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Three cases of papular acantholytic dyskeratosis on the anogenital area
( Dae-lyong Ha ),( Kihyuk Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Papular acantholytic dyskeratosis (PAD) is a rare skin disease, presented as an eruption of multiple, asymptomatic or itchy, skin-colored to whitish papules that coalesce to plaques located on the anogenital and genitocrural areas. PAD show a characteristic histopathologic findings of focal suprabasal acantholysis that distinguishes it from Hailey-Hailey disease or Darier’s disease. Herein, we reports a series of three cases of PAD (M:F=1:2). All patients showed whitish papules that coalesce to plaque located on the anogenital area and complained itching sensation. Histopathologic examination showed hyperkeratosis, acanthosis, suprabasal cleft and acantholysis. The first patient was treated with topical tacrolimus, the second patients was treated with electrodessication, and the third patients treated with oral alitretinoin. All lesions showed improvement after treatment. Our cases suggest that PAD may be more common in men than has been previously been described. It is difficult to differentiate it with condyloma, eczema, and tinea cruris clinically. Dermatologists should consider PAD as a differential diagnosis of inguinal papular eruption and perform a skin biopsy to avoid delaying the diagnosis.
Large infantile hemangioma with subfascial location: a case with difficulty of clinical diagnosis
( Dae-lyong Ha ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo K 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
The unexpected finding of newly growing lump in an infant induces anxiety to parents and results in an urgent visit to hospital. Before performing invasive interventions for this infant patient, benign conditions like infantile hemangioma (IH) should be excluded as it could show variable clinical characteristics. A 6-month-old girl was presented with protruding skin-colored tumor on right upper back, with approximately 10cm in diameter and without surface change. The tumor abruptly enlarged over the period of 2 weeks without any previous episode. MRI showed a lobulated hypervascular mass in the subfascial layer with neovascularization inside. Through this findings, thought by radiologist and orthopedic surgeon to be malignant tumor, exploratory surgery was planned. Before surgical excision, this patient was consulted to our department. As the lesion was softly palpable and movable, incisional biopsy was performed to rule out the benign tumor like deep type IH. Histopathologic examination showed numerous vessels lined by plump endothelial cells. Immunohistochemical staining revealed the positivity of endothelial cells for CD-31, GLUT-1. Under the diagnosis of IH, the patient received oral propranolol medication for 1 year. Following the patient, we found the tumor diminished dramatically in volume. Although IHs are common benign tumor in infancy, Subfascial location is unfamiliar and rare. So, we herein report a case of subfascial lH.
Eosinophilic pustular folliculitis in Korea: a single centre experience and literature review
( Dae-lyong Ha ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bu 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: Eosinophilic pustular folliculitis (EPF) is a kind of chronic inflammatory disease. Though the clinical characteristics of EPF are well-described, the clinical data about Korean EPF need to be investigated. Objectives: To investigate the clinical findings of EPF in Korea. Methods: We retrospectively reviewed medical records, and clinical photos of 42 patients diagnosed with EPF by skin biopsy in the Pusan National University Hospital (Busan and Yangsan) over the 15 year period (2002-2017). And we also reviewed other Korean EPF patients collected by pubmed and Koreamed searching. Results: Among 145 patients, we found 118 cases of classic EPF (mean age; 34.7 years, male to female ratio [M:F]; 1:1.15) mostly affecting the face (88.1%); 14 cases of immunosuppression-associated EPF (mean age: 40.9 years, M:F; 2.5:1) less frequently affected the face (50%) and 13 cases of infancy-associated EPF (mean age; 0.6 years, M:F; 1:1.17) primarily affecting the scalp (85%). Of 116 patients, with topical and systemic treatment, 71 patients (61.2%) showed improvement, 23(19.8%) patients showed partial response and 20 patients (17.2%) showed no response. Conclusion: Compared to previous Caucasian studies, classic EPF is more common in Korea. Our study could be used as the basic data of Korean EPF and be helpful for dermatologist to understand characteristics of EPF in Korea.
Solitary juvenile xanthogranuloma: clinical and dermoscopic findings
( Dae-lyong Ha ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bu 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: Juvenile xanthogranuloma (JXG) is a common non-Langerhans cell histiocytosis. JXG can have 2 main clinical forms with a popular form as multiple papules in infants and children and a nodular form as 1 or a few lesions in adults. Most data about JXG have been focused on common popular form, and clinical data about nodular form or solitary JXG are very limited. Objectives: To investigate the clinical and dermoscopic findings of solitary JXG. Methods: We retrospectively reviewed medical records, and clinical and dermoscopic photos of 51 patients with solitary JXG among 93 JXG patients confirmed histopathologically in the Pusan National University Hospital (Busan and Yangsan) from 2005 to 2017. Results: Solitary JXG was more common than classic multiple popular form (51/93, 54.8%). Of 51 patients with solitary JXG, 40 (78.4%) were children (range in 0.25-6) and 11 (21.6%) were adults (range in 22-55). Childhood JXG was bigger than adult JXG (mean diameter: 6.3 mm vs 3.7 mm, P < 0.0001). The predominant involved anatomical site was scalp (35%) in childhood JXG and face (36.4%) in adult JXG. Setting sun appearance was the most common dermoscopic feature. 23 lesions were removed during biopsy and 4 with follow-up had spontaneous involution. Conclusion: The majority of JXG studies were done on Caucasians and there has been no study focusing on solitary JXG like this study.
[P444] Bizarre leiomyoma of the scrotum : Is that benign or malignancy?
( Dae-lyong Ha ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Leiomyomas are common neoplasm originate from smooth muscle that can arise almost anywhere in the body. Leiomyoma with pleomorphic atypical nuclei with a low mitotic activity is termed as bizarre leiomyoma, which can be easily misdiagnosed as malignant tumor. We report a case of scrotal bizarre leiomyoma in a 75-year-old man, with a 10-year history of asymptomatic solitary skin-colored nodule on the right side of scrotum which reamined stable. Biopsy result revealed interlacing bundles of spindle-shaped muscle cell, and some of the tumor cells had bizarre nuclei. The nuclei were large and multilobulated with hyperchromatic chromatin and macronucleoli. Immunohistochemical staining revealed that the tumor cells were positive for h-caldesmon and desmin, and less than 1% of the tumor cell nuclei showed Ki-67 labeling index. The postsurgical course was uneventful for 1 year after the resection, and no recurrence has been recognized. We made a diagnosis of bizarre leiomyoma based on biopsy results and the history of the patient. To our knowledge, only around 10 cases of bizarre leiomyoma of the scrotum have been reported in the literature. The disease should be distinguished from leiomyosarcoma to avoid unnecessary treatment. Therefore, we herein report a case of bizarre leiomyoma of the scrotum which showed the bizarre nuclei without mitoses.
[P213] Infantile hyper-IgE syndrome presenting as eosinophilic pustular folliculitis
( Dae-lyong Ha ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyun-chang Ko ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Various conditions can occur as vesiculopustular dermatoses during the neonatal period. Most of the disorders presenting vesiculopustular lesion in infancy are benign and self-limited, but some can be life-threatening. Accurate diagnosis of these diseases is important to manage appropriately and prevent complications. A 5-day-old male presented with erythematous papules and vesiculopustules with crusts on whole body. Initial laboratory findings showed elevated eosinophil count in complete blood cell count with normal serum IgE level. Histopathologic findings showed infiltration of eosinophils in the intraepidermal vesicle and inter- and intrafollicular areas. Under the diagnosis of infantile eosinophilic pustular folliculitis (EPF), systemic corticosteroid and indomethacin were administrated. Owing to limited treatment response and following eczematous lesion and recurrent scalp abscesses, the follow up laboratory examination was done. Laboratory findings showed extremely elevated serum IgE level and STAT3 gene mutation by gene sequencing. Based on these findings, the diagnosis of hyperimmunoglobulin E syndrome (HIES) was confirmed. HIES is a rare immunodeficiency disorder, which characterized by eczema, high serum IgE, and recurrent infections. Although newborn initially presents clinical manifestation as EPF and normal serum IgE level, HIES should be considered when seeing infantile vesiculopustular disease.
Clinical and laboratory differences between early-onset and late-onset adult atopic dermatitis
( Dae-lyong Ha ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Moon-bum Kim ),( Byung-so 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: Atopic dermatitis (AD) of adult is not rare skin disease and its prevalence has been increasing during the past decades. Yet, there has been a paucity of data regarding the difference between early-onset and late-onset adult AD. Objectives: To investigate the clinical and laboratory differences between early-onset and late-onset adult atopic dermatitis. Methods: We retrospectively reviewed medical records and clinical photos of 214 adult AD patients (≥ 18 years of age) over a 3 year period. We classified patients into 2 group; early-onset (first onset of AD under 12 years old) vs. late-onset (first onset of AD at 12 years of age or older). Results: Among 214 patients, we found 151 patients (70.6%) of early-onset group (mean age, 24.5 years), consisting of 101 males and 50 females whereas 63 patients of late-onset group (mean age, 29.5 years) consist of 39 males and 24 females. Early-onset group had a significantly likelihood of generalized involvement (90.4% vs. 72.1%). Association with allergic asthma and/or rhinitis, elevated total serum IgE and sensitivity to food-allergens were more commonly found in early-onset group. There was no statistical difference in the mean EASI score, eosinophil counts and sensitivity to aeroallergens between two groups. Conclusion: Adult AD shows different clinical and laboratory characteristics depending on onset age. This study could be of help for assumption of a heterogeneity of AD in adulthood.
Unilateral linear capillaritis
( Dae Lyong Ha ),( Hyunju Jin ),( Hyang Suk You ),( Woo Haing Shim ),( Jeong Min Kim ),( Gun Wook Kim ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Unilateral linear capillaritis (ULC) is a rare variant of pigmented purpuric dermatosis (PPD), also known as unilateral pigmented purpuric eruption or quadrantic capillaropathy. It is characterized clinically by asymmetrically distributed linear or segmental purpuric macules on the lower extremities, and usually fades spontaneously. A 10-year old girl presented with linearly distributed unilateral asymptomatic pigmented purpuric macules on the left lower extremity for 2 years. The patient had no history of the previous skin diseases and had not taken any medications. Skin biopsy revealed histopathological features of PPDs, such as perivascular infiltration of lymphocytes and extravasation of red blood cells. However, dense, band-like, dermal, inflammatory infiltrate was not found which differentiates the case from lichen aureus. We made diagnosis of ULC based on the clinical characteristics and histopathologic findings. Our patient did not receive any specific treatment and the lesions improved after 6 months. To our knowledge, ULC is an extremely rare disease and only around 10 cases have been reported world widely. Moreover, the case of ULC has not previously been reported in the Korean dermatology literature. So, we herein report a case of ULC which shows the characteristic unilateral segmental distribution on lower extremity.