Acitretin as a Therapeutic Option for Chronic Hand Eczema

No abstract available.

Neutrophilic Dermatosis of the Palms in Association with Myelodysplastic Syndrome

No abstract available.

Effectiveness of Specific Sublingual Immunotherapy in Korean Patients with Atopic Dermatitis

BACKGROUND: Sublingual immunotherapy (SLIT) with house dust mites (HDM) preparation has recently been proven to be beneficial for treating allergic rhinitis and asthma. However, there has been no report regarding the efficacy and safety of SLIT in Korean patients with atopic dermatitis (AD). OBJECTIVE: We intended to investigate the efficacy and safety of SLIT in Korean patients with AD. METHODS: A total of 34 patients with AD and immunoglobulin E (IgE)-proven HDM sensitization (Class ≥3) were recruited. Eczema area and severity index (EASI) score, total serum IgE level, specific IgE assays to Dermatophagoides pteronyssinus, D. farinae, and adverse effects were recorded during follow-up. "Responder" was defined as a patient with ≥30% improvement in EASI score after SLIT. RESULTS: Twenty-three patients continued SLIT for 12 months or more, whereas 3 patients (8.8%) dropped out because of exacerbation of dermatitis, and 8 patients (23.5%) were lost to follow-up. The average duration of SLIT treatment was 22.4 months (range, 12~32 months). EASI scores reduced significantly after 6 months of treatment (p<0.05) compared with those at baseline. A total of 18 patients were determined to be responders to SLIT after 6 months. Total and specific IgE serum levels did not significantly reduce after SLIT. No patients experienced serious adverse events, with the exception of two patients who developed transient lip and tongue swelling. CONCLUSION: Our study demonstrated that SLIT with HDM extracts is effective and tolerable in Korean patients with AD. Further controlled long-term trials are required to reinforce the current results.

Mycoplasma pneumoniae-induced Rash and Mucositis / 대한피부과학회지

Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of respiratory tract infections in pediatric and adult populations worldwide. M. pneumoniae is also associated with extrapulmonary complications, such as mucocutaneous eruptions. In dermatologic disorders, M. pneumoniae infection is known to be associated with erythema multiforme and Stevens-Johnson syndrome in children and young adults. Recently, several cases with M. pneumoniae-associated mucositis, which lacks typical target lesions, have been reported. The term Mycoplasma-induced rash and mucositis was suggested as a revised version of the term, Mycoplasma pneumoniae-associated mucocutaneous disease, which previously included erythema multiforme and Stevens-Johnsons syndrome. This revision helps to distinguish Mycoplasma-induced rash and mucositis, which has a distinct morphology, mild disease course, and potentially important clinical implications regarding treatment. Herein, we report a patient with Mycoplasma-induced rash and mucositis.

Tuberous Sclerosis Presenting with Connective Tissue Nevi Only: Usefulness of Genetic Testing / 대한피부과학회지

Tuberous sclerosis complex (TSC) is a neurocutaneous disorder with variable manifestations. The diagnosis is based on clinical criteria, and is divided into definite, probable, and possible TSC. If patients present with mild symptoms, clinicians may hesitate to perform further evaluations because of the high economic burden. A 16-year-old male presented with multiple skin-colored papules on the lower back and buttock. The histopathologic findings were compatible with connective tissue nevi (CTN). No other findings were observed with the exception of one hypomelanotic macule on the left shin. As the patient's parents wished to confirm the diagnosis, genetic testing was performed, and a TSC1 gene mutation was detected. With this genetic result, further evaluations were performed without hesitation. Genetic testing is a sensitive and specific modality for the diagnosis of TSC. We report a case of TSC presenting with CTN only, in which genetic testing was very useful to confirm the diagnosis and to determine the appropriateness of further high-cost studies.

Photodrug Dermatitis Induced by Lomefloxacin / 대한피부과학회지

No abstract available.

Notalgia Paresthetica of the Back Successfully Controlled by Pregabalin / 대한피부과학회지

Notalgia paresthetica (NP) is a chronic localized itch, affecting mainly the inter-scapular area particularly between the T2-T6 dermatomes. Occasionally it has a more widespread distribution and involves the shoulders, back, and upper chest. There are no specific cutaneous signs, apart from those attributed to scratching and rubbing. Various etiologies have been reported, but the cause of NP is not established. The current hypothesis regarding its etiology postulates that a neuropathic itch develops due to nerve entrapment of the posterior rami of spinal nerve arising at T2-T6. Another recent documented case showed an increase in the number of intradermal nerves by neural immunochistochemistry staining of S-100 protein, protein gene product 9.5 (PGP 9.5). Herein, we experienced an uncommon case of NP of the back and tried to clarify pathogenesis by using quantitative sensory testing, such as neurometer and Von-Frey filaments. Also, we performed neural immunochemistry to confirm an increase in nerve fibers at the site of the lesion.

Dermatoses of the Glans Penis in Korea: A 10-Year Single Center Experience

BACKGROUND: A variety of infectious, inflammatory, and neoplastic dermatoses can develop on the glans penis, and definitive diagnosis in such cases may be difficult owing to their non-specific symptoms and clinical appearance. Furthermore, data on dermatoses of the glans penis in Korea are limited. OBJECTIVE: In the present study, we aimed to determine the prevalence of dermatoses of the glans penis in Korea and provide clinical data to assist in making an accurate diagnosis. METHODS: We retrospectively reviewed the medical records, clinical photographs, and histologic slides of 65 patients with dermatoses of the glans penis that visited the Pusan National University Hospital between January 2004 and August 2013. RESULTS: Twenty-six types of dermatoses were identified: inflammatory dermatosis was the most common (38/65, 58.5%), followed by infectious (13/65, 20.0%), neoplastic (10/65, 15.4%), and other dermatoses (4/65, 6.2%). The most common dermatosis of the glans penis was seborrheic dermatitis, followed by lichen planus, herpes progenitalis, condyloma accuminatum, erythroplasia of Queyrat, Zoon's balanitis, and psoriasis. In the topographic analysis, the most common type of dermatosis was dermatoses that localized to the glans penis (39/65, 60.0%), followed by dermatoses involving the extra-genitalia and glans penis (22/65, 33.9%), and the genitalia (glans penis plus other genital areas) (4/65, 6.2%). CONCLUSION: This study shows the usefulness of a topographic approach in the diagnosis of dermatoses of the glans penis in Korea. The findings could be used as baseline data for establishing an accurate diagnosis in Koreans.

The Usefulness of Dermoscopy for Detection of Subungual White Foreign Bodies

No abstract available.

A Unique Cutaneous Presentation of Breast Cancer: A Red Apple Stuck in the Breast

No abstract available.

Leuprolide Acetate-induced Foreign Body Granuloma in a Patient with Prostate Cancer / 대한피부과학회지

Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.

Leuprolide Acetate-induced Foreign Body Granuloma in a Patient with Prostate Cancer / 대한피부과학회지

Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.

Polyarthritis and Pancreatic Panniculitis in a Patient with Pancreatic Acinar Cell Carcinoma / 대한피부과학회지

No abstract available.

Low Grade Malignant Peripheral Nerve Sheath Tumor Arising from Solitary Neurofibroma / 대한피부과학회지

No abstract available.

Non-bullous Neutrophilic Dermatosis in a Patient with Lupus Nephritis / 대한피부과학회지

Neutrophilic infiltrates of skin in the setting of lupus patients with bullous systemic lupus erythematosus (SLE) and leukocytoclastic vasculitis are well documented. However, most dermatology studies do not consider cutaneous involvement by SLE in the histologic differential diagnosis of neutrophilic inflammatory dermatosis in non-bullous or non-vasculitic lesions. Nevertheless, an increasing number of studies have reported cell-rich or Sweet's-like neutrophilic reactions as well as patients with skin lesions characterized by paucicellular neutrophilic dermal infiltrates. A 56-year-old female patient with history of lupus nephritis presented with multiple erythematous to brownish papulo-patches and plaques on both legs for 1 month. She had no signs or systemic symptoms of Sweet's syndrome. Histopathologic finding showed perivascular and interstitial neutrophilic infiltration with leukocytoclasia in the upper dermis, but not as dense as commonly observed in Sweet's syndrome with absence of papillary dermal edema. Herein, we present a rare case of non-bullous neutrophilic dermatosis associated with SLE. It is important to consider SLE-associated neutrophilic dermatosis in the differential diagnosis of neutrophilic tissue reactions and to be aware of the broad histologic spectrum that may be encountered in SLE-associated neutrophilic dermatosis, ranging from subtle paucicellular lesions to florid Sweet's-like lesions.

A Case of Soft Fibroma of the Nipple with a Cauliflower-Like Appearance

No abstract available.

The Malignant Transformation of Sebaceoma into Sebaceous Carcinoma in Nevus Sebaceous / 대한피부과학회지

Nevus sebaceous appears at birth or within the first few months after birth. Secondarily to nevus sebaceous, benign or malignant tumors such as basal cell carcinoma, trichoblastoma, syringocystadenoma papilliferum, squamous cell carcinoma, sebaceoma, and sebaceous carcinoma might occur. Sebaceoma is a benign tumor composed of incompletely differentiated sebaceous cells of varying degrees of maturity. We experienced an uncommon case of malignant transformation of sebaceoma in a 47-year-old man who had a solitary, well-defined, 3.1x2.1 cm sized, round, erythematous nodule on the scalp. Histopathologic examination revealed the presence of irregular lobules of varying size with a well-defined margin from the adjacent interstitial tissue in the dermis. Focally there were atypical cells with a foamy cytoplasm and undifferentiated cells. To the best our knowledge, only one case, from another country, has been reported in the literature. Therefore, we report a very rare case of malignant transformation of sebaceoma that occurred in nevus sebaceous.

A Clinical Study of Atopic Eruption of Pregnancy / 대한피부과학회지

BACKGROUND: There are limited literatures regarding the clinical characteristics of the specific dermatoses of pregnancy, and their terminology has been confusing and misleading. A simplified classification is proposed with the new terminology 'atopic eruption of pregnancy', comprising several disease entities such as eczema of pregnancy, prurigo of pregnancy, and pruritic folliculitis of pregnancy. OBJECTIVE: A clinical study was performed to determine the exact nature of atopic eruption of pregnancy in Korea. METHODS: We retrospectively reviewed the medical records of 75 patients who were diagnosed and reclassified as atopic eruption of pregnancy at Pusan National University Hospital. RESULTS: Among 121 patients with the specific dermatoses of pregnancy, 75 (62%) were diagnosed with atopic eruption of pregnancy. The most affected sites were the flexural surfaces of the neck and extremities, followed by the abdomen and back. The mean gestational age was 18.5 weeks. In 92% of cases, atopic eruption of pregnancy started during the 1st and 2nd trimesters of pregnancy. Major fetal problems were not seen. Atopic disease was observed in 26 (34.7%) patients. Total serum IgE levels were elevated in 10 (50%) patients among the 20 patients who were tested for IgE levels. Forty-four (58.5%) patients improved after delivery, and atopic eruption of pregnancy recurred after delivery in 6 (8%) patients. CONCLUSION: The characteristics of AEP in Korea were mostly similar to those of AEP in Western countries. However, AEP in Korea seems to show a poor prognosis and be refractory to treatment compared to that of Western countries.

Usefulness of Dermatoscopy for the Preoperative Assessment of the Histopathologic Aggressiveness of Basal Cell Carcinoma

BACKGROUND: Limited information is available regarding dermatoscopic differences between non-aggressive and aggressive types of basal cell carcinoma (BCC). OBJECTIVE: To investigate dermatoscopic differences between non-aggressive and aggressive types. METHODS: We evaluated 145 histopathologically confirmed BCCs from 141 patients. Histopathologic types and aggressiveness from 4 mm punch biopsy and their dermatoscopic findings were evaluated. We assessed the statistical significance of dermatoscopic differences between non-aggressive and aggressive types. To objectively predict aggressiveness, we created a "dermatoscopic index of BCC aggressiveness" in which 1 point was added and subtracted for each dermatoscopic finding significantly higher in aggressive and non-aggressive types, respectively. RESULTS: Large blue-gray ovoid nests were found more frequently in non-aggressive type than aggressive one (85/105 [80.9%] vs. 21/40 [52.5%], p=0.001). Compared to non-aggressive type, aggressive type had more multiple blue-gray globules (29/40 [72.5%] vs. 57/105 [54.3%], p=0.046), arborizing telangiectasia (29/40 [72.5%] vs. 48/105 [45.7%], p=0.004), and concentric structure (11/40 [27.5%] vs. 12/105 [11.4%], p=0.018). Regarding dermatoscopic index, cases of aggressive type with a score of 1 were most common (n=18, 45.0%), followed by a score of 2 (n=14, 35.0%). Limited number of aggressive type of BCCs and the effect of width on the determination of histopathologic aggressiveness. CONCLUSION: Aggressive type BCCs more often exhibited multiple blue-gray globules, arborizing telangiectasia, and concentric structure, while the non-aggressive type exhibited large blue-gray ovoid nests more frequently. Score exceeding 2 on the dermoscopic index can be screening criteria for aggressiveness. These dermatoscopic features and dermoscopic index could be useful for assessing aggressiveness of BCCs before surgery.

Screening for Psoriatic Arthritis in Korean Psoriasis Patients Using the Psoriatic Arthritis Screening Evaluation Questionnaire

BACKGROUND: Psoriatic arthritis (PsA) is chronic seronegative inflammatory arthritis that causes irreversible joint damage. Early recognition of PsA in patients with psoriasis is important for preventing physical disability and deformity. However, diagnosing PsA in a busy dermatology outpatient clinic can be difficult. OBJECTIVE: This study aimed to validate the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire for the detection of PsA in Korean patients with psoriasis. METHODS: The PASE questionnaire was prospectively given to 148 patients diagnosed with psoriasis but without a previous diagnosis of PsA. All patients underwent radiologic and laboratory examinations, and a subsequent clinical evaluation by a rheumatologist. RESULTS: Eighteen psoriasis patients (12.2%) were diagnosed with PsA according to the Classification Criteria for Psoriatic Arthritis. The PASE questionnaire scores of differed significantly between PsA and non-PsA patients. Receiver operator characteristic analysis showed an area under the curve of 0.82 (95% confidence interval: 0.72, 0.92) for PASE score. A PASE score cut-off of 37 points had a sensitivity of 77.8% and specificity of 82.3% for the diagnosis of PsA. CONCLUSION: The PASE questionnaire is a simple and convenient screening tool for detecting PsA in Korean dermatology clinics. A PASE questionnaire score of 37 points appears to be an appropriate cut-off for screening Korean psoriasis patients.