BACKGROUND: Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. OBJECTIVE: To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. METHODS: To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. RESULTS: The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. CONCLUSION: Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.
Activities of Daily Living ; Dermatitis, Contact ; Eczema* ; Female ; Hand* ; Health Personnel ; Humans ; Korea* ; Medical Records ; Occupations ; Prevalence ; Quality of Life ; Seasons ; Skin ; Surveys and Questionnaires

The Nocardia species are aerobic Gram-positive filamentous bacteria found worldwide in soil and decaying organic plant matter. Primary cutaneous nocardiosis is a rare entity and most commonly caused by Nocardia brasiliensis (N. brasiliensis). However, it can rarely be caused by N. farcinica, which is recognized as a human pathogen. Here we report a case of a 54-year-old female patient who presented with erythematous nodules on her abdomen for 1 week. She had been treated with methotrexate and prednisolone due to systemic lupus erythematosus and rheumatoid arthritis. By bacterial culture and 16S ribosomal RNA gene sequencing, the patient was diagnosed with a primary cutaneous nocardiosis caused by N. farcinica, which has not previously been reported in the Korean dermatological literature.
Abdomen ; Arthritis, Rheumatoid ; Bacteria ; Female ; Humans ; Lupus Erythematosus, Systemic ; Methotrexate ; Middle Aged ; Nocardia Infections* ; Nocardia* ; Plants ; Prednisolone ; RNA, Ribosomal, 16S ; Soil

BACKGROUND: It has been reported that nail psoriasis is common in psoriatic arthritis (PsA) patients, however, studies on the prevalence of PsA with nail psoriasis and the relationship between the severity of the diseases has not previously been reported in Korea. OBJECTIVE: The aim of this study was to investigate nail psoriasis and its relation to psoriasis and PsA. METHODS: After researching past medical records, 48 patients with nail psoriasis and 247 patients without nail psoriasis were enrolled in this study. Nail psoriasis was classified according to the morphologic types of nails and severity was evaluated using the modified nail psoriasis severity score index (mNAPSI). We assessed the severity of psoriasis and PsA by psoriasis area and severity index (PASI), and swollen and tender joint counts (STJC), respectively. Finally, we analyzed the relationship between mNAPSI, PASI, and STJC. RESULTS: Nail involvement was observed in 48 (16.3%) of 295 patients. Prevalence of PsA was higher in nail psoriasis (31.3%) than in uncomplicated psoriasis (9.3%, p<0.001). mNAPSI showed a positive correlation with STJC (p=0.002, Pearson correlation=0.427), but not with PASI (p=0.094, Pearson correlation=0.202). CONCLUSION: The results show that PsA is more common and severe in psoriatic patients with nail involvement than in uncomplicated psoriasis. Clinicians should be alert to nail involvement in psoriatic patients, as it could be related to the disease course and prognosis of PsA.
Arthritis, Psoriatic* ; Humans ; Joints ; Korea ; Medical Records ; Prevalence ; Prognosis ; Psoriasis*

BACKGROUND: Cyclosporine, which is one of the effective systemic treatments for psoriasis, has a rapid therapeutic effect. However, despite the efficacy of cyclosporine, the recurrence of psoriasis may still occur if treatment with this drug is discontinued. Several studies on the efficacy and safety of cyclosporine for psoriasis have already been conducted. However, studies on the factors causing psoriasis recurrence after cyclosporine treatment are rare. OBJECTIVE: The aim of this study was to identify the factors that cause recurrence of psoriasis in patients treated with cyclosporine. METHODS: We performed a retrospective study of the medical records obtained between January 2007 and March 2014 of 174 patients diagnosed with psoriasis and followed up for at least 6 months after treatment. We analyzed the differences in the demographic characteristics, body surface area, psoriasis area and severity index (PASI) score, psoriasis type, accompanying psoriatic nail, involvement of exposed areas, and several treatment-related factors (starting dose, last dose, maximal dose, cumulative dose, mean daily dose, and treatment duration) between the group that experienced a recurrence and the group that did not. Additionally, we analyzed the effects of these factors on the recurrence and the time to recurrence. RESULTS: Of the 174 patients, 57 (32.8%) reported a recurrence of the disease. There were statistically significant differences between the two groups in terms of their PASI score (p=0.031) and mean daily dose (p=0.014). In the multiple logistic regression analysis, the PASI score (p=0.017, odds ratio=1.057) and treatment duration (p=0.035, odds ratio=0.984) showed a significant relation with relapse. CONCLUSION: This study suggests that long-term treatment with cyclosporine is necessary for high-severity psoriasis in patients to prevent recurrence. However, as this study is retrospective, further prospective and large-scale studies are necessary to confirm this fact.
Body Surface Area ; Cyclosporine* ; Humans ; Logistic Models ; Medical Records ; Psoriasis* ; Recurrence* ; Retrospective Studies

BACKGROUND: Cyclosporine, which is one of the effective systemic treatments for psoriasis, has a rapid therapeutic effect. However, despite the efficacy of cyclosporine, the recurrence of psoriasis may still occur if treatment with this drug is discontinued. Several studies on the efficacy and safety of cyclosporine for psoriasis have already been conducted. However, studies on the factors causing psoriasis recurrence after cyclosporine treatment are rare. OBJECTIVE: The aim of this study was to identify the factors that cause recurrence of psoriasis in patients treated with cyclosporine. METHODS: We performed a retrospective study of the medical records obtained between January 2007 and March 2014 of 174 patients diagnosed with psoriasis and followed up for at least 6 months after treatment. We analyzed the differences in the demographic characteristics, body surface area, psoriasis area and severity index (PASI) score, psoriasis type, accompanying psoriatic nail, involvement of exposed areas, and several treatment-related factors (starting dose, last dose, maximal dose, cumulative dose, mean daily dose, and treatment duration) between the group that experienced a recurrence and the group that did not. Additionally, we analyzed the effects of these factors on the recurrence and the time to recurrence. RESULTS: Of the 174 patients, 57 (32.8%) reported a recurrence of the disease. There were statistically significant differences between the two groups in terms of their PASI score (p=0.031) and mean daily dose (p=0.014). In the multiple logistic regression analysis, the PASI score (p=0.017, odds ratio=1.057) and treatment duration (p=0.035, odds ratio=0.984) showed a significant relation with relapse. CONCLUSION: This study suggests that long-term treatment with cyclosporine is necessary for high-severity psoriasis in patients to prevent recurrence. However, as this study is retrospective, further prospective and large-scale studies are necessary to confirm this fact.
Body Surface Area ; Cyclosporine* ; Humans ; Logistic Models ; Medical Records ; Psoriasis* ; Recurrence* ; Retrospective Studies

No abstract available.

BACKGROUND: Autoimmune blistering skin diseases such as pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid and epidermolysis bullosa acquisita substantially affect patients' daily life and psychosocial well-being. OBJECTIVE: The aim of this study was to evaluate the quality of life (QOL) in patients with autoimmune blistering diseases and to identify the factors that can influence their QOL by comparing them to healthy controls. METHODS: Forty patients with autoimmune blistering skin diseases and 40 healthy controls were interviewed using the Korean version of Skindex-29. The study assessed the clinical severity of the disease. RESULTS: The total, symptom, function, and emotion scores of Skindex-29 were significantly higher in patients with autoimmune blistering skin diseases (35.28, 40.78, 30.57, and 36.67, respectively) than in the healthy controls (6.90, 9.38, 5.47, and 6.60, respectively) (p<0.001). Higher disease severity had a negative correlation with QOL in patients with blistering skin diseases, and QOL was lower when patients had low levels of satisfaction with treatment. CONCLUSION: The results show that autoimmune blistering skin diseases can affect patients' QOL. In addition, disease severity and low satisfaction with treatment are important factors that reduce QOL. Development of new treatments should improve treatment efficacy and the QOL of patients with autoimmune blistering diseases.
Blister* ; Epidermolysis Bullosa Acquisita ; Humans ; Pemphigoid, Bullous ; Pemphigus ; Quality of Life* ; Skin Diseases* ; Skin Diseases, Vesiculobullous ; Treatment Outcome

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Demography ; Eczema/pathology ; Face/pathology ; Female ; Humans ; Lupus Erythematosus, Cutaneous/pathology ; Male ; Middle Aged ; Psoriasis/pathology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Tinea/*diagnosis/microbiology ; Trichophyton/isolation & purification ; Young Adult

Fasciitis can occur very rarely with sclerotic-type chronic cutaneous graft-versus-host disease (GVHD). A 54-year-old woman presented with painful skin tightness on upper and lower limb with limited range of movement. She was diagnosed with chronic myelocytic leukemia 5 years ago and underwent allogeneic bone marrow transplantation. Histopathologically, the interlobular septum of subcutis and fascia were remarkably thickened with fibrosis and moderate inflammatory infiltrates accompanying the dilated lymphatic channels with considerable leakage of lymph fluids. Herein, we report a case of extensive fasciitis as a manifestation of chronic GVHD associated with poor prognosis.
Bone Marrow Transplantation ; Fascia ; Fasciitis ; Female ; Fibrosis ; Graft vs Host Disease ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Lower Extremity ; Prognosis ; Skin

Myxoid and round cell liposarcoma is a variant of liposarcoma characterized by a morphologic continuum in which tumor progression from low-grade myxoid to high-grade hypercellular or round cell areas may be observed. A 28-year old man presented with a painful skin colored subcutaneous mass on his left flank. The skin lesion was discovered about two months ago. Computed tomography revealed a well-defined tumor in the subcutaneous area without significant lymphadenopathy. A histopathologic study showed a nonencapsulated nodular growing tumor mass under the deep dermis composed of a mixture of atypical proliferating lipoblasts in a prominent myxoid stroma, occasional uniform round to oval shaped primitive nonlipogenic mesenchymal cells and plexiform, chicken wire shaped capillaries. Based on these findings, we diagnosed this case as myxoid and round cell liposarcoma. Because liposarcomas are large tumors of the deep subcutis or deeper soft tissue, they rarely come to the attention of the dermatologist. However, liposarcoma should be of concern, especially when rapid growing subcutaneous tumors are shown.
Abdomen ; Capillaries ; Chickens ; Dermis ; Liposarcoma ; Lymphatic Diseases ; Skin ; Subcutaneous Tissue