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Spontaneous intracerebral hemorrhage in a patient with severe psoriasis vulgaris
( Sang-jin Cheon ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Moon-bum Kim ),( Byung-soo 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Psoriasis is chronic immune-mediated inflammatory skin disorder of unknown etiology. Psoriasis was previously believed to affect only the skin, and in some patients, the joints. Recent evidence suggests that chronic psoriasis may lead to other comorbidities such as cardiovascular disease, obesity, and type 2 diabetes mellitus. However, the association between psoriasis and intracerebral hemorrhage (ICH) has rarely been reported. The patient was 43-years-old female with a history of severe chronic psoriasis vulgaris for 6 years refractory to conventional immunomodulatory treatments and phototherapy. She was unregularly followed-up and 2 month ago, she was treated with cyclosporine (2.5mg/kg), but the disease aggravated. Four days ago, abruptly, she started to notice weakness of right lower extremity and dysarthria. She denied any history of trauma. On magnetic resonance imaging study, bilateral ICH in basal ganglia was observed. She did not have any risk factors such as trauma, advanced age, and hypertension for ICH. Therefore, we suspected that severe chronic psoriasis vulgaris may have played an important role in occurrence of spontaneous ICH.
( Sang Hyok Lim ),( Hong Woo Cheon ),( Ho Sung Lee ),( Jae Sung Choi ),( Ki Hyun Seo ),( Yong Hoon Kim ),( Ju Ock Na ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Metastatic squamous cell carcinoma of intrathoracic lymph node with cancer of unknown primary (CUP) is very rare. We report a case of metastatic squamous cell carcinoma of hilar lymph node with CUP and review of the associated literatures. Abnormal mass in the right hilar was incidentally detected. The patient was performed a right pneumonectomy and mediastinal lymph node dissection. Microscopically, metastatic squamous cell carcinoma at hilar lymph nodes without primary lung or other lesion was diagnosed. He has currently been received adjuvant chemotherapy under diagnosis of T0N1M0 Lung cancer.
FC 2-14 Clinical study of hypopigmentation induced by intra-articular corticosteroid injection
( Sang-jin Cheon ),( Hyun Ju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Jeong-min Kim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
Background: Intra-articular corticosteroid injection (IACI) is commonly used in the field of orthopedic surgery and rheumatology for management of the joint disease. However, there have been very limited data about IACI-induced hypopigmentation. Objectives: The purpose of present study was to investigate characteristics of IACI-induced hypopigmentation. Methods: 43 patients who were diagnosed as IACI-induced hypopigmentation at Pusan National University Hospitals (Busan and Yangsan) from 2004 to 2016. Results: Of the 43 patients, 53 lesions were analyzed in this study, the male to female ratio was 1:7.8 and the mean age at diagnosis was 46.4 ± 13.5 years. The most common (24/43, 56%) impression at the local clinics was vitiligo. Mean number of injection 1.8 times and the interval from injection to the onset of IACI-induced hypopigmentation was 3.3 months. Wrist was the most commonly affected site (18/53, 34%), followed by elbow (13/53, 25%), ankle (11/53, 21%) and knee (7/53, 13%). All of the lesions showed hypopigmentation accompanying promient underlying veins (28/53, 52.8%), skin atrophy (27/53, 50.9%), telangiectasia (10/53, 18.9%). Hypopigmented patches clinically showed various figures such as polygonal-linear (23/53, 43%), polygonal (16/53, 30%), and linear (14/53, 26%) appearances. And, they mostly had speculated border (43/53, 81%). Conclusion: Dermatologists need to be familiar with IACI-induced hypopigmentation in order to avoid incorrect management under misdiagnosis of vitiligo.
[P113] Clinical and histopathologic features of 4 cases of adult-onset Still`s disease
( Sang-jin Cheon ),( Sung-min Park ),( Hyun-joo Lee ),( Hyun Ju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Adult-onset Still`s disease (AOSD) is a rare systemic inflammatory disorder characterized by classic clinical triad of persistent high spiking fever, arthralgia, and typical salmon colored maculopapular rash. Recently, comprehensive review of literature showed that cutaneous involvement occurs in about 80% of AOSD patients. However, clinical and histopathologic characteristics of skin lesion of AOSD are rarely reported in dermatologic literature. We experienced 4 cases of AOSD (M:F=1:3). The diagnosis is based upon the clinical and laboratory criteria. Among them, 2 patients clinically showed multiple persistent pruritic erythematous papules and plaque. Histopathologic examination of erythematous plaque revealed multiple dyskeratotic keratinocytes in the upper epidermis. The other 2 patients presented with disseminated pruritic urticarial rash. Histopathologic examination of urticarial lesion revealed perivascular and interstitial infiltrates with neutrophils and a few mononuclear cells in the dermis. Diagnosing of AOSD is difficult due to nonspecific symptoms and absence of characteristic laboratory test. Herein, we report rare cases of AOSD presenting with persistent pruritic papules and plaques and urticarial rash. And we considered that dyskeratotic keratinocytes in upper dermis of pruritic plaques and neutrophils infiltration in perivascular and interstitial infiltration may be clue for a suspicious of AOSD.
[P404] Cervical chondrocutaneous branchial remnant
( Sang-jin Cheon ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Gun-wook Kim ),( Woo-haing Shim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyang-suk You ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Cervical chondrocutaneous branchial remnants (CCBRs) are rare developmental anomalies of the branchial apparatus. They are derived from dislocated branchial apparatus component comprised of cartilage tissues. They are clinically asymptomatic protruding papule and nodule, and typically located in the middle or lower third of anterior border of the sternocleidomastoid muscle. The patient was a 44-year-old female who presented with solitary asymptomatic skin-colored nodule on the left side of neck. The patient denied any history of trauma, operation and injection history. Physical examination revealed no remarkable findings except for the skin lesion. Ultrasonographic finding showed 8 x 3mm hyperechoic nodule on subcutaneous layer and the lesion was not connected to underlying structure. Histopathological examination after surgical excision showed hyaline cartilage core in the dermis without connection to epidermis. A diagnosis of CCBRs was confirmed, and the patient showed no recurrence during 9 months of follow up Herein, we present a rare case of CCBRs composed of hyaline cartilage. Dermatologist should consider CCBRs in the differential diagnosis of the skin lesion associated with neck nodule.
[P212] A case of pigmentary mosaicism associated with diploid/triploid mixoploidy
( Sung-min Park ),( Sang-jin Cheon ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyun-chang Ko ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Pigmentary mosaicism (PM) is characterized by cutaneous manifestations that are hypo- and hyperpigmented macules in a streaky configuration along the lines of Blaschko. Chromosomal mosaicism has been reported in many cases of PM. Among these cases, diploid/triploid mixoploidy (DTM) is extremely rare. A 21-month-old girl was referred to dermatology clinic for evaluation of skin pigmentation. She was born at 37 weeks of gestation following caesarean section because of severe intrauterine growth retardation, and her birth weight was 1.49 kg (below the 5th percentile). Physical examination revealed dysmorphic features including hypertelorism, microretrognathia, low-set ears, macrocephaly, brachydactyly, clinodactyly, and hypodontia. Neurological examinations revealed generalized hypotonia, and Bailey developmental assessment detected global developmental delay. Karyotyping of peripheral blood lymphocytes showed a normal karyotype. Additionally, karyotyping of fibroblasts from hyperpigmented patch was performed, and the results revealed triploidy (69, XXX). Clinical findings, and the results of cytogenetic studies in our patient were consistent with those of PM associated with DTM. Pigmentary skin change with neurological and morphological abnormalities could be a sign of karyotypic abnormality. In this situation, obtaining a skin biopsy for karyotyping of could be helpful to understand the underlying genetic abnormalities.
Case Report : Portal biliopathy treated with endoscopic biliary stenting
( Sung Jin Jeon ),( Jae Ki Min ),( So Young Kwon ),( Jun Hyun Kim ),( Sun Young Moon ),( Kang Hoon Lee ),( Jeong Han Kim ),( Won Hyeok Choe ),( Young Koog Cheon ),( Tae Hyung Kim ),( Hee Sun Park ) 대한간학회 2016 Clinical and Molecular Hepatology(대한간학회지) Vol.22 No.1
Portal biliopathy is defined as abnormalities in the extra- and intrahepatic ducts and gallbladder of patients with portal hypertension. This condition is associated with extrahepatic venous obstruction and dilatation of the venous plexus of the common bile duct, resulting in mural irregularities and compression of the biliary tree. Most patients with portal biliopathy remain asymptomatic, but approximately 10% of them advance to symptomatic abdominal pain, jaundice, and fever. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are currently used as diagnostic tools because they are noninvasive and can be used to assess the regularity, length, and degree of bile duct narrowing. Management of portal biliopathy is aimed at biliary decompression and reducing the portal pressure. Portal biliopathy has rarely been reported in Korea. We present a symptomatic case of portal biliopathy that was complicated by cholangitis and successfully treated with biliary endoscopic procedures. (Clin Mol Hepatol 2016;22:172-176)