Tae Young Han

A Clinical and Histopathological Study of 122 Cases of Dermatofibroma (Benign Fibrous Histiocytoma)

BACKGROUND Many variants of dermatofibromas have been described, and being aware of the variants of dermatofibromas is important to avoid misdiagnosis. OBJECTIVE We wanted to evaluate the clinical and pathologic characteristics of 122 cases of dermatofibromas. METHODS We retrospectively reviewed the medical records and 122 biopsy specimens of 92 patients who were diagnosed with dermatofibroma in the Department of Dermatology at Eulji Hospital of Eulji University between January 2000 and March 2010. RESULTS Nearly 80% of the cases occurred between the ages of 20 and 49 years, with an overall predominance of females. Over 70% of the lesions were found on the extremities. The most common histologic variant was a fibrocollagenous dermatofibroma (40.1%). Other variants included histiocytic (13.1%), cellular (11.5%), aneurysmal (7.4%), angiomatous (6.5%), sclerotic (6.5%), monster (4.9%), palisading (1.6%) and keloidal dermatofibromas (0.8%). There were 9 dermatofibromas (7.3%) that were the mixed type with two co-dominant histologic features. CONCLUSION The results of this study are consistent with previous reports on the clinical features of dermatofibromas. However, we observed several characteristic subtypes of dermatofibroma and we compared the frequency of the histologic subtypes.

Correlation between Severity of Atopic Dermatitis and Sleep Quality in Children and Adults

Background The atopic dermatitis (AD) can limit a patients physical and psychosocial development as well as lower their overall quality of life (QOL), including sleep quality. Objective The purpose of this study was to evaluate the relationships between clinical disease severity, QOL and sleep quality in children and adults with AD. Methods The SCORing atopic dermatitis (SCORAD) was examined to evaluate the severity of AD in fifty adult AD patients and 50 children AD patients. A questionnaire based on the childrens sleep habits questionnaire (CSHQ) and the childrens dermatology life quality index (CDLQI) were used to evaluate QOL and sleep disturbance in children AD patients. The Pittsburgh sleep quality index (PSQI) and dermatology life quality index (DLQI) were used in adult AD patients. Results The SCORAD and CSHQ score, the SCORAD and CDLQI score and the CSHQ and CDLQI score demonstrated significant correlations. The SCORAD and PSQI score showed no significant correlation. However, there were significant correlations between the SCORAD and DLQI score and the PSQI and DLQI score. Conclusion Increasing severity of AD affects sleep quality in child AD patients. In adults, even though the total score of the sleep questionnaire is not associated with the severity of AD, two components of sleep questionnaire are associated with the severity of AD. There is a significant correlation between sleep quality and QOL in both children and adults. Therefore, we suggest that evaluating the sleep quality as well as clinical severity of the disease is necessary in the management of AD patients.

Subdermal Minimal Surgery with Hyaluronic Acid as an Effective Treatment for Neck Wrinkles

BACKGROUND Neck wrinkles are common, troublesome aesthetic deformities for which a limited number of treatments exist. Although previous study has demonstrated the safety and efficacy of subdermal minimal surgery technology in treatment of acne scarring, this technology has never been applied to treatment of wrinkles. OBJECTIVE To evaluate the efficacy and safety of subdermal minimal surgery technology in the treatment of horizontal neck wrinkles. MATERIALS AND METHODS All 12 enrolled participants were Koreans (Fitzpatrick skin types II–IV) with horizontal neck wrinkles. Participants underwent up to four sessions of treatment with subdermal minimal surgery technology at 4‐week intervals. Wrinkle assessments were conducted at baseline and 2 months after the final treatment session. Participants and physicians evaluated improvement using pre‐ and post‐treatment photographs. RESULTS All participants completed the study. Improvement of wrinkling by at least 50% was observed at 6 months (2 months after the final treatment session) in more than half of the participants, as determined according to physician and participant evaluation. CONCLUSION Findings from this preliminary study demonstrate that use of subdermal minimal surgery technology results in an effective decrease of the appearance of neck wrinkles. The authors have indicated no significant interest with commercial supporters.

Vitamin D Status and Its Association with the SCORAD Score and Serum LL-37 Level in Korean Adults and Children with Atopic Dermatitis

Background Vitamin D insufficiency could be associated with the prevalence of atopic dermatitis (AD). Objective To examine vitamin D status and the relations between serum 25-hydroxyvitamin D levels, SCORAD score, serum LL-37 level, and body mass index (BMI) in Korean AD patients, and to explore whether these associations differ between adults and children. Methods Serum 25-hydroxyvitamin D levels, serum LL-37, and clinical features were analyzed in a total of 72 Korean patients with AD (39 adults and 33 children) and 140 healthy control subjects (70 adults and 70 children). Results Serum 25-hydroxyvitamin D levels were significantly reduced in children with AD (15.06±4.64 ng/ml) compared with normal children in the control group (16.25±6.60 ng/ml) (p=0.036). Significant inverse correlations were found between BMI and 25-hydroxyvitamin D level (r=-0.315, p=0.007) and between the SCORAD score and serum LL-37 level (r=-0.3, p=0.011) in the total AD patients. Conclusion The results showed that serum vitamin D levels were lower in children with AD than in healthy children; however, the same relation was not observed between adults with AD and healthy adults. Serum 25-hydroxyvitamin D concentration was not significantly correlated with AD severity or serum LL-37 levels in our study population.

Vitiligo and overt thyroid diseases: A nationwide population-based study in Korea

Background: Associations between vitiligo and thyroid diseases have been reported repeatedly. Objective: We investigated the associations between vitiligo and overt autoimmune thyroid diseases and thyroid cancer using the Korean National Health Insurance claims database. Methods: We defined patients with vitiligo as those whose records showed ≥4 physician contacts between 2009 and 2013 in which vitiligo was the principal diagnosis. We also established an age‐ and sex‐matched control group without vitiligo (2 per 1 vitiligo patient). The outcomes of interest were concurrent Graves disease and Hashimoto thyroiditis (the patients were taking relevant thyroid medications) and thyroid cancer. Results: The study enrolled 73,336 vitiligo patients and 146,672 controls. Patients with vitiligo were at increased risks of Graves disease (odds ratio [OR] 2.610 [95% confidence interval {CI} 2.319‐02.938]), Hashimoto thyroiditis (OR 1.609 [95% CI 1.437‐1.802]), and thyroid cancer (OR 1.127 [95% CI 1.022‐1.242]), compared with the controls. The associations were consistently stronger in males and younger patients. Limitations: Individual clinical information was not available, and the homogeneous population may limit the generalizability of the results. Conclusion: Vitiligo was significantly associated with overt autoimmune thyroid diseases and overt thyroid cancer.

A clinicopathologic study of thirty cases of acquired perforating dermatosis in Korea.

Background Acquired perforating dermatosis (APD) is histopathologically characterized by transepidermal elimination of materials from the upper dermis. APD can be divided into four diseases: Kyrles disease, perforating folliculitis, elastosis perforans serpiginosa, and reactive perforating collagenosis. APD is usually associated with systemic diseases, especially diabetes mellitus or chronic renal failure. So far, there have only been a few Korean studies of APD, which have a limited number of patients. Objective The aim of this study is to evaluate the clinical and histopathologic characteristics of 30 cases of APD and to examine the association with systemic diseases. Methods We retrospectively reviewed the medical records and biopsy specimens of 30 patients who were diagnosed with APD. Results The mean age was 55.5 years, and the average duration of the lesion was 7.8 months. The lower extremities (73.3%) were the most frequently occurring sites of the lesion. Twenty-five patients (83.3%) had pruritus, and Koebners phenomenon was present in 11 patients. Patients of 63.3% had at least one systemic disease. Diabetes mellitus (n=17, 56.7%) and chronic renal failure (n=10, 33.3%) were the most commonly associated conditions. Most patients received topical steroids (93.3%) and antihistamines (80.0%). The most common histopathologic type was reactive perforating collagenosis (n=23, 73.3%). Conclusion In this study, most patients had a systemic association to the diseases. Therefore, we suggest that further evaluation is necessary for patients who present with APD. This includes reviewing patients comprehensive past medical history, clinical exam, and additional diagnostic testing to check for the possibility of associated systemic diseases.

The Effects of 830 nm Light-Emitting Diode Therapy on Acute Herpes Zoster Ophthalmicus: A Pilot Study.

Background Skin lesions and pain are the most distinctive features of herpes zoster. Light-emitting diode (LED) therapy is an effective treatment known for its wound-healing effects. Objective To determine whether the LED treatment affects wound healing and acute pain in acute herpes zoster ophthalmicus. Methods We recruited 28 consecutive Korean patients with acute herpes zoster ophthalmicus for the study. In the control group (group A), 14 subjects received oral famcyclovir. In the experimental group (group B), 14 subjects received oral famcyclovir and 830 nm LED phototherapy on days 0, 4, 7, and 10. In order to estimate the time for wound healing, we measured the duration from the vesicle formation to when the lesion crust fell off. The visual analogue scale (VAS) was used for the estimation of pain on days 4, 7, 10, and 14. Results The mean time required for wound healing was 13.14±2.34 days in group B and 15.92±2.55 days in group A (p=0.006). From day 4, the mean VAS score showed a greater improvement in group B, compared with group A. A marginal but not statistically significant difference in the VAS scores was observed between the two groups (p=0.095). Conclusion LED treatment for acute herpes zoster ophthalmicus leads to faster wound healing and a lower pain score.

Successful treatment of argyria using a low-fluence Q-switched 1064-nm Nd:YAG laser

Background  Argyria is a rare skin disease caused by cutaneous deposits of silver granules as a result of exposure to silver substrates or ingestion of silver salt. This pigmentation change causes cosmetic problems, and there was previously no recognized effective treatments for argyria.

Squamous Cell Carcinoma Developing within Lesions of Disseminated Superficial Actinic Porokeratosis.

Disseminated superficial actinic porokeratosis (DSAP) consists of multiple annular, hyperkeratotic lesions that have a bilateral distribution on sun-exposed areas, particularly the extremities. DSAPs have a wider distribution than porokeratosis of Mibelli and usually develop during the 3rd or 4th decade of life. Squamous cell carcinoma that arises in the classical type of porokeratosis of Mibelli is well-documented, but there are only a few reports of squamous cell carcinoma in DSAP. Here, we describe a 62-year-old man with DSAP who developed squamous cell carcinoma on his right forearm.

Ziprasidone-induced hypersensitivity syndrome confirmed by reintroduction

cient for professionals to feel confident in prescribing psychotropic medications. In this study, 88% of respondents reported that they did not feel comfortable in prescribing antidepressants, and 88% did not feel comfortable in prescribing antipsychotics. The present report marks the first study of its kind in Chile. It is limited by the low response rate to the survey and by the fact that Chilean dermatologists who have a special interest in psychodermatology would have been more likely to respond. Subsequent to appropriate educational changes, it will be interesting to measure these data in future generations of dermatologists.