Introduction: Cutaneous protothecosis usually presents as pyoderma-like lesions or infiltrating papules and plaques on the extensor side of the extremities. It can be misdiagnosed as eczema, pyoderma, or a fungal infection. Although it has been isolated from a swimming pool, sewers and rivers in the Philippines, there has been no reported case of cutaneous protothecosis in the country. Case summary: A 78-year-old Taiwanese male farmer visited the dermatology clinic due to a six-month history of a large, pruritic erythematous plaque studded with papulopustules on his left forearm. A potassium hydroxide (KOH) examination showed negative for hyphae or spores. And a skin biopsy showed morula-like bodies, which were highlighted by the Periodic acid-Schiff stain. Conclusion We report a case of cutaneous protothecosis from Taiwan so Filipino dermatologists will be aware of the clinical and histopathologic manifestations and management of cutaneous protothecosis.
Skin Diseases, Infectious ; Administration, Cutaneous

BACKGROUND: Bacterial skin infections occur secondarily in conditions involving a vulnerable skin barrier such as atopic eczema, as well as primarily such as impetigo. They are mainly caused by Staphylococcus aureus and Streptococci. Recently, the prevalence of methicillin-resistant S. aureus has been increasing. OBJECTIVE: To determine the characteristics of community-acquired bacterial skin infections, to observe their antibiotic susceptibility patterns, and to evaluate factors contributing to the treatment response. METHODS: We retrospectively reviewed outpatients under 30 years old from 2010 to 2015, from whom we had taken skin swabs for antibiotic susceptibility testing. We collected clinical and microbiological characteristics from the medical records. RESULTS: We evaluated the culture results of 197 patients and reviewed their medical records. Overall, 86.3% (n=170) of the patients responded to the initial treatment regimen. S. aureus was the most commonly isolated pathogen (52.6%) and showed a high resistance rate to penicillin (90.9%) and oxacillin (36.3%). In the multivariable logistic regression analysis, resistance to 3 or more antibiotics (p=0.044), culture amounts described as “many” (p=0.040), and non-systemic antibiotic use (p < 0.001) were significantly associated with lower treatment response. However, methicillin resistance was not associated with lower treatment response both in univariable and multivariable analyses. CONCLUSION: Among young patients, S. aureus was the most predominant pathogen present in bacterial skin infections. Resistance to high numbers of antibiotics and the use of non-systemic antibiotics were associated with lower treatment response. First-generation cephalosporins may be the most effective first-line empirical regimen for bacterial skin infections treated in outpatient settings, regardless of methicillin resistance.
Anti-Bacterial Agents ; Cephalosporins ; Dermatitis, Atopic ; Humans ; Impetigo ; Logistic Models ; Medical Records ; Methicillin Resistance ; Outpatients ; Oxacillin ; Penicillins ; Prevalence ; Retrospective Studies ; Skin Diseases, Infectious ; Skin* ; Staphylococcus aureus

Intra-articular hyaluronic acid injections for symptomatic treatment of osteoarthritis are widely used but can result in complications, such as infectious arthritis. Staphylococcus lugdunensis is a common normal skin flora but can cause severe infectious disease, such as infective endocarditis. We present the first report of infectious arthritis caused by methicillin-sensitive S. lugdunensis after intra-articular hyaluronic acid injection in an immunocompromised patient in Korea.
Arthritis, Infectious* ; Arthritis, Rheumatoid* ; Communicable Diseases ; Diabetes Mellitus* ; Endocarditis ; Humans ; Hyaluronic Acid* ; Immunocompromised Host ; Korea ; Osteoarthritis ; Skin ; Staphylococcus lugdunensis* ; Staphylococcus*

BACKGROUND: Pediatric infectious skin diseases are different from their counterparts in adults, since the sources of infection and disease progressions are distinct. To our knowledge, there have been no reports of epidemiologic studies of pediatric infectious skin diseases in Korea. OBJECTIVE: The purpose of this study was to evaluate the distribution of pediatric infectious skin diseases in the Ansan and Southwestern area of Gyeonggi-do, and to compare the results with previous reports about general pediatric dermatoses. METHODS: The authors retrospectively evaluated 4,366 cases of pediatric infectious skin diseases from July 2003 to June 2013 in the Department of Dermatology at Korea University Ansan Hospital. The monthly, seasonal, and annual incidences, as well as the ages and genders of the patients were evaluated. RESULTS: The study included 2004 (45.0%) girls and 2362 (55.0%) boys. The most frequent age of infection was 4 to 6 years old (range 0~15 years), and the peak incidences occurred in July, August, and January. The most common infectious dermatoses were viral (76.0%), bacterial (11.5%), fungal (8.3%), and parasitic (4.0%). The 10 most common pediatric infectious skin diseases were viral wart (45.8%), molluscum contagiosum (20.9%), impetigo (10.3%), tinea (7.1%), scabies (3.8%), herpes zoster (2.5%), varicella (1.6%), herpes simplex (1.5%), eczema herpeticum (1.1%), and cellulitis (0.9%). CONCLUSION: Compared to previously published reports, the distribution of pediatric infectious skin diseases has changed and was different from general pediatric dermatoses.
Adult ; Cellulitis ; Chickenpox ; Dermatology ; Disease Progression ; Epidemiologic Studies* ; Epidemiology ; Female ; Gyeonggi-do* ; Herpes Simplex ; Herpes Zoster ; Humans ; Impetigo ; Incidence ; Kaposi Varicelliform Eruption ; Korea ; Molluscum Contagiosum ; Retrospective Studies ; Scabies ; Seasons ; Skin Diseases ; Skin Diseases, Infectious* ; Tinea ; Warts

BACKGROUND: With the advancement of socioeconomic and medical sciences, the number of elderly patients with skin diseases significantly increased. Therefore, the epidemiologic survey of dermatologic disease is in need for the elderly population. OBJECTIVE: The purpose of this study was to evaluate the prevalence of dermatologic diseases in elderly patients and to compare the results with the previous reports in malignant and benign skin tumors. METHODS: We retrospectively reviewed the clinical records of 2,678 outpatients older than 65 years of age, who visited the Department of Dermatology from January 2010 to December 2013. We compared the clinical diagnoses and analyzed the distribution of dermatologic diseases and clinical features, including the factors of age and sex. Among them, 575 patients who received biopsy for skin tumors were pathologically analyzed, confirmed, and classified as malignant or benign tumor. RESULTS: The incidence of skin disease in the group of patients older than 65 years of age was 15.6% (2,678). The ratio of men to women was 1 : 1.13 (1,257 : 1,421). The types of skin diseases in the group were as follows: infectious skin disease (26.1%); eczema (23.2%); epidermal and adnexal nevi and tumors (17.5%); drug eruption, erythema, and urticaria (7.0%); pruritus, psychocutaneous disorder, and neurocutaneous dermatoses (6.6%); papulosquamous disease (3.3%); diseases of the skin appendages (3.2%); disorders of pigmentation (2.5%); diseases of the mucous membrane (2.3%); cutaneous vascular diseases (2.2%); and skin tumors (21.5%). The most common malignant tumors were as follows: squamous cell carcinoma (33.9%), basal cell carcinoma (31.2%), Bowen's disease (19.0%), keratoacanthoma (7.2%), malignant melanoma (5.0%), and lymphoma (1.8%). The most common benign tumors were as follows: actinic keratosis (48.0%), seborrheic keratosis (17.2%), epidermal cyst (12.7%), melanocytic nevus (6.2%), hemangioma (3.7%), milia (2.0%), and hypertrophic scar and keloid (2.0%). The incidence of malignant tumors in women was much higher than in men, with a ratio of 1 : 1.96. CONCLUSION: This study provides useful data on the incidence and the characteristics of elderly skin diseases. Compared to the previous studies, the frequency of malignant tumors was relatively higher and variable. We advise physicians to make the appropriate diagnosis and treatment for the early detection of skin tumor, especially the squamous cell carcinoma and basal cell carcinoma, which are caused by long-term exposure to the sun.
Aged* ; Biopsy ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cicatrix, Hypertrophic ; Dermatology ; Diagnosis ; Drug Eruptions ; Eczema ; Epidermal Cyst ; Erythema ; Female ; Hemangioma ; Humans ; Incidence ; Keloid ; Keratoacanthoma ; Keratosis, Actinic ; Keratosis, Seborrheic ; Lymphoma ; Male ; Melanoma ; Mucous Membrane ; Nevus ; Nevus, Pigmented ; Outpatients ; Pigmentation ; Prevalence ; Pruritus ; Retrospective Studies ; Skin ; Skin Diseases* ; Skin Diseases, Infectious ; Solar System ; Urticaria ; Vascular Diseases

The Korean list of occupational skin diseases was amended in July 2013. The past list was constructed according to the causative agent and the target organ, and the items of that list had not been reviewed for a long period. The revised list was reconstructed to include diseases classified by the International Classification of Diseases (10th version). Therefore, the items of compensable occupational skin diseases in the amended list in Korea comprise contact dermatitis; chemical burns; Stevens-Johnson syndrome; tar-related skin diseases; infectious skin diseases; skin injury-induced cellulitis; and skin conditions resulting from physical factors such as heat, cold, sun exposure, and ionized radiation. This list will be more practical and convenient for physicians and workers because it follows a disease-based approach. The revised list is in accordance with the International Labor Organization list and is refined according to Korean worker's compensation and the actual occurrence of occupational skin diseases. However, this revised list does not perfectly reflect the actual status of skin diseases because of the few cases of occupational skin diseases, incomplete statistics of skin diseases, and insufficient scientific evidence. Thus, the list of occupational diseases should be modified periodically on the basis of recent evidence and statistics.
Burns, Chemical/pathology ; Dermatitis, Contact/pathology ; Humans ; Occupational Diseases/*economics ; Occupational Exposure ; Republic of Korea ; Skin/*pathology ; Skin Diseases/*economics/*pathology ; Skin Diseases, Infectious/pathology ; Stevens-Johnson Syndrome/pathology ; Vitiligo/pathology ; Workers' Compensation/*economics

BACKGROUND: Telemedicine can be useful in dermatology on Ulleung island which is 217 km away from Pohang and without dermatologists. OBJECTIVE: The purpose of this study is to measure the effectiveness of telemedicine in treating skin diseases on Ulleung island. METHODS: 33 patients on Ulleung island were examined by a fullmotion real-time video by one dermatologist in a Dongsan hospital of Keimyung University once a week. From June 2011 to June 2012, there have been 53 treatments of telemedicine in 33 patients. RESULTS: 14 diseases were found in 33 patients. The most common disease group was infectious skin disease and eczema in 9 patients. In addition, there were other skin diseases such as acne vulgaris, allergic contact dermatitis, prurigo nodularis, lichen simplex chronicus, malignant melanoma, seborrheic dermatitis, polymorphous light eruption and so on. CONCLUSION: Dermatology favors telemedicine because we had investigated its value and possibilities by clinical experience of telemedicine between Ulleung island and Dongsan medical center in Daegu.
Acne Vulgaris ; Dermatitis, Allergic Contact ; Dermatitis, Seborrheic ; Dermatology ; Eczema ; Humans ; Light ; Melanoma ; Methylmethacrylates ; Neurodermatitis ; Polystyrenes ; Prurigo ; Skin ; Skin Diseases ; Skin Diseases, Infectious ; Telemedicine

BACKGROUND: Dermatologic comorbidities can be the clue for the diagnosis and treatment of systemic conditions and a need for dermatological expert opinion is increased. OBJECTIVE: To analyze the patterns and to quantify the dermatologic consultations referred by the department of obstetrics and gynecology (OBGY). METHODS: We retrospectively studied the data from 479 cases referred by OBGY for a dermatologic consultation during a three-year period in a tertiary hospital. RESULTS: The most common skin disorder was pregnancy-related dermatoses (29.77%) in obstetric inpatients, while cutaneous infection (33.33%) was the most frequent in gynecologic inpatients. The distribution of the skin disorders in consulted OBGY inpatients was consistent with the previous reports. However, there were some differences, such as high proportion of infectious disease. Infectious skin diseases were significantly more frequent (p<0.001) in the chemotherapy group of gynecologic inpatients compared to that of the non-chemotherapy group, viral infection being the most common. In addition, superficial fungal infection accounted for the same proportion as the viral infection (37.50% each) among obstetrical inpatients. Maculopapular or urticarial eruption (51.52%) was the most common type of chemotherapy-related adverse drug reaction. CONCLUSION: This study revealed the distribution of skin disorders in patients referred by OBGY for dermatologic consultation. Furthermore, it could be helpful as an educational material to assist cooperation between dermatology and OBGY.
Communicable Diseases ; Comorbidity ; Dermatology ; Expert Testimony ; Gynecology ; Humans ; Inpatients ; Obstetrics ; Referral and Consultation ; Retrospective Studies ; Skin ; Skin Diseases ; Skin Diseases, Infectious

BACKGROUND: The incidence of infantile dermatoses shows a tendency to increase, despite medical development and environmental improvement. Infantile dermatoses must be regarded discretely, due to special characteristics of the neonatal and infantile skin. OBJECTIVE: The purpose of this study is to evaluate the incidence of dermatologic diseases in the infant patients. METHODS: One hundred fifty nine out-patients, younger than 1 year who had visited the department of dermatology from January 2001 to December 2011, were analyzed, retrospectively. RESULTS: The 0~1 year age group accounted for 0.58% of all new patients (261/44,718). The ratio of male to female was 1 to 0.69. Patients visited the hospital most frequently in the winter (34.5%). The most common disease was atopic dermatitis (30.3%), followed by hemangioma (9.2%), and irritant contact dermatitis (7.7%). The most common disease group was eczema (44.8%), followed by an infectious skin disease (19.2%), and dermal and subcutaneous tumors (10.7%). CONCLUSION: This study provides useful data on the incidence and characteristics of dermatologic diseases in infant patients.
Dermatitis, Atopic ; Dermatitis, Contact ; Dermatology ; Eczema ; Female ; Hemangioma ; Humans ; Incidence ; Infant ; Male ; Outpatients ; Skin Diseases ; Skin Diseases, Infectious

Norwegian or crusted scabies is a rare, highly contagious atypical form of scabies caused by the mite Sarcoptes scabiei var. homonis. It is usually associated with advanced age, immunosuppression, physical debility, and developmental disabilities. We report here a case of Norwegian scabies in an institutionalized patient with chronic kidney disease (CKD) and Down syndrome. A 56-year-old male presented at our department with pruritic rash and general weakness of 2 months' duration. Examination showed hyperkeratotic, scaly, crusted erythematous plaques on the hands, trunk, and back of the patient. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites. The patient was treated with hemodialysis and repeated applications of 1% lindane lotion for 2 weeks. He reported significant relief of pruritus and resolution of the skin lesions after the treatment. In addition to uremic pruritus, infectious skin diseases such as Norwegian scabies should be considered in the institutionalized patients with advanced CKD and resistant pruritus.
Developmental Disabilities ; Down Syndrome ; Exanthema ; Hand ; Humans ; Hydroxides ; Immunosuppression ; Kidney Failure, Chronic ; Lindane ; Male ; Middle Aged ; Mites ; Potassium ; Potassium Compounds ; Pruritus ; Renal Dialysis ; Renal Insufficiency, Chronic ; Sarcoptes scabiei ; Scabies ; Skin ; Skin Diseases, Infectious ; Weights and Measures