Immunohistochemical Analysis of Prurigo Nodularis in 209 Patients: Clinicopathological Analysis between Atopic and Non-Atopic Patients and between Treatment Response Groups

Background@#Prurigo nodularis (PN) is a highly pruritic disease that significantly impairs patient quality of life. Although the mechanism that causes pruritus is not clear, one hypothesis argues that neural hyperplasia, mast cell, and Merkel cell neurite complexes may be associated with PN pathogenesis. @*Objective@#The objective of this study was to analyze whether special staining outcomes differed depending on the presence of atopic dermatitis (AD) and treatment response. @*Methods@#A total of 209 patients diagnosed with PN was analyzed retrospectively. Patients were divided into two groups according to presence or past history of AD and by treatment response. Histopathologic features were obtained using the following stains: Giemsa, S-100, neuron-specific enolase, cytokeratin (CK)-20, CAM5.2, and CK8/CK18. @*Results@#A total of 126 patients (60.29%) had AD, and 68 (32.54%) showed clinical improvement. There were no statistically significant differences in the staining results between the PN groups with AD (PN c̅ AD) and without AD (PN s̅ AD). Additionally, there were no statistically significant differences in staining results between the improved and non-im-proved groups. @*Conclusion@#Implementing the special stains helped to identify PN pathogenesis. Because there were no statistically significant differences in the special stain results between the improved and non-improved groups, we conclude that mast cell proliferation, neural hyperplasia, and Merkel cell hyperplasia may not have a significant effect on treatment response.

Immunohistochemical Analysis of Prurigo Nodularis in 209 Patients: Clinicopathological Analysis between Atopic and Non-Atopic Patients and between Treatment Response Groups

Background@#Prurigo nodularis (PN) is a highly pruritic disease that significantly impairs patient quality of life. Although the mechanism that causes pruritus is not clear, one hypothesis argues that neural hyperplasia, mast cell, and Merkel cell neurite complexes may be associated with PN pathogenesis. @*Objective@#The objective of this study was to analyze whether special staining outcomes differed depending on the presence of atopic dermatitis (AD) and treatment response. @*Methods@#A total of 209 patients diagnosed with PN was analyzed retrospectively. Patients were divided into two groups according to presence or past history of AD and by treatment response. Histopathologic features were obtained using the following stains: Giemsa, S-100, neuron-specific enolase, cytokeratin (CK)-20, CAM5.2, and CK8/CK18. @*Results@#A total of 126 patients (60.29%) had AD, and 68 (32.54%) showed clinical improvement. There were no statistically significant differences in the staining results between the PN groups with AD (PN c̅ AD) and without AD (PN s̅ AD). Additionally, there were no statistically significant differences in staining results between the improved and non-im-proved groups. @*Conclusion@#Implementing the special stains helped to identify PN pathogenesis. Because there were no statistically significant differences in the special stain results between the improved and non-improved groups, we conclude that mast cell proliferation, neural hyperplasia, and Merkel cell hyperplasia may not have a significant effect on treatment response.

A Case of Hyaline Fibromatosis Syndrome with a New Variant of Genetic Mutation in ANTXR2 Gene

No abstract available.

A Case of Nivolumab-Induced Lichen Planus

No abstract available.

Chronic Exfoliative Cheilitis Successfully Treated by Pinhole Method Using CO₂ Laser

No abstract available.

A Case of Mycosis Fungoides Occurring after Primary Gamma-Delta T-Cell Lymphoma

No abstract available.

Effects of platelet-rich plasma on tooth replantation in dogs: a histologic and histomorphometric analysis

PURPOSE: The purpose of this study was to evaluate the effects of platelet-rich plasma (PRP) on periodontal healing of replanted root surfaces in dogs histologically and histomorphometrically. METHODS: A total of 36 roots of mandibular incisors and premolars from 6 mongrel dogs were used. The roots were randomly divided into 3 groups: 1) a positive control group (n=12), in which the periodontal ligament (PDL) and cementum were retained and the roots were soaked in saline; 2) a negative control group (n=12), in which the PDL and cementum were removed and the roots were soaked in saline; and 3) an experimental group (n=12), in which the PDL and cementum were removed and the roots were soaked in PRP. After soaking the root surfaces, the extracted roots were replanted into the extraction sockets. The roots were covered using a coronally repositioned flap RESULTS: Histologically, irregular-thickness PDL-like and cementum-like tissues were observed in the 4-week experimental group and the positive control group. PDL-like tissue and cementum-like tissue with a more uniform thickness were observed at 8 weeks. In the negative control group, PDL-like tissue and cementum-like tissue were rarely found, and root resorption and ankylosis were observed. In the cross-sectional histomorphometric analysis, the experimental group demonstrated a higher rate of formation of cementum-like tissue and a lower tooth ankylosis rate than the positive and negative control groups at 4 and 8 weeks. Although there was a significant difference in the tooth ankylosis rate and the formation of cementum-like tissue across the 3 groups (P 0.017). CONCLUSIONS: Applying PRP to root surfaces during tooth replantation in dogs can reduce tooth ankylosis and increase PDL-like and cementum-like tissue formation.

Delayed Granulomatous Reaction Occurring after Eyebrow Tattooing / 대한피부과학회지

No abstract available.

Olmutinib Induced Lichen Planus Like Eruption

Drug induced lichen planus like eruption is an uncommon cutaneous adverse effect of several drugs. This appears symmetric eruption of erythematous or violaceous plaques resembling lichen planus on the trunk and extremities. A 50-year-old male presented with scaly, violaceous plaques and dusky brown macules on whole body. For four months, the patient was treated with olmutinib, an oral, third-generation epidermal growth factor receptor-tyrosine kinase inhibitor. In May 2016, olmutinib received its first global approval in South Korea for the treatment of patients with locally advanced or metastatic epidermal growth factor receptor T790M mutation-positive non-small cell lung cancer. The biopsy specimen from the patient showed features of lichen planus. We diagnosed him with olmutinib-induced lichen planus like eruption. He was treated with oral methylprednisolone and topical desoxymethasone 0.25% ointment. At the same time, olmutinib dose was decreased to three-fourths of this patient's starting dose. After that, the cutaneous lesions improved.

Clinical Features and Incidence of Skin Cancer and Precancerous Lesions after Solid Organ Transplantation: A 22-year Single-center Experience in Korea / 대한피부과학회지

BACKGROUND: It is well known that skin cancer and precancerous disease develop more frequently in patients undergoing solid organ transplantation than normal populations in the normal population in Western countries. However, to date, the clinical and demographic features of skin cancer and precancerous disease after solid organ transplantation are not established in Asian countries. We evaluated the clinical and demographic features of primary skin cancer and precancerous lesions after solid organ transplantation and compared these with the trends observed in Western countries. METHODS: We retrospectively reviewed the medical records of patients who underwent kidney, liver, heart, and lung transplantation between January 1995 and April 2017 and who developed skin cancer or precancerous lesions after transplantation. The various lesions observed were squamous and basal cell carcinoma, malignant melanoma, Kaposi sarcoma, Bowen's disease, and actinic keratosis. RESULTS: We identified 4604 patients who received organ transplant. The mean age of patients was 44.8 years (male, 64.6%; female, 35.4%), and the sum of the person-year of observation time was 31,024 person-years. The incidence rate per 100,000 person-years was 29.01 for squamous cell carcinoma, 19.34 for basal cell carcinoma, 6.45 for malignant melanoma 3.22 for Kaposi sarcoma, and 74.17 for Bowen's disease and actinic keratosis. The incidence rate per 100,000 person-years was the highest in patients undergoing heart transplantation (610.50), followed by those who underwent kidney transplantation (136.54) and liver transplantation (90.15). Koreans showed lower incidence rates than those observed in Westerners. CONCLUSION: The incidence of primary skin cancer and precancerous lesions after solid organ transplantation in Koreans was lower than that in Westerners. Squamous cell carcinoma was the most common skin cancer in patients undergoing solid organ transplantation and the incidence rate of skin cancer and precancerous lesions was the highest in patients undergoing heart transplantation.

Treatment Effect of Tranexamic Acid in Plasma D-dimer Level Elevated Anti-histamine Resistant Chronic Urticaria Patients / 대한피부과학회지

No abstract available.

Eruptive Vellus Hair Cysts Successfully Treated by Topical Tretinoin 0.01% Cream / 대한피부과학회지

No abstract available.

Efficacy of Punch Reduction Prior to Cryotherapy in Patients with Viral Warts: A Case-Control Study in a Single Tertiary Center

BACKGROUND: Cutaneous warts are a common complaint to visit dermatologic clinic and its course is variable, ranging from spontaneous resolution to a chronic condition refractory to treatment. OBJECTIVE: To evaluate the efficacy and safety of punch biopsy for cutaneous warts. METHODS: Thirty-nine patients who received punch biopsy for warts were reviewed through charts and photos. Among them, 15 were matched with cryotherapy-only controls in terms of size and location of the wart. We compared the number and cost of treatments between the two groups. RESULTS: Eleven of the total 39 patients were treated with cryotherapy in addition to punch biopsy and the average number of treatments was 4.1±3.3 (mean±standard deviation). In a case-control study, the ratio value of cost was 2.9±3.6 in the experimental group and was 5.9±4.1 in controls (p<0.05). CONCLUSION: Punch biopsies can decrease the number and cost of treatment by reducing the size of warts and inducing local inflammation to accelerate resolution. Therefore, punch reduction should be considered as a viable measure to treat warts.

A Case of Bullous Pemphigoid Following Chronic Lymphocytic Leukemia / 대한피부과학회지

Bullous pemphigoid is a rare nonhematologic autoimmune complication of chronic lymphocytic leukemia. There have been roughly 10 cases worldwide since 1974, and searches through Korean dermatological literature revealed no reported cases. A 72-year-old man had been diagnosed with chronic lymphocytic leukemia and treated with chemotherapy for 7 months. After that, he was in complete remission, and the chemotherapy was discontinued consequently. One month later, multiple erythematous blisters, papules, and crusts developed on his trunk and both extremities. Histopathologic examination and immunofluorescence of the tense blister revealed a bullous pemphigoid. We present this rare case as the first documented case report of bullous pemphigoid following chronic lymphocytic leukemia in the Korean dermatological literature.

A Case of Serious Complication after Cryotherapy / 대한피부과학회지

Cryotherapy is a simple, relatively inexpensive therapeutic modality that is widely-used in clinical practice. It is especially appropriate for patients with an intolerance to anesthesia as well as high risk factors for developing hypertrophic scars after surgery. It can be applied to skin lesions located close to vital structures such as vessels and nerves. Potential side effects include pain, hemorrhage, edema, blisters, infection, hypopigmentation, and sensory damage. There are a numerous reports in the literature describing the side effects of cryotherapy. However, cases with severe complications have rarely been reported as yet. Herein, we report a case of serious complications of cryotherapy, a result of the course of treatment for linear porokeratosis.

Clinical Features and Awareness of Hand Eczema in Korea

BACKGROUND: Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. OBJECTIVE: To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. METHODS: To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. RESULTS: The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. CONCLUSION: Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.

Analysis of 69 Cases of Adverse Events Associated with Laser Treatments / 대한피부과학회지

BACKGROUND: During the past two decades, laser treatments have been increasingly performed by various personnel in Korea. However, as a result, adverse events related to laser treatments have also increased. OBJECTIVE: This study aimed to characterize cutaneous adverse events associated with laser treatments in Korea and to consider feasible ways to minimize possible laser-associated adverse events. METHODS: Adverse event reports after laser treatments were collected from the members of the Korean Dermatological Association. A retrospective analysis of clinical data was performed regarding the pre-treatment lesion, specific laser type applied, personnel who performed the procedure, and consequences in terms of treatmentrelated complications. RESULTS: A total of 69 reported cases of adverse events associated with laser treatment were collected. The most frequently reported adverse event was postinflammatory dyspigmentation, followed by secondarily induced dermatological disease, treatment-inflicted burn, and residual scar. CONCLUSION: Both expected and unexpected adverse events occur after laser treatments. Most adverse events are not serious, but proper dermatological attention should be given to avoid complications. It should be noted that the safest and the most successful laser treatment can be provided only by qualified personnel.

Blastic Plasmacytoid Dendritic Cell Neoplasm: Analysis of Clinicopathological Feature and Treatment Outcome of Seven Cases

BACKGROUND: Blastic plasmacytoid dendritic cell neoplasm (BPDCN), which is derived from the precursor of plasmacytoid dendritic cells, is a rare and highly aggressive hematologic malignancy. It has only recently been recognized as a distinct entity. BPDCN characteristically has a predilection for cutaneous involvement. OBJECTIVE: The aim of this study was to describe the clinical and pathological features of BPDCN, and to review the treatment courses to analyze the prognosis and the optimal therapeutic approach. METHODS: We retrospectively reviewed seven BPDCN cases registered in the Samsung Medical Center database between January 2010 and December 2014. RESULTS: The median age of the patients was 52 years (range, 18~79 years), and six patients were male. The clinical staging was as follows: skin (n=5), lymph node (n=6), bone marrow (n=4), and peripheral blood (n=2). The skin manifestations were bruise-like tumefaction (n=4), erythematous nodule (n=4), or multiple erythematous papules (n=1). The pathological evaluation revealed dense diffuse or nodular infiltration of neoplastic cells, which were positive for CD4, CD56, and CD123 in the immunohistochemical analysis. Six patients received multiagent chemotherapy as the first-line treatment, alone (n=4), or followed by stem cell transplantation (SCT, n=1) or concurrent radiotherapy (n=1). The median progression-free survival after the first-line treatment was 6 months (range, 2~12 months). CONCLUSION: Three different skin manifestations were observed, with pathological features analogous to each other. All patients who received chemotherapy without SCT achieved partial or complete response but experienced relapse. Furthermore, they showed various clinical courses irrelevant to the cutaneous involvement.

Antibiotic Susceptibility of Staphylococcus aureus in Atopic Dermatitis: Current Prevalence of Methicillin-Resistant Staphylococcus aureus in Korea and Treatment Strategies

BACKGROUND: Staphylococcus aureus is a well-known microbe that colonizes or infects the skin in atopic dermatitis (AD). The prevalence of methicillin-resistant S. aureus (MRSA) in AD has recently been increasing. OBJECTIVE: This study aimed to determine the antimicrobial susceptibility patterns in AD skin lesions and evaluate the prevalence of MRSA in Korea. We also recommend proper first-line topical antibiotics for Korean patients with AD. METHODS: We studied S. aureus-positive skin swabs (n=583) from the lesional skin of infants, children, and adults who presented to our outpatient clinic with AD from July 2009 to April 2012. RESULTS: S. aureus exhibited high susceptibility against most antimicrobial agents. However, it exhibited less susceptibility to benzylpenicillin, erythromycin, clindamycin, and fusidic acid. The prevalence of MRSA was 12.9% among 583 S. aureus isolates, and the susceptibility to oxacillin was significantly lower in infants in both acute and chronic AD lesions. CONCLUSION: S. aureus from AD has a high prevalence of MRSA and multidrug resistance, especially in infants. In addition, the rate of fusidic acid resistance is high among all age groups, and mupirocin resistance increases with age group regardless of lesional status. This is the first study comparing the antimicrobial susceptibility rates of S. aureus isolates from AD cases with respect to age and lesion status in Korea.

Are Podoplanin Gene Polymorphisms Associated with Atopic Dermatitis in Koreans?

BACKGROUND: The histologic characteristics of atopic dermatitis (AD) include perivascular edema and dilated tortuous vessels in the papillary dermis. A single nucleotide polymorphism (SNP) of the fms-related tyrosine kinase 4 (FLT4) gene is associated with AD. OBJECTIVE: To investigate the associations between podoplanin (PDPN) gene SNPs and AD. METHODS: We genotyped 9 SNPs from 5 genes of 1,119 subjects (646 AD patients and 473 controls). We determined the promoter activity of 1 SNP (rs355022) by luciferase assay; this SNP was further investigated using 1,133 independent samples (441 AD patients and 692 controls). RESULTS: The rs355022 and rs425187 SNPs and the C-A haplotype in the PDPN gene were significantly associated with intrinsic AD in the initial experiment. The rs355022 SNP significantly affected promoter activity in the luciferase assay. However, these results were not replicated in the replication study. CONCLUSION: Two SNPs and the C-A haplotype in the PDPN gene are significantly associated with intrinsic AD; although, the results were confirmed by luciferase assay, they could not be replicated with independent samples. Nevertheless, further replication experiments should be performed in future studies.