Analysis of clinical features and lifestyle in Korean senile gluteal dermatosis patients.

BACKGROUND: Senile gluteal dermatosis (SGD) is characterized by hyperkeratotic lichenified skin lesions on the superior part and both sides of the anal cleft. These lesions are particularly prevalent in sedentary and elderly patients. OBJECTIVES: The purpose of this study was to investigate the prevalence, clinical manifestations, and other clinical characteristics of SGD in elderly Korean individuals. METHODS: A total of 280 subjects aged >60 years identified through the outpatient department at our hospital were included in this study. Basic clinical information was collected, and the subjects were evaluated clinically for gluteal lesions. Skin biopsies were performed in eight of the patients diagnosed with SGD. RESULTS: Among a total of 280 subjects, 37 were diagnosed with SGD. Their mean age was 70.4 years. The prevalence of SGD was found to increase with age. In addition, there was a significant positive correlation between SGD and lower lean body mass, longer period of a sedentary lifestyle, use of a Korean-style mattress, and diabetes mellitus. Most patients had either mild symptoms or were asymptomatic. Skin biopsies showed hyperkeratosis, acanthosis, follicular plugging, and meandering superficial vessel proliferation with mild lymphohistiocytic infiltration. None of the biopsy specimens exhibited amyloid deposition. CONCLUSIONS: Our findings suggest that SGD is a common disorder in elderly Korean individuals and is associated with prolonged periods of rest such as those occurring in a highly sedentary lifestyle and with sleeping on a Korean-style mattress.

Altered levels of sphingosine and sphinganine in psoriatic epidermis.

BACKGROUND: Ceramides are the main lipid component of the stratum corneum and are a structurally heterogeneous and complex group of sphingolipids of which sphingoid bases are the basic structural constituents. Altered levels of sphingoid bases have been reported in skin conditions that involve dryness and barrier disruption, including atopic dermatitis. OBJECTIVE: The purpose of this study was to investigate the altered levels of sphingoid bases in psoriatic epidermis and their relationship with the clinical severity of the psoriasis. METHODS: Samples from the lesional and non-lesional epidermis were obtained from eight psoriasis patients. Levels of sphingosine and sphinganine were analyzed by high-performance liquid chromatography. The expression of ceramide synthase and ceramidase proteins, which are related to sphingosine and sphinganine metabolism, were measured using Western blot analysis. RESULTS: Levels of sphingosine and sphinganine in the lesional epidermis were significantly higher than those in the non-lesional epidermis. Although there was no altered ceramide synthase and ceramidase, there was a highly significant positive correlation between the % change of ceramidase, the degradative enzyme of ceramide into sphingosine, and the Psoriasis Area Severity Index (PASI) score. CONCLUSION: The levels of sphingosine and sphinganine were significantly increased in psoriatic epidermis and the % change of ceramidase was positively correlated with the clinical severity of psoriasis.

Bullous eosinophilic cellulitis in a child treated with dapsone.

Eosinophilic cellulitis, or Wells syndrome, is a rare but well-described condition in which bullous lesions are uncommon, especially in childhood. We report a case of bullous eosinophilic cellulitis recalcitrant to steroid therapy in a 9-year-old boy who was successfully treated with oral dapsone.