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An assessment method for dermal structures using cross-polarized light imaging with a green light-emitting diode. Skin Res Technol 2020; 26:932-936. [PMID: 32585066 DOI: 10.1111/srt.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several experimental methods for evaluating dermal structures exist; however, most of these are not used in dermatology clinics because of cost and functional limitations. OBJECTIVE To propose a simple, non-invasive method for dermal structure evaluation using a green light-emitting diode (LED) with cross-polarized light (CPL) imaging and compare the quality of the images taken using either green or white LED. MATERIALS AND METHODS Skin specimens were taken from fifteen cadavers. Images were captured using CPL photography with a green or white LED. The Commission International d'Eclairage L*a*b* (CIELAB) values were calculated for each image. The skin specimens were processed and stained with Masson's trichrome to visualize collagen fibers with major image scattering. The images were histologically analyzed, and correlational and regression analyses were performed to determine the relationship between the L* values and histologic measurements. RESULTS The L* values for the green images were positively correlated with collagen fiber density, reticular collagen bundle diameter, and dermal thickness. They were effective for estimating dermal properties. The L* values for the white images were positively correlated with reticular collagen bundle diameter and dermal thickness. Correlational coefficients for white images were lower than those for green images. In regression analysis, green images showed a higher coefficient of determination (R2 ) for predicting reticular collagen bundle diameter than white images (0.1128 vs. 0.0827). CONCLUSION Cross-polarized light imaging with a green LED is a simple, non-invasive method for evaluating dermal structures. The use of a green LED was also more effective for image analysis.
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A simple morphometric analysis method for dermal microstructure using color thresholding and moments. Skin Res Technol 2019; 26:132-136. [PMID: 31541511 DOI: 10.1111/srt.12776] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/28/2019] [Accepted: 08/22/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Proper assessment of dermal collagen fibers by dermatologists and researchers is essential. Histologic evaluation methods have limitations. We present a simple method for measurement of collagen fibers in human skin using Masson's trichrome staining. MATERIALS AND METHODS Normal skin specimens from a cadaver were processed with Masson's trichrome, which can effectively stain collagen fibers blue with aniline dye. Optical photomicrographs of these slides were analyzed using ImageJ software. Color image processing, a histogram-based function of ImageJ for image segmentation, was performed with color moments thresholding technique. We selected blue areas by adjusting the blue channel to include specific values. The selected areas were highlighted and evaluated. We divided the image into layers of 0.09-mm2 areas from the top to bottom of the dermis. Each area was cropped and evaluated. RESULTS Quantitative assessment yielded the quantitative size occupied by collagen fibers in an area of 0.09 mm2 . Calculation of the percentage in each area can be used to determine the density of collagen fibers. CONCLUSION Measurements obtained with our method can be applied to research on dermal collagen fibers. We present a convenient quantitative assessment method for the dermal constituents in Masson's trichrome-stained slides.
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Lightening Effect of a Light-Emitting Diode Mask on Facial Skin: A Colorimetric Assessment. Ann Dermatol 2019; 31:247-248. [PMID: 33911584 PMCID: PMC7992664 DOI: 10.5021/ad.2019.31.2.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 11/25/2022] Open
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Demographic and clinical features of hidradenitis suppurativa in Korea. J Dermatol 2018; 45:1389-1395. [PMID: 30294846 DOI: 10.1111/1346-8138.14656] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/16/2018] [Indexed: 11/29/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin disorder. Although several epidemiological studies have been conducted in Western countries, such data regarding Asian populations are scarce. In this study, we sought to investigate the demographic and clinical features of HS in Korea. A total of 438 patients, diagnosed with HS from May 2007 to April 2017, were enrolled and the electronic medical record of each patient was reviewed. Male patients were predominant with a male : female ratio of 2.5:1. Mean age of disease onset was 23.9 years and most patients had no family history. The most frequently affected area was the buttocks, followed by axillae and groin. Acne and diabetes mellitus were the most prevalent associated diseases and no patients with inflammatory bowel diseases were observed. In the univariable analysis, male patients had severe diseases compared with females with an odds ratio (OR) of 1.790. Two or more affected body regions were associated with HS severity with an OR of 1.693. While involvement of the perineum (OR, 4.067) and buttocks (OR, 1.471) tended to be associated with increased severity of the disease, the inguinal area (OR, 0.620) showed a tendency to be inversely associated with the severity. In multivariable analysis, identified risk factors were the involvement of the perineum (OR, 3.819) and buttocks (OR, 2.288). Smoking status and high body mass index seemed to be associated with more severe diseases. Our results will provide clinical characteristics of HS patients in Asia and help to broaden understanding of HS.
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Low‐fluence Q‐switched Nd:YAG laser for the treatment of melasma in Asian patients. J Cosmet Dermatol 2018; 17:1053-1058. [DOI: 10.1111/jocd.12760] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/05/2018] [Accepted: 07/31/2018] [Indexed: 11/27/2022]
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A man with macroglossia and hemorrhagic bulla. JAAD Case Rep 2018; 4:399-401. [PMID: 29984262 PMCID: PMC6031481 DOI: 10.1016/j.jdcr.2017.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Correlations between histopathologic and dermoscopic findings in Korean actinic keratosis. Microsc Res Tech 2018; 82:12-17. [DOI: 10.1002/jemt.23043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/06/2018] [Accepted: 04/04/2018] [Indexed: 11/10/2022]
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Epidemiological and clinical features of rosacea in Korea: A multicenter cross-sectional study. J Dermatol 2018; 45:546-553. [PMID: 29574999 DOI: 10.1111/1346-8138.14281] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 02/05/2018] [Indexed: 11/29/2022]
Abstract
Rosacea is a common chronic inflammatory skin condition. Although several epidemiological and etiologic studies with large sample sizes have been conducted on Caucasians, such data regarding Asian populations are lacking. A total of 580 patients diagnosed with rosacea were enrolled from October 2014 to February 2015 at 14 general hospitals. Questionnaires, including the standard classification and grading system, were used for evaluation. The average age of the patients was 47.9 years. While 83.8% of patients revealed a single subtype, 16.2% of patients revealed mixed subtypes showing two or more subtypes simultaneously. Erythematotelangiectatic rosacea (ETR) was the most prevalent subtype. ETR combined with papulopustular rosacea showed the highest proportion in the mixed subtype group. Mild severity was revealed in 71.9% of patients. The most common aggravating factor was emotional changes (51.7%), followed by stress (48.4%). Approximately half of the patients (47.4%) showed relatively low awareness of rosacea. By identifying the epidemiological and etiologic features in Korea, we can suggest valuable clinical avenues for research, education and awareness among rosacea patients.
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Clinical experience of ingenol mebutate gel for the treatment of Bowen's disease. J Dermatol 2018; 45:425-430. [DOI: 10.1111/1346-8138.14240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/25/2017] [Indexed: 01/17/2023]
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Features Causing Confusion between Basal Cell Carcinoma and Squamous Cell Carcinoma in Clinical Diagnosis. Ann Dermatol 2017; 30:64-70. [PMID: 29386834 PMCID: PMC5762478 DOI: 10.5021/ad.2018.30.1.64] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 07/28/2017] [Accepted: 08/01/2017] [Indexed: 01/03/2023] Open
Abstract
Background Although squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) can be easily diagnosed clinically, proper diagnosis is sometimes difficult when based on clinical information alone. Objective To know what causes clinical misdiagnosis between SCC and BCC, and evaluate whether dermoscopy can improve diagnostic accuracy. Methods Clinical and dermoscopic photographs of inversely diagnosed cases (histologically confirmed BCC with a clinical impression of SCC or vice versa) were randomly presented to six dermatologists and the reasons for each correct or incorrect diagnosis were analyzed. Results Among 154 cases (SCCs or BCCs), 13 cases were inversely diagnosed; 9 SCCs were clinically misdiagnosed as BCC and 4 BCCs were clinically misdiagnosed as SCC. Clinically, scales, pigmentation and rolled border were meaningful factors to discern two carcinomas. Scales without both pigmentation and rolled border was favored for SCC, but BCC favored vice versa. Ulceration, telangiectasia and translucency contributed as confusing factors for proper diagnosis. Dermoscopy improved overall diagnostic accuracy to odds ratio 2.86. Conclusion SCC has a higher tendency to be clinically misdiagnosed as BCC than vice versa. Pigmentation and rolled border are factors causing misdiagnosis of SCC as BCC and BCC may be misdiagnosed as SCC in the presence of scaling. Dermoscopy seems to improve the clinical diagnostic accuracy but has limitations for some ambiguous lesions.
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A Type II Segmental Vitiligo Developed under Infliximab Treatment for Ulcerative Colitis. Ann Dermatol 2017; 29:826-827. [PMID: 29200787 PMCID: PMC5705380 DOI: 10.5021/ad.2017.29.6.826] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/28/2016] [Accepted: 12/14/2016] [Indexed: 11/08/2022] Open
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Relationship between skin color and solar elastosis in aged Asian skin: A colorimetric-pathologic correlation. Microsc Res Tech 2017; 80:1073-1077. [PMID: 28602047 DOI: 10.1002/jemt.22901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 05/04/2017] [Accepted: 05/28/2017] [Indexed: 11/11/2022]
Abstract
Aged skin is reported to be associated with unattractive skin color changes and solar elastosis. However, comparative studies have not documented the possible correlation between the two factors. This study investigated the plausible relationship between the facial skin color of elderly Asians and solar elastosis. A total of 22 skin specimens were collected from 22 Korean patients who underwent cheek skin biopsies. Skin color was quantitatively measured using colorimetric photography techniques to produce CIE L*a*b* values; the degree of solar elastosis was quantifiably assessed using a histologic grading scale. These values were used to investigate a correlation between the CIE L*a*b* coordinates and solar elastosis grade. The solar elastosis grade increased according to patient age (r = 0.67, p = .0006). However, the extent of solar elastosis was not statistically correlated with the CIE L*a*b* values, including L*, a*, and b* (r = 0.02, p = .95; r = 0.15, p = 0.50; r = -0.07, p = 0.76, respectively). The results showed that the solar elastosis grade increased, according to patient age, because of cumulative actinic damage. However, colorimetric skin color data did not correlate with the degree of solar elastosis. Therefore, cutaneous color changes and solar elastosis are separate, age-related phenomena. Physicians should be aware of the possible histologic changes in actinically damaged facial skin, regardless of the skin color.
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Rosacea Subtypes Visually and Optically Distinct When Viewed with Parallel-Polarized Imaging Technique. Ann Dermatol 2017; 29:167-172. [PMID: 28392643 PMCID: PMC5383741 DOI: 10.5021/ad.2017.29.2.167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/08/2016] [Indexed: 11/28/2022] Open
Abstract
Background Parallel-polarized light (PPL) photography evaluates skin characteristics by analyzing light reflections from the skin surface. Objective The aim of this study was to determine the significance of quantitative analysis of PPL images in rosacea patients, and to provide a new objective evaluation method for use in clinical research and practice. Methods A total of 49 rosacea patients were enrolled. PPL images using green and white light emitting diodes (LEDs) were taken of the lesion and an adjacent normal area. The values from the PPL images were converted to CIELAB coordinates: L* corresponding to the brightness, a* to the red and green intensities, and b* to the yellow and blue intensities. Results A standard grading system showed negative correlations with L* (r=−0.67862, p=0.0108) and b* (r=−0.67862, p=0.0108), and a positive correlation with a* (r=0.64194, p=0.0180) with the green LEDs for papulopustular rosacea (PPR) types. The xerosis severity scale showed a positive correlation with L* (r=0.36709, p=0.0276) and a negative correlation with b* (r=−0.33068, p=0.0489) with the white LEDs for erythematotelangiectatic rosacea (ETR) types. In the ETR types, there was brighter lesional and normal skin with white LEDs and a higher score on the xerosis severity scale than the PPR types. Conclusion This technique using PPL images is applicable to the quantitative and objective assessment of rosacea in clinical settings. In addition, the two main subtypes of ETR and PPR are distinct entities visually and optically.
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Analysis of Korean acne patients according to age groups based on two multicenter studies. J Dermatol 2016; 44:186-188. [PMID: 27790755 DOI: 10.1111/1346-8138.13642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/30/2016] [Indexed: 10/20/2022]
Abstract
Along with increasing public concerns on acne and its complications, increasing treatment options seem to lead more acne patients to clinics globally, including Korea. The aim of the present study was to investigate the number and distribution of acne patients according to age group by analyzing number and age of outpatients from several general hospitals in Korea. Two retrospective multicenter studies including 14 general hospitals for a maximum of 10 years were conducted by medical chart review of acne patients. During the last 10 years, total acne patients have increased by 60% in number and patients under the age of 19 years have doubled. Adult acne patients (aged >18 years) accounted for the biggest portion in total acne patients at over 80%. Although upper grade of elementary school patients (aged 10-12 years) accounted for the biggest portion among the childhood acne patients, children under 10 years have also increased rapidly by 73% during the last 10 years. Childhood acne patients (aged <13 years) accounted for 11% of total acne patients. We found that acne patients were increasing consistently and the portion of those aged under 19 years is getting bigger. Additionally, childhood acne patients have increased remarkably.
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Cutaneous Metastatic Rectal Adenocarcinoma in Zosteriform Distribution. Ann Dermatol 2016; 28:393-5. [PMID: 27274644 PMCID: PMC4884722 DOI: 10.5021/ad.2016.28.3.393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/04/2015] [Accepted: 06/01/2015] [Indexed: 11/26/2022] Open
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Application of Analytic Technique Using Green Light Parallel-Polarized Light Images in Various Skin Diseases. Ann Dermatol 2016; 28:242-5. [PMID: 27081274 PMCID: PMC4828390 DOI: 10.5021/ad.2016.28.2.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/07/2015] [Accepted: 04/08/2015] [Indexed: 11/08/2022] Open
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Nicolau syndrome involving whole ipsilateral limb induced by intramuscular administration of gentamycin. Indian J Dermatol Venereol Leprol 2016; 80:96. [PMID: 24448148 DOI: 10.4103/0378-6323.125516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Pathogenesis of Plantar Epidermal Cyst: Three-Dimensional Reconstruction Analysis. Ann Dermatol 2016; 28:133-5. [PMID: 26848239 PMCID: PMC4737825 DOI: 10.5021/ad.2016.28.1.133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 11/08/2022] Open
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Adult Multiple Myofibromas on an Atrophic Patch on the Thigh. Ann Dermatol 2015; 27:622-3. [PMID: 26512183 PMCID: PMC4622903 DOI: 10.5021/ad.2015.27.5.622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/14/2014] [Accepted: 11/21/2014] [Indexed: 11/08/2022] Open
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Synchronous Onset of Symmetrically Associated Extragenital Lichen Sclerosus and Vitiligo on both Breasts and the Vulva. Ann Dermatol 2015; 27:456-7. [PMID: 26273168 PMCID: PMC4530162 DOI: 10.5021/ad.2015.27.4.456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 07/21/2014] [Accepted: 08/12/2014] [Indexed: 11/18/2022] Open
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Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis. Ann Dermatol 2015; 27:404-10. [PMID: 26273156 PMCID: PMC4530150 DOI: 10.5021/ad.2015.27.4.404] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 11/18/2014] [Accepted: 11/23/2014] [Indexed: 11/16/2022] Open
Abstract
Background Pigmented purpuric dermatoses (PPD) are a spectrum of disorders characterized by a distinct purpuric rash. Although PPD can be easily diagnosed, the disease entity remains an enigma and a therapeutic challenge. Objective The purpose of this study was to investigate the characteristics and clinical manifestations of PPD and to elucidate the relationship between assumed etiologic factors and the clinical manifestations of PPD and treatment responses. Methods Retrograde analyses were performed to identify appropriate PPD patients who visited Korea University Medical Center Anam Hospital from 2002 to 2012. Results Information on 113 patients with PPD was analyzed, and 38 subjects with skin biopsy were included for this study. Schamberg's disease was the most frequent clinical type (60.5%). Concomitant diseases included hypertension (15.8%), diabetes (10.5%), and others. Associated medication histories included statins (13.2%), beta blockers (10.5%), and others. Possibly associated etiologic factors were recent upper respiratory infection (5.3%), high orthostatic pressure due to prolonged standing (2.6%), and strenuous exercise (2.6%). A total of 36 patients (94.7%) were treated with one or more treatment methods, including oral antihistamines, pentoxifylline, topical steroids, and/or phototherapy. There was no significant difference in disease progress according to underlying diseases, medications, or association factors (p>0.05). Conclusion Our overall results were grossly consistent with the existing literature, excluding several findings. Although a possible relationship between PPD and cardiovascular disease or cardiovascular medication was proposed at the beginning of the study, no statistically significant correlations were found according to the specific clinical types and treatment responses (p>0.05).
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Egr-1 is a key regulator of IL-17A-induced psoriasin upregulation in psoriasis. Exp Dermatol 2015; 23:890-5. [PMID: 25256120 DOI: 10.1111/exd.12554] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2014] [Indexed: 12/11/2022]
Abstract
The early growth response (Egr)-1 is a transcriptional factor which plays an important role in the regulation of cell growth, differentiation, cell survival and immune responses. Emerging evidences including our data demonstrate that the Egr-1 expression is up-regulated in the psoriatic skin lesions. The purpose of this study was to investigate the significance and regulatory mechanism of Egr-1 in the pathogenesis of psoriasis. Through microarray analysis, we found out that psoriasin (S100A7) expression was increased in the Egr-1 overexpressed cells. Our results showed that IL-17A increased Egr-1 expression in the skin of psoriatic patients and cultured human keratinocytes. We then investigated activation of mitogen-activated protein kinase as an upstream signal regulator of Egr-1 expression. IL-17A-induced Egr-1 expression was suppressed by ERK inhibitor. In addition, IL-17A induced psoriasin expression in cultured keratinocytes and the skin of IL-17A intradermally injected mouse. IL-17A-mediated psoriasin upregulation was reduced after treatment of small interfering RNAs against Egr-1. Furthermore, the results of chromatin immunoprecipitation assays demonstrated that Egr-1 directly binds the psoriasin promoter. Our findings present a novel signalling mechanism by which IL-17A can induce the Egr-1-dependent psoriasin expression via the ERK pathway in human keratinocytes. This study suggests that Egr-1 may be a novel and important modulator in IL-17A-mediated immune response in psoriasis.
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Thymic stromal lymphopoietin downregulates filaggrin expression by signal transducer and activator of transcription 3 (STAT3) and extracellular signal-regulated kinase (ERK) phosphorylation in keratinocytes. J Allergy Clin Immunol 2015; 136:205-208.e9. [DOI: 10.1016/j.jaci.2015.04.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 03/23/2015] [Accepted: 04/10/2015] [Indexed: 11/25/2022]
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Polycyclic Annular Lesion Masquerading as Lupus Erythematosus and Emerging as Tinea Faciei Incognito. Ann Dermatol 2015; 27:322-5. [PMID: 26082592 PMCID: PMC4466288 DOI: 10.5021/ad.2015.27.3.322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 11/12/2014] [Indexed: 11/13/2022] Open
Abstract
Tinea incognito is a dermatophytic infection induced by immunosuppressive agents that lacks the classic features of a typical fungal infection. Although the treatment of tinea incognito is simple and relatively easy, its clinical manifestation varies and can masquerade as various skin disorders, causing misdiagnosis and thus preventing prompt and appropriate treatment. Here, we report an interesting case of tinea incognito occurring after topical steroid administration in an immunosuppressed patient with dermatitis artefacta. A 40-year-old female patient who had been taking systemic glucocorticoid for 4 years for chronic inflammatory demyelinating polyneuropathy presented with itching multiple erythematous erosive lesions on the face and upper chest for 2 months. Initial biopsy produced nonspecific findings. The skin lesion was aggravated and became polycyclic and erythematous; after azathioprine was added, her chronic inflammatory demyelinating polyneuropathy became aggravated. A second biopsy confirmed hyphae in the cornified layer. Complete remission was achieved after admonishing oral terbinafine and topical amorolfine.
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The suitability of gray-scale electronic readers for dermatology journals. Ann Dermatol 2014; 26:700-5. [PMID: 25473221 PMCID: PMC4252666 DOI: 10.5021/ad.2014.26.6.700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/17/2014] [Accepted: 02/23/2014] [Indexed: 12/12/2022] Open
Abstract
Background The rapid development of information and communication technology has replaced traditional books by electronic versions. Most print dermatology journals have been replaced with electronic journals (e-journals), which are readily used by clinicians and medical students. Objective The objectives of this study were to determine whether e-readers are appropriate for reading dermatology journals, to conduct an attitude study of both medical personnel and students, and to find a way of improving e-book use in the field of dermatology. Methods All articles in the Korean Journal of Dermatology published from January 2010 to December 2010 were utilized in this study. Dermatology house officers, student trainees in their fourth year of medical school, and interns at Korea University Medical Center participated in the study. After reading the articles with Kindle 2, their impressions and evaluations were recorded using a questionnaire with a 5-point Likert scale. Results The results demonstrated that gray-scale e-readers might not be suitable for reading dermatology journals, especially for case reports compared to the original articles. Only three of the thirty-one respondents preferred e-readers to printed papers. The most common suggestions from respondents to encourage usage of e-books in the field of dermatology were the introduction of a color display, followed by the use of a touch screen system, a cheaper price, and ready-to-print capabilities. Conclusion In conclusion, our study demonstrated that current e-readers might not be suitable for reading dermatology journals. However, they may be utilized in selected situations according to the type and topic of the papers.
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Retreatment using a dual mode of low-fluence Q-switched and long-pulse Nd:YAG laser in patients with melasma aggravation after previous therapy. J COSMET LASER THER 2014; 17:129-34. [PMID: 25415369 DOI: 10.3109/14764172.2014.988730] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Aggravated melasma after treatment is vulnerable to stimulation, can easily deteriorate, and may be distressing without proper management. OBJECTIVE To retrospectively assess the effectiveness and safety of combination therapy using low-fluence Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (QSNY) and long-pulse Nd:YAG laser (LPNY) (dual toning) in patients with rebound melasma. MATERIALS AND METHODS A total of 30 patients with aggravated melasma after previous therapy who were treated with dual toning were enrolled. A total of 10 sessions were conducted at 1-week intervals, followed by maintenance treatment. The results were evaluated using the modified Melasma Area and Severity Index (mMASI) and the physician's global assessment (PGA) before and 2 months after completing the 10 treatment sessions. RESULTS The baseline mMASI was 10.48 ± 3.64, which significantly decreased to 3.22 ± 1.45 2 months after completing the 10 treatment sessions (p < 0.001). Twenty-four patients (80%) had PGA grade 4 (76-100% improvement) and 6 patients (20%) had PGA grade 3 (51-75% improvement). CONCLUSION Dual toning may be a safe and effective salvage treatment for patients with aggravated melasma after previous treatment. LPNY may stabilize melasma activity to prevent rebound hyperpigmentation via dermal remodeling.
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Retrospective analysis of melasma treatment using a dual mode of low-fluence Q-switched and long-pulse Nd:YAG laser vs. low-fluence Q-switched Nd:YAG laser monotherapy. J COSMET LASER THER 2014; 17:2-8. [DOI: 10.3109/14764172.2014.957217] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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A Comparison of the Scar Prevention Effect Between Carbon Dioxide Fractional Laser and Pulsed Dye Laser in Surgical Scars. Dermatol Surg 2014; 40:973-8. [DOI: 10.1097/01.dss.0000452623.24760.9c] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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A retrospective analysis of the clinical efficacies of Q-switched Alexandrite and Q-switched Nd:YAG lasers in the treatment of nevus of Ota in Korean patients. J DERMATOL TREAT 2014; 26:240-5. [PMID: 24888365 DOI: 10.3109/09546634.2014.930409] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND While the Q-switched Alexandrite laser (QSAL) and the Q-switched neodymium: yttrium-aluminum-garnet (QSNY) laser have been widely used in treating nevus of Ota, few studies compared them. OBJECTIVE To compare the efficacies of the QSAL and the QSNY laser in the treatment of nevus of Ota in Korean patients. METHODS AND MATERIALS A retrospective multicenter study was conducted in 76 patients with nevus of Ota. Thirty-one patients were treated with a QSAL (5.5-8.0 J/cm(2), 4-mm spot size) and 45 patients were treated with QSNY laser (6.0-12.0 J/cm(2), 2-mm spot size). Treatment outcomes were categorized into five grades and the results were compared with the relevant variables taken into account using multivariate logistic regression analysis. RESULTS QSAL treatment was more likely to achieve a better response compared with that with QSNY laser treatment. The odds ratio of achieving an excellent response, compared with the odds ratio of having a poor response, was 12.213-times more likely when a QSAL was used than when a QSNY laser was used (p = 0.026). CONCLUSION The QSAL tends to be more efficient than the QSNY laser in the treatment of nevus of Ota in Korean patients. Further controlled, prospective comparison studies are needed.
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3D reconstruction of skin pathological tissue: the understanding of microrelief pattern and dermal ridge. Skin Res Technol 2013; 20:213-7. [PMID: 23981137 DOI: 10.1111/srt.12108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2013] [Indexed: 11/28/2022]
Abstract
AIM Most studies about the structures of the human skin have been on the general histologic features of the skin. The purpose of this study was to understand the relationship between the microrelief (MR) pattern and histologic structure of the human skin, and to find the usefulness of the three-dimensional reconstruction (3DR) technique of pathological skin tissue. MATERIALS, SUBJECTS, AND METHODS Human skin specimens were obtained from the medial forearm, abdomen, and volar aspects of the finger tips of cadavers. Two-dimensional surface-viewed images of the skin showing MR patterns were obtained using dry dermoscopy. Histologic structures of the skin were evaluated by 3D images obtained using the 3DR technique. RESULTS MR was deeper and wider in the abdomen than in the medial side of the forearm. In the medial side of the forearm, 10.27 rete ridges were distributed in a plateau, on average. In the abdomen, about 14.37 rete ridges were distributed in a plateau. From 3DR technique, MR pattern thought to be a superordinate concept to rete ridges. CONCLUSION The 3DR technique was useful and may allow a better understanding of the pathogenetic changes in the skin surface in aging skin.
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Ablative fractional laser treatment for hypertrophic scars: comparison between Er:YAG and CO2 fractional lasers. J DERMATOL TREAT 2013; 25:299-303. [PMID: 23621348 DOI: 10.3109/09546634.2013.782090] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Nonablative fractional photothermolysis has been reported to show early promise in the treatment of hypertrophic scars, but there are few reports on ablative fractional photothermolysis for the treatment of hypertrophic scars. AIM To evaluate and compare the efficacy and safety of Er:YAG fractional laser (EYFL) and CO2 fractional laser (CO2FL) for treatment of hypertrophic scars. METHODS Thirteen patients with hypertrophic scars were treated with 2,940 nm EYFL, and ten were treated with 10,600 nm CO2FL. An independent physician evaluator assessed the treatment outcomes using Vancouver scar scale (VSS) and 5-point grading scale (grade 0, no improvement; grade 1, 1-25%; grade 2, 26-50%; grade 3, 51-75%; grade 4, 76-100% improvement). Patients are queried about their subjective satisfaction with the treatment outcomes. RESULTS After the final treatment, average percentage changes of VSS were 28.2% for EYFL and 49.8% for CO2FL. Improvement was evident in terms of pliability, while insignificant in terms of vascularity and pigmentation. Based on physician's global assessment, mean grade of 1.8 for EYFL and 2.7 for CO2FL was achieved. Patient's subjective satisfaction scores paralleled the physician's objective evaluation. CONCLUSION CO2FL is a potentially effective and safe modality for the treatment of hypertrophic scars, particularly in terms of pliability.
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Abstract
Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 ± 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.
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Recalcitrant cutaneous ulcer of comorbid patient treated with platelet rich plasma: a case report. J Korean Med Sci 2012; 27:1604-6. [PMID: 23255868 PMCID: PMC3524448 DOI: 10.3346/jkms.2012.27.12.1604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 08/22/2012] [Indexed: 11/20/2022] Open
Abstract
The platelet-rich plasma (PRP) has been advocated as a way to introduce increased concentrations of growth factors and other bioactive molecules to injured tissues in an attempt to optimize the local healing environment. A 94-yr-old woman with various comorbidities presented with a two-week history of severe cutaneous ulcer on the left dorsum of foot. It was caused by recurrent mechanical trauma and did not respond to several wound debridement and simple dressings. However, after she was completed on seven times of autologous PRP treatments, we observed complete healing of the skin lesion within 3 months. Herein, we report a case of recalcitrant cutaneous ulcer with various comorbidities and discuss about the promising possibility of autologous PRP as an effective alternative therapeutic modality.
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A case of squamous cell carcinoma treated with chlorine photodynamic therapy. Ann Dermatol 2012. [PMID: 23197925 PMCID: PMC3505790 DOI: 10.5021/ad.2012.24.4.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Phacomatosis pigmentokeratotica without extracutaneous abnormalities: a case study involving a preterm baby. J Korean Med Sci 2012; 27:1444-6. [PMID: 23166433 PMCID: PMC3492686 DOI: 10.3346/jkms.2012.27.11.1444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 07/27/2012] [Indexed: 11/20/2022] Open
Abstract
Phacomatosis pigmentokeratotica (PPK) is a rare syndrome defined by the association of an organoid nevus occasionally with sebaceous differentiation, a speckled lentiginous nevus, and other extracutaneous anomalies. A preterm male infant of only 830 g at 27 week gestational age had an organoid nevus showing sebaceous differentiation. Also, he had multiple speckled-lentiginous nevus. Correlating the observed clinical presentation with the histopathological findings, the diagnosis of PPK was established. There have been less than 10 cases of PPK without extracutaneous manifestation. We present an uncommon case of a preterm patient with PPK who had no extracutaneous abnormalities.
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The basic chromospheres of skin that might not be differentiated visually: observations on aneurysmal fibrous histiocytomas and malignant melanomas. Skin Res Technol 2012; 19:e521-4. [DOI: 10.1111/srt.12004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2012] [Indexed: 11/28/2022]
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A nationwide study of acne treatment patterns in Korea: analysis of patient preconceived notions and dermatologist suggestion for treatment. Acta Derm Venereol 2012; 92:236-40. [PMID: 22367348 DOI: 10.2340/00015555-1331] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients often have preconceived notions about acne treatments before visiting dermatologists. The aim of this study was to explore the association between patients' beliefs regarding acne and physicians' suggestion for treatment modality in dermatology clinics. A cross-sectional, nationwide multicentre study was conducted. A total of 1,370 patients completed questionnaires about beliefs about acne treatment before seeking medical care, and 101 dermatologists assessed their acne severity and proposed treatment methods. We found that patients had preconceptions in understanding disease characteristics, assessing subjective acne severity and preferring specific treatment modalities. Dermatologists' determination of topical agents as first-line treatment was affected by disease severity and patients' preferences. They were also more likely to prescribe isotretinoin even in moderate acne compared to oral antibiotics and topical agents. Selections of physical treatments and light-based therapies were affected by patients' preferences, subjective self-evaluation and dermatologists' assessments. Thus, we suggest that acne treatment strategies should incorporate both patients' subjective perceptions and objective clinical practices into a management paradigm.
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Abstract
The distinction of a spitz nevus from a melanoma can be difficult and in some cases, impossible. A misdiagnosed spitz nevus can metastasize and lead to fatal outcomes, especially in children. A 5-yr-old girl presented with a 1-yr history of a solitary pinkish nodule on her left hand. On physical examination, she had a palpable left axillary lymph node. We performed biopsy and checked 3 sentinel lymph nodes (SLN) on her axillary area. The biopsy specimen showed multiple variably sized and shaped nests with large spindle or polygonal cells and SLN biopsy showed 3 of 3 lymph nodes that were metastasized. Under the diagnosis of spitzoid melanoma, she was treated with excision biopsy and complete left axillary lymph nodes were dissected. She received interferon-α2b subcutaneously at a dose of 8 MIU per day, 3 times weekly for 12 months, and shows no recurrence.
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Cigarette smoke-induced early growth response-1 regulates the expression of the cysteine-rich 61 in human skin dermal fibroblasts. Exp Dermatol 2011; 20:992-7. [PMID: 21995436 DOI: 10.1111/j.1600-0625.2011.01380.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Tobacco smoke is known to be an element contributing to accelerate premature skin ageing. Cysteine-rich 61 (Cyr61) is a member of the connective tissue factor CCN (Cyr61, CTGF and Nov) family, and early growth response-1 (Egr-1) is a generally expressed member of the zinc-finger family of transcription factors. To investigate the regulatory potential of Egr-1 on expression of Cyr61 by smoking, this study examined the hypothesis that cigarette smoke-induced Egr-1 induces expression of Cyr61 in human skin dermal fibroblasts (HSDF). HSDF were exposed to different concentrations of cigarette smoke extract (CSE) for 24 h; a cytotoxicity assay was then performed for the detection of cell proliferation. Results of Western blot and reverse transcription-polymerase chain reaction (RT-PCR) showed that CSE induces a transient synthesis of Egr-1 in HSDF. Cyr61 mRNA and protein levels showed a marked increase in a time-dependent manner after CSE exposure. Following transfection with an Egr-1 overexpression vector, HSDF showed increased activity of the Cyr61 promoter in a dose-dependent manner. Using Egr-1 interfering RNA, we confirmed that CSE-induced Cyr61 expression was dependent on Egr-1 expression. Findings of this study indicate that Egr-1-dependent induction of Cyr61 may contribute to premature skin ageing by smoking.
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Syringocystadenoma Papilliferum in Co-existence with Tubular Apocrine Adenoma on the Calf. Ann Dermatol 2011; 23:S175-8. [PMID: 22148043 PMCID: PMC3229058 DOI: 10.5021/ad.2011.23.s2.s175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 01/26/2011] [Accepted: 01/26/2011] [Indexed: 11/24/2022] Open
Abstract
Syringocystadenoma papilliferum (SCAP) occurs singly or in association with other tumors. Although it is rare, the association of tubular apocrine adenoma (TAA) with SCAP in the background of nevus sebaceous (NS) on the scalp is well documented. However, the co-existence of these two tumors without background of NS has not been reported on the extremities. We report a case of SCAP associated with TAA on the calf without pre-existing NS in an adult.
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Better understanding of digital photography for skin color measurement: With a special emphasis on light characteristics. Skin Res Technol 2011; 17:20-5. [PMID: 20923467 DOI: 10.1111/j.1600-0846.2010.00468.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM Digital photography can be used to measure skin color colorimetrically when combined with proper techniques. To better understand the settings of digital photography for the evaluation and measurement of skin colors, we used a tungsten lamp with filters and the custom white balance (WB) function of a digital camera. MATERIALS AND METHODS All colored squares on a color chart were photographed with each original and filtered light, analyzed into CIELAB coordinates to produce the calibration method for each given light setting, and compared statistically with reference coordinates obtained using a reflectance spectrophotometer. They were summarized as to the typical color groups, such as skin colors. We compared these results according to the fixed vs. custom WB of a digital camera. RESULTS The accuracy of color measurement was improved when using light with a proper color temperature conversion filter. The skin colors from color charts could be measured more accurately using a fixed WB. In vivo measurement of skin color was easy and possible with our method and settings. CONCLUSION The color temperature conversion filter that produced daylight-like light from the tungsten lamp was the best choice when combined with fixed WB for the measurement of colors and acceptable photographs.
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Up-regulation of TNF-alpha secretion by cigarette smoke is mediated by Egr-1 in HaCaT human keratinocytes. Exp Dermatol 2011; 19:e206-12. [PMID: 20653771 DOI: 10.1111/j.1600-0625.2009.01050.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Many epidemiologic studies have pointed to a significant association between cigarette smoking and inflammatory skin disease such as psoriasis. Cigarette smoke induces expression of regulators of inflammation such as interleukin (IL)-1, IL-6, IL-8 and tumor necrosis factor (TNF)-alpha. It was recently demonstrated that early growth response-1 (Egr-1) transcription factor is significantly up-regulated in the skin lesions of patients with psoriasis. The mechanism by which cigarette smoke extract (CSE) regulates inflammatory cytokine expression in keratinocyte was still unknown. The aim of this study was to investigate the signalling of CSE-induced Egr-1 expression and the role for Egr-1 in CSE-induced TNF-alpha expression. Cytotoxicity of CSE in HaCaT cells was measured by thiazolyl blue tetrazolium bromide (MTT) assay. CSE-induced Egr-1 expression was investigated by western blot, luciferase reporter assay and confocal microscopy. TNF-alpha expression was measured by reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay. Involvement of Egr-1 in CSE-induced TNF-alpha secretion was determined by using Egr-1 specific siRNA. CSE increases the Egr-1 expression, promoter activity and its nuclear translocation in human HaCaT keratinocytes. CSE activates mitogen-activated protein kinase (MAPK) pathways including extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK). Up-regulation of Egr-1 expression by CSE stimulation was found to be inhibited by an ERK and JNK but not p38 inhibitor. CSE increases TNF-alpha expression and secretion. This increase is mediated by CSE-induced Egr-1 expression. Our results showed that CSE induces Egr-1 expression via MAPK pathway in human keratinocytes and TNF-alpha expression by Egr-1. This pathway may contribute to the development of inflammatory disease such as psoriasis.
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A quantitative assessment of the human skin surface using polarized light digital photography and its dermatologic significance. Skin Res Technol 2010; 16:270-4. [PMID: 20636994 DOI: 10.1111/j.1600-0846.2010.00439.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Quantitative and objective investigations of parallel-polarized light (PPL) photography for dermatologic purposes are scarce. OBJECTIVE To determine the significance of quantitative analysis of PPL photography to develop objective measurement methods of skin surface characteristics. METHOD For PPL photography, a digital camera, a light-emitting diode illuminator, and polarizing filters were arranged and kept constant. We analyzed the PPL photography images of the glabella, the medial aspect of the forearm, and the posterior aspect of the lower leg, and measured the CIELAB values. A dermatologist evaluated the clinical severity of the actual photographed sites with respect to glossiness and dryness. These clinical severities were compared statistically with the CIELAB values. RESULTS According to the correlation analysis, the L* value was negatively correlated with dryness (r=-0.29869, P=0.0047) and glossiness (r=-0.35367, P=0.0185). CONCLUSION The method used in this study is applicable to the quantitative evaluations of other dermatologic diseases or conditions, especially in relation to skin surface changes.
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A novel consistent photomicrography technique using a reference slide made of neutral density filter. Microsc Res Tech 2010; 74:397-400. [PMID: 20812249 DOI: 10.1002/jemt.20921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Accepted: 07/09/2010] [Indexed: 11/07/2022]
Abstract
Obtaining consistent photomicrographic images of pathology slides is not always easy because of many different types and settings of the equipment such as the microscopes and digital cameras. In this study, we developed a photomicrography technique that could acquire consistent images of pathology slides. The neutral density (ND) filter was attached to a transparent glass slide as a reference slide, photographed using consistent settings, and acquired images that harbored all of the areas of gray, white, and black. In the same way, the slide was replaced by the actual pathology slide, and photomicrographed. To simulate different light environment, the above photographic session was repeated using two different light intensities and microscopes. A graphic program was used to adjust levels of the reference slide images and this leveling, or calibration, was saved as a file for each. This file for leveling process was applied to actual subsequent photomicrographic images. The same sites of noncalibrated and calibrated images of the pathology slide were calculated into CIELAB or CIE L*a*b* coordinates. Then, the color differences (ΔE*ab) were calculated. As results, in the study using a 50% transmittance ND filter, two original different images were made nearly identical to the unaided eye, especially in two-point (white and gray) and three-point (black, white, and gray) leveling. In comparison of different light intensities, the ΔE*ab of the selected area was 0.9 in two-point leveling. Between different microscopes, 10.7 of ΔE*ab was the smallest value in three-point leveling. This method would be helpful for acquiring consistent photomicrographic images of pathology slides.
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Cigarette smoke-induced Egr-1 represses TβR-II expression in human skin dermal fibroblasts. Toxicology 2010; 275:29-35. [DOI: 10.1016/j.tox.2010.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2010] [Revised: 05/25/2010] [Accepted: 05/25/2010] [Indexed: 11/24/2022]
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Upregulation of Fas and downregulation of CD94/NKG2A inhibitory receptors on circulating natural killer cells in patients with new-onset psoriasis. Br J Dermatol 2009; 161:281-8. [PMID: 19438461 DOI: 10.1111/j.1365-2133.2009.09178.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Psoriasis has been considered as a T-helper 1 cell-mediated autoimmune disease driven by collaboration with multiple components of innate and acquired immune cells. Natural killer (NK) cells have been shown to bridge innate and acquired immunity, and thus could potentially contribute to the pathophysiology of psoriasis. OBJECTIVES To investigate the phenotypic changes of circulating NK cells in patients with new-onset psoriasis. METHODS Fifteen patients with plaque psoriasis (eight women and seven men) who visited our clinic after their first episode of psoriasis and did not have a history of previous systemic therapy or phototherapy participated in this study. Peripheral blood mononuclear cells were isolated and stained with a panel of antibodies against cell surface receptors expressed on T and/or NK cells and analysed by flow cytometry. RESULTS As compared with normal healthy volunteers, patients with new-onset psoriasis showed no significant changes in numbers of peripheral NK, NK-T or T cells. NK activating receptors 2B4, CD48, NKG2D, CD16 and CD56 were found to be unchanged in new-onset psoriasis. However, the expression of Fas (activation-induced death receptor) was upregulated, whereas the expression of the NK inhibitory receptors CD94 and NKG2A was dramatically reduced on NK cells of new-onset psoriasis. These changes occurred at the level of mean fluorescent intensity, but minimally affected percentages of cells expressing Fas, CD94 and NKG2A. CONCLUSIONS Our findings demonstrate that changes in the expression of Fas and CD94/NKG2A receptors on NK cells may occur during new-onset psoriasis, and are likely to contribute to the pathogenesis of psoriasis.
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Treatment-seeking behaviors and related epidemiological features in Korean acne patients. J Korean Med Sci 2008; 23:969-74. [PMID: 19119438 PMCID: PMC2610661 DOI: 10.3346/jkms.2008.23.6.969] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 07/11/2008] [Indexed: 11/20/2022] Open
Abstract
Little is known about the treatment-seeking behaviors of acne patients, especially Asian acne patients. This study was performed to obtain detailed information about the treatment-seeking behaviors in Korean acne patients. Patients who visited the dermatology departments at 17 university hospitals completed a self-administered questionnaire. Most patients obtained information about acne from doctors or the Internet. The most important criteria for selecting a treatment method or choosing a particular clinic were effectiveness and accessibility. Patients used traditional medicine, visited beauty clinics, drank more water, and used over-the-counter topical agents more frequently than they sought doctors during the worsening period. The degree of satisfaction in treatment was found to depend on the total cost of treatment, number of places visited, site affected by acne, and emotional stress. Those who had experienced a side effect tended to have been treated for longer, to have paid more for treatment, and to have an associated skin disease. Treatments prescribed by dermatology clinics had the lowest aggravating rate, although improvement rates for family medicine clinics were also fairly high. This is the first study to investigate in detail the demographic features and characteristics of the treatment-seeking behaviors of acne patients in Asia.
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Precursor B-cell lymphoblastic lymphoma presenting as solitary infiltrative plaque in a child. Acta Derm Venereol 2008; 88:282-4. [PMID: 18480935 DOI: 10.2340/00015555-0402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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