A Case of Acrodermatitis Enteropathica Localized on the Hands and Feet with a Normal Serum Zinc Level

Acrodermatitis enteropathica is classified as a congenital autosomal recessive type and an acquired transient type. This disease manifests as acral and periorificial dermatitis, alopecia, intractable diarrhea, and failure to thrive. Whereas the autosomal hereditary type is caused by malabsorption of zinc in the intestine, the acquired type is caused by low nutritional support or decreased peripheral release of zinc from blood. We experienced a case of a 5-month old, breast feeding, full-term female presenting with only acral bullous dermatitis without diarrhea, periorificial dermatitis and an abnormal serum zinc level.

A New Method for Investigation of the Hair Shaft: Hard X-Ray Microscopy with a 90-nm Spatial Resolution

Various methods have been used to investigate the hair shaft. In the ultrastructural hair field, scanning and transmission electron microscopies are widely used investigative methods, but they have some technical limitations. Recently, X-ray microscopes with sub-micron spatial resolution have emerged as useful instruments because they offer a unique opportunity to observe the interior of an undamaged sample in greater detail. In this report, we examined damaged hair shaft tips using hard X-ray microscopy with a 90 nm spatial resolution. The results of this study suggest that hard X-ray microscopy is an alternative investigative method for hair morphology studies.

A Retrospective Study of the Effect of Superficial Cryotherapy on Alopecia Areata / 대한피부과학회지

BACKGROUND: There are some reports that superficial cryotherapy of alopecia areata could be an effective mode of treatment with many advantages. OBJECTIVE: We retrospectively evaluated the efficacy and side effects of superficial cryotherapy in patients with alopecia areata. METHODS: We retrospectively reviewed the clinical records of 153 patients with alopecia areata, who had been treated with superficial cryotherapy for more than 4 weeks, during the twelve years since 1993. We then evaluated the efficacy of superficial cryotherapy and its relationship with various clinical factors and side effects. Superficial cryotherapy using liquid nitrogen spray for 2~3 seconds was applied to the alopecic patches, and repeated three or four times per session. Positive therapeutic response was defined as the regrowth of terminal hairs. RESULTS: The results are summarized as follows: Positive therapeutic responses were noted in 105 (68.6%) of 153 patients reviewed. Patients who responded, vellus hair appeared within 4 weeks of treatment, terminal hair within 7 weeks, and a marked recovery was achieved within 12 weeks. A relatively good response rate was obtained in those patients who had less than 4 weeks of treatment, and the area of treatment was less than one fourth of the total scalp area, or less than two alopecic patches. On the other hand, those over 50 years of age and with more than 3 weeks of treatment interval seemed to have a relatively poor response rate. Other factors were not significant. There were no significant side effects, except slight pain, swelling and erythema. CONCLUSION: Superficial cryotherapy in patients with alopecia areata can be an effective treatment modality. It is a simple and convenient method, and has relatively good therapeutic response with less side effects. Therefore, we propose the superficial cryotherapy as a first-line treatment for patients with a milder form of alopecia areata, especially in children who are vulnerable to therapeutic side effects and pain.

Adult Onset Still's Disease / 대한피부과학회지

Adult onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology and pathogenesis, characterized by systemic symptoms including high fever, evanescent rash, arthritis and a sore throat. There is no single diagnostic test, therefore the diagnosis is based upon clinical criteria. Treatment consists of anti-inflammatory medication such as aspirin, NSAIDs, corticosteroids, anti-rheumatics and immunosuppresants. We report a typical case of AOSD, in which a 29-year-old female patient presented with high fever, typical Still's rash, arthritis and a sore throat.

Effects of Calcitonin Gene-Related Peptide on the Hair Growth in Human Hair Follicle Organ Culture / 대한피부과학회지

BACKGROUND: It has recently been reported that the peripheral nervous system has an important role in the hair growth and hair cycle change, which is mediated by neuropeptides. Furthermore, the expression of various growth factors and apoptosis-related molecules are important in the hair growth and hair cycle change. Therefore, it is important that the relationship between the influence of neuropeptides and expression of various factors that regulate hair growth is analysed. OBJECTIVE: The purpose of this study was to investigate the relationship between influence of neuropeptides and expression of various hair growth-related factors in the hair follicle, after pre- treatment of cultured hair follicles and dermal papilla cells with a calcitonin gene-related peptide (CGRP). METHOD: Normal human scalp samples were obtained, and anagen hair follicles and dermal papilla cells were isolated and cultured in Dulbeco?s Modified Eagle's Medium (DMEM) with several combinations of supplements, in an air incubator with an atmosphere of 5% CO2/95%. The culture plates were divided into two groups: a control group (DMEM only) and a CGRP group(10-7M CGRP dissolved in DMEM). The results were then evaluated by measuring the linear hair growth and hair follicle morphology under a light microscope. In addition, after pre-treatment of cultured hair follicles and dermal papilla cells with CGRP, we examined changes of expression of hair growth factors (FGF-7, IGF-1, VEGF), hair growth-inhibitory factors (IL-1alpha, IL-1beta) and apoptosis-related molecules (p53, caspase-3). RESULTS: The following results were obtained: 1. The CGRP did not have statistically significant effect on the rate of linear hair growth in cultured hair follicles. However, it shortened the anagen stage of the hair cycle. 2. In hair follicles, the expression of IL-1beta, a hair growth inhibitory factor, was increased in the CGRP group, compared to the control. The expression of caspase-3, an apoptosis-related molecule, was also found to be higher than the control. In dermal papilla cells, no change in morphology, expression of hair growth factors or apoptosis-related molecules were found. However the expression of IL-1beta was increased, compared to the control. CONCLUSION: From these results, we can conclude that CGRP has a growth-inhibitory effect, especially in shortening the duration of the anagen phase without affecting the linear hair growth rate. CGRP also shows a hair growth-inhibitory effect at the molecular level in hair follicles and dermal papilla cells.

A Cases of Bowen's Disease Arising in an Old Burn Scar / 대한피부과학회지

It is known that Bowen's disease is a representative precancerous lesion of squamous cell carcinoma, along with actinic keratosis. Chronic sun-exposure and arsenism are main causes of Bowen's disease. Also trauma, radiation, and viral infection are associated. Up to now, it is not yet reported that burn scar can induce Bowen's disease. We report an unusual case of Bowen s disease, which arose in an old burn scar.

Two Cases of Fordyce's Spots Treated with Combination of CO2 Laser and Trichloroacetic Acid / 대한피부과학회지

Fordyce's spots are ectopically located sebaceous glands, clinically characterized by minute orange or yellowish pinhead-sized macules or papules on the mucosa of the lips, cheeks, and less often, on the gums. Similar lesions may occur on the areola, glans penis, and labia minora. Because it is asymptomatic and inconsequential, treatment should be undertaken only if there are significant cosmetic problems. We could not find any remarkable therapeutic modality in textbooks or literatures satisfying both patients and physicians. We report herein the combination use of CO2 laser and chemical agent (Trichloroacetic acid) as new therapeutic modality.

Effects of Substance P on the Expression of Various Factors to control Hair Growth in Human Hair Follicle Culture / 대한피부과학회지

BACKGROUND: Among constituents of the skin, hair follicle is an organ where nerve fibers with the most highest density are distributed. Recently, it has been reported that neuropeptides, which are secreted by nerve fibers, have important roles in the hair growth and hair cycle change, and that, the expression of various growth factors and apoptosis-related molecules are important in the hair growth and hair cycle change. Therefore, it was thought of import to analyse the relationship between the effect of neuropeptides and the expression of various factors to control hair growth in the hair follicle and hair follicle cells. OBJECTIVE: The purpose of this study was to investigate the relationship between the effect of neuropeptides and the expression of various hair growth-related factors at the level of hair follicle after pretreatment of cultured hair follicles and dermal papilla cells with SP. METHODS: Normal human scalp samples were obtained, and anagen hair follicles and dermal papilla cells were isolated and were cultured in Dulbeco's Modified Eagle's Medium (DMEM) with several combination of supplements in an atmosphere of 5% CO2/95% air incubator. We divided the culture plates into two groups; i.e. control group (DMEM only) and SP group (10-6M SP dissolved in DMEM). The results were evaluated by measuring linear hair growth and hair follicle morphology under a light microscope. Also, after pretreatment of cultured hair follicle and dermal papilla cells with SP, we examined changes of expression of hair growth factors (FGF-7, IGF-1, VEGF), hair growth-inhibitory factors (IL-1alpha, IL-1beta), and apoptosis-related molecules (p53, caspase-3). RESULTS: The following results were obtained. 1. SP did not have any statistically significant effect on the rate of linear hair growth in cultured hair follicles. However, it prolonged the anagen stage of hair cycle. 2. In hair follicles, the expression of FGF-7, a hair growth factor, was increased more than control, while the expression of caspase-3, an apoptosis-related molecule, was decreased more than control. Also, morphological changes as well as the changes of expression of hair growth factors and apoptosis-related molecules were not found in dermal papilla cells. However, the expression of IL-1beta, a hair growth-inhibitory factor, was decreased more than control. CONCLUSION: We can conclude from the results that SP has growth-stimulatory effect and especially prolongs the duration of anagen phase without affecting the rate of linear hair growth. Also, in hair follicles and dermal papilla cells, SP shows hair growth-stimulatory effect at the molecular levels.

Multiple Lichen Aureus / 대한피부과학회지

Lichen aureus appears usually as asymptomatic golden to purpuric colored lesion and consists of lichenoid papules, patches, and plaques. This disease is regarded as a variant of pigmented purpuric dermatitis. The main cause remains largely unknown. It is common on the lower extremity, and generally occurs as a solitary lesion, however, also rarely occurred as a zonal, bilateral or segmented form. We present a 28-year-old man who had multiple, variable sized, red-brownish to purpuric colored papules and patches on both lower extremities, ankles and forearms. On histopathological examination, the lesion revealed features of lichen aureus. This patients condition was improved by treatment with oral and topical corticosteroid agent. Since this case appeared to be a very unique case of multiple lichen aureas, we reported the case herein.

A Case of Scleroderma Probably Induced by Colon Cancer or 5-FU Therapy / 대한피부과학회지

Scleroderma is a chronic disease of unknown etiology, it is the sclerosis of the skin characterized by the appearance of circumscribed or diffuse, hard, smooth and ivory-colored areas that are immobile and give the appearance of hidebound skin. Progressed scleroderma can lead to develop various tumors by affecting organs. It is rarely reported that the tumor itself or systemic chemotherapy could be one of the causes of scleroderma. Up to now, the pathogenesis about scleroderma occurring from cancer itself or anticancer drugs are uncertain.