Tumor Necrosis Factor-Alpha Inhibitor-Associated Psoriatic Alopecia in a Patient with Ulcerative Colitis:A Case Report and Review of the Literature

Paradoxical reactions in patients treated with tumor necrosis factor-alpha inhibitors (TNFis) have an estimated prevalence of 1.5% to 5%. Such reactions usually present as psoriasiform eruptions on the trunk and extremities along with palmar and flexural involvement. When affecting the scalp, new-onset psoriasis induced by TNFi can result in non-scarring or scarring alopecia. Although the paradoxical reaction was first reported in 2003, this TNFi-associated psoriatic alopecia (TiAPA) has been recently reported with increasing frequency. This condition is characteristically reversible and requires clinical and histopathological identification from other diseases for proper treatment. The cessation of TNFi therapy may not be mandatory, and decision to continue TNFi therapy depends on the severity of TiAPA and the riskbenefit ratio of treatment modification on the underlying disease. Herein, we report a case of TiAPA in a patient with inflammatory bowel disease whose alopecia improved following suspension of TNFi. We also describe the clinical and histopathological diagnostic criteria based on review of the literature.

Extraocular Sebaceous Carcinoma in situ Concurrent with Actinic Keratosis: A Case Report and Review of the Literature / 대한피부과학회지

Sebaceous carcinoma is a malignant neoplasm frequently classified as periocular or extraocular. Extraocular sebaceous carcinoma is a relatively rare tumor commonly appearing in the head and neck region. Furthermore, extraocular sebaceous carcinoma limited to the epithelium, which is called ‘extraocular sebaceous carcinoma in situ’ is extremely rare with less than 10 cases reported in the literature. Herein, we present the case of a 93-year-old female who diagnosed as extraocular sebaceous carcinoma in situ occurring concurrently with actinic keratosis. In the present case, extraocular sebaceous carcinoma in situ as identified without any connection to an adnexal component but concurrent with actinic keratosis. This case is evidence that extraocular sebaceous carcinoma can arise from the epidermis and the tumor cells of intraepidermal squamous neoplasia can differentiate toward malignant sebocytes.

Clinical and Histopathologic Study of Noneczematoid Cutaneous Diseases on Umbilicus / 대한피부과학회지

Background@#Umbilical skin lesions are rare but diverse and are rarely diagnosed by biopsy. @*Objective@#This study aimed to analyze the clinical and histopathological features of umbilical skin lesions that require histopathological investigation and to aid in the diagnosis of diseases in patients with umbilical skin lesions. @*Methods@#We performed a retrospective analysis of the patients who visited Korea University Medical center for umbilical skin lesions between January 2008 and December 2019. Age, sex, clinical features, etiologies, and histopathological features were obtained from the patients’ medical records. @*Results@#In total, 41 cases of histologically confirmed umbilical lesions were observed. There were 29 female patients (70.73%). The lesions included hypertrophic scars (11/41), epidermal cysts (7/41), verruca (6/41), seborrheic keratosis (4/41), nevus (4/41), steatocystoma (2/41), and one case each of endometriosis, hidrocystoma, neurofibroma, soft fibroma, foreign body granuloma, tick bite, and heterotopic gastric mucosa. @*Conclusion@#The most common umbilical skin lesions were hypertrophic scars, probably because of the increasing number of laparoscopic surgeries. Compared to the known trends in other countries, fewer biopsies were performed on the umbilical lesions for the diagnosis of metastatic cancer in this study, which might have been due to the low incidence of advanced gastric cancer and the early detection of cancer through endoscopy and computed tomography scan in Korea. Clinically, changes in treatment modality and diagnostic development can alter the frequency of the previously well-recognized diseases; therefore, medical personnel should be aware of the changing incidence of related diseases.

Extraocular Sebaceous Carcinoma in situ Concurrent with Actinic Keratosis: A Case Report and Review of the Literature / 대한피부과학회지

Sebaceous carcinoma is a malignant neoplasm frequently classified as periocular or extraocular. Extraocular sebaceous carcinoma is a relatively rare tumor commonly appearing in the head and neck region. Furthermore, extraocular sebaceous carcinoma limited to the epithelium, which is called ‘extraocular sebaceous carcinoma in situ’ is extremely rare with less than 10 cases reported in the literature. Herein, we present the case of a 93-year-old female who diagnosed as extraocular sebaceous carcinoma in situ occurring concurrently with actinic keratosis. In the present case, extraocular sebaceous carcinoma in situ as identified without any connection to an adnexal component but concurrent with actinic keratosis. This case is evidence that extraocular sebaceous carcinoma can arise from the epidermis and the tumor cells of intraepidermal squamous neoplasia can differentiate toward malignant sebocytes.

Clinical and Histopathologic Study of Noneczematoid Cutaneous Diseases on Umbilicus / 대한피부과학회지

Background@#Umbilical skin lesions are rare but diverse and are rarely diagnosed by biopsy. @*Objective@#This study aimed to analyze the clinical and histopathological features of umbilical skin lesions that require histopathological investigation and to aid in the diagnosis of diseases in patients with umbilical skin lesions. @*Methods@#We performed a retrospective analysis of the patients who visited Korea University Medical center for umbilical skin lesions between January 2008 and December 2019. Age, sex, clinical features, etiologies, and histopathological features were obtained from the patients’ medical records. @*Results@#In total, 41 cases of histologically confirmed umbilical lesions were observed. There were 29 female patients (70.73%). The lesions included hypertrophic scars (11/41), epidermal cysts (7/41), verruca (6/41), seborrheic keratosis (4/41), nevus (4/41), steatocystoma (2/41), and one case each of endometriosis, hidrocystoma, neurofibroma, soft fibroma, foreign body granuloma, tick bite, and heterotopic gastric mucosa. @*Conclusion@#The most common umbilical skin lesions were hypertrophic scars, probably because of the increasing number of laparoscopic surgeries. Compared to the known trends in other countries, fewer biopsies were performed on the umbilical lesions for the diagnosis of metastatic cancer in this study, which might have been due to the low incidence of advanced gastric cancer and the early detection of cancer through endoscopy and computed tomography scan in Korea. Clinically, changes in treatment modality and diagnostic development can alter the frequency of the previously well-recognized diseases; therefore, medical personnel should be aware of the changing incidence of related diseases.

A Case of Pediatric Subcorneal Pustular Dermatosis / 대한피부과학회지

Subcorneal pustular dermatosis (SPD), also known as Sneddon-Wilkinson's disease, is a rare pustular eruption that occurs mainly in middle-aged women and rarely during childhood. Clinically, the pustules are distributed on the trunk and proximal region of the limbs, and cultures of the pustules consistently do not reveal bacterial growth. Histopathology shows subcorneal pustules containing polymorphonuclear leukocytes and chronic progression. SPD is a rare condition, especially in children, and only one case has been reported in Korea. Here, we report a case of 4-year-old girl as an educational case for the diagnosis and treatment of pediatric SPD.

Epigenetics: general characteristics and implications for oral health

Genetic information such as DNA sequences has been limited to fully explain mechanisms of gene regulation and disease process. Epigenetic mechanisms, which include DNA methylation, histone modification and non-coding RNAs, can regulate gene expression and affect progression of disease. Although studies focused on epigenetics are being actively investigated in the field of medicine and biology, epigenetics in dental research is at the early stages. However, studies on epigenetics in dentistry deserve attention because epigenetic mechanisms play important roles in gene expression during tooth development and may affect oral diseases. In addition, understanding of epigenetic alteration is important for developing new therapeutic methods. This review article aims to outline the general features of epigenetic mechanisms and describe its future implications in the field of dentistry.

The Relationships among Levels of Agreement about Perceived Family Support, Emotional Expressivity and Psychiatric Symptoms in Patients with Schizophrenia and their Families / 신경정신의학

OBJECTIVES: The aim of this study was to explore relationships among the level of agreement about perceived family support, emotional expressivity and psychiatric symptoms in patients with schizophrenia and their families. METHODS: The Family Support Scale, the Emotional Expressivity Scale and the Symptom Checklist-90-Revision were administered to 73 patients with schizophrenia and their 73 family members. RESULTS: Agreement about perceived family support was divided into four levels. The first level was where there was affirmative agreement between the patient and the family member. The second level was where there was negative agreement between the patient and the family member. At the third level there was a negative perception by the patient and an affirmative perception by the family member, and the final level was where there was an affirmative perception by the patient and a negative perception by the family member. The more positive the patients perceived their family support to be, the more they expressed their emotional expressivity. The patients, who agreed affirmatively with their family member about family support, were more able to express their emotion and had fewer psychiatric symptoms than the patients, who had negative agreement with their family member about family support. CONCLUSION: The level of perceived agreement of the family support affects emotional expressivity and psychiatric symptoms in patients with schizophrenia. The family support perception by the patient and family member can help you understand emotional expressivity and psychiatric symptom in schizophrenics.