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Lipodermatosclerosis is a type of sclerosing panniculitis that typically affects the lower legs and is frequently associated with vascular dysfunction. The cause of lipodermatosclerosis is not clearly understood, but it is believed to be associated with chronic venous insufficiency, obesity, arterial hypertension, arterial ischemia, and thrombophlebitis. Furthermore, in patients with lipodermatosclerosis, not only deep venous incompetence but also calf muscle abnormality can be observed. Increased muscle fat infiltration is associated with spinal stenosis, which leads to a reduction in calf muscle pump function. Our patient, who is obese and has had spinal stenosis for a long time, presented with a sudden onset of heating sensational erythematous patch on the right lower leg. A muscle biopsy revealed fat infiltration, and an incisional biopsy confirmed the diagnosis of lipodermatosclerosis. Our case suggests that increased fat infiltration in the muscles, along with spinal stenosis, leads to calf muscle atrophy, potentially resulting in acute lipodermatosclerosis.
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Background@#Primary cicatricial alopecia (PCA) is a rare disease that causes irreversible destruction of hair follicles and affects the quality of life (QOL). @*Objective@#We aimed to investigate the disease awareness, medical use behavior, QOL, and real-world diagnosis and treatment status of patients with PCA. @*Methods@#A self-administered questionnaire was administered to patients with PCA and their dermatologists. Patients aged between 19 and 75 years who visited one of 27 dermatology departments between September 2021 and September 2022 were included. @*Results@#In total, 274 patients were included. The male-to-female ratio was 1:1.47, with a mean age of 45.7 years. Patients with neutrophilic and mixed PCA were predominantly male and younger than those with lymphocytic PCA. Among patients with lymphocytic PCA, lichen planopilaris was the most common type, and among those with neutrophilic PCA, folliculitis decalvans was the most common type. Among the total patients, 28.8% were previously diagnosed with PCA, 47.0% were diagnosed with PCA at least 6 months after their first hospital visit, 20.0% received early treatment within 3 months of disease onset, and 54.4% received steady treatment. More than half of the patients had a moderate to severe impairment in QOL. Topical/intralesional steroid injections were the most common treatment. Systemic immunosuppressants were frequently prescribed to patients with lymphocytic PCA, and antibiotics were mostly prescribed to patients with neutrophilic PCA. @*Conclusion@#This study provides information on the disease awareness, medical use behavior, QOL, diagnosis, and treatment status of Korean patients with PCA. This can help dermatologists educate patients with PCA to understand the necessity for early diagnosis and steady treatment.
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Background@#The prevalence of psoriasis differs by population, and it appears to be more common among Europeans than in East Asians. Recent genome-wide association studies (GWAS) have identified alleles that increase the risk of psoriasis, and these alleles may present different frequencies in different geographic regions. @*Objective@#We aimed to gain insights into the causes of differences in disease frequencies according to populations and the factors affecting prevalence and pattern differences. @*Methods@#We collected a total of 147 psoriasis-associated single-nucleotide polymorphisms (SNPs) from the GWAS catalog and compared the allele frequency differences in 27 populations using public population frequency in the 1000 Genomes Project phase 3 (n=2,504) and the Korean Reference Genome Database (n=1,722). Additionally, we calculated the composited genetic risk scores across the population groups. @*Results@#There were distinct patterns of allele frequencies in different population groups.In many cases, East Asians exhibited allele frequencies opposite to that of Europeans. The genetic risk score was higher in Europeans (average: 0.487) and Americans (average: 0.492) than in East Asians (average: 0.471). The prevalence of psoriasis correlated with the average genetic risk score of the population. @*Conclusion@#We observed a difference in the allele frequencies of psoriasis-associated SNPs between the studied populations. This result suggests that the difference in the prevalence of psoriasis between population groups can be interpreted to some extent by the genotype.
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Background@#Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual. @*Objective@#To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea. @*Methods@#We searched for relevant studies from inception to May 2021 regarding the systemic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus. @*Results@#Current evidence supports the efficacy of systemic corticosteroids, oral cyclosporine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively. @*Conclusion@#The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.
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Background@#Alopecia areata (AA) is a chronic disease with an unpredictable disease course and severe psychological impact. @*Objective@#To provide evidence- and consensus-based insights regarding the treatment of patients with AA in Korea. @*Methods@#We searched for relevant studies on the topical and device-based treatment of AA in the literature from inception until May 2021. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statements, and an agreement of 75% or greater was considered as consensus. @*Results@#Currently, there remains a scarcity of topical treatments, which is supported by robust evidence from a number of high-quality randomized controlled trials. Current evidence supports the efficacy of topical corticosteroids, corticosteroid intralesional injection, and contact immunotherapy in AA patients. Topical corticosteroids and contact immunotherapy are recommended for pediatric AA. A consensus was achieved in 6 out of 14 (42.8%), and 1 out of 5 (20.0%) statements pertaining to topical and device-based treatments in AA, respectively. The expert consensus was from a single country, and the study may not cover all the treatments used. @*Conclusion@#The present study provides up-to-date, evidence-based treatment guidelines for AA based on the consensus reached among experts after considering regional healthcare circumstances, adding diversity to the previous guidelines.
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Merkel cell carcinoma (MCC), a rare cutaneous neuroendocrine carcinoma, is most common in sun-exposed areas of aged individuals. Merkel cell polyomavirus (MCPyV) is one causative agent of MCC. Cases of MCC concurrent with other skin tumors, especially squamous cell carcinoma, are rarely reported. Immunohistochemical staining is performed using antibodies to the MCPyV large-T antigen (CM2B4) only in select cases. To date, no cases of MCPyV have been reported in Korea. Here we report a case of MCC concurrent with squamous cell carcinoma in an aged man and discuss the pathogenesis of the case through CM2B4 staining.
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Background@#Androgenetic alopecia (AGA) is the most common cause of hair loss in adults. Topical application of the fermented extract of medicinal plants promoted hair growth through stimulation of the telogen to anagen transition in a mouse model. However, controlled studies are necessary to evaluate the efficacy of the topical application of the fermented extract solution in humans. @*Objective@#We aimed to assess the efficacy and safety of topical poly-gamma glutamic acid hydrogel nanoparticlebased fermented extract of a medicinal plant solution (PGA solution) in terms of the clinical improvements in patients with AGA. @*Methods@#This 24-week, randomized, double-blinded, placebo-controlled, single-center clinical trial enrolled 50 patients with AGA (36 men and 14 women); the participants were treated with either PGA solution or placebo twice daily for 24 weeks. Efficacy was evaluated by a phototrichogram (total hair count per 1 cm 2 ), patient’s subjective assessments, and investigator’s subjective assessments of clinical improvements in overall hair regrowth. Any adverse reactions were reported during the study. @*Results@#At week 24, compared with baseline, the PGA solution group showed a significantly increased hair density compared to the placebo group (7.24±2.52/cm 2 vs. 1.53±1.39/cm 2 , p＜0.0001). The average hair density after 24 weeks was 129.90±23.04/cm 2 and 115.32±20.35/cm 2 in the PGA solution group and the placebo group, respectively.There was no adverse reaction over the 24-week period. @*Conclusion@#PGA solution may provide a safe and effective adjunctive treatment for patients with AGA.
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Eccrine porocarcinoma is a rare, malignant skin tumor that originates from the eccrine sweat gland. This disease affects elderly people, primarily. It is clinically present in varied forms and the location is not related to sweat-gland distribution, which occurs on the lower limb, trunk, and head. Herein, we report a rare case of pedunculated eccrine porocarcinoma, which had developed on the flank of a 79-year-old woman.
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Anciano , Femenino , Humanos , Porocarcinoma Ecrino , Cabeza , Extremidad Inferior , Piel , Glándulas SudoríparasRESUMEN
Basal cell carcinoma (BCC) is the most common malignant tumor of the skin and usually seen on hair-bearing skin that is frequently exposed to the sun, especially on the face. Polypoid BCC, which is thought to be a new variant, is distinguished from other histologic types by having a stalk and by restriction of the tumor aggregation to the pedunculated zone. We report a case of polypoid BCC in a 73-year old man who had a skin-colored pedunculated papule in the perianal area mimicking soft fibroma.
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Carcinoma Basocelular , Fibroma , Piel , Sistema SolarRESUMEN
BACKGROUND: Poroid neoplasms consist of classic poroma, hidroacanthoma simplex, dermal duct tumor, and poroid hidradenoma. Poroid neoplasms are not rare tumors in dermatology. However, studies of the clinicopathologic characteristics of poroid neoplasms in Korea are very limited. OBJECTIVE: To investigate the clinicopathologic characteristics of poroid neoplasms in Korea. METHODS: The clinicopathologic characteristics of forty three cases of poroid neoplasms were retrospectively analyzed. RESULTS: Poroid neoplasms were diagnosed mostly in the sixth decade, without sex predominance. The most common site was the lower extremities, followed by the head & neck, the trunk, the sole, the palm, and the upper extremities. All cases were observed as a solitary lesion. Papule or nodule shape, verrucous surface, and erythmatous color were most common characteristics of poroid neoplasms. The two cases showed sebaceous differentiation. Some cases showed melanin pigmentations in the lesions or perilesional basal layer. CONCLUSION: Our study will be a resourceful data of poroid neoplasms for dermatologists and pathologists.
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Acrospiroma , Dermatología , Cabeza , Corea (Geográfico) , Extremidad Inferior , Melaninas , Metilmetacrilatos , Cuello , Pigmentación , Poliestirenos , Poroma , Estudios Retrospectivos , Extremidad SuperiorRESUMEN
Acute generalized exanthematous pustulosis (AGEP) is manifested by rapid development of many sterile, nonfollicular pustules on a background of edematous erythema. More than 90 percent of AGEP are induced by medication, mostly antibiotics. Drug patch test can be helpful in the diagnosis of AGEP. This paper reports the first case of celecoxib-induced AGEP confirmed by patch test in Korean literature.