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The enigmatic development of new psoriasiform lesions following toxic epidermal necrolysis
( Jim Yung Seo ),( Howard Chu ),( Young In Lee ),( Do Young Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
A 64-year-old male visited our dermatology clinic with a two-month history of increasing numbers of psoriatic skin lesions over his trunk and limbs. The lesions were erythematous and scaled plaques without symptoms. Three months ago, the patient had been treated for toxic epidermal necrolysis (TEN), which developed due to chemotherapy drugs for acute myeloid leukemia. The patient underwent two cycles of cytarabine plus idarubicin. A skin biopsy of one of the trunk lesions showed interface dermatitis with separation of dermo-epidermal junction and some dyskeratotic cells, which was not compatible with psoriasis. He was treated with topical corticosteroids and moisturizing cream under the suspicion of the vegetating type of cutaneous response, which may appear in response to the drug-related insult of TEN. After 4 weeks of topical treatment, the lesions disappeared. In certain diseases accompanying erosions such as pemphigus vulgaris, there is a tendency to develop excessive granulation tissue and crusting, which results in vegetating lesions. To our knowledge, this is the first report of a vegetating type of response during the advanced stage of TEN. Conservative treatment using topical steroids can be considered as a treatment option.
P132 : Off label use of topical vitamin D on various dermatosis
( Jim Yung Seo ),( Dong Yun Shin ),( Do Young Kim ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
Background: Topical vitamin D(vit.D) is a widely used FDA-approved drug for the treatment of psoriasis. However, there have been suggestions from recent studies that the usage of topical vit.D in other skin disorders can show favorable outcomes. Objectives: The goal of this study was to investigate the off label use of topical vit.D in a real clinical setting. Methods: The efficacy of topical vit.D was analyzed retrospectively. Using Clinical Data Retrieval System(CDRS) at Severance Hospital a total of 137 patients were selected who were prescribed with topical vit.D for non-psoriatic dermatosis between Jan. 2010 and Dec. 2011. Clinical efficacy was rated with a 3-point scale. Results: Among 137 cases, morphea(29.9%) was the most common skin condition, followed by hand eczema(21.1%), pustulosis palmaris et plantaris(15.3%) and onychodystrophy (12.4%). The percentage of improvement was 90.2%, 86.2%, 90.4% and 88.2% respectively. Of the 59 cases treated with topical vitamin D monotherapy, morphea was the most frequently prescribed disease entity, 93.5 percent of the patient with morphea showed improvement. According to current literature, there has been a few cases with acrodermatitis continua showing marked improvements after using topical vit.D. Clinical improvement by topical vit.D were also noticed in ichthyosis, morphea, palmoplantar keratoderma, and vitiligo. Conclusion: Topical vit.D can be used as an alternative treatment option for various benign skin diseases in an off label manner.
( Ji Hee Kim ),( Jim Yung Seo ),( Hong Sun Jang ),( Dan Bi Li ),( Kee Yang Chung ),( Byung Ho Oh ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.1
Secondary intention healing (SIH) is a reconstructive option by which the skin defect is gradually restored with the granulation tissue. And during SIH, large skin defect naturally progress into remodeling phase of wound healing reducing the scar through contraction and reepithelization. SIH do have disadvantages due to prolonged healing period, requiring regular and frequent dressing changes and may bear risk of infection. There have been reports of acceptable functional and cosmetic outcomes of SIH, especially when applied in skin defects of fingertip amputation, concave area of the face, and wide excision of melanoma on the foot. However, for dermatologic surgeon, it is not easy to decide SIH as a restorative option because of results are hardly predictable in initial stage with may vary depending on the location, size, depth, concomitant diseases, and dressing materials. We herein report cases of large skin defect treated with SIH after wide excision of malignant tumors such as scalp angiosarcoma, dermatofibrosarcoma protuberans on the shoulder, non-melanoma skin cancers on the face, and etc. Moreover, we would like to evaluate the aesthetic and functional results as well as possible complication of the SIH procedures, and analyze the factors affecting these results with a review of the literature.
Primary hypertrophic osteoarthropathy with SLCO2A1 gene mutation in siblings
( Hee Joo Kim ),( Min Seok Lee ),( Jim Yung Seo ),( Sungsik Shin ),( Dongyun Shin ),( Dae Suk Kim ),( Min Geol Lee ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Primary hypertrophic osteoarthropathy (PHO), also named pachydermoperiostosis, is a rare genetic disease that affects both skin and bones. PHO is characterized by clubbed nails, periostosis, acroosteolysis, painful joint enlargement, and skin manifestations that include thickened facial skin, a thickenedscalp, and coarse facial features. Two genes are known to be related to PHO: SLCO2A1 and HPGD. Here, we report two siblings clinically presenting with cutis verticis gyrata, acromegaly, joint pain with swelling, and clubbed fingers. Interestingly, the patients suffered from frequent watery diarrhea. Homozygous guanine-to-adenine transition at the invariant +1 position of the donor site of intron 7 (c.940 + 1G > A) was found in both brothers whose father had a heterozygous mutation.
오병호 ( Byung Ho Oh ),서지명 ( Jim Yung Seo ),정기양 ( Kee Yang Chung ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.3
Background: The incidence of skin tumors has been increasing over the past few years due to an aging population, environmental changes, and improved access to medical institutions. Objective: To report the rate of relapse and complications after surgical treatment, and suggest appropriate ways of treating benign skin tumors. Methods: We performed a retrospective review of 846 patients with benign skin tumors who were diagnosed and treated by a single dermatosurgeon. Results: Of the 846 patients, 18 (2.1%) developed local recurrence. Epidermal cysts (15/390) were the most common skin condition, followed by lipomas (2/149). The recurrence rate of epidermal cysts showed no statistical difference when treatment options and the presence of inflammation or suppuration at the first visit were considered. Six patients (0.7%, 6/846) had one of the complications such as persistent inflammation over one month, severe pain, secondary infection, or skin necrosis. All the lipomas following recurrence or those with complications were located in the intramuscular or submuscular area of the forehead, which were easily localized by sonography. Conclusion: Surgery is a valuable method for the treatment of benign skin tumors with low rates of complication and relapse. For better outcomes after treatment, dermatologists should attempt to remove these tumors completely and consider the use of imaging studies before treatment. (Korean J Dermatol 2015;53(3):202∼208)