Inbong Memorial Lecture : A clinicopathological analysis of 177 acral melanomas in Koreans: Anatomic mapping and relevance of spreading pattern and physical stress

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Importance: The pathogenesis of acral melanoma remains unclear, even though trauma may be a predisposing factor. A study about the association of chronic physical stress with the incidence and spreading patterns through detailed anatomic mapping may be important to understand the unique features of acral melanoma. Objectives: To analyze the epidemiological and clinicopathological characteristics of melanoma occurring on the acral site, and evaluated how chronic physical stress or pressure strength influenced acral melanoma based on the analysis of the differences in incidence, prognosis of the distinct site (weight or non-weight-bearing portion of sole, volar or subungual location) and the spreading pattern of melanoma located on the soles. Design: Cross-sectional, retrospective. Setting: Republic of Korea, January 1, 1994, through October 31, 2012. Patients: A total of 177 Korean patients with acral melanoma. Main Outcome Measures: Anatomical mapping and histolopathological examination of acral melanoma. Results: The male: female ratio was 1:1.03, and the mean age at first admission was 55.3 years. Acral lentiginous melanoma was the most common histopathological subtype (85.9%), and nodular melanoma was 12.8%. There was a high incidence of acral melanoma at more physically stressed sites such as the center area of heels and inner forefoot area. In addition, a peculiar spreading pattern, with the long axis, typically along naturally occurring creases due to chronic pressure on the soles was often observed. The prognostic index and survival rate showed no significant difference between volar and subungual locations, and between weight and non-weight-bearing portions of the soles. Conclusions and Relevance: Clinicohistopathology of acral melanoma diagnosed at an advanced stage and resulting in a low survival rate is not significantly different in Koreans from other Asians. Interestingly, based on our study, chronic physical stress or pressure strength can influence the incidence and spreading pattern of acral melanoma in a particular manner. Acral melanoma occurs on more physically stressed sites with long axis along natural creases on the sole. A further prospective investigation of especially in situ lesions about the location-based differences in incidence, progress and Importance: The pathogenesis of acral melanoma remains unclear, even though trauma may be a predisposing factor. A study about the association of chronic physical stress with the incidence and spreading patterns through detailed anatomic mapping may be important to understand the unique features of acral melanoma. Objectives: To analyze the epidemiological and clinicopathological characteristics of melanoma occurring on the acral site, and evaluated how chronic physical stress or pressure strength influenced acral melanoma based on the analysis of the differences in incidence, prognosis of the distinct site (weight or non-weight-bearing portion of sole, volar or subungual location) and the spreading pattern of melanoma located on the soles. Design: Cross-sectional, retrospective. Setting: Republic of Korea, January 1, 1994, through October 31, 2012. Patients: A total of 177 Korean patients with acral melanoma. Main Outcome Measures: Anatomical mapping and histolopathological examination of acral melanoma. Results: The male: female ratio was 1:1.03, and the mean age at first admission was 55.3 years. Acral lentiginous melanoma was the most common histopathological subtype (85.9%), and nodular melanoma was 12.8%. There was a high incidence of acral melanoma at more physically stressed sites such as the center area of heels and inner forefoot area. In addition, a peculiar spreading pattern, with the long axis, typically along naturally occurring creases due to chronic pressure on the soles was often observed. The prognostic index and survival rate showed no significant difference between volar and subungual locations, and between weight and non-weight-bearing portions of the soles. Conclusions and Relevance: Clinicohistopathology of acral melanoma diagnosed at an advanced stage and resulting in a low survival rate is not significantly different in Koreans from other Asians. Interestingly, based on our study, chronic physical stress or pressure strength can influence the incidence and spreading pattern of acral melanoma in a particular manner. Acral melanoma occurs on more physically stressed sites with long axis along natural creases on the sole. A further prospective investigation of especially in situ lesions about the location-based differences in incidence, progress and survival is necessary to better understand the pathophysiology of acral melanoma.survival is necessary to better understand the pathophysiology of acral melanoma.

각질형성세포에서 UVB에 의한 Peroxiredoxin 1의 발현 조절: H2O2에 의한 Peroxiredoxin 1의 조절

윤숙정 ( Sook Jung Yun ),이재욱 ( Jae Wook Lee ),최지영 ( Jee Young Choi ),이승철 ( Seung Chul Lee ) 대한피부과학회 2005 대한피부과학회지 Vol.43 No.9

폐암 환자들에서 Gefitinib (Iressa)에 의한 피부 부작용

윤숙정 ( Sook Jung Yun ),이지범 ( Jee Bum Lee ),김규식 ( Kyu Sik Kim ),김영철 ( Young Chul Kim ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.2

배경: 최근 폐암 환자에서 사용하는 표적치료 항암약물인 gefitinib (Iressa)은 종양세포의 표피성장인자 수용체의 티로신 키나아제 활동을 선택적으로 억제하여 종양 세포의 성장에 관여하는 신호를 차단함으로써 치료효과를 나타낸다. Gefitinib 복용에 의한 피부 부작용으로 여드름양 발진, 피부 건조증, 모발 변화 등이 알려져 있다. 대상 및 방법: 2004년 10월부터 2005년 9월까지 화순전남대병원에서 비소세포 폐암으로 진단받고 gefitinib을 복용 중인 환자들 중 피부 부작용이 발생하여 피부과에 의뢰된 환자 23명을 대상으로 임상 양상을 분석하였다. 결과: 나이는 23-72세였고, 비소세포 폐암의 종류는 선암 17명, 편평상피세포 폐암 5명이었고, 여자 6명, 남자 17명이었다. 가장 흔한 부작용은 여드름양 발진으로 15명(65.2%)에서 발생하였으며, 주로 두피, 얼굴, 가슴, 등 부위에 무증상의 홍반성 구진으로 나타나며 대부분 gefitinib 복용 1달 이내에 발생하였다. 여드름양 발진의 빈도는 gefitinib 치료에 대한 반응과 유의한 상관관계를 보이지 않았고, 조직 형에 따른 차이도 관찰되지 않았다. 피부 소양증은 9명(39.1%)에서 발생하였으며 경도의 전신 소양증이 가장 많았고, 특히 눈 주변의 소양증을 호소하였다. 인설을 동반한 피부 건조증이 6명(26.1%)에서 발생하였고, 손발바닥의 홍반과 표피 박탈이 5명(21.7%), 손톱이나 발톱주변에 조갑주위염이 5명(21.7%)에서 발생하였다. 드물게 모발이 부러지거나 겨드랑이, 오금에 간찰진이 발생하였다. 결론: 본 연구에서 gefitinib에 의한 다양한 피부 부작용들을 관찰할 수 있었다. Gefitinib을 처방하는 의사들은 피부 부작용에 대한 관심이 필요하며 환자들에게 피부 관리에 대한 교육과 필요한 경우 피부과 의사와 함께 피부 부작용을 치료함으로써 부작용을 경감시킬 수 있었다. Background: Gefitinib (ZD 1839, Iressa) is a new anticancer agent; more specifically, it is a selective epidermal growth factor receptor tyrosine kinase inhibitor that is, widely used for various solid cancers, including lung cancer. Cutaneous adverse reactions induced by gefitinib have recently been reported; however, not much on this topic has been reported in the Korean literature. Method: We studied cutaneous adverse reactions of gefitinib in 23 patients who suffered with non-small cell lung cancer at Chonnam National University Hwasun Hospital from October 2004 to September 2005. Result: The patients ranged from 23-72 years old, and there were 17 patients with adenocarcinoma, 5 with squamous cell carcinoma and 1 with bronchioloalveolar carcinoma. The most common adverse reaction was acneiform eruptions in 15 patients (65.2%). This reaction appeared within 2 months after medication, and it didn`t correlate with the therapeutic response and tumor type. Pruritus was the second most common reaction (39.1%), which was mild and generalized, especially around eyelid area. Xerosis (26.1%), exfoliation on palm and sole (21.7%), and paronychia (21.7%) followed. Hair breakage and intertrigo were rare adverse reactions. Conclusion: Various cutaneous adverse reactions were observed in patients with non-small cell lung carcinoma after gefitinib treatment. The skin complications could be alleviated with dermatologic consultations and treatments, skin complications could be alleviated. (Tuberc Respir Dis 2006; 61: 150-156)

Skin cancer: long-term management strategy for difficult patients

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.72 No.2

Which skin cancer is the most difficult in terms of long-term management? Because most skin cancers are just widely excised, and that is the cure, except some invasive melanomas and other rare cancers. Among them, in this presentation, I will present a difficult extramammary Paget’s disease (EMPD) patient and review recent therapies on EMPD and present some patients from my experience. Then, I want to suggest long-term management strategy of EMPD.

Malignant tumors on head and neck

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2022 대한피부과학회 학술발표대회집 Vol.73 No.2

Quiz 2

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

Education: 1991-1997 Chonnam National University Medical School (MD), Gwangju, Korea 1998-2000 Chonnam National University Medical School (MS), Gwangju, Korea 2001-2004 Chonnam National University Medical School (PhD), Gwangju, Korea Training and Fellowship Appointments: 1999.2003 Dermatology residency, Chonnam National University Hospital, Gwangju, Korea 2003.2004 Dermatology fellow, Chonnam National University Hospital, Gwangju, Korea 2008.3-2009.2 Visiting Scholar, Dept. of Dermatology, Univ. of Pennsylvania, Philadelphia, USA 2009.1-2009.1 Visiting Scholar, Dept. of Dermatology, Univ. of Texas, Houston, USA 2013.8-2014.6 Visiting Associate Professor, Dept. of Pathology, Univ. of Pennsylvania, USA Faculty Appointment: 2004-2006 Clinical Instructor, Dermatology, Chonnam National University Hospital 2006-2008 Full time Instructor, Dermatology Chonnam National University Medical School 2008-2012 Assistant professor, Dermatology, Chonnam National University Medical School 2013-present Associate Professor, Dermatology, Chonnam National University Medical School 2013.8-2014.6 Visiting Associate Professor, Dept. of Pathology, Univ. of Pennsylvania Memberships: 1999-present Korean Dermatological Association 2004-present Korean Society of Dermatopathology 2009-present Korean Society of Skin Cancer 2005-present American Society of Dermatology 2010-present International Melanoma Pathology Study Group 2009-present International Society of Dermatopathology 2010-present Society of Melanoma Research

Focus 2-4 (FS 2-4) : Topical therapeutics: Best indications considering efficacy, safety and limitations

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

A skin-colored nodule on the chin in a 76 year-old woman

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Skin tumors that dermatologists should know

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

As a dermatologist, all of us should know skin tumors. Especially, we should not mis-diagnose malignant skin tumors. However, in reality, there are lots of skin cancers that mimicking benign skin tumors or inflammatory skin diseases. In this talk, I want to show various interesting skin cancers that dermatologists should know. In addition, I will introduce various benign mimickers of each skin cancers. Epidermal skin cancers Actinic keratosis Squamous cell carcinoma in situ, Bowen’s disease Squamous cell carcinoma, Verrucous carcinoma Basal cell carcinoma Melanoma Skin appendage tumors Eccrine and apocrine tumors Sebaceous tumors Paget’s disease and extramammary Paget’s disease Mycosis fungoides and Lymphoma Leiomyosarcoma Kaposi’s sarcoma Angiosarcoma Dermatofibrosarcoma protuberans Metastatic carcinoma

Imiquimod for precancerous lesions and skin cancers

윤숙정 ( Sook Jung Yun ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2