Silica-Based Advanced Nanoparticles For Treating Ischemic Disease

Recently, various attempts have been made to apply diverse types of nanoparticles in biotechnology. Silica nanoparticles (SNPs) have been highlighted and studied for their selective accumulation in diseased parts, strong physical and chemical stability, and low cytotoxicity. SNPs, in particular, are very suitable for use in drug delivery and bioimaging, and have been sought as a treatment for ischemic diseases. In addition, mesoporous silica nanoparticles have been confirmed to efficiently deliver various types of drugs owing to their porous structure. Moreover, there have been innovative attempts to treat ischemic diseases using SNPs, which utilize the effects of Si ions on cells to improve cell viability, migration enhancement, and phenotype modulation. Recently, external stimulus-responsive treatments that control the movement of magnetic SNPs using external magnetic fields have been studied. This review addresses several original attempts to treat ischemic diseases using SNPs, including particle synthesis methods, and presents perspectives on future research directions.

Various Three-Dimensional Culture Methods and Cell Types for Exosome Production

Cell-based therapies have been used as promising treatments for several untreatable diseases. However, cellbased therapies have side effects such as tumorigenesis and immune responses. To overcome these side effects, therapeutic effects of exosomes have been researched as replacements for cell-based therapies. In addition, exosomes reduced the risk that can be induced by cell-based therapies. Exosomes contain biomolecules such as proteins, lipids, and nucleic acids that play an essential role in cell–cell and cell–matrix interactions during biological processes. Since the introduction of exosomes, those have been proven perpetually as one of the most effective and therapeutic methods for incurable diseases. Much research has been conducted to enhance the properties of exosomes, including immune regulation, tissue repair, and regeneration. However, yield rate of exosomes is the critical obstacle that should be overcome for practical cell-free therapy. Three-dimensional (3D) culture methods are introduced as a breakthrough to get higher production yields of exosomes. For example, hanging drop and microwell were well known 3D culture methods and easy to use without invasiveness. However, these methods have limitation in mass production of exosomes. Therefore, a scaffold, spinner flask, and fiber bioreactor were introduced for mass production of exosomes isolated from various cell types. Furthermore, exosomes treatments derived from 3D cultured cells showed enhanced cell proliferation, angiogenesis, and immunosuppressive properties. This review provides therapeutic applications of exosomes using 3D culture methods.

Leser-Trelat Sign Associated with Malignant Melanoma / 대한피부과학회지

Leser-Trelat sign is a rare paraneoplastic dermatosis that is characterized by the eruptive and rapid development of multiple seborrheic keratosis that coincides with an internal malignancy. Eruptive seborrheic keratosis can be pruritic and appear in a "Christmas-tree pattern." This sign occurs in association with a number of cancers, such as adenocarcinoma of the gastrointestinal tract and various lymphoproliferative disorders. However, Leser-Trelat sign associated with a malignant melanoma is very rare. A 58-year-old male patient presented with an asymptomatic black mass on the penile orifice and patch on the glans penis. He complained of gross hematuria. At the same time, he developed asymptomatic multiple brown papules and plaques on the back. The histopathologic findings of the glans and back lesions were consistent with malignant melanoma and seborrheic keratosis, respectively. Here, we describe a rare case of Leser-Trelat sign associated with malignant melanoma.

Cutaneous Wound Myiasis in a Missing Old Woman / 대한피부과학회지

No abstract available.

Cutaneous Crohn's Disease on the Groin / 대한피부과학회지

Crohn's disease is a systemic inflammatory and granulomatous disease, mainly involving the gastrointestinal tract with extraintestinal manifestations such as the skin, liver and bone. Cutaneous manifestations of Crohn's disease are relatively common; however, the groin is an unusual site for cutaneous Crohn's disease. A 36-year-old male presented with mild pruritic nodules on the left groin for 2 months. Nine years ago, he was diagnosed with intestinal Crohn's disease by endoscopic biopsy. Histopathologic examination of the cutaneous lesion showed non-caseating granulomatous reactions composed of multinucleated giant cells with lymphohistiocytic infiltration in the dermis. Staining for periodic acid-Schiff and acid-fast bacilli was negative. From these findings, we diagnosed these lesions as cutaneous Crohn's disease. The lesions were markedly improved with three rounds of intralesional steroid injection.

Infantile Erythema Annulare Centrifugum / 대한피부과학회지

Erythema annulare centrifugum is an inflammatory skin disorder of unknown etiology characterized by erythematous urticarial papules that enlarge in a centrifugal pattern to form annular appearance. These lesions are usually asymptomatic. Erythema annulare centrifugum generally tends to be a chronic condition. It develops most frequently in adults between 30 and 50 years of life, and only a few infantile cases have been reported in the English literature. Herein, we present an additional case of infantile erythema annulare centrifugum with a review of the literature.

Therapeutic Effects of 308 nm Excimer Laser in the Treatment of Vitiligo Patients: A Single Center Study in Korea / 대한피부과학회지

BACKGROUND: Treatment with a 308 nm excimer laser has been used widely for vitiligo. However, there have been few clinical reports about the therapeutic effects of excimer laser in the Korean literature. OBJECTIVE: The purpose of this study was to investigate the clinical efficacy of treatment of vitiligo patients in Korea using a 308 nm excimer laser. METHODS: Eighty-five patients were treated using a 308 nm excimer laser, which was performed twice a week, for a total of 20 treatments. We analyzed the grade of repigmentation with respect to various clinical parameters. RESULTS: Thirty-one of the 85 patients (36.5%) achieved more than 50% repigmentation. Response to treatment was related to age, duration of vitiligo, type of vitiligo and site of lesions (respectively, p=0.049, 0.030, 0.001, 0.001). There were no relationship between treatment response, sex and history of previous treatments (respectively, p=0.636, 0.781). Twenty-nine patients (34.1%) had side effects including erythema, perilesional hyperpigmentation and burn, but they were mild and transient. CONCLUSION: The use of a 308 nm excimer laser for the treatment of vitiligo patients is effective and safe. However, patient age, duration of vitiligo, type of vitiligo and site of lesions may be the key factors affecting the clinical outcome.

Two Cases of Poikiloderma of Neck and Chest Treated by Intense Pulsed Light / 대한피부과학회지

Poikiloderma is a combination of telangiectasia, irregular mottled hyperpigmentation/depigmentation and superficial atrophy in a reticular pattern. Poikiloderma of Civatte is a rather common, acquired poikiloderma of the face and neck, most often affecting the middle-aged or the elderly. Poikiloderma of Civatte runs a chronic, benign, but irreversible course. The ideal treatment is elimination of both the vascular and pigmented components simultaneously. Most methods to treat this condition are ineffective, inefficient, or inconvenient and may cause significant side effects such as depigmentation and scarring. Recently, intense pulsed light sources have been used in poikiloderma of Civatte with their ability to target vascular and pigment components simultaneously. We experienced two cases of poikiloderma of Civatte treated by intense pulsed light with different parameters than those used in former reports, so we report this case with a review of previously published cases.

Localized Involutional Lipoatrophy in a Child

No abstract available.

Localized Involutional Lipoatrophy in a Child

No abstract available.

Clinical and Histopathological Analysis of Inflammatory Lesions on the Lips / 대한피부과학회지

BACKGROUND: Inflammatory labial lesions are quite common in dermatology. However, a few studies have been performed regarding the clinical and histopathological findings of inflammatory labial diseases. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological features of inflammatory labial diseases. METHODS: We retrospectively reviewed the data of 48 patients who underwent biopsy for inflammatory labial lesions between June 2005 and December 2012. Clinical features and histopathological findings of the lesions were investigated, and they were compared to each other for differential diagnosis. RESULTS: The most frequent inflammatory labial diseases were actinic cheilitis (25%), oral lichen planus (23%), plasma cell cheilitis (23%), oral lichenoid lesion (17%), and eczema (12%). Most of the labial lesions were located on the lower lip (87%). We found a broad overlap in the clinical features of lesions with each other, and in many cases, clinical impressions were inconsistent with their final diagnosis. Histopathologically, the degree of eosinophilic infiltrates in actinic cheilitis was comparable to those in eczema. Oral lichen planus showed orthokeratotic hyperkeratosis rather than parakeratosis, and oral lichenoid lesion displayed more frequent perivascular and deep inflammatory cell infiltrates than oral lichen planus. CONCLUSION: The diagnosis of inflammatory labial diseases may be challenging, because inflammatory labial diseases often show similar clinical features and have a broad overlap in histological features. Therefore, clinico-pathologic correlation is necessary to confirm the diagnosis and for proper management.

A Study of the Causative Diseases for Eyelid Dermatitis / 대한피부과학회지

BACKGROUND: The eyelids are uniquely susceptible to inflammation. Although eyelid dermatitis is common by various causes, there are few comprehensive studies on this disease in the Korean literature. OBJECTIVE: The purpose of this study was to analyze the causative disease for eyelid dermatitis in Koreans. METHODS: Medical records of patients with eyelid dermatitis treated between 2006 and 2011 were reviewed. RESULTS: Four hundred and five patients (152 males and 303 females) were enrolled in this study, and the mean age of onset was 32.7 (range: 0~84). The most common causes of eyelid dermatitis were allergic contact dermatitis (42.6%), atopic dermatitis (27.9%), irritant contact dermatitis (12.7%), seborrheic dermatitis (8.6%), insect bite (2.4%), etc., in the order of frequency. In the 194 patients of eyelid dermatitis caused by allergic contact dermatitis, 98 patients (50.5%) were in the 30's to 50's, and 120 patients (94.5%) of the 127 patients with atopic dermatitis were under thirty years of age. The frequency of causative diseases for eyelid dermatitis in men were atopic dermatitis (44.7%), allergic contact dermatitis (23.7%) and irritant contact dermatitis (12.5%), and those in women were allergic contact dermatitis (52.1%), atopic dermatitis (19.5%) and irritant contact dermatitis (12.9%). There was a seasonal variation with frequency in fall (30.3%) and spring (26.4%). Among the 341 patients who were followed up, 294 patients (86.2%) showed good response to treatment, but 64 patients (21.8%) of the improved 294 patients relapsed. Four patients experienced adverse effects including irritation (3 cases) and folliculitis (1 case) after using topical glucocorticoids. CONCLUSION: The frequency of eyelid dermatitis decreased by age. Eyelid dermatitis was more common in women, but the ratio of males to females was increased compared with previous reports. The most common causes of eyelid dermatitis were allergic contact dermatitis, atopic dermatitis and irritant contact dermatitis, which were similar with the results of previous reports. Eyelid dermatitis was more common in fall and spring. The recurrence rate was relatively high, but adverse effects of topical corticosteroids were unusual. This study will be useful for clinicians when treating patients with eyelid dermatitis.

Topical Tretinoin Treatment for Confluent and Reticulated Papillomatosis / 대한피부과학회지

BACKGROUND: Confluent and reticulated papillomatosis (CRP) is a rare cutaneous disorder, characterized by persistent, scaling brown papules, patches, and plaques located on the trunk, neck, axillae, and shoulders. Many different treatments with variable success have been attempted, and oral minocycline treatment is effective in most patients with CRP. There were a few case reports of CRP responding to topical retinoid, but no clinical studies on the efficacy of the topical retinoid treatment for CRP have been reported. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of the topical tretinoin treatment for CRP. METHODS: A retrospective study was performed based on the medical records and clinical photographs of patients with CRP treated with 0.025% tretinoin cream. RESULTS: Nine patients (4 men and 5 women) were enrolled in the study. The mean age of the patients was 17.4 (11~34) years and the mean age at onset of CRP was 15.1 (3~33) years. The duration of disease varied from 1 month to 7 years. Six of the nine patients showed complete remission, and CRP lesions improved markedly after averagely 6.2 weeks from the beginning of the topical tretinoin treatment. The treatment response was better in patients without itch than in patients with itch (p=0.048). Adverse effects were detected in 3 patients, and were mild irritant contact dermatitis to the topical tretinoin. CONCLUSION: We think that topical 0.025% tretinoin treatment is an effective and safe treatment modality for CRP and this treatment can be an alternative or additional modality to the systemic treatment.

Mycosis Fungoides with Coincidental Ureter Cancer / 대한피부과학회지

An 82-year-old woman presented with a 5-year history of erythematous to brown patches and plaques on both legs, arms and trunk. Histopathological findings of biopsy specimens were consistent with mycosis fungoides, and the tumor cells were positive for CD3 and negative for CD20 in immunohistochemical stain. Imaging studies proposed the suspicion of ureter cancer, and the result of cystoscopic biopsy showed papillary urothelial carcinoma. Mycosis fungoides is the most common type of cutaneous T-cell lymphoma, characterized by variable cutaneous manifestations, including patches, plaques, tumors, and erythroderma. There were several studies concerning the evaluation of the second malignancy risk after cutaneous T-cell lymphoma, however the relationship between mycosis fungoides and ureter cancer is not revealed. This patient is considered a case of mycosis fungoides with coincidental ureter cancer.

A Clinical Study of Herpes Zoster: Focused on the Characteristics of Pruritus in Herpes Zoster / 대한피부과학회지

BACKGROUND: Herpes zoster is a common dermatologic disorder. However, there have been no reported studies of the characteristics of pruritus in herpes zoster in Korean literature. OBJECTIVE: The purpose of this study is to investigate the epidemiological features and clinical characteristics of pruritus in herpes zoster. METHODS: Retrospective study was performed by reviewing the medical records of 178 patients with herpes zoster. The analyses of age, gender, accompanying symptoms, dermatomal distribution, underlying disease, treatment and complication were performed. RESULTS: The ratio of male to female patients was 2:3. The age distribution ranged from 1 to 87 years old. A total of 76.4% of the patients with herpes zoster experienced pruritus, and 18.4% of the patient with pruritus had pruritus that disrupted normal activities. There were no relationships between the incidence of pruritus and age of patients, gender, dermatomal distribution, and incidence of pain. As the severity of pain increased, the incidence and the severity of pruritus increased (p=0.01, p=0.01). Pruritus was improved within 3 weeks in the 74.3% of the patients with pruritus; however, 9.6% of the patients felt complaint with pruritus over 6 weeks. The duration of the pruritus extended with advancing age (p=0.01). As the severity of pruritus and pain increased, the duration of pruritus increased (p=0.025). CONCLUSION: Pruritus is a common symptom in herpes zoster, and this study describes the general aspects of pruritus in herpes zoster. Advancing age and the severity of the pruritus and the pain are possible risk factors of long-lasting pruritus.

Atrophying Pityriasis Versicolor / 대한피부과학회지

Atrophying pityriasis versicolor is a rare variant of pityriasis versicolor. Clinically, atrophying pityriasis versicolor is characterized by well defined, slightly scaly, depressed macules and patches with minimal symptoms. The etiology of the atrophy is unknown, though several hypotheses have been suggested, including immune reaction to antigens of Malassezia species. A 23-year-old male was presented with multiple, slightly brown colored macules and patches on the chest and back. In the potassium hydroxide preparation, lots of yeasts and hyphae were found. A histopathologic study showed multiple yeasts and hyphae on the stratum corneum, focal epidermal thinning, and perivascular lymphocytic infiltration on the upper dermis. The patient was treated with 100 mg itraconazole a day with topical antifungal agents. After 3 weeks of treatment, clinical improvement and mycological improvement were achieved. We present an additional case of atrophying piryriasis versicolor developed on the chest and back with the review of the relevant literature.

Clinicopathological Study of Pyogenic Granuloma / 대한피부과학회지

BACKGROUND: Pyogenic granuloma is a common vascular neoplasm of the skin and mucous membranes. However, few comprehensive studies are available on the clinical and histopathological characteristics of pyogenic granuloma. OBJECTIVE: To analyze the clinical and histopathological characteristics of pyogenic granuloma. METHODS: Patients with pyogenic granuloma diagnosed clinically and histopathologically were reviewed retrospectively. RESULTS: Fifty patients (17 males and 33 females) were enrolled, and the mean age of onset was 33.6 years old. The mean lesion size was 6.7 mm. Forty-eight patients had a solitary lesion, whereas two patients had multiple lesions on the skin and mucosa. The most common area for lesions was the head and neck followed by the hands, trunk, and lower extremities. Patient complained of easy bleeding, pain, tenderness, and pruritus. Dermoscopic findings of nine lesions showed patterns of a reddish homogenous area, white scaly collarette, white rail lines, and a hemorrhagic crust. Histopathological findings of all biopsy cases showed a lobular pattern of angiomatous tissue with numerous congested capillaries, a flattened epidermis, a well-formed epidermal collarette, and CD34-positive endothelial cells. Various treatment modalities including surgery and laser have been used, but lesions recurred following a single laser treatment with a pulsed dye laser or long-pulsed Nd:YAG laser. CONCLUSION: A correlation between clinicopathological and dermoscopic findings was useful for the differential diagnosis of other diseases mimicking pyogenic granuloma and to detect recurrence after treatment. Laser treatments were less invasive therapy, but the recurrence rate was higher than that of other surgical modalities when used alone. Additional prospective studies are needed to determine the effectiveness of the various treatment modalities.

Morphea Developing at the Site of Healed Herpes Zoster

Wolf's isotopic response describes the occurrence of a new, unrelated disease that appears at the same location as a previously healed skin disease, and the most common primary skin disease of this phenomenon is herpes zoster. Several cutaneous lesions have been described to occur at the site of healed herpes zoster, and granulomatous dermatitis and granuloma annulare have been reported to be the most common second diseases. The pathogenesis of the isotopic response is still unclear. Morphea can develop at the site of regressed herpes zoster and a few such cases have been reported. We present here an additional case of morphea that developed at the site of previously healed herpes zoster, and we review the relevant literature.

A Clinical Study of Herpes Zoster in Children / 대한피부과학회지

BACKGROUND: Herpes zoster is a common dermatologic disorder. However, there has been no reported study of herpes zoster in children exclusively in the Korean literature. OBJECTIVE: The purpose of this study was to analyze epidemiological features and clinical characteristics of herpes zoster in children. METHODS: A retrospective study was performed by reviewing the medical records of 64 patients who were under 12 years old and who had herpes zoster. We searched for cases occurring during a 10-year-period from January 2000 to December 2009. We analyzed for age, gender, accompanying symptoms, dermatomal distribution, underlying disease, treatment and complications. RESULTS: Children under 12 years old account for 2.48% of all herpes zoster patients. The ratio of males to females is 1:1. The number of enrolled patients was increasing according to age (p=0.0004). The number (p=0.0009) and the proportion (p=0.0187) of pediatric patients has been increasing year by year. Underlying diseases were observed in 17.2%, and included asthma, atopic dermatitis, chronic sinusitis, epilepsy and tic disorder. There was no patient with immunocompression. Lesions of herpes zoster were most frequently found in the trigeminal dermatome (35.9%), followed by the thoracic (34.4%), cervical (14.1%), lumbar (9.4%), and sacral (4.7%) dermatomes, and multiple involvement (1.16%). Pain accompanying herpes zoster was reported in 54.7% and pruritus in 71.9%. Complications were observed in 14.1%; the most common one was eye involvement. CONCLUSION: The incidence of accompanying pain in children with herpes zoster is lower than in adults with this disease. However, the incidence of accompanying pruritus was higher in children than in adults. Postherpetic neuralgia did not developed in children.

A Case of Adenoid Cystic Carcinoma on the Nipple with Axillary Lymph Node Metastasis / 대한피부과학회지

Adenoid cystic carcinoma of the breast is an uncommon type of breast cancer, and it accounts for 0.1% of all breast cancer. In contrast to the aggressive nature of extramammary adenoid cystic carcinoma, adenoid cystic carcinoma of the breast has a more favorable prognosis. A 55-year-old female patient presented with a 6-month history of a tender mass confined to the nipple of the left breast. A skin biopsy showed a linear and tubular pattern of atypical cells, which was consistent with adenoid cystic carcinoma. Left breast conserving surgery with axillary lymph node dissection was performed. The histopathology of the specimen showed a 1.5 cm sized mass localized to the nipple, and the axillary lymph nodes were positive for tumor metastasis.