A case of congenital neurofollicular hamartoma

( Yun Seon Choe ),( Jung Yoon Ohn ),( Kyu Han Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

A 7-month old male presented with well-demarcated, irregularly grouped, pinkish to skin colored papules on upper back since birth. There was no symptom like itching or tenderness, and the size of lesion has changed little over the seven months. He had no perinatal problem,and has shown normal development well. Punch biopsy was performed, and hyperplastic folliculo-sebaceous units surrounded by bland-looking spindle cell proliferation were observed. Immunohistochemical studies showed positivity for S-100 among the spindle cells, otherwise negativity for Melan A(MART-1) and CD34. By clinic-pathologic findings, it was diagnosed as neurofollicular hamartoma, which is characterized by a stroma composed of spindle cells proliferation and hyperplastic pilosebaceous units. Neurofollicular hamartoma is an unusual dermal neoplasm, and diagnosed by histopathological findings with immunohistochemical features consistent with neuroid differentiation showing positive S-100 antigen. Clinically it is usually appeared on nose or nasolabial fold of middle aged male as tiny solitary skin colored papule. However, our case was congenital lesion and showed bigger and grouped feature on the back, not on the face. Herein, we report a rare case of congenital neurofollicular harmatoma with review of literature.

A case of sebaceous hyperplasia showing clinical features of epidermal nevus in a child with Kimura`s disease

( Yun Seon Choe ),( Min Woo Kim ),( Dong Young Kim ),( Kyu Han Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

A 13-year old male presented with linearly distributed multiple verrucous skin-colored papules on right postauricular area since three years ago. He had been diagnosed as Kimura’s disease due to cervical lymphadenopathy 9 years ago, and under follow up for eosinophilia and nodules on neck and right upper arm. Other past medical history and family history were nonspecific. Under the impression of epidermal nevus, punch biopsy was done. In the pathologic findings, hyperplastic sebaceous glands in superficial dermis were noted, and there were no clues which were suggestive of epidermal nevus. It was diagnosed as sebaceous hyperplasia, and CO2 laser was done to remove those lesions. After only one time of laser treatment, there was no recurrence till 1-year follow up. Sebaceous hyperplasia generally affects middle-aged to elderly adults, showing yellowish to skin-colored, less than 5 mm sized papules, especially on the seborrheic area of face like forehead, nose and cheeks. In the considerations of the young age, postauricular location, and linear distribution, the clinical feature of this patient was unusual. There is no report of Kimura’s disease with sebaceous hyperplasia, so the basis of this possible association is unclear. Herein, we report a case of sebaceous hyperplasia showing clinical features of epidermal nevus in a child patient with Kimura’s disease with review of literature.

P165 : Epidemiologic study of pediatric cutaneous neoplasm in Korea

( Yun Seon Choe ),( Dong Young Kim ),( Young Woon Park ),( Kyu Han Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: Pediatric cutaneous neoplasm has different distributions and clinical features from adult cases. However, there are few epidemiologic studies of pediatric cutaneous neoplasm in Korea. Objectives: The aim of this study was to determine the distribution of pediatric cutaneous neoplasm in Korea and to compare the results with previous reports conducted for all ages. Methods: We retrospectively reviewed patients under age 20 first clinically diagnosed with benign or malignant cutaneous neoplasm at the dermatology department of a tertiary hospital in Korea from 2009 to 2013. Demographic data, tumor data, and skin biopsy results in available cases were analyzed statistically. Results: The study included 2,541 patients (M:F=1:1.09) for 2,776 benign tumors, and 17 patients (M:F=1:0.42) for 17 malignant tumors. Hemangioma was the most common benign tumor, comprising 24.7% of all benign tumors, followed by nevus sebaceous (10.34%), nevus flammeus (6.09%),pilomatricoma (5.33%), and epidermal cyst (5.30%). In malignant tumor, lymphoma (n=11) was the most common, as accounting for 64.7% of all malignancy. Skin biopsy was performed in all malignant cases, whereas only 10.99% (n=305) of benign tumors were confirmed by biopsy. Of those, biopsy was performed most commonly for nevus sebaceous cases. Conclusion: The distribution of pediatric cutaneous neoplasm was quite different from that of adult cases in previous reports, showing that benign tumors, especially vascular tumors, were predominant.

CASE REPORT : A Novel Approach for Full-Thickness Defect of the Nasal Alar Rim: Primary Closure of the Defect and Reduction of the Contralateral Normal Ala for Symmetry

( Yun Seon Choe ),( Min Woo Kim ),( Seong Jin Jo ) 대한피부과학회 2015 Annals of Dermatology Vol.27 No.6

In full-thickness defects of the nasal alar rim, to achieve projection and maintain airway patency, cartilage graft is frequently needed. However, cartilage graft presents a challenge in considerations such as appropriate donor site, skeletal shape and size, and healing of the donor area. To avoid these demerits, we tried primary closure of alar rim defects by also making the contralateral normal ala smaller. We treated two patients who had a full-thickness nasal alar defect after tumor excision. Cartilage graft was considered for the reconstruction. However, their alar rims were overly curved and their nostril openings were large. To utilize their nasal shape, we did primary closure of the defect rather than cartilage graft, and then downsized the contralateral nasal ala by means of wedge resection to make the alae symmetric. Both patients were satisfied with their aesthetic results, which showed a smaller nostril and nearly straight alar rims. Moreover, functionally, there was no discomfort during breathing in both patients. We propose our idea as one of the reconstruction options for nasal alar defects. It is a simple and easy-to-perform procedure, in addition to enhancing the nasal contour. This method would be useful for patients with a large nostril and an overly curved alar rim. (Ann Dermatol 27(6) 748∼750, 2015)

A study of the eczema herpeticum in Korean

( Yun Seon Choe ),( Kyu Han Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Eczema herpeticum (EH) often presents as complication of atopic dermatitis (AD). Objectives: We aimed to evaluate the epidemiologic trends of EH during last 10 years, comparing those with prevalence of AD. Methods: A retrospective analysis was carried out for EH patients between Jan 2005 and Dec 2014. Variables ofinterest included age, sex, season of onset, treatment, outcomes, recurrence, and history of underlying AD. The prevalence of AD at the same period was investigated. Results: Total 1,043 episodes of EH in 621 patients were diagnosed during ten years. Mean age at onset was 23.4 years, and sex ratio was M:F = 1:1.4. The patients who had recurrent episodes tend to be older (25.9 years) than those with EH episode only once (21.3 years). At the same period, total 33,692 patients were diagnosed as AD in our clinic, with continuous increase of prevalence annually. The ratio of EH/AD was 1.83% in average, and it was steadily decreased by years. EH was more commonly complicated in old age, showing significantly increased EH/AD ratio above 30 years old. Conclusion: EH is not a rare complication of AD, affecting about 2% of AD patients. While the prevalence of AD is increased over the years, total number of EH patients was little changed, leading to slight but continuous decline of EH/AD ratio. As patients getting older, EH could be more commonly complicated in AD, and show more recurrent course than in younger patients.

P257 : Clinical study for recurrence of postoperative malignant melanoma in Korean patients

( Yun Seon Choe ),( Kwang Hyun Cho ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: As malignant melanoma is rising in Korea as well as western countries, a considerable number of melanoma patients recur after operation. Objectives: The aim of this study was to investigate the clinicopathologic features of recurrent malignant melanoma after operation and to predict risk of recurrence. Methods: A retrospective study was conducted for primary cutaneous melanoma patients who got operation for curative purpose on single tertiary hospital in Korea from Jan 2009 to Feb 2014. Results: Among 126 patients, 56 males and 70 females were included and the age at diagnosis was 59.3 years. The surgical methods were wide excision or amputation. The median follow up duration was 27.3 months (rage 6.4 - 68.5), and 42 cases (33.3%) recurred. The recurrence rate was significantly different according to the tumor location, histologic subtype, and stage. In melanoma on hands or feet, 16 out of 79 cases (20.6%) recurred, while other site melanoma recurred in 26 out of 47 cases (55.3%). The recurrence rate of acral lentiginous type and nodular type was 11.11% (7 out of 63), and 74.3% (26 out of 35), respectively. A significant correlation was found between stage at the operation and recurrence rate. Recurrence rate were as in the following: melanoma in situ (9.1%), stage I (12.9%), stage II (45.8%), and stage III (56.0%). Conclusion: In Korean postoperative melanoma patients, close surveillance to detect recurrence is required, especially for non-acral type melanoma or advanced stage.

P047 : Clinical characteristics of erythema infectiosum

( Yun Seon Choe ),( Kyu Han Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: Erythema infectiosum is an infection of human parvovirus B19, which often occurs in outbreaks among school aged children. Although it could be resolved without specific treatments, to know accurate diagnosis and prognosis is important to avoid unnecessary examinations or treatments. Objectives: The aim of this study was to analyze clinical characteristics of erythema infectiosum. Methods: Sixteen cases suspected for erythema infectiosum from last three years (June 2011 - May 2014) of a tertiary hospital in Korea were reviewed. Results: The patents were 7 females, 9 males and 6.1 years old in average age. Most cases were diagnosed at spring and winter; 7 for spring and 8 for winter. All patients had no underlying disease, and 6 showed mild lymphocytosis among 8 patients who had laboratory results at visit. 3 patients had mild fever, and 1 had itching sense. No mucosal involvement was found. We identified parvovirus B19 by polymerase chain reaction (PCR) from serum in 5 cases, and all of them showed positive results. Only by oral antihistamine and mild potency topical steroids, skin lesions were resolved in 1-2 weeks without aplastic anemia or other serious complications.Conclusion: Usually erythema infectiosum is diagnosed clinically, so it is important to know its clinical findings very well. And for atypical cases, PCR for parvovirus B19 from serum could be a simple and useful method to confirm the diagnosis of erythema infectiosum.

P166 : Epidemiological trends of atopic dermatitis in Korea

( Yun Seon Choe ),( Dong Young Kim ),( Young Woon Park ),( Kyu Han Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: The prevalence and severity of atopic dermatitis are concerns worldwide, but there are few epidemiological studies about atopic dermatitis in Korea. Objectives: The aim of this study was to evaluate the prevalence and severity of atopic dermatitis in Korea by age group over a 10-year span. Methods: A retrospective analysis of atopic dermatitis patients during 2004-2013 in a Korean tertiary hospital examined age, sex, duration of treatment, and history of taking oral immunosuppressants. Results: The number of atopic dermatitis patients more than doubled from 2004 (n = 2298) to 2013 (n = 4783). The increase was continuous over time, with infants showing the most dramatic increase (587.5%). Treatment duration was typically less than 6 months, suggesting that atopic dermatitis is a minor illness. However, the number of patients treated longer than 6 months increased rapidly, even accounting for the increase in atopic dermatitis overall. The proportion of patients treated long-term increased from 5.03% to 43.72%, with the highest increase being for patients in their thirties. There was no significant change in the number of patients taking immunosuppressants over time. Conclusion: Our epidemiological study shows the social burden of atopic dermatitis in Korea. Both its prevalence and severity have been increasing for all age groups. Prevalence has increased the most for children, whereas severity has increased considerably for adults, mainly in their thirties.

P296 : A typical case of dyschromatosis universalis hereditaria

( Yun Seon Choe ),( Eun Jee Kim ),( Young Woon Park ),( Hyun Sun Yoon ),( So Yun Cho ),( Hyun Sun Park ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.1

P649 : A case of cutaneous metastatic melanoma treated with topical diphencyprone (DPCP)

( Yun Seon Choe ),( Eun Jung Hwang ),( Jin Yong Kim ),( Mi Ra Choi ),( Kwang Hyun Cho ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.1