Sorafenib-induced Syringoma-like Eccrine Duct Proliferation in a Patient with Hepatocellular Carcinoma / 대한피부과학회지

Syringomas are common benign neoplasms that are derived from the intradermal eccrine duct and frequently manifest in adult females as 1~3-mm flesh-colored papules on the face, especially on the lower eyelid. There are two hypotheses about their pathogenesis: ductal obstruction by keratin plugs and reactive eccrine proliferation following an inflammatory condition. The patient was a 66-year-old man with multiple erythematous papules and nodules on both periorbital areas after 7-day sorafenib (Nexavar®) treatment. A skin biopsy of the Rt. periorbital lesion revealed multiple cysts and tadpole-shaped tubular structures in the dermal layer. Inflammatory cell infiltration was seen throughout the dermis. Based on the clinical features and histological findings, we diagnosed the patient with syringoma-like eccrine duct proliferation. The indications for and use of Sorafenib have increased recently. Although sorafenib-associated cutaneous side effects have increased, no cases of syringoma-like eccrine duct proliferation have been reported to date. Here we report a case of sorafenib-induced syringoma-like eccrine duct proliferation in a patient with hepatocellular carcinoma.

Sarcoidal Reaction on Old Scars during Pegylated Interferon-α and Ribavirin Therapy in a Patient with Chronic Hepatitis C / 대한피부과학회지

No abstract available.

Use of Q-switched Nd:YAG Laser in the Treatment of Longitudinal Melanonychia / 대한피부과학회지

No abstract available.

Irritant Contact Dermatitis Induced by Benzalkonium Chloride (Zephanon®) / 대한피부과학회지

No abstract available.

Subcorneal Pustular Dermatosis Caused by Darbepoetin-α in Hemodialysis Patients / 대한피부과학회지

Subcorneal pustular dermatosis is a pustular eruption that shows subcorneal pustules containing polymorphonuclear leukocytes and chronic progression. It most commonly affects the trunk, inguinal region, and axilla of middle-aged women, and the pustules are distributed bilaterally. Cultures of the pustules consistently do not reveal bacterial growth. Subcorneal pustular dermatosis rarely happens, and no specific etiology and pathogenesis are known. Thus, we present this case to provide dermatologists with information on its adequate diagnosis and treatment and to inform them of the risk of subcorneal pustular dermatosis in kidney dialysis patients who use darbepoetin-α.

Disseminated Papules and Pustules with Lymphadenitis after Bacillus Calmette-Guerin Vaccination in an Infant / 대한피부과학회지

Bacillus Calmette-Guerin (BCG) is the live attenuated strain of Mycobacterium bovis that produces resistance to tuberculosis (TB) infection. BCG vaccination may induce various dermatologic complications. A 3-month-old infant who had BCG vaccination a month after birth developed erythematous papules and pustules on the trunk and both extremities. The biopsy from the left leg showed a granulomatous lesion. Acid fast staining and nested TB polymerase chain reaction (TB-PCR) were negative. A tuberculin skin test and an interferon-gamma release assay also revealed a negative result. A painful mass was noted on the left axillary area with a positive-nested TB-PCR and surgical excision was performed. The skin eruptions improved after 2 months of anti-tuberculosis medication. Herein, we report a case of disseminated papules and pustules with lymphadenitis after BCG vaccination.

Giant Infantile Hemangioma Treated with Beta-blocker with Intermittent Triamcinolone Intralesional Injection / 대한피부과학회지

No abstract available.

A Case of Primary Cutaneous Aspergillosis of the Dorsum of Hand Due to Aspergillus niger Manifested by Edematous Lesion / 대한의진균학회지

Aspergillus is the most ubiquitous fungi found in soil, water and decaying vegetation. It commonly affects immunocompromised individuals and in primary cutaneous aspergillosis, the skin is directly inoculated of spores by intravenous catheters, trauma and surgery. Primary cutaneous aspergillosis is a rare entity, mostly caused by Aspergillus(A) flavus, A. fumigatus, and rarely, by A. niger. And clinically, the lesion is usually characterized by macules, papules, nodules or plaques. In our case, a 71-year-old male visited with erythmeatous swollen patch and two ulcers on the dorsum of left hand. There was no other associated medical illness except diabetes mellitus and gastric ulcer, and no history of trauma or invasive procedure. The skin biopsy and the culture of cutaneous lesions confirmed the diagnosis of primary cutaneous aspergillosis by A. niger. Herein, we report a rare case of primary cutaneous aspergillosis due to A. niger manifestated by edematous lesion.

Adalimumab-induced Lupus Erythematosus Profundus in a Rheumatoid Arthritis Patient / 대한피부과학회지

The clinical manifestations and immunohistologic findings of drug-induced lupus erythematosus (DILE) are similar to those of idiopathic lupus. However, DILE is different from idiopathic lupus because it is induced after continuous drug exposure and resolves after discontinuation of the causative drug. DILE can be divided into systemic lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus (CCLE). Lupus erythematosus profundus is a subtype of CCLE, and drug-induced CCLE is very rarely reported in the literature. Herein, we report a rare case of adalimumab-induced lupus erythematosus profundus developed in a rheumatoid arthritis patient. The patient is a 43-year-old Korean woman who had multiple tender nodules and plaques on her face, trunk, and both extremities after using adalimumab for rheumatoid arthritis. She was diagnosed with adalimumab-induced lupus erythematosus profundus, and her condition improved after discontinuation of adalimumab.

Adalimumab-induced Lupus Erythematosus Profundus in a Rheumatoid Arthritis Patient / 대한피부과학회지

The clinical manifestations and immunohistologic findings of drug-induced lupus erythematosus (DILE) are similar to those of idiopathic lupus. However, DILE is different from idiopathic lupus because it is induced after continuous drug exposure and resolves after discontinuation of the causative drug. DILE can be divided into systemic lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus (CCLE). Lupus erythematosus profundus is a subtype of CCLE, and drug-induced CCLE is very rarely reported in the literature. Herein, we report a rare case of adalimumab-induced lupus erythematosus profundus developed in a rheumatoid arthritis patient. The patient is a 43-year-old Korean woman who had multiple tender nodules and plaques on her face, trunk, and both extremities after using adalimumab for rheumatoid arthritis. She was diagnosed with adalimumab-induced lupus erythematosus profundus, and her condition improved after discontinuation of adalimumab.

Prurigo Pigmentosa Triggered by Contact Dermatitis / 대한피부과학회지

No abstract available.

Anti-fibrotic Effect of Silibinin in Keloid Fibroblasts and a Bleomycin-induced, Scleroderma-like Animal Model / 대한피부과학회지

BACKGROUND: Silibinin reduces the expression of Type I collagen in normal skin fibroblasts through down-regulation of the TGF-beta/smad pathway. However, it is largely unknown whether silibinin can reduce the expression of Type I collagen in vivo sclerotic animal models, as well as in keloid fibroblasts. OBJECTIVE: The purpose of this study was to investigate the effect of silibinin on the expressions of type I collagen, matrix metalloproteinase-1 (MMP-1), MMP-2, smad2/3, and TGF-b1 receptor in keloid fibroblasts in vitro, and to evaluate the anti-fibrotic effect of silibinin in a bleomycin-induced, scleroderma-like animal model in vivo. METHODS: Keloid and normal skin fibroblasts were treated with silibinin (20~100 mM), and the expressions of type I collagen, MMP-1, MMP-2, and TGF-b1 receptor were analyzed with western blot. The animal model was established by bleomycin treatment (1.0 mg/mL) for 2 weeks in C57/BL9 mice. Then silibinin was injected on one side of the back and the same volume of normal saline was injected on the other side of the back. The specimen was evaluated with H&E, Masson-trichrome, and TGF-beta1 immunohistochemical staining. RESULTS: Expressions of Type I collagen, MMP-1, and MMP-2 decreased, but the expression of TGF-beta1 receptor increased in keloid fibroblasts after silibinin treatment. Thickened dermis with dense extracellular matrix and inflammatory cell infiltration of the bleomycin-induced, scleroderma-like animal model improved after silibinin treatment. Expression of TGF-beta1 decreased after silibinin treatment in the bleomycin-induced, scleroderma-like animal model. CONCLUSION: Silibinin treatment decreased the expression of Type I collagen in keloid fibroblasts in vitro. In addition, silibinin decreased the expression of Type I collagen by inhibiting TGF-beta1 expression in the bleomycin-induced, scleroderma-like animal model. These results indicate that silibinin has the potential to be an effective antifibrotic agent.

Weber-Cockayne Type Epidermolysis Bullosa Simplex Resulting from a Novel Mutation (c. 608T>C) in the Keratin 5 Gene

Epidermolysis bullosa simplex (EBS), an inherited genetic disorder, is most often caused by a dominant-negative mutation in either the keratin 5 (KRT5) or the keratin 14 (KRT14) gene. These keratin mutants result in a weakened cytoskeleton and cause extensive cytolysis. It is important to analyze the KRT5 or KRT14 genes of the patient and their family members by mutational analysis in order to identify genetic defects as well as the need for genetic counseling. In this study, we present a 5-year-old Korean boy who had been developing blisters and erosions on the palms of his hands and soles of his feet since infancy. In addition, while his younger sister and father showed similar clinical manifestation, his mother did not. The patient was diagnosed with EBS based on clinical manifestation, which is characterized by the presence of blisters restricted to the palms and soles, histological findings, and mutational analysis. Mutational analysis of the patient's DNA revealed a thymine-to-cytosine transition at codon 608 in the KRT-5 gene, resulting in a leucine-to-proline substitution in the keratin 5 protein. The same mutation was identified in the paternal, but not maternal, DNA. Here, we report a case of Weber-Cockayne type EBS with vesicles and bullae restricted to the palms and soles with a novel, paternally inherited mutation in KRT5 gene (exon2, c.608T>C).

Nonsexually Acquired Genital Ulceration on the Perianal Area in an Elderly Man / 대한피부과학회지

Nonsexually acquired genital ulceration (NSAGU) is characterized by the abrupt appearance of painful genital ulcers, most often in young women. The onset may be preceded by an acute systemic illness such as fever or malaise, and many of the patients have a history of oral aphthosis. Its pathogenesis is not fully understood. In our case, a 72-year-old male visited with multiple painful erythematous ulcers on the perianal area. By history taking, laboratory tests, and skin biopsy, we excluded etiologies such as herpes simplex virus infection, syphilis, chancroid, and Behcet's disease. Thus, we diagnosed the patient with NSAGU and treated him with systemic steroids, nonsteroidal anti-inflammatory drugs, antibiotics, cyclosporine, and triamcinolone injection. Approximately 13 months after resolution, there had been no relapse. NSAGU is an uncommon condition and underrecognized by physicians. There have been no documentarily reported cases of NSAGU in Korea. Therefore, we present a case of NSAGU on the perianal area in an elderly man.

Effect of Botulinum Toxin A on Acute and Chronic Pain in Herpes Zoster Patients / 대한피부과학회지

BACKGROUND: Many strategies are currently used to reduce herpes zoster pain, such as opioid analgesic administration and transcutaneous electrical nerve stimulation. However, a more effective and convenient method to reduce herpes zoster pain is needed. OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of botulinum toxin A in patients with herpes zoster pain. METHODS: Seventy-five patients with herpes zoster pain were enrolled. We reviewed the medical records and divided the patients into three groups according to the treatment they received: standard treatment with botulinum toxin A, standard treatment only, and standard treatment with normal saline injection. Data on patients' age, sex, involved dermatome, and the duration and severity of pain evaluated with the visual analogue scale (VAS) were collected. Botulinum toxin A (1 unit/1 cm2, total 10~20 units) was injected intradermally, and the patients were evaluated on initial visit, and at 1 and 28 days after injection. RESULTS: In concordance with previous studies, this study showed that botulinum toxin A had a rapid and considerable effect on reducing both acute and postherpetic pain. The mean VAS was 6.96 on initial visit, 2.90 after 1 day, and 2.03 after 28 days in the botulinum toxin injection group. This result was statistically significant (p<0.001) when compared with the standard treatment group and the standard treatment with normal saline injection group. Few adverse effects were observed. CONCLUSION: Intradermal injection of botulinum toxin A is an effective and safe method for reducing pain in patients with herpes zoster.

Dapsone Hypersensitivity Syndrome with EBV Reactivation / 대한피부과학회지

No abstract available.

Erythema Multiforme-like Eruptions Caused by Accidental Exposure to Glufosinate Ammonium / 대한피부과학회지

Glufosinate ammonium herbicide is a nonselective herbicide used worldwide because it is less toxic than paraquat. Acute glufosinate ammonium intoxications manifest as injuries of the intestinal mucosa, abdominal pain, vomiting, diarrhea, convulsions, respiratory distress, and death resulting from human abuse. We present a case of irritant contact dermatitis on the back caused by accidental exposure to glufosinate ammonium and followed by erythema multiforme-like eruptions without systemic intoxication, which has not been documented previously in Korea.

Pneumococcal Vaccination-Induced Localized Cutaneous Toxic Reaction Mimicking Fixed Drug Eruption on a Nearby Vaccination Injection Site in an Infant / 대한피부과학회지

Pneumococcus is a very important pathogen for children and elderly people, and causes considerable morbidity and mortality in these groups. Pneumococcal vaccination is relatively safe, and is being increasingly used for the prevention of pneumococcal disease, such as meningitis, pneumonia, otitis media, and bacteremia. Mild adverse reactions of pneumococcal vaccination are relatively common, and include erythema, pain, fever, myalgia, and headaches. However, adverse skin reactions are very rare. Here, we present a case of pneumococcal vaccination-induced localized toxic reaction mimicking fixed drug eruption on a nearby vaccination injection site in an infant, which has not previously been documented in Korea.

Effect of Horse Oil on Anti-bacterial, Inflammatory Cytokines, and Type I Collagen Expressions in Human HaCaT Keratinocytes and Fibroblasts / 대한피부과학회지

BACKGROUND: Anti-inflammation, anti-bactericidal, and collagen synthesis are important for health skin conditions. However, the effect of horse oil on anti-inflammation, anti-bactericidal, and collagen synthesis is largely unknown. OBJECTIVE: The aim of this study was to evaluate the anti-bactericidal, anti-inflammatory, and synthesis of type I collagen of horse oil. METHODS: Anti-bacterial effect was evaluated by disc diffusion test. Expressions of inflammatory cytokines were studied by RT-PCR analysis, real time PCR. Type I collagen expression was evaluated by Western blot in human HaCaT kertinocytes and fibroblasts. RESULTS: Our data showed that horse oil exerted anti-bacterial effect on P.acnes and S.aureus. Expression of IL-10 was increased by horse oil-treated HaCaT cells. In addition, increased expression of type I collagen was observed in horse oil-treated human skin fibroblasts. CONCLUSION: Horse oil exerts an anti-bactericidal effect against P.acnes and S.aureus. In addition, anti-inflammatory and anti-aging effects of horse oil will be mediated by up-regulation of IL-10 and type I collagen, respectively.

Erratum: Author's Name Correction. Dapsone Hypersensitivity Syndrome with EBV Reactivation / 대한피부과학회지

Author list should be corrected.