Angiosarcoma Presenting with a Wide Range of Histopathological Features and Differentiation: A Case Report

( Yeongjoo Oh ),( Hemin Lee ),( Sang Kyum Kim ),( Sang Ho Oh ) 대한피부과학회 2019 大韓皮膚科學會誌 Vol.57 No.5

Long-term outcomes of laser treatment for congenital melanocytic nevus

( Yeongjoo Oh ),( Si-hyung Lee ),( Jungmin Lim ),( Kee Yang Chung ),( Mi Ryung Roh ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Although various laser treatments have been tried for CMNs, only small retrospective studies with short-term follow-up had been done to assess outcomes. Objectives: We analyzed the long-term outcomes of laser treatment for CMN and compared the outcomes with the combination treatment of partial excisions followed by laser treatments. Methods: Patients with CMN treated with lasers and followed-up for more than 1 year were retrospectively reviewed and patients with more than 3-year follow-up were grouped as the long-term follow-up group. Results: A total of 67 cases of CMN were reviewed. 52 patients were treated with laser only, and 15 patients were treated with combination treatment of partial excision followed by laser treatments. Among 20 patients (20/52, 38.5%) with nearly total clearance during laser-only treatment, 11 patients were in long-term follow-up group and 5 of them showed repigmentation. 15 patients showed repigmentation regardless of clearance, and the mean period until repigmentation was 3.93 years from the initial treatment. Patients with combination treatment of partial excision and lasers showed higher Investigator’s Global Assessment (IGA) scores, less number of laser treatments and shorter treatment period compared to patients with laser-only treatment. Conclusion: More than 4 years of follow-up is required to evaluate the efficacy of lasers in CMN and combination treatment of partial excision and lasers can be an effective treatment option.

What to include in IRB for research using human samples

( Yeongjoo Oh ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Prognostic factors of recurrence and validation of staginig systems in cutaneous squamous cell carcinoma removed by Mohs micrographic surgery

( Yeongjoo Oh ),( Byung Ho Oh ),( Mi Ryung Roh ),( Kee Yang Chung ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: The prognosis of cutaneous squamous cell carcinoma (cSCC) is associated with recurrence of tumor after the removal and Mohs micrographic surgery (MMS) is considered as the best method for removal of cSCC. Objectives: To find out risk factors of recurrence in cSCC treated after MMS. Methods: In this retrospective study, cSCC patients treated with MMS at the department of dermatology in Severance hospital from 2000 to 2017 were reviewed. Correlation among various clinical factors and recurrence were statistically analyzed. Predictive powers for recurrence of four staging systems for cSCC (AJCC 7th, AJCC 8th, BWH, Breuninger) were analyzed. Results: A total of 241 patients with cSCC treated by MMS were reviewed. A total of 40 patients showed recurrence and 21 showed local recurrences and 19 showed recurrences as distant metastasis. Comorbidity of diabetes, history of preceding Bowens disease and poor differentiation of cSCC were correlated with recurrence. History of trauma on the cSCC site, history of solid organ transplantation and removal of tumor by more than 3 stages of MMS were correlated with local recurrence. Preceding Bowens disease and poor differentiation were correlated with distant metastasis. (all p<0.05) Among four staging systems, AJCC 8th staging system showed highest predictive value. Conclusion: Comorbidity of diabetes, history of preceding Bowen disease and poor differentiation of cSCC are risk factors for recurrence after MMS.

Efficacy and safety of silymarin containing antioxidant serum as an adjuvant treatment of acne vulgaris

( Yeongjoo Oh ),( Jemin Kim ),( Hyun Kim ),( Jihee Kim ) 대한피부과학회 2022 대한피부과학회 학술발표대회집 Vol.73 No.2

Case series of Ingenol mebutate in treatment of melanoma in situ

( Yeongjoo Oh ),( Jihee Kim ),( Byung Ho Oh ),( Mi Ryung Roh ),( Kee Yang Chung ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Because of large involved area of melanoma in situ compared to depth, various non-surgical treatment options had been tried. There are several case reports of using topical ingenol mebutate for treatment of lentigo maligna. We report our experience with topical ingenol mebutate for melanoma in situ and atypical melanosis. Total 11 patients were treated with topical ingenol mebutate for melanoma in situ or atypical melanosis and 5 patients had melanoma in situ and 6 patients had atypical melanosis. Topical ingenol mebutate was applied on recurred lesions after previous surgery for 5 patients and on newly diagnosed lesions for 6 patients. Previous fractional ablative laser treatment was done before application. Gross pigmentation showed improvement after 1 or 2 treatments in all patients. However, 5 patients showed recur of melanoma in situ after the clearance. The other 6 patients showed no recurrence. Average follow-up period from the last treatment was 11.2months for patients with no recurrence. 2 patients out of 5 patients with recurrence had lesion on genital mucosa. 3 patients of recurred patients had treatment on newly diagnosed lesion and 2 patients on recurred lesion. From this result, we suggest topical ingenol mebutate as a treatment option for recurred atypical pigmentation which has high possibility of melanoma in situ. Further studies are needed to establish the adequate indication for topical ingenol mebutate.

Risk factors of recurrence in early-stage cutaneous melanoma without nodal metastasis

( Yeongjoo Oh ),( Sooyie Choi ),( Byung Ho Oh ),( Mi Ryung Roh ),( Kee Yang Chung ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Complete removal of primary tumor is only required for localized melanomas, however relapses after removal had been frequently observed which cause poor prognosis. Therefore, predicting the risks of relapse and classifying “high-risk” localized melanomas are essential to define candidates for adjuvant systemic treatments. Objectives: To find out risk factors of recurrence in early-stage melanoma in Korea Methods: In this retrospective study, cutaneous melanoma patients visited and followed-up for more than 6 months at the department of dermatology in Severance hospital from 2000 to 2018, without evidence of nodal or distant metastasis, were retrospectively reviewed. Results: A total of 340 patients diagnosed with cutaneous melanoma and staged as melanoma in situ, stage I or II at Severance Hospital were reviewed. Acral melanoma (239/340) was predominant. 92 patients showed recurrence after the removal of primary melanoma and included 29 local recurrences, 49 regional recurrences (in-transit and regional lymph node metastasis) and 28 distant metastases. Sex(male), Clark level and Breslow thickness deeper than 2mm were correlated with increased risk of recurrence (p<0.05) and shorter relapse-free survival (p<0.05). Conclusion: Sex(male), Clark level and Breslow thickness deeper than 2mm are risk factors for recurrence in Asian early-stage melanoma patients

[P081] Wolf`s isotopic response as an early clinical sign of diabetes mellitus

( Yeongjoo Oh ),( Young In Lee ),( Chang Ook Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Wolf`s isotopic response is the phenomenon of development of secondary skin disorder after another kind of primary skin disorder disappears. We report 1 case of Wolf`s isotopic response which arises from herpes zoster lesion which was followed by hyperglycemic event. A 69 years old male patient, who had history of herpes zoster 2 years before the visit, had visited our clinic for multiple grouped skin color papules and nodules on his left lower back. The patient assumed recurrence of herpes zoster because the lesion area was consistent with the previous zoster area. Under impression of Wolf`s isotopic reaction, skin biopsy was done on the new lesion and pathology showed histiocytic infiltration with mucin deposition which is consistent with granuloma annulare. Intralesional corticosteroid injection was done and showed no effect. Then, oral steroid intake was prescribed. After two weeks of steroid intake, patient had hyperglycemic event (reaching to serum glucose 900) and diagnosed as diabetes mellitus. In several review articles about Wolf`s isotope, herpes zoster were reported to be most common primary lesion and granuloma annulare to be most common second lesion. The pathophysiology of Wolf`s isotopic response is not well known, however in this case it`s interesting that the response presented before development of DM. We report this case to recommend systemic surveillance including DM when Wolf`s isotopic response develops.

[P169] A case of Rowell`s syndrome developing in systemic lupus erythematosus

( Yeongjoo Oh ),( Jae Won Lee ),( Sang Won Lee ),( Chang Ook Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

The disease entity of lupus erythematosus with EM-like skin lesion is called Rowell`s syndrome and diagnostic criteria include major criteria of coexistence of LE and EM-like lesions, positive antinuclear antibodies(ANA) and minor criteria of chilblains, reactive rheumatoid factor(RF) and positive anti-Ro(SS-A), anti-La(SS-B). A 51-years old male patient had been transferred to our hospital for renal failure and had target-like skin lesions on his face and back. His both fingers showed chilblain-like lesion. Kidney biopsy was done and diagnosed with lupus nephritis. Elevated serum ANA titration, positive Anti-DNA screening, low serum C3 and serum C4 were proven by laboratory test. The pathology of skin biopsy had perivascular and perifollicular inflammation with lymphohistocytes, and neutrophils. Diagnosis of systemic lupus erythematosus (SLE) was established and Steroid pulse therapy was done for 3 days followed by cyclophosphamide low dose pulse treatment. During 3 days of steroid pulse therapy, his skin lesion showed regression and after few days most of erythematous part was regressed with only crust left. Based on diagnosis of SLE and clinical feature of EM-like lesion, positive ANA and chilblain-like lesion, we report 1 case of Rowell`s syndrome which represents a new entity of lupus erythematosus.

[P204] A case of retiform hemangioendothelioma further diagnosed as angiosarcoma; is it a disease spectrum from retiform hemangioendothelioma to angiosarcoma?

( Yeongjoo Oh ),( Hemin Lee ),( Sang Ho Oh ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Hemangioendothelioma(HE) is considered to be a disease entity which has characteristics between completely benign hemangioma and malignant angiosarcoma. Retiform hemangioendothelioma (RH), also known as a “Hobnail HE”, has been reported as a distinct form of low grade angiosarcoma because it has a slow indolent course. A 56 years old female patient presented with diffuse erythematous to purpuric plaque on her scalp for 10 years. Skin pathology showed rete testis form anastomosing vessels, hobnail-like endothelial cells lining the vessels, consistent with the findings of RH. On whole body CT and PET-CT, done for systemic evaluation, enhancement of multiple neck lymph nodes was observed. And ultrasound-guided needle aspiration biopsy from neck node appeared typical pathologic findings of angiosarcoma differently from original mass of RH. RH is a rare vascular neoplasm with very high local recurrence and a very rare metastasis. However, this patient diagnosed as RH showed distant metastasis different from RH. We assume that RH could be a spectrum disease, possibly progressing and/or transforming into malignant angiosarcoma. Or skin specimen might be obtained only from a part showing the feature of RH that the primary mass could be composite HE, in which share features of at least two HE variants including angiosarcoma. Therefore, multiple biopsy is needed and workup of systemic involvement is necessary to evaluate a rare metastasis.