Decreasing incidence of Trichophyton mentagrophytes in Korea: analysis of 6,250 cases during the last 21-year-period (1992-2012).

Trichophyton mentagrophytes is the second common dermatophyte in Korea. However, few reports have been issued on the epidemiological and mycological characteristics of T. mentagrophytes in Korea based on long-term, large-scale study. The purpose of this study was to elucidate the epidemiological and mycological characteristics of T. mentagrophytes in Korea. During the 21-yr-period from 1992 to 2012, 6,250 patients with T. mentagrophytes were surveyed to determine annual incidence and the distribution of subjects by age, sex, season, involved sites, and place of residence. T. mentagrophytes infections were confirmed by fungal culture. In addition, the colony appearance of T. mentagrophytes was classified as granular, persicolor, powdery, or downy. Epidemiological analysis showed that annual incidence reached a peak in 2005, and then gradually decreased. T. mentagrophytes infection was most common in July, and was found predominantly in middle-aged adults, especially in those in their forties. Mycological analysis showed a powdery colony appearance was the most common, followed by persicolor and granular colonies. Toewebs were most frequently involved. This investigation on T. mentagrophytes provides insights into its incidence and characteristics.

A Comparative Study of Oral Cyclosporine and Betamethasone Minipulse Therapy in the Treatment of Alopecia Areata.

BACKGROUND: Various systemic agents have been assessed for the treatment of alopecia areata (AA); however, there is a paucity of comparative studies. OBJECTIVE: To assess and compare cyclosporine and betamethasone minipulse therapy as treatments for AA with regard to effectiveness and safety. METHODS: Data were collected from 88 patients who received at least 3 months of oral cyclosporine (n=51) or betamethasone minipulse therapy (n=37) for AA. Patients with ≥50% of terminal hair regrowth in the alopecic area were considered responders. RESULTS: The responder of the cyclosporine group was 54.9% and that of the betamethasone minipulse group was 37.8%. In the cyclosporine group, patients with mild AA were found to respond better to the treatment. Based on the patient self-assessments, 70.6% of patients in the cyclosporine group and 43.2% of patients in the betamethasone minipulse group rated their hair regrowth as excellent or good. Side effects were less frequent in the cyclosporine group. CONCLUSION: Oral cyclosporine appeared to be superior to betamethasone minipulse therapy in terms of treatment effectiveness and safety.

Alopecia Areata in the Elderly: A 10-Year Retrospective Study.

BACKGROUND: Alopecia areata (AA) is an organ-specific autoimmune disease that typically occurs in young adults. AA in the elderly is relatively rare, thus little data have been reported. OBJECTIVE: This study aimed to understand the clinical characteristics of AA in the elderly. METHODS: We performed a 10-year retrospective study of AA in the elderly who visited our dermatologic clinic from January 2002 to December 2011. A clinical review of medical records and telephone interviews were performed by two dermatologists. RESULTS: Among 1,761 patients with newly diagnosed AA, 61 (3.5%) were older than 60 years at the first visit. Among those who completed a telephone interview, 74.3% (26/35) had less than 50% of scalp-localized hair loss. There was no association between the extent of AA and hair graying (p=0.679). Favorable therapeutic response was observed in 62.9% (22/35) of cases. CONCLUSION: AA in the elderly shows mild disease severity and favorable treatment response. There is no association between graying and the extent of AA. However, the influence of aging on the pathogenesis of AA in the elderly deserves further investigation.

Topical timolol maleate 0.5% for infantile hemangioma; it's effectiveness and/or adjunctive pulsed dye laser - single center experience of 102 cases in Korea.

Although oral beta-blocker, propranolol, was shown excellent outcome for infantile hemangioma (IH) up to date, concern of side effects and reluctance of treatment-related cumbersome evaluations are major obstacles to employ. Instead, topical beta-blockers were recently introduced as an effective alternative, but few studies are reported. So we performed a retrospective study of IH treated with topical beta-blockers, timolol maleate 0.5%, and adjunctive role of pulsed dye laser from 2011 to 2014. Among 102 IH enrolled, 61 patients (59.8%) treated with only timolol maleate and 41 (40.2%) patients treated with combination of pulsed dye laser. A clinical review of medical records and evaluation at 4-8 weeks intervals using the physicians' Global Assessment Scores (GAS) and patients' parents' GAS at the latest visit. Physicians' GAS was used to grade the lesions compared with the baseline photo by two physicians' evaluation. And parents' GAS was assessed by direct or telephone interview. In the only timolol treatment group, mean change was within 47.0% improvement from baseline by physicians. In addition, adjunctive treatment of pulsed dye laser group showed 66.5% improvement. No side effects were found on both groups, and mean change was 54.5% improvement by overall parent assessments.

Effects of topical application of a recombinant staphylococcal enterotoxin A on DNCB and dust mite extract-induced atopic dermatitis-like lesions in a murine model.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease with biphasic T cell-mediated abnormalities. Staphylococcal superantigens contribute to the exacerbation of inflammation in AD. The underlying immunopathological mechanisms are not fully understood. OBJECTIVE: To determine whether epicutaneous application of recombinant staphylococcal enterotoxin A (rSEA) would exacerbate AD-like allergic inflammation induced by 2, 4-dinitrochlorobenzene (DNCB) and house dust mite extract (Dermatophagoides farinae extract, DFE) in a murine model. MATERIALS AND METHODS: We first established an AD-like model using BALB/c mice exposed to DNCB/DFE on the ear. Next, Staphylococcus (S.) aureus or rSEA were topically applied to the mice. We evaluated the clinical and histopathological features of the animals. Serum immunoglobulin levels were also measured. In addition, real-time PCR analysis of cytokines produced by T cell subsets in the ears was conducted. RESULTS: Mice treated with S. aureus and rSEA had more severe clinical symptoms, including increased mean dermatitis scores and ear thickness, compared to animals with only AD-like lesions. Total IgE, IgG2a and serum histamine levels were increased in all groups except the normal control group. The S. aureus- and rSEA-treated groups showed increased levels of cytokines such as IL-4, IL-13, INF-γ, IL-17, and IL-18. In particular, increased cytokine expression was more conspicuous in the rSEA-treated group than in mice exposed to S. aureus. CONCLUSION: The results of this study showed that topical exposure to rSEA as well as SEA-producing S. aureus aggravate atopic skin inflammation. This may be associated with the induction of a mixed Th1/Th2 type dermatitis.

Ultraviolet B irradiation increases the expression of inflammatory cytokines in cultured sebocytes.

Sebaceous gland hyperplasia and increased sebum secretion after irradiation of ultraviolet (UV)-B has been widely accepted. This study was performed to clarify expression of inflammatory cytokines after irradiating UV-B in cultured sebocytes. Reverse transcription polymerase chain reaction was performed to measure gene expression of inflammatory cytokines, including interleukin (IL)-1ß, IL-6, IL-8 and tumor necrosis factor-α, in cultured sebocytes after exposure to 40 and 70 mJ/cm(2) UV-B. Protein expression of inflammatory cytokines and lipid production in cultured sebocytes after exposure to UV-B were measured using enzyme-linked immunoassay and lipid analysis kit. The expression of inflammatory cytokines, especially IL-1ß and IL-8, was significantly increased in cultured sebocytes after treatment with UV-B. Many more studies on the effect of UV-B on sebaceous glands should be performed to reveal the pathogenic mechanism of acne.