A case of lipodermatosclerosis misdiagnosed as erythema nodosum

( Hyoeun Park ),( Yujin Jung ),( Jongsic Kim ),( Yu Ri Woo ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Lipodermatosclerosis(LDS) is a chronic variant of panniculitis related to venous insufficiency, characterized by a painful erythema in the early stage and ulcerative sclerosis appearing as an inverted champagne bottle in the advanced stage. It is often clinically misdiagnosed as erythema nodosum(EN).A 67-year-old woman with a history of femur fracture operation due to a car accident presented with a painful, solitary, 1 cm-sized, erythematous subcutaneous nodule with swelling on left leg for a month. The lab showed increased inflammatory markers like erythrocyte sedimentation rate, C-reactive protein, and procalcitonin, and MRI showed diffuse superficial soft tissue swelling. Intravenous antibiotic did not improve the patient’s lesion, which developed into more diffuse indurated plaques. Histopathological examination first done revealed the septal panniculitis without vasculitis suggesting EN. The second biopsy showed pronounced venous stasis in the dermis, septal fibrosis, lobular panniculitis, and lipomembranous fat necrosis. The lesion showed negative of bacterial, fungal, and tuberculosis polymerase chain reaction. Based on clinicopathological findings, the patient was diagnosed with LDS and treated with a systemic corticosteroid and colchine. Since LDS may appear similar to EN, in order to avoid misdiagnosis, sometimes additional biopsy in the follow-up may be necessary to ensure the clinicopathological diagnosis of LDS.

Demographic characteristics of ustekinumabrefractory patients with plaque psoriasis

( Hyoeun Park ),( Yujin Jung ),( Jongsic Kim ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Psoriasis is a chronic immune-mediated inflammatory disease. Ustekinumab is an effective biological treatments in plaque psoriasis. However, there have been few studies on patients with plaque psoriasis who did not show clinical improvement after the administration of ustekinumab. Objectives: To evaluate the changes in psoriasis area severity index (PASI) through a year follow-up and to analyze the demographic characteristics of the patients with plaque psoriasis who did not achieve PASI 75 at 16 weeks after ustekinumab use. Methods: We reviewed the medical records and clinical photographs of 20 patients with plaque psoriasis who were treated with ustekinumab and did not achieve PASI 75 on the 16 weeks assessment. The PASI scores were evaluated at 16 and 48 weeks, and demographic characteristics were investigated. Results: There were 10 patients in each group, and after 48 weeks, the PASI change and the average age was 88.15±4.35 %, 42.3±12.05 years old and 65.03±8.86 %, 54.4±12.62 years old (p<0.05), In addition, there were no statistically significant differences between the two groups in terms of sex, disease duration, BMI, smoking, drinking, family history, arthritis, nail involvement, and comorbidities. Conclusion: Among the patients who showed persistent lesions even after ustekinumab treatment, patients in the group with a large PASI change were younger than those in the group with small PASI change, at 48 weeks. Other factors have no association.

Alitretinoin in twenty-nail dystrophy: case series

( Hyoeun Park ),( Yujin Jung ),( Jongsic Kim ),( Yu Ri Woo ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Twenty-nail dystrophy (TND) is a condition characterized by longitudinal ridging, pitting, and roughness of the nail surface. It tends to be resistant to various treatment modalities, often leading to clinically unsatisfactory outcome. Alitretinoin (9-cis-retinoic acid; alitoc®) is approved for the patients with severe chronic hand eczema, and has been shown to be effective for other skin diseases. However, there have been few studies demonstrating the efficacy of oral alitretinoin for the treatment of TND. Objectives: We aimed to evaluate the efficacy and safety of oral alitretinoin for the treatment of TND. Methods: We reviewed the medical records and clinical photographs of patients with TND who were treated with oral alitretinoin. The Physician Global Assessment (PGA) scale was used to assess the degree of nail roughness at 0, 1, 3 and 6 months. Results: In total, 17 patients were included, and the average age of the patients was 50.9±9.6 years old. The patient group was consisted of 7 male and 10 female. 52% of patients had disease duration of over five years, and three patients had the persisting lesions for more than 19 years. After treatment with 10~30mg/day dose of oral alitretinoin, the PGA score tended to decrease as the number of treatment sessions increases. After 6 months of treatment, the roughness of the lesions improved more than 50% in 66.7% of patients, and over 90% in 16.7% of patients. Conclusion: Oral alitretinoin may be an effective treatment option for TND.

A case of vitiligo-like lesions after anti-PD1 treatment in the patient with melanoma

( Hyoeun Park ),( Yujin Jung ),( Jongsic Kim ),( Yu Ri Woo ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

By triggering T-cell activation, anti-programmed cell death protein-1(anti-PD1) antibodies are increasingly being used in the melanoma treatment. Cutaneous toxicities like vitiligo, lichenoid dermatitis, and psoriasis are the most common immune-related adverse effects associated anti-PD1 A 73-year-old male patient diagnosed with malignant melanoma with multiple metastasis in lung lesions presented asymptomatic, variable-sized, hypo-pigmented patches on the face for several months after treatment of anti-PD1. He had no family history of vitiligo, autoimmune disorders or thyroiditis, the features often found in vitiligo patients. Hispathological examination revealed decreased melanin and melanocytes in basal layer and loss of melanocytes with a Melan A stain. The patient continued to undergo the anti-PD1 treatment, and vitiligo-like lesions remained constant. Similar to the patient, characteristic patterns of vitiligo-like lesions are multiple flecked hypo-pigmented macules mainly localized on photo-exposed areas like cheeks and neck, while vitiligo is presented with symmetrically distributed white patches on forehead and areas around eyes, noses, and elbows. As hypo-pigmented lesions occurs more often with anti-PD-1 than other immunotherapies regardless of the dose, the clinicians should carefully examine the distinctive pattern and occurrence of vitiligo-like lesions several months after starting anti-PD1.

Nanoparticle as a Prodrug of Bile Acid to Improve Bone Regeneration and Osteogenic Differentiation of Mesenchymal Stem Cells by Scavenging Hydrogen Peroxide

Hyoeun PARK,Yoshie ARAI,Byoung Ju KIM,Alvin BELLO,Inho BEAK,Anoop PUTHIYOTH DAYANANDAN,Jiseong KIM,Hyejong CHOI,Minju LEE,Sunjun LEE,Soo-Hong LEE 한국생물공학회 2021 한국생물공학회 학술대회 Vol.2021 No.4

A case of targetoid hemosiderotic nevus

( Hyoeun Park ),( Yujin Jung ),( Jongsic Kim ),( Yu Ri Woo ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Targetoid hemosiderotic nevus (THN) appears as a slightly elevated melanocytic nevus surrounded by a peripheral pigmented targtoid halo, which has a predilection for the trunk. The development of the ring may be sudden without any known traumatic event, and the ecchymotic halo often regresses. A 17-year-old female was presented with an asymptomatic 5mm-sized, brown-colored macule on left breast for 10 years, which developed a sudden violaceous halo and enlargement. The patient had no history of trauma on the lesion. Histopathological examination revealed the intradermal, melanocytic component, which had symmetrical, well-circumscribed melanocytes arranged in uniform nests intermingled with dilated vascular spaces and red blood cells extravasation. As most THN spontaneously regresses, the patient was instructed to re-examine after one year. The clinicians should consider a diagnosis of THN when observing a sudden change in color or size of the pre-existing melanocytic nevus regardless of any traumatic event. Its favored location on the trunk might be prone to repeated mild traumas leading to the development of THN. By using dermoscopy, clinicians can avoid unnecessary procedures as THN is a clinical simulator of clinically worrisome malignant transformation.

A case of erythema-multiforme like lesions in a patient with hand-foot-mouth disease

( Hyoeun Park ),( Yujin Jung ),( Jongsic Kim ),( Yu Ri Woo ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Hand-foot-mouth disease(HFMD) is a viral infection caused by Coxsackie virus and enterovirus that predominantly affects children. Typical symptoms include erythematous maculopapular or vesicular eruptions localized on palms, soles, and perioral skin. An increasing number of HFMD adults present with atypical exanthems similar to erythema multiform (EM), which is a mucocutaneous targeotid eruption caused by a hypersensitivity reaction due to infection. A 38-year-old male was presented with pruritic, multiple, variable-sized, erythematous maculopapular targetoid eruptions on both hands, feet, and trunk for 1 week. Initially, he experienced malaise, and his children were diagnosed with HFMD 3 weeks before. Histopathological examination showed neutrophils presented with necrosis in upper epidermis and vacuolar alteration on dermoepidermal junction. The laboratory examination showed positive titers of 1:128, 1:16, and 1:64 respectively, in Coxsackie virus A type 6, 10, and 16. The patient was diagnosed with HFMD based on characteristic clinical features and positive results in Coxsackie serologic markers. After treatment with antihistamine, the lesions completely resolved. The patient was presented with erythema-multiforme like lesions on the trunk without involvement of the mouth. As HFMD often affects children and sometimes immune-compromised adults, herein, we report the immune-competent adult patient with atypical clinical manifestations.

Cardiac-specific delivery by cardiac tissue-targeting peptide-expressing exosomes

Kim, Hyoeun,Yun, Nuri,Mun, Dasom,Kang, Ji-Young,Lee, Seung-Hyun,Park, Hyelim,Park, Hyewon,Joung, Boyoung Elsevier 2018 Biochemical and biophysical research communication Vol.499 No.4

<P><B>Abstract</B></P> <P>Naturally occurring RNA carriers such as exosomes might be an untapped source of effective delivery vehicles. However, if exosomes are to be exploited for therapeutic applications, they must target specific tissues or cell types to avoid off-target effects. This study evaluated whether genetic modification of exosomes could enhance exosome delivery to heart cells and heart tissue without toxicity. Exosomes expressing cardiac-targeting peptide (CTP)-Lamp2b on the exosomal membrane (CTP-Exo) were generated by introducing vectors encoding CTP-Lamp2b into HEK 293 cells. The expression of CTP-Lamp2b peptide on exosomes was stabilized by attaching glycosylation sequences. Exosomes expressing only Lamp2b on exosomal membranes (CTL-Exo) were generated as a control. The <I>in vitro</I> and <I>in vivo</I> uptake of CTL-Exo and CTP-Exo was evaluated in cell lines and mice. Both exosomes were delivered to HEK 293 and H9C2 cells. The delivery of the exosome was not different between CTP-Exo and CTL-Exo in HEK 293 cells, whereas the delivery of CTP-Exo was 16% greater than that of CTL-Exo in H9C2 cells (P = 0.047). Cell viability was maintained at almost 100% with different dosages of both CTL-Exo and CTP-Exo. Moreover, compared with CTL-Exo, the <I>in vivo</I> delivery of exosomes to the hearts of mice was increased by 15% with CTP-Exo (P = 0.035). The delivery to livers and spleens was not different between the two exosomes. Genetic modification of exosomes by expressing CTP-Lamp2b on the exosomal membrane enhanced exosome delivery to heart cells and the heart tissue. These results suggested that CTP-Exo might be used as a therapeutic tool for heart disease.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Genetic modification of exosomes could enhance exosome delivery to heart. </LI> <LI> CTP-Exo did not show toxic effects <I>in vitro</I> or <I>in vivo.</I> </LI> <LI> CTP-Exo might be used as a therapeutic tool for heart disease. </LI> </UL> </P>

Development of TRT Kit for Optical Experiments with Reflective Telescopes

Woojin Park,Soojong Pak,Seunghyuk Chang,Geon Hee Kim,Byeongjoon Jeong,Sanghyuk Kim,Hye-In Lee,Tae-Geun Ji,Jeongha Gwak,Kwang Jo Lee,Hyoeun Kim,Saepbyul Choi,Soonchang Park 한국천문학회 2016 天文學會報 Vol.41 No.2

정신적 장애인의 건강수준과 노동시장 차별경험이 경제활동에 미치는 요인분석

박효은 ( Hyoeun Park ),임국환 ( Kookhwan Rhim ),최만규 ( Mankyu Choi ) 대한보건협회 2015 대한보건연구 Vol.41 No.2

Objective: The aim of the study was to analyze some factors determining economic activities of mentally ill people : First, the factors associated with sociology of population, health resources, and discrimination on labor``s market. Further, the research was to suggest practical and policy implications for boosting economic activities by people with mental disorders. Methods: The data were based on the 4th Panel Survey of Employment for the Disabled(2011) by Korea Employment Agency for the Disabled, including 346 mentally incapacitated people of a total of 5,092 subjects in the study. Logistic regression analysis was performed to examine the factors influencing employment status and those determined by type of disability. Results: The result of the study is as follows. Of 346 subjects of analysis, 64(18.2%) were economically active population, and 284(81.8%), not. In an integrated model, one of the most influencing factors for economic activities was experienced discrimination in job-seeking and employment. Additionally, it showed some favoring factors in economic activities for : those residing in medium-sized cities, those with larger households, those married, those in ``subjectively`` good health, and those independent of daily lives`` assistance. Conclusion: According to our analysis, through these results, some suggestions should be made as follows : Against the backdrop, business owners and colleagues should achieve a better understanding of people with psychological disorders and should take practical action against ``adverse selection`` for them. The government should implement policies to promote active employment of the mentally incapacitated and to support business owners with practical assistance.