Correlation between Severity of Atopic Dermatitis and Sleep Quality in Children and Adults

BACKGROUND: The atopic dermatitis (AD) can limit a patient's physical and psychosocial development as well as lower their overall quality of life (QOL), including sleep quality. OBJECTIVE: The purpose of this study was to evaluate the relationships between clinical disease severity, QOL and sleep quality in children and adults with AD. METHODS: The SCORing atopic dermatitis (SCORAD) was examined to evaluate the severity of AD in fifty adult AD patients and 50 children AD patients. A questionnaire based on the children's sleep habits questionnaire (CSHQ) and the children's dermatology life quality index (CDLQI) were used to evaluate QOL and sleep disturbance in children AD patients. The Pittsburgh sleep quality index (PSQI) and dermatology life quality index (DLQI) were used in adult AD patients. RESULTS: The SCORAD and CSHQ score, the SCORAD and CDLQI score and the CSHQ and CDLQI score demonstrated significant correlations. The SCORAD and PSQI score showed no significant correlation. However, there were significant correlations between the SCORAD and DLQI score and the PSQI and DLQI score. CONCLUSION: Increasing severity of AD affects sleep quality in child AD patients. In adults, even though the total score of the sleep questionnaire is not associated with the severity of AD, two components of sleep questionnaire are associated with the severity of AD. There is a significant correlation between sleep quality and QOL in both children and adults. Therefore, we suggest that evaluating the sleep quality as well as clinical severity of the disease is necessary in the management of AD patients.

Malignant Syphilis in an HIV Seropositive Man / 대한피부과학회지

No abstract available.

A Case of Histiocytoid Sweet Syndrome without a Hematologic Disorder / 대한피부과학회지

Histiocytoid Sweet syndrome (HSS) is a recently described rare variant of acute febrile neutrophilic dermatosis. HSS is clinically characterized by painful inflammatory plaques or nodules with high fever and neutrophilia. About 20% of HSS patients also have an associated malignancy, most commonly of hematologic origin. Histopathologically, HSS is characterized by dense histiocytic infiltration with prominent upper dermal edema, and little neutrophil infiltration. A 69-year-old female presented with a 1-week history of painful erythematous plaques on both elbows accompanied by fever. She was diagnosed with acute pyelonephritis and treated with ciprofloxacin for 2 weeks. Routine laboratory tests showed elevated white blood cell count (predominantly neutrophils), erythrocyte sedimentation rate, C-Reactive Protein, and a mildly elevated liver function test. Peripheral blood smears were normal. Histopathologic examination showed papillary dermal edema and diffuse interstitial infiltration of histiocytoid cells. Immunohistochemical studies revealed that the histiocytoid cells were positive for CD 68 and myeloperoxidase. After treatment with systemic glucocorticoids, the skin lesions and fever gradually resolved. Based on the clinical and histopathologic examination, we diagnosed HSS with no evidence of a hematologic disorder. Herein, we report an unusual case of HSS without associated bone marrow dysplasia.

Vitamin D Status and Its Association with the SCORAD Score and Serum LL-37 Level in Korean Adults and Children with Atopic Dermatitis

BACKGROUND: Vitamin D insufficiency could be associated with the prevalence of atopic dermatitis (AD). OBJECTIVE: To examine vitamin D status and the relations between serum 25-hydroxyvitamin D levels, SCORAD score, serum LL-37 level, and body mass index (BMI) in Korean AD patients, and to explore whether these associations differ between adults and children. METHODS: Serum 25-hydroxyvitamin D levels, serum LL-37, and clinical features were analyzed in a total of 72 Korean patients with AD (39 adults and 33 children) and 140 healthy control subjects (70 adults and 70 children). RESULTS: Serum 25-hydroxyvitamin D levels were significantly reduced in children with AD (15.06+/-4.64 ng/ml) compared with normal children in the control group (16.25+/-6.60 ng/ml) (p=0.036). Significant inverse correlations were found between BMI and 25-hydroxyvitamin D level (r=-0.315, p=0.007) and between the SCORAD score and serum LL-37 level (r=-0.3, p=0.011) in the total AD patients. CONCLUSION: The results showed that serum vitamin D levels were lower in children with AD than in healthy children; however, the same relation was not observed between adults with AD and healthy adults. Serum 25-hydroxyvitamin D concentration was not significantly correlated with AD severity or serum LL-37 levels in our study population.

Two Cases of Pacinian Neuroma on the Finger / 대한피부과학회지

Pacinian neuroma is a rare skin disease characterized by hyperplasia or hypertrophy of the Vater-Pacini corpuscles which are responsible for the appreciation of deep pressure and vibration. It usually affects the volar aspects of the fingers in middle-aged adults and it produces severe pain and tenderness on the affected skins. About half of previously reported cases revealed the association with precipitating factors such as local trauma, but underlying mechanisms are not established. Two patients presented with a several months history of solitary pale-colored papule on the tip of finger. The patients reported a severe tenderness on the lesion with a history of repetitive trauma. The histopathologic examination from the lesions showed increased number of onion-like stratified structures around nerve fibers, compared to the usual density of pacinian corpuscles (3~5/cm2). The histopathological features were consistent with pacinian neuroma. The symptoms of the patients disappeared soon after the surgery. Herein, we present two patients with pacinian neuroma on the finger, and we also propose that pacinian neuroma should be considered for the differential diagnosis of tender papule on the digit.

Three Cases of Generalized Granuloma Annulare in Infancy Following Bacillus Calmette-Guerin Vaccination / 대한피부과학회지

Generalized granuloma annulare is a rare benign granulomatous dermatosis characterized by disseminated necrobiotic dermal papules forming an annular or nonannular configuration. It usually occurs in adults and rarely affects infants. Histologically, it presents as a lymphohistiocytic granuloma associated with varying degrees of connective tissue degeneration. Clinical associations between generalized granuloma annulare and diabetes mellitus, thyroid disease, malignancy, infection, and vaccination have been reported. There are a few cases reports of generalized granuloma annulare associated with Bacillus Calmette-Guerin (BCG) vaccination. Herein, we report three cases of generalized granuloma annulare following BCG vaccination in infants.

A Case of Childhood Granulomatous Periorificial Dermatitis Presenting as Scaly Patches / 대한피부과학회지

No abstract available.

Idiopathic Granulomatous Vulvitis / 대한피부과학회지

Granulomatous vulvitis is a rare localized inflammatory disease characterized by a painless, swollen, indurated and distorted vulva. Histopathologically, it shows chronic non-necrotizing granulomatous inflammation with edema, fibrosis, and lymphangiectasia. Some cases are associated with granulomatous cheilitis or Crohn's disease. So far, only a few cases of idiopathic granulomatous vulvitis have been reported. A 43-year-old female presented with a 1-year-history of persistent swelling of the vulva. The lesion was enlarged, edematous, and indurated, and there were clustered vesicles and papules on the labia major. Histopathologic examination of the swollen labia major showed granulomatous inflammation composed of multinucleated giant cells and epithelioid cells, with numerous lymphocytes in the dermis. Another biopsy specimen obtained from the clustered vesicles showed lymphangiectasia with chronic inflammation. Based on these characteristic histopathologic features and clinical findings, the patient was diagnosed with idiopathic granulomatous vulvitis. Herein, we reported a rare case of idiopathic granulomatous vulvitis that developed in a healthy woman.

Partial Unilateral Lentiginosis with an Ocular Involvement / 대한피부과학회지

Partial unilateral lentiginosis is a rare pigmentary disorder which is characterized by multiple grouped lentigines in unilateral or segmental distributions. The ocular involvement of the disease is extremely rare and only four cases have been reported until today. The exact pathophysiology is still unknown. An 18-year-old woman is being presented with unilateral hyperpigmented macules on her left forehead, eyelid, cheek, lip and chin which all demarcated sharply at the midline of her face. The lesion has been presented since the age of 1. Also, there are discrete brownish pigmentations on her left bulbar conjunctiva. Biopsy specimen is being obtained from the left chin and the histopathological examinations revealed increasing basal layer of pigmentations and mild elongation of rete ridges. The histopathological features are also consistent with lentigo simplex. Herein, we present a rare case of partial unilateral lentiginosis with an ocular involvement. We have also proposed that the partial unilateral lentiginosis has a possibility of ocular involvements.