[P372] Basal cell carcinoma arising from the scar of cryosurgery and laser ablation For treating actinic keratosis

( Ga-hye Na ),( Do-hyeon Kim ),( Soo-hyeon Noh ),( Eun-jung Kim ),( Kun Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Some authors found that about 7% of basal cell carcinoma had a previous history of trauma. And basal cell carcinomas have been reported to develop within scars caused by surgery, laser ablation, and other injuries. A 65-year-old man presented with asymptomatic erythematous plaque on right mandible. Histopathologic findings revealed that buds and irregular proliferations of basaloid tumor cells attached to the undersurface of the epidermis. Four years earlier, he had presented with erythematous plaque on same site. Histologic examination of initial lesion was consistent with actinic keratosis, and this lesion was treated by cryosurgery and CO₂ laser ablation. Based on these findings, we diagnosed him as basal cell carcinoma arising from the scar of cryosurgery and laser ablation for a pre-existing actinic keratosis.

P074 Clinical experience of adapalene on molluscum contagiosum

( Ga-hye Na ),( Do-hyeon Kim ),( Soo-hyeon Noh ),( Jin-kyung Chae ),( Kun Park ),( Eun-jung Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Molluscum contagiosum (MC) is one of the most common viral skin infections in children. There are a variety of therapeutic modalities for this condition, including curettage, cryotherapy, and topical treatment. However, some patients are intolerable to these modalities, because these treatments often cause pain or irritation. Objectives: To evaluate the safety and efficacy of topical adapalene in treating MC. Methods: Thirteen patients with multiple MC lesions were treated with topical adapalene cream. The patients were evaluated every 2 weeks for clinical response to therapy as well as the presence of side effects. A post-treatment questionnaire was administered to evaluate the satisfaction of the patients’ parents with this therapy. Results: Of the 13 patients, 6 patients (45.2%) showed clearance of MC lesions. Over 70% of the patients’ parents noticed that topical application of adapalene was convenient. And side effects were observed in only 4 patients (30.7%), including mild erythema, dryness, and a burning sensation. The side effects were transient and tolerable in most cases. Conclusion: Adapalene is relatively convenient and safe treatment modality in MC. It will be an alternative treatment option in children who are intolerable to other treatments.

Cutaneous squamous cell carcinoma arising in a patient with neurofibromatosis type 1: a case report

( Ga-hye Na ),( Bo-ra Lim ),( Do-hyeon Kim ),( Soo-hyeon Noh ),( Eun-jung Kim ),( Kun Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

A 31-year-old man with a past history of neurofibromatosis type 1 presented with 2.5x1.5cm sized, exophytic tumor of back covered with crust and oozing. Histopathologic findings were consistent with poor differentiated squamous cell carcinoma. Neurofibromatosis type 1 (NF1) is an autosomal dominant inherited disease. It is known that the incidence of tumors in patients with NF1 is high compared with the normal population. And majority of the tumors are non-epithelial neoplasms, including neurofibromas, malignant peripheral nerve sheath tumors, gliomas and leukemia. Also, some studies have suggested that patients with NF1 also have a significantly higher risk of certain types of carcinomas, including breast cancer. However, the occurrence of cutaneous squamous cell carcinoma in a patient with NF1 is rarely reported and the association between NF1 and cutaneous squamous cell carcinoma is not established. Herein, we report a case of cutaneous squamous cell carcinoma occurring on the back of a 31-year-old man with neurofibromatosis type 1.

[P446] Blue toe syndrome mistaken for senile purpura

( Ga-hye Na ),( Do-hyeon Kim ),( Soo-hyeon Noh ),( Eun-jung Kim ),( Kun Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Blue toe syndrome (BTS) is often defined as the development of blue or violaceous discoloration in one or more digits. Initial cutaneous signs of BTS are usually non-specific, including intermittent pain, firm nodule localized to the lower leg, livedo reticularis, petechial, and purpura. A 82-year old woman presented with a 2-month-history of multiple purpuric patch on both leg with intermittent pain. In physical examination, both dorsalis pedis arteries were normally palpated. At first, the patient was diagnosed as senile purpura. After 2 weeks, she presented with increasing pain, ulceration, and black discoloration on multiple toes and heel. Radiologic examination revealed thinning of leg blood vessels with cholesterol thrombus on aorta. Based on clinical and radiologic findings, she was finally diagnosed as blue toe syndrome. And she underwent toe amputation for gangrenous change of toes. Here, we report a case of blue toe syndrome mistaken for senile purpura because this case highlights the importance of early diagnosis of blue toe syndrome

Linear sebaceous hyperplasia following Blaschko's line: Case report and review of published work

( Ga Hye Na ),( Do-hyeon Kim ),( Bo-ra Lim ),( Soo-hyeon Noh ),( Kun Park ),( Eun Jung Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Sebaceous hyperplasia is a common and benign disorder of the sebaceous gland. It commonly develops in middle aged to older persons, and usually presents as yellowish, scattered, umbilicated papules on the forehead, nose, and cheeks. However, several unusual variants of sebaceous hyperplasia have been reported, including a premature form, familial form, sebaceous hyperplasia et plaque, and a linear form. Here, we report an unusual case of sebaceous hyperplasia in a 37-year old woman, presenting as linear arranged, yellowish papules on the right post-auricular area. We also reviewed the literature concerning linear sebaceous hyperplasia, and found that almost all cases show the common features of younger age at onset and linear pattern arranged along Blaschko`s lines.

A comparative study between cellulitis and necrotizing fasciitis

( Ga Hye Na ),( Kun Park ),( Eun Jung Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: Necrotizing fasciitis is a life-threatening soft tissue infection involving the fascia and subcutaneous tissues. The diagnosis of necrotizing fasciitis is often delayed because of underestimation or confusion with cellulitis. Objectives: This study aimed to evaluate and compare the clinical, laboratory, and microbiological characteristics of cellulitis and necrotizing fasciitis. Methods: We retrospectively reviewed the medical records of patients diagnosed as having cellulitis or necrotizing fasciitis and hospitalized to our hospital between January 2011 and December 2016. Results: The study included data from 185 patients having cellulitis and 33 patients having necrotizing fasciitis. Cellulitis and necrotizing fasciitis showed significant differences with regard to clinical and laboratory factors. A thigh/buttock location, pain not controlled by non-opioid analgesics, serum sodium level of less than 135mEq/L, and a serum procalcitonin level of more than 0.32ng/ml on admission were predominantly associated with necrotizing fasciitis. Additionally, polymicrobial infections and Gram-negative organisms were more commonly associated with necrotizing fasciitis compared to cellulitis. Conclusion: When patients present with lesions on the thigh or buttock, severe pain, low serum sodium level, or high serum procalcitonin level, it would be appropriate to evaluate for the possibility of necrotizing fasciitis and use broad-spectrum antibiotics to cover for Gram-negative organisms.

A case of telangiectasia macularis multiplex acquisita

( Ga Hye Na ),( Soo Hyun Noh ),( Jin Keung Chae ),( Kun Park ),( Eun Jung Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Telangiectasia macularis multiplex acquisita (TMMA) is a rare disease with distinctive clinical manifestation. Skin lesions are insidious onset of crops of telangiectatic vessels superimposed on erythematous macules over bilateral upper arms, forearms, shoulders, V-shaped area of the anterior chest, and back. It is occurring predominantly in middle-aged adults. It may be associated with other diseases, such as hepatitis, diabetes, or cardiovascular diseases. A 60-year-old man visited our hospital due to multiple erythematous macules with telangiectasia accompanied by hyperpigmentation on both arms, shoulders, back and anterior upper chest that had been presented for 3 years. He denied any itching symptoms on the lesions. The mucosa was not involved. He was diagnosed with diabetes melitus 10 years previously. He was a hepatitis B carrier who had hepatitis B surface antigen(HBsAg) in the blood. On the biopsy, the specimen showed hyperpigmented basal layer, telangiectasia in the dermis and mild perivascular infiltration of mononuclear cells. The patient was finally diagnosed as TMMA according to the clinical features and histopathological study. We report a rare case of TMMA in man which is the first reported case in Korean literatures.

A case of pemphigoid gestationis accompanying preterm birth

( Ga Hye Na ),( Soo Hyeon Noh ),( Jin Kyung Chae ),( Eun Jung Kim ),( Kun Park ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Pemphigoid gestationis (PG) is a rare dermagologic disease during pregnancy, which usually occurs in second or third trimester of pregnancy. It is known to be associated with prematurity or fetal death. But, interestingly, five cases of pemphigoid gestationis that reported in Korean literature were not associated with preterm birth. We reported a case of pemphigoid gestationis accompanying premature birth. A 33-year-old female was consulted to dermatology for her skin lesion. She had experienced severe pruritus since 32 weeks. At 34 weeks, puritic erythematous annular target lesion with multiple vesicle appeared on umbilical area. And she experienced preterm labor at 35 weeks. Skin lesion spread to trunk and both arm after delievery. She had no specific past history and laboratory finding was normal. Histopathologic finding of skin lesion reveals subepidermal bullae formation with diffuse eosinophil infiltration. Based on clinical and histopathologic finding, she was diagonsed with pemphigoid gestationis and treated by oral methylprednisone, topical methylprednisolone aceponate and antihistamine. Skin lesion improved 4 weeks after treatment. And recurrence has not been observed.

Hematoma beneath nail matrix after finger injury

( Ga-hye Na ),( Bo-ra Lim ),( Do-hyeon Kim ),( Soo-hyeon Noh ),( Eun-jung Kim ),( Kun Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Fingertip injuries are commonly seen, and many of the cases are simple to treat and do not need specialized treatment. However, there are certain conditions where early intervention is warranted for better functional and aesthetic outcomes. A 54-year old man presented with injured fingertip after crushing injury on left 2th finger. Inspection of the digit revealed bluish change of nail plate with erosion on proximal nail fold. Conventional radiograph showed multi-fragmentary fracture of the distal phalanx. After removal of nail plate, nail bed showed bloating. After incision on proximal nail fold, nail matrix showed bloody change with congestion. According to these findings, we diagnosed him as hematoma beneath nail matrix. Then, we incised the transverse line on nail matrix and remove hematoma beneath nail matrix. After this procedure, the patient didn`t complain of any pain. And nail plate showed normal growth without dystrophy. It is difficult to predict solitary nail matrix injury after fingertip injury. Nail matrix injury can cause persistent pain, disturb growth of normal nail plate, and increase the risk of infection. Therefore, evaluating nail matrix in fingertip injury is very important, especially accompanying significant injury to nail fold or digit. And injured nail matrix should be treated by appropriate method.

Food allergen sensitization in young children with typical signs and symptoms of immediate-type food allergies: a comparison between monosensitized and polysensitized children

Kim, Na Yeon,Kim, Ga Ram,Kim, Joon Hwan,Baek, Ji Hyeon,Yoon, Jung Won,Jee, Hye Mi,Baek, Hye Sung,Jung, Yong Ho,Choi, Sun Hee,Kim, Ki Eun,Shin, Youn Ho,Yum, Hye Yung,Han, Man Yong,Kim, Kyu-Earn The Korean Pediatric Society 2015 Clinical and Experimental Pediatrics (CEP) Vol.58 No.9

Purpose: The clinical interpretation of children sensitized to allergens is challenging, particularly in children with food allergies. We aimed to examine clinical differences between children with monosensitization and those with polysensitization to common food allergens and to determine risk factors for polysensitization in young children <10 years of age with immediate-type food allergies. Methods: The study included children <10 years of age with signs and symptoms indicative of immediate-type food allergies. Serum total IgE level was measured, and ImmunoCAP analysis for food allergens was performed. Results: The mean age of the study subjects was $1.6{\pm}1.6$ years (75 boys and 51 girls). Thirty-eight children (30.2%) were monosensitized and 88 children (69.8%) were polysensitized. Multivariate logistic regression analysis showed that the development of polysensitization to common food allergens was positively associated with a parental history of allergic rhinitis (adjusted odds ratio [aOR], 6.28; 95% confidence interval [CI], 1.78-22.13; P=0.004), season of birth (summer/fall) (aOR, 3.10; 95% CI, 1.10-8.79; P=0.033), and exclusive breastfeeding in the first 6 months of age (aOR, 3.51; 95% CI, 1.20-10.25; P=0.022). Conclusion: We found significant clinical differences between children with monosensitization and those with polysensitization to common food allergens and identified risk factors for the development of polysensitization in young children with immediate-type food allergies. Clinicians should consider these clinical risk factors when evaluating, counseling, treating, and monitoring young children with food allergies.