Baumann Skin Type in the Korean Male Population

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.

Baumann Skin Type in the Korean Female Population

BACKGROUND: To meet the need for a subspecialized skin type system, the Baumann skin type (BST) system was proposed. OBJECTIVE: To evaluate the distribution of BST types and influencing factors among Korean women. METHODS: BST questionnaires were administered to 1,000 Korean women. The possible responses were as follows: oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). The correlations of the BST with the subjects' age, location, ultraviolet (UV) ray exposure, drinking and smoking habits, and blood type were assessed. RESULTS: The OSNT, DSNT, DRNT, and OSNW skin types were the most common skin types (55.3%). The O, S, P, and W types accounted for 46.6%, 68.8%, 23.2%, and 31.9%, respectively. The proportion of the O and S type was the highest in Gyeongsangbuk-do (55.0%) and Seoul (77.2%). The proportion of the P and W type was the highest in Gyeongsangbuk-do (33.0%) and Chungcheong-do (39.0%). The O type decreased in the higher age group, whereas the P and W type showed a reversed tendency. In smokers, the proportion of W type was significantly higher than in the non-smokers (66.3% vs. 24.1%, p<0.05). CONCLUSION: The 4 most common BST types were OSNT, DSNT, DRNT, and OSNW. In the comparison across the 4 BST parameters according to the age, region, smoking and drinking habits, occupation, blood type, and UV exposure, significant differences were observed. Individualized and customized skin care is required according to the personal skin type.

Regulatory Effects of Fenofibrate with Inflammatory Response and Myocardiac Dysfunction in Lipopolysaccharide-stimulated Heart Tissues

PURPOSE: This study was intended to establish experimental conditions for monitoring the cardioprotective effects of fenofibrate on cardiac function in lipopolysaccharide (LPS)-stimulated BalB/c mice. METHODS: To investigate the effects of fenofibrate on cardiac function, expression of Peroxisome proliferator-activated receptors (PPARs) and Peroxisome proliferator-activated receptor Gamma coactivator 1(PGC-1) and its target gene in the heart tissues of mice was compared after controls and LPS injection with pretreated fenofibrate or alone using reverse transcriptase-polymerase chain reaction (RT-PCR), Western blot analysis, and immunohistochemistry. In addition, Enzyme-linked-immunosorbent-assays (ELISA) were performed for assessment of pro-inflammatory cytokines of blood serum. RESULTS: Pretreated with fenofibrate had protective effects of diminishing the levels of LPS-induced pro-inflammatory cytokines, including interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) and recovery from reduction of messenger Ribo-nucleic acid, protein level of PPARs and PGC-1 in LPS-administered heart tissue. In addition, increasing expression of PPARs and PGC-1 ameliorated the expression and activity of catalase blocked production of lipid peroxidation. CONCLUSION: Treatment with fenofibrate resulted in augmented expression of transcription factors and reduced production of pro-inflammatory cytokines and lipid peroxidation after LPS administration. Therefore, results of this study suggested that fenofibrate should not only have a protective effect but should also restore cardiac function in several cardiac dysfunctional situations.

A Clinical Observation of the Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Jeju Island / 대한피부과학회지

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, acute life-threatening, hypersensitivity reaction usually to certain medications. Although SJS and TEN occur at an estimated incidence of 0.4 and 1.2 cases per million per year, these conditions have occurred, not infrequently, on Jeju island. OBJECTIVE: We performed this study to evaluate the clinical characteristics of the 15 patients diagnosed as SJS and TEN in Jeju island. METHODS: The retrospective clinico-epidemiologic analysis of 10 months' data of 15 inpatients, including 5 SJS patients, 8 SJS/TEN overlap patients and 2 TEN patients, was conducted through the available medical records. RESULTS: 1. Mean time of onset of clinical disease following the institution of a new drug was 10.1 days. Mean duration of drug exposure was 9.3 days. There were 4 cases showing positive response to skin test. The most common culprit drugs were anti-glaucoma agents (26.7%) such as methazolamide or acetazolamide, and anti-convulsants (26.7%) including valproic acid. 2. The clinical outcome was as follows; recovery in 13 patients, transfer in one patient, and expire in one. Time from appearance of first skin lesions to the initiation of therapy (time to treat) in 15 patients was 3.5 days; time from start of hospital treatment to interruption of further progression (time to arrest), 4.1 days; time to heal, 14.1 days; length of hospital stay, 20.6 days. The four patients with delayed withdrawal of drugs represented a longer time to treat (4.8 days), time to arrest (4.5 days), time to heal(15 days), and length of hospital stay (26.5 days) than those in the 11 patients with early withdrawal. 3. The fraction of patients corresponding to risk factors of SJS or TEN was as follows; elder (>60 years old) (46.6%), widespread lesions (>10%) (66.6%), lymphopenia (66.6%), leukopenia (40%), neutropenia (26.7%), thrombocytopenia (20%), abnormal BUN/Cr (20%), abnormal liver function (46.7%), symptoms of respiratory tract (53.3%), sepsis (13.3%). There were conjunctivitis (66.6%), keratitis (60%), gastroenterologic complications (40%), anxiety disorder (13.3%), and urologic complications (13.3%) in the accompanied systemic complications at first visit. 4. The analysis of a medication history in 15 patients showed 10 cases of prescribed medication and 5 female cases of non-prescribed medication. The patients taking prescribed medication were younger (47.3 years old) than the cases of non-prescribed medication (68 years old). Four cases among the patients with non-prescribed medication at the pharmacy corresponded to the prescription drugs. CONCLUSION: In Jeju island, the incidence of SJS and TEN seems to be higher than that in the published literatures. Along with the habitual pattern of too frequent, prolonged medication by elder patients, the territorial trait of seeing a pharmacist for the disease care at first, and the pharmacists practicing medicine like a physician instead of dispensing a prescription, might contribute to this higher incidence. Anti-glaucoma ophthalmics and anti-convulsants might be the principal causative drugs leading to SJS or TEN in Jeju island.

A Retrospective Clinical Epidemiological Study of the Health Care Utilization of the Outpatients in the Dermatologic Field after 1 year's Separation of Dispensary from Medical Practice / 대한피부과학회지

BACKGROUND: Despite 2 years' separation of dispensary from medical practice since year of 2000, many outpatients in Korea have a lack of understanding this separation. In addition, the illegal practices of pharmacists such as medical examination have contributed to the recent problematic situation. OBJECTIVE: We performed this study to evaluate the actual situation of the separation of dispensary from medical practice in the dermatologic field. METHODS: The clinico-epidemiologic analysis of 17 months' data of 18, 230 outpatients was conducted through the available medical records and serial questionnaires. RESULTS: The medical or non-medical institutions that 18, 230 outpatients with skin diseases had chosen at first, were as follows by the order of frequency; pharmacy(78.5%), folk remedies or self-medication(9.8%), dermatologic institutions(5.5%), non-dermatologic medical clinics(3.4%), herb clinics(2.8%). Accordingly, most(94.5%, 17, 223) of the new patients did not select a dermatologic institution for the care of their skin diseases. The patterns of health care utilization of the patients mostly(72.9%) showed a fixed tendency to visit the one particular institution or formula continuously prior to final visit to the research hospitals. Most of the patients(62.8%) firstly visited a pharmacy for their disease care and did not revisit another institution. Since the first visit to a pharmacy, 9.6% of the patients repetitively utilized one or more herb clinic(s) or folk remedies in addition to one or more medical institution(s). The patients utilizing non-dermatologic measures for skin disease care at first, were mostly in their fifties(25.3%). The patients seeking herb medicine or non-dermatologic medical clinics, were in their teens(27.3% and 24.3%, respectively). Of the cases misdiagnosed as another disease or aggravated in the patients choosing non-dermatologic care, fungal infections are most common(24.0%). In front of 97.1% of the patients seeking pharmacy at first, the pharmacists practiced medicine like a physician in a wrong way instead of dispensing a prescription. CONCLUSION: In Korea, the majority of dermatologic clinics has been deprived of a position as an institution for primary care of skin diseases. It is imperative that dermatologists should be granted independent and unconstrained authority in the medical profession for the benefit of their patients.

A Case of Tufted Folliculitis / 대한피부과학회지

We report a case of tufted folliculitis which developed in a 33-year-old woman. Tufted folliculitis is a rare condition, characterized by a peculiar tufting of hair within areas of scarring alopecia. Histologically, it is characterized by a superficial folliculitis that involves several follicles opening into a common ostium from which multiple hairs come out. Some pathogenetic mechanisms have been proposed to explain the development of tufted folliculitis, but exact mechanism has not been found. Up to now, about 22 reports have been reported, and most of them were cases of westerners is has been reported only once in Korea. So, we report herein a Korean woman with tufted folliculitis of scalp.

A Case of Isolated Epidermolytic Acanthoma / 대한피부과학회지

No Abstract Available.

A Case of Perforating Pseudoxanthoma Elasticum / 대한피부과학회지

Perforating pseudoxanthoma elasticum is a localized, cutaneous disorder found mostly in obese, multiparous middle-aged women. It is characterized clinically by a slowly enlarging, yellowish, well-defined reticulated plaque usually in the periumbilical area with keratotic papules scattered on its surface, and histologically by transepidermal elimination of altered basophilic calcified elastic fibers, which are short, fragmented, and curled, in the middle portion of the reticular dermis. We present a case of a 36 year-old female who had a skin lesion, which showed chracteristic features consistent with perforating pseudoxanthoma elasticum in her neck region but not in the periumbilical area.

Two Cases of Acquired Dermal Melanocytosis / 대한피부과학회지

Dermal melanocytosis is observed in various congenital conditions including nevus of Ota, nevus of Ito and Mongolian spot. It usually appears at birth or in early childhood. Several types of acquired dermal melanocytosis which usually appear in adult life have been reported. As the late onset has been stressed, the term acquired is used. We report two cases of acquired dermal melanocytosis on the forearm and the back without any similar pigmentation elsewhere on the body. The first case is a 47-year-old man who had numerous grey-blue colored macules and patches on the upper back. Histopathologic findings showed a large number of spindle-shaped cells containing melanin granules in the dermis. On electron microscopy, dermal melanocytes with stage 3, 4 melanosomes and lipid droplet were observed. The second one is a 13-year-old girl who had a 3.8 X 2.5 cm sized dark grey colored patch on the left forearm. Histopathologic and EM finding were similar to case 1. We treated both cases with topical cream(retinoid and hydroquinone), but could not observe improvement. Their lesions have persisted without any change.

Keratosis Follicularis and Familial Benign Pemphigus in the Same Patient / 대한피부과학회지

Keratosis follicularis and familial benign pemphigus is an autosomal dominant inherited disease. Keratosis follicularis is characterized by keratotic papules predominantly on the seborrheic areas and familial benign pemphigus, recurrent bullous and vesicular dermatitis on the opposing surfaces. The differential diagnosis of the two diseases with histopathological findings is difficult and still in confusion. We present a case of a 23-year-old woman who had plaques composed of keratotic papules on the anterior shin areas and oozing crusted patches on the buttocks and calves which had some resemblance to the clinical features of familial benign pemphigus. The histological features of the former were consistent with keratosis follicularis, whereas that of the latter was characteristic of familial benign pernphigus.

Measurement of Normal Corpus Callosum with MRI in Korean Adults and Morphological Change of Corpus Callosum by Grade of Hydrocephalus

PURPOSE: To measure the size of normal corpus callosum in each portion using objective and reproducible method with MRI and evaluation of morphological change of corpus callosum by grade of hydrocephalus. MATERIALS AND METHODS: Midsagittal Tl-weighted MR imaging of the corpus callosum was investigated in 41 volunteers of normal Korean adults and 19 patients with hydrocephalus. Corpus callosum was measured for the anteroposterior length(A), height(B), and the thickness of genu(C), body (D), splenium(E), and the narrowest portion of body(F). And the analysis of morphology and signal intensity of the corpus callosum were also evaluated. Hydrocephalus was graded as mild, moderate, and severe, and comparision of thickness with normal corpus callosum in each portion was done. RESULTS: The mean length and height were 72.3mm, 28.6mm in male, and 70.7ram, 28.9mm in female. And the mean dimention for C, D, E, and F were 13.1 ram, 8ram, 13.2mm, 5.2ram in male, and 12.8mm, 7.5ram, 12.3 ram, 5mm in female. The morphology of normal corpus callosum was "hook" shaped on midline sagittal Tl-weighted image. Narrowing at posterior third portion of body were present on 30 cases(73.2%) and even in thickness of the body in 11 cases(26.8%). The signal intensity of the corpus callosum on midsagittal Tl-weighted spin echo image of normal cases was homogeneous hyperintense as compared with cerebral gray matter. In hydrocephalus, A and B were increased and other portions were decreased in thickhess. Genu and the narrowest portion of body showed significant difference of thickness according to the grade of hydrocephalus. CONCLUSION: The mean dimention of all portion of corpus callosum were larger in male than female except for callosal height but not significant statistically with the exception of splenium. Hydrocephalus lead to morphological change of the corpus callosum. Among the portion of corpus callosum, genu and the narrowest portion of the body were thought to be the most sensitive indicators of degree in hydrocephalus.

Dynamic MR Imaging of Hepatic Hemangioma and Hepatocellular: Findings and Differential Diagnosis

PURPOSE: We performed dynamic MR imaging using GdDTPA to find characteristic enhancement pattern of hepatic hemangioma distinguishing from hepatocellular carcinoma. METHODS AND MATERIALS: 28 hepatic hemangiomas and 10 hepatocellular carcinomas were evaluated. Serial dynamic scans after Gd-DTPA(0.1mmol/kg) intravenous injection were obtained by using 0.5T machine and analyzed contrast-to-noise ratio(CNR) of the lesion and enhancement pattern on each scan. RESULTS: Hepatic hemangiomas had positive CNR from 1-2 minute images, and revealed typical "fill-in phenomenon" on early phase with prolonged enhancement in 26 cases(92.8%), and early homogeneous enhancement with isointensity on delayed phase in 2 cases(7.2%) of small hemangiome~ Hepatocellular carcinomas revealed inhomogeneous enhancement with hypointensity on delayed phase in 10 cases(100%) and 3 cases (30%) of capsular enhancement. CONCLUSION: Hepatic hemangioma can be easily distinguished from hepatocellular carcinoma by using Gd DTPA enhanced dynamic MR imaging according to its typical enhancement pattern of "fill-in phenomenon" and prolonged enhancement.

Contrast Enhancement Pattern in MR Imaging of Acute Cerebral Infarction

PURPOSE: To present the enhancement pattern of acute cerebral or cerebellar cortical infarctions aged 1-3 days on MR. MATERIALS AND METHODS: Contrast-enhanced MR images of 26 patients with acute cerebral or cerebellar ischemic events were retrospectively reviewed. MR was performed within 3 days after ictus. RESULTS: Contrast enhancement in the area of infarction was observed in 61.5% (16/26) on MR. Of these 50% (13/26) showed non-parenchymal enhancement (NPE) representing either vascular or leptomeningeal enhancement, 7.7% (2/26) showed parenchymal enhancement (PE), and 2.8% (1/26) showed both NPE and PE. The earliest enhancement was seen in images obtained 12 hours after the onset of symptoms and appeared as NPE. One patient showed NPE without apparent high signal intensity at the corresponding area on T2-weighted images. In 38. 5% (10/26), there was no enhancement. CONCLUSION: Contrast-enhanced MR imaging may be needed in acute ischemic infarction, because NPE may be seen as the earliest MR finding of acute cortical infarction aged 1-3 days.

A clinical and histopathologic study of epidermal cysts / 대한피부과학회지

BACKGROUND: Epidermal cyst is a common disease. The clinical and histo pathologic findings in patients with epidermal cysts are described. OBJECTIVE: Our purpose is to identify the clinical and histopathologic feastures of epidermal cysts. MEHTODS: We ealuated the clinical and histopathologie features of 11 cases which were diagnosed with epidermal cysts at the department of dermatology in Wonju Chist.an Hospital and Jeju Severance Dermatologic clinic for 13 years, from January 1980 to June 1992. RESULTS: The ratio of males to females was 1.9: 1 with male predominance. Age distribution at first visit was variable, ranging from to 85 years old. The mean age was 3.5 years old. The Duration of lesions was variable, ranging from a 3 days to 20 years, with the mean duration of 2.4 years. The most common site of lesions was the face(36%), followed by the trunk(18%), neck(13%), leg(13%), arm (8%), scalp(3%), scrotum(3%), vagina(3%), palm(1%) and fingers(1%). Histopathologically, 46 cases(41%) were ruptured. The most common stromal change was fibrosi followed by granulation tissue formation, giant cell, calcifiration, pilomatricoma like change, pigment, squamous eddy, bone formation and vessel proliferation. The most common cystic content was keiatinous material followed by parakeratotic cell, bacterial colony, calcification, cholesterol cleft, pigment and RBC. The most common cystic wall change was acanthosis followed by atrophy, hyperplasia, hyergranulosis, basalioma like change, parakeratosis and reticulation. CONCLUSION: Epidermal cysts are slowly growing tumors. They occur nost commonly on the face, trunk, neck, legs and arms. Histopathologically, they have a wall compose 1 of true epidermis. When an epidermal cyst ruptures, a foreignbody reaction with numerous multinu leated giant cells occurs.

A case of cutaneous calcinosis following extravasation of calcium chloride / 대한피부과학회지

We report a case of cutaneous calcinosis following extravasation of calcium calcium chloride in a 3-week old neonate, After extravasation of 3% calcium chloride infusion, rapid and marked swelling, erythema, and signs of soft tissue necrosis developed over the extensor surface of both upper extremities. Through the small channels of the destroyed epidermis, tiny white pieces of calcific masses were eliminated spontaneously. Histologically the calcium deposits were found as amorphous masses in the upper dermis and the discharge of calcium deposits also took place by means of transepidermal elimination. The central bone formation and surrounding calcium deposition were present along with dense lymphohistiocytic cell infiltration in the deep dermis. Complications of extravasation of calcium solution during intravenous infusion included localized calcification and, ocasionally necrosis. The incidence of compllcations was about eight percent. This is a case which again emphasises of the danger of using calcium chloride intravenously in the neonate or young infant.

Atrophoderma Vermiculatum Occuring in a Patient with Congenital heart Disease / 대한피부과학회지

A 6-year old girl was diagnosed as atrophoderma vermiculatum on face, especially on cheek and preauricular area, and dorsum of both hands. She had suffered from congenital heart disease which was diagnosed as ventricular septal defect by cardiac: catheterization and cineangiography in final. Three months after patch repair of ventricular septal defect, no further new skin lesion developed. But reticulate skin atrophy was remained.

A Case of Keratosis Palmoplantaris Nummularis / 대한피부과학회지

A case of 39-year-old male with keratosis palmoplantaria nummularis was reported. The skin lesions were characterized by the presence of painful focal keratoses on the plantar pressure points. Biopsy of a keratotic plantar lesion revealed excessive hyperkerstosis, hypergranulosis, focal hypogranulosis, and acanthosis in the epidermis. We could observe aymptomatic relief of this patient who was treated with mixture of corticosteroid, 25% urea and 2.5% salicylic acid.

A Statistical Study of Dermatoses in Wonju Area During the Recent 5 Years ( 1980 ~ 1984 ) / 대한피부과학회지

In this report, 20,536 new outpatients who have visited the Department of Dermatology of Wonju Christian Hospital from Jan. 1st, 1980 to Dec. 31st, 1984 were analized. The results suggest that the age, sex, monthly and yearly distribution patterns of dermatoses in Wonju area are similar to those of other areas in Korea except that infective dermtoses(40.3%), especially scabies(9.8%) and herpes zoster(1.6%) are more common.

A Case of Systemic Amyloidosis Associated with Multiple Myeloma / 대한피부과학회지

Amyloidosis is a disease complex associated with deposition of insoluble filbrillar protein in various tissues of the body. Cutaneous lesions are present in up to 40 % of patients with primary and myeloma associated systemic amyloidosis. We present a case of systemic amyloidosis associated with multiple myleoma occuring in 54-year-old male who had waxy papules with petechiae on nasola bial fold, postauricular area, and cheek. The diagnosis was confirmed by Congo red stain, electron microscope, immunelectrophoresis, Bence-Jones proteinuria, immunoperoxidase stain, and bone marow biopsy.

A Morphological Study of Stratum Corneum / 대한피부과학회지

Stratum corneum was obtained from 10 healthy individuals aged 23 and 24 years, in order to observe morphological differences in a three-dimensionsl structure of stratum corneum from 3 anatomical sites, i. e., flexor surface of the forearm, abdomen, and palm. The stratum corneum obtained by the skin surface biopsy was ohserved under a scanning electron microscope(SME). The surfaces of stratum eorneum obtained by the replice, technique were observed under a stereomicrascope(SM). The results were as follows : 1) SEM observation of the posterior surfaces of the stratum corneum from the skin surface biopsies of the flexor surface of the forearm and abdomen showed divisions with folding lines which were elliptic in the forearm and squere in the abdomen. But there were no similar folding linea in the palm. Among the 3 anatomiral sites, overlapping corneocytes on the palm were most prominent. On a higher magnification, small pits and fine wrinklings in the forearm, fine wrinklings in the abdomen, and villous projections in the palm were observed respeeti vely. 2) SM observation of the stratum corneum from the negative replica of the flexor surface of the forearm, abdomen, and palm showed divisions with folding lines which were X-shape a.t the site of their crossinga in the forearm, *-shape in the abdomen, and linear shape in the palm, Among the 3 snatomical sites, tiny holes on the palm were most prominent. Follicular openings were observed on the pa1m, and abdomen,