[P327] Multiple basal cell carcinomas around the nose

( Minkee Park ),( Gi Hyun Sung ),( Myeong Jin Park ),( Mi Soo Choi ),( Seung Phil Hong ),( Myung Hwa Kim ),( Byung Cheol Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Basal cell carcinoma(BCC), the most common cutanenous malignancy, occurs mainly in a single but rarely multiple. Multiple BCCs may occur with genetic disease like nevoid BCC syndrome, Bazex syndrome and Rombo syndrome and with UV radiation and long-term arsenic intake. We herein report a rare case of multiple BCCs around the nose without genetic disease. A 73-year-old female presented with multiple black colored macules, patches and nodule around the nose for about 1 year. Personal medical history was unremarkable. There was no history of sunburn, familial history of BCC nor of arsenic treatment. A skin biopsy was performed in all five separate black colored lesions. Histopathologic examination revealed that all these lesions corresponded to BCCs mostly micronodular type. After diagnosis of BCC, all lesions were excised by Mohs micrographic surgery with free resection margin. Thereafter the patient remains under close follow-up. With our knowledge, this is a rare case of multiple BCCs lacking risk factors around the nose.

FC 2-6 A survey on the awareness of balneotherapy in dermatologic outpatients and dermatologists

( Minkee Park ),( Myeong Jin Park ),( Mi Soo Choi ),( Chan Hee Nam ),( Byung Cheol Park ),( Myung Hwa Kim ),( Seung Phil Hong ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

Background: Balneotherapy, although not a well-established medicine, have been used in dermatologic diseases from ancient to modern times. However, there is little data regarding on the current awareness of balneotherapy. Objectives: To understand the current situation of balneotherapy, we first evaluated utilization and awareness of balneotherapy among the dermatology outpatients and the dermatologists. Methods: A written questionnaire was completed by 183 dermatology at a university hospital. Online questionnaire was completed by 37 dermatologists. Results: According to outpatients, using thermal springs/spa with therapeutic purpose was little and 93% used for leisure and rest. Most outpatients thought the cleanliness of water is the most important factor in thermal springs/spa. Though the majority of respondents regarded balneotherapy as a folk remedy, almost all outpatients (98%) thought it helps general health including fatigue, skin diseases, blood circulation and pain. But still most dermatologists said it is hard to judge an efficacy of balneotherapy because of lack of sufficient evidences. Conclusion: Although balneotherapy is not yet considered as a confirmative therapeutic modality because of lack of medical verification, there is positive recognition and outlook for the effect of balneotherapy in Korea. To offer the precise information to the patients, the more attention of dermatologists need to confirm whether it would be actually effective or not.

Comparison of responses to picosecond and nanosecond lasers in the treatment of hyperpigmented skin lesions

( Minkee Park ),( Hye Young Kang ),( Mi Soo Choi ),( Jong Gu Kim ),( Byung Cheol Park ),( Myung Hwa Kim ),( Seung Phil Hong ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: In the field of the treatment of pigmentary lesion, the picosecond 755 Кalexandrite laser has been recently introduced, hoping for a better effect on tattoo removal and pigmentation disorders. Objectives: This study compared the efficacy of the picosecond based alexandrite laser (750 Э, 755 К) with nanosecond based conventional Q-switched Nd:YAG lasers (10 Ю, 532 and/or 1064 К) lasers in the treatment of both epidermal pigmented and multi-colored dermal tattoo lesions. Methods: KIWA:A1 guinea pigs with epidermal hyperpigmentation induced by UVB irradiation were treated with each of 755 Кpicosecond laser or 532 КQs-Nd:YAG laser. 6 different color tattoos (red, orange, yellow, green, blue, and black) on the back of albino guinea pigs were treated with one session of 755 К picosecond, 1064 Кor 532 КNd:YAG laser treatment. Results: Although both picosecond and Nd:YAG lasers showed the same effect on epidermal hyperpigmentation, the Nd:YAG laser had more initial tissue reaction and latterly developed post-inflammatory hyperpigmentation. The picosecond laser was superior for removing blue and green color tattoos only, whereas it was inferior or similar for other colors. Conclusion: Picosecond laser is better than conventional Qs-Nd:YAG laser in the treatment of epidermal pigmented lesions, because of no damage to surrounding tissue. However, this device may be less effective in the treatment of color tattoo lesions.

NONLINEAR MODEL-BASED STIFFNESS CONTROL

Minkee Park,Euntai Kim,Mignon Park 대한전자공학회 1995 대한전자공학회 학술대회 Vol.1995 No.12

Microepidemic of fiberglass dermatitis in the villages near thermoelectric power plant

( Minkee Park ),( Gi Hyun Seong ),( Myeong Jin Park ),( Byung Cheol Park ),( Myung Hwa Kim ),( Seung Phil Hong ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

It is presumed that many skin diseases are caused by environmental factor, but it is usually difficult to identify the direct cause. Fiberglass dermatitis is a classic example of occupational irritant contact dermatitis owing to the penetration into the skin of over 5 μm in diameter, fine and sharp particles. In May 2016, there was a fire explosion at the thermolelectric power plant, and since then, some nearby residents have appealed the itching of nonspecific aspects. The fire debris contained glass fiber, which was thought to have spread to neighboring villages and caused symptoms. In the spring of 2017, some of the residents recurred the symptoms and were referred to our dermatologic clinic. Fourty among about 600 nearby residents complained of generalized itching and showed nonspecific lesions of irritant contact dermatitis. In 9 among 40 patients, skin biopsy was performed and among them birefringent crystal-like materials were observed in the stratum corneum of seven patients in the polarized light microscope. After that, under electron microscope using Energy Dispersive X-ray analysis, the foreign matters were revealed to mainly consist of Si, Al and Ca, which is consistent with the composition of the glass fiber. Through this case, we learned that it should be considered that nonspecific irritant dermatitis pattern could be due to unidentified environmental factors.

A case of ostraceous psoriasis with psoriatic arthritis in AIDS patient

( Minkee Park ),( Myeong Jin Park ),( Misoo Choi ),( Chan Hee Nam ),( Byung Cheol Park ),( Seung Phil Hong ),( Myung Hwa Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Human immunodeficiency virus infection may be presented as severe and atypical cutaneous diseases. Psoriasis also can be developed in HIV patients associated with immune dysfunction and be presented as more severe and atypical manifestation. Furthermore, treatment of psoriasis in HIV patients can be complex and challenging. A 50-year old man with a history of 9 years of HIV presented for thick scaly hyperkeratotic plaques on the distal part of extremities and face. He has stopped highly active antiretroviral therapy (HAART) for 8 years. Physical examination showed diffuse areas of greasy scaling with underlying erythema on face and scalp. Extremities showed firmly adhered thick scales resembling an oyster shell. T lymphocyte subsets of peripheral blood revealed that CD4+ T-cell count was 66cell/ul and CD4/CD8 ratio was decreased to 0.19. HIV RNA titer was 224, 701 copies/mL. Histopathologic analysis confirmed psoriasis and rheumatologist confirmed psoriatic arthritis (PsA). We diagnosed him as an ostraceous type psoriasis with PsA. Treatment was initiated with oral acitretin, oral low-dose steroid, topical calcipotriol topical corticosteroid and re-initiation of HAART therapy. Herein, we report uncommon clinical variant of psoriasis with PsA in AIDS patient and discuss about a possible pathogenesis and treatment.

A case of generalized molluscum contagiosum in an adult patient with severe atopic dermatitis

( Minkee Park ),( Myeong Jin Park ),( Mi Soo Choi ),( Chan Hee Nam ),( Byung Cheol Park ),( Myung Hwa Kim ),( Seung Phil Hong ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Molluscum Contagiosum (MC) is a common viral skin disease caused by Molluscipoxvirus and is characterized by discrete, multiple flesh-colored papules. Most cutaneous molluscum contagiosum infection occurs in children, but it may be found in adults, especially who have been infected with human immunodeficiency virus (HIV). A 37-year-old man presented with multiple pea-sized firm skin-colored round papules, which first appeared on the arms and then quickly spread over whole body for last 2 months. He has been treated for severe atopic dermatitis with systemic immunosuppressive therapies for 2 years. Screening test for HIV was negative. The lesions were diagnosed as molluscum contagiosum based on histopathologic findings of typical eosinophilic cytoplasmic molluscum inclusion bodies on the acanthotic epidermis as well as dermal inclusion cyst. This is a very unusual case because widespread MC infection in adults was reported in some HIV positive patients. We supposed that our patient’s disseminated infection may be related with the combination of perturbed skin barrier and systemic immunosuppressive therapy under severe atopic condition.

A case of using hair transplantation as a treatment of scarring alopecia assoicated with incontinentia pigmenti

( Minkee Park ),( Myeong Jin Park ),( Mi Soo Choi ),( Chan Hee Nam ),( Seung Phil Hong ),( Myung Hwa Kim ),( Byung Cheol Park ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Incontinentia pigmenti (IP) is a rare X-linked genodermatosis caused by a mutation in nuclear factor-κ B essential modulator (NEMO) gene located on Xq28. The condition is characterized by typical cutaneous lesions and abnormalities of the central nervous system and eyes. It affects the skin in three or four stages: vesicular, verrucous and hyperpigmented, with or without an atrophic stage. The skin lesions typically follow the lines of Blaschko. A 20-year-old female presented with linear hypopigmented, atrophic skin lesions and whorled pattern of alopecia with surrounding erythema at vertex. And also associated with absence of molar teeth, hypermetropic astigmatism and urinary problem. Her mother also have an alopecia and urinary problem. Histopathologic examination showed few structure of hairs but sclerotic collagens in dermis which was consistent with scarring alopecia on scalp and superficial perivascular lymphocytic infiltration with decreased basal pigmentation on leg. Although there was no history of previous linear vesicular, verrucous or hyperpigmented lesion, she was diagnosed clinically as an Incontinentia pigmenti. After 18months of treatment of remained inflammation, she had a hair transplantation as a treatment of scarring alopecia. Here we report a case of using hair transplantation in treatment of scarring alopecia associated with IP with no recurrence.

Expression of wound healing markers in Neurofibromatosis type 1

( Minkee Park ),( Seung Phil Hong ),( Byung Cheol Park ),( Myung Hwa Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: Neurofibromatosis type 1(NF1) is an autosomal dominant disorder, caused by heterozygous mutations of the NF1 gene. NF1 protein has been suggested to be a downregulator of the Ras-signaling pathway which increases the cell growth and proliferation in most tissues. Although the surgical treatment is major therapeutic option to remove the NF, there are few studies regarding the complex process of wound healing in the skin of NF1. Objectives: To investigate expression of wound healing markers in the skin of NF1 compared with normal skin and hypertrophic scar(HTS). Methods: Real-time PCR was performed to compare mRNA expression of 14 wound healing marker genes. Based on the real-time PCR results, immunohistochemistry was done on NF lesions comparing HTS and normal skin. Results: Of 14 genes, the mRNAs of MMP-1, MMP-9, FGF2, KGF, TNF-α and IL-6 were in NF lesions, and that of MMP-9 showed a significant increase comparing to normal tissues (p=0.021). Immunohistochemically, MMP-9 was decreased in NF tumor per se and scar area of HTS comparing with reticular dermis of normal tissue. FGF2 and TNF-α showed moderate to intense expression in epidermis and peritumoral and tumoral area of NF lesions. By contrast, the expression of TNF-α was decreased in scar area of HTS. Conclusion: NF lesions have high expression of MMP-9 mRNA, FGF2 protein and TNF-α protein. These altered level of expression in NF suggest that NF lesion could be expected almost normal healing process instead of leaving HTS.

Hybrid cyst with verrucous feature on scalp

( Minkee Park ),( Mi Soo Choi ),( Chan Hee Nam ),( Ji Seok Kim ),( Byung Cheol Park ),( Myunghwa Kim ),( Seung Phil Hong ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Various skin appendageal cysts including epidermal cysts, trichilemmal cysts, vellus hair cysts, pilomatricoma or steatocystoma can develop from pilosebaceous unit. A Hybrid cyst is a term proposed to describe a rare cystic lesion which involves more than two components of pilosebaceous unit. So far, there are four reports of hybridcysts in Korea up to date, however, none of them showed verrucous feature on the surface. A 46-year-old male presented with 0.5 x 0.3cm sized yellowish tender subcutaneous nodule on scalp which persisted for a year. Skin biopsy was done, featuring cystic lesion with multiple components including epidermal cyst and trichilemmal cyst. Furthermore, hyperplastic epidermis showed verrucous features. It has been reported that HPV infection could be closely related to appendageal cystic lesion, particulary plantar cyst. The report told that 30.8% of cases showed parakeratosis, vacuolar structures, and eosinophilic inclusion bodies, and 38.5% of cases showed positivity in PCR for HPV. To know whether the lesion of patient in our case corresponds with hybrid cyst with secondary verrucous change, or hybrid cyst arising from preexisting verruca, further investigation is needed regarding relationship of HPV and pathogenesis of tumors from pilosebaceous unit and multipotential stem cells of hair follicles.