[P236]A case of Marie-Unna hereditary hypotrichosis

( Hyun-bin Kwak ),( Soo-han Woo ),( Seok-kweon Yun ),( Han-uk Kim ),( Jin Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Marie Unna hereditary hypotrichosis (MUHH) is a rare autosomal dominant genodermatosis characterized by progressive non-scarring hair loss starting in early childhood and aggravating at puberty. Recent progress has been made in determining the genetic etiology of MUHH. Until now, two possible loci for MUHH have been mapped to chromosome 8p21 and 1p21.1.1q21.3. Herein, we report a 33-year-old male with characteristic clinical features suggestive of MUHH in previously affected Korean family. A 33-year-old Korean man presented with progressive alopecia of the scalp since childhood. On examination, hair loss patches were prominent on the vertex and occipital margins, with coarseness and kinking in texture. Eyebrows, eyelashes, and axillary and pubic hair were also scanty. There were no other ectodermal and systemic abnormalities. Laboratory findings, including hormone analyses, were within normal limits. Histopathologic examination revealed decreased and miniaturized hair follicles, with trichomalacia and some bizarre hair shaft morphology, pigment clumps in fibrous root sheath. Scanning electron microscopy revealed thickening, longitudinal grooving, twisting, and longitudinal and transverse breakage of the hair shaft. At least three members among three generations of the patient’s family, including her mother and sister displayed similar manifestations. Based on these clinicopathological findings, the patient was diagnosed with MUHH.

Pityriasis Amiantacea: An Epidemiologic Study of 44 Cases in Korean Patients

( Hyun-bin Kwak ),( Seok-kweon Yun ),( Han-uk Kim ),( Jin Park ) 대한피부과학회 2020 Annals of Dermatology Vol.32 No.1

Intravascular papillary endothelial hyperplasia on the palm

( Hyun-bin Kwak ),( Eui-sung Jung ),( Seok-kweon Yun ),( Han-uk Kim ),( Jin Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Intravascular papillary endothelial hyperplasia, also known as Masson’s tumor, is a benign lesion of the skin and subcutaneous tissue consisting of a reactive proliferation of endothelial cells with papillary formations related to a thrombus. It presents as a primary phenomenon within a thrombosed normal blood vessel (usually a vein) or as an incidental finding (secondary form) within other vascular tumors, especially deep-seated cavernous hemangiomas or in lesions such as hemorrhoids. Three cases of Masson’s tumor on the hand have been reported in previous literatures. A 47-year-old woman presented with tender, purple-colored and hyperkeratotic papule with easily bleeding condition. The lesion was lasted over a one year and there was no history of trauma. Physical examination revealed a dark purple colored hard papule approximately 4mm with hyperkeratosis and surrounding erythema. The excisional biopsy specimen showed dilated and thin-walled capillary in the upper dermis underlying an epidermis that had hyperkeratosis with elongation of the rete ridges. In the subset of dilated thin-walled vascular spaces, masses of papillary processes associated with some thrombus were found. The patient was diagnosed as intravascular papillary endothelial hyperplasia. For the removal of the remnant flat vascular patch, Long pulse dye laser therapy was done for 5 times and there was no apparent change.

Congenital melanocytic nevus of the nipple in a young male

( Hyun-bin Kwak ),( Eui-sung Jung ),( Sang-woo Park ),( Su-kyung Park ),( Jin Park ),( Seok-kweon Yun ),( Han-uk Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Congenital melanocytic nevi occur at any site of the body. However, involvement of the nipple is very rare, with only two cases reported. Herein, we report a rare and interesting case of congenital melanocytic nevus of the nipple in a young male. A 22-year-old male presented with an asymptomatic, brown pigmented papules with cobblestone appearance on the right nipple. He and his mother stated that the lesion had been present from birth without significant changes. The breasts had no evidence of any nodularity or gynecomastia. A biopsy of the pigmented lesion on the right nipple revealed a diffuse infiltrate of small monomorphous melanocytes extending into the deep dermis. Melanocytes were also present around smooth muscle cell bundles of the nipple and mammary ducts. On the basis of clinical findings and histopathology, he was diagnosed as congenital melanocytic nevus with an unusual location.

Cutaneous candidiasis of the hands in an infant

( Hyun-bin Kwak ),( Eui-sung Jung ),( Sang-woo Park ),( Su-kyung Park ),( Jin Park ),( Seok-kweon Yun ),( Han-uk Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

The clinical manifestations of infection with Candida species range from local mucous or cutaneous infection to widespread dissemination with multisystem organ failure. Candida species are considered to be normal flora in the gastrointestinal tract. Cutaneous candidiasis in early infancy may appear as diaper dermatosis or intertrigo. Candidiasis on the hand is considered to be a rare condition . We report a case of cutaneous candidiasis seen in a healthy 50-day-old infant. The palms showed erythematous scaly lesions of about 20 days duration. Scales in 10% potassium hydroxide solution revealed spores with pseudohyphae. The specimens were cultured on Sabouraud dextrose agar media and the white yeast-form colonies were observed. Microscopic features prepared with lacto-phenol cotton blue revealed round spores. Candida albicans was identified with internal transcribed spacer region sequencing of PCR amplified gDNA. Skin lesions were improved after 20 days without any antifungal agent.

Dermoscopic study of tinea faciei incognito

( Hyun-bin Kwak ),( Seok-kweon Yun ),( Han-uk Kim ),( Jin Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Tinea incognito is a dermatopyte infection of the skin modified by previous treatments such as prolonged use of topical steroids. The diagnosis of tinea faciei incognito can be delayed or missed because of its atypical appearance without classic ringworm-like pattern. Objectives: We aims to investigate the dermoscopic findings of tinea faciei incognito and its diagnostic usefulness. Methods: We retrospectively evaluated mycologically proven 38 patients with tinea faciei incognito in our institution between July 2014 and July 2018. Results: Mean age was 59.6±20.4 years with female predominance (male:female ratio 1:1.4). Mean duration until confirmation of diagnosis was 3.4 months. Eczema-like conditions (20, 52.6%) were the most common clinical manifestation, followed by psoriasis-like (5, 13.2%) and rosacea-like (4, 10.5%) conditions. Dermoscopic patterns was observed as follows; 1) Skin: scales (81.6%), follicular pustules (44.7%), diffuse erythema and arborizing vessels (42.1%), 2) Facial vellus hairs: empty follicles (57.9%) and translucent hairs (28.9%), 3) Terminal hairs (eyebrow, beard and mustache): broken hairs (39.5%), black dots (34.2%) and empty follicles (23.7%). Conclusion: The distinct dermoscopic patterns, especially in hair follicle in this study could be usuful in clinical diagnosis of tinea faciei incognito.

[P178] Plaque-type blue nevus in a Korean woman

( Hyun-bin Kwak ),( Sang-woo Park ),( Su-kyung Park ),( Soo-han Woo ),( Jin Park ),( Seok-kweon Yun ),( Han-uk Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Plaque-type blue nevus is a rare variant of blue nevus, the precise prognostic significance of which is unknown. We report the unusual and rare case of an uncommon large, agminated blue nevus of the ``plaque type`` in a 23-year-old Korean female. She presented with a large blue plaque, 2.5 x 6cm in size, on the right lower flank. There were spots of various shades of blue on the plaque. The lesion had developed since birth and became more prominent over the past years. The patient had noticed subcutaneous nodules recently. On physical examination, subcutaneous nodules were found on palpation with no pain. No enlargement of the regional lymph nodules was found. Upon dermoscopic examination, the lesion was typified by areas of homogenous, unstructured blue pigmentation, brownish-blue in the center and blue at the periphery. At the periphery, tan pigmentation was noted. A biopsy was taken from the lesions. Elongated melanocytes in the interstices of the collagen with some melanophages were typical of a common blue nevus. No malignant features were found. A diagnosis of plaque-type blue nevus was made.

Pityriasis amiantacea: a clinical and pathologic study of 39 patients

( Hyun-bin Kwak ),( Seok-kweon Yun ),( Han-uk Kim ),( Jin Park ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: Pityriasis amiantacea (PA) is a unique clinical syndrome characterized by thick, asbestos-like, adherent scales engulfing tufts of scalp hairs. It occurs as a part of several inflammatory skin dermatoses. Objectives: We studied to investigate the clinical and etiopathologic characteristics of PA. Methods: We retrospectively analyzed a series of 39 PA who visited Chonbuk national university hospital from March 2008 to May 2017. Results: The mean age of the patients was 42.7 ±23.3 years (4 months ~ 79 years) with a female predominance (M:F=1:2). The most common skin diseases associated with PA was seborrheic dermatitis (30.7%), followed by psoriasis (12.8%), pemphigus (12.8%), lichen planopilaris (7.6%), folliculitis decalvans (7.6%), tinea capitis (5.1%). Five patients (12.8%) was isolated PA with no associated with other skin disease. PA was localized in 21 patients (53.8%), widespread in 13 patients (33.3%), whole scalp in 6 patients (15.3%). Scarring alopecia was detected in 6 patients (15.3%) mainly associated with primary cicatricial alopecia. Most of patients were well responded to medical treatment including antifungal agent, corticosteroid, or retinoid; however, physical removal was additionally performed in recalcitrant cases. Conclusion: PA represents a particular,exaggerated reaction pattern of the scalp result from various inflammatory and infectious skin diseases. Therefore, individualized treatment is necessary depending on the underlying skin conditions.

[P177] Angiokeratomas on the nipple associated with enlargement of the ipsilateral breast: A rare lesion in an adolescent boy

( Hyun-bin Kwak ),( Sang-woo Park ),( Su-kyung Park ),( Soo-han Woo ),( Jin Park ),( Seok-kweon Yun ),( Han-uk Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

We experienced a rare and interesting case of angiokeratomas localized on the left nipple of an adolescent boy, associated with enlargement of the ipsilateral breast. To the best of our knowledge, this is the first reported case. A 13-year-old Korean boy presented with asymptomatic black papules on his left nipple with easy bleeding on touch. On examination, he had multiple, discrete, smooth red to black papules restricted to the left sided nipple with enlargement of the underlying breast, giving the breast an asymmetric and unnatural appearance. Dermoscopy revealed blood-filled vascular spaces and crusts. Skin biopsy from the lesion showed mild hyperkeratosis, papillomatosis and acanthosis of epidermis with large, numerous, dilated and congested capillaries in the papillary dermis. Ultrasonography breast were done to rule out any vascular anomaly. No mass was observed in either breast. On the basis of clinical findings and histopathology, he was diagnosed as angiokeratoma with unique presentation as an unusual location.

Two cases of congenital Becker’s nevus presenting only linear hypertrichosis in children

( Hyun-bin Kwak ),( Eui-sung Jung ),( Seok-kweon Yun ),( Han-uk Kim ),( Jin Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Becker’s nevus typically present as a brown hyperpigmented, hypertrichotic patch predominantly on shoulder, chest, or upper back. It usually occurs in male, first appearing as an irregular brown flat patch during or short after puberty. After a few years of appearing, coarse hair grows in the lesion. Herein, we report two congenital Becker’s nevus showing unusual presentation. The first case was a 5-year-old girl presented with a circumscribed hypertrichotic patch on the right posterior thigh since birth. The hairy lesion showed linear configuration that may follows the Blaschko’s line, and there was no pigmented change. First impression of the skin lesion was nevoid hypertrichosis. The second patient was a 20-month-old girl presented with a hypertrichotic patch on the middle part of the right posterior leg since birth. Physical examination revealed grouped terminal hairs without pigmented lesion. Histopathological findings of the both patients revealed epidermal changes including mild acanthosis, elongation of rete ridges, basal hyperpigmentation, and slight smooth-muscle hamartomatous changes, which was consistent with Becker’s nevus.