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Oh, Narang,Lee, Kija,Chung, Jinyoung,Ahn, Jinok,Choi, Sooyoung,Park, Inchul The Korean Society of Veterinary Service 2019 韓國家畜衛生學會誌 Vol.42 No.4
An 8-year-old castrated male Korean short hair cat was referred with chronic vomiting, diarrhea, and anorexia. The cat was diagnosed with alimentary lymphoma via fine needle aspiration. Three weeks later, he was presented again with anorexia. Hepatomegaly and hyperechoic change in the liver parenchyma were observed. Computed tomography while awake was performed and revealed hypoattenuation of the hepatic parenchyma. The cat was tentatively diagnosed with feline hepatic lipidosis secondary to alimentary lymphoma. In the feline patient with lymphoma, hepatomegaly is important to differentiate hepatic lipidosis from hepatic infiltration of lymphoma on liver. In the present case, fatty infiltration of the liver was identified via non-invasive, rapid, and convenient computed tomography examination in an awake cat with a lymphoma.
Very Early Patch Stage of AIDS-related Kaposi Sarcoma: A Case Report
( Dong Heon Lee ),( So Yun Park ),( Narang Hong ),( Hyung Don Kook ),( Hye Jung Jung ),( Jiyoung Ahn ),( Mi Youn Park ) 대한피부과학회 2023 Annals of Dermatology Vol.35 No.7
Kaposi sarcoma (KS) is a vascular and lymphatic neoplasm caused by human herpesvirus 8 (HHV-8). AIDS-related KS has variable clinical courses ranging from mild disease presenting as an incidental finding to severe disease presenting as an aggressively progressing neoplasm that can lead to poor prognosis or even death. Typical clinical manifestation of KS is known as multiple cutaneous lesions on the extremities, trunk, and face with mucosal involvement. A 46-year-old male with AIDS complained of an erythematous patch on the right forearm which appeared 5 months ago. For a year, he was treated with antiretroviral drugs for AIDS. Physical examination revealed a 2.5-cm solitary erythematous patch only on the right forearm. Laboratory data revealed human immunodeficiency virus (HIV)-1 RNA of less than 40 copies/ml and a CD4 cell count of 264 cells/mm3. Histological examination revealed numerous slit-like spaces and vascular proliferation with primitive blood vessels dissecting between the collagen bundles and the dermis. Immunohistochemical staining showed positive HHV-8 nuclear staining of spindle cells. The histological features and positive HHV-8 immunohistochemical stain were consistent with the diagnosis of early patch stage of AIDS-related KS. KS can readily be misdiagnosed in early patch stage even by experienced clinicians, which leads to requirement of pathologic determination. On close inspection, it can be distinguished from other mimickers by its distinctive histologic features and immunohistochemical staining for HHV-8. Therefore, in cases of HIV-positive patients with clinically or histologically vascular-appearing mucocutaneous lesions, KS should be considered as a possible differential diagnosis.
Tuberculous Lymphadenitis in a Patient Treated with Dupilumab: A Case Report
( Dong Heon Lee ),( Narang Hong ),( Hyung Don Kook ),( Hye Jung Jung ),( Mi Yeon Park ),( Jiyoung Ahn ) 대한피부과학회 2023 Annals of Dermatology Vol.35 No.7
Tuberculous lymphadenitis is among the most frequent presentations of extrapulmonary tuberculosis; the most common presentation is isolated chronic non-tender lymphadenopathy in young adults without systemic symptoms. Dupilumab is a fully human monoclonal antibody directed against interleukin-4 receptor-α that blocks the synergistic effects of interleukin-4 and interleukin-13 on allergic inflammation. Its well-known adverse events are allergic conjunctivitis, injection site reaction, and dupilumab facial redness. A 32-year-old female with severe atopic dermatitis was treated with dupilumab for 2 months at our clinic. She complained of multiple enlarged palpable lymph nodes on the right side of the neck and inguinal area for 2 months. Laboratory tests showed an increased total eosinophil count and immunoglobulin E level, as well as positive interferon-γ release assays. Radiological examination showed multiple low echoic and heterogeneous well-enhancing lymph nodes in level II, III, IV, and V of the neck. Histological examination revealed caseous necrosis and tuberculoid granuloma. The lymph node enlargements were completely relieved after anti-tuberculosis treatment. The mechanism for the development of tuberculous lymphadenitis in a patient receiving dupilumab is not fully understood yet. In some previous studies, treatment with dupilumab suppressed the expression of genes related not only to T helper 2 and eosinophil response but also to proinflammatory responses. It could not inhibit the intracellular growth of Mycobacterium tuberculosis in macrophages, predisposing them to the development of tuberculous infection. To the best of our knowledge, this is the first report on the development of tuberculosis lymphadenitis in a patient treated with dupilumab.
( Dong Heon Lee ),( Ho Eun Gwag ),( So Yun Park ),( Narang Hong ),( Hyung Don Kook ),( Hye Jung Jung ),( Mi Yeon Park ),( Jiyoung Ahn ) 대한피부과학회 2024 대한피부과학회지 Vol.62 No.1
Background: Since the disease burden of atopic dermatitis (AD) understandably increases with its disease severity, studies, especially on the baseline characteristics of severe AD, have been conducted in some countries to deepen the understanding of the disease and, by extension, formulate a relevant national policy. However, research on the baseline characteristics of severe AD in Korea remains insufficient. Objective: To report the baseline demographics and describe the clinical characteristics of adult Korean patients with severe AD, including medical and treatment history, clinical manifestations, disease severity, and laboratory findings, in order to understand the characteristics of severe AD. Methods: A single-center, prospective, non-interventional, observational, longitudinal study of 108 patients with severe AD was conducted between January 2021 and December 2022. Clinical data and patient-reported measures of signs and symptoms of AD were recorded at baseline. Results: The mean Eczema Area and Severity Index score of the patients was 28.5±6.8. The mean pruritus numerical rating scale, Patient-Oriented Eczema Measure, Dermatology Life Quality Index, and Atopic Dermatitis Control Tool scores were 8.1±1.7, 23.6±4.8, 21.9±6.6, and 19.5±3.9, respectively. Although a larger proportion of the head/neck and trunk are affected than both limbs, the key signs of AD were less severe in the head/neck region than in the other regions. Erythema and lichenification were more representative clinical signs of severe AD than induration and excoriation. The baseline data on previous treatments reflected the AD treatment guidelines in Korea. Conclusion: This real-world data will provide dermatologists with a better understanding of severe AD, which will eventually lead to better clinical and health policy decisions for patients with severe AD. (Korean J Dermatol 2024;62(1):29∼41)