Nail lichen striatus: report of seven cases and review of the literature.

BACKGROUND: Nail involvement in lichen striatus (LS) is rare and has not been documented extensively. OBJECTIVES: This study describes the clinical and histological features, response to treatment, and follow-up in seven patients with nail LS. METHODS: We reviewed seven cases of nail LS between 2006 and 2012 at the Dermatology Department, Yeouido St Mary's Hospital, Seoul, South Korea. RESULTS: The median patient age was 11 years (range: 4-33 years), and the female:male ratio was 3:4. All patients had both typical skin lesions and nail abnormalities. In these cases, LS usually involved a single digit (n = 5). The most common nail change was longitudinal fissuring (n = 4). We actively treated both skin and nail lesions from the time of diagnosis. Most nail lesions resolved within a mean of four months of the initiation of treatment. CONCLUSIONS: Nail involvement in LS is rare; this case series highlights the associated nail changes. We emphasize that early accurate diagnosis and treatment may be beneficial in reducing nail deformities in patients with nail involvement.

Subungual soft tissue chondroma with nail deformity in a child.

Soft tissue chondroma is a rare benign tumor of the cartilage. It occurs commonly in distal extremities of middle-aged patients. It is usually asymptomatic and grows slowly, making early diagnosis difficult. We report a 10-year-old patient with a 1-year history of a subungual soft tissue chondroma on her left fifth finger. The lesion arose from nail bed and distal nail matrix, resulting in nail dystrophy. Magnetic resonance imaging revealed a soft tissue tumor in the subungual region and soft tissue chondroma was diagnosed, based on histopathologic findings. Dermatologists should consider soft tissue chondroma in the differential diagnosis of subungual tumors of children.

Expression of insulin-like growth factor-1 receptor in conventional cutaneous squamous cell carcinoma with different histological grades of differentiation.

BACKGROUND: Insulin-like growth factor-1 receptor (IGF-1R) is a key regulator of cell transformation and controls the expression of genes that governs cell cycling and cell survival. The aim of this pilot study was to gain insight into the expression pattern of IGF-1R in conventional cutaneous squamous cell carcinoma (CSCC) using immunohistochemical analysis. MATERIALS AND METHODS: Five cases of normal human paraffin-embedded skin sections, 4 cases of actinic keratosis, and 28 cases of paraffin-embedded sections of different histological subtypes of CSCC were selected for immunohistochemical analysis. RESULTS: In normal skin, IGF-1R expression was detected in the epidermal basal cell layer. In actinic keratosis, IGF-1R was expressed in the lower part of the epidermis. IGF-1R was detected in the cell surface membrane of well-differentiated CSCC. In moderately differentiated CSCC, IGF-1R was expressed predominantly in the cytoplasm. Interestingly, IGF-1R was expressed in the nuclei of tumor cells of poorly differentiated CSCC. CONCLUSIONS: The strong and differential expression of IGF-1R in different histological degrees of CSCC indicates a possible role for IGF-insulin receptor in the carcinogenesis and differentiation of this disease and identifies IGF-1R as an interesting target for prevention and treatment of CSCC that deserves further investigation.

Clinical characteristics of cholinergic urticaria in Korea.

BACKGROUND: Cholinergic urticaria is a type of physical urticaria characterized by heat-associated wheals. Several reports are available about cholinergic urticaria; however, the clinical manifestations and pathogenesis are incompletely understood. OBJECTIVE: The purpose of this study was to investigate the clinical characteristics of cholinergic urticaria in Korea. METHODS: We performed a retrospective study of 92 patients with cholinergic urticaria who were contacted by phone and whose diagnoses were confirmed by the exercise provocation test among those who had visited The Catholic University of Korea, Catholic Medical Center from January 2001 to November 2010. RESULTS: All 92 patients were male, and their average age was 27.8 years (range, 17~51 years). Most of the patients had onset of the disease in their 20s and 30s. Non-follicular wheals were located on the trunk and upper extremities of many patients, and the symptoms were aggravated by exercise. Eight patients showed general urticaria symptoms and 15 had accompanying atopic disease. Forty-three patients complained of seasonal aggravation. Most patients were treated with first and second-generation antihistamines. CONCLUSION: Dermatologists should consider these characteristics in patients with cholinergic urticaria. Further investigation and follow-up studies are necessary to better understand the epidemiological and clinical findings of cholinergic urticaria.

A woman with a nose like an "Elephant's Trunk".

For more than a century, exogenous lipids and injectable silicone have been used by nonmedical personnel or even licensed physicians to correct body defects and augment parts of the human body. Any skin-implanted exogenous substances can trigger an inflammatory response in individuals. Notably, oily substances have commonly been reported to produce a foreign body granulomatous reaction known as "sclerosing lipogranuloma". Despite local and systemic complications, injections of illegal materials by unlicensed practitioners are widespread and are still a problem throughout East Asian Countries. We herein present a unique case of sclerosing lipogranuloma following illegal filler injection.

Effects of multi-polar radiofrequency and pulsed electromagnetic field treatment in Koreans: case series and survey study.

BACKGROUND: Recently, a novel combined multi-polar radiofrequency and pulsed electromagnetic field device was developed for non-ablative skin tightening. However, little is known about the clinical effects of this device. OBJECTIVES: The present study evaluated the clinical efficacy and safety of the multi-polar radiofrequency and pulsed electromagnetic field device. MATERIALS AND METHODS: Ten Korean patients underwent eight treatment sessions over 6 weeks. Clinical photographs of the skin were taken before and after the treatment at each week of treatment. Satisfaction score (0; dissatisfied, 5; neutral, 10; very satisfied) and pain score (0; no pain, 10; too painful) was determined using weekly questionnaires. A dermatologist evaluated the improvement of facial skin aging, including laxity, nasolabial fold, facial contour, skin texture, and skin color tone. RESULTS: The mean satisfaction score was high (>8) and the mean pain score was low (1.5). Improved skin laxity, nasolabial fold, and facial contour were observed in four, one, and three patients, respectively. Skin texture and skin color tone improved in 90% and 70% of the patients, respectively. CONCLUSION: The novel combined multi-polar radiofrequency and pulsed electromagnetic field device is safe and effective for rejuvenating aged skin in Korean subjects.

Effects of long-pulsed 1,064-nm neodymium-doped yttrium aluminum garnet laser on dermal collagen remodeling in hairless mice.

BACKGROUND: Nonablative lasers are used for dermal collagen remodeling. Although clinical improvements have been reported using various laser devices, the mechanism of dermal collagen remodeling remains unknown. OBJECTIVE: To investigate the effects of energy fluences of the long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) nonablative laser on dermal collagen remodeling and evaluate the dermal collagen remodeling mechanism. MATERIALS AND METHODS: Hairless mice were pretreated with ultraviolet B irradiation to produce photo-damage. The laser treatment used a long-pulse 1,064-nm Nd:YAG laser at energy fluences of 20, 40, and 60 J/cm(2) . The amount of dermal collagen and expressions of transforming growth factor beta (TGF-ß), matrix metalloproteinase-1 (MMP-1), and tissue inhibitor of metalloproteinase-1 (TIMP-1) of laser treated skin were compared with those of nontreated control skin. RESULTS: The long-pulse Nd:YAG laser treatment increased dermal collagen and significantly increased TGF-ß expression. The expression of MMP-1 decreased with low energy fluence. The expression of TIMP-1 was not significantly different. CONCLUSION: Long-pulsed 1,064-nm Nd:YAG laser increases the dermal collagen in association with the increased expression of TGF-ß.

Erythroid differentiation regulator 1 (Erdr1) is a proapototic factor in human keratinocytes.

Skin is constantly exposed to physical and chemical stressors. The exposure of keratinocytes to ultraviolet B (UVB) irradiation causes epidermal damage via induction of apoptosis. Erythroid differentiation regulator 1 (Erdr1) modulates growth and survival of cells under various stressful conditions, but the function of Erdr1 in human keratinocyte apoptosis has not been investigated so far. Here, we investigated the effect of Erdr1 on UVB-induced apoptosis in human keratinocytes and also examined the underlying regulatory mechanism. First, Erdr1 expression was detected in human primary keratinocytes and normal human skin tissues. Expression of Erdr1 was enhanced in human keratinocytes following UVB irradiation. Knock-down of Erdr1 led to resistance to UVB-induced apoptosis. Also, Erdr1 overexpression increased UVB-induced apoptosis and induced caspase-3 activation. Furthermore, the extracellular signal-regulated kinase (ERK) inhibitor PD98059 and the p38 mitogen-activated protein kinase (MAPK) inhibitor SB203580 significantly reduced Erdr1 expression following UVB irradiation. These results indicate that UVB induces Erdr1 via a MAPK-dependent mechanism. Taken together, these findings suggest that Erdr1 has a role as a proapoptotic factor in human keratinocytes and acts via ERK and p38 MAPK pathways. Therefore, Erdr1 may be a potential therapeutic target to reduce apoptosis in keratinocytes in conditions such as psoriasis and skin cancer.