BACKGROUND: Nodular fasciitis presents as a solitary, slightly painful, rapidly growing nodule. It is associated with a reactive, proliferative process of unknown cellular origin and can be misdiagnosed as a sarcoma. OBJECTIVE: Our study was designed to investigate the process and cellular origin of the disease. METHODS: The clinical and histopathologic findings from 28 cases of nodular fasciitis were reviewed. Additional histochemical and immunohistochemical staining was done. RESULTS: The mean age of onset was 29.8 years. A majority of patients with nodular fasciitis had a duration of symptoms of less than 6 months. The upper extremity and face were most frequently involved. Most of the lesions had diameters less than 2 cm. Total excisions were performed in 23 lesions; 3 lesions recurred thereafter. Histopathologically, a subcutaneous plane was most frequently involved. The nodule consisted of numerous large, pleomorphic fibroblasts growing haphazardly in a vascular stroma containing varying amounts of mucoid ground substance, which was confirmed by histochemical stains. In the immunohistochemical stain, most lesions had positive findings for smooth muscle actin (SMA), vimentin and negative findings for CD34 except in a few cases. The stains for desmin and S-100 were negative in all cases. CONCLUSION: It is suggested that nodular fasciitis is associated with a reactive proliferation of myofibroblasts rather than with a sarcomatous process.
Actins ; Age of Onset ; Coloring Agents ; Desmin ; Fasciitis ; Fibroblasts ; Humans ; Muscle, Smooth ; Myofibroblasts ; Upper Extremity ; Vimentin

BACKGROUND: Interplay of numerous constitutional and precipitating factors are involved in the development of atopic dermatitis (AD). Most of these etiologic factors are not controllable, but barrier dysfunction can be managed. Correction of barrier abnormalities has been accepted as a first-line therapy with effective anti-inflammatory therapy. OBJECTIVE: We wished to establish standardized skin care guidelines for Korean patients who suffer from atopic dermatitis. METHODS: The skin care guidelines were proposed by the Korean Atopic Dermatitis Association (KADA), with a particular emphasis for barrier dysfunction in AD from a review of more than 100 published studies and related documents in the clinical literature by a task force team (TFT) of the KADA. The TFT also evaluated the reliability of the studies based on scientific evidence and the size of the study populations. The TFT disregarded controversial findings and summarized all of the collected studies. RESULTS: Skin care guidelines were proposed by the KADA, particularly for barrier dysfunction in AD. A warm bath for approximately 20 minutes was recommended once daily. Soap can be used two or three times per week and aggressive skin scrubbing should be avoided. A topical moisturizer should be applied at least twice a day. Immediate application of emollient is required after bathing. The donning of clothing made of cotton is recommended. Nails should be cut short to reduce skin damage caused by a skin scratch. CONCLUSION: Application of moisturizer immediately after appropriate bathing may be the most important treatment for skin care. A topical steroid should be used whenever AD develops. Nail care and proper clothing are also be helpful for the prevention of dermatitis aggravation. Proper ways to bathe, use of moisturizer and topical steroids and nail care and appropriate clothing were considered.
Advisory Committees ; Baths ; Clothing ; Dermatitis ; Dermatitis, Atopic ; Humans ; Nails ; Precipitating Factors ; Skin ; Skin Care ; Soaps ; Steroids

BACKGROUND: The pathogenesis of melasma has not yet been clearly demonstrated. But, clinical manifestations such as remarkable lesional symmetry and the distribution related to trigeminal nerves, suggest that the neural system could play a pathogenic role in melasma. OBJECTIVE: This study was carried out to examine the expression of some neuropeptides and their receptors, which are well known to be major contributors of neuroinflammation in many dermatoses, in melasma lesions. METHODS: Skin biopsies were obtained from the lesional and non-lesional facial skin of 6 Korean women with melasma. Immunofluorecence staining and confocal laser scanning microscopy were performed. RESULTS: In our results, no difference could be detected with regard to the intensity of immunoreactivity for vasoactive intestinal peptide (VIP), calcitonin gene-related peptide (CGRP), calcitonin gene-related peptide receptor (CGRPR), substance P (SP), substance P receptor (SPR), somatostatin (SOM), pituitary adenylate cyclase activating peptide (PACAP) and pituitary adenylate cyclase activating peptide receptor (PACAPR) in the lesional skins compared with the non-lesional skins. CONCLUSION: These results suggest that neuroinflammation induced by neuropeptides such as substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and somatostatin and their receptors included in this study, are not directly associated with melasma pathogenesis.
Adenylyl Cyclases ; Biopsy ; Calcitonin Gene-Related Peptide ; Female ; Humans ; Melanosis ; Microscopy, Confocal ; Neuropeptides ; Receptors, Neurokinin-1 ; Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide ; Skin ; Skin Diseases ; Somatostatin ; Substance P ; Trigeminal Nerve ; Vasoactive Intestinal Peptide

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that's influenced by many genetic and environmental factors. Various treatment modalities are being applied for AD, including phototherapy, topical applicants and systemic agents. However, there has been no mass survey in Korea concerning the compliance of patients' to use their prescribed medication, which might influence the clinical efficacy of the physicians' treatment. OBJECTIVE: The purpose of the present study is to evaluate the efficacy, safety and patient compliance with using topical pimecrolimus to treat AD. METHODS: We reviewed the medical recordings, laboratory profiles, clinical severity scoring and photographs of AD patients at 9 general hospitals in Seoul and the local area of Korea. Interviews with the patients and a telephone survey were also done. Those patients who weren't perscribed topical applicants or those who did not use topical pimecrolimus or steroid within 6 months were excluded from this study. RESULTS: Topical pimecrolimus cream effectively controlled AD with a reduction of the EASI score from baseline 13.75 to 11.39 at 2 weeks and 4.46 at 10 weeks of topical pimecrolimus application. When topical pimecrolimus cream was applied for more than 12 months it significantly suppressed the recurrence and reactivation of AD (p<0.05). Although 22.6% of the patients complained of adverse effects, these were all transient and they did not evoke significant medical problems. Using topical pimecrolimus cream did not show significant adverse effects or complications. CONCLUSION: Topical pimecrolimus might well be an effective treatment modality for treating AD when patients show good compliance for applying the cream.
Compliance ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Korea ; Medical Records ; Patient Compliance ; Phototherapy ; Recurrence ; Skin Diseases ; Tacrolimus ; Telephone

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that's influenced by many genetic and environmental factors. Various treatment modalities are being applied for AD, including phototherapy, topical applicants and systemic agents. However, there has been no mass survey in Korea concerning the compliance of patients' to use their prescribed medication, which might influence the clinical efficacy of the physicians' treatment. OBJECTIVE: The purpose of the present study is to evaluate the efficacy, safety and patient compliance with using topical pimecrolimus to treat AD. METHODS: We reviewed the medical recordings, laboratory profiles, clinical severity scoring and photographs of AD patients at 9 general hospitals in Seoul and the local area of Korea. Interviews with the patients and a telephone survey were also done. Those patients who weren't perscribed topical applicants or those who did not use topical pimecrolimus or steroid within 6 months were excluded from this study. RESULTS: Topical pimecrolimus cream effectively controlled AD with a reduction of the EASI score from baseline 13.75 to 11.39 at 2 weeks and 4.46 at 10 weeks of topical pimecrolimus application. When topical pimecrolimus cream was applied for more than 12 months it significantly suppressed the recurrence and reactivation of AD (p<0.05). Although 22.6% of the patients complained of adverse effects, these were all transient and they did not evoke significant medical problems. Using topical pimecrolimus cream did not show significant adverse effects or complications. CONCLUSION: Topical pimecrolimus might well be an effective treatment modality for treating AD when patients show good compliance for applying the cream.
Compliance ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Korea ; Medical Records ; Patient Compliance ; Phototherapy ; Recurrence ; Skin Diseases ; Tacrolimus ; Telephone

BACKGROUND: Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin, which can involve any organs including the skin. OBJECTIVE: The purpose of this study is to investigate the clinical characteristics of sarcoidosis in patients in Seoul and Gyeonggi-do. METHODS: A total of 62 patients with sarcoidosis, where sarcoidosis was confirmed by histopathologic examinations at seven university hospitals in Seoul and Gyeonggi-do from 2000 to 2006, were enrolled in this study. The clinical characteristics were analyzed by a thorough review of medical records, histopathologic and radiologic examinations. RESULTS: Man to woman ratio was 1 : 1.48 and 42% of the patients were in their fifth decade. The most frequent chief complaints were cutaneous symptoms (37%), followed by respiratory symptoms (31%). The most frequently involved organs were intrathoracic organs (84%), followed by the skin (37%), peripheral lymph nodes (13%), bones (11%), spleen (8%) and eyes (5%). The most common cutaneous lesion was subcutaneous nodule (74%), followed by papule (13%). Extremities (65%) were the most frequent sites of cutaneous lesions. Systemic organ involvements were observed in 70% of patients with cutaneous sarcoidosis. Among them, the most frequently involved organs were intrathoracic organs (81%), followed by bones (25%), eyes (19%), and peripheral lymph nodes (19%). CONCLUSION: The results were generally similar with the previous domestic reports. Compared with the foreign reports, cutaneous involvement was more frequent and ophthalmic involvement was less frequent. Subcutaneous nodule was the most frequent cutaneous lesion which seems to be a unique feature of this study.
Extremities ; Female ; Gyeonggi-do ; Hospitals, University ; Humans ; Lymph Nodes ; Medical Records ; Sarcoidosis* ; Seoul ; Skin ; Spleen

BACKGROUND: Tinea pedis is the most common dermatophytosis in Korea. It has been increased gradually with time and the proportion of that in the aged has been significantly increased. OBJECTIVE: The aim of this study is to evaluate the clinical characteristics of tinea pedis according to the clinical types and their mycologic findings. METHODS: A clinical and mycological study was performed with 212 cases of tinea pedis among outpatients examined for 9 months from March 2005 to November 2005 at Department of Dermatology of the 11 University Hospitals in Korea. RESULTS 1. The age distribution showed patients in their 50s and 60s to be the most common. The ratio of male to female was 1.33:1 2. The most frequent clinical type was interdigital only type (55.2%), interdigital hyperkeratotic type (39.8%), vesicular type (2.8%) and interdigital vesicular type (2.2%), in descending order. There are no hyperkeratotic only type and hyperkeratotic vesicular type. 3. The duration of tinea pedis was longer than 5 years in 73.1%. The proportion of interdigital hyperkeratotic type was the highest in longer than 10 years of duration group than in other duration groups. 4. The rate of coexistent dermatophytosis with tinea pedis was 19.3%, and tinea cruris was the most common (10.3%). 5. The positive culture rate was 73.1%, and Trichophyton(T.) rubrum was the most common isolates (93.5%) followed by T. mentagrophytes var. mentagrophytes (3.9%) and T. mentagrophytes var. interdigitale (2.6%). CONCLUSIONS: All these findings suggest that the prevalence of tinea pedis in the aged was high, longer duration of the disease was more common and the rate of coexistent dermatophytosis increased. Further studies about tinea pedis and other dermatophytosis in the aged person will be necessary.
Age Distribution ; Dermatology ; Female ; Hospitals, University ; Humans ; Korea ; Male ; Outpatients ; Prevalence ; Tinea Pedis* ; Tinea*

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease with genetic and environmental background. The diagnosis of AD depends on the clinical presentation and history because there are no objective laboratory tests. The criteria established by Hanifin and Rajka have become the standard for the clinical diagnosis of AD (Until now, we used conventional Hanifin and Rajka's diagnostic guidelines). But diagnostic criteria for Korean have not been studied yet. OBJECTIVE: The purpose of the present study was to establish the diagnostic criteria of Korean AD. METHODS: We made out a draft for diagnostic criteria for Korean on the basis of the Hanifin and Rajka's guidelines and published Korean journals. And we established the diagnostic criteria for Korean after collecting extensive opinions from dermatologic specialists in many university hospitals. RESULTS: The major criteria of AD is similar to conventional diagnosic criteria, but three additional minor features (periauricular eczema, scalp scale, skin prick test reactivity) were significant for the diagnosis of AD in Korean patients. The other eleven minor features of the conventional minor diagnostic features were also significant. CONCLUSION: We established Korean diagnostic criteria for AD. Our result suggest that ethnic backgrounds influence the phenotype of AD and that additional three features need to be included in the Korean diagnostic criteria. Continued refinement of these guidelines will facilitate diagnosis in specific ethnic populations and in specific subgroups of patients.
Dermatitis, Atopic* ; Diagnosis ; Eczema ; Hospitals, University ; Humans ; Phenotype ; Scalp ; Skin ; Skin Diseases ; Specialization

BACKGROUND: Atopic dermatitis is a chronic, relapsing, inflammatory skin disease, with genetic and environmental background. Successful management of atopic dermatitis requires a multipronged approach. However, standardized guidelines for the management of Korean atopic dermatitis patients do not exist. OBJECTIVE: This study was performed to provide a standardized treatment guideline for atopic dermatitis in Korea. METHODS: On the basis of treatment guidelines proposed by the ADRG (Atopic Dermatitis Research Group), we consider the characteristic provocation factors reported in previous Korean cases and the new modalities which have recently been introduced. RESULTS: Management should compromise of a disease-adapted treatment which combines adjuvant basic therapy, symptomatic relief and, if needed, anti-inflammatory treatment and the identification and avoidance of trigger factors. New therapies such as topical calcineurin inhibitors are also considered to be good alternatives for the long-term control of atopic dermatitis. CONCLUSION: The algorithm contained within the article was presented as the basis for a guideline of clinical practice that could be used to facilitate the treatment of atopic dermatitis at any stage in Korea.
Calcineurin ; Dermatitis ; Dermatitis, Atopic* ; Humans ; Korea ; Skin Diseases

OBJECTIVE: This study was designed to investigate the effects of long term clozapine treatment on changes of weight, glucose and cholesterol levels and their relation to clozapine and its metabolite blood levels in outpatients with chronic schizophrenia. METHODS: Among outpatients diagnosed with schizophrenia according to the DSM-IV criteria, 19 consented subjects receiving long-term treatment of clozapine, its dosage level had been constant for last one month, were selected for the study. The serum level of clozapine, metabolites as well as body weight, BMI, glucose level, cholesterol level, insulin, and c-peptide were gathered and analyzed before and after the use of clozapine. RESULTS: Glucose increase after clozapine treatment was statistically meaningful but it was due to two patients who got diagnosed with diabetes. Glucose levels of other patients are all below 120 mg/dl. Cholesterol level showed significant increase after the treatment. Weight and BMI changes over the treatment are not statistically meaningful overall, but 8 out of 17 showed more than 7% increase. The changes of weight and BMI were positively correlated with weight and BMI of pre-treatment. Mean serum level of clozapine, metabolites were not correlated with glucose, cholesterol level, insulin, and C-peptide. CONCLUSIONS: Results indicate that long term treatment of clozapine is correlated with increase of glucose and cholesterol level and weight gain of the patients. Clinicians should be aware of the potential risks of diabetes, hyperlipidemia, and weight gain in patients taking clozapine.
Blood Glucose* ; Body Mass Index ; Body Weight* ; C-Peptide ; Cholesterol ; Clozapine* ; Diagnostic and Statistical Manual of Mental Disorders ; Glucose ; Humans ; Hyperlipidemias ; Insulin ; Outpatients ; Schizophrenia* ; Weight Gain