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The pattern and profile of alopecia areata: A retrospective study of 221 cases
( Sunyoung Jo ),( Hanhim Jeoung ),( Seunggi Hong ),( Kiwoong Ro ),( Eunphil Heo ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Alopecia areata (AA) is considered an autoimmune disease with undetermined pathogenesis. Few studies report clinical course and epidemiology of AA patients. Objectives: The purpose of this study is to assess the clinical features of of AA according to its severity. Methods: We reviewed the records of patients with AA presenting to our clinic between Jan 2016 and Feb 2018. The extent of AA at the time of first visit was categorized as follows: mild to moderate (< 50% scalp hair loss), severe ( >50% scalp hair loss) Results: Of the included 221 patients, 138 patients (62.4%) presented as mild to moderate AA and 83 patients (37.6%) presented as severe AA. The average onset age was 33.30±1.45 years and 32.93±1.99 years in the mild to moderate and severe groups, respectively, and the patients diagnosed before the age of 13 were 24 patients (17.4%) with mild-to-moderate AA and 17 patients (20.5%) with severe AA. The average disease duration was 10.84 ±1.61 months and 42.92±7.59 months, respectively, and the mild to moderate and severe AA patients had disease duration of longer than 1 year in 21.7% and 63.9% of patients. 8.7% of patients with mild to moderate AA had an associated family history of AA, and 13.3% of patients with severe AA had. Conclusion: In this study, compared with the patients with mild to moderate AA, those with severe AA tended to have longer disease duration, early onset and frequent family history of AA. The findings of this study are consistent with previous studies
A case of pemphigus vegetans presenting as chronic pustular dermatitis of the foot
( Sunyoung Jo ),( Hanhim Jeong ),( Seunggi Hong ),( Jaewan Go ),( Hyunjoo Lee ),( Eunphil Heo ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Pemphigus vegetans is a variant of pemphigus vulgaris mainly involving skin folds, face, scalp and mucous membranes. Of the two subtypes, Hallopeau type pemphigus vegetans starts with pustules with subsequent vegetation, and has a relatively benign course. In this case, the patient is an 87 year-old woman presenting with erythematous pustules on left sole suspicious of chronic pustular dermatitis. Three years ago, the patient had presented with macerated erythematous papules and plaques on external genitalia, inguinal area and left axilla which were improved after treatment with oral corticosteroid. She had been diagnosed as pemphigus vegetans by her laboratory findings of positive Desmoglein 1, Desmoglein 3 and pathologic findings of papillomatosis, acanthosis, suprabasal acantholysis and microabscess containing eosinophils. Under suspicion of infection with positive culture result of extended-spectrum beta-lactamase producing Escherichia coli from pustule, she was treated with IV antibiotics. Pustules recurred and vegetating lesion appeared after partial improvement, then she was treated with IV corticosteroid. After showing complete response and slow tapering of corticosteoid, there has been no recurrence with low dose oral steroid. We report a rare case of Hallopeau pemphigus vegetans misunderstanded as chronic pustular dermatitis because of atypical involvement of foot and positive bacterial culture in an 87-year-old female.
A case of blastic plasmacytoid dendritic cell neoplasm presenting as leukemia
( Sunyoung Jo ),( Seunggi Hong ),( Kiwoong Ro ),( Eunphil Heo ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy that is derived from plasmacytoid dendritic cells. This disease typically presents with cutaneous manifestations and have an aggressive clinical course involving lymph nodes, peripheral blood and bone marrow leading to leukaemic transformation. In our case, the patient is a 56 year-old man presenting with multiple erythematous to violaceous plaques, nodules and mass suspicious of leukemia cutis predominantly distributed on the trunk and upper extremity. At the onset of the disease, the patient only had one erythematous nodule on the left forearm which are refractory to antibiotics medication. Histopathological examination of the left upper arm lesion demonstrated nodular dense neoplastic infiltration in the dermis sparing the epidermis with a Grenz zone. On immunohistochemistry, the specimen were positive for CD4, CD56, and CD123. Thus, the patient was consecutively diagnosed with BPDCN. 1 week after biopsy done, the patient complain of gingival hypertrophy and more widespread skin lesions. Through immediate staging investigations, the patient was revealed to have blood and BM involvement. He has been treated with multi-agent chemotherapy. We report a case of blastic plasmacytoid dendritic cell neoplasm with leukaemic dissemination at presentation.
( Sunyoung Jo ),( Hongpil Jeong ),( Hanhim Jeong ),( Seunggi Hong ),( Hyunjoo Lee ),( Eunphil Heo ),( Jaewan Go ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Many patients have visited the emergency center for dermatological diseases in Gyeongnam Province, but no statistical study was conducted on them. Objectives: The purpose of this study is to assess the incidence and characteristics associated with patients with dermatological diseases who visited the regional emergency center (EC). Methods: We retrospectively reviewed the records of patients presenting to the EC of Samsung Changwon Hospital between Jan 2009 and May 2019. We evaluated the age, sex, disease diagnoses, temporal distribution, visit length, outpatient follow-up rate and admission rate. Results: A total of 8755 patients were seen with the mean age of 34.55 years old. Males and females appear to visit the EC almost equally (male 4338 cases, female 4417 cases). The most common disease visited by patients was urticaria/angioedema (15.95%) followed by herpes zoster (14.35%), contact dermatitis (8.88%) and erysipelas/ cellulitis (8.66%). The most frequent visits were in September (13.90%), and the lowest number of patients was in November (6.61%). The average visit length is about 3hrs, and 65.38% of patients stayed for less than 3 hours. The outpatient follow-up rate was 56.95%. The admission rate was 9.11% (40 cases). Conclusion: Our study revealed that data of dermatologic patients visiting to the EC in Gyeongnam Province. This data can provide useful information to physicians who treats the patients visiting the emergency department with cutaneous manifestations.
A case of blastic plasmacytoid dendritic cell neoplasm relapse to which skin lesions serve as clues
( Sunyoung Jo ),( Hanhim Jeong ),( Seunggi Hong ),( Jaewan Go ),( Hyunjoo Lee ),( Eunphil Heo ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare aggressive hematologic malignancy derived from plasmacytoid dendritic cells. This disease typically presents with cutaneous manifestations and have an aggressive clinical course involving lymph nodes, peripheral blood and bone marrow leading to leukaemic transformation. The majority of patients initially respond to multi-agent chemotherapy, though most relapse within a year and the prognosis is very poor. In our case, the patient was a 57 year-old man presenting with solitary indurated plaque on left lower leg with history of BPDCN. He had maintained a complete response for 3 months after treatment with multi-agent chemotherapy. Histopathological examination of the left lower leg lesion demonstrated nodular dense neoplastic infiltration in the dermis sparing the epidermis with a Grenz zone positive for CD4, CD56 on immunohistochemistry. Thus, the patient was diagnosed with recurred BPDCN. He have been treated with L-asparaginase-containing chemotherapy. We report a case of blastic plasmacytoid dendritic cell neoplasm relapse manifesting as a skin lesion.
A retrospective study of 140 cases positive for antinuclear antibody test
( Sunyoung Jo ),( Seunggi Hong ),( Sungeun Song ),( Kiwoong Ro ),( Eunphil Heo ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: Antinuclear antibody(ANA) test is commonly used to screen for autoimmune diseases. Cutaneous manifestations may be first signs in patients with systemic autoimmune disease. Objectives: We investigated the clinical utility of ANA test by reviewing the initial presentations, ANA titer, and final diagnosis. Methods: We reviewed the records of patients presenting to our dermatologic clinic between July 2012 and June 2017. The symptoms and signs at the time of ANA testing, ANA titers, and the final diagnosis were analyzed. Results: Of the included 1694 patients, 139 patients (8.2%) were positive for ANA test. Urticaria (41%) was the most common initial presentation. 25 patients (18.0%) had systemic autoimmune disease. The most common systemic autoimmune disease was Lupus erythematosus (9.3%), followed by Sjogren’s disease (2.2%), Dermatomyositis (0.7%), Behcet’s disease (2.2%) and others. Eighteen patients (72%) of patients with systemic autoimmune disease were initially presented with cutaneous manifestation. These patients were likely to complain of arthralgia (50%), dry eye or dry mouth (39%), and hematologic abnormality (28%) and others. Conclusion: In this study, compared with the patients with low ANA titer(<1:80), those with high ANA titer(≥1:640) were more susceptible to systemic autoimmune disease. But 82% of ANA-positive patients did not have systemic autoimmune disease. ANA serologies has little clinical value in predicting a flare of autoimmune disease.
A case of tubular apocrine adenoma clinically mimicking dermatofibroma
( Sunyoung Jo ),( Seunggi Hong ),( Kiwoong Ro ),( Eunphil Heo ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Tubular apocrine adenoma (TAA) is a rare skin appendage tumor with apocrine differentiation and presents as a well-defined nodule that is located on the scalp. Here we report a case of TAA, the lesion of which was rarely located on the right knee. The patient is a 25-year old woman who presented a dome shaped papule on the inner side of the right knee occurred three years ago. A punch biopsy was done. Histological examination revealed a infiltration of irregularly dilated shaped tubular structures that are lined by two layers of epithelial cells and some of the tubules have intraluminal papillary projections. There is no definite decapitation secretion. Under suspicion of papillary eccrine adenoma or TAA, an excisional biopsy was done. On microscopic examination, a well circumscribed nodule in the dermis and the decapitation secretion of the luminal cells were seen. Thus, the patient was consecutively diagnosed with TAA. In following up for three months, there is no evidence of recurrence. In this case, TAA occurred on a unusual location of non-apocine area which was not reported before. For the more correct differential diagnosis, immunoshistochemical stain is needed to be done.