Won Soo Lee

Quality of Life Assessment in Male Patients with Androgenetic Alopecia: Result of a Prospective, Multicenter Study

Background Androgenetic alopecia (AGA) is a common hair loss disease with genetic predisposition among men and women, and it may commence at any age after puberty. It may significantly affect a variety of psychological and social aspects of ones life and the individuals overall quality of life (QoL). Objective This study aimed to investigate the QoL of AGA patients and discover the factors that can influence the QoL of AGA patients, including previous experience in non-medical hair care, reasons for hospital visits, age, duration, and the severity of AGA. Methods A total of 998 male patients with AGA were interviewed, using the Hair Specific Skindex-29 to evaluate the QoL of AGA patients. Results The results of the Hair Specific Skindex-29 on patients with AGA were as follows: symptom scale: 26.3±19.5, function scale: 24.0±20.1, emotion scale: 32.1±21.8, and global score: 27.3±19.1. According to this assessment, QoL was more damaged if the patient had severe alopecia, a longer duration of AGA, younger age, had received previous non-medical hair care, and visited the hospital for AGA treatment. Conclusion This study showed that AGA could harmfully affect the patients QoL. These findings indicate that dermatologists should address these QoL issues when treating patients with alopecia.

Hyperkeratosis of the nipple and areola simultaneously developing with cutaneous T-cell lymphoma

Hyperkeratosis of the nipple and areola is rare. Since its first description by Tauber (cited in Oberste-Lehn’) in 1923, about 20 cases have been reported in the literature.2-4 Clinically the typical lesions are characterized by verrucous thickening and brown pigmentation of the nipple and areola. The histopathologic features are acanthosis, hyperkeratosis, and papillomatosis. To our knowledge this is the first reported case of hyperkeratosis of the nipple and areola that simultaneously developed with cutaneous T-cell lymphoma.

Characteristics of Androgenetic Alopecia in Asian

Androgenetic alopecia (AGA), or pattern hair loss, is a common disorder in Asian men and women, with a reported incidence of up to 73% among general population. There are several descriptions regarding the characteristics of AGA in patients of European descent. Asian patients with AGA have different types of hair loss and family histories from Europeans, which may affect treatment response. Therefore, in this review, prevalence, hair loss patterns, familial factors, androgen receptor gene polymorphisms of Asian AGA patients, and management based on algorithmic guidelines for AGA are discussed. This review may be useful for dermatologists in clinical practice for diagnosing and designing management approaches for Asian patients with AGA.

Behçet's syndrome associated with bullous necrotizing vasculitis

We recently saw a case of Behçets syndrome in an 11-year-old Korean boy who had severe bullous necrotizing vasculitis as a skin manifestation. The patient exhibited three major criteria of the Shimizu classification, namely, oral and genital ulcerations, uveitis, and bullous necrotizing vasculitis as the skin manifestation. Immunologic laboratory data showed an increased OKT4/OKT8 ratio and a lymphocyte stimulation index with phytohemagglutinin. A skin specimen taken from a developing lesion showed features of lymphocytic vasculitis extending into the panniculus.

Confluent and Reticulated Papillomatosis: A Clinical, Histopathological, and Electron Microscopic Study

The clinical, histopathological, and electron microscopic features often patients with confluent and reticulated papillomatosis (CRP) of Gougerot and Carteaud were studied. Histopathologically, hyperkeratosis, decreased granular layer, irregular papillomatosis, and hypermelanosis of the basal layer were present. In an electron microscopic study, we found transitional cells between the stratum granulosum and stratum corneum that were increased in CRP. This finding supported the suggestion that this is a defect of keratinization.

Effect of IGF-I on Hair Growth Is Related to the Anti-Apoptotic Effect of IGF-I and Up-Regulation of PDGF-A and PDGF-B

Background Insulin-like growth factor-I (IGF-I) shares a high degree of structural and functional homology with insulin and is a potent mitogen supporting cell growth and survival in many kinds of the tissues and cells. It also plays a role in some differentiation and anti-apoptotic functions. In previous reports, it has been shown that IGF-I stimulates hair follicle (HF) growth, maintains the anagen stage, and postpones the catagen stage. Objective The exact mechanism of the effect of IGF-I on HF growth is not yet established. Therefore, we investigated the relationships between IGF-I and various other factors (i.e. apoptosis related molecules, pro-inflammatory cytokines, other growth factors, etc.) in the control of HF growth. Methods The effect of IGF-I on human hair growth was measured using an organ culture model of human HFs and compared with a control group that did not receive IGF-I. We also measured mRNA expression of factors related to hair growth and apoptosis (which was determined by reverse transcription polymerase chain reaction (RT-PCR). RT-PCR was done on days 2, 4, 6, and 8 of organ culture. Results In organ cultured human hair follicles, IGF-I had a positive effect on the rate of linear hair growth. IGF-I maintained the anagen phase. IGF-I increased the expression of platelet-derived growth factor (PDGF)-A, PDGF-B and the expression ratio of Bcl-2/Bax. Conclusion The effect of IGF-I on hair growth appears to be related to the upregulation of PDGF-A and PDGF-B and to the anti-apoptotic effect of IGF-I.

Clinical and Pathological Features of Generalized Granuloma Annulare with Their Correlation: A Retrospective Multicenter Study in Korea

BACKGROUNDnGeneralized granuloma annulare (GGA) is a benign skin disorder of an unknown etiology. Though some cases of GGA have been reported, few systemic reviews of the clinical and pathological features of GGA have been performed.nnnOBJECTIVEnThe purpose of this study is to analyze and correlate the clinical and pathological characteristics of GGA in Korean patients.nnnMETHODSnWe conducted a retrospective study that included 54 biopsy specimens of Korean GGA patients, and the clinical and pathological features of GGA were reviewed and analyzed for their correlation.nnnRESULTSnThe cutaneous lesions could be divided into the annular (24, 44%) and nonannular types (30, 56%), and the lesions were more common in males than in females (29 males and 25 females). The incidence of GGA showed a bimodal age distribution. The number of patients who presented within the first decade was 24 cases (44%), and 24 cases (44%) were over the fifth decade. Eight patients (15%) had systemic diseases. Especially, diabetes mellitus (DM) occurred only in the adult GGA patients over forty years old. The pathological findings showed dermal granulomatous lesions that consisted of either a palisading pattern (28, 52%) or an interstitial pattern (26, 48%).nnnCONCLUSIONnIn contrast to the previously reported studies, the age of GGA onset showed a bimodal distribution, and GGA was observed more often in males. The prevalence of DM in the GGA affected individuals was higher than that found in the general Korean population. Therefore, it is recommended to perform a work-up for DM in the GGA affected patients who are over forty years old.

Acral Darier's disease: Report of a case complicated by Kaposi's varicelliform eruption

We report a case of acral Dariers disease in a 16-year-old Korean boy that was complicated by Kaposis varicelliform eruption. It is uncommon in Dariers disease for dyskeratotic papules to be limited to acral areas. In our patient, Kaposis varicelliform eruption occurred on the face where there were no preexisting lesions of Dariers disease.

Partial Unilateral Lentiginosis Associated with Segmental Neurofibromatosis

Partial unilateral lentiginosis associated with segmental neurofibromatosis is rare. Therefore, we describe here a patient with partial unilateral lentiginosis associated with ipsilateral segmental neurofibromatosis who developed multiple, rice‐sized, brown macules on the right side of her face, trunk, and upper arm and several bean‐sized, café‐au‐lait spots on the right upper arm and right upper back. To our knowledge, partial unilateral lentiginosis associated with ipsilateral segmental neurofibromatosis has not been reported in the English literature.

Steatocystoma multiplex localized only in the face.

A 60‐year‐old man presented with lesions on his face to the Department of Dermatology, Wonju Christian Hospital on November 10, 1994. There were over 10, slightly elevated, flat‐topped, yellowish colored, subcutaneous nodules on the face (Fig. 1). The lesions had first appeared on the left upper eyebrow at the age of 58 years, and since then they had abruptly increased in size and number and had spread into both temporal areas. Their size varied from 3 to 10 mm in diameter. No other lesions were observed on the extremities or trunk. The patients past and family history were noncontributory and the results of routine laboratory findings were within normal limits or were negative.