After anaplastic large-cell lymphoma (ALCL) was first described by Stain in 1985, there have been several histological variants of ALCL reported. There are classified histological subtypes of ALCL, such as lymphohistiocytic, small cell, Hodgkin-like, composite pattern, and other less common variants including neutrophil-rich ALCL. A 63-year-old male patient presented with erythematous exophytic mass on the left lower leg. In the past, his condition had been diagnosed as abdominal primary cutaneous ALCL (pcALCL), which recurred as systemic ALCL (sALCL) in the left bronchus. After treatment, he achieved complete remission. Histopathologic examination showed large-sized pleomorphic, anaplastic mitotic tumor cells, several neutrophils, and a few lymphocytes. Neutrophil-rich ALCL is a rare histological variant of ALCL. It is characterized by the presence of CD30-positive anaplastic tumor cells with numerous neutrophil infiltrations. Neutrophil-rich ALCL responds well to treatment but tends to recur. There were four cases reported to have recurrent neutrophilrich ALCL. All cases were diagnosed with neutrophil-rich pcALCL prior to recurrence.Three cases had local recurrence, and only one case relapsed as sALCL. Herein, we present the first case of neutrophil-rich ALCL recurring as sALCL twice.

Background: Oral alitretinoin is effective in the treatment of chronic hand eczema (CHE), and ≥12 weeks of alitretinoin treatment has been shown to be effective in Korean patients.However, in the real world, a considerable number of patients discontinue alitretinoin, which leads to treatment failure. Objective: To evaluate the compliance rate of alitretinoin treatment and explore common reasons for poor compliance in patients with CHE in the real world. Methods: We retrospectively reviewed the electronic medical records of CHE patients treated with alitretinoin. We defined ‘poor-compliance’ as subjects who were treated with alitretinoin for ＜12 weeks and ‘good-compliance’ as subjects who were treated with alitretinoin for ≥12 weeks. We reviewed the demographics, dose, and duration of alitretinoin usage, efficacy, and reasons for poor compliance. Results: A total of 137 subjects were enrolled, and 77 (56.2%) did not complete the 12-week treatment with alitretinoin. Among them, the non-improvement rate was significantly higher in the poor-compliance group than in the good-compliance group (p＜0.01). The main reasons for the alitretinoin cessation in the poor-compliance group were insufficient response (40.8%), followed by high cost (34.7%), and adverse events (24.5%). Conclusion Alitretinoin appears the preferred longterm treatment option for CHE. Although there are complaints about late efficacy, cost, and side effects, following proper explanation, these should not justify discontinuation. Physicians need to recognize the reasons for poor compliance with alitretinoin for each patient and suggest continuing alitretinoin for the successful treatment of CHE.

Purpose: This study used a mixed methods research design in an attempt to verify the effects of robot-assisted rehabilitation on the gait ability of stroke patients with hemiplegia, and thereby further understand the benefits and challenges of stroke patients’ experiences relying on robot-assisted rehabilitation. Methods: An exploratory sequential mixed methods study design was used in order to combine both quantitative and qualitative data. For the quantitative data collection, a total of 30 stroke patients with hemiplegia were recruited from one rehabilitation hospital. Qualitative data were collected through individual interviews using semi-structured questionnaires for a group of 15 patients who were currently undergoing robot-assisted rehabilitation. The data were analyzed through qualitative content analysis. Results: As a result of the quantitative analysis, there were significant differences between the two groups in terms of daily living activity patterns, total number of steps, and average walking speed. As a result of the qualitative analysis, the four main themes derived consisted of, ‘curiosity about the usage of robot-assisted rehabilitation,’ ‘pleasure experienced while using the robots,’ ‘insufficient information about robots,’ and ‘a lack of education about robot-assisted rehabilitation.’ Conclusions Robot-assisted rehabilitation had a significant effect on the walking ability of stroke patients with hemiplegia. Additionally, stroke patients with hemiplegia experienced difficulty during the course of their robot-assisted rehabilitation, due to a lack of sufficient information on correct usage techniques. These quantitative and qualitative findings could provide the basic foundation for the development of an educational program on robot-assisted rehabilitation.

Background: The skin barrier is made of the outermost layers of skin and is responsible for preventing cutaneous water loss. Skin barrier function is easily affected by external environmental factors, such as temperature and relative humidity, especially in areas with four distinct seasons, such as Busan, Korea. Objective: This study was conducted to analyze the seasonal variation in skin barrier function on the face and to determine whether it is affected by thermo-hygrostat conditioning. Methods: Ten healthy female volunteers aged 28 to 34 years were enrolled in this study. Each subject was put into a thermo-hygrostat–controlled room maintained at a temperature of 22.4°C to 23.8°C with a relative humidity of 50.2% to 52.0%. Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) were measured before and after a 20-minute session in the room. Measurements were taken once in the middle of each season. Results: Regardless of thermo-hygrostat conditioning, TEWL and SCH values changed significantly between all four seasons (both p＜0.001). With thermo-hygrostat conditioning, 1 of 6 ΔTEWL and 4 of 6 ΔSCH values showed significant seasonal differences in post-hoc analysis. Difference of TEWL and SCH obtained before and after thermo-hygrostat conditioning was significant only in summer (TEWL, p=0.009; SCH, p=0.002). Conclusion Skin barrier function differed significantly between seasons, regardless of thermo-hygrostat conditioning. Thermo-hygrostat conditioning significantly affected TEWL and SCH only during summer. However, with Busan’s excessively humid summer, even a short period of thermo-hygrostat conditioning could increase the precision of skin barrier function measurement.

Background: Vulvar dermatoses are common, but numerous obstacles impede their adequate clinical investigation. Many outpatient patients with vulvar dermatoses had inappropriate behavioral habits to manage their diseases. Objective: This study was performed to investigate the clinical aspects of vulvar dermatoses and to evaluate the proper management for vulvar eczema and pruritus vulvae. Methods: We retrospectively reviewed medical records from female patients presenting with vulvar dermatoses in a tertiary hospital and analyzed the age, clinical manifestation, diagnosis, and further evaluated treatment and clinical course of vulvar eczema and pruritus vulvae. Results: A total of 163 patients were reviewed in this study. The most frequent type of skin manifestation was macule/patch, with itching as the most common symptom. Lichen simplex chronicus (35, 21.5%) was the most common dermatosis, followed by lichen sclerosus et atrophicus (21, 12.9%) and Behcet’s disease (18, 11.0%). In addition, 57 patients (35.0%) suffered from acute/chronic vulvar eczema or pruritus vulvae and over half of them had been misdiagnosed as fungal infection or had mistreated themselves with multiple self-products. These patients mostly showed good response to hygiene management plus low potency topical corticosteroids. Conclusion In this study, we identified clinically common vulvar dermatoses in a cohort of women visiting our dermatology clinic. We found that patients with vulvar eczema or pruritus vulvae suffered from misdiagnosis and inappropriate self-management sustained patients’ problems. They could be effectively controlled by education of hygiene management with/without steroids. Further prospective investigation with a larger group of patients would provide better understanding of the characteristics of vulvar dermatoses.

Background: The skin barrier is made of the outermost layers of skin and is responsible for preventing cutaneous water loss. Skin barrier function is easily affected by external environmental factors, such as temperature and relative humidity, especially in areas with four distinct seasons, such as Busan, Korea. Objective: This study was conducted to analyze the seasonal variation in skin barrier function on the face and to determine whether it is affected by thermo-hygrostat conditioning. Methods: Ten healthy female volunteers aged 28 to 34 years were enrolled in this study. Each subject was put into a thermo-hygrostat–controlled room maintained at a temperature of 22.4°C to 23.8°C with a relative humidity of 50.2% to 52.0%. Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) were measured before and after a 20-minute session in the room. Measurements were taken once in the middle of each season. Results: Regardless of thermo-hygrostat conditioning, TEWL and SCH values changed significantly between all four seasons (both p＜0.001). With thermo-hygrostat conditioning, 1 of 6 ΔTEWL and 4 of 6 ΔSCH values showed significant seasonal differences in post-hoc analysis. Difference of TEWL and SCH obtained before and after thermo-hygrostat conditioning was significant only in summer (TEWL, p=0.009; SCH, p=0.002). Conclusion Skin barrier function differed significantly between seasons, regardless of thermo-hygrostat conditioning. Thermo-hygrostat conditioning significantly affected TEWL and SCH only during summer. However, with Busan’s excessively humid summer, even a short period of thermo-hygrostat conditioning could increase the precision of skin barrier function measurement.

Background: Patients with rosacea usually suffer from skin irritations, such as itching, stinging, burning, and pain.These symptoms may be related to the skin barrier function disruption. Objective: We investigated the skin barrier functions in patients with mild to moderate rosacea and the associated improvements based on the skin care habit modifications and treatment modalities. Methods: We analyzed the data on transepidermal water loss (TEWL) and stratum corneum hydration (SCH) of skin lesions in 27 patients with rosacea and healthy skin of 29 control subjects. We compared the results of TEWL and SCH based on sex, age, type of rosacea, skin care habits, and the treatment modalities. Results: The skin in the patients with rosacea exhibited increased TEWL and decreased SCH compared with that in control subjects. Male patients showed increased TEWL and decreased SCH compared to female patients. Combination therapy with systemic minocycline and topical metronidazole improved the skin barrier functions. Patients with better skin care habits presented better skin barrier functions and clinical improvement. Conclusion Patients with rosacea, especially those with poor skin care habits, showed reduced skin barrier functions. Appropriate skin care habits with cleansers and moisturizers are recommended for the management of rosacea.

We performed a point seroprevalence survey of measles among healthcare workers (HCWs) at two Korean teaching hospitals in 2019. A total of 2,830 HCWs underwent an antibody test.The overall seropositivity of measles was 93.1%. The seroprevalence of measles was lowest in HCWs aged 20 - 24 years (81.2%), followed by those aged 25 - 29 years (90.1%). The rates of anti-measles IgG positivity were significantly different between the two hospitals (97.0% vs.89.4%, P <0.001). These results suggest that the seropositivity of measles in HCWs may differ depending on the hospital's vaccination policy.