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Photobiomodulation therapy for the prevention of radiodermatitis in breast cancer patients
( Donghwi Jang ),( Hyun Jeong Byun ),( Jongeun Lee ),( Chan Seong Park ),( Youngkyoung Lim ),( Ji-hye Park ),( Jong-hee Lee ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Radiotherapy for breast cancer (BC) may accompany acute radiodermatitis and photobiomodulation therapy (PBMT) has been recently applied as a treatment option in diverse fields by promoting tissue repair. Objectives: To evaluate the effectiveness and safety of PBMT for the prevention of acute radiodermatitis in BC patients undergoing radiotherapy. Methods: The control group was 10 BC patients without PBMT and a total of 22 subjects was divided into two groups; group 1 and group 2 (11 subjects each, PBMT of wavelength 633 nm and 830nm, respectively). The degrees of radiodermatitis were assessed based on CTCAE grade and compared between the groups. The differences of skin measurements (melanin, erythema, moisture, and sebum content index) between the irradiated side and the non-irradiated side were evaluated at four time points and the changes were evaluated and compared between the groups. Results: The incidence of high grade radiodermatitis (more than grade 2a) was significantly higher in the control than in the PBMT groups right after the radiotherapy (p=0.0259). The differences in skin measurements at each time point were not significant between the groups except for moisture index which PBMT groups showed lesser change from the baseline compared to the control group right after the radiotherapy(ps <0.05). Conclusion: PBMT might play a role in the prevention of acute radiodermatitis in BC patients, which needs further study.
Clinical, dermoscopic and pathologic features of onychopapilloma
( Donghwi Jang ),( Dong Min Shin ),( Jongeun Lee ),( Hyun Jeong Byun ),( Hyun Je Kim ),( Se Jin Oh ),( Ji-hye Park ),( Jong-hee Lee ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1
Background: Onychopapilloma is a benign neoplasm of nail unit commonly presenting as longitudinal chromonychia with occasional splinter hemorrhages or distal subungal keratosis. Pathologically, onychopapilloma shows papillomatous nail bed and distal matrix with layers of hyperkeratosis or matrix metaplasia. Objectives: To identify clinical, dermoscopic, and pathologic features of onychopapilloma patients. Methods: We retrospectively analyzed the clinical, dermoscopic, and pathologic features of patients who were diagnosed with onychopapilloma within last 5 years, and reviewed the published literature. Results: A total of 16 patients were included (9 women, 7 men) with a median age of 45 years. The common clinical presentation was longitudinal erythronychia (n=7), followed by longitudinal leukonychia (n=5), and longitudinal melanonychia (n=4). Distal subungal hyperkeratosis was shown in all patients and distal onycholysis (n =11) and splinter hemorrhage (n=9) were commonly shown features. Dermoscopic findings were consistent with clinical features. Localized subungal layered hyperkeratosis of nail plate and papillomatosis with acanthosis of nail bed were commonly shown pathologic features. Conclusion: Clinicians should be aware for the diagnosis of onychopapilloma when typical findings of longitudinal chromonychia with distal sunbungal hyperkeratosis are shown.
Effect of photobiomodulation therapy on radiodermatitis in mouse model
( Donghwi Jang ),( Dong Min Shin ),( Jongeun Lee ),( Hyun Jeong Byun ),( Hyun Je Kim ),( Se Jin Oh ),( Ji-hye Park ),( Jong-hee Lee ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1
Background: Radiodermatitis, a side effect of radiotherapy, presents as erythema, desquamation, skin necrosis or ulceration. Photobiomodulation therapy (PBMT) has been applied in diverse clinical fields with effects of reducing inflammation, acceleration of wound healing, and pain alleviation. Objectives: To evaluate the effect of PBMT for prevention of radiodermatitis and to evaluate skin changes histopathologically in an irradiated mouse model. Methods: Irradiated mice were randomly distributed into three groups: A (633 nm), B (830 nm), and C (without PBMT). On post-irradiation Day 7 and 21, we evaluated acute skin damage due to irradiation and compared irradiated skin to non-irradiated skin using H&E, Masson’s trichrome, anti-CD45 and PCNA immunohistochemistry, and a TUNEL assay. Results: Grade 3 radiodermatitis was evident only in Group C. Compared to Group C, Group A and B skin had significantly less epidermal hyperplasia, inflammatory cell infiltration, and thinner dermis on Day 7, and less inflammatory cell infiltration, fewer apoptotic cells, and thinner dermis on Day 21. However, there was no significant difference between Group A and B. Conclusion: This study indicates PBMT could prevent severe radiodermatitis by reducing epidermal and dermal damage, inflammation, and cellular apoptosis. There was no difference in PBMT efficacy between the 633 and 830 nm wavelengths.
( Donghwi Jang ),( Jongeun Lee ),( Jaihee Bae ),( Yeonjoo Jung ),( Heeyeon Kim ),( Se Jin Oh ),( Jong Hee Lee ),( Dong-youn Lee ),( Ji-hye Park ) 대한피부과학회 2023 대한피부과학회지 Vol.61 No.1
Bullous pemphigoid (BP) is a chronic and recurrent bullous disorder that may be associated with the administration of certain drugs. Recently, bullous cutaneous adverse events after immunotherapy (IT) or targeted therapy have been increasingly reported. Here, we report a case of BP in a patient diagnosed with metastatic melanoma after treatment with pembrolizumab, dabrafenib, and trametinib. Histopathological examination showed a subepidermal blister with perivascular lymphocytic and eosinophilic infiltration; the accompanying findings of linear immunoglobulin G and C3 deposition by immunofluorescence microscopy were consistent with BP. Since IT agents may initiate immune dysregulation and pathologic autoantibody production, which are required for the pathogenesis of BP, the lesions were thought to be cutaneous adverse events caused by IT. (Korean J Dermatol 2023;61(1):62∼65)
Conservative surgical management for subungual melanoma: 27cases
( Donghwi Jang ),( Hyun Jeong Byun ),( Jongeun Lee ),( Chan Seong Park ),( Youngkyoung Lim ),( Ji-hye Park ),( Jong-hee Lee ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Subungual melanoma (SUM), an uncommon variant of acral lentiginous melanoma, arises from the nail matrix and may involve various other components of nail unit. In the past, amputation had been considered and recommended as the treatment of choice for SUM. Recently, conservative surgical management (CSM) has shown better outcomes both functionally and cosmetically than amputation and suggested as an alternative management for SUM. Objectives: To report a series of SUM patients treated by CSM and to evaluate the post-operative outcome of the patients. Methods: A total of 27 patients who were diagnosed with in situ or minimally invasive SUM and treated by CSM in Samsung medical center, Seoul from 2016 to 2019 were reviewed retrospectively. The patients’ demographics and clinical characteristics including disease presentation, delay to diagnosis, and postoperative outcomes were reviewed. Results: The mean age at diagnosis was 49.6 years and male to female ratio was 1.45:1. The most prevalent group of delay to diagnosis was more than 10 years. The most common complication after treatment was contracture, and amputation was performed due to infection in one case. There was no melanoma related death case and only one recurrence case which underwent secondary operation. Conclusion: CSM in patients with in situ or minimally invasive SUM is a procedure with good cosmetic and functional outcome and the prognosis is not inferior to amputation.