in conventional treatment of atopic dermatitis (AD) and they are very effective for improving the symptoms, but they also have several complications. Many studies have reported that short-term use of cyclosporine (CsA) is effective for severe AD as a substitute for steroid. However, there are very few studies on the long-term use of CsA for AD in the Korean population. OBJECTIVE: The purpose of this study was to investigate whether long-term CsA therapy is effective and safe for treating AD. METHODS: We performed a retrospective study of the patients with AD and who were treated with CsA at Kyung Hee Medical Center between January 2001 and February 2008. Among 147 patients, 61 received CsA treatment for more than 6 months. To evaluate the efficacy of CsA treatment, the objective SCORAD was checked for all 61 patients at every visit. Extensive laboratory tests were performed every two months to assess the safety of treatment. RESULTS: The mean duration of CsA treatment was 13.5+/-8.4 months and the mean initial dose of CsA was 2.7+/-0.9 mg/kg/day. The mean objective SCORAD values significantly decreased from 34.1+/-11.2 at baseline to 11.4+/-10.7 after 6-month of CsA treatment (p<0.05). A significant decline of the SCORAD score was observed starting from 1-month of CsA treatment. The mean duration of remission was 4.5+/-2.9 months. A total of 13 adverse events in 10 patients were recorded during the study period. One patient dropped out due to renal dysfunction. Elevation of peripheral blood pressure was noted in 8 patients. Three patients complained of gastrointestinal troubles, and one patient had hypertrichosis, but the problems of these 4 patients were mild and easily treated. CONCLUSION: We suggest that long-term, low-dose CsA treatment is safe and effective for patients who suffer from AD.
Blood Pressure ; Cyclosporine ; Dermatitis, Atopic ; Humans ; Hypertrichosis ; Retrospective Studies ; Steroids

Clinically, folliculosebaceous cystic hamartoma (FSCH) lacks distinct features, but it has been reported as an asymptomatic, 1- to 3-cm, dome-shaped nodule on the face. Histopathologically, FSCH is characterized by adnexal and folliculosebaceous cystic proliferation with various mesenchymal changes. This case presented an unusually large, small-fist-sized mass in the right mandibular area that was accompanied by intermittent itching. Histopathologic findings demonstrated appropriate features of FSCH. We present an interesting case of giant FSCH in a 48-year-old female.
Female ; Hamartoma ; Humans ; Middle Aged ; Pruritus

Background: YouTube is one of the most popular video-sharing websites in Korea, but incorrect or biased information is not properly regulated. Acne is common in adolescents and young adults who are familiar with YouTube. Thus, misleading information about isotretinoin in YouTube videos could distort the perception of treatment. Objective: We evaluated the quality of information about isotretinoin in YouTube videos. Methods: The keywords searched on YouTube Korea on July 1, 2020 were: isotretinoin, Roaccutane, and Isotinone. The DISCERN tool was used to evaluate the reliability and quality of information, and eight items were used to evaluate scientific accuracy and comprehensiveness: mechanism, indications, dose regimen, contraindications, side effects, blood tests, drug interactions, and pregnancy-related issues. Results: The number of videos searched was 728. After excluding duplicate or inappropriate videos, 164 videos were analyzed. In the DISCERN tool, the mean overall quality score was 2.24 on a 5-point scale from 1 to 5. The mean score in the 8-issue-criteria, a 3-point scale from 0 to 2, was 0.61. Particularly, indications, blood tests, and drug interactions were poorly addressed in YouTube videos. Medical personnel offer better video quality than non-medical personnel. However, no significant difference in quality existed between the videos of dermatologists and those of other medical personnel. The quality score was not correlated with the popularity of the video. Conclusion YouTube videos covering isotretinoin showed poor overall quality. Content quality did not have a significant correlation with popularity, so incorrect information could be propagated on YouTube.

Elephantiasis nostras verrucosa (ENV) is a rare clinical condition associated with chronic non-filarial lymphedema caused by bacterial or non-infectious lymphatic obstruction. A variety of etiologies, including infection, tumor obstruction, trauma, radiation, chronic venous stasis, congestive heart failure, and obesity, can lead to chronic lymphatic obstruction and edema. Mossy papules, plaques, and cobblestone-like nodules are clinically impressive features of ENV, but biopsy reveals only moderately abnormal findings such as pseudoepitheliomatous hyperplasia, dilated lymphatic spaces, fibrous tissue hyperplasia, and chronic inflammation. We present a case of ENV in a 67-year-old man with a 10-year history of multiple nodules and verrucous plaques on both feet. Microbiology ruled out a filarial infection. Nodule biopsy revealed pseudoepitheliomatous hyperplasia, marked dermal fibrosis, and a chronic inflammatory infiltrate. No evidence of carcinoma was identified. Both venous stasis and recurrent cellulitis could contribute to the dermal fibrotic changes of the lesions. However, before the recurrent cellulitis, he did not have any nodular lesions on his feet despite a 10-year history of venous disease. Therefore, this case suggests that venous stasis alone cannot produce the fibrotic nodular lesions of ENV
Aged ; Biopsy ; Cellulitis ; Edema ; Elephantiasis ; Fibrosis ; Foot ; Heart Failure ; Humans ; Hyperplasia ; Inflammation ; Non-Filarial Lymphedema ; Obesity

Peripheral T-cell lymphoma, unspecified (PTCL-U) is an infrequent type of non-Hodgkin's lymphoma (NHLs), which occurs mainly in adults. The common predilection sites is the peripheral lymph node; however, other sites, such as bone marrow, liver, spleen, and skin, may also be affected. PTCL-U and other types of PTCLs are the most aggressive types of the NHLs. Response to treatment is poor and the overall 5-year survival rates do not surpass 20%. A 57-year-old female presented with a 1-week-history of multiple and painful subcutaneous nodules. The shape and distribution of the nodules were similar to those of erythema nodosum. The histopathologic findings of the skin lesion fitted that described for PTCL-U. In spite of chemotherapy, she expired in 1 month after diagnosis.
Adult ; Bone Marrow ; Erythema Nodosum ; Female ; Humans ; Liver ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell, Peripheral ; Middle Aged ; Skin ; Spleen ; Survival Rate

BACKGROUND: Poly-gamma glutamic acid (gamma-PGA) is a natural polymer that is synthesized by Bacillus subtilis. Because of the reported anti-tumor effect, gamma-PGA and its derivatives have attracted enormous interest in the past few years. OBJECTIVE: The anti-tumor effects of gamma-PGA against ultraviolet B (UVB) were evaluated by irradiating hairless mice with UVB. METHODS: The experimental animals were 12-week-old male Albino hairless Skh:HR-1 mice. Thirty-two mice were divided into 4 groups: a chronologic aging (control); irradiation with UVB without gamma-PGA administration (T1); irradiation with UVB and 2,000 kDa gamma-PGA orally (T2); and irradiation with UVB and 5,000 kDa gamma-PGA orally (T3). The irradiation period was 12 weeks. The anti-tumor effect of gamma-PGA was evaluated with photographs and skin biopsy. A 51Cr release assay was performed to determine nutural killer cell (NK cell) activity. RESULTS: After 20 weeks of UVB irradiation, seborrheic keratosis, actinic keratosis, Bowen's disease, squamous cell carcinoma, and basal cell carcinoma were observed on the backs of mice. The most common skin lesion was seborrheic keratosis. gamma-PGA showed inhibitory effects on the total number of skin tumors and the premalignant and malignant skin lesions induced by UVB. The NK cell activities showed a tendency to increase based on the molecular weight of gamma-PGA. CONCLUSION: We suggest that gamma-PGA shows anti-tumor effects that inhibit the tumor generation induced by UVB, and the antitumor effects are related to the molecular weight of gamma-PGA.
Aging ; Animals ; Bacillus subtilis ; Biopsy ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Glutamic Acid ; Humans ; Keratosis, Actinic ; Keratosis, Seborrheic ; Killer Cells, Natural ; Male ; Mice ; Mice, Hairless ; Molecular Weight ; Polyglutamic Acid ; Polymers ; Skin

BACKGROUND: Scabies is a common parasitic infestation that is an important public-health problem in many resource-poor regions. The incidence of scabies decreased during the past 20 years, but it has been increasing with the increase in the number of elderly people and nursing hospitals in Korea. OBJECTIVE: This study was performed to evaluate and compare the clinical aspects and etiologic factors between outpatients and inpatients diagnosed with scabies. Also, we tried to investigate the clinical efficacy of topical therapies for the treatment of scabies. METHODS: We conducted a retrospective analysis of the medical records of 200 patients who were diagnosed with scabies with a mineral oil test or skin biopsy between September 2009 and August 2013. RESULTS: Of 200 patients, 91 (45.5%) were men and 109 (54.5%) were women. The mean age of the patients was 59.2+/-26.6 years (men: 54.9+/-27.6 years/women: 62.8+/-25.2 years), and 61% of patients were aged >60 years. There was no seasonal variation in occurrence. Common primary lesions were papules and burrows in both inpatients and outpatients. Also, hyperkeratotic lesions were more commonly observed in inpatients (60%) than in outpatients (16.4%). The majority of the suspected routes of infection were transmissions through the nursing homes or hospitals (outpatients: 37.6%, inpatients: 71.4%). The mean time to diagnosis was 59+/-85.1 days (outpatients: 62.97+/-92.11 days, inpatients: 40.6+/-32.2 days) and to complete treatment was 31.87+/-49.2 days (outpatients: 35.3+/-53.14 days, inpatients: 14.8+/-13.87 days). CONCLUSION: We confirmed that nursing homes or hospitals are sources of herd infection. Therefore, dermatologists should educate the medical team and caregivers who work in nursing homes and hospitals about the clinical aspects and treatments of scabies.
Aged ; Biopsy ; Caregivers ; Diagnosis ; Female ; Gyeonggi-do ; Humans ; Incidence ; Inpatients* ; Korea ; Male ; Medical Records ; Mineral Oil ; Nursing ; Nursing Homes ; Outpatients* ; Retrospective Studies ; Scabies* ; Seasons ; Skin

Eccrine spiradenoma is a rare, benign, slow-growing adnexal neoplasm. It has been historically designated as an eccrine tumor, but is now considered an apocrine tumor. It typically presents as a single, tender, pink-to-blue, well-defined intradermal or deeply subcutaneous nodule on the head or trunk. In rare cases, multiple tumors are present and can be arranged in various patterns including zosteriform and/or linear distributions. A 40-year-old female patient presented with a 7-year history of multiple, small, tender nodules distributed in an annular pattern on her left shoulder. The diagnosis of eccrine spiradenoma was made by clinical and histopathological findings, and the larger nodules were surgically removed. We herein present an unusual case of multiple eccrine spiradenoma in an annular distribution.
Adult ; Diagnosis ; Female ; Head ; Humans ; Shoulder

BACKGROUND: Melasma, a common chronic pigmentary disorder, is resistant to various treatments. Recently, pulse-in-pulse type of intense pulsed light (PIP IPL) has been introduced as a treatment for melasma. It can emit multiple peaks during one pulse wave to deliver photothermal energy more effectively with gentle and even low energy so that complications are minimal. OBJECTIVE: The purpose of this study was to compare the efficacy and safety of PIP IPL to low-fluence, multi-pass, Q-switched Nd:YAG laser in the treatment of facial melasma. METHODS: Fifteen female patients with melasma who had Fitzpatrick skin type III or IV were enrolled in this study between November 2014 and April 2015. Patients underwent 6 sessions of treatment at an interval of 1 week. One half of each patient's face was treated with 2 passes of PIP IPL with a fluence of 13~15 J/cm₂. The other half of the face was treated with 4 passes of Q-Switched Nd:YAG laser with a fluence of 1.6~1.8 J/cm₂. Results were evaluated at every visit, including modified Melasma Area and Severity Index (MASI) score, subject's global assessment, and investigator's global assessment. RESULTS: Modified MASI scores were significantly (p<0.05) reduced in both groups after 6 treatment sessions. Q-Switched Nd:YAG laser treatment was more effective than PIP IPL for the treatment of melasma, although the two treatments did not significantly (p=0.44) differ in effectiveness. However, the discomfort levels of patients in the PIP IPL group following procedures were significantly lower compared to those in the Q-Switched Nd:YAG group. CONCLUSION: The current investigation demonstrated that PIP IPL treatment for melasma in Korean women was not inferior to collimated low fluence Q-switched Nd:YAG laser treatment.
Female ; Humans ; Melanosis* ; Skin