ABSTRACT
Apert syndrome is a rare genetic disorder characterized by malformations of the skull, face, hands, and feet. We report a case of severe hyperhidrosis in a 13-month-old female infant with Apert syndrome who was born with craniosynostosis, midface hypoplasia, and syndactyly of both hands. She had a history of excessive sweating since birth and this was confirmed using the iodine-starch test. Hyperhidrosis was first reported as a key cutaneous manifestation of Apert syndrome in 1993. However, the main focus in the field of dermatology is on antibiotic-refractory acne, which serves as another cutaneous hallmark of the disease. This is the first report in the Korean literature that describes hyperhidrosis in Apert syndrome. We highlight the presentation of hyperhidrosis as a key cutaneous manifestation in Apert syndrome.
Subject(s)
Female , Humans , Infant , Acne Vulgaris , Acrocephalosyndactylia , Craniosynostoses , Dermatology , Foot , Hand , Hyperhidrosis , Parturition , Skull , Sweat , Sweating , SyndactylyABSTRACT
Dacomitinib (PF-00299804) is a newly developed irreversible pan-HER (human epidermal growth factor receptor) inhibitor for the treatment of non-small cell lung cancer (NSCLC). Inhibiting HER-1 (epidermal growth factor receptor, EGFR), HER-2, and HER-4 may induce similar cutaneous side effects to those of traditional EGFR inhibitors. We report two patients who developed acneiform eruption on the face and trunk, induced by dacomitinib treatment for NSCLC. The skin lesions appeared 3~4 weeks after the initiation of dacomitinib use, and they improved after oral minocycline and topical clindamycin treatment. There has been no report of acneiform eruption after dacomitinib treatment in Korean dermatology journals.
Subject(s)
Humans , Acneiform Eruptions , Carcinoma, Non-Small-Cell Lung , Clindamycin , Dermatology , Drug Therapy , Epidermal Growth Factor , Minocycline , SkinABSTRACT
Dacomitinib (PF-00299804) is a newly developed irreversible pan-HER (human epidermal growth factor receptor) inhibitor for the treatment of non-small cell lung cancer (NSCLC). Inhibiting HER-1 (epidermal growth factor receptor, EGFR), HER-2, and HER-4 may induce similar cutaneous side effects to those of traditional EGFR inhibitors. We report two patients who developed acneiform eruption on the face and trunk, induced by dacomitinib treatment for NSCLC. The skin lesions appeared 3~4 weeks after the initiation of dacomitinib use, and they improved after oral minocycline and topical clindamycin treatment. There has been no report of acneiform eruption after dacomitinib treatment in Korean dermatology journals.
Subject(s)
Humans , Acneiform Eruptions , Carcinoma, Non-Small-Cell Lung , Clindamycin , Dermatology , Drug Therapy , Epidermal Growth Factor , Minocycline , SkinABSTRACT
BACKGROUND: As aging occurs, the skin develops more wrinkles and pigmentation, becomes drier, and loses its elasticity. In previous reports, light-emitting diode (LED) phototherapy was proven to stimulate collagen synthesis and accelerate fibroblast-myofibroblast transformation, which has a composite rejuvenation effect. OBJECTIVE: To evaluate the effectiveness and safety of LED phototherapy with 592 nm yellow light for photoaged skin. METHODS: Forty patients with photoaged skin (Korean photographic scale; grade 4approximately7) were enrolled and treated with an LED device producing 592+/-10 nm yellow light for 5 minutes twice a week for 4 weeks. The skin changes were assessed at 0, 2, 4, and 8 weeks by clinical photographs and the Cutometer(R) & Mexameter(R) (MPA 580, Courage+Khazaka Electronic GmbH, Koln, Germany). Measurements were made on the cheek, periorbital area, nasolabial fold, and glabella. RESULTS: At the final visit at 8 weeks, the Cutometer(R) parameters R4 and R6 decreased significantly compared to before treatment, from 0.118 to 0.099 for the periorbital (p=0.017) and 0.517 to 0.425 for the nasolabial fold (p=0.003). The average melanin index decreased significantly, from 133.65 to 124.55 (p<0.005). Fine improvement of wrinkles was shown grossly by reviewing follow-up clinical photographs. No adverse reactions occurred. LED phototherapy with 592+/-10 nm wavelength can be effective and safe in the treatment of photoaged skin. CONCLUSION: The findings suggest the LED with 592 nm yellow light might be an adjuvant therapeutic tool for photoaged skin.
Subject(s)
Humans , Aging , Cheek , Collagen , Elasticity , Follow-Up Studies , Melanins , Nasolabial Fold , Phototherapy , Pigmentation , Rejuvenation , SkinABSTRACT
BACKGROUND: Home-use devices designed for cosmetic purposes have recently gained popularity. Small, low-energy, low-cost intense pulsed light (IPL) systems provide safe, convenient, and private treatment for several medical conditions. OBJECTIVE: In this study, we aimed to assess the efficacy and safety of a home-use IPL device for hair removal, acne treatment, achieving a whitening effect for hyperpigmentation, and wrinkle reduction. METHODS: Five IPL hair removal treatment sessions were performed at 1-week intervals. A total of 10 sessions were performed in a split-face manner for other medical conditions. Four independent randomized controlled trials were performed using a blind evaluation method. All subjects were followed up twice to evaluate the maintenance of efficacy. RESULTS: A significant reduction in hair was observed via trichoscopy following two sessions of treatment (p<0.001). A mean hair reduction of 80% was observed at week 4; however this returned to the previous state upon cessation of treatment. Acne grading decreased from 2.6 to 1.1 at week 8, and IPL treatment induced a significant reduction in melanin index after 2 weeks. The average values of the difference of R2 (Cutometer(R)) between IPL-treated areas and baseline were higher than those of the difference of R2 between control area and baseline. CONCLUSION: This home-use IPL device was effective for hair removal and treatment of acne, hyperpigmentation, and wrinkles.
Subject(s)
Acne Vulgaris , Hair , Hair Removal , Hyperpigmentation , Melanins , Pigmentation , Pigmentation Disorders , Withholding TreatmentABSTRACT
Extraskeletal Ewing's sarcoma is an extremely rare malignant soft tissue tumor, which presents the exact same histopathologic features with Ewing's sarcoma of bone. Tumor composed of small, blue, round cells with vesicular nuclei and scant cytoplasm is the characteristic histopathology of the disease. Extraskeletal Ewing's sarcoma is known to occur usually in the deep soft tissues of the extremities. We report a case of 22-year-old boy with solitary extraskeletal Ewing's sarcoma on his back without any evidence of bone involvement. The patient went through wide excision with meticulous lymph node dissection followed by chemotherapy. For the 15 months of follow up, there is not a sign of recurrence or metastasis observed.
Subject(s)
Humans , Young Adult , Cytoplasm , Extremities , Follow-Up Studies , Lymph Node Excision , Neoplasm Metastasis , Recurrence , Sarcoma, EwingABSTRACT
Porokeratosis of Mibelli, a chronic heritable disorder of the skin, presents with characteristic histopathological features including cornoid lamella as a result of faulty keratinization. Amyloid deposits are characterized by the accumulation of ultrastructually fibrillar material and have been observed in inflammatory and tumoral skin diseases. Some cases of amyloid deposits in the upper dermis in various subtypes of porokeratosis have been reported, but no porokeratosis of Mibelli reports are available in Korea. We report a case of a 26-year-old woman with three verrucous hyperkeratotic plaque lesions on her right popliteal fossa with histological feature of hyperkeratosis, cornoid lamella, and dermal amyloid deposits.
Subject(s)
Adult , Female , Humans , Amyloid , Dermis , Keratins , Korea , Plaque, Amyloid , Porokeratosis , Skin , Skin DiseasesABSTRACT
Erythema multiforme (EM) is an extremely rare condition in infancy. To the best of our knowledge, there have been only three cases of neonatal EM described in the literature, and no such cases have been reported in Korea. A preterm neonate born at 35 weeks and six days of gestation presented with multiple annular erythematous patches with a targetoid shape over his entire body at 36 days of age (corrected age of 7 days). He had no systemic symptoms except for transient mild fever. No triggering factor except for hepatitis B and BCG vaccination was found. Neutropenia was noted upon laboratory analysis. Skin biopsy specimens showed findings suggestive of erythema multiforme. The skin lesions improved rapidly upon administration of intravenous methylprednisolone; however, neutropenia continued for a much longer period. The significance of neutropenia with respect to the development of EM was not clarified. There has been no recurrence of skin lesions over a one-year follow-up period.
Subject(s)
Humans , Infant, Newborn , Pregnancy , Biopsy , Erythema , Erythema Multiforme , Fever , Follow-Up Studies , Hepatitis B , Korea , Mycobacterium bovis , Neutropenia , Recurrence , Skin , VaccinationABSTRACT
Acne is one of the most common skin diseases. It usually occurs during adolescence, but can persist into middle age. The most deleterious form can result in permanent scarring on the face, chest, and back. The pathogenesis of acne is thought to be multifactorial. There are four most significant pathogenic factors of acne: Androgen-stimulated production of sebum, hyperkeratinization and obstruction of sebaceous follicles, proliferation of Propionibacterium acnes and inflammation. Therefore, pharmacologic treatment of acne should be focused on at least one of these main causative factors. The ultimate goal of treatment is to address as many of the pathogenic factors of acne as possible while minimizing side effects. Topical retinoids correct abnormal keratinization, but it should be applied cautiously because of irritation. Benzoyl peroxide is an effective bactericidal agent against P. acnes. Main topical antibiotics are erythromycin and clindamycin. Recently, fixed combination topical products have been highlighted. Use of Systemic antibiotics, including tetracyclines and macrolides rapidly improves inflammatory acne lesions. Oral isotretinoin is effective against all of the pathogenic features of acne but is contraindicated in pregnant women and has been associated with elevations in triglyceride levels, cheilitis and dry skin. Hormonal therapy has been found to improve acne in some women and should be considered for appropriate candidates. Because acne is a complex multifactorial disorder, combination treatment may be required to target its various pathogenic factors. Combination treatments also offer the most improvement over the shortest time. This review provides a general overview of pharmacologic treatment of acne.
Subject(s)
Adolescent , Female , Humans , Middle Aged , Acne Vulgaris , Anti-Bacterial Agents , Benzoyl Peroxide , Cheilitis , Cicatrix , Clindamycin , Erythromycin , Inflammation , Isotretinoin , Keratins , Macrolides , Pregnant Women , Propionibacterium acnes , Retinoids , Sebaceous Glands , Sebum , Skin , Skin Diseases , Tetracyclines , ThoraxABSTRACT
BACKGROUND: Antimicrobials have been a mainstay of inflammatory acne treatment for more than 30 years. However, antibiotic-resistant propionibacteria had been isolated with increased frequency, and associated with failure to respond to antibiotic therapy. OBJECTIVE: The aim of this study was to investigate the clinical efficacy and tolerance of 1% nadifloxacin cream. METHODS: In the final analysis, 197 patients with mild to moderate facial acne vulgaris were enrolled. The patients were instructed to apply 1% nadifloxacin cream twice daily to the affected skin after washing the face. Following 2 and 4 weeks of treatment, patients were observed for clinical response: number of the acne lesions, Korea acne grading system (KAGS), global improvement, and occurrence of adverse reactions. RESULTS: During 4 weeks of treatment, nadifloxacin caused significant reduction in the number of inflamed papulo-pustular lesions and open/closed comedones. In addition, significant reduction of KAGS was observed. About 96% of patients showed clinical improvement in the overall evaluation of the therapeutic effect by physicians. All reported adverse events were mild. CONCLUSION: This study shows that 1% nadifloxacin cream can be an effective and safe treatment for mild to moderate acne vulgaris.
Subject(s)
Humans , Acne Vulgaris , Fluoroquinolones , Korea , Quinolizines , Republic of Korea , SkinABSTRACT
Ectopic nail is characterized by growth of nail-like tissue in a location other than the nail bed. It is an extremely rare disorder that can be either congenital or acquired from incidents such as trauma. An 8-year old female presented with a complaint of a nail-like lesion on the dorsal surface around the center of the right fifth toe. It had been present for 3 years, while the patient continuously clipped it upon growth. The fifth toe was initially injured by a chair that had fallen on that toe 4 years prior to her visit. There was no associated bony deformity or other physical changes in the nail. A clinical diagnosis of ectopic nail was made and it was surgically excised under local anesthesia. The histopathological examination revealed a normal nail unit and there was no recurrence during the 6 month follow-up period.
Subject(s)
Female , Humans , Anesthesia, Local , Congenital Abnormalities , Follow-Up Studies , Nails , Recurrence , ToesABSTRACT
Paclitaxel is one of the taxoid-antineoplastic agents. These agents are used in the treatment of breast, lung and ovary cancer. Nail changes due to treatment with the taxanes (mainly docetaxel) are reported in 30~40 percent of patients. Paclitaxel is not commonly associated with dermatological reactions, although localized skin reactions and tissue necrosis following extravasation have been reported. Reports of the incidence of nail changes associated with paclitaxel is noted as the pigmentation or discoloration of the nail bed, vary from 2~20%. We report a patient with onycholysis and subungual suppuration during treatment with paclitaxel.
Subject(s)
Humans , Breast , Incidence , Lung , Nails , Necrosis , Onycholysis , Ovarian Neoplasms , Paclitaxel , Pigmentation , Skin , Suppuration , TaxoidsABSTRACT
Little is known about the treatment-seeking behaviors of acne patients, especially Asian acne patients. This study was performed to obtain detailed information about the treatment-seeking behaviors in Korean acne patients. Patients who visited the dermatology departments at 17 university hospitals completed a self-administered questionnaire. Most patients obtained information about acne from doctors or the Internet. The most important criteria for selecting a treatment method or choosing a particular clinic were effectiveness and accessibility. Patients used traditional medicine, visited beauty clinics, drank more water, and used over-the-counter topical agents more frequently than they sought doctors during the worsening period. The degree of satisfaction in treatment was found to depend on the total cost of treatment, number of places visited, site affected by acne, and emotional stress. Those who had experienced a side effect tended to have been treated for longer, to have paid more for treatment, and to have an associated skin disease. Treatments prescribed by dermatology clinics had the lowest aggravating rate, although improvement rates for family medicine clinics were also fairly high. This is the first study to investigate in detail the demographic features and characteristics of the treatmentseeking behaviors of acne patients in Asia.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Acne Vulgaris/epidemiology , Demography , Health Behavior , Health Knowledge, Attitudes, Practice , Hospitals, University , Korea , Patient Satisfaction , Surveys and Questionnaires , Sex Factors , Stress, PsychologicalABSTRACT
Erlotinib (Tarceva(R)) is a new anti-cancer agent which acts by inhibiting epidermal growth factor receptor (EGFR) signal transduction. It is currently used in the treatment of advanced stage non-small cell lung cancer and pancreatic cancer. We report a case of acneiform eruption and paronychia induced by erlotinib in a 69-year-old man. The patient visited our clinic with multiple erythematous papules and pustules on the face, periungual erythema and pus discharge, xerosis, fissures on the sole. He had taken erlotinib for the treatment of recurred lung cancer for 4 weeks. The skin lesions were partially improved with oral pyridoxine, corticosteroid and topical antibiotics.
Subject(s)
Aged , Humans , Acneiform Eruptions , Anti-Bacterial Agents , Carcinoma, Non-Small-Cell Lung , Erythema , Lung Neoplasms , Pancreatic Neoplasms , Paronychia , Pyridoxine , ErbB Receptors , Signal Transduction , Skin , Suppuration , Erlotinib HydrochlorideABSTRACT
Solar urticaria is an uncommon photodermatosis characterized by the occurrence of pruritic erythema and wheals after exposure to sunlight or artificial radiation. A 52-year-old woman presented with a month long history of pain, wheal and sometimes mild dyspnea which developed after sunlight exposure. Phototesting for UVA, UVB and visible light were all positive, which has never been reported in Korea. The patient was treated with antihistamine and antimalarial drug.
Subject(s)
Female , Humans , Middle Aged , Dyspnea , Erythema , Korea , Light , Sunlight , UrticariaABSTRACT
Drug-induced hypersensitivity syndrome is a rare, but severe, life-threatening disease with multiorgan failure. Aromatic antiepileptic drugs are frequent causes of this syndrome. The association of the human herpes virus-6 has been recently reported in patients with drug-induced hypersensitivity syndrome. We report two patients who were diagnosed as having antituberculosis drug-induced hypersensitivity syndrome based on clinical course and laboratory data. In addition, human herpes virus-6 DNA was detected by polymerase chain reaction in peripheral blood mononuclear cells and the serum. There was a favorable outcome after discontinuation of the causative drug, plus corticosteroid therapy. After the treatment, human herpes virus-6 DNA was not detected by polymerase chain reaction. This is the first report of antituberculosis drug-induced hypersensitivity syndrome associated with reactivation of human herpes virus-6.
Subject(s)
Humans , Anticonvulsants , DNA , Hypersensitivity , Polymerase Chain ReactionABSTRACT
Infantile acne is a much less common disease than adolescent and postadolescent acne. It occurs in children approximately at 3 to 6 months of age. An 8 month-old male infant, accompanied by his mother, visited our clinic with a history of erythematous skin lesions on both cheeks, which started 5 months ago. Physical examination revealed closed comedones, several relatively well demarcated, erythematous papules, nodules and pustules. Inflammatory lesions left scars scattered over the face. For further evaluation of endocrinologic abnormalities or other systemic diseases, an additional abdominal ultrasound was done after a visit to the pediatrician. A skin biopsy revealed findings compatible with acne. Skin lesions were improved by treatment with oral and topical antibiotics, adapalene and isotretinoin. We report herein a case of infantile acne which has not been reported in Korean dermatological literature.