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A case of primary cutaneous perivascular epithelioid cell tumor (PEComa)
( Haneul Oh ),( Jae Yeong Jeong ),( Sook In Ryu ),( Bo Young Kim ),( Hye Rim Moon ),( Il-hwan Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Primary cutaneous perivascular epithelioid cell tumors (PEComa) are rare, recently described mesenchymal tumors composed of perivascular epithelioid cells. These rare tumors are characterized by the co-expression of melanocytic and muscle markers. A 66-year-old female was referred to our dermatology clinic because of a suspected clear cell neoplasm in excisional biopsy performed at local clinic. According to the patient, the lesion was a 1 cm-sized asymptomatic nodule on her right knee. On histopathological examination, the tumor was a dermal tumor composed of nests of epithelioid cells exhibiting clear cytoplasm and showed involvement of resection margins. In immunohistochemistry, tumor cells were positive for HMB-45, Vimentin and CD-10. These clinical and histological findings were consistent with a diagnosis of primary cutaneous PEComa. Because of the marginal positive lesion, additional excision was performed and no lesion remained in the pathologic report. After a complete excision, the patient has not experienced relapse until now. We herein reported a rare case of primary cutaneous PEComa in a 66-year-old female with diagnosis based on clinical and histologic findings. This case indicated primary cutaneous PEComa is rare but could occur and mimic other cutaneous tumors including clear cell fibrous histiocytoma, claear cell sarcoma and melanocytic neoplasms with balloon cell change.
Clinicodermoscopic features of atypical dermatofibroma compared with typical type
( Haneul Oh ),( Tae Jun Park ),( Bo Young Kim ),( Chang Min Kim ),( Hwa Jung Ryu ),( Hye Rim Moon ),( Il-hwan Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize, but in some cases its differentiation from atypical dermatofibroma may be difficult. Objectives: To describe the clinical and dermoscopic features of atypical dermatofibromas and to differentiate from typical type according to the above features. Methods: We retrospectively searched the database of patients from Korea University Ansan Hospital from January 2010 to July 2018, who had skin biopsy or excision operation with the resulting pathology report of typical and atypical dermatofibroma. Analysis of the clinical demographics (age, gender, anatomical site etc.) and dermoscopic features was done. Results: Of the 240 patients diagnosed with dermatofibroma, 19 (7.9%) were identified as atypical deramtofibroma. In comparison of clinical features, the atypical type was not significantly different from the typical type. However, dermoscopy findings of four patients with atypical dermatofibroma were analyzed, and These dermoscopic findings are patterns that appear below 6% in typical types. Conclusion: Atypical dermatofibroma is clinically difficult to distinguish from the typical counterpart and biopsy is essential for diagnosis. If dermatofibroma is suspected and exhibits rare dermoscopy findings, it may be an atypical type and should be treated with caution when treating because of the tendency to recur and metastasis.
Clinico-dermoscopic features of atypical dermatofibroma
( Haneul Oh ),( Byeong Geun Park ),( Jae Yeong Jeong ),( Tae Jun Park ),( Hwa Jung Ryu ),( Il-hwan Kim ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1
Background: Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize, but in some cases its differentiation from atypical dermatofibroma may be difficult. Dermoscopy, which is widely used in recent years, may be helpful in early detection of atypical dermatofibroma. Objectives: To describe the clinical and dermoscopic features of atypical dermatofibroma and to differentiate from typical type. Methods: We retrospectively searched the database of patients from Department of Dermatology, Korea University Ansan Hospital from 2010 to 2019, who had skin biopsy or excision operation with the resulting pathology report of typical and atypical dermatofibroma. Results: Of the 220 patients diagnosed with dermatofibroma, 20 (9.1%) cases were identified as atypical deramtofibroma. In comparison of clinical features, the atypical type was not significantly different from the typical type. However, dermoscopy findings of atypical dermatofibroma showed several distinct features. Peripheral homogeneous pigmentation and central white network pattern was the most common finding, which is only found in 6% of the typical dermatofibroma. Conclusion: Atypical dermatofibroma is clinically difficult to distinguish from the typical counterpart and biopsy is essential for diagnosis. If dermatofibroma is suspected and exhibits uncommon dermoscopy findings, it may be an atypical type and should be treated with caution when treating because of the tendency to recur and metastasis.
A case of HIV-associated psoriasis successfully treated with acitretin
( Haneul Oh ),( Jae Yeong Jeong ),( Tae Jun Park ),( Bo Young Kim ),( Hwa Jung Ryu ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
HIV-associated Psoriasis is more severe, tends to be non-responsive to treatment, and has more limitations on treatment options. However, reports on HIV-associated psoriasis are very rare in Korea. A 22-year-old male patient with a history of three years of HIV infection visited our dermatology clinic because of psoriasis exacerbations. He was diagnosed with psoriasis two years ago and was well controlled with topical steroid/calcipotriol ointment. But skin lesions recently worsened without the decrease in CD4 T-cell count and responded poorly to therapy with a topical ointment. He was on antiretroviral therapy without change, had 391 cells/mm3 of CD4 T-cell count. Because of the impaired immunological status of the patient, acitretin 20 mg daily was started as initial treatment instead of traditional severe psoriasis treatment such as MTX, Cyclosporin. When he visited our clinic a month later, most of the scales and papuloerythematous skin lesions had disappeared. Acitretin 20 mg daily was continued for 2 more months and the patient has not experienced relapse until now. HIV-associated psoriasis is a condition that requires careful treatment selection, because of the high risk of worsening the conditions of an already impaired immune system existing in these patients. we hearin report a case of HIV-associated psoriasis successfully treated with acitretin
비전형적 피부섬유종의 임상적 특징과 더모스코피 소견에 관한 연구
오하늘 ( Haneul Oh ),문혜림 ( Hye-rim Moon ),유화정 ( Hwa-jung Ryu ),김일환 ( Il-hwan Kim ) 대한피부과학회 2021 대한피부과학회지 Vol.59 No.5
Background: Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize; however, in some cases, it is difficult to differentiate it from atypical dermatofibroma. Atypical dermatofibroma is a rare variant of a more aggressive nature and requires complete excision due to its tendency to recur. Objective: To describe the clinical and dermoscopic features of dermatofibromas with special emphasis on the characteristics of atypical subtypes and to differentiate them from typical subtypes on the basis of results. Methods: We retrospectively searched the databases of patients of Korea University Ansan Hospital from January 2010 to December 2019 who underwent skin biopsies or excision surgeries and had pathological reports of dermatofibroma. Analyses of the clinical characteristics (age, sex, number of lesions, anatomical site) and dermoscopic patterns were performed. Results: Dermoscopic patterns were analyzed in 148 cases of dermatofibroma; peripheral delicate pigment networks and central white scar-like patches were the most common patterns found in 45 cases (30.4%). In eight cases of atypical dermatofibroma, three cases (37.5%) showed peripheral homogenous areas and central white networks, followed by multiple white scar-like patches in 2 cases (25.0%), peripheral delicate pigment networks, and central white scar-like patches in 2 cases (25.0%). Dermoscopy revealed a statistically significant difference in the peripheral homogenous area and the central white network pattern between the two groups. Conclusion: In this study, we analyzed the dermoscopic findings of 148 patients with dermatofibroma and found that the peripheral homogenous area and central white network patterns were significantly more in atypical dermatofibroma. (Korean J Dermatol 2021;59(5):341∼347)