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Eccrine angiomatous hamartoma (EAH) is a benign skin nodule characterized by the proliferation of eccrine glands and vascular structures in the dermis. It usually presents as a single papule or nodule on the extremities, and usually arises at birth or in early childhood, but several cases which appeared in adulthood have been reported. A 52-year-old female presented with a tender subungual nodule on the right great toenail for 3 months. Skin biopsy from the lesion showed proliferation of eccrine glands and capillaries in the dermis, and immunohistochemistry confirmed the diagnosis of EAH. We excised it as a treatment, and at the 3-month follow-up, pain by her lesion has resolved without any adverse effects.Our presented case is an adult-onset EAH that occurred as a subungual lesion. Unlike the previous cases, it did not cause any nail deformity or destruction and initially was misinterpreted as some other subungual tender nodule. To the best of our knowledge, we report the first case of adult-onset subungual EAH without nail deformity.
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Background@#Atopic dermatitis (AD) is a chronic pruritic inflammatory dermatosis. Whether gamma-linolenic acid (GLA) supplementation is beneficial in AD patients remains debatable. @*Objective@#This study investigated whether adjuvant GLA supplementation is associated with clinical improvement in AD patients receiving systemic treatment, as assessed by patient-reported outcome measures. @*Methods@#We enrolled 70 AD patients. Patients who received GLA at a dose of 80∼160 mg/d for over 1 month were included in the GLA group, while others were included in the non-GLA group. Each group was subgrouped into control, immunomodulator, and dupilumab groups based on treatment history. The patients evaluated their symptoms using the Atopic Dermatitis Control Tool (ADCT), Patient Global Assessment of Disease (PGA), and Dermatology Life Quality Index (DLQI). @*Results@#The Mann-Whitney U-test was used to compare differences in ADCT, PGA, and DLQI between both groups. The ADCT scores were significantly lower in the control and immunomodulatory group supplemented with GLA (control U=13.5, p=0.04; immunomodulatory U=28.0, p=0.01), but not in patients taking dupilumab (U=44.5, p=0.70). The PGA and DLQI scores also tended to be lower in the GLA group than those in the non-GLA group. @*Conclusion@#GLA supplementation is a potential adjuvant to systemic therapy may yield additional symptomatic relief in AD patients.
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Background@#Atopic dermatitis (AD) and asthma are chronic allergic diseases that affect quality of life. @*Objective@#In this study, we analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) to determine the association between allergic diseases and number of household members living with the patient. @*Methods@#This study included 20,893 participants ＞19 years of age from the KNHANES (2010∼2013). Multiple logistic regression analysis was performed to evaluate the odds ratio (OR) for presence of AD or asthma according to number of household members. @*Results@#The OR of allergic diseases including AD and/or asthma increased as the number of household members decreased in the age ＜40 group after adjustments for age, sex, smoking status, drinking status, regular physical activity, education level, income level, and stress level (1 member: adjusted OR [aOR]=2.019, 95% confidence interval [CI]=1.256∼3.245; 2 or 3 members: aOR=1.3, 95% CI=1.031∼1.64; ≥4 members: reference). And those with an allergic disease were less likely to have a spouse and had a higher stress level compared to those without. @*Conclusion@#Based on a nationwide population-based survey, this study showed that the number of household members was significantly related to rates of AD and asthma. The prevalence of allergic diseases tended to be higher in households with fewer members.
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Background@#Hormone replacement therapy (HRT) is used to relieve menopause symptoms, but has been reported to be associated with coronary heart disease and cancers in women.However, a link between HRT and psoriasis has yet to be established. The aim of this study was to determine the association between HRT and the risk of psoriasis. @*Methods@#We executed a nationwide population-based study. A total of 1,130,741 postmenopause women were enrolled in the national health care insurance database based on the enrollment criteria. The study population was classified into four groups based on the duration of the HRT, and the risk of psoriasis was analyzed. @*Results@#The incidence rates of psoriasis per 1,000 person-years were 3.36 and 4.09 in the no history of HRT and ≥ 5 years of HRT, respectively. After adjustment for age, smoking, alcohol intake, regular exercise, body mass index, diabetes mellitus, hypertension, and dyslipidemia, the most prolonged duration of the HRT group (≥ 5 years) exhibited significantly increased risk of developing psoriasis (hazard ratio, 1.22; 95% confidence interval, 1.16–1.29). @*Conclusion@#We propose that HRT in post-menopausal women is associated with an increased likelihood of psoriasis development.
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Warty dyskeratoma (WD) is an uncommon skin tumor that histologically presents as focal acantholysis and dyskeratosis and is a common finding among acantholytic diseases such as Darier’s disease. WD most commonly occurs on the head or neck of adults as an isolated papule or nodule. To our knowledge, only 6 cases of WD in the genital area have been previously reported in the literature, and no case have occurred on the scrotum to date.We report the first case of multiple WD that occurred on the scrotum successfully treated with 0.025% tretinoin cream. A 55-year-old male presented with asymptomatic, multiple, 0.1∼0.2-cm-sized, skin-colored papules on the scrotum for the previous 6 months. A skin punch biopsy and human papillomavirus (HPV) polymerase chain reaction test were performed for a clinical suspicion of genital warts or bowenoid papulosis. The histopathologic examination showed cup-shaped epidermal invaginations with central keratotic plug. Prominent villi, acantholytic clefting and corps ronds were also shown. The patient tested negative for HPV and was diagnosed with WD with typical pathologic findings. The patient was treated with 0.025% tretinoin cream for 2 weeks, and the lesions decreased in both size and number.
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Background@#Dermatofibromas (DF) are fibrohistiocytic tumors of unknown etiology, and multiple DF (MDF) are relatively rare. MDF have been reported in the setting of autoimmune diseases, human immunodeficiency virus infection, or comorbidities treated with immunosuppressive drugs. @*Objective@#The present study investigated whether underlying conditions with impaired immune function are associated with MDF. @*Methods@#A total of 338 patients with DF was enrolled. We divided patients into two groups as MDF and solitary DF (SDF) groups. We retrospectively reviewed patient medical records and classified all patients by underlying diseases. Statistical significance of SDF and MDF for each conditions was analyzed. @*Results@#The demographics and comorbidities were compared between MDF group (n=82) and SDF group (n=256). Among underlying conditions, systemic lupus erythematosus (SLE) (odds ratio, 10.397; 95% confidence interval, 2.743∼39.404; p＜0.001) was significantly associated with MDF over SDF. Vitiligo and post status of kidney transplant were related more highly to MDF (p=0.014; p=0.014, respectively) than to SDF. Presence of overall comorbidities, autoimmune diseases, and immunosuppressive drug use were associated with DF number (p＜0.001;p＜0.001; p＜0.001, respectively). @*Conclusion@#We propose an association between MDF and comorbidities, especially SLE and immunosuppressant use. MDF lesions seem to be impacted by compromised immune function. This is of significance since it is essential to search for associated conditions in patients presenting with MDF in dermatologic clinical settings.
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Background@#As the use of laser therapy for skin lesions has increased significantly, laser treatment is performed in many cases without an accurate diagnosis. @*Objective@#This study aimed to analyze cases in which skin lesions recurred or remained after laser treatment by investigating the clinicopathological diagnosis. @*Methods@#We retrospectively analyzed the patients who visited the Seoul Saint Mary’s hospital from January 2011 to December 2020, the clinical records of 518 cases of patient who had a history of laser treatment and underwent histopathological examination. @*Results@#The number and proportion of patients who visited the hospital showed a steadily increasing trend for 10 years. In 187 patients, the time between laser treatment and hospital visits was ＞1 year. The most common site of lesions was the face (66.2%), especially the cheek (29.3%) and nose (12.2%). Final diagnosis of the lesion yielded 59 cases (11.4%) of premalignant diseases and 55 cases (10.6%) of malignant tumors, and the rate increased with increasing age. The most common malignant tumor was basal cell carcinoma (69.1%), followed by squamous cell carcinoma (14.5%) and malignant melanoma (12.7%). @*Conclusion@#In this study, we found that laser treatment for premalignant and malignant tumors is not rare. This study emphasizes that indiscriminate laser treatment should be avoided, and an accurate diagnosis and proper medical treatment by an experienced dermatologist are needed.
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Background@#Cutaneous warts tend to recur despite of various treatment modalities. However, previous studies provided few data on their reinfection rate. @*Objective@#In this study, we investigated the reinfection rate along with the incidence and prevalence rates of cutaneous warts. @*Methods@#We conducted a nationwide, cross-sectional population-based study using the Korean National Health Insurance Service database from January 2006 through December 2016. Patients who visited outpatient clinics with an International Classification of Disease-10 code of viral warts (B07) were included. The reinfection rate was calculated as a percentage of patients with an initial visit in 2010 and subsequent visits for cutaneous warts with at least a six-month interval from last visit until 2016. @*Results@#From 2006 to 2016, the overall incidence and prevalence rates of cutaneous warts increased from 2.99 to 7.69 per 1,000 population and from 3.45 to 10.94 per 1,000 population, respectively. The overall reinfection rate of cutaneous warts was 30.9%. The reinfection rate of males and females was 31.6% and 30.0%, respectively. Children under ten years old had the highest reinfection rate (34.3%). @*Conclusion@#These results demonstrate that the reinfection rate of cutaneous warts is the highest in male children under ten years old. Therefore, these patients should be monitored closely after treatment.
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Background@#Cutaneous warts tend to recur despite of various treatment modalities. However, previous studies provided few data on their reinfection rate. @*Objective@#In this study, we investigated the reinfection rate along with the incidence and prevalence rates of cutaneous warts. @*Methods@#We conducted a nationwide, cross-sectional population-based study using the Korean National Health Insurance Service database from January 2006 through December 2016. Patients who visited outpatient clinics with an International Classification of Disease-10 code of viral warts (B07) were included. The reinfection rate was calculated as a percentage of patients with an initial visit in 2010 and subsequent visits for cutaneous warts with at least a six-month interval from last visit until 2016. @*Results@#From 2006 to 2016, the overall incidence and prevalence rates of cutaneous warts increased from 2.99 to 7.69 per 1,000 population and from 3.45 to 10.94 per 1,000 population, respectively. The overall reinfection rate of cutaneous warts was 30.9%. The reinfection rate of males and females was 31.6% and 30.0%, respectively. Children under ten years old had the highest reinfection rate (34.3%). @*Conclusion@#These results demonstrate that the reinfection rate of cutaneous warts is the highest in male children under ten years old. Therefore, these patients should be monitored closely after treatment.
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BACKGROUND: Empirical evidences for efficacy of hot spring (HS) water in inflammatory skin disorders have not been substantiated with sufficient, immunological “hard evidence”. Mageumsan HS water, characterized by its weakly-alkaline properties and low total dissolved solids content, has been known to alleviate various immune-inflammatory skin diseases, including atopic dermatitis (AD). OBJECTIVE: The trial attempted to quantitatively analyze in vitro expression levels of chemical mediators in cutaneous inflammation from HaCaT cell line treated with Mageumsan HS, and suggest the likely mode of action through which it exerts the apparent anti-inflammatory effects in AD. METHODS: Using membrane-based human antibody array kit, customized to include 30 different, keratinocyte-derived mediator proteins, their expression levels (including interleukin [IL]-1, IL-6, IL-8, thymic stromal lymphopoietin, thymus and activation-regulated chemokine, and granulocyte macrophage colony-stimulating factor) were assessed in vitro. Selected key proteins were further quantified with enzyme-linked immunosorbent assay. RESULTS: There was a clear pattern of overall suppression of the mediators, especially those noted for their pro-inflammatory role in AD (monocyte chemoattractant protein [MCP]-1, regulated on activation, normal T cell expressed and secreted, cutaneous T-cell-attracting chemokine, Eotaxin, and macrophage inflammatory protein-1α, etc.). Also, reduced expression of involucrin and cytokeratin 1 was also reduced in the HS-treated group. CONCLUSION: The present study has shown that Mageumsan HS water may exert its effects on inflammatory skin disorders through regulation of proinflammatory cytokines. These evidences are to be supported with further future investigations to elucidate immunological mechanism behind these beneficial effects of HS water in the chronically inflamed skin of AD.
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Humanos , Linhagem Celular , Quimiocina CCL17 , Quimiocina CCL27 , Citocinas , Dermatite Atópica , Ensaio de Imunoadsorção Enzimática , Granulócitos , Fontes Termais , Técnicas In Vitro , Inflamação , Interleucina-6 , Interleucina-8 , Interleucinas , Queratinas , Macrófagos , Análise Serial de Proteínas , Pele , Dermatopatias , ÁguaRESUMO
Cryptococcosis is caused by several Cryptococcus species, including C. neoformans and C. gattii. Skin involvement is seen in 10~20% of systemic cryptococcosis. There are also rare cases of primary cutaneous cryptococcosis in which skin-penetrating trauma is the alleged mechanism of infection. A 16-year-old male presented with multiple, 0.2~0.3 cm-sized, brownish papules on the whole body for 2 weeks. He had past history of acute lymphoblastic leukemia and received bone marrow transplant 1 year ago. After leukemia had recurred 1 month ago and after chemotherapy, multiple brownish papules developed. Histopathologic examinations revealed narrow-based budding yeasts in hematoxylin and eosin, Periodic acid-Schiff, and Gomori methenamine silver stains. Also in mucicarmine stain there were pink-colored capsules around the cell walls. Finally it was diagnosed as deep fungal infection due to Cryptococcus species. In spite of administrating fluconazole, the patient expired due to respiratory failure caused by pneumonia. Herein, we report a case of Cryptococcus species infection in a bone marrow transplant patient.
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Adolescente , Humanos , Masculino , Medula Óssea , Cápsulas , Parede Celular , Corantes , Criptococose , Cryptococcus , Tratamento Farmacológico , Amarelo de Eosina-(YS) , Fluconazol , Hematoxilina , Leucemia , Metenamina , Pneumonia , Leucemia-Linfoma Linfoblástico de Células Precursoras , Insuficiência Respiratória , Saccharomycetales , PeleRESUMO
Sea urchins are marine invertebrates commonly found in coastal areas around the world. The potential mechanisms of injury are primary puncture wounds, envenomation, and the foreign body reaction. A 20-year-old woman presented with multiple, 0.2 to 0.3 cm-sized, erythematous papules with central blackish particles accompanied by numbness and pain on the dorsum of the right foot and ankle for 7 days. She had been injured by a sea urchin 7 days prior at the seaside in Guam. A skin biopsy of the lesion showed inflammation with foreign body reaction. The attending physician removed all the blackish particles and applied mupirocin ointment. Although skin lesions improved over time, numbness and pain still remained. There have been only six reported cases of sea urchin granuloma in Korea, but no reports of sea urchin injury with neurologic symptoms. Herein, we report a rare case of sea urchin injury accompanied by paresthesia.
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Feminino , Humanos , Adulto Jovem , Tornozelo , Biópsia , Pé , Reação a Corpo Estranho , Granuloma , Guam , Hipestesia , Inflamação , Invertebrados , Coreia (Geográfico) , Mupirocina , Manifestações Neurológicas , Parestesia , Punções , Ouriços-do-Mar , Pele , Ferimentos e LesõesRESUMO
Although the management of benign pigmented skin tumors are mainly conducted by dermatologists, some Korean traditional doctors provide care. We aimed to evaluate the appropriateness of the medicinal knowledge of pigmented benign skin tumors that is recorded in the Korean traditional medicinal literature, in the context of modern medicine. We defined benign pigmented skin tumors as macules, papules, or nodules with homogeneous surfaces and coloration patterns, that are round or oval in shape, exhibit regular outlines, and have relatively sharp borders. We investigated textbooks and articles in the Korean traditional medicinal field to analyze descriptions of clinical classification, pathophysiology, histologic knowledge, and treatment method. We compared them with modern medicinal facts. In Korean traditional medicine, clinical classification of pigmented skin tumors is simple and did not include histologic natures. Unique theories, such as Yin-Yang and Qi, were applied to pathophysiologic understanding of these diseases. Interestingly, oral medications were used beside surgical methods. We could not find any comment about skin tumors with worrisome clinical features that warrant excision in Korean traditional medicinal literature. There is still a gap between traditional medicine and modern medicine regarding pigmented skin tumors. Traditional Korean medicinal knowledge about benign pigmented skin tumors seemed to be insufficient in the context of modern medicinal standards.
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Classificação , Diagnóstico , História Moderna 1601- , Medicina Tradicional Coreana , Medicina Tradicional , Melanoma , Métodos , Nevo Pigmentado , Qi , Pele , Yin-YangRESUMO
Ticks are parasites that usually suck the blood of wild or domestic animals; rarely, they ingest human blood and spread various febrile infectious diseases along with skin problems. Out of 40 cases of tick bite reported in Korea, only 3 were caused by nymphal ticks, and tick bites by nymphal Amblyomma testudinarium have not been reported previously. Herein, we report a rare case of tick bite by nymphal A. testudinarium. A 57-year-old woman presented with an asymptomatic solitary erythematous nodule on the left thigh that had been present for 6 days. The tick, which the patient removed from the lesion and brought to the hospital, was identified as a nymphal A. testudinarium. Doxycycline (200 mg) was used as treatment, and after seven days of use, the patient improved and no other lesions were detected.
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Feminino , Humanos , Pessoa de Meia-Idade , Animais Domésticos , Doenças Transmissíveis , Doxiciclina , Coreia (Geográfico) , Ninfa , Parasitos , Pele , Coxa da Perna , Picadas de Carrapatos , CarrapatosRESUMO
PURPOSE: There are many reports that the prevalence of food allergy (FA) is globally increasing. We investigated the change in FA prevalence since the last 20 years in elementary school children, in Seoul, Korea. METHODS: A modified International Study of Asthma and Allergies in Childhood questionnaire survey was done to elementary school children in Seoul, Korea in 1995, 2000, 2005, 2008, and 2012. The numbers of subjects included in the analysis were 7,963, 7,971, 7,131, 3,975, and 3,307, respectively. Blood and skin prick tests were done in 2008 and 2012. RESULTS: The prevalence rates of FA diagnosis ever were 4.6% (95% confidence interval [CI], 4.1-5.1), 5.2% (95% CI, 4.7-5.7), 6.4% (95% CI, 5.9-7.0), 5.5% (95% CI, 4.8-6.3), and 6.6% (95% CI, 5.8-7.6) in 1995, 2000, 2005, 2008, and 2012, respectively (P-value for trend <0.001). Asthma (adjusted odds ratio [aOR], 2.209; 95% CI, 1.589-3.072), allergic rhinitis (aOR, 1.874; 95% CI, 1.473-2.384), and atopic dermatitis (aOR, 4.288; 95% CI, 3.340-5.506) were associated with FA diagnosis. Parental allergic disease history (aOR, 2.191; 95% CI, 1.666-2.881), antibiotics use in infancy (aOR, 1.484; 95% CI, 1.170-1.883), and house mold exposure in infancy (aOR, 1.540; 95% CI, 1.172-2.024) were risk factors for FA diagnosis. Sensitization to inhalant allergens (aOR, 1.867; 95% CI, 1.091-3.194) and increased serum total IgE (aOR, 2.014; 95% CI, 1.081-3.752) were associated with FA diagnosis. CONCLUSION: The prevalence of FA diagnosis is likely to be increasing since the last 20 years in Seoul. Antibiotics use in infancy and house mold exposure in infancy were risk factors for FA diagnosis.
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Criança , Humanos , Alérgenos , Antibacterianos , Asma , Dermatite Atópica , Diagnóstico , Hipersensibilidade Alimentar , Fungos , Hipersensibilidade , Imunoglobulina E , Coreia (Geográfico) , Razão de Chances , Pais , Prevalência , Rinite Alérgica , Fatores de Risco , Seul , PeleRESUMO
Spinal cord compression is fatal condition to oncologic patients. Metastatic spinal cord compression from ovarian cancer is rarely reported in the literature. We experienced a case of solitary spinal cord compression with paraplegia in recurrent ovarian cancer patients.
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Humanos , Neoplasias Ovarianas , Paraparesia , Paraplegia , Medula Espinal , Compressão da Medula EspinalRESUMO
We report a case of periumbilical pseudoxanthoma elasticum in a 73-year-old female. It is characterized by a dark-yellowish plaque present on the periumbilical area of the lower abdomen. The plaque is well-demarcated and its surface is grooved or fissured, atrophic and verrucoid. This localized lesion of the periumbilical area occurs in a multiparous woman with no history of hereditary systemic pseudoxanthoma elasticum.
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Idoso , Feminino , Humanos , Abdome , Pseudoxantoma ElásticoRESUMO
We report a case of xanthoma disseminatum in a 24 year old male paitient. Multiple yellow-brown papules developed on the flexor aurfaces, such as the neck, axillae, antecubital fossae, groin, and perianal regions. Some papules were detected arouns the eyes and uvulai. biopsy specimen revealed a dense infiltrate of histiocytes, foam cells, Touton giant cells, and other inflammatory cells. No Langerhans granules were seen in the electron microscopic analysis.