A Sporadic Case of Mal de Meleda Caused by Gene Mutation in SLURP-1 in Korea

Mal de Meleda (MDM), also known as keratoderma palmoplantaris transgrediens, is a rare inherited form of palmoplantar keratoderma. It is characterized by erythema and hyperkeratosis of the palms and soles, extending to the dorsal aspects of the hands and feet. A 15-year-old Korean female presented with sharply demarcated hyperkeratotic plaques on the palms and soles, which extended to the dorsal surfaces of the hands and feet, in a "glove-and-socks" distribution. The histopathologic study showed marked hyperkeratosis, acanthosis, and normogranulosis, without epidermolysis. Her genetic study detected compound heterozygous mutation in exon 3 of the ARS gene encoding SLURP-1. Family history did not reveal any other affected members and no consanguineous relationship was found. In view of these findings, we diagnosed this case as the first reported sporadic case of MDM in Korea, the farthest location from the endemic island of Meleda

Treatment-Seeking Behaviors and Related Epidemiological Features in Korean Acne Patients

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

An Unusual Case of Carcinoma Erysipelatoides Originating from Gastric Adenocarcinoma

Carcinoma erysipelatoides, also known as inflammatory metastatic carcinoma, is a rare form of cutaneous metastasis. It is most commonly caused by breast carcinoma, but rarely associated with gastric adenocarcinoma. Herein, we report an unusual case of carcinoma erysipelatoides in a 55 year-old female who had been diagnosed with signet ring cell carcinoma of the stomach metastasizing to ovaries

Successful Treatment of Cutaneous Lesions of Dermatomyositis with Topical Pimecrolimus

Dermatomyositis (DM) is an idiopathic inflammatory process characterized by proximal muscle weakness and cutaneous lesions, such as the Gottron's sign, heliotrope rash, and erythematous photosensitive rash. Administration of systemic agents for the treatment of underlying systemic diseases leads to remission of the cutaneous lesions in many cases. However, cutaneous lesions may remain refractory to treatment. Pimecrolimus is a calcineurin inhibitor with combined anti-inflammatory and immunomodulatory activity. It has high affinity to the skin and low permeation potential, even in patients with acute skin inflammation and in those undergoing post-topical corticosteroid therapy. We herein report two DM patients whose cutaneous lesions were refractory to conventional treatment but showed dramatic response to topical pimecrolimus. The clinical outcomes suggest that topical pimecrolimus may be a good therapeutic alternative for the management of the cutaneous lesions of DM

Fiddler's Neck Accompanied by Allergic Contact Dermatitis to Nickel in a Viola Player

"Fiddler's neck" is an irritant contact dermatitis that frequently affects violin and viola players. The etiology of the skin changes associated with this condition are probably attributable to a combination of factors--including increased pressure, friction, poor hygiene, and excessive perspiration. Clinically, the lesions generally consist of a localized area of lichenification on the left side of the neck just below the angle of the jaw. Herein, we report a case of fiddler's neck in a viola player, attended by allergic contact dermatitis to the nickel in the metal fixtures of a viola. We hope that our case report draws the attention of dermatologists toward this, and many other skin problems that affect musicians