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A case of trichilemmal cyst on the toe
( Cho Ah Lim ),( Myum Im ),( Young Lee ),( Young Joon Seo ),( Jeung Hoon Lee ),( Hae Eul Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Trichilemmal cysts are benign cutaneous tumors that originate from the outer root sheath of hair follicle and frequently affect middle-aged females. These are mostly found on the scalp and rarely involve the face, neck and trunk. A 30-year-old male visited our clinic for skin-colored, tender, subcutaneous nodule on the 5th toe of his right foot without any history of trauma. A complete excision of the tumor was performed. Histopathological examination revealed a trichilemmal cyst that is lined by a stratified squamous epithelium composed of swollen pale keratinocytes, without the formation of a granular layer. Only few cases have been reported to occur on locations with no hair follicles. This case describes a trichilemmal cyst on the toe, which is an unusual location for these tumors.
Ah-Ra Cho,Young-Ho Lim,Sae-Hoon Chung,Eun-Hi Choi,Jong Youb Lim 대한재활의학회 2016 Annals of Rehabilitation Medicine Vol.40 No.3
Bilateral anterior opercular syndrome and partial Kluver–Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersexuality, hypermetamorphosis, and memory disturbances. Here, we report a case of an adult stroke patient who suffered from bilateral anterior opercular syndrome accompanied by partial Kluver–Bucy syndrome.
A case of merkel cell carcinoma in association with bowen’s disease
( Cho-ah Lim ),( Kyung-duck Park ),( Young Lee ),( Jeung-hoon Lee ),( Young-joon Seo ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Merkel cell carcinoma(MCC) is a rare, aggressive cutaneous malignancy that has a predilection for local recurrence and distal metastasis. It is occasionally found to coexist with other disease, such as squamous cell carcinoma, basal cell carcinoma, miscellaneous adnexal tumors, and rarely Bowen's disease. A 76-year-old man presented with a 1-year history of an erythematous plaque on his left lower leg. He was diagnosed with Bowen's disease on histological examination, and received 5 sessions of cryotherapy until there was no remaining lesion clinically. 4 months later, a solitary dome-shaped erythematous nodule developed on the lesion. Microscopically, the nodule showed a number of small hyperchromatic cells with scanty cytoplasm. Immunohistochemical staining for cytokeratin 8/18, chromogranin and CD56 were positive. From these findings, we diagnosed this lesion as a MCC developed on Bowen's disease. It is known to be very rare in the literature and physicians should consider that MCC could be included in the differential diagnosis of nodular lesions in Bowen's disease.
[P434] A case of nodular cystic fat necrosis on both arms
( Cho-ah Lim ),( Young Lee ),( Jeung-hoon Lee ),( Young-joon Seo ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Nodular cystic fat necrosis is a distinct spectrum characterized clinically by mobile subcutaneous nodules and histologically by encapsulated fat necrosis showing membranocystic change. A 74-year-old female presented multiple asymptomatic subcutaneous nodules on her both arms with a 3-year history. She was also diagnosed with diabetes mellitus and suffered from diabetic retinopathy for 7 years. No worthy trauma history was mentioned. On physical examination, multiple firm subcutaneous nodules measured 10-15mm in diameter were scattered at the extensor aspect of her both arms. Histologically, the excised cutaneous mass showed well encapsulated fat necrosis and marked lipomembranous change. . The etiology of nodular cystic fat necrosis is still unclear. Its pathogenesis seems to be related to trauma, rapid vascular insufficiency and subsequent fibrous capsule formation. It has been reported that patients with diabetes mellitus exhibit reduced skin blood flow compared with non-diabetic patients representing local ischemia in skin. Accompanying diabetic retinopathy, microangiopathy may have contributed to the induction of nodular cystic fat necrosis with lipomembranous change in our patient.
[P248] Anti-tuberculosis drugs-induced anagen effluvium with generalized drug eruption
( Cho-ah Lim ),( Young-joon Seo ),( Jeung-hoon Lee ),( Young Lee ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Anagen effluvium is an abrupt loss of hair that is in its growing phase due to event that impairs the mitotic or metabolic activity of hair follicle. Anagen effluvium is commonly associated with chemotherapy, radiation, toxic chemicals and drugs. However, alopecia due to anti-tuberculosis drugs has rarely been reported in literature. A 50-year-old female was diagnosed as intestinal tuberculosis and started on anti-tuberculosis therapy containing isoniazid, rifampicin, ethambutol, and pyranzinamide. After a month of medication, erythematous to brown patches appeared on her whole body followed by diffuse hair loss on scalp and body. Hair exam showed intact inner and outer root sheaths with fully pigmented hair bulb and histopathological examination of scalp biopsy showed vacuolar degeneration in interfollicular epidermis and perifollicular infiltration of mononuclear cells and eosinophils. The patient was diagnosed as anagen effluvium with drug eruption and potent corticosteroid lotion was prescribed to put on scalp twice a day. After complete hair loss, anti-tuberculosis medications were withdrawn and the hair regrowth started after 4months. Here, we report a rare case of anagen effluvium with generalized drug eruption due to anti-tuberculosis medication.
( Cho-ah Lim ),( Young Lee ),( Young-joon Seo ),( Jeung-hoon Lee ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Exenatide Extended-Release (BYDUREON<sup>®</sup>) is recently developed antidiabetic drug which acts as a glucagon-like peptide-1 (GLP-1) receptor agonist. Exenatide Extended-Release is formulated to encapsulate exenatide in poly-(D,L-lactide-co-glycolide; PLG) microspheres and releases the active drug over a sustained time interval. PLG undergoes hydrolysis into lactic and glycolic acids, which are eventually eliminated as carbon dioxide and water. A 54-year-old male visited our clinic for subcutaneous tender nodule on his left thigh that developed within 1 week. The patient had BYDUREON<sup>®</sup> injection for 5 months to treat diabetes. Histopathological examination showed subcutaneous panniculitis with lymphohistiocytes and eosinophils infiltration and the patient was diagnosed as injection panniculitis due to Exenatide Extended-Release injection. Among injection site reactions in Exenatide Extended-Release users (17.1%), reports of injection-site nodules are infrequent. As more patients are using Exenatide Extended-Release in Korea, clinicians who care for patients with diabetes who use Exenatide Extended-Release should be aware of the possibility that serious injection-site nodules may occur.
Segmental neurofibromatosis on the face
( Cho-ah Lim ),( Young Lee ),( Young-joon Seo ),( Jeung-hoon Lee ),( Kyung-duck Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Segmental neurofibromatosis(SN) is a rare form of neurofibromatosis that is characterized by cafe-au-lait macules and neurofibromas, or only neurofibromas in limited dermatome. SN is thought to arise from a postzygotic mutation in the NF1 gene leading to somatic mosaicism. A 34-year-old man presented asymptomatic, multiple, soft, skin colored papules on his right nasolabial fold with a 20-year history. Physical examination was normal including intelligence, speech, auditory functions and there was no cafe-au-lait macule on the rest of the body. He had no family history of neurofibromatosis. Histological examination showed non-capsulated intradermal tumor consisted of loosely spaced spindle-shaped cells and wavy collagenous strands in the myxoid stroma. Overall, the features were consistent with segmental neurofibromatosis. Patients with the segmental neurofibromatosis need to be assured that they have a low risk of developing any disease-related complications. Herein we report a rare case of segmental neurofibromatosis on the face.
Scrotal involvement in childhood Henoch-Schonlein purpura
( Cho-ah Lim ),( Kyung-duck Park ),( Young-joon Seo ),( Jeung-hoon Lee ),( Young Lee ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Henoch-Schonlein purpura (HSP) is a systemic leukocytoclastic vasculitis of the small vessels with perivascular deposition of immunoglobulin A immune-complexes. HSP mainly affects the small vessels of the skin, joints, gastrointestinal tract and kidney. Testicular or scrotal involvement has been rarely reported that the diagnosis can be easily missed. A 5-year-old boy presented acute painful erythematous scrotal swelling and multiple erythematous macules on his lower extremities. Skin biopsy from the lower extremities revealed leukocytoclastic vasculitis and IgA deposition along the dermal capillary walls. Scrotal Doppler ultrasonography demonstrated a good blood flow to the testes, excluding the possibility of testicular torsion. Scrotal involvement of HSP is a self-limited benign disease without long-lasing sequelae. However scrotal pain, tenderness, swelling or discoloration sometimes mimics testicular torsion which is a true surgical emergency, and testicular involvement of HSP with torsion of testis has been reported together. Therefore recognition of scrotal involvement in children with HSP is important and testicular torsion should be first excluded for avoiding unnecessary surgical operation. Here we report an interesting case of scrotal involvement in child HSP.