Yun Sun Byun

Dietary Pattern and Nutrient Intake of Korean Children with Atopic Dermatitis

Background Atopic dermatitis (AD) is characterized by itching and eczema-like skin lesions, and its symptoms alleviate with age. Recently, the prevalence of AD has increased among adolescents and adults. The increasing prevalence of AD seems to be related to westernized lifestyles and dietary patterns. Objective The aim of this study was to evaluate the dietary patterns and nutrient intake of patients with AD. Methods The study population consisted of 50 children with AD who visited the Department of Dermatology at Kangnam Sacred Heart Hospital, Seoul, Korea from May 2008 to May 2009. Physical condition and calorie intake were evaluated using the Eczema Area and Severity Index score and Food Record Questionnaire completed by the subjects, and the data were analyzed using the Nutritional Assessment Program Can-pro 3.0 (The Korean Nutrition Society, 2005) program to determine the gap between the actual ingestion and average requirements of 3 major nutrients (i.e. carbohydrates, proteins, and lipids), vitamins (i.e. A, B, C, and E), niacin, folic acid, calcium, iron, phosphorus, and zinc in all subjects. Results The intake rate of proteins was 18.02% (recommended dietary allowance [RDA], 7%~20%), of carbohydrates was 67.7% (RDA, 55%~70%), and of lipids was 14.24% (RDA, 15%~30%). Thirty-one subjects (62%) showed deficiency of folic acid, and 21 subjects (42%), of iron supplements. Conclusion Essential nutrient intake tends to be lower in AD patients than in healthy subjects, and this low intake is closely related to the severity of AD.

Two Cases of Successful Treatment of Refractory Chronic Inflammatory Skin Disease, Atopic Dermatitis and Psoriasis with Oral Alitretinoin

Vol. 29, No. 4, 2017 503 Received July 11, 2016, Revised August 1, 2016, Accepted for publication August 8, 2016 *These authors contributed equally to this work and should be considered co-first authors. Corresponding author: Hye One Kim, Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5221, Fax: 82-2-832-3237, E-mail: hyeonekim@gmail.com Chun Wook Park, Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5221, Fax: 82-2-832-3237, E-mail: dermap@hanmail.net This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

A Case of Eccrine Spiradenoma: A Rarely Seen Soft Tissue Tumor on the Extensor Surface of Arm

Vol. 29, No. 4, 2017 519 Received August 5, 2016, Revised August 18, 2016, Accepted for publication August 22, 2016 *These authors contributed equally to this work and should be considered co-corresponding authors. Corresponding author: Hye One Kim, Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5221, Fax: 82-2-832-3237, E-mail: hyeonekim@gmail.com Chun Wook Park, Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5221, Fax: 82-2-832-3237, E-mail: dermap@ hanmail.net This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons. org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

Fibro-Osseous Pseudotumor of the Digit Presenting as an Enlarging Erythematous Subungual Nodule

Vol. 29, No. 4, 2017 497 Received May 30, 2016, Revised July 25, 2016, Accepted for publication July 28, 2016 *These authors contributed equally to this work and should be considered co-first authors. Corresponding author: Chun Wook Park, Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5221, Fax: 82-2-832-3237, E-mail: dermap@hanmail.net Hye One Kim, Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5221, Fax: 82-2-832-3237, E-mail: hyeonekim@gmail.com This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons. org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

Intense Pulsed Light and Q-Switched 1,064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser Treatment for the Scarring Lesion of Discoid Lupus Erythematosus

Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus that can cause permanent scarring. Treatment of DLE includes protection from sunlight and artificial sources of ultraviolet light, as well as systemic and topical medications. The first-line standard therapies are antimalarials and topical steroids. Other systemic therapies include systemic steroid, azathioprine, dapsone, and immunosuppressive agents. Topical tacrolimus and pimecrolimus have also been evaluated. Recent studies reported that several treatments, including pulsed dye laser, CO2 laser, intense pulsed light (IPL), and 1,064-nm long-pulse neodymium-doped yttrium aluminum (Nd:YAG) have been used for the cosmetic treatment of DLE. Here, we report a case of a DLE scar that was successfully treated with a combination therapy of IPL and Q-switched 1,064-nm Nd:YAG laser.

Hyperkeratotic Hand Eczema due to Use of Rubber Gloves While Driving.

Dear Editor: Hyperkeratotic hand eczema (HHE) is defined as a lesion of hand dermatitis that shows thick hyperkeratotic plaques with or without deep fissures. This diagnosis was established in 2%~5% of patients with hand dermatitis1,2. HHE is considered to have multiple causes, such as exposure to repetitive irritation, atopy, contact allergy, and friction3. Previous studies have revealed that contact sensitization is less common in HHE2. Here, we report a case of chronic HHE associated with contact sensitization to black rubber mix and thiuram mix. A 50-year-old nonatopic male patient presented with chronic HHE that had been refractory to previous treatments for the last 2 years. Physical examination revealed relatively well-demarcated erythematous scaly plaques on the palmar sides of both hands (Fig. 1A). He was a salesman who had always driven a car to his meetings. For 3 years, he had been wearing his work gloves, which had rubber on the palmar side, to prevent his hand from sliding off the steering wheel while driving because of his palmar hyperhidrosis (Fig. 2A). He had received eczema treatment with potent topical corticosteroid creams and moisturizer at local clinics; however, his symptoms did not improve. Then, he was referred to our hospital. We performed patch tests with a thin-layer rapid use epicutaneous (TRUE) test kit (Mekos Laboratories AS, Hillerod, Denmark). There were positive reactions to thiuram mix(++) and black rubber mix(++) at 48 h, and additional positive reactions to p-tertbutylphenol formaldehyde resin(+) and p-phenylenediamine(+) at 96 h (Fig. 2B). He was advised to apply a topical steroid with medium potency and to drive without wearing gloves, and his symptoms improved 2 weeks later (Fig. 1B). Thereafter, he underwent use tests with the work gloves, which worsened his symptoms. Fig. 1 (A) Localized scaly yellowish plaques on the palmar sides of both hands. (B) Two weeks after avoiding exposure to the offending allergen. Fig. 2 (A) Blue rubber dotted work gloves. (B) Positive patch test reactions to thiuram mix(++), black rubber mix(++), p-tertbutylphenol formaldehyde resin(+), and p-phenylenediamine(+) at 96 h. A hyperkeratotic morphology is known to be less frequently associated with contact sensitization, irritant exposure, and atopic dermatitis1. Thus, strongly positive reactions to more than two materials during the patch test have clinical implications. We made a diagnosis of HHE due to repetitive use of the work gloves on the basis of the patients history, patch tests, and use tests. Thiurams are accelerants that are commonly used to manufacture natural rubber latex products. These mixes are present in natural or synthetic rubber products making up materials that are used either at work or at home4. Many tire workers are sensitized to black rubber mix. Concerning nonoccupational exposure, it has been shown that black rubber footgear and the rubber tips of walking sticks can also cause contact dermatitis5. Positive reaction to p-tertbutylphenol formaldehyde resin is related to contact with waterproof glue, bonded leather, and construction materials, whereas that to p-phenylenediamine is related to contact with permanent or semipermanent hair dyes, dyed textiles, and cosmetics; however, these are less relevant compared with our case. In conclusion, this report suggests that patients with HHE should be comprehensively evaluated through history taking and correctly treated by avoiding the suspicious material.