Granuloma annulare occurring on preceding herpes zoster as an isotopic response

( Seong Rak Seo ),( In Jae Jeong ),( Dong Ju Hyun ),( Jae Yang Park ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

In 1995, Wolf et al. coined the term isotopic response to describe the occurrence of a new, unrelated disease at the site of another already healed skin disease. Most reported in the literature as original disease is herpes zoster. However, greatly varied in isotopic response including granulomatous reactions, malignant tumors, leukemic infiltrations, dysimmune reactions. A 54-year-old female presented with multiple erythematous, flat-topped papules, some coalescing, in a zosteriform distribution on the right T11 dermatome area. 6 months before, exactly the same area was involved by herpes zoster and treated with no scar formation. Histopathology showed irregular and eosinophilic collagen with moderate cellular infiltration in upper dermis. A palisades of histiocytes, lymphocytes, and multinucleated giant cells surrounding focal degenerated collagen were seen in high magnifications. From the clinical and histopathologic findings, the diagnosis of granuloma annulare as an isotopic response was made. The patient was treated with mometasone furoate cream twice a day with resolution noted in 1 month. We herein report a case of granuloma annulare occuring on preceding herpes zoster as an isotopic response.

Generalized primary cutaneous nodular amyloidosis

( Seong Rak Seo ),( In Jae Jeong ),( Dong Ju Hyun ),( Jae Yang Park ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Primary cutaneous amyloidosis refers to a group of diseases caused by extracellular deposition of amyloid in the skin without the involvement of other organs. Primary cutaneous amyloidosis has been divided into the following types: macular, lichen and nodular. Primary cutaneousnodular amyloidosis is the rarest form. A 41-year-old female presented with multiple yellowish nodules of the neck and extremities. The lesions occurred 10 years ago after insect bites from when she was living in Uzbekistan. The patient did not have any systemic symptoms and had no disease history. Excision biopsies were made at three different sites of nodular lesions of lower legs. Histopathology showed severe perivascular plasma cell infiltration with extensive deposition of proteinaceous material in the connective tissue and blood vessel. Deposits are highlighted by Congo red staining with apple-green birefringence under polarized light. A subsequent work-up for systemic amyloidosis was unremarkable and there was no evidence of monoclonal gammopathy. From clinical and histologic findings, the diagnosis of primary cutaneous amyloidosis was made. We recommended close follow-up to the patient, but she did not want further treatment and was subsequently lost to follow-up. As of now, generalized primary cutaneous nodular amyloidosis has not been reported in Korea. Herein, we present a case of primary cutaneous nodular amyloidosis with review of the literature.

Inverted follicular keratosis on the groin

( Seong Rak Seo ),( Seon Gu Lee ),( In Jae Jeong ),( Dong Ju Hyun ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Inverted follicular keratosis is characterized by an expansion of the infundibular portion of the hair follicle in an exo-endophytic pattern. The lesion most often arises as a solitary nodule on the face of middle aged to elderly individuals. The diagnosis is generally made by histopathology because the clinical appearance is difficult to differentiate from other lesions such as verruca vulgaris, seborrheic keratosis, cutaneous horn, squamous cell carcinoma. A 18-year-old man presented with a 6-year history of asymptomatic, 0.5x0.3 cm sized solitary skin-colored dome shaped nodule on the right groin. Excisional biopsy showed well-delineated endophytic epithelial proliferations centered around hair follicles with inverted papillomatous and acanthotic components containing several squamous eddies. There was no atypia, mitotic activity, or stromal invasion. From the histopathologic findings, the patient was diagnosed with inverted follicular keratosis and there was no evidence of recurrence when he was examined 6 months later. Herein, we report a case of inverted follicular keratosis on the groin which is an unusual area and age with review of the literature.

Generalized annular lichen planus mimicking granuloma annulare

( Seong Rak Seo ),( Seon Gu Lee ),( In Jae Jeong ),( Dong Ju Hyun ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Annular lichen planus is one of distinct clinical variants of lichen planus, clinically developed as arcuate groupings of individual papules that develop rings or peripheral extension of clustered papules with central clearing. Until now, generalized type of annular lichen planus has rarely been reported. A 56-year-old male patient presented with 5-year history of multiple erythematous to violaceous plaques consisting of annular elevated border and clear center on the buttocks and both extremities showing granuloma annulare-like features. He also complained mild itching sensation. Skin biopsy revealed typical features of lichen planus such as characteristic saw-tooth appearance with wedge-shaped hypergranulosis, vacuolar degeneration and upper dermal lichenoid infiltration. Inflammatory infiltrate was chiefly lymphocytic and forms a dense band in the superficial dermis. He has been treated with topical corticosteroid and systemic antihistamine, and the lesions showed partial regression. We herein present a rare case of generalized annular atrophic lichen planus mimicking granuloma annulare with review of the literature.

Elastosis perforans serpiginosa in a patient with Wilson`s disease

( Seong Rak Seo ),( In Jae Jeong ),( Dong Ju Hyun ),( Jae Yang Park ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Elastosis perforans serpiginosa(EPS) is a reactive perforating dermatosis characterized by the elimination of abnormal elastic fibers from the upper dermis through the epidermis. There are 3 types of EPS: (1) Idiopathic type without associated disease, (2) Reactive type with associated connective tissue disease, and (3) Penicillamine-induced type. A 37-year-old man presented with a 1-year history of asymptomatic, multiple erythematous hyperkeratotic papules in annular and serpiginous configuration on the neck. The patient’s had been taken D-penicillamine(1.5g/d) for about 10 years due to Wilson’s disease. Punch biopsy showed formation of a narrow channel from the dermis through an acanthotic epidermis with degenerated eosinophilic elastic fibers and basophilic debris at the base of the channel. Markedly increased abnormal elastic fibers in the upper dermis were confirmed by Verhoeff-van Gieson stain. Diagnosis of elastosis perforans serpiginosa, caused by longterm ingestion of D-penicillamine, was made. He had been treated with 5 sessions of liquid nitrogen cryothearpy and the lesions showed partial regression. To the best of our knowledge, only few cases have been reported as elastosis perforans serpiginosa associated with D-penicillamine in a patient with Wilson’s disease. Herein, we report a case of D-penicillamine induced elastosis perforans serpiginosa in a patient with Wilson’s disease with review of the literature.

Generalized deep morphea

( Seong Rak Seo ),( Seon Gu Lee ),( In Jae Jeong ),( Dong Ju Hyun ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Generalized morphea is characterized by more than or equal four morphea lesions on at least two of seven different anatomic sites. Meanwhile, the term deep morphea describes the microscopic changes affecting mainly the superficial muscle, fascia, subcutis and deep dermis. As of now, only few cases have been reported as mixed manifestations of generalized and deep morphea A 45-year-old female visited our clinic with multiple variable sized brownish plaques with some depressed skin lesions on the both forearm area which developed 15 years ago. She denied Raynaud’s phenomenon, nailfold capillary change or any systemic symptoms. Laboratory examinations of the patient were positive for antinuclear antibody (1:1280, discrete speckled pattern) and anti-centromere antibodies, while anti-Scl-70 antibodies test were within normal range. Histopathology showed dense, mononuclear cell infiltrates mainly in the deep dermis and subcutis with marked hyalinization of the connective tissue. From clinical, laboratory and histologic findings, the diagnosis of generalized deep morphea was made. We recommended several treatment options including systemic corticosteroid and methotrexate, but the patient refused treatment Herein, we report a rare case of generalized deep morphea with review of the literature.

[P317] Superficial basal cell carcinoma arising within seborrheic keratosis

( Seong Rak Seo ),( Ji Hae An ),( Seon Gu Lee ),( In Jae Jeong ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Seborrheic keratosis is the most common benign epidermal tumor of the skin, but is occasionally associated with several skin malignancies. A 63-year-old woman presented with recently growing erythematous and blackish papule within brownish plaque on the right breast area. Four years ago, the patient underwent a biopsy of the brownish plaque diagnosed as seborrheic keratosis in our clinic, and there were no erythematous or blackish lesions at that time. Punch biopsies were made on erythematous and blackish lesions. In microscopic section, erythematous lesion showed typical features of inflamed seborrheic keratosis. A blackish lesion revealed small buds of basophilic tumor cells extending from epidermis. Basaloid tumor cells showed peripheral palisading, indicating superficial basal cell carcinoma. We herein report a case of superficial basal cell carcinoma arising in seborrheic keratosis on the breast area which was previously histopathologically confirmed as seborrheic keratosis. We emphasize that histological examination should be done when there is inflammation, bleeding, rapid growth, ulceration and/or uneven pigmentation of the seborrheic keratosis lesion.

[P115] Isolated HLA-B27-associated dactylitis in a child and review of literature

( Seong Rak Seo ),( Ji Hae An ),( Seon Gu Lee ),( In Jae Jeong ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Dactylitis is considered a hallmark feature of spondyloarthropathies. Even though the dactylitis is more frequent in psoriatic arthritis, it has been observed in all forms of spondyloarthropathies, including the undifferentiated ones. In undifferentiated spondyloarthropathy, dactylitis may sometimes the only longstanding clinical manifestation of an HLA-B27-associated disease process. A 25-month-old female child presented with 2-month history of erythematous swelling of left fifth toe that did not respond to antibiotics for 4 weeks. She had no subjective symptoms including tenderness, heating sensation, and any other systemic symptoms. Skin biopsy revealed chronic nonspecific mixed infiltration in whole dermis. In laboratory study, HLA-B27 typing was positive and other routine evaluations were normal. Foot ultrasonography showed severe soft tissue swelling on distal phalanx, but flexor tenosynovitis or peritendinous inflammation were not clearly identified. We observed the child closely, but dactylitis persisted for the next 18 months. We herein present a rare case of isolated HLA-B27-associated dactylitis in a child with review of the literature.

Eccrine poroma on the pubic region

( Seong Rak Seo ),( In Jae Jeong ),( Dong Ju Hyun ),( Jae Yang Park ),( Hee Jung Lee ),( Dong Hyun Kim ),( Moon Soo Yoon ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Eccrine poroma is a common, benign, slow-growing solitary adnexal tumor originating from the intraepidermal portion of the eccrine sweat duct. It can occur anywhere on the body where eccrine gland exists and most commonly found on the sole or the side of the foot. Other common sites are the hands and fingers, with sporadic occurrences on the neck, chest, forehead, nose and scalp. But, eccrine poroma on the pubic region has rarely been reported. A 76-year-old man visited our clinic with 0.4x0.2cm sized asymptomatic, solitary pinkish pedunculated papule on penile shaft which was found 3 days ago. The patient denied previous history of trauma. Skin biopsy revealed broad anastomosing bands of monomorphic cuboidal cells with intercellular bridges and occasional ductal lumina growing downward into the dermis. Benign eccrine poroma was diagnosed based on the histologic findings. As the lesion showed complete clearance, additional treatment was not performed. There was no evidence of recurrence when he was examined 6 months later. Herein, we report a case of eccrine poroma arising on the pubic region which is an unusual area with review of the literature.

Improvement of dyslipidemic activity of Smilax sieboldii extract in C57BL/6 mice fed a high-carbohydrate diet

Seo Hyun Park,Min Hee Hwang,Jung A Lee,Young-Rak Cho,Seong Su Hong,Eun-Kyung Ahn 한국식품영양과학회 2022 한국식품영양과학회 학술대회발표집 Vol.2022 No.10