Aspergillosis comprises a spectrum of diseases caused by species of a ubiquitous saprophytic mold, Aspergillus, that usually lives on decaying vegetation. Aspergillus organisms rarely behave as pathogens in an immunocompetent host. But, in the presence of immunosuppression, Aspergillus may be invasive and take a fulminant course. Although extensive investigation has clarified multiple aspects of pulmonary aspergillosis, cutaneous aspergillosis occurs relatively less frequently and therefore remains poorly characterized. With this review, we have attempted to better define risk factors and common clinical presentations, as well as to formulate a reasonable approach to the diagnosis and management of cutaneous aspergillosis.
Aspergillosis* ; Aspergillus ; Diagnosis ; Fungi ; Immunosuppression ; Pulmonary Aspergillosis ; Risk Factors

Verrucous carcinoma is a slow growing, low grade squamous cell carcinoma, which usually occurs on oropharynx, genitalia and soles. When it occurs on feet, it is known as epithelioma cuniculatum. Epithelioma cuniculatum is characterized by its histologic sinuses and cystic formations in a cuniculate(rabbit burrow-like) pattern. A 59-year-old man was consulted to our department for a well circumscribed, 5 × 5 cm sized, round, hyperkeratotic, verrucous plaque on the right great toe. He suffered from diabetes mellitus for 16 years and was managed by peritoneal dialysis three times a week due to chronic renal failure for last two years. The plaque had gradually increased in size. The biopsy specimen taken from the tumor mass showed chronic ulcerative inflammation with atypical squamous cell proliferation. We herein report a case of verrucous carcinoma occurring in a patient with diabetes melli-t tus and chronic renal failure.
Biopsy ; Carcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Cell Proliferation ; Diabetes Mellitus* ; Foot ; Genitalia ; Humans ; Inflammation ; Kidney Failure, Chronic* ; Middle Aged ; Oropharynx ; Peritoneal Dialysis ; Toes ; Ulcer

BACKGROUND: Androgenetic alopecia is considered to be a genetically determined disorder influenced by age and androgen. The proportion of patients with androgenetic alopecia among the total number of patients with alopecia seems to be gradually increasing. OBJECTIVE: The purpose of this study was to find the family history, clinical and endocrine status of the patients with androgenetic alopecia. METHOD: 736 patients with androgenetic alopecia who had visited the Department of Dermatology, Yongsan and Pil-dong Hospital, College of Medicine, Chung-Ang University during the last 2 years(1999.1-2000.12) were examined. RESULTS: 1) Incidence of androgenetic alopecia among the total number of alopecia patients was 75.8%. 2) There were 571 male and 165 female patients being most prevalent in the 3rd decade in male patients and in the 4th decade in female patients. 3) In male androgenetic alopecia, Norwood-Hamilton's type II was the most common and following IIIv, II, IV, IIIa, and in female patients, Ludwig's type I was most common. 4) There was a family history of baldness in 59.5% of first degree relatives in male patients and 30.9% in female patients. 5) The most common associated disorder is seborrheic dermatitis. 6) Serum testosterone levels were increased in 78 males(13.7%) and 23 females(13.9%). CONCLUSION: Based on these results, the number of young patients who visit dermatologists tends to be increasing and genetic factor, ages and abnormal androgen metabolism in scalp are affecting the development of androgenetic alopecia.
Alopecia ; Dermatitis, Seborrheic ; Dermatology ; Female ; Humans ; Incidence ; Male ; Metabolism ; Scalp ; Testosterone

Motor loss caused by herpes zoster is less well known but occurs in a significant number of cases, probably far more frequent than is recognized because the weakness is readily obscured by pain. The incidence of herpetic motor involvement was reported to be between 0.5% and 31%. A 65-year-old male patient with herpes zoster on the right lower limb had complained with progressive weakness of the limb, during treatment. We examined the limb using electromyographic(EMG) and motor nerve conduction velocity(MNCV) studies. Thereafter we concluded he had motor paralysis caused by herpes zoster. The weakness progressed to the complete motor loss of the right limb. Presenty, he still suffers from the paralysis of the right limb.
Aged ; Extremities ; Herpes Zoster* ; Humans ; Incidence ; Lower Extremity ; Male ; Neural Conduction ; Paralysis*

Dermatomyositis is a rare inflammatory myopathy with characteristic skin manifestations and muscular weakness. Immunologic factors are most likely involved in the pathogenesis of the disease. We describe a 44 year old man with a 5 month history of severe pruritus on the trunk and upper extremities with intermittent tremor of upper extremities. Hydroxychloroquine and methotrexate were combined with glucocorticoids for one month, improvement of clinical manifestations could be observed.
Adult ; Dermatomyositis* ; Glucocorticoids ; Humans ; Hydroxychloroquine ; Immunologic Factors ; Methotrexate ; Muscle Weakness ; Myositis ; Pruritus ; Skin Manifestations ; Tremor* ; Upper Extremity*

Kaposi's sarcoma is an unusual neoplasm that has proved to be an enigma in many ways since its original description by Kaposi in 1872. Of the several different type of Kaposi's sarcoma, iatrogenically immunosuppressed patients predisposed to Kaposi's sarcoma are usually either transplant recipients or patients receiving immunosuppressive therapy. We report a case of recurrent Kaposi's sarcoma in a 56 year old male, which has occurred during the cyclosporine therapy of kidney transplantation. Cyclosporine was discontinued and chemotherapy began and the resolution of Kaposi's sarcoma has been obtained. Cyclosporine maintenance therapy was started again for the prevention of graft rejection. But 1 year later, Kaposi's sarcoma recurred probably due to re-use of cyclosporine.
Cyclosporine* ; Drug Therapy ; Graft Rejection ; Humans ; Kidney Transplantation* ; Kidney* ; Male ; Middle Aged ; Sarcoma, Kaposi* ; Transplantation

Adriamycin extravasation into subcutaneous tissues during intravenous administration results in an intense inflammatory response, which may progress to full thickness skin loss. With increased use of the potent anticancer drug adriamycin, there are increasing numbers of severe local tissue damage at the venous administration sites. We report a case of skin necrosis that was caused by extravasation of adriamycin in the treatment of multiple myeloma. When anticancer drug extravasation occurs, early recognition and adequate management is required.
Administration, Intravenous ; Doxorubicin* ; Multiple Myeloma ; Necrosis* ; Skin* ; Subcutaneous Tissue

PURPOSE: Therapeutic hypothermia (TH) has become a standard strategy for reducing brain damage in the postresuscitation period. The aim of this study is to investigate the outcomes and current performance of TH with out-of-hospital cardiac arrest (OHCA) survivors through the Korean hypothermia network (KORHN) registry. METHODS: We used the KORHN registry, a web-based, multicenter registry that includes 24 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TH from 2007 to 2012 were included. The primary outcomes were neurologic outcome at hospital discharge and in-hospital mortality. The secondary outcomes were TH performance and adverse events during TH. RESULTS: A total of 930 patients were included; of these, 556 (59.8%) patients survived to discharge and 249 (26.8%) were discharged with good neurologic outcomes. The median time from return of spontaneous circulation (ROSC) to the start of TH was 101 (interquartile range (IQR): 46-200) minutes. The induction, maintenance, and rewarming durations were 150 (IQR: 80-267) minutes, 1440 (IQR: 1290-1440) minutes, and 708 (IQR: 420-900) minutes, respectively. The time from the ROSC to coronary angiography was 1,045 (IQR: 121-12,051) hours. Hyperglycemia (46.3%) was the most frequent adverse event. CONCLUSION: Over one quarter of OHCA survivors (26.8%) were discharged with good neurologic outcome. TH performance was managed appropriately in terms of the factors related to the timing of TH, which were the start time for cooling and the rewarming duration.
Adult ; Brain ; Coma ; Coronary Angiography ; Hospital Mortality ; Humans ; Hyperglycemia ; Hypothermia* ; Hypothermia, Induced ; Korea ; Out-of-Hospital Cardiac Arrest* ; Registries ; Republic of Korea ; Rewarming ; Survivors

BACKGROUND: Topical tacrolimus is an effective anti-inflammatory therapy for acute and chronic states of atopic dermatitis (AD) in both adults and children. Topical tacrolimus has particular use at sensitive areas such as the face, anogenitals, and skin folds of neck and extremities. However, many AD patients also experience aggravated symptoms on trunk. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of topical tacrolimus for AD patients with truncal lesions. METHODS: AD patients with truncal lesions who were aged ≥2 years were recruited from 20 centres in Korea. They received treatment with topical tacrolimus ointment twice daily during 4 weeks. The primary end point was change of the local eczema area and severity index (EASI) of the trunk from baseline to day 28. The secondary end points were changes in the patient global assessment (PGA) score and itch visual analogue scale (VAS) score of the trunk between baseline and day 28. RESULTS: Two hundred and ninety-one patients were recruited, and 176 patients completed the full 4-week treatment course. By the end of the treatment, the mean local EASI of the trunk (2.2±4.71) was significantly decreased from that at baseline (4.71±4.03, p < 0.001). PGA (1.71±1.15) and itch VAS score of the trunk (2.61±2.19) on day 28 were also profoundly decreased compared with the baseline (2.96±1.07 and 5.15±2.47, respectively). No serious adverse events were observed during the study period. CONCLUSION: Topical tacrolimus is an effective and safe therapy for truncal lesions in AD patients.
Administration, Topical ; Adult ; Child ; Dermatitis, Atopic* ; Eczema ; Extremities ; Humans ; Korea ; Neck ; Skin ; Tacrolimus*

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.