Oral Allergy Syndrome to Watermelon and Melon / 대한피부과학회지

Oral allergy syndrome (OAS) usually presents as an immediate swelling and itching sensation of the mouth and throat after ingestion of a food allergen. OAS may be the most common food allergy-related manifestation. Watermelon and melon belong to the Cucurbitaceae family and often show allergenic cross reactivity. Profilin is a 13 kda protein that is identified as a relevant pollen allergen in airborne pollen and related plant food allergies. Profilin is found in both watermelon and melon. Here we report a case of OAS to watermelon and melon in an 11 year-old boy. He was positive to the skin prick test, patch test and oral challenge test with watermelon and melon.

Dose-Dependent Effects of Evening Primrose Oil in Children and Adolescents with Atopic Dermatitis

BACKGROUND: Previous clinical trials with evening primrose oil in atopic dermatitis (AD) treatment have shown different results. In addition, the optimal dose and duration of treatment with evening primrose oil have not yet been determined. OBJECTIVE: The aim of this study is to investigate the dose-response treatment effects of evening primrose oil on clinical symptoms of AD and serum concentrations of polyunsaturated fatty acids. METHODS: Forty AD patients were enrolled for the study and randomly divided into 2 groups: those who received evening primrose oil 160 mg daily for 8 weeks and those who received 320 mg of evening primrose oil twice daily for 8 weeks. We evaluated the Eczema Area Severity Index (EASI) scores of all AD patients at weeks 0, 2, 4 and 8. In addition, we measured the levels of serum fatty acids, including C16 : 0 (palmitic), C18 : 2n (linoleic), C18 : 3n (linolenic) and C20 : 4 (arachidonic acid) using gas chromatography. RESULTS: The serum fatty acid levels C18 : 3n and C20 : 4 were higher in the 320 mg group than in the 160 mg group, with statistical significance. After evening primrose oil treatment, EASI scores were reduced in the 2 groups. The improvement in EASI scores was greater in the 320 mg group than in the 160 mg group. There were no side effects seen in either group during the study in the 2 groups. CONCLUSION: The results of this study suggest that the 320 mg and 160 mg groups may be equally effective in treating AD patients and show dose-dependent effects on serum fatty acid levels and EASI scores.

Dose-Dependent Effects of Evening Primrose Oil in Children and Adolescents with Atopic Dermatitis

BACKGROUND: Previous clinical trials with evening primrose oil in atopic dermatitis (AD) treatment have shown different results. In addition, the optimal dose and duration of treatment with evening primrose oil have not yet been determined. OBJECTIVE: The aim of this study is to investigate the dose-response treatment effects of evening primrose oil on clinical symptoms of AD and serum concentrations of polyunsaturated fatty acids. METHODS: Forty AD patients were enrolled for the study and randomly divided into 2 groups: those who received evening primrose oil 160 mg daily for 8 weeks and those who received 320 mg of evening primrose oil twice daily for 8 weeks. We evaluated the Eczema Area Severity Index (EASI) scores of all AD patients at weeks 0, 2, 4 and 8. In addition, we measured the levels of serum fatty acids, including C16 : 0 (palmitic), C18 : 2n (linoleic), C18 : 3n (linolenic) and C20 : 4 (arachidonic acid) using gas chromatography. RESULTS: The serum fatty acid levels C18 : 3n and C20 : 4 were higher in the 320 mg group than in the 160 mg group, with statistical significance. After evening primrose oil treatment, EASI scores were reduced in the 2 groups. The improvement in EASI scores was greater in the 320 mg group than in the 160 mg group. There were no side effects seen in either group during the study in the 2 groups. CONCLUSION: The results of this study suggest that the 320 mg and 160 mg groups may be equally effective in treating AD patients and show dose-dependent effects on serum fatty acid levels and EASI scores.

A Case of a Subepidermal Calcified Nodule on the Sole without Trauma

Subepidermal calcified nodule is an uncommon form of calcinosis cutis, which most commonly occurs in children. It usually presents as an asymptomatic, solitary verrucous nodule on the head and neck region, but occasionally as multiple lesions. Serum calcium and phosphorus levels are usually normal. Histopathology shows well-formed homogeneous eosinophilic material and granules in the upper dermis. Material in the dermis stained with von Kossa was positive. We report on an unusual case of a subepidermal calcified nodule occurring on the sole. A 21-month-old male presented with an oval-shaped, whitish, hard nodule measuring 5x5 mm on the left sole, without any previous history of trauma.

Acute Health Effects of the Hebei Oil Spill on the Residents of Taean, Korea / 예방의학회지

OBJECTIVES: On December 7, 2007, the Hebei Spirit oil tanker spilled out 12,547 kl of crude oil on the Yellow Sea 10 km away from the cost of Taean Province, Korea. As the coastline has been contaminated, local residents have been exposed to crude oil. Because the residents were showing many symptoms, we investigated the acute health effects of this oil spill on them. METHODS: We conducted a cross-sectional study consisting of the heavy and moderately oil soaked area in Taean and the lightly oil soaked area in Seocheon. Ten seashore villages were selected from each area, and 10 male and female adults were selected from each village. We interviewed the subjects using a structured questionnaire on the characteristics of residents, the cleanup activities, the perception of oil hazard, depression and anxiety, and the physical symptoms. The odds ratios and 95% confidence intervals were analyzed using logistic regression analysis. The logistic regression model was adjusted for age, gender, education, smoking, the perception of oil hazard and anxiousness. RESULTS: The more highly contaminated the area, the more likely it was for residents to be engaged in cleanup activities and have a greater chance of exposure to oil. The indexes of anxiety and depression were higher in the heavy and moderately oil soaked areas. The increased risks of headache, nausea, dizziness, fatigue, tingling of limb, hot flushing, sore throat, cough, runny nose, shortness of breath, itchy skin, rash, and sore eyes were significant. CONCLUSIONS: The results suggest that exposure to crude oil is associated with various acute physical symptoms. Long-term investigation is required to monitor the residents' health.

Anti-irritant Effect of Aloe Vera Gel Against a Lactic Acid Sting Test Reaction / 대한피부과학회지

BACKGROUND: Aloe vera has been used for medical purposes since antiquity, so it is known as the healing plant or silent healer. It has been claimed that aloe has several important therapeutic properties, including wound healing, thermal injury healing and anti-inflammation and immunomodulation properties. Because of these effects, it has become an ingredient in a wide variety of cosmetic products, including night creams, soaps, shampoos, suntan lotions and cleansers. OBJECTIVE: In order to determine the anti-irritant effect of aloe vera, we compared the degree of stinging intensity caused by 10% lactic acid solution and a mixture of 20% lactic acid and 100% aloe vera. METHODS: We carried out sting tests on 34 volunteers who were all over 20 years of age and they had no past and present history of atopic dermatitis and other eczema. The lactic acid sting test consisted of a 10-minute exposure on the left cheek with 10% lactic acid solution using a Hilltop chamber and the subjects recorded the degree of stinging intensity by themselves every 1 minute during 10-minutes of exposure. We also carried out a sting test with a mixed solution of 20% lactic acid and 100% aloe vera, and we compared the intensity and onset time of the stinging sensation. RESULTS: Aloe vera had some effect to ameliorate the intensity of the stinging sensation and also to delay the time required for the stinging sensation caused by lactic acid. There was a significant difference between the two groups (p<0.05). CONCLUSION: We found that aloe vera has an anti-irritant effect on the stinging sensation caused by lactic acid.

Anti-irritant Effect of Aloe Vera Gel Against a Lactic Acid Sting Test Reaction / 대한피부과학회지

BACKGROUND: Aloe vera has been used for medical purposes since antiquity, so it is known as the healing plant or silent healer. It has been claimed that aloe has several important therapeutic properties, including wound healing, thermal injury healing and anti-inflammation and immunomodulation properties. Because of these effects, it has become an ingredient in a wide variety of cosmetic products, including night creams, soaps, shampoos, suntan lotions and cleansers. OBJECTIVE: In order to determine the anti-irritant effect of aloe vera, we compared the degree of stinging intensity caused by 10% lactic acid solution and a mixture of 20% lactic acid and 100% aloe vera. METHODS: We carried out sting tests on 34 volunteers who were all over 20 years of age and they had no past and present history of atopic dermatitis and other eczema. The lactic acid sting test consisted of a 10-minute exposure on the left cheek with 10% lactic acid solution using a Hilltop chamber and the subjects recorded the degree of stinging intensity by themselves every 1 minute during 10-minutes of exposure. We also carried out a sting test with a mixed solution of 20% lactic acid and 100% aloe vera, and we compared the intensity and onset time of the stinging sensation. RESULTS: Aloe vera had some effect to ameliorate the intensity of the stinging sensation and also to delay the time required for the stinging sensation caused by lactic acid. There was a significant difference between the two groups (p<0.05). CONCLUSION: We found that aloe vera has an anti-irritant effect on the stinging sensation caused by lactic acid.

A Case of Familiar Painful Piezogenic Pedal Papules / 대한피부과학회지

We report a case of painful pizogenic pedal papules in a 10-year-old female patient who had developed tense, skin-colored papules with pain on both heels when weight was placed on the feet. Histopathologic findings showed subcutaneous fatty tissue protruding into the lower dermis and a basophilic degenerative change of part of the collagen in the dermis. Her father also had the same skin lesions on his both heels.

A Study of Histamine Content in Food in Korea / 대한피부과학회지

BACKGROUND: It is often stated that ingestion of food rich in histamine can result in absorption of sufficient histamine to provoke signs and symptoms of an allergic reaction. To date, No study has systemically examined in Korea. OBJECTIVE: We evaluated the histamine content of 29 common dishes. METHODS: The histamine content of food was measured using high performance liquid chromatography and post column derivation system with fluorescence detector. RESULTS: Sausages (3,572 mg/kg) showed the highest histamine level and fish such as tuna (2,927 mg/kg) and mackerel (2,467 mg/kg) also showed high levels of histamine. From the fruit and vegetable group, spinach (1,358 mg/kg) showed the highest level, containing a moderate amount of histamine. From the dairy product group, cheese (533 mg/kg) showed a moderate amount of histamine. From the group containing caffeine green tea (878 mg/kg) showed a slightly high histamine level. The alcohol group showed relatively low levels of histamine. CONCLUSION: High histamine concentrations were found in fish, meat and processed meat, spinach, and green tea, etc. These results are in agreement with those of previous studies of histamine content of food in other countries. This is the first work that has evaluated histamine content in food in Korea. Further studies including other Korean food will be required.

A Study of Nickel Content in Korean Foods / 대한피부과학회지

BACKGROUND: Nickel-sensitive patients may suffer from persistent dermatitis even if they avoid cutaneous contact with nickel-plated items. Therefore, an endogenous cause of nickel-induced dermatitis has been suggested. In Western countries, many studies suggested that reduction of dietary intake of nickel might benefit nickel-sensitive patients. OBJECT: We measured the nickel content of Korean foods, since a nickel-restricted diet is essential for nickel-sensitive patients. METHOD: We ground the food, then nitric acid, sulphuric acid, and fluoric acid were added to the ground foods to dissolve organic matter. We then measured nickel content in these samples using Inductive Coupled Plasma-Mass Spectrometry. RESULTS: A green tea bag contained 235.57mg Ni/kg, a black tea bag 62.79mg Ni/kg, chocolate 27.87mg Ni/kg, crisps 12.70mg Ni/kg, wheat flour 12.15mg Ni/kg, Welsh onion 0.026mg Ni/kg, garlic 0.016mg Ni/kg, milk 0.004 mg Ni/kg, egg 0.002mg Ni/kg, and salt 0.0mg Ni/kg. CONCLUSION: High nickel concentrations were found in green tea bag, chocolate, crisps, wheat flour, coffee bean, peanuts, and kimchi etc. On the other hand, rice, barley and spice had low content of nickel. Formulation of nickel-restricted diet using these results is expected to be helpful in the treatment of nickel-sensitive patients.

Latex Allergy in Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Allergy against natural rubber latex is an increasing problem in recent years, especially in health care workers, children with spina bifida. Many studies reported atopic dermatitis could be also one of risk factors of latex allergy. OBJECTIVE: Purposes of this study were not only to access the prevalence of latex sensitization in patients with atopic dermatitis, but to evaluate the relationship between latex sensitization and clinical allergy. METHODS: Of the total of 110 patients, 80 patients were atopic dematitis and 30 patients were controls. A questionaire-based history was taken, skin prick tests (SPTs) with latex glove extract and commercial latex allergen and several commercial fruit extracts were done. If SPT to latex was positive, use test performed. Patch tests for delayed type hypersensitivity were carried out with a small piece of latex glove, commercial latex allergens and rubber additives. RESULTS: Eighteens (22.5%) of 80 atopic dermatitis reported symptoms whenever they used rubber products. In skin prick test, 3 of 80 (3.8%) patients with atopic dermatitis were positive to latex glove extration solutions and also the commercial latex antigens. Reactions to fruit extracts including mixed nuts, potato, tomato, banana were 8.8%, 6.3%, 6.3%, 5.0%, respectively. Use test was done with all of 4 patients positive to SPT, and only one of them showed positive reaction. There is no positive result in latex glove or latex extraction in patch tests. CONCLUSION: There were no differences in latex sensitivities between patients with atopic dermatitis and healthy people. In patch tests, ZnBDC and mercapto mix were the highst rate of reaction addictives of NRLs.

A Study on Anti-irritant Effect of Aloe Vera Gel Against the Irritation of Sodium Lauryl Sulfate / 대한피부과학회지

BACKGROUND: Aloe vera has been used for medical purposes since antiquity, so it has been known as the healing plant or silent healer. It has been claimed that aloe has several important therapeutic properties including promotion of wound healing, thermal injury healing, anti-inflammation and immunomodulation. Using these effects, it has become an ingredient in a wide variety of cosmetic products including night creams, soaps, shampoos, suntan lotions, and cleansers. OBJECT: In order to investigate the anti-irritant effect of aloe vera we measured transepidermal water loss (TEWL) and erythema index (E-index) after performing a patch test using sodium lauryl sulfate (SLS) and aloe vera we then compared the extent of damaging effect on the skin barriers and the difference of the recovery process in each case. METHODS: Fifteen volunteers, all over 18 years of age, who hadn't had past or present history of atopic dermatitis and other eczemas, were tested in this study. SLS was dissolved in distilled water to the concentration of 1% and aloe vera gel was dissolved in distilled water to the concentrations of 10, 20, 50, and 100%. Then we mixed 1% SLS solution and each concentration of aloe vera solution with the ratio 1: 1. Each solution was applied to marked sites of both volar aspect of the forearm at random, for 24 hours, using large Finn chamber with filter paper. TEWL and E-index were measured before test (BL) and at 30 minutes (D0), 1st day (D1), 2nd day (D2), 1st week (W1), 2nd week (W2), and 3rd week (W3) after removal of the patches. RESULTS: TEWL after removing a patch of 0.5% SLS was higher than that of 100% aloe vera mixed with 1% SLS. In addition, TEWL after removing a patch of 0.5% SLS and 100% aloe vera patch mixed with 1% SLS were higher than that of 100% aloe vera. E-index after removing a patch of 0.5% SLS was higher than that of 50% aloe vera mixed with 1% SLS, 100% aloe vera mixed with 1% SLS, and 100% aloe vera. CONCLUSION: We have come to know that aloe vera has an effect in the recovery of skin barriers and erythema induced by irritant such as SLS. However, it only happens when the gel of aloe vera has a high concentration.

Phototherapy of Acne Vulgaris with Low Level Narrow Band Red Light (680 nm) / 대한피부과학회지

BACKGROUND: It has been reported that the phototherapy with blue light (415 nm) or a mixed blue and red light (415 nm and 660 nm) is effective in the treatment of acne vulgaris. however, the effects of red light on acne vulgaris have not been investigated. OBJECT: To examine the effects of red light (680 nm) on patients with moderate acne vulgaris. METHODS: Patients treated their skin by themselves, using portable light source (680 nm), and irradiation was performed for 7 minute twice daily. Each patient was evaluated every 2 weeks with Burton scale and the numbers of papules and pustules. After 6 weeks, the degrees of satisfaction of patients and physicians were assessed. RESULT: Therapy with red light significantly decreased the numbers of papules and pustules (p<0.01). The numbers of satisfied patients and physicians at the end of treatment were 59 (83.1%) and 56 (78.9%) respectively. Side effect was not reported, except only one patient complained of headache. CONCLUSION: Phototherapy with red light (680 nm) was effective and safe treatment for patients with acne vulgaris.

A Study of the Latex Allergy in Operating Room Nurses / 대한피부과학회지

BACKGROUND: Allergy to natural rubber latex has become an important occupational health concern in recent years, particularly among health care workers. Studies have estimated that the prevalence of latex allergy ranged from 2.8% up to 12.1% of health care workers. Latex sensitization is more common in operating rooms or with special care nurses whose jobs require frequent glove use. OBJECT: The present study was undertaken to assess the prevalence of latex sensitivity in operating room nurses, and to evaluate the relationship between questionnaire responses and skin tests. METHODS: Eighty operating room nurses working in the Hallym Medical Center and 27 healthy controls were included in this study. The questionnaire was completed by a dermatology doctor during an interview. Skin prick tests(SPT) were carried out on the volar surface of the forearm using latex glove extract solution, commercial latex extract and several commercial fruit extracts. If SPT was positive, use test was performed. Patch tests for delayed type hypersensitivity were carried out with small piece of latex glove(as is), commercial latex antigen and rubber additives. RESULTS: 1. Twenty two(27.5%) of 80 operating room nurses reported at least one symptom when wearing gloves. Although the symptom development was increased as glove-wearing time increased, but the difference was not statistically significant. The history of atopy and dental care did not influence the prevalence of symptoms. Subjects with hand eczema had significantly higher prevalence of symptoms than without hand eczema. 2. In SPT, 9(11.3%) of 80 operating room nurses were positive to latex glove extract solution. This level was significantly higher than healthy controls who showed positive reaction in only one. The history of hand eczema and dental care did not influence the prevalence of symptoms. Although the difference was not statistically significant, the symptom development was increased as glove-wearing time and years of experience increased. The percentage of skin reactions to latex was 2.6 times higher in nurses with atopy than without atopy, but the difference was not statistically significant. Reactions to fruit extracts including tomato, banana, mixed nut and potato were 5.0%, 3.8%, 2.5% and 1.3%, respectively. Use test was done with 7 of 9 showing positive reaction to SPT, and all of them showed positive responses. 3. Patch tests revealed positive results for latex gloves in 3 (3.8%), for commercial latex extract in 2 (2.5%) and for thiuram mix in 1 (1.3%) of 80 operating room nurses. But there were no positive results with ZnBDC, ZnEDC, TMTD, mercapto mix and mercaptobenzothiazole in nurses. For all allergens in patch test, any healthy subjects did not show positive results. CONCLUSION: Twenty two(27.5%) of 80 operating room nurses reported at least one symptom when wearing gloves. The most commonl compained symptom was itching, which was ceported in all of them. Localized wheal, generalized wheal and pain were reported in 8.8%, 5.0% and 2.5%, respectively. However, anaphylaxis was not reported. As the positive rate was 3.8% in patch test and 11.3% in SPT using latex glove extract, most of the symptoms related to the wearing of latex gloves appeared to be due to irritation. It could be considered that latex allergy could be induced by repeated wearing of latex gloves in operating room nurses.

Two Cases of Irritant Contact Dermatitis due to Garlic / 대한피부과학회지

Garlic(Allium sativum) has been used for centuries for culinary purposes in folk medicine as a medicinal agent for the treatment various disorders, including parasitic and fungal infections. Garlic, however, is responsible for allergic and irritant contact dermatitis in cooks and housewives. Recently we experienced two cases of irritant contact dermatitis after application of garlic used as a naturopathic remedy for the treatment of pruritus.

A comparison study on allergen components between Korean (Arachis fastigiata Shinpung) and American peanut (Arachis hypogaea Runner)

The prevalence of peanut allergy in Korea is lower than in America. Peanut extract allergens between the two countries have not been standardized. This study was performed to compare the allergenicity of raw Korean and American peanuts with that of roasted peanuts. We prepared the peanut extracts in Korean raw (KP) and roasted peanuts (KRP), and also in American raw (AP) and roasted (ARP) peanuts. We compared the peanut extract allergens of KP, KRP, AP and ARP in vitro with sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting, T-cell proliferation assay and skin prick test with sera from peanut-allergic patients. SDS-PAGE and Western blotting demonstrated four allergenic extracts, numerous bands that displayed a high prevalence of IgE binding. IgE-binding bands were at 64, 36 and 17 kDa. Western blot inhibition revealed that either KP or AP could almost completely inhibit the reactivity of the other extract. There were no differences between T-cell proliferation assay and skin prick test. In conclusion, this investigation showed no different allergic components in both raw and roast extracts of Korean and American peanuts.

Two Cases of Bullous Dermatoses in Childhood / 대한피부과학회지

We presented two cases of bullous dermatoses in childhood. The first case was a 13-year-old boy who had numerous tense bullae on the scalp, both forearms and dorsa of hands, trunk and both thighs in symmetrical distribution, but he had not any oral lesion. On histologic examination, subepidermal bullae containing many neutrophils and only a few eosinophils were demonstrated. The lesions began to subside prornptly since 2 days after ornl administration of prednisolone and there was no evidence of recurrence during the follow-up studies of 4 months. The second case was a 14-year-old boy who had erythematous macules, vesicles, bullae and crusts scattered irregularly on almost entire body surface and had some oral lesions. Histologically erythematous macular lesions revealed many microabscesses composed almost entirely oi neutrophils on the tip of dermal papillae but vesicular lesions showed intraepidermal bulla containing numerous eosinophils exclusively. His skin lesions were well suppressed by DDS but reappeared one or two days after cessation of DDS. We thought these two cases were not the typical cases of bullous pemphigoid or dermatitis herpetiforrnis. We did not perform immunologic studies, so we cannot assure that these two cases were belong to either bullous pemphigoid or dermatitis herpetiformis and the so-called benign chronic bullous dermatosis of childhood.