Prevalence and Clinical Features of Non-alcoholic Fatty Liver Disease in Psoriatic Patients with Abnormal Liver Function Tests / 대한피부과학회지

Background@#Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. @*Objective@#To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. @*Methods@#We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. @*Results@#A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). @*Conclusion@#Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.

Prevalence and Clinical Features of Non-alcoholic Fatty Liver Disease in Psoriatic Patients with Abnormal Liver Function Tests / 대한피부과학회지

Background@#Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. @*Objective@#To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. @*Methods@#We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. @*Results@#A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). @*Conclusion@#Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.

Two Cases of Thrombosis of the Palmar Digital Vein

Palmar digital vein thrombosis causing one or more nodules seems to be a relatively rare condition, judging by the dearth of reports in the literature. It should always be considered in a patient who presents with a painful, firm, blue nodule located at or in close proximity to one of the flexion crease of the finger. Common lesions presenting as one or more solid digital nodules are ganglions, epidermal inclusion cysts, giant cell tumors, and lipomas. Thrombosis of the palmar digital veins should, however, be part of the differential diagnosis of palmar digital nodules because it is possible to manage it conservatively. We report two cases of thrombosis of palmar digital vein in a 33-year-old woman and a 78-year-old man.

A Case of Pilonidal Sinus Mimicking Inflammatory Epidermal Cyst / 대한피부과학회지

Pilonidal sinus is one of a follicular occlusion tetrad, and is a chronic inflammatory disease that is associated with hair; a midline hairy patch or pit in the sacral region with a sinus orifice in the bottom, or a cyst beneath it, in which hair is growing. The exact pathogenesis of pilonidal sinus remains unknown, but hair insertion may be the essential cause of the disease. It is usually treated by radical excision, marsupialization or incision and curettage. However, these surgical options often lead to a high recurrence rate, especially for hirsute patients. Wide excision and simple primary closure of the pilonidal sinus is an easy, simple method and the recurrence rate is low. We report here the case of an 18-year-old male patient with recurrent pilonidal sinus mimicking inflammatory epidermal cyst. The pilonidal sinus was treated by wide excision and primary closure.

Fatal Cutaneous gamma/delta T-Cell Lymphoma with Central Nerve System Metastasis

Cutaneous gamma/delta T-cell lymphoma is an extremely rare and highly aggressive tumor that is often resistant to treatment, such as polychemotherapy and radiotherapy. Due to the complexity of clinical, pathologic, and immunohistochemical features of this disease entity, the physician should perform a careful evaluation; however, treatment should be rapid and aggressive. We present a case of fatal cutaneous gamma/delta T-cell lymphoma of a 55-year old woman who died after recurrence with central nerve system metastasis.

A Case of Sinusoidal Hemangioma with Lipoma

Sinusoidal hemangioma is a distinctive subset of a group of lesions known collectively as cavernous hemangiomas. Clinically, it develops in adults, predominantly females, and presents as a solitary, painless, bluish, deep dermal or subcutaneous nodule. Lipoma is the most common benign soft tissue tumor. Lipoma is distinguished from sinusoidal hemangioma on both clinical and histological grounds. Several studies have suggested that adipocytes originate from perivascular cells during adipogenesis. Angiogenic cytokines released by adipocytes play a role in the vasoproliferative response. The rearrangement or loss of chromosome 13 can also be associated with hemangioma. However, no previous cases of sinusoidal hemangioma have been associated with benign tumors like lipoma. Here, we describe an unusual case of sinusoidal hemangioma that occurred together with a lipoma on the right upper arm of a 43-year-old male.

A Two-week Interval Is Better Than a Three-week Interval for Reducing the Recurrence Rate of Hand-foot Viral Warts after Cryotherapy: A Retrospective Review of 560 Hand-foot Viral Warts Patients

BACKGROUND: Viral warts are a common infectious disease and liquid nitrogen cryotherapy is one of the most common methods for treatment of these warts. Hand-foot viral warts frequently recur and reduce quality of life as well. OBJECTIVE: To find the ideal treatment interval between cryotherapy sessions that can influence not only the cure rate but also the recurrence rate for hand-foot viral warts. METHODS: A retrospective study was designed to compare a 2 week interval and a 3 week interval between cryotherapy sessions on hand-foot viral warts with respect to cure rate, recurrence rate, treatment number, duration of treatment, mean time to recurrence and adverse events. RESULTS: A total of 560 patients were enrolled. The overall cure rate was 75.7% and the recurrence rate was 19.6%. The mean time to recurrence was 7.8 months (range 1~26 months). For the 2-week and 3-week groups, cure rates were, respectively, 76.6% (196) and 75.0% (228); recurrence rates were 13.3% (26) and 25.0% (57). The mean time to recurrence was 9.8 months and 6.9 months, respectively. Adverse events were not statistically different. CONCLUSION: We suggested that 2-week cryotherapy is optimal not only because of the rapid cure but also because of the lower recurrence rate and similar adverse events.

Ezrin and Endothelin-1 Expression in Dermatofibroma and Dermatofibrosarcoma Protuberans / 대한피부과학회지

BACKGROUND: Distinction of dermatofibroma (DF) from dermatofibrosarcoma protuberans (DFSP) is occasionally difficult. Histologically, DF shows fibrohistiocyte growth, and DFSP shows myofibroblast proliferation. This difference is usually targeted by several immunohistochemical staining to differentiate between these two entities. Ezrin, a member of ezrin-radixin-moesin family of protein, has a critical role in oncogenic transformation. And endothelin-1 (ET-1) is a family of endothelin-derived peptides that promotes myofibroblast contraction and migration. OBJECTIVE: The purpose of this study was to evaluate the usefulness of ezrin and endothelin-1 in differentiating between DF and DFSP. METHODS: Formalin-fixed and paraffin-embedded tissues from 20 DFs and 10 DFSPs were immunohistochemically stained with ezrin and ET-1 monoclonal antibodies. RESULTS: No DF case showed ezrin expression, whereas 3 of 10 DFSP cases showed weak positive reaction for ezrin. This difference was not statistically significant. In DF, 5 cases showed strong positive, 3 showed moderate positive, 4 were weak positive and 8 cases showed negative by ET-1 staining. In DFSP, 6 cases were strong positive, 1 was moderate positive, 2 were weak positive and 1 showed negative by ET-1. CONCLUSION: Ezrin and endothelin-1 are not useful in distinguishing between DF and DFSP. Further studies are needed to determine the factors which differentiate DFSP from DF.

A Case of Secondary Milium Caused by Pencil Injury / 대한피부과학회지

Milium is an asymptomatic, tiny, subepidermal, keratinous cyst found primarily on the cheek and eyelids. Milium is thought to result from pilosebaceous or eccrine duct plugging. Secondary milium develop when other underlying factors are present such as bullous diseases, various inflammatory skin diseases, and trauma. We report an 8-year-old boy who had a solitary, dome-shaped, whitish papule with 2x3 mm gray macule at the site, pricked by pencil. Histopathologically, the lesion showed the typical findings of milium and foreign body reaction caused by graphite. We treated this using punch excision and there has been no evidence of recurrence for 7 months.