Sang Lim Kim

Possible existence of melanocytes or melanoblasts in human sebaceous glands.

Background Melanocytes are present in both basal epidermis and hair follicles. Melanocyte stem cells have been found in hair follicle bulge. During embryogenesis, the outer cells of the bulge differentiate into the sebaceous gland (SG) and proliferate. Objective To identify and determine the distribution and morphological characteristics of melanocytes in human SGs. Methods A total of 171 biopsy specimens of face and scalp were studied. Of these specimens, 103 samples contained SGs. We conducted a retrospective review of slides stained with H&E, F-M, anti-S100, anti-c-kit, anti-HMB-45, anti-CD1a, anti-MITF, and anti-tyrosinase. The presence and distribution of melanocytes in human SGs was also evaluated by electron microscopy. In addition, melanocytes were isolated from SGs for primary culture. Results S-100-positive cells were observed mainly at the periphery of SGs in 34 of 54 specimens. We did not find F-M-positive and HMB-45-positive cells in SGs. CD1a-positve cells were identified in two specimens. We also found c-kit-, MITF-, and tyrosinase-positive cells in SGs. Electron micrograph showed the presence of melanocytes in the suprabasal portion of SGs. These melanocytes showed fewer melanin-containing granules than the melanocytes of basal epidermis. However, the individually distributed melanosomes in suprabasal melanocytes were larger than those in epidermal melanocytes. Primary culture of melanocytes derived from SGs showed morphologically homogeneous, slender cell bodies with few dendrites. Conclusion Our study confirms the presence of non-melanogenic melanocytes and Langerhans cells in human SGs. In addition, the characteristics of the melanocytes in SGs were found to be different from those of the epidermal melanocytes.

The Epidemiology of Dermatophyte Infection in Southeastern Korea (1979~2013)

Background: Dermatophytosis is common worldwide and isbelieved to affect more than 20-25% of the world’s population. The epidemiology of dermatophyte infection is influenced by variable factors. Objectives: To investigate the epidemiology of fungal skin infections through a retrospective analysis of patient’s medical records between 1979 and 2013. Methods: Of total 4,275,715 patients, 415,526 patients with clinically suspicious fungal infection were collected at Catholic Skin Disease Clinic in Daegu. KOH examination and culture were performed. Of 415,526 patients, 131,440KOH- and culture-proven patients were included in this study. Results: The annual number of patients with dermatophytosis ranged from 1,973 to 6,166 between 1979 and 2013. Trichophyton (T.) rubrum was the most commonly identified dermatophyte, followed by T. mentagrophytes, Microsporum (M.) canis, and Epidermophyton (E.) floccosum. T. rubrum infection was found predominantly in thirties, T. mentagrophytes infection in forties, and M.canis and T. tonsurans infection in teenagers. T. rubrum and T. mentagrophytes infection were most commonly seen in summer. M. canis infection was most commonlyseen in winter and T. tonsurans infection in spring and winter. The most common site was toe web in T. rubrum and T. mentagrophytes infection, scalp in M. canis infection, and trunk in T. tonsurans infection. Conclusion: This study will provide valuable information on current epidemiological trends for fungal infections in Korea.

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.

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.

Magnesium Ascorbyl Phosphate Regulates the Expression of Inflammatory Biomarkers in Cultured Sebocytes.

Background Acne is an inflammatory skin disorder caused by inflammatory biomarkers. Magnesium ascorbyl phosphate (MAP) is a stable precursor of vitamin C. It achieves a constant delivery of vitamin C into the skin and has antioxidative effects. Objective We performed this study to evaluate the effect of MAP on the expression of inflammatory biomarkers in cultured sebocytes. Methods Reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay were performed for inflammatory cytokines and matrix metalloproteinases (MMPs) before and after treatment of cultured sebocytes with MAP (10-2 M), lipopolysaccharide (LPS) (5 µg/ml) and a combination of MAP and LPS. RT-PCR and western blotting were also performed for antimicrobial peptides (AMPs) and Toll-like receptor (TLR)-4 before and after treatment of cultured sebocytes with MAP, LPS, and a combination of MAP and LPS. Quantification of lipid peroxidation was also conducted. Results The increased expression of inflammatory cytokines after treatment of cultured sebocytes with LPS was decreased after treatment with MAP. MMPs, AMPs, and TLR-4 were decreased after treatment of cultured sebocytes with MAP and a combination of MAP and LPS, and increased after treatment of cultured sebocytes with LPS alone. Lipid peroxidation was significantly decreased after treatment of cultured sebocytes with MAP and a combination of MAP and LPS. MAP decreased the increased lipid peroxidation after treatment of cultured sebocytes with LPS. Conclusion MAP may be an effective alternative agent to improve inflammatory reactions in acne.