BACKGROUND: Pediatric dermatoses show different clinical presentations and responses to treatment than that in adults. However, data on inpatient pediatric dermatology are limited in the current medical literature. OBJECTIVE: The purpose of this study was to analyze patterns of dermatologic consultations in pediatric inpatients. METHODS: We retrospectively reviewed the records of inpatient pediatric (age <18 yrs) consultation requests received by the dermatology department from January 2012 to December 2014. The age, sex, diagnosis, requesting department, and reason for consultation were recorded. RESULTS: Among 27,323 inpatients, 581 (2.1%) had undergone consultation. Of these, 318 (54.7%) were boys and 263 (45.4%) were girls (M: F=1.2:1). Patients ranged in age from newborn to 17 years, and 22.4% were under 1 year. Most of the consultation requests (57.7%) were made by pediatrics, followed by neurosurgery (7.7%) and general surgery departments (7.7%). The most common diagnostic categories included eczema (26.3%), skin appendigeal diseases (18.7%), infectious disease (17.7%), neoplasms (12.8%), and drug eruptions, erythema, and urticaria (7.1%). The most common reasons for consultation were dermatologic diseases or conditions (82.5%), skin lesions of a systemic disease (9.5%), and diseases related to treatment (6.5%). CONCLUSION: Information obtained from this study can not only improve the quality of patient care but also inform clinicians about the array of pediatric dermatology conditions in the hospital setting.
Adult ; Communicable Diseases ; Dermatology* ; Diagnosis ; Drug Eruptions ; Eczema ; Epidemiology ; Erythema ; Female ; Humans ; Infant, Newborn ; Inpatients* ; Neurosurgery ; Patient Care ; Pediatrics ; Referral and Consultation* ; Retrospective Studies* ; Skin ; Skin Diseases ; Urticaria

Aged ; Aged, 80 and over ; Dermatology ; Female ; Health Services Needs and Demand ; Humans ; Ichthyosis ; diagnosis ; epidemiology ; Keratosis, Seborrheic ; diagnosis ; epidemiology ; Lentigo ; diagnosis ; epidemiology ; Male ; Mass Screening ; Middle Aged ; Pilot Projects ; Poverty ; Singapore ; epidemiology ; Skin Diseases ; diagnosis ; epidemiology ; Skin Neoplasms ; diagnosis ; epidemiology ; Social Class ; Vulnerable Populations

This study was conducted to clarify the prevalence of common skin diseases and their associated factors among military personnel in Korea. Four dermatologists visited adjacent military units and examined soldiers. A structured questionnaire that included questions about known skin diseases, demographic information, and questions for the Perceived Stress Index was completed for each participant. The soldiers that had been diagnosed with a skin disease answered one additional questionnaire (Skindex-29) which assess the influence of an individual's skin disease on daily life. Of 1,321 soldiers examined, 798 (60.4%) had one or more skin diseases. The three most common skin problems were acne (35.6%), tinea pedis (15.2%) and atopic dermatitis (5.1%). The diseases closely related to the period of military service were acne, tinea pedis, viral warts and corns. The diseases related to the amount of stress were atopic dermatitis, seborrheic dermatitis, and acne. The most troublesome skin diseases were atopic dermatitis, tinea cruris, and seborrheic dermatitis. These results demonstrated that the prevalence of skin disease among military personnel in Korea is very high, and that some of the skin disorders may have a significant influence on their daily lives.
Acne Vulgaris/epidemiology ; Adult ; Cross-Sectional Studies ; Dermatitis, Atopic/epidemiology ; Humans ; Male ; Military Personnel ; Odds Ratio ; Prevalence ; Quality of Life ; Questionnaires ; Republic of Korea/epidemiology ; Risk Factors ; Skin Diseases/diagnosis/*epidemiology ; Stress, Psychological ; Tinea Pedis/epidemiology ; Young Adult

BACKGROUND: The incidence of atopic of atopic dermatitis (AD) varies widely by different ages and it has been well-founded that the epidemiology of AD has been studied on admission of the first grade schoolchildren. AD is a common skin disease of childhood and tends to increase significantly during recent decades, but informations regarding the exact prevalence of AD, based on the large-scale general population study, are unavailable in korea. OBJECTIVE: The purpose of this study is to elucidate the exact prevalence of AD and to evaluate the diagnostic significance of some well-known minor clinical features associated with AD in the first grade school children in one of Kouean cities, Puchon, kyunggi-do. METHODS: Four thousands and eighteen first grde school children (boys ; 2072, girls ; 1946) participated inthis study. Two dermatologists determined the presence of skin lesions by through skin examination. Diagnosis of AD was made only when typical flexural and/or extensor and/or infraauricular fissure/eczema exist. The frequency as well as their diagnostic significance of ten minor features of AD (xerosis, ichthyosiform skin lesion, hyperlinear palm,)keratosis pilaris, non-specific hand/foot dermatitis, cheilitis, nipple eczema, perifollicular accentuation, pityriasis alba, Dennie-Morgan infraorbital fold) thought suitable items for field survey by authors, were also evaluated. RESULTS: The total prevalence of AD in the first grade school children of Puchon city was 3. 78%. The prevalence in boys was 3.37% and that in girls was 4.2 Associated minor features in individuals diagnosed as having AD were, in order of frequency, pityriasis alba (59.8%), perifollicular accentuation (57.8%), , keratosis pilaris (56.5%), hyperlinear palms (55.2%), xerosis (43.3%), Dennie-Morgan infraorbital fold (26.3%), etc. All but the ichthyosiform skin lesions and nipple eczema were significantly more frequent in individuals diagnosed as having AD (P<0.01). CONCLUSION: A relatively low prevalence shown in this study might be due to rather strict diagnostic criteria. Some helpful and diagnostically significant minor clinical features of AD, suitable for field survy, is suggested. Further studies are needed for accurate estimation of the prevalence of AD in korea including different regional and age population.
Cheilitis ; Child ; Dermatitis ; Dermatitis, Atopic* ; Diagnosis ; Eczema ; Epidemiology ; Female ; Gyeonggi-do ; Humans ; Incidence ; Keratosis ; Korea ; Nipples ; Pityriasis ; Prevalence* ; Skin ; Skin Diseases

OBJECTIVEChronic granulomatous disease (CGD) is a rare primary immunodeficiency of phagocytic oxidative bursts leading to recurrent severe bacterial and fungal infections as well as granuloma formation. There were few reports on the clinical characteristics of this disease in China. The purpose of this study was to evaluate the clinical features of 48 Chinese cases with CGD which were confirmed by clinical features, dihydrorhodamine (DHR) assay and gene mutation analysis.

METHODThe study cohort was the population of CGD patients diagnosed in Children's Hospital of Fudan University from January, 2004, to June, 2011. Cases included in our analysis were restricted to those who had complete data of the clinical symptoms and laboratory tests. The patients were followed up by outpatient visiting and telephone call regularly for 0.5 to 6 years. The history and data of physical examination and treatment of 48 cases were collected and reviewed.

RESULTAll the patients were diagnosed by DHR analysis. The age of onset of all the 48 patients were less than 6 months, including 43 male and 5 female. The mean age at diagnosis was 2.42 years; 12 patients were infants under six months, 10 were between 6 and 12 months, 9 were between 1 and 2 years, 5 patients were between 2 and 3 years, 4 were between 4 and 5 years, and 8 were between 6 and 10 years. Recurrent respiratory infection (44/48) and chronic diarrhea (31/48) were the common symptoms in all the patients, and then skin lesion (22/48), including marked reaction at BCG infected site, pustular eruption and infected skin ulcer and urinary tract infection (3/48) were also general symptoms in our study. In addition, lymphadenectasis occurred in 31 cases and 23 of them were considered to be associated with BCG vaccination. The pathogens caused the infection were mycobacteria (52.08%), fungi (43.75%) and pyogenic bacteria. Thirty-seven patients had mutations in CYBB/CYBA/NCF1/NCF2 genes. Recombinant human interferon-gamma (rhIFN-γ) plus sulfamethoxazole were used for the prevention and treatment of infection, the frequency and severity of the disease could be reduced.

CONCLUSIONThe age at onset and diagnosis of the present group of CGD was younger. Clinical symptoms were associated with recurrent mycobacterial, fungal and pyogenic bacterial infection, which involved respiratory tract, alimentary tract, skin and lymph node. rhIFN-γ partially improved the prognosis of CGD.

Bacterial Infections ; epidemiology ; etiology ; prevention & control ; Child ; Child, Preschool ; Female ; Gastrointestinal Diseases ; epidemiology ; etiology ; prevention & control ; Granulomatous Disease, Chronic ; complications ; diagnosis ; genetics ; Humans ; Infant ; Interferon-gamma ; therapeutic use ; Lung Diseases ; epidemiology ; etiology ; prevention & control ; Male ; Mutation ; Mycobacterium Infections ; epidemiology ; etiology ; prevention & control ; Recombinant Proteins ; Retrospective Studies ; Skin Diseases ; epidemiology ; etiology ; prevention & control

BACKGROUND: Tinea versicolor is regarded as one of the most common dermatoses. It constitutes about 3% of dermatological patients. OBJECTIVE: The present study was undertaken to evaluate the frequency of tinea versicolor among patients with fungal skin infections. Special attention was paid to sex and age distribution, as well as to the associated cutaneous and systemic disorders. MATERIAL AND METHODS: The study was based on 2665 questionnaires. The clinical diagnosis of tinea versicolor was confirmed by positive direct mycological examination in 10~20% potassium hydroxide solution with addition of dimethyl sulfoxide and by yellow-orange Wood's lamp fluorescence of the lesions. RESULTS AND CONCLUSIONS: Tinea versicolor was diagnosed in 325 patients (12.2% of all patients with different fungal skin and nail infections). Female patients constituted 52.3% and males 47.7%. The majority of patients were from the big towns (81.2%), only 4% of patients lived in the rural areas. 45.3% of patients finished secondary school, 23.4% had higher education. The age of patients varied from 10 to 79 years, mean age 36.1 +/- 15.3 years. Tinea versicolor was diagnosed in 45.0% of patients between the age of 16 and 35 years and it was uncommon in children (5.2%). The duration of the disease was 1 week to 23 years, mean 2.5+/-3.5 years. 49.5% of patients were previously treated with different regimens, Other cutaneous abnormalities were found in 20.6% of patients with tinea versicolor. Among them acne (4.9%), seborrheic dermatitis (3,1%) and onychomycosis (3.1%) were the most common ones. 14.5% of tinea versicolor patients suffered from systemic diseases, such as arterial hypertension (4%), thyroid abnormalities (3.1%), coronary insufficiency (2.5%) and diabetes melllitus (1.5%).
Acne Vulgaris ; Age Distribution ; Child ; Dermatitis, Seborrheic ; Diagnosis ; Dimethyl Sulfoxide ; Education ; Epidemiology ; Female ; Fluorescence ; Humans ; Hypertension ; Malassezia ; Male ; Onychomycosis ; Potassium ; Prospective Studies* ; Skin ; Skin Diseases ; Thyroid Gland ; Tinea Versicolor* ; Tinea* ; Surveys and Questionnaires

BACKGROUND: Hand dermatitis is a common chronic relapsing skin disease resulting from a variety of causes, including endogenous predisposition and environmental exposures to irritants and allergens. Lifestyle factors such as smoking have been implicated in hand dermatitis. OBJECTIVE: To evaluate the association between tobacco exposure and hand dermatitis using the 2003~2004 National Health and Nutrition Examination Survey (NHANES) database. METHODS: Data were retrieved and analyzed from 1,301 participants, aged 20~59 years, from the 2003~2004 NHANES questionnaire study who completed health examination and blood tests. Diagnosis of hand dermatitis was based on standardized photographs of the dorsal and palmar views of the hands read by two dermatologists. RESULTS: There were 38 diagnosed cases of active hand dermatitis out of the 1,301 study participants (2.9%). Heavy smokers (>15 g tobacco daily) were 5.11 times more likely to have active hand dermatitis (odds ratio [OR], 5.11; 95% confidence interval [CI], 1.39~18.88; p=0.014). Those with serum cotinine >3 ng/ml were also more likely to have active hand dermatitis, compared with those with serum cotinine ≤3 ng/ml (OR, 2.50; 95% CI, 1.26~4.95; p=0.007). After adjusting for confounding factors such as age, atopic diathesis, occupational groups, and physical activity, the association between tobacco exposure and active hand dermatitis remained significant. CONCLUSION: Smoking has a significant association with the presence of active hand dermatitis. It is important to consider smoking cessation as part of management of hand dermatitis.
Adult* ; Allergens ; Cotinine ; Dermatitis* ; Diagnosis ; Disease Susceptibility ; Eczema ; Environmental Exposure ; Epidemiology ; Hand* ; Hematologic Tests ; Humans ; Irritants ; Life Style ; Motor Activity ; Nutrition Surveys ; Occupational Groups ; Skin Diseases ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco ; United States*

Exposure to cephalosporins could cause occupational allergic diseases in health care workers (HCWs). We evaluated the prevalence of serum specific IgE and IgG antibodies to cephalosporin-human serum albumin (HSA) conjugate and to identify potential genetic risk factors associated with sensitization to cephalosporins in exposed HCWs. The study population consisted of 153 HCWs who had been exposed to antibiotics in a single university hospital and 86 unexposed healthy controls. A questionnaire survey of work-related symptoms (WRS) was administered. A skin-prick test (SPT) was performed, and serum-specific IgE and IgG antibodies to 3 commonly prescribed cephalosporins were measured by ELISA. Four single-nucleotide polymorphisms of the candidate genes related to IgE sensitization were genotyped. The prevalence of WRS to cephalosporins was 2.6%. The prevalence rates of serum-specific IgE and IgG antibodies to cephalosporins were 20.3% and 14.7%, respectively. The FcepsilonR1beta-109T > C polymorphism was significantly associated with IgE sensitization to cephalosporins in HCWs (P = 0.036, OR = 3.553; CI, 1.324-9.532). The in vitro functional assay demonstrated that the T allele of FcepsilonR1beta-109T had greater promoter activity than did the C allele (P < 0.001). The FcepsilonR1beta-109T > C polymorphism may be a potential genetic risk factor for increased IgE sensitization to cephalosporins.
Adult ; Alleles ; Anti-Bacterial Agents/analysis/*immunology ; Cephalosporins/analysis/*immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Genetic Predisposition to Disease ; Health Personnel ; Humans ; Hypersensitivity/*diagnosis/epidemiology ; Immunoglobulin E/blood ; Immunoglobulin G/blood ; Male ; Occupational Diseases/*chemically induced/epidemiology ; Occupational Exposure ; Odds Ratio ; Questionnaires ; Receptors, IgE/genetics ; Skin Tests ; Young Adult

Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. the findings presented in this report are useful measures of the major health problems an even more important, as a guide to planning for improves medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural area. -to assess the rural population's needs in terms of health and medial care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group , the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample: Sample size was one fourth of total population: 1,438. The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination. Examination sessions usually were held in the morning every Tuesday, Wednesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior hgh school in Taegu city so the time was not convenient for them to receive examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Public health problems. Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years of older was 201 needed more health care and 65 of them had disabilities (table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health. Average number of pregnancies of eligible women was 4 times. There was almost no pre-and post-natal care. Pregnancy wastage. Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery Condition. More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimate about 35 per 10,000 live births. Child health. Consultation rate for child health was almost non existent. In general, vaccination rate of children was low; vaccination rates for children but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16). Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eight of estimate number of tuberculosis in the area. Number of discharged cases in the pat accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge on the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental Problems: More than 50% of the total population have lest one or more dental problems. (Table 19) B. Medical care Problems. Incidence rate: 1. In one month. Incidence rate of medical care problems during one month was 19.6% percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-n the order. The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years of over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old th rate of health problems increases gradually with aging. Eighty-three percent of health problems that occurred during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at those because of illness during one month were 1.7days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year. The incidence rate of medical care problems during a year was 7.8%, among them health problems which required rest at those was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occurred most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10) ,diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3)-in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were 16 days per interviewee and 4 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequency were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as follows:(previous page). Utilization of medical care (treatment) by various medical for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82% while the rate of those who have health problems which did not required rest was 61percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitated used were as follows: Hospital and clinics: 32-35%. Herb clinics: 9-10%. Drugstore: 53-58%. Hospitalization. Rate of hospitalization was 1.7% and the estimate number of hospitalization among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,1109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27).Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation. 2. MCH except medical care problems. 3. Family planning except surgical intervention. 4. Tuberculosis control except diagnosis and prescription. 5. Dental care except operational intervention. 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. b. Medical care problems. 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost. Considering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is need government to solve health and medical care problems for rural people.
Abortion, Induced ; Abortion, Spontaneous ; Adult ; Aging ; Anemia ; Bias (Epidemiology) ; Child ; Child Health ; Communicable Diseases ; Contraception ; Daegu ; Delivery of Health Care ; Dental Care ; Developed Countries ; Diagnosis ; Diarrhea ; Drinking ; Early Diagnosis ; Economic Development ; Family Characteristics ; Family Planning Services ; Female ; Follow-Up Studies ; General Practitioners ; Headache ; Health Education ; Health Services ; Hope ; Hospitalization ; Humans ; Incidence ; Infant ; Korea* ; Live Birth ; Male ; Maternal Death ; Maternal Health ; Midwifery ; Mortality ; Neuralgia ; Parasites ; Parturition ; Philosophy ; Pregnancy ; Prescriptions ; Primary Health Care ; Public Health ; Pulmonary Disease, Chronic Obstructive ; Rural Health ; Rural Population ; Sample Size ; Sanitation ; Secondary Care ; Skin ; Skin Diseases ; Specialization ; Spouses ; Students, Medical ; Toilet Facilities ; Tuberculosis ; Urban Health ; Vaccination ; Young Adult