A case of generalized granuloma annulare presenting as large scaly plaque lesions

( Myeong Heon Chae ),( Su Hyun Park ),( Jee Yon Shin ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Granuloma annulare (GA) is a poorly understood condition characterized by a set of morphologic variants. Generalized GA is a common variant of GA, and it usually appears as numerous papules or small plaques, generally not exceeding 5cm. Common involved sites are the trunk, neck and extremities. A 76-year-old man had a 6-months history of erythematous large scaly plaques on the trunk and lower extremities. At first, the plaques were diagnosed as psoriasis at a private clinic, and he was treated with topical vitamin D3 and corticosteroid. He said that the lesions coalesced into large plaques despite taking the treatment. Skin biopsy was done at the trunk and lower extremities and the biopsy specimens showed focal mucin deposition with collection of histiocytes intercalated between collagen bundles in the dermis. Based on these findings, a diagnosis of generalized GA was made. Herein, we report a rare case of generalized GA presenting as the distinct large scaly plaque lesions.

A clinical and histopathological review of chronic cutaneous lupus erythematosus alopecia in Korea

( Myeong Heon Chae ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Chronic cutaneous lupus erythematosus (CCLE) often affects the scalp leading scarring alopecia. So far, no studies have been conducted about CCLE alopecia in Korea. Objectives: The aim of this study is to investigate clinical and histopathological features of CCLE alopecia in Korean patients. Methods: A retrospective study was conducted on 20 patients who were diagnosed with CCLE alopecia of the scalp between 1998 and 2018. We reviewed the clinical and histopathological features of CCLE alopecia and compared the treatment response according to the histopathological features. Results: Among the 20 CCLE alopecia patients, 13 patients (65%) were diagnosed with discoid lupus erythematosus (DLE) and 7 patients (35%) with lupus erythematosus panniculitis (LEP). Common clinical features were erythema, atrophy, and hyperpigmentation. Histopathologically, dermal mucin deposition and a lymphocytic infiltrate around mid to lower portion of the hair follicles were common. According to the histopathological features, a group with sebaceous gland reduction showed no hair regrowth. Conclusion: We found a novel discovery in this study that the treatment effect was decreased in the group with sebaceous gland reduction. Further study is needed to determine whether the reduction of sebaceous glands reflects the permanent destruction of hair follicular stem cells, or it could be primary cause of the permanent destruction of hair follicles in CCLE alopecia.

A case of trichotillomania with a histologic finding of peribulbar neutrophilic infiltrate

( Myeong Heon Chae ),( Su Hyun Park ),( Jee Yon Shin ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Trichotillomania is a form of traumatic alopecia caused by an irresistible compulsion to pull out of one’s own hair. Histological features of trichotillomania show distorted hair follicles, without inflammation. A 16-year-old man had a 2-years history of an alopecic patch on the scalp. His mother said that he usually pulled out his hair by himself, but he denied it. On close inspection, a circular alopecic patch with sharply demarcated borders containing hairs of varying length was seen. Histologic finding showed distorted hair follicles along with pigment casts on the peribulbar area. Additionally, odd shaped hair shafts with peribulbar neutrophilic infiltrate were observed. Brown-Brenn staining and Gram staining reveled no pathogenic organism. Based on these findings, a diagnosis of trichotillomania with pseudofolliculitis was made. Here, we report a rare case of trichotillomania with a unique histologic finding of peribulbar neutrophilic infiltrate.

Perforating Granuloma Annulare Mimicking Papulonecrotic Tuberculid

( Myeong Heon Chae ),( Jee Yon Shin ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2018 Annals of Dermatology Vol.30 No.6

Perforating granuloma annulare (PGA), a rare variant of granuloma annulare, is characterized by transepidermal elimination of altered collagen that clinically manifests an umbilicated papule with a central crust. It can be confused with papulonecrotic tuberculid (PNT) because of their similar appearance. Unlike PGA, PNT is usually related to tuberculosis infection with a typical histologic finding of wedgeshaped dermal necrosis. Here, we report the first Korean case of PGA mimicking PNT both clinically and histologically. A 43-year-old Korean woman presented with erythematous papules localized on the extensor surface of her limbs for one year. Some of these papules had a central umbilication or a crust. Regarding comorbidity, she had latent tuberculosis diagnosed with QuantiFERON^®-TB Gold test about five months ago. She was on antituberculous medication. Initially, a diagnosis of papulonecrotic tuberculid accompanied by latent tuberculosis was considered. However, despite taking the antituberculous medication for five months, her skin lesions were not improved. Biopsy specimen from her arm lesion showed wedge-shaped area of necrosis in the dermis. Additionally, there were multiple focal mucin depositions and palisading granulomatous inflammation throughout the dermis. A diagnosis of PGA was made and she was treated with topical corticosteroid. After two weeks of applying top-ical corticosteroid, most of her skin lesions disappeared, leaving some hyperpigmented scars. (Ann Dermatol 30(6) 716 ∼720, 2018)

A case of nodular lichen myxedematosus

( Myeong Heon Chae ),( Jee Yon Shin ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Lichen myxedematosus is characterized by extensive eruption of soft papules generally 2 to 3 mm in diameter. Although densely grouped, they usually do not coalesce. A 74-year-old woman had a 1 year history of asymptomatic growing nodule on her right thigh. On close inspection, the nodule was flesh-colored and about 7 cm in diameter with some brownish papules on its surface. Skin biopsy was done at the nodular lesion and the biopsy specimen showed mild acanthosis with diffuse mucin deposition throughout the dermis. Based on these findings, a diagnosis of nodular lichen myxedematous was made. Diagnostic tests for monoclonal gammopathy were done, and all of them showed negative or normal results. Herein, we report a rare case of lichen myxedematosus presenting as a nodular lesion.

Lichen Myxedematosus Presenting as a Solitary Nodule

( Myeong Heon Chae ),( Dae Hwi Eun ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2020 Annals of Dermatology Vol.32 No.2

A case of alopecia areata mimicking linear morphea

( Myeong Heon Chae ),( Jee Yon Shin ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Alopecia areata commonly presents a well-demarcated round or oval bald spot on hair-bearing area of the body. A 37-year-old man presented with linear atrophic alopecic patches on the scalp for three years. Two years ago, He was treated with steroid intralesional injection at a private clinic for about three months. The alopecic lesion didn’t spread further, but there were no regrowth of hairs. On close inspection, there were no follicular openings in the alopecic lesions. Initially, a diagnosis of linear morphea was considered. Biopsy specimen from the alopecic lesion showed a definite peribulbar lymphocytic infiltrate around terminal anagen and catagen hair follicles with normal-appearing dermal collagen bundles. Based on these findings, a diagnosis of alopecia areata was made. Herein, we report an unusual case of alopecia areata mimicking linear morphea.

A case of lichen planopilaris

( Myeong Heon Chae ),( Jee Yon Shin ),( Ji Yeoun Lee ),( Tae Young Yoon ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Lichen planopilaris presents with multifocal, coalescing areas of hair loss with perifollicular erythema and scaling. Most patients are white women in their early fifties. A 53-year-old Korean man had a 2 years history of multiple alopecic patches on the scalp. At first, the alopecic patches were diagnosed as an alopecia areata at a private clinic, and he was treated with topical and intralesional corticosteroid for 1 year without improvement. On close inspection, there was no follicular opening at the alopecic lesions and perifollicular erythema with scaling was seen. Biopsy specimen from the alopecic lesion showed dense lymphocytic infiltrate and interface dermatitis around the upper part of the hair follicles with perifollicular fibrosis. Based on these findings, a diagnosis of lichen planopilaris was made. Herein, we report a typical case of lichen planopilaris for an educational purpose.

만성피부홍반루푸스 탈모의 임상 및 조직소견에 대한 고찰

채명헌 ( Myeong Heon Chae ),이지연 ( Ji Yeoun Lee ),윤태영 ( Tae Young Yoon ) 대한피부과학회 2019 大韓皮膚科學會誌 Vol.57 No.2

Background: Chronic cutaneous lupus erythematosus (CCLE) often affects the scalp and results in alopecic lesions. To date, no studies have examined CCLE alopecia in Korea. Objective: The aim of this study was to investigate the clinical and histopathological features of CCLE alopecia in Korean patients. In addition, we reviewed the histopathological features that could potentially affect treatment response. Methods: A retrospective study was conducted on 20 patients who were diagnosed with CCLE alopecia of the scalp between 1998 and 2018. We reviewed the clinical and histopathological features of CCLE alopecia and compared the treatment response according to the histopathological features. Results: Among the 20 CCLE alopecia patients, 13 patients (65%) were diagnosed with discoid lupus erythematosus (DLE) and 7 patients (35%) with lupus erythematosus panniculitis (LEP). The most frequently affected site was the vertex, and 65% of the patients had multiple lesions at the time of diagnosis. Common clinical features were erythema, atrophy, and hyperpigmentation. Histopathologically, dermal mucin deposition and a lymphocytic infiltrate around the mid to lower portion of the hair follicles were common. Among the treated patients, hair regrowth was observed in 42.9% of DLE patients and in 100% of LEP patients at the margin of the existing lesion. According to the histopathological features, the group exhibiting a reduction of sebaceous glands showed no hair regrowth. Conclusion: The novel finding in this study was that the treatment effect was decreased in patients with sebaceous gland reduction. Further study is needed to determine whether the reduction of sebaceous glands reflects the permanent destruction of hair follicular stem cells or whether it acts as the primary cause of the permanent destruction of hair follicles in DLE alopecia. (Korean J Dermatol 2019;57(2):66∼75)

총의치환자의 교육

정재헌(Chae Heon Chung),최명식(Myeong Sik Choi),김옥희(Ok Hee Kim) 조선대학교 구강생물학연구소 1987 Oral Biology Research (Oral Biol Res) Vol.11 No.-

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