BACKGROUND: Lack of sunlight exposure is the primary reason for the worldwide epidemic of vitamin D deficiency. Although recommended sunlight exposure guidelines exist, there is no evidence regarding whether current guidelines are optimal for increasing vitamin D levels among individuals with vitamin D deficiency.METHODS: Sixty Korean adults aged 20–49 years with serum 25-hydroxyvitamin D (25[OH]D) levels of < 20 ng/mL were randomly assigned to three groups: sunlight exposure (n = 20), vitamin D supplementation groups (n = 20), and daily living (n = 20) for 1 month. The sunlight exposure group had sunlight exposure on 20% to 30% of their body surface areas for 30–60 minutes per day, 3 times a week during the summer season. Vitamin D supplementation was prescribed with 800 IU/day of vitamin D. The serum levels of 25(OH)D were measured at baseline and at 1-month follow-up examinations.RESULTS: The largest change in serum 25(OH)D was observed among the vitamin D supplementation group (+3.5 ng/mL, P < 0.001). The sunlight exposure group showed a slight increase in serum 25(OH)D level, but the absolute increase was less than one-third that of the vitamin D supplementation group (+0.9 ng/mL, P = 0.043). Only two participants in the sunlight exposure reached serum concentrations of 25(OH)D ≥ 20 ng/mL at follow-up. The daily living group showed no difference in vitamin D levels (−0.7 ng/mL, P = 0.516).CONCLUSION: Sunlight exposure was not sufficient to overcome vitamin D insufficiency or deficiency in the current study subjects. Effectiveness of current sunlight exposure guidelines among various populations should be reassessed in larger clinical studies.TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0002671
Adult ; Body Surface Area ; Follow-Up Studies ; Humans ; Information Services ; Seasons ; Solar System ; Sunlight ; Vitamin D Deficiency ; Vitamin D ; Vitamins

BACKGROUND: Many students are interested in their appearance and express a strong concern about cosmetics use. However, few studies have reported on cosmetics use in teenagers visiting dermatologic clinics. Recently, there was a report on consumer's behavior regarding cosmetics in Korea, so we attempted to assess this behavior in our clinics. OBJECTIVE: This study aimed to assess behavior regarding cosmetics use in teenagers. METHODS: We conducted a questionnaire survey with 26 questions concerning cosmetics use behavior of teenagers who visited dermatologic clinics and participated in the campaign program. The questionnaire consisted of basic information about the type of cosmetics most frequently used. RESULTS: A total of 269 individuals participated in our survey, consisting of 118 men (43.9%) and 151 women (56.1%). Most participants (92.2%) used cosmetics. The most frequently used skin care and makeup product was sun cream (81.5%) and lip balm/gloss (40.7%). Most participants (80.2%) responded that they use cosmetics daily. This result shows that cosmetics use is common among teenagers. The common influences of starting cosmetics use are friends and neighbors. Teenagers used cosmetics mainly for cosmetic purpose (42.3%), followed by increasing self-regard (35.9%) and improving skin status (19.4%). Seventy-eight teenagers (31.5%) developed side effects after using cosmetics. The most common side effects were contact dermatitis (78.4%). CONCLUSION: This study found that teenagers are becoming a rising consumer in the cosmetics industry. Therefore, we suggest that dermatologist should provide teenagers with appropriate education and management on cosmetics use.
Adolescent ; Dermatitis, Contact ; Education ; Female ; Friends ; Humans ; Korea ; Lip ; Male ; Skin ; Skin Care ; Solar System

BACKGROUND: Acne is a common inflammatory skin disease that involves the seborrheic area, developing not only in adolescence but also in adulthood. Abnormal epidermal barrier function in acne is reported and suspected as a risk factor that leads to sensitive skin through a few experimental studies. Impaired skin barrier function against environmental factors and irritants may play a role in increasing sensitivity of the skin in patients with acne. OBJECTIVE: This study aimed to investigate the clinical characteristics of patients with acne and analyze the association between acne and sensitive skin. METHODS: Acne severity and history of treatments were recorded and subjective symptoms of sensitive skin with aggravating factors were analyzed through a questionnaire. Acne severity was determined using the Investigator's Global Assessment scale of acne severity and Global Acne Grading System. The score and severity of sensitive skin were determined using the Baumann skin-type test. RESULTS: Of 100 patients with acne, 76% were actually confirmed to have sensitive skin. However, there was no significant association between acne severity and severity of sensitive skin (p=0.805). The most common aggravating factor of sensitive skin was washing the face (60%), followed by cosmetics use (56%) and hot weather (55%). The most common symptom of sensitive skin was itching (55%), which was proven as the only factor associated with severity of sensitive skin (p=0.016). CONCLUSION: Cosmetics use on the face is a noticeable important aggravating factor of sensitive skin, which can provoke itching, which is proven as the only symptom significantly related with severity of sensitive skin. Therefore, in the treatment of acne with sensitive skin, proper use of moisturizers and careful washing are required, and it is important to avoid hot weather and excessive sun exposure and carefully choose cosmetics.
Acne Vulgaris ; Adolescent ; Clinical Study ; Humans ; Irritants ; Pruritus ; Risk Factors ; Skin Diseases ; Skin ; Solar System ; Weather

Transient acantholytic dermatosis, or Grover's disease, usually appears as pruritic erythematous papules and vesicles on the trunk in middle-aged men. The pathogenesis remains unclear, though sun exposure, heat, and sweating may be aggravating factors. A 58-year-old male visited our clinic for evaluation of an asymptomatic erythematous patch on the left temple that developed 40 years ago. Here, we report the rare case of Grover's disease with atypical features presenting as one large patch on the face.
Acantholysis ; Hot Temperature ; Humans ; Male ; Middle Aged ; Skin Diseases ; Solar System ; Sweat ; Sweating

BACKGROUND: Research into the Baumann skin type (BST) has recently expanded, with growing interest in the development of an efficient and effective skin type classification system for better understanding of this skin condition. OBJECTIVE: We aimed to identify male-specific skin type characteristics with investigation into the distribution of BST by age and region in the Korean male population and to determine the intrinsic and extrinsic factors related to skin type. METHODS: A questionnaire was administered to collect information about age, region, working behavior, drinking behavior, smoking behavior, usual habit of sun protection, medical history, and the BST which consisted of four parameters; oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). RESULTS: We surveyed 1,000 Korean males aged between 20 and 60 years who were divided equally by age and region. Of the total respondents, OSNW type accounted for the largest percentage and ORPW type the lowest. In terms of Baumann parameters, O type was 53.5%, S type was 56.1%, N type was 84.4% and W type was 57.5%. Several behavioral factors were found to have various relationships with the skin type. CONCLUSION: The predominant skin type in the Korean male respondents was OSNW type, and the distribution of skin types with regards to age and region was reported to be distinct. Therefore, skin care should be customized based on detailed skin types considering the various environmental factors.
Classification ; Drinking Behavior ; Humans ; Male ; Skin Care ; Skin ; Smoke ; Smoking ; Solar System ; Surveys and Questionnaires

PURPOSE: This study differentiates patient and care delays of breast cancer and explores the related factors as well as the associations with the prognosis in Guangzhou, a southern city of China. METHODS: A cohort of female incident breast cancer patients (n=1,551) was recruited from October 2008 to March 2012 and followed up until January 1, 2016 (n=1,374) in the affiliated hospitals of Sun Yat-sen University. The factors associated with patient and care delays were analyzed with multivariable logistic models. Cox proportional hazards regression models were constructed to estimate the impacts of the delays on the prognosis. RESULTS: There were 40.4% patient delay (≥3 months) and 15.5% care delay (≥1 month). The patient delay, but not the care delay, was significantly related to the clinical stage and consequently worsened the prognosis of breast cancer (hazard ratio, 1.45; 95% confidence interval, 1.09 to 1.91 for progression-free survival). The factors related to an increased patient delay included premenopausal status, history of benign breast disease, and less physical examination. CONCLUSION: Patient delay was the main type of delay in Guangzhou and resulted in higher clinical stage and poor prognosis of breast cancer. Screening for breast cancer among premenopausal women may be an effective way to reduce this delay.
Breast Diseases ; Breast Neoplasms ; Breast ; China ; Cohort Studies ; Female ; Humans ; Logistic Models ; Mass Screening ; Physical Examination ; Prognosis ; Solar System

PURPOSE: The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized. METHODS AND MATERIALS: Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival. RESULTS: Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT: 1-3 years, 38.1%; 3-5 years, 33.9%; and >5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (≥50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival. CONCLUSION: This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.
China ; Cohort Studies ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Incidence ; Intelligence ; Lung Neoplasms ; Male ; Methods ; Multivariate Analysis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Smoke ; Smoking ; Solar System ; Survivors

BACKGROUND: Dry eye is a common disease, and coffee is a popular beverage that is heavily consumed in Korea and worldwide. We examined the correlation between coffee consumption and dry eye.METHODS: This study was performed using data from the 5th Korean National Health and Nutrition Examination Survey, which was a cross-sectional study of the Korean population conducted from 24 months. We included adults aged ≥19 years who underwent ophthalmologic examination and excluded those who had comorbid conditions with dry eye. The subjects were divided into dry eye and control groups. The dry eye group consisted of those who had been clinically diagnosed with dry eye. A multiple logistic regression analysis was conducted to determine the correlation between coffee consumption and dry eye.RESULTS: An inverse correlation was found between coffee consumption and dry eye in the group that consumed 3 cups of coffee a day (P=0.001). However, after multivariate adjustment, the statistical significance of the correlation disappeared (P=0.283).CONCLUSION: Consumption of 3 cups of coffee a day in comparison to non-consumption group was negatively correlated with dry eye in an univariate analysis model, but the correlation was not statistically significant after adjusting for age, sex, body mass index, smoking, binge drinking, sun exposure time and history of eye surgery.
Adult ; Beverages ; Binge Drinking ; Body Mass Index ; Coffee ; Cross-Sectional Studies ; Dry Eye Syndromes ; Humans ; Korea ; Logistic Models ; Nutrition Surveys ; Smoke ; Smoking ; Solar System

Acquired brachial cutaneous dyschromatosis (ABCD) is an acquired disorder of pigmentary change that presents as chronic, asymptomatic, geographic-shaped, gray-brown patches, consisting of mixed hyper and hypopigmented macules on the dorsal aspect of the forearms. We report a case of a 40-year-old male who presented with asymptomatic, multiple brown-colored macules on the outer aspects of both arms. He had no history of hypertension and had never taken angiotensin converting enzyme inhibitors. He also denied chronic sun exposure history. Histologic examination demonstrated epidermal atrophy, increased basal layer pigmentation, and several telangiectatic vessels in the upper dermis. Solar elastosis was not remarkable. The patient's clinical and histopathologic features were consistent with a diagnosis of ABCD. Poikiloderma of Civatte, melasma, acquired bilateral telangiectatic macules and other pigmentary disorders should be considered in the differential diagnosis of ABCD. Herein, we report a case of ABCD in a middle-aged male without hypertension and medication.
Adult ; Angiotensin-Converting Enzyme Inhibitors ; Arm ; Atrophy ; Dermis ; Diagnosis ; Diagnosis, Differential ; Forearm ; Humans ; Hypertension ; Male* ; Melanosis ; Middle Aged* ; Pigmentation ; Pigmentation Disorders ; Solar System

Incidence of basal and squamous cell carcinoma is increasing among Korean. With increasing this incidence we need to attend the management and prevention of these cutaneous malignancies. Basal cell carcinoma (BCC) is the most common skin malignancy. Sun exposure is the most important environmental cause of BCC. Daily sun protection especially avoiding sun exposure between 10 a.m. and 4 p.m. provides most effective prevention against chronic ultraviolet-induced skin damage. Hedgehog pathway inhibitors are used locally advanced and metastatic BCC lesions in Korea. Until recently, there are no reports whether it developed resistance of Hedgehog pathway inhibitors with advanced BCC in Korean patients. Among malignant skin tumors, 19.1% were squamous cell carcinoma (SCC). The incidence of SCC was rapidly increased over the past years. However, the incidence rate of SCC in Japan has not been changed from the period 1976–1980 to 1986–1990. Sentinel lymph node biopsy for SCC did not provide diagnostic value. Bowen's disease and Erythroplasia of Queyrat are considered as carcinoma in situ of the skin. Erythroplasia of Queyrat have worse prognosis with a higher rate of malignant degeneration. Dermoscopy may helpful tool in assisting the noninvasive diagnosis of carcinoma in situ of the skin.
Bowen's Disease ; Carcinoma in Situ ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermoscopy ; Diagnosis ; Epithelial Cells ; Erythroplasia ; Hedgehogs ; Humans ; Incidence ; Japan ; Korea ; Prognosis ; Sentinel Lymph Node Biopsy ; Skin ; Solar System