Low-Grade Myofibroblastic Sarcoma on Back with Repeated Localized Recurrence and Regional Metastasis

( Hyeon Jeong Park ),( Yeon-gu Choi ),( Seung-wan Chae ),( Won-serk Kim ) 대한피부과학회 2023 Annals of Dermatology Vol.35 No.7

Low-grade myofibroblastic sarcoma (LGMS) is a rare spindle cell tumor with indolent course. Due to rarity and low-grade histologic features of LGMS, accurate diagnosis is challenging. We report a 63-year-old female patient with a three-month history of a 3.1 cm×2.5 cm sized, firm, skin-colored, painless, protruding left back mass. Initial excisional biopsy was performed and the mass was diagnosed as nodular fasciitis. After 18 months after excision, the mass recurred with pain and grew larger. Considering the clinical manifestations, diagnostic impression was changed as dermatofibrosarcoma protuberans not nodular fasciitis. Second wide excision was performed and the histopathology revealed proliferative atypical spindle cells with moderate nuclear atypia and a distinctive whorling pattern, which is suggestive of low-grade sarcoma. Additional computed tomography and positron emission tomography revealed no metastasis and suspicious residual viable malignant tissue. To remove suspicious residual tumor, third wide excision were performed and the diagnosis confirmed as LGMS. A microscopically clear resection was achieved with deep and lateral safety margin 0.6 cm each. Despite of postoperative radiotherapy with 35 times, recurrence of the tumor and lung metastasis was found after 7 months later. LGMS rarely metastasizes and occurs most commonly in the head and neck region. Thus, we report a rare case of LGMS on back which repeated localized recurrence and regional lung metastasis occurred despite wide excision and adjuvant radiotherapy.

Comparative analysis of clinical features between cosmetic-associated irritant contact folliculitis and acne

( Hyeon Jeong Park ),( Jin Seop Kim ),( Yeon Gu Choi ),( Gyoo Huh ),( Yun Ho Lee ),( Junghwa Yang ),( Heun Joo Lee ),( Young Jun Choi ),( Won-serk Kim ),( Ga-young Lee ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Contact dermatitis by cosmetics is due to both irritation and delayed type hypersensitivity, which manifests various conditions including acneiform eruptions. Cosmetics are nowadays extensively tested for the comedogenicity, so they are infrequent cause of acneiform eruptions. Meanwhile, the incidence of the high oil concentration products (ex. water-in-oil emulsions)-induced acneiform eruptions seems to be increasing. Objectives: To review the clinical findings of acneiform eruptions caused by oil-type cosmetics and acne vulgaris. Methods: We evaluated 20 patients who were diagnosed as oil-type cosmetics-induced acneiform eruptions (Contact folliculitis group, CF group). As a control, 20 acne patients were included. The CF group stopped the oil-type products, and both groups were treated with minocycline. Underlying skin disorders, oil-type cosmetics used by patients, the treatment periods and the investigator’s global assessment (IGA) etc. were evaluated. Results: A total of forty patients (mean age 29.0 ± 11) were analyzed. In the CF group, the average time taken to “almost clear” was 21.4 days. It was shorter than that of the control group (p < 0.05). The average of IGA score was decreased from 2.97 to 0.46 at 2W later visit. The number of comedons and inflammatory papules were also decreased (p < 0.05). Conclusion: Acneiform eruptions, a low grade irritant contact folliculitis, caused by oil-type cosmetics can be improved within a short time only if the patients stop using the causative oil products. To check the patient’s daily care products is important to avoid unnecessary over-treatment misdiagnosing the transient irritant contact folliculitis as chronic acne vulgaris.

Benign skin tumors on the plantar surface of the foot

( Hyeon Jeong Park ),( Yun Ho Lee ),( Junghwa Yang ),( Jung Yup Kim ),( Sunmin Yim ),( Jae Yun Lim ),( Heun Joo Lee ),( Young Jun Choi ),( Ga-young Lee ),( Won-serk Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Tumors of the foot are rarely found in the general population. Most of the foot tumors are benign conditions, while malignant tumors are very rare to encounter. There are studies that have reported the relevance of mechanical stress and acral melanomas, but it’s relevance with benign tumors of the foot is still not clear. Objectives: To evaluate prevalence and correlation between types of tumors and weight bearing regions. Methods: A total of 87 patients were retrospectively evaluated. Based on the biopsy data, the type of tumor and its location in the foot were evaluated. Results: The distribution of benign tumors in weight bearing regions versus non-weight-bearing regions was calculated with the use of the chi-square godness-of-fit test. The p-value was less than 0.001 and the result was significant at p=<0.05. The most frequent anatomical location was sesamoids of 1st metatarsal bone (n=20, 22.99%), in order of frequency, tuberosity of calcaneus (n=18, 20.69%), heads of 2nd to 5th metatarsal bones (n=13, 14.94%). In terms of tumor type, among the non-tumors, the rates were higher in the order of epidermal cyst (n=26, 29.89%), dermatofibroma (n=9, 10.34%), hemangioma (n=8, 9.20%), eccrine poroma (n=6, 6.90%), ganglion cyst (n=3, 3.45%), vascular leiomyoma (n=2, 2.30%), lipoma (n=2, 2.30%). Conclusion: The data shows that understanding the relationship between the anatomical location and the type of tumor may be helpful in the diagnosis of tumor on the foot.

Treatment of nail psoriasis with pulsed dye laser and picosecond Nd:YAG laser: a pilot study

( Hyeon Jeong Park ),( Yeon Gu Choi ),( Gyoo Huh ),( Yun Ho Lee ),( Junghwa Yang ),( Jung Yup Kim ),( Sunmin Yim ),( Heun Joo Lee ),( Young Jun Choi ),( Ga-young Lee ),( Won-serk Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Nail involvement is prevalent in psoriasis, and affects over 50% of patients with psoriasis. The treatment of nail psoriasis is challenging, and the gold standard treatment for nail psoriasis is not yet established. Recently, several studies have shown that the microsecond 1064-nm Nd:YAG laser has been successful in treating onychodystrophy. Also, there are reports that pulsed dye laser (PDL) was effective for the improvement of nail psoriasis. We performed a left-to-right split study, and irradiated both nails with a picosecond 1064-nm Nd:YAG laser and PDL. Therefore, we compared the clinical improvement of two laser devices in three patients with nail psoriasis. A decrease in NAPSI score in both nail matrix and nail bed was observed with both treatments. Clinical improvement of nail psoriasis was theoretically due to the destruction of abnormal vasculature, collagen rejuvenation of the nail matrix, nail bed, and proximal nail fold. And we also hypothesized that increased local blood circulation and triggered immune reactions in the nail apparatus improve the nail matrix function. We experienced the temporary improvement with the use of PDL and picosecond 1064-nm Nd:YAG laser in the treatment of nail psoriasis. We need a prospective study designed with a larger number of patients, and a longer follow-up period.

Chronic skin wounds successfully treated with a new negative pressure device

( Hyeon Jeong Park ),( Yeon Gu Choi ),( Gyoo Huh ),( Yun Ho Lee ),( Junghwa Yang ),( Jung Yup Kim ),( Sunmin Yim ),( Heun Joo Lee ),( Young Jun Choi ),( Ga-young Lee ),( Won-serk Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Wounds that do not heal within three months are defined as chronic skin wounds. Here we introduce several cases of chronic skin wounds successfully treated with a new negative pressure wound therapy (NPWT) device. We treated patients using a NPWT dressing (PICO™, Smith and Nephew, Hull, UK), which has the advantages of portable size, lower cost, and higher patient compliance. This device has a lighter pad consisting of four layers which retains exudate and bacteria instead of the heavy canister. Three patients with chronic skin wounds were applied with this device who had various traumatic wounds. A minimum of four weeks follow-up was required until healed. Using this NPWT device, the epithelium was regenerated more rapidly and showed marked reduction of exudates such as seroma and hematoma. We experienced rapid clinical improvement by applying new NPWT device to chronic wound patients who did not respond well to conventional dressing therapy. It has no canister which could increase patient compliance, is noninvasive, and shows rapid improvement only with outpatient treatment. This new device is expected to be applicable to a variety of diseases in the field of dermatologic surgery.

Superficial CD34+ fibroblastic tumor on the plantar foot

( Hyeon Jeong Park ),( Kyu Yeon Kim ),( Bo Bin Cha ),( Jin Seop Kim ),( Yeon Gu Choi ),( Gyoo Huh ),( Heun Joo Lee ),( Young Jun Choi ),( Won-serk Kim ),( Ga-young Lee ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.72 No.2

Fibroblastic mesenchymal tumors show a spectrum of biological behavior, from benign to malignant. We here in report our experience of a distinctive features of superficial CD34-positive fibroblastic tumor (SCPFT), which is a newly described neoplasm, previously undescribed low-grade fibroblastic tumor of the superficial soft tissues. A 45-year-old man presented with subcutaneous nodular lesion on the mid foot area of the right sole. The lesion was near the area of skin graft of the foot, which undergone traumatic amputation by traffic accident 40 years ago. The right foot MR examination revealed 2.0x1.6x0.8 cm sized enhancing mass involving skin and subcutaneous layer. After total excision with supralesional flap surgery, the histopathological study of the 1.9x1.8x0.5 cm sized mass revealed some nodular growing pattern of atypical spindle cell proliferative lesion with distinctive angiomatosis, moderate nuclear atypia, admixed some inflammatory cells in fibro-fatty tissue, and mitotic figures of 1/10 HPFs. The CD34 stain showed diffusely positive reaction for the lesion, and the expression of Ki-67 protein was very low. Finally, the patient was diagnosed with SCPFT. To date, 42 cases of SCPFT have been reported. The incidence rate of this entity is much higher due to the lack of sufficient recognition of this tumor. Herein, we report a rare case of the SCPFT to enhance the recognition and diagnostic level of the disease.

HCC : PE-074 ; A case of synchronous hepatocellular carcinoma and renal cell carcinoma treated with radio-frequency ablation

( Yoon Serk Lee ),( Jeong Han Kim ),( Hyeon Young Yoon ),( Soon Young Ko ),( Won Hyeok Choe ),( So Young Kwon ),( Chang Hong Lee ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Radio-frequency ablation (RFA) is curative treatment for hepatocellular carcinoma (HCC). Recently, RFA is also known to be an effective treatment option for renal cell carcinoma (RCC) less than 4 cm. Case: We experienced a case of 53-year-old male who was referred to konkuk university hospital because of suggestive HCC, RCC, and alcoholic liver cirrhosis (Child-Pugh score 9, stage B). Contrast-enhanced abdomen CT and MRI images showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 2.4 cm hypervascular mass in left kidney. These findings were compatible with double primary cancers of HCC and RCC. There was no evidence of lymph node or distant metastasis. Serum AFP was 6.93 ng/mL (<7.0 ng/mL). HBsAg, Anti-HBs, Anti-HCV were all negative. Transarterial chemoembolization (TACE) was performed to treat the HCC. After TACE, focal lipiodol uptake defect was noticed on follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no significant complication after the procedure. One month later, follow-up CT images were taken. There was no evidence of recurrence. Conclusions: We report a case of synchronous HCC and RCC treated with RFA.

Association between serum vitamin D level and psoriasis: A clinical review in Korean patients in a single tertiary center

( Hyeon Jeong Park ),( Yeon Gu Choi ),( Gyoo Huh ),( Yun Ho Lee ),( Junghwa Yang ),( Jung Yup Kim ),( Sunmin Yim ),( Heun Joo Lee ),( Young Jun Choi ),( Won-serk Kim ),( Ga-young Lee ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Psoriasis is a chronic, inflammatory autoimmune disease. Vitamin D (Vit D) is a hormone that may have important immunomodulatory effects in psoriasis. Some studies have demonstrated a relationship between Vit D deficiency and psoriasis. Objectives: We aimed to compare serum levels of Vit D of patient with active psoriasis and non-patient seen at the outpatient clinic. Methods: Based on the retrospective chart reviews, a total of 181 patients between April 2018 and Aug 2019 were observed. The analysis of Vit D serum levels was performed by immune-assay and according to recent report, values < 20ng/ml were considered deficiency, from 20 to < 30ng/ml insufficiency and ≥ 30ng/ml sufficiency. Statistical data were evaluated by Chi-Square test and the values were considered significant when P < 0.05. Results: In psoriasis group (n=83, 26 females and 57 males), mean age was 42.04 and patients with serum Vit D deficiency was 59.04% (n=49). In non-psoriasis group (n=98, 46 females and 52 males), mean age was 43.60 and the frequency of serum Vit D deficiency was 71.43% (n=70). There was no statistically significant difference between the two groups (p=.080, > 0.05). However, serum Vit D level and the PASI showed a negative correlation (R=-0.134), although the relationship was weak. Conclusion: We observed that there was no significant differences in serum Vit D level between two groups. Further study is needed considering age, gender, comorbidity associated with disease severity.

Case Report : A synchronous hepatocellular carcinoma and renal cell carcinoma treated with radio frequency ablation

( Yoon Serk Lee ),( Jeong Han Kim ),( Hyeon Young Yoon ),( Won Hyeok Choe ),( So Young Kwon ),( Chang Hong Lee ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.3

Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month. (Clin Mol Hepatol 2014;20:306-309)

Web-based Patient Monitoring System Using Wireless Diaper Wetness Sensor

Hyun-serk Lee,Jeong-ho Bak,Bo-kyeong Sim,Hak-on Lee,Sang-won Han,Byoung-won Min,Hyeun-Tae Lee 한국콘텐츠학회 2008 ICCC International Digital Design Invitation Exhib Vol.2008 No.12