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( Kihyuk Shin ),( Hyunju Jin ),( Hyang Suk You ),( Woo Haing Shim ),( Jeong Min Kim ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ),( Gun Wook Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Dermal fillers have been used increasingly recently for facial soft tissue augmentation. Although complications are rare and most of them are mild and transient, accidental intra-arterial filler injection could cause severe complications such as skin necrosis and visual loss. First lines of treatment are prompt recognition, early intervention with hyaluronidase, oral aspirin, topical nitropaste, warm compresses, and massage of the affected area. If ischemia is still present after initial treatment, evidence, although weak, suggests that hyperbaric oxygen therapy (HBOT) may benefit some patients to rescue marginal tissue that might undergo necrosis. A 35-year-old female presented with sudden partial bilateral visual loss and skin necrosis of the glabellar area. It occurred instantly after filler injection through nasal tip and early intervention such as hyaluronidase and oral aspirin was already done by physician who injected filler. The patient came to our department 2 days after filler injection, thus we treated her with 1000mg methylprednisolone for 3 consecutive days and HBOT. Our patient``s skin lesions were almost cleared within 2 months, however there was only mild improvement in visual acuity. To our knowledge, this is the 1st case of severe complications following filler injection treated with steroid pulse therapy and HBOT in the Korean dermatologic literature.
[P533] Cheilitis granulomatosa successfully treated with roxithromycin
( Kihyuk Shin ),( 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
Cheilitis granulomatosa (CG) is characterized by chronic painless swelling of the lip due to non-necrotizing granulomatous inflammation. The treatment of CG is exceedingly difficult. While several therapeutic methods have been applied to CG, there has been no reliable treatment option. A 27-year-old male presented with swelling of the lower lip. The lesion began to develop 1 year previously in the absence of any specific provoking factor and the patient reported no subjective symptom. Histopathology revealed non-caseating granulomas surrounded by lymphocytes and plasma cells, and these findings were consistent with CG. However, no improvement was observed within 1 month of methylprednisolone (8mg/day) or oral cyclosporine (200mg/day). Subsequently, oral roxithromycin (150mg/day) and intralesional corticosteroid therapy (triamcinolone, 10mg, 1-month interval) were initiated and lesions completely subsided within 2 months. However, after the discontinuation of roxithromycin, the lower lip swelling recurred. Readministration of oral roxithromycin (150mg/day) was done, the swelling disappeared gradually. To our knowledge, this is the first report of CG successfully treated with roxithromycin in the Korean dermatologic literature.
Efficacy of oral alitretinoin for the treatment of recalcitrant trachyonychia
( Kihyuk Shin ),( 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-bum 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: The patients with trachyonychia usually complain that it is stigmata in social life. However, trachyonychia is often refractory to conventional treatments including topical or intralesional steroids, cyclosporine and retinoids. Therefore, something new is needed for the treatment of this recalcitrant trachyonychia. Objectives: To evaluate the efficacy and safety of oral alitretinoin for the treatment of trachyonychia. Methods: A total of 15 patients with 160 nails affected by trachyonychia were enrolled. All patients took 30 mg of alitretinoin daily for at least 3 months. Clinical outcomes were measured by physician’s global assessment proposed by Park JM, et al. (degree of roughness: 0, clear; 1, mild; 2, moderate; 3, marked; 4, severe) at baseline and 1, 2, 3, and 6 months after treatment. Results: After 1, 3, and 6 months of treatment, 67.5% (108/160), 97.5% (156/160) and 99.2% (119/120) of nails showed clinical improvement, respectively; 0% (0/160), 21.9% (35/160), and 69.2% (83/120) were completely free from nail abnormalities, respectively. The mean physician’s global assessment score at baseline was 3.4, decreasing significantly to 2.5, 1.3, and 0.7 at 1, 3, and 6 months following treatment, respectively. Conclusion: This is the first study which evaluates the efficacy and safety of oral alitretinoin for the treatment of recalcitrant trachyonychia. The results suggest that oral alitretinoin can be an effective treatment for trachyonychia.
Cuticle as a predictor of the thumbnail growth rate
( Kihyuk Shin ),( Jun-oh Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Growth rate of nails is affected by various conditions. However, little is known about the anatomic factor which can predict the nail growth rate. Objectives: To investigate the anatomic factors that could predict the growth rate of thumbnails. Methods: Twenty-four healthy young adults were enrolled in the study. We marked a line with ultrapulse CO<sub>2</sub> laser on thumbnails at the baseline. Thumbnails were photographed with ruler at the baseline and six weeks after marking. The distance from the mark to the proximal nailfold, and the length of lunula and cuticle was measured by analyzing magnified photos with ImageJ. Results: The female to male ratio was 1.4:1 and the mean age was 30.3 years (24-39 years). Growth rate of dominant hand thumbnails was faster than that of non-dominant hand thumbnails (3.85 vs. 3.28 mm/ month, P < 0.0001). Cuticle length was positively correlated with thumbnail growth rate (r=0.3946 and P=0.0055), and cuticle length of dominant hand thumbnails was longer than that of non-dominant hand thumbnails (P=0.0002). Age, sex, height, weight, body mass index (BMI), length of lunula were not significantly associated with thumbnail growth rate. Conclusion: This study highlights the role of cuticle in predicting thumbnail growth rate. These results could be helpful in the treatment of nail disorders as well as for investigation on medication affecting nail growth rate.
P179 The importance of ultrasonography diagnosing epidermal cyst and lipoma in dermatologic field
( Kihyuk Shin ),( Hyunju Jin ),( Hyang-suk You ),( Jeong-minkim ),( Woo-haing Shim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook 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: Ultrasonography (US) is a simple and reliable tool which can aid the diagnosis of benign subcutaneous lesions such as epidermal cyst and lipoma. Objectives: To determine the efficacy of US for the diagnosis of epidermal cysts and lipomas Methods: This study included 100 patients with epidermal cyst (n=45) or lipoma (n=55) who underwent US and then received a pathologic diagnosis in the dermatology department of Pusan National University Hospitals (Busan and Yangsan). Results: US and clinical impression accurately diagnosed the epidermal cyst in 90.0% and 88.0% of the patients, respectively, and the lipoma in 92.0% and 88.0% of the patients, respectively. US combined with clinical impression significantly increased the diagnostic yield of the epidermal cyst (98%; p=0.008 and 0.002, compared to US and clinical impression, respectively) and the lipoma (99%; p=0.016 and 0.001, compared to US and clinical impression, respectively). On US, frequency of posterior acoustic enhancement found in epidermal cysts was higher than lipomas (82.2% and 29.1%, respectively; p<0.001), and internal debris such as internal linear echogenic reflections or dark clefts was more frequently found in the lipomas than epidermal cysts (90.9% and 6.7%. respectively; p<0.001). Conclusion: This study implies that diagnostic role of US can be greatly enhanced by knowledge of the clinical presentation.
A Case of Malignant Solitary Fibrous Tumor of the Skin
( Kihyuk Shin ),( Tae-wook Kim ),( Hyun-joo Lee ),( Sung-min Park ),( Hyunju Jin ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyang-suk 대한피부과학회 2019 Annals of Dermatology Vol.31 No.2
[P167] A case of acquired acrodermatitis enteropathica in an adult with a normal serum zinc level
( Kihyuk Shin ),( 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-soo Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Acrodermatitis enteropathica is classified as either congenital or acquired, and typically presents as eczematous cutaneous lesions on acral and periorificial areas with possible paronychia, alopecia, chronic diarrhea, or photophobia, which are attributed to zinc deficiency. However, although serum zinc levels are usually lower than normal in acrodermatitis enteropathica, they are sometimes normal. A 73-year-old woman presented with a 3-days history of erythematous scaly patches on the perioral region, palms, and soles. There had been no change in medications for more than 6 months. The patient had not been eating well over the past few months because of a lack of appetite. Due to concerns about the possibility of drug eruption, a skin biopsy was performed and oral corticosteroid therapy was started. Histopathologic examination revealed cytoplasmic pallor in the upper epidermis and focal spongiosis. Based on clinical symptoms, histopathologic findings, and lack of clinical response to systemic corticosteroid, acquired acrodermatitis enteropathica was considered. Although her serum zinc level was normal (81.4ug/dL), her skin lesions had improved within five days of oral zinc sulfate treatment (1.5mg/kg/day). Because serum zinc levels do not reflect zinc status, when a patient with typical symptoms and signs of acrodermatitis enteropathica is encountered, zinc supplementation should not be delayed even when serum zinc levels are normal.
P127 Clinical and dermoscopic features of arteriovenous hemangioma
( Kihyuk Shin ),( Hyunju Jin ),( Hyang-suk You ),( Jeong-min Kim ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 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: Arteriovenous hemangioma (AVH) is a rare benign acquired cutaneous vascular lesion characterized by an intermingled complex of aggregated arterial and venous structures. Until now, investigation on clinical and dermoscopic features of AVH is limted. Objectives: To investigate the clinical and dermoscopic features of AVH. Methods: We retrospectively analyzed the clinical and dermoscopic characteristics of 22 patients who are pathologically confirmed as AVH at dermatology department of Pusan National University Hospitals (Busan and Yangsan). Results: The male to female ratio was 1:0.8 and the mean age of onset was 43.4±21.4 years. Face (16/22, 72.7%) was the most commonly involved area and they usually appeared as papules or nodules (16/22, 72.7%). Size increase (12/22, 54.5%) was the most frequently observed change in AVH patients. Dermoscopically, milky-red areas (18/22, 81.8%) was the most frequently observed morphological vessel type on AVH lesions. Conclusion: This study highlights the clinical and dermoscopic features of AVH. These results might be helpful to differentiate AVH from other vascular tumors.
Clinical features of nail lichen striatus
( Kihyuk Shin ),( 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-bum 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: Lichen striatus is an uncommon, self-limiting linear dermatosis which usually occurs along Blaschko’s lines. Because nail involvement is rare in lichen striatus, nail lichen striatus has not been investigated extensively. Objectives: To investigate the clinical features of nail lichen striatus Methods: We reviewed 16 cases of pathologically confirmed nail lichen striatus from 2007 to 2017 at dermatology department of Pusan National University Hospitals (Busan and Yangsan). Results: The female to male ratio was 1:0.6 and the mean age of onset was 7.2 years (1.5-33 years). All patients had both nail abnormalities and typical skin lesions. In these cases, lichen striatus usually involved a single digit (68.8%, 11/16). The most common nail deformity was longitudinal ridging (87.5%, 14/16) followed by onychoschizia (8/16, 50%), nail thickening (3/16, 18.8%), onychomadesis (3/16, 18.8%), and onycholysis (1/16, 6.3%). We treated both skin and nail lesions with topical tacrolimus ointment. Half of the nail lesions resolved within a mean of 8.3 months (1-16 months) from the initiation of treatment. Conclusion: This study highlights the clinical features of nail lichen striatus on the largest scale until now. These results might be helpful to differentiate nail lichen striatus from other nail disorder.