BACKGROUND: Demodicosis is a parasitic skin disease caused by Demodex mites, and the determination of mite density per square centimeter is important to diagnose demodicosis. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd). However, no study has previously compared these two methods with respect to clinical types and distribution patterns of demodicosis. OBJECTIVE: The aim of this study was to compare the value of SSSB and DME findings in reference to the clinical types and distribution patterns of demodicosis. METHODS: The medical records of 35 patients diagnosed with demodicosis between December 2011 and June 2015 were retrospectively reviewed. Demodicosis was classified according to four clinical types (pityriasis folliculorum, rosacea type, acne type, and perioral type) and three distribution patterns (diffuse pattern, U-zone pattern, and T-zone pattern). Two samples, one for SSSB and one for DME, were obtained from a lesion of each patient. RESULTS: In all patients, mean Dd and the proportion with a high Dd (>5D/cm²) by DME (14.5±3.3, 80.0%, respectively) were higher than by SSSB (5.5±1.3, 37.1%, respectively; p<0.01, p=0.02, respectively). In terms of clinical types, for rosacea type, mean Dd and proportion with a high Dd by DME (12.4±3.5, 84.6%, respectively) were significantly greater than those determined by SSSB (3.6±1.2, 23.1%; p=0.04, p=0.04, respectively). In terms of distribution pattern, for the diffuse pattern, mean Dd and the proportion with a high Dd by DME (17.5±3.7, 100%, respectively) were significantly higher than those determined by SSSB (6.0±2.7, 26.7%; p<0.01, p<0.01, respectively). CONCLUSION: The results of our study revealed that DME is a more sensitive method for detecting Demodex than SSSB, especially in patients with diffuse pattern and suspected rosacea type. Further research is needed to confirm this finding.
Acne Vulgaris ; Biopsy* ; Humans ; Medical Records ; Methods ; Mites* ; Retrospective Studies ; Rosacea ; Skin Diseases, Parasitic ; Skin*

BACKGROUND: The prevalence of skin diseases at a university hospital may not truly indicate their prevalence in the general population; nevertheless, it is the only available source of information. OBJECTIVE: This study aimed to investigate the prevalence of common dermatoses and compare this with previous reports. METHODS: We reviewed 29,477 new outpatients who visited the department of dermatology at Wonju Severance Christian Hospital from 2010 to 2014, and statistically analyzed the findings. RESULTS: Among the 29,477 outpatients, 14,501 (49.2%) were men and 14,976 (50.8%) were women. More patients were in their sixth decade (17.1%) or over 70 years (15.4%), in their seventh decade (13.5%) or in their fifth decade (13.0%), comprising 59% of the total outpatients. The 20 most common dermatoses were found to be urticaria, dermatophytosis, allergic contact dermatitis, other types of eczema, atopic dermatitis, pruritus, verruca, herpes zoster, alopecia, psoriasis, seborrheic dermatitis, drug eruptions, folliculitis, rosacea, benign epidermal tumor, melanocyte nevus, vitiligo, scabies, herpes simplex virus infection, and bacterial infection. In the distribution of dermatoses as disease groups, viral disease (11.2%), atopic dermatitis and eczema (10.7%); contact dermatitis and drug eruption (10.3%); erythema and urticaria (8.4%); fungal disease (7.6%); skin appendage disease (6.9%); seborrheic dermatitis, psoriasis, and pustular dermatoses (5.5%); epidermal nevi, neoplasms, and cysts (4.8%); pruritus and neurocutaneous dermatoses (4.6%); and acne (3.8%) constituted 73.8% of the total. CONCLUSION: Compared to the previous studies in the same area, the distribution of skin diseases was similar. The increasing tendency of older individuals with diseases in Gangwon province has persisted since 2000.
Acne Vulgaris ; Alopecia ; Bacterial Infections ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Dermatology ; Drug Eruptions ; Eczema ; Erythema ; Female ; Folliculitis ; Gangwon-do* ; Herpes Zoster ; Humans ; Male ; Melanocytes ; Nevus ; Outpatients ; Prevalence ; Pruritus ; Psoriasis ; Rosacea ; Scabies ; Simplexvirus ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Virus Diseases ; Vitiligo ; Warts

BACKGROUND: While the incidence of skin diseases in our university hospital may not indicate their true incidence in the population, it nonetheless represents the only available source of information. Recently, the composition of the Wonju population has changed rapidly in that the population of old people is increasing and urbanization is accelerating. Thus, statistical study of the latest data is necessary. OBJECTIVE: To study the prevalence of common dermatoses and compare this with previous reports. METHODS: We reviewed 27,718 new outpatients who visited the department of dermatology at Wonju Christian Hospital from 2005 to 2009, and statistically analyzed the findings. RESULTS: The study results are summarized as follows: Of the 27,718 outpatients, the total number of male patients was 14,190 (51.2%), and the numbers of female patients was 13,528 (48.8%). The most frequent age groups were the fifth decade (15.9%), sixth decade (13.9%), seventh decade (13.2%), and fourth decade (12.5). The 20 most common dermatoses were dermatophytosis, urticaria, atopic dermatitis, allergic contact dermatitis, other eczema, verruca, alopecia, herpes zoster, pruritus, psoriasis, drug eruption, vitiligo, acne, seborrheic dermatitis, folliculitis, benign epidermal tumors, nevocellular nevus, irritant contact dermatitis, bacterial diseases, and rosacea. The dermatoses which revealed a decreasing tendency to be treated by medicine included dermatophytosis, atopic dermatitis, other eczema, pruritus, psoriasis, drug eruption, vitiligo, acne, and irritant contact dermatitis. An increasing tendency was noted in urticaria, allergic contact dermatitis, verruca, alopecia, herpes zoster, seborrheic dermatitis, folliculitis, benign epidermal tumor and nevocellular nevus. Diseases with high seasonal distribution in summer were dermatophytosis, herpes zoster, vitiligo, folliculitis, irritant contact dermatitis and bacterial infections. However, atopic dermatitis, pruritus, and psoriasis showed high incidence in the winter period. Verruca, acne and nevocellular nevus had a peak incidence in both summer and winter. CONCLUSION: The distinct characteristic of skin diseases of the Gangwon province was a high incidence of pruritus and seborrheic dermatitis which represent the senile diseases.
Acne Vulgaris ; Alopecia ; Bacterial Infections ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Dermatology ; Drug Eruptions ; Eczema ; Female ; Folliculitis ; Herpes Zoster ; Humans ; Incidence ; Male ; Nevus ; Outpatients ; Prevalence ; Pruritus ; Psoriasis ; Rosacea ; Seasons ; Skin Diseases ; Statistics as Topic ; Tinea ; Urbanization ; Urticaria ; Vitiligo ; Warts

Bokbunja (Rubus Coreanus Miquel) is a wild berry to Rosaceae genus of which application areas have been expanded due to many health effects. Bokbunja contains carbohydrates, protein, fats and dietary fibers as major components and various flavonoids such as tannins, volatile components including organic acids, alcohols and hydrocarbons as minor ones. Those active compounds attribute to increase in immune function, antioxidant and anti-inflammatory activity. Recently pure compounds have been isolated from the extracts for the development of medicines. We report here on two cases of acne vulgaris that was successfully treated with Rubus Coreanus Miquel extracts.
Acne Vulgaris ; Alcohols ; Carbohydrates ; Dietary Fiber ; Fats ; Flavonoids ; Fruit ; Hydrocarbons ; Propionibacterium acnes ; Rosacea ; Rosaceae ; Tannins

Kakkonkokato is a special formula used for the treatment of rosacea-like dermatitis lesions in the nasal region, but very few cases treated with this formulation have been reported so far. Here, we report three patients with refractory facial eruptions of rosacea-like dermatitis treated successfully with kakkonkokato. Case1was a 39-year-old man who presented with a 15-year history of rosacea-like dermatitis lesions in the nasal region. After 3 weeks' treatment with kakkonkokato, a marked improvement of his lesions was seen, with disappearance of the redness of his face. Case 2 was a 56-year-old woman who presented with a prolonged history of itchy eruptions around her mouth and nasal region. After 8 weeks' treatment with kakkonkokato, an almost complete disappearance of her eruptions was observed. Case 3 was a 26-year-old woman who presented with atopic dermatitis and intractable erythema under her nose, which was refractory to treatment with steroid ointments and antiallergic agents. After 2 months' treatment with kakkonkokato, her erythema completely resolved, along with improvement of the systemic lesions of atopic dermatitis. The observations in these three cases suggest that kakkonkokato may be a useful formula for the treatment of not only rosacea-like dermatitis in the nasal region, but also of refractory facial eruptions of other causes.
therapeutic aspects ; seconds ; Lesion, NOS ; Nasal ; Acne Rosacea

BACKGROUND: 5-aminolevulinic acid (ALA), is the precursor of heme biosynthesis and used in photodynamic therapy (PDT). When applied exogenously, it is converted to protoporphyrin IX (PpIX) that is an immediate photosensitizer. PpIX is accumulated selectively in various cells including tumor cells. Because most of photosensitizers emit fluorescence of a specific wavelength, it is very important to identify the fluorescence in the tissues and cells targeted for therapy. OBJECTIVE: This study was undertaken to identify the presence of PpIX fluorescence image and localization in various dermatologic diseases with methyl 5-aminolevulinate (MAL), that satisfactorily penetrates cutaneous lipid layers and cell membranes. METHODS: Various skin diseases such as basal cell carcinoma (6), squamous cell carcinoma (4), keratoacanthoma (6), malignant melanoma (3), extramammary Paget's disease (4), verruca (5), psoriasis vulgaris (5), rosacea (2), and acne (5) were included. We applied MAL, ALA ester, ointment to cutaneous lesions and perilesional area for at least 3 hours. After that, we identified the fluorescence image with Wood's lamp (wavelength 320~400 nm) and photographed fluorescence image. Also, we performed skin biopsies of fluorescence site and investigated the PpIX fluorescent location with a fluorescence microscope. In addition, we treated three cultured cell lines (HaCaT cells, human dermal fibroblasts, A431 cells) with MAL and investigated PpIX fluorescence. RESULTS: The PpIX fluorescence images were observed significantly in basal cell carcinoma, squamous cell carcinoma, extramammary Paget's disease, keratoacanthoma, psoriasis, rosacea, and acne. In tissues, PpIX fluorescence was expressed mainly in the pilosebaceous unit, abnormal keratinocytes, tumor cells including basal cell carcinoma, and extramammary Paget's disease. In addition, PpIX was expressed in the cytoplasm of HaCaT cells, human dermal fibroblasts, and A431 cells in vitro. CONCLUSION: In applieation of photodynamic therapy, this study is expected to be helpful in enhancement of therapeutic effectiveness and increase of indications of diseases.
Acne Vulgaris ; Aminolevulinic Acid* ; Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cell Membrane ; Cells, Cultured ; Cytoplasm ; Fibroblasts ; Fluorescence ; Heme ; Humans ; Keratinocytes ; Keratoacanthoma ; Melanoma ; Paget Disease, Extramammary ; Photochemotherapy ; Photosensitizing Agents ; Psoriasis ; Rosacea ; Skin ; Skin Diseases ; Warts

Gram-negative folliculitis is an infection with Gram-negative bacteria that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne or rosacea. A 21-year-old male soldier with acne vulvaris had been treated with broad-spectrum antibiotics for two months because of severe pyoderma on the soles. While the plantar lesions improved significantly, prolonged use of the systemic antibiotics resulted in widespread follicular pustules on his face, scalp, and back of the neck. A skin biopsy showed features of superficial pustular folliculitis. Klebsiella species were identified from the pus culture. A diagnosis of gram-negative folliculitis was made. The lesions almost disappeared after 4 weeks of treatment with oral isotretinoin (0.5 mg/kg/day).
Acne Vulgaris ; Anti-Bacterial Agents* ; Biopsy ; Diagnosis ; Folliculitis* ; Gram-Negative Bacteria ; Humans ; Isotretinoin ; Klebsiella ; Male ; Military Personnel ; Neck ; Pyoderma ; Rosacea ; Scalp ; Skin ; Suppuration ; Young Adult

Gram-negative folliculitis is an infection with Gram-negative bacteria that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne or rosacea. A 21-year-old male soldier with acne vulvaris had been treated with broad-spectrum antibiotics for two months because of severe pyoderma on the soles. While the plantar lesions improved significantly, prolonged use of the systemic antibiotics resulted in widespread follicular pustules on his face, scalp, and back of the neck. A skin biopsy showed features of superficial pustular folliculitis. Klebsiella species were identified from the pus culture. A diagnosis of gram-negative folliculitis was made. The lesions almost disappeared after 4 weeks of treatment with oral isotretinoin (0.5 mg/kg/day).
Acne Vulgaris ; Anti-Bacterial Agents* ; Biopsy ; Diagnosis ; Folliculitis* ; Gram-Negative Bacteria ; Humans ; Isotretinoin ; Klebsiella ; Male ; Military Personnel ; Neck ; Pyoderma ; Rosacea ; Scalp ; Skin ; Suppuration ; Young Adult

BACKGROUND: The prevalence of patients over the age of 25 years with acne has significantly increased over the past 10 years. Several etiologic factors such as genetic factor, hyperandrogenism, stress, and cosmetics have been studied. OBJECTIVES: The purpose of this study is to evaluate the differences between adolescent acne and post-adolescent acne, based on the clinical features, asoociated diseased and aggravating factors of 327 acne patients. METHODS: 327 consective patients, first visited to our hospital with clinical facial acne between March 2000 and February 2001, were enrolled. 220 adolescent patients(AP) were under the age of 25 and post-adolescent patients(PP) were over age of 25. RESULTS: 1. In the face, cheeks and forehead in adolescents, chin and cheeks in post-adolescents were predilection sites. The predominant type was a comedonal type in adolescents and a papulopustular type in post-adolescents(P<0.05). Severity of inflammatory type was not different between two groups. Familial factors were important in both groups, but more frequently found in post-adolescents with persistent acne(P<0.05). 2. Rosacea, chloasma, and hyperandrogenic features such as hirsutism and androgenetic alopecia were more frequently observed in post-adolescents. Seborrheic and atopic dermatitis were more frequent in adolescents. Four patients had all the features of chloasma, acne, rosacea, seborrheic dermatitis and hirsutism. 3. Aggravation by weason especially summer, sweating, stress, and cosmetics was more frequent in adolescents. In PP, acne was more frequently aggravated by sunlight, foods and menstrual period. CONCLUSION: Post-adolescent acne was mainly a papulopustular type predominantly located on the chin and cheeks with mild to moderated severity, and family history and hyperandrogenism were strong etiologic factors in persistent acne. Aggravating factors were not significantly different between two group, which suggested cosmetics and stress might not be important in post adolescent acne.
Acne Vulgaris* ; Adolescent* ; Alopecia ; Cheek ; Chin ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Forehead ; Hirsutism ; Humans ; Hyperandrogenism ; Melanosis ; Prevalence ; Rosacea ; Sunlight ; Sweat ; Sweating

BACKGROUND: Rosacea is a very common affection but so far there are no reliable figures for its true prevalence. Symptoms are usually progressive, but early diagnosis and appropriate management can alleviate patient discomfort and psychological distress as well as prevent serious long term complications. OBJECTIVE: The purpose of this study was to elucidate the clinical observations of rosacea. METHOD: During 1-year-period from feb. 1999 to feb. 2000, 112 patients were evaluated with regard to age, sex, location of skin lesions, clinical type, duration, aggravating and relieving factors, family history, and smoking history. RESULTS: 1. Of the 112 cases were diagnosed with rosacea, 60 were male patients and 52 females. The incidence was peaked in the fifth decades of life. 2. The most common type of rosacea was erythematotelangiectatic rosacea(81.3%) and the average initial severity score of rosacea was 5.55. 3. The average duration of rosacea was 7.9 years. 4. The predilection sites of the rosacea were: nose(48.2%), cheek(27.7%), entire face(24.1%). 5. Associated diseases with rosacea were: seborrheic dermatitis(59.8%), acne(42%), migraine(28.6%), chloasma(22.3%). 6. Associated symptoms with rosacea were: eye symptoms(58.0%), irritating symptoms(60.7%). 7. The aggravating factors of rosacea were: hot bath(58.9%), sun exposure(53.6%), alcohol(48.2%), spicy food(40.2%), emotional stress(36.6%), hot beverages or food(36.6%), coffee and tea(10.7%), summer season(33.0%), and winter season(28.6%). However in summer and on sun exposure 9.8% and 4.5% of the patients were relieved respectively. 8. The relieving factors of rosacea were: rest and relax(55.4%), cooling(34.8%), winter season(15.2%). 9. The family history of rosacea was detected in 20.5% and the smoking history 38.4%.
Acne Vulgaris ; Beverages ; Coffee ; Dermatitis, Seborrheic ; Early Diagnosis ; Female ; Humans ; Incidence ; Male ; Melanosis ; Migraine Disorders ; Prevalence ; Rosacea* ; Skin ; Smoke ; Smoking ; Solar System