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Elastosis perforans serpiginosa (EPS) is a rare condition that belongs to the group of acquired perforating dermatosis. It usually appears as keratotic papules in serpiginous configuration with central atrophy on the head, nape, and extremities. It is characterized by the transepidermal elimination of elastic fibers with clumping and vertical orientation of elastic fibers. In many cases, it is associated with genetic or connective tissue diseases. A 26-year-old female patient with Down syndrome presented with brownish keratotic papules on both arms. The lesion had been present for 2 years, but there were no symptoms. The biopsy specimen showed transepidermal elimination of the degenerated elastic fibers. Verhoeff elastic staining revealed an increased number of thick elastic fibers. Based on these findings, the patient was diagnosed with EPS. Treatment with CO 2 laser was performed with a successful outcome.
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Background@#In a previous study, we carried out whole-exome sequencing to identify genetic variants associated with early onset atopic dermatitis (AD) in Koreans and found that collagen VI α6 chain (COL6A6) gene polymorphisms are associated. COL6A6 is one of the chains that makes up the triple helix of collagen VI, and little is known about its role in AD. @*Objective@#To identify how COL6A6 changes in AD and clarify its role. @*Methods@#Immunohistochemical staining for COL6A6 was performed on tissues of AD, other skin diseases, and healthy controls. Human keratinocytes and fibroblasts were exposed to inflammatory cytokines and cultured to evaluate changes in COL6A6 expression. COL6A6 small interfering RNA (siRNA) was transfected into cells to identify the role of COL6A6. @*Results@#Total COL6A6 mRNA was higher in AD than in controls. In AD tissues, COL6A6 mRNA decreased significantly in the epidermis compared to controls, whereas COL6A6 protein was increased in the dermis. In the cultured cells, COL6A6 mRNA was suppressed in the epidermis by interleukin (IL)-4 and IL-13, whereas COL6A6 protein was induced in the dermis. In the COL6A6 siRNA-transfected keratinocyte, mRNA of FLG, LOR, and CASP14 decreased compared to controls; in contrast, mRNA of MMP1 increased. @*Conclusion@#The reduction of epidermal COL6A6 due to the genetic mutation can cause skin barrier damage and it can contributes to the early onset of AD. COL6A6 is induced by IL-4 and IL-13, and it may play a role in fibrotic remodeling and inflammatory processes, which are major features of AD.
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Background@#Increasing numbers of individuals are getting tattoos in recent times; however, the possible adverse effects of tattoos performed by non-medical practitioners are often overlooked. Limited information is available regarding the actual numbers of individuals getting tattoos and the perception regarding tattoos in the general population. @*Objective@#We investigated the prevalence of tattoos and public perception of tattoos. @*Methods@#Between August and September 2019, we performed a questionnaire survey that included 1,000 individuals aged ≥20 years. @*Results@#Among the 1,000 participants in this survey, 370 (37%) had received a tattoo; the number of participants with cosmetic tattoos (68.4%) was nearly 2-fold higher than the number of participants with body tattoos (31.6%). The most common motivation for getting a tattoo was “for beauty” (44.9%), followed by “convenience of make-up” (34.1%), and “recommendation from friends or others” (14.6%). In the tattoo-related satisfaction category, information regarding injected dye-induced adverse effects, facility hygiene, and pre-allergy testing were commonly rated as unsatisfactory by respondents. Only 322 (32.2%) participants were aware that semi-permanent tattoos could not be erased. Furthermore, 780 (78.0%) participants had a negative impression regarding body tattoos, and 844 (84.4%) participants preferred to get tattoos at specialized medical institutions based on the national regulations to minimize possible tattoo-induced adverse effects. @*Conclusion@#This study confirmed that a relatively large number of individuals had received tattoos but had a negative impression regarding this procedure. Educational and institutional management for public safety are necessary owing to a lack of awareness regarding tattoos and tattoo-related safety.
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Background@#Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. @*Objective@#To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. @*Methods@#We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. @*Results@#A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). @*Conclusion@#Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.
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Background@#Light-based and laser therapy have emerged as alternative therapies for the treatment of acne. Blue and red light-emitting diode (LED) phototherapy and pulsed dye laser (PDL) therapy are recognized as effective modalities in the treatment of acne vulgaris. @*Objective@#To compare the efficacy of LED phototherapy and PDL therapy in the treatment of acne. @*Methods@#We randomly allocated a total of 11 patients to receive LED combination therapy or PDL monotherapy.Outcome assessments included the number of inflammatory and non-inflammatory lesions, investigator’s and subject’s assessment, MexameterTM and CorneometerTM measurements. @*Results@#Five men and six women were enrolled in the study. After treatment, a greater improvement in the inflammatory and non-inflammatory lesions was recorded in the LED treatment group. Erythema score decreased more in the PDL treatment group than in the LED treatment group. Patient’s self-satisfaction was better in the LED treatment group than in the PDL treatment group. @*Conclusion@#This study suggests that both combination LED phototherapy and PDL monotherapy could be effective in the treatment of acne. Additional large-scale studies should be conducted to compare the efficacy of these two treatments.
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Cancer metastasis to the skin, especially epidermotropic metastasis, is uncommon. Sometimes it is difficult to find the primary lesion; immunohistochemical (IHC) staining of cutaneous metastasis is used to determine the origin, but diagnosis may occasionally prove difficult. A 77-year-old man visited our hospital with a 1-month diagnostic history of multiple nodules in the right axilla. The patient had undergone surgery for gastric adenocarcinoma (T3N3M0) 21 years ago, and was diagnosed with lung adenocarcinoma 1 year previously; however, no treatment was ongoing. Biopsy of the lesions revealed atypical cells surrounding the papillary projections of the epidermis and tumor nests of the upper dermis. IHC staining was positive for CK7 and CEA and negative for CK5/6, CK20, napsin A, TTF-1, GCDFP 15, and p63. The tissues revealed glandular structures and tested negative for p63 and CK5/6 on IHC staining. The patient was diagnosed with epidermotropic metastasis of lung adenocarcinoma.
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Background@#Social standards for skin health have changed and have led to a rise in the general population’s interest to achieve flawless skin. @*Objective@#To survey the Korean public’s perception of skin health and dermatologists and skinhealth-related behaviors. @*Methods@#A total of 355 participants of the Skin Health Expo 2018, held by the Dermatological Research Foundation of the Korean Dermatological Association from September 14 to 16, 2018, completed a questionnaire that assessed demographics, status, and behaviors regarding skin health. The questionnaire also included lifestyle characteristics, satisfaction, behavioral factors, and perceptions regarding skin-care products. @*Results@#Participants were using various skin-care products including toners, lotions, hydrating or nutrition creams, sunscreens, essences, serums, facial masks and packs, body, hand, and foot moisturizers, eye creams, and hair products. The participants believed that the most reliable source of information on skin-care product recommendations was the dermatologist (41.55%). However, purchases were also being made at skin-care product stores (27.64%) based on the recommendation of a friend or acquaintance (40.11%). The results also revealed that 23.8% of participants experienced side effects from using skin-care and cosmetic products, and about 40% of participants could not yet distinguish hospitals run by dermatologists. @*Conclusion@#Demand for skin-care products has been increasing, and dermatologists should provide proper information about skin health to prevent adverse effects from skin-care products. Educational and informative activities, such as the expo planned by dermatologists, are necessary to improve skin health in the general population.
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Background@#Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. @*Objective@#To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. @*Methods@#We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. @*Results@#A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). @*Conclusion@#Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.
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Background@#Light-based and laser therapy have emerged as alternative therapies for the treatment of acne. Blue and red light-emitting diode (LED) phototherapy and pulsed dye laser (PDL) therapy are recognized as effective modalities in the treatment of acne vulgaris. @*Objective@#To compare the efficacy of LED phototherapy and PDL therapy in the treatment of acne. @*Methods@#We randomly allocated a total of 11 patients to receive LED combination therapy or PDL monotherapy.Outcome assessments included the number of inflammatory and non-inflammatory lesions, investigator’s and subject’s assessment, MexameterTM and CorneometerTM measurements. @*Results@#Five men and six women were enrolled in the study. After treatment, a greater improvement in the inflammatory and non-inflammatory lesions was recorded in the LED treatment group. Erythema score decreased more in the PDL treatment group than in the LED treatment group. Patient’s self-satisfaction was better in the LED treatment group than in the PDL treatment group. @*Conclusion@#This study suggests that both combination LED phototherapy and PDL monotherapy could be effective in the treatment of acne. Additional large-scale studies should be conducted to compare the efficacy of these two treatments.
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BACKGROUND: Some cosmetics used for treating acne are considered as cosmeceuticals. Consequently, patients with acne are now more likely to perceive such products as actual treatments. OBJECTIVE: We aimed to investigate the awareness and use of cosmetics for acne and to compare them with hospital treatments in terms of efficacy and safety. METHODS: We surveyed patients who presented at the National Medical Center for acne treatment. We collected data on demographics, hospital treatments, kinds of cosmetics for acne, awareness and use of cosmetics for acne, efficacy and adverse effects (cosmetics for acne vs. hospital treatments), and overall patient satisfaction. RESULTS: Of 101 enrolled participants, 94 (mean [SD] age, 25.6 [6.5] years; 59 women) were analyzed. Seventy-one (75.5%) patients used cosmetics for acne. Only 30% perceived that cosmetics for acne were insufficient to treat acne, whereas 45~55% deemed cosmetics for acne as applicable replacements for topical and oral treatments. The participants rated their improvement to be significantly better with hospital treatments than with cosmetics for acne (much improved: 45.1% vs. 2.8%, became worse: 1.4% vs. 8.5%, p<0.01). There were significantly fewer adverse events after hospital treatments than after use of cosmetics for acne. The overall satisfaction scores were significantly higher with hospital treatments than with cosmetics for acne. CONCLUSION: Patients with acne mistakenly believe that cosmetics for acne can replace topical and oral treatments. Dermatologists should disseminate information and educate patients about the proper treatments for acne. Moreover, it is desirable to exclude the word “acne” from the name of cosmeceuticals.
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Humanos , Acne Vulgar , Cosmecêuticos , Demografia , Satisfação do PacienteRESUMO
BACKGROUND: In Korea, new human immunodeficiency virus (HIV) patients continue to be diagnosed. Due to the development of highly active anti-retroviral therapy (HAART) and lengthening of survival period of infected person, the aspect of skin diseases of HIV-infected patients is also changing. OBJECTIVE: To determine skin diseases of HIV-infected patients according to immune status and the relationship between folliculitis and HAART drug. METHODS: Subjects were HIV-infected patients who were treated in the department of dermatology from September 1, 2008 to August 31, 2018. Medical records of 376 subjects were retrospectively analyzed. RESULTS: Of 376 patients were studied, tinea infection, folliculitis, and seborrheic dermatitis were the most common regardless of their CD4 T cell counts or treatment group (initial treatment or retreatment). Seborrheic dermatitis, irritant contact dermatitis, and pruritic papular eruption were significantly more common in patients with CD4+T cells less than 200×106 cells/L while warts were significantly more frequent in patients with CD4+T cells greater than 200×106 cells/L. Most HAART agents were found to be helpful in reducing the incidence of folliculitis. CONCLUSION: There were many skin diseases in HIV patients, different from previous studies. In our study, the top three diagnoses were tinea infection, folliculitis, and seborrheic dermatitis. HAART medication was helpful in reducing folliculitis. These changes will require different treatments for skin diseases in HIV patients.
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Humanos , Síndrome da Imunodeficiência Adquirida , Terapia Antirretroviral de Alta Atividade , Contagem de Células , Dermatite de Contato , Dermatite Seborreica , Dermatologia , Diagnóstico , Foliculite , HIV , Incidência , Coreia (Geográfico) , Prontuários Médicos , Estudos Retrospectivos , Dermatopatias , Pele , Tinha , VerrugasRESUMO
BACKGROUND: Patients with acne are at risk of using various over-the-counter drugs (OTCs). In addition, several OTCs are introduced in pharmacies in Korea. However, only few drugs are supported by well-established data. Among the treatments, acne patches are easy to purchase and use. Thus, they are widely used by patients. OBJECTIVE: This study aimed to investigate the patient's perception and usage of acne patches. METHODS: A questionnaire survey was conducted on 80 patients with acne who visited the outpatient department of the National Medical Center for 2 months. RESULTS: A total of 42 (52.5%) patients answered that they had used acne patches, and 38 (47.5%) patients stated that they had never used patches. Moreover, 27 (64.29%) patients responded that they used the patches on inflammatory lesions. Moreover, several patients were using acne patches after pricking themselves. There was only one response to confirm the ingredient when purchasing acne patch. Moreover, 14 (33.33%) participants responded that they noted side effects after using acne patches. Overall, the satisfaction score for the use of acne patches was 5.05. CONCLUSION: Patients often use acne patches because they can be easily purchased and used. However, they do not know how to properly choose and use the product that fits their skin. Therefore, doctors must educate patients on how to properly select and use the products.
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Humanos , Acne Vulgar , Bandagens , Coloides , Coreia (Geográfico) , Medicamentos sem Prescrição , Pacientes Ambulatoriais , Farmácias , PeleRESUMO
BACKGROUND: Healthy skin is an important determinant of the quality of life and physical and mental well-being. The demand for dermatological information is increasing not only in patients with skin diseases, but also in the general population with normal/healthy skin. However, public perception and behavior with regard to skin health among Koreans are not known. OBJECTIVE: To examine public perception and behaviors with regard to skin health in Koreans visiting the Skin Health Expo 2017. METHODS: A total of 597 participants completed a questionnaire that assessed demographics, status, and behavior for skin health and Expo satisfaction. RESULTS: Respondents with higher stress levels and a history of skin diseases showed lower satisfaction with self-skin health. Most participants considered adequate sleep and water intake to be important factors associated with healthy skin. One-on-one consultation with dermatologists was the most satisfactory among participants at the Expo. CONCLUSION: Educational tools using mass media and informative activities such as the Expo planned by dermatologists and the government are necessary to spread awareness and provide proper information to improve skin health in the general population and to emphasize the key role of dermatologists in skin disorders with a social burden.
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Humanos , Demografia , Ingestão de Líquidos , Coreia (Geográfico) , Meios de Comunicação de Massa , Qualidade de Vida , Relatório de Pesquisa , Dermatopatias , Pele , Inquéritos e QuestionáriosRESUMO
No abstract available.
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Ciclosporina , Eczema , Mãos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Multiple therapies involving ablative and nonablative techniques have been developed for the rejuvenation of photodamaged skin. Radiofrequency (RF) is emerging as a gentler, nonablative skin-tightening device that delivers uniform heat to the dermis at a controlled depth. OBJECTIVE: To compare the efficacy of bipolar radiofrequency (Polaris™) and 1,550-nm fractional erbium-glass laser (Mosaic™) for the treatment of photoaging using a randomized, split-face, patient- and evaluator-blind study. METHODS: We evaluated the clinical effects after the treatment of photoaging. Ten Asian women (Fitzpatrick skin type III to IV) underwent 9 weeks of treatment (3 sessions at 3-week intervals) with monotherapy (Polaris™) on one side of the face and combination therapy with non-ablative bipolar radiofrequency (Polaris™) and 1,550-nm fractional erbium-glass laser (Mosaic™) on the other side. RESULTS: Among 10 patients, 4 were male and 6 were female. Subjective and objective assessments showed that the combination therapy was more effective. As the number of the treatment sessions increased, there was an accompanying increase in the satisfaction level and efficacy. CONCLUSION: This study suggests that bipolar radiofrequency combined with 1,550-nm fractional erbium-glass laser could be effective treatment for photoaging.