Sang Seok Kim

The Therapeutic Effect and the Changed Serum Zinc Level after Zinc Supplementation in Alopecia Areata Patients Who Had a Low Serum Zinc Level

BACKGROUNDnIt has been reported that some alopecia areata patients have zinc deficiency. There have also been several reports published concerning oral zinc sulfate therapy, with encouraging results, in some alopecia areata patients.nnnOBJECTIVEnThe purpose of this study was to evaluate the therapeutic effects of oral zinc supplementation for twelve weeks in alopecia areata patients who had a low serum zinc level.nnnMETHODSnOral zinc gluconate (50 mg/T/day) supplementation was given to alopecia areata patients without any other treatment for twelve weeks. The serum zinc level was measured before and after zinc supplementation. A four-point scale of hair regrowth was used to evaluate the therapeutic effect of oral zinc supplementation in these patients.nnnRESULTSnFifteen alopecia areata patients were enrolled in this study. After the therapy, the serum zinc levels increased significantly from 56.9 microg/ to 84.5 microg/dl. Positive therapeutic effects were observed for 9 out of 15 patients (66.7%) although this was not statistically significant. The serum zinc levels of the positive response group increased more than those of the negative response group (p=0.003).nnnCONCLUSIONnZinc supplementation needs to be given to the alopecia areata patients who have a low serum zinc level. We suggest that zinc supplementation could become an adjuvant therapy for the alopecia areata patients with a low serum zinc level and for whom the traditional therapeutic methods have been unsuccessful.

Aquagenic Urticaria: A Report of Two Cases

Aquagenic urticaria is a rare form of physical urticaria, in which contact with water evokes wheals. A 19-year-old man and a 4-year-old boy complained of recurrent episodes of urticaria. Urticaria appeared while taking a bath or a shower, in the rain, or in a swimming pool. Well-defined pin head to small pea-sized wheals surrounded by variable sized erythema were provoked by contact with water on the face, neck, and trunk, regardless of its temperature or source. Results from a physical examination and a baseline laboratory evaluation were within normal limits. Treatment of the 19-year-old man with 180 mg fexofenadine daily was successful to prevent the wheals and erythema. Treatment with 5 ml ketotifen syrup bid per day resulted in improvement of symptoms in the 4-year-old boy.

Treatment of digital mucous cysts with intralesional sodium tetradecyl sulfate injection.

BACKGROUND Digital mucous cysts (DMCs) are benign myxoid cysts typically involving the distal interphalangeal joint or over the proximal nail fold. There are various treatment modalities for DMCs, and intralesional sodium tetradecyl sulfate injection has been reported as an alternative treatment. OBJECTIVE To assess the efficacy and safety of intralesional sodium tetradecyl sulfate injection in treating DMCs. MATERIALS AND METHODS We performed intralesional injection of sodium tetradecyl sulfate in 17 patients (6 men and 11 women) with 20 DMCs. At each session, 1% to 3% sodium tetradecyl sulfate of 0.2 to 0.5 mL was injected into a lesion and repeated every 4 weeks if the cyst persisted. Changes in lesions and adverse reactions were recorded, and therapeutic efficacy was evaluated. RESULTS Of the 20 lesions treated with intralesional sodium tetradecyl sulfate injection, 80% responded. Recurrences were observed in 2 patients, and 2 patients did not respond well to the treatment. No patient reported any major adverse effects. CONCLUSION Intralesional sodium tetradecyl sulfate injection is a simple, safe, and effective modality for distal mucous cyst. Treatment was well tolerated with few side effects and favorable cure rate. Therefore, we believe that intralesional sodium tetradecyl sulfate injection should be considered an alternative treatment of DMCs.

Solitary Fibrous Tumor With Myxoid Stromal Change.

We report the case of a 46-year-old Korean woman who presented with a 5-month history of a hyperkeratotic plaque on the left palm. On examination, the plaque showed an annular pattern with an umbilicated central nodule and a peripheral palisading induration, which had a verrucous surface. After surgical resection, histopathologic analysis revealed that the tumor was composed of haphazardly arranged spindle cells and displayed a predominantly myxoid appearance in the stroma. The tumor cells were positive for CD34 and bcl-2, but negative for smooth muscle actin and S-100. The clinical manifestation and histopathologic findings were most consistent with a diagnosis of solitary fibrous tumor with myxoid stromal change. There was no evidence of recurrence or metastasis during the 8-month follow-up period. This case highlights the importance of an accurate diagnosis of solitary fibrous tumors, which may have extensive myxoid stromal change, hence mimicking other myxoid-type spindle cell tumors.

A case of milium‐like syringoma limited to the neck

large number and recurring nature of the lesions. Graft-versus-host-disease is the outcome of donor’s T-lymphocytes reacting against the recipient’s antigens. The chronic form (cGVHD), develops more than 100 days after transplant and limited cGVHD affects the skin or oral cavity locally and needs no treatment. There are no consensus criteria on the diagnosis of GVHD in solid organ transplants and it is based on a combination of clinical signs, positive lymphocyte chimerism in blood or bone marrow and a biopsy specimen with histopathological findings consistent with GVHD. In our patient, the histopathological findings of inflammatory reaction and apoptosis are suggestive of a mixed cellular and humoral GVHD-like reaction and the acute inflammatory reaction could be secondary to mucin extravasation, which also induces fibrosis in the long term. Inspissated mucin, which is common in CF, was not seen in the glands, hence the histological findings were not typical of CF. Mucocoeles have been documented in association with CF involving the nose and paranasal sinuses. Our patient never had mucocoeles before the transplant and a meticulous search of the literature failed to show any increase in the incidence of oral mucocoeles in CF. We believe the presentation of the mucocoeles has a direct association with her lung transplant. A drug reaction remains unlikely since multiple trials of changes in medication failed to improve the mucocoeles and none of her medications has been reported to cause similar adverse reaction. Considering that lung transplants are becoming more prevalent and patients’ survival is improving, dermatologists should be familiar with these rare complications.

Metastatic cutaneous Crohn's disease in a child

Metastatic cutaneous Crohns disease (MCD) is defined as histologically characteristic granulomas of Crohns disease occurring distant to and separate from the gastrointestinal tract [1]. MCD is rare, especially in children, and the genitalia are the most common site of MCD [2]. We report an unusual case of a 13-year-old boy with a 6-month history of skin lesions on his chest, which were finally diagnosed as MCD. He had experienced intermittent abdominal pain, chronic constipation and recurrent perianal [...]