Background: Pigmented purpuric dermatosis (PPD) is known as a chronic recurrent eruption which usually presents with petechiae and pigmented macules on the lower extremities.Dermoscopy is a noninvasive diagnostic tool in identifying pigmented and vascular lesions, which can also be beneficial in the evaluation of PPD. Objective: We aimed to analyze the common dermoscopic characteristics of PPD, and correlate those findings with the histopathologic features. Additionally, dermoscopic and pathological findings in this study population were compared with other similar studies from the literature review. Methods: A retrospective analysis was performed using data of 60 patients who were diagnosed as PPD by skin biopsy and had dermoscopic examination. The pathologic analysis was performed by categorizing the pattern into lichenoid, perivascular, interface, and spongiotic subtype, and the dermoscopic assessment was performed by the three authors independently. Results: In dermoscopy, 96.7% of the patients showed red globules and dots, followed by brownish patch, coppery-red pigmentation, and annular comma-like vessels. The pathologic pattern analysis revealed statistically significant association of lichenoid pattern with coppery red pigmentation, perivascular pattern with annular/comma-like vessels, and spongiosis pattern with reticular pigmented network and linear vessels. The interrater similarity test showed total kappa value of 0.811which referred to “very good”. Conclusion In this study, the prevalence of dermoscopic features in Asian PPD patients was identified, which was similar with previous studies. The dermoscopic-pathologic correlation was found in four dermoscopic features. We suggest that dermoscopic examination is helpful in clinical diagnosis and pathological prediction of PPD.

Background: Pigmented purpuric dermatosis (PPD) is known as a chronic recurrent eruption which usually presents with petechiae and pigmented macules on the lower extremities.Dermoscopy is a noninvasive diagnostic tool in identifying pigmented and vascular lesions, which can also be beneficial in the evaluation of PPD. Objective: We aimed to analyze the common dermoscopic characteristics of PPD, and correlate those findings with the histopathologic features. Additionally, dermoscopic and pathological findings in this study population were compared with other similar studies from the literature review. Methods: A retrospective analysis was performed using data of 60 patients who were diagnosed as PPD by skin biopsy and had dermoscopic examination. The pathologic analysis was performed by categorizing the pattern into lichenoid, perivascular, interface, and spongiotic subtype, and the dermoscopic assessment was performed by the three authors independently. Results: In dermoscopy, 96.7% of the patients showed red globules and dots, followed by brownish patch, coppery-red pigmentation, and annular comma-like vessels. The pathologic pattern analysis revealed statistically significant association of lichenoid pattern with coppery red pigmentation, perivascular pattern with annular/comma-like vessels, and spongiosis pattern with reticular pigmented network and linear vessels. The interrater similarity test showed total kappa value of 0.811which referred to “very good”. Conclusion In this study, the prevalence of dermoscopic features in Asian PPD patients was identified, which was similar with previous studies. The dermoscopic-pathologic correlation was found in four dermoscopic features. We suggest that dermoscopic examination is helpful in clinical diagnosis and pathological prediction of PPD.

Background: Applying antibiotic ointment after skin surgery can decrease infection and improve scar. Epidermal growth factor (EGF) is known to be able to promote the growth and movement of epidermal cells to stimulate wound healing. Recombinant human EGF (rhEGF) ointment can be used in wet closed dressing to promotes wound healing and prevent complications by maintaining a wet environment. Objective: To compare the efficacy of rhEGF ointment and conventional antibiotic ointment after cutaneous resection. Methods: Patients who had excision procedures in two or more sites were enrolled. Each wound was assigned to the rhEGF group or the antibiotic ointment group. Wounds were subjected to Physician Global Assessment (PhGA), Patient Global Assessment (PGA), and Patient satisfaction assessment (PSA). The length and area of wounds, and melanin and erythema index (MI and EI) were also assessed for these wounds. Results: Among 11 patients with a total of 20 pairs of resection sites, PhGA, PGA, MI, and EI showed no significant difference between rhEGF and antibiotic ointment groups. However, changes in length and area of wounds showed significant differences between the two groups. Conclusion RhEGF ointment showed similar short-term cosmetic results with antibiotic ointment, and improved surgical results in regards of the wound size. Applying rhEGF could reduce the use of antibiotic ointments for cutaneous clean (class I) wound surgery.

Basal cell carcinoma is a common cancer and has been reported to account for approximately 80% of non-melanoma skin cancers. Superficial basal cell carcinoma occurs mainly in the trunk or limbs and is characterized by clinical features of scaly erythema with or without epidermal atrophy. These clinical features require differentiation from those of other benign and malignant skin diseases. Recently, specific dermoscopic findings of basal cell carcinoma have been helpful for diagnosis. Common dermoscopic findings of superficial basal cell carcinoma include superficial telangiectasia and maple leaf-like areas. Herein, we report a case of superficial basal cell carcinoma that was not diagnosed by punch biopsy but by dermoscopy.

BACKGROUND: Rosacea is a chronic inflammatory disease characterized by centrofacial erythema. Excess cathelicidin is suggested to be important to the pathophysiology of the disease. Recently, presence of a vitamin D response element was revealed in the cathelicidin gene promoter. OBJECTIVE: The aim of this study was to determine whether vitamin D and cathelicidin are associated with rosacea, both serologically and histopathologically. METHODS: Subjects with rosacea and without chronic skin disorders were enrolled in the patient and control groups, respectively. Serum 25-hydroxy-vitamin D and cathelicidin levels were measured. Tissue expression of cathelicidin and vitamin D receptor were measured with immunostaining-intensity-distribution index. RESULTS: The mean serum 25-hydroxyvitamin D level of patients with rosacea was 12.18±5.65 ng/ml, which is lower than that of the controls (17.41±6.75 ng/ml). Mean serum cathelicidin levels in patients with rosacea and the controls were 85.0±26.1 ng/ml and 55.0±23.3 ng/ml, respectively. Cathelicidin expression in rosacea tissue was significantly higher than that in control tissue (5.21 vs. 4.03). No significant difference was observed in vitamin D receptor expression. CONCLUSION: Higher cathelicidin expression in rosacea supports the hypothesis that an abnormal inflammatory response of the innate immune system is important in pathogenesis of rosacea, but the role of high cathelicidin serum levels is complicated. Serum vitamin D was lower in patients with rosacea, although serum cathelicidin was higher than that of the controls. This suggests that the role of vitamin D level in the pathogenesis of rosacea merits further investigation.
Erythema ; Humans ; Immune System ; Receptors, Calcitriol ; Rosacea* ; Skin ; Vitamin D Response Element ; Vitamin D* ; Vitamins*

OBJECTIVES: Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. METHODS: We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. RESULTS: A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. CONCLUSIONS: The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.
Biliary Tract Neoplasms ; Blood Glucose ; Breast ; Cardiovascular Diseases ; Cholesterol ; Cohort Studies ; Colon ; Colonic Neoplasms ; Diabetes Mellitus, Type 2 ; Female ; Follow-Up Studies ; Gallbladder ; Humans ; Hypertension ; Kidney Neoplasms ; Larynx ; Liver ; Male ; Metabolome ; National Health Programs ; Obesity ; Ovarian Neoplasms ; Pharynx ; Proportional Hazards Models ; Rectum ; Risk Factors ; Smoke ; Smoking

INTRODUCTIONThere have been intermittent reports of peroneal neuropathy (PN) occurring after liver transplantation. Although PN may not be viewed as a serious complication by liver transplant (LT) recipients who require the transplant for survival, PN can significantly reduce quality of life. The incidence of PN appears to have increased after the use of gel pads was introduced. These gel pads, which are placed under patients' knees during surgery, are used to reduce lower back strain and prevent contact between the peroneal nerve at the fibular head and the hard surface of the operating table. The aim of the present study was to investigate the association, if any, between the use of gel pads and the incidence of PN.

METHODSThe medical records of 261 adult LT recipients were retrospectively reviewed. The recipients were divided into gel pad (n = 167) and non-gel pad (n = 94) groups. The incidence and possible risk factors of PN were compared between the two groups.

RESULTSThe overall incidence of PN was 8.0% (21/261). The occurrence of PN was significantly higher in the gel pad group than in the non-gel pad group (10.8% vs. 3.2%; p < 0.05). Other possible risk factors were comparable between the two patient groups.

CONCLUSIONAs the use of gel pads may increase the incidence of PN, we recommend against the use of gel pads under the knees of LT recipients.

Adult ; Female ; Gels ; Humans ; Incidence ; Liver Failure ; complications ; surgery ; Liver Transplantation ; adverse effects ; Low Back Pain ; prevention & control ; Male ; Middle Aged ; Peroneal Neuropathies ; etiology ; prevention & control ; Postoperative Complications ; prevention & control ; Protective Devices ; Quality of Life ; Retrospective Studies ; Risk Factors ; Treatment Outcome

No abstract available.

BACKGROUND: The reconstruction of eyelid defects is extremely complex because both functional and aesthetic aspects should be considered. Numerous techniques for reconstruction are available for repairing eyelid defects, depending on the size, location, and extent of the defect. OBJECTIVE: This study was aimed at assessing the effectiveness and cosmetic consequences of various reconstruction techniques for eyelid defects after Mohs micrographic surgery. METHODS: Twenty patients who received a diagnosis of skin cancer of the eyelids from November 2005 to August 2009 were analyzed. Among them, 15 patients were treated with a local flap to reconstruct the defective eyelids, and the remaining patients were treated with primary closure. The medical records and photographs were reviewed by two independent physicians, and postoperative results were evaluated. RESULTS: Eyelid defects were reconstructed with various surgical techniques, such as primary closure, transposition flap, subcutaneous island pedicle flap, advancement flap, rotation flap, Tenzel flap, and hard palate mucous membrane graft. The cosmetic results were satisfactory, and 16 of 20 (80%) patients showed good to excellent results. However, one patient developed a sclera show and another patient showed tumor recurrence. CONCLUSION: Many reconstruction techniques can be used for eyelid defects. An optimal choice would be one that is based on the extent, depth, and location of the defect; skin condition and wishes of the patient; and the surgeon's experience. Furthermore, it is important to have an understanding of the anatomy of the eyelid, the basic principles of the reconstruction techniques, and the merits and drawbacks of each technique.
Diagnosis ; Eyelids* ; Humans ; Medical Records ; Mohs Surgery* ; Mucous Membrane ; Palate, Hard ; Recurrence ; Sclera ; Skin ; Skin Neoplasms* ; Transplants

BACKGROUND: Liposuction and laser ablation for treatment of osmidrosis are leading treatment methods for osmidrosis and have less complication compare to conventional surgical method. We treated patients with the two methods simultaneously to maximize the efficiency for less complication. METHODS: Eighteen patients with axillary osmidrosis (total 36 axillae) were included in this study. They had been treated by liposuction with diode laser ablation from December 2011 to August 2012. The results of operation was assessed by questionnaire subjectively and microscopic study objectively. RESULTS: Eighteen patients were followed over 10 months postoperatively (range, 10 to 18 months; mean, 13.8 months). The patients were satisfied with their results in terms of reduced foul odor except one patient. No hematoma, infections, skin necrosis, hair loss or hypertrophic scar occurred. And there was quantitative reduction of apocrine glands in microscopic study. CONCLUSIONS: We suggest that simultaneous apply of liposuction with laser ablation which is clinically and histologically proven method for treatment of axillary osmidrosis could be more effective method than treatment with each method alone, and has same morbidity allowing the patients early exercise.
Apocrine Glands ; Cicatrix, Hypertrophic ; Hair ; Hematoma ; Humans ; Hyperhidrosis ; Laser Therapy ; Lasers, Semiconductor* ; Lipectomy* ; Methods ; Necrosis ; Odors ; Skin ; Surveys and Questionnaires