Efficacy and Safety of Oral Alitretinoin in Various Refractory Dermatologic Diseases: A Retrospective Study / 대한피부과학회지

Background@#Patients with dermatologic diseases refractory to conventional treatments including corticosteroids, immunosuppressants, and phototherapy require new treatment options. Limited studies have investigated the efficacy of alitretinoin for various diseases. @*Objective@#This study aimed to evaluate the efficacy and safety of oral alitretinoin for various refractory dermatologic diseases. @*Methods@#A total of 168 patients treated with oral alitretinoin for various dermatologic diseases such as psoriasis, contact dermatitis, hand eczema, and pityriasis rubra pilaris were reviewed. Treatment response was measured according to the Physician’s Global Assessment scale and adverse events (AEs) based on medical records. @*Results@#Patients with a mean age of 46.6±14.7 years were treated with oral alitretinoin for 26.1±27.6 weeks. The overall response rate (very good or excellent) was 49.5%. The response rate was the highest (74.4%) in the eczema disease group. Overall, 80 patients (74.8%) experienced AEs, and headache (46.7%) was the most common AE, followed by decreased serum free T4 (16.8%) and elevated triglycerides (12.1%). Most AEs were tolerable, except for one case of benign intracranial hypertension. @*Conclusion@#Despite its limited approval for severe chronic hand eczema, oral alitretinoin may be a relatively safe and effective option for various refractory dermatologic diseases.

Clinicopathological Characteristics of H-Zone and Non-H-Zone Basal Cell Carcinoma in the Head and Neck Region / 대한피부과학회지

Background@#Basal cell carcinoma (BCC) is the most common type of skin cancer. However, limited comparative data on the characteristics and prognosis of BCC in the H-zone and non-H-zone exist. @*Objective@#We aimed to compare the clinical, histopathological, and surgical characteristics of BCCs in the head and neck region between the H- and non-H-zones. @*Methods@#We retrospectively reviewed the clinical and histopathological characteristics of 292 head and neck BCC lesions in 275 patients and the characteristics of Mohs micrographic surgery (MMS) of 252 BCC lesions in 239 patients. @*Results@#In the H-zone, 226 lesions (77.4%) were found. Clinically, patients with H-zone BCC, compared to those with non-H-zone, were significantly older (71.6±11.4 years vs. 64.6±13.5 years) and smaller in diameter (10.1±7.1 mm vs. 12.4±9.9 mm). The noduloulcerative type was more frequent in the H-zone, while the superficial and morpheaform types in the non-H-zone. Histopathologically, the infiltrative subtype was particularly noted in the H-zone than the non-H-zone (7.5% vs. 1.5%). Out of 37 BCC patients with prior treatment history, 31 (83.8%) were in the H-zone. Two out of 252 lesions (0.8%) recurred after MMS at our institution. The mean stages of MMS were comparable between the H- and non-H-zones (1.59 vs. 1.45, p=0.135). @*Conclusion@#H-zone BCCs were associated with older age and smaller tumor size compared to the non-H-zone BCCs. The noduloulcerative clinical and nodulocystic pathologic subtypes were the most common in both H-zone and non-H-zone BCCs.

Proliferative Myositis on the Tongue / 대한피부과학회지

Proliferative myositis is a rare, benign, probably pseudosarcomatous fibroblastic proliferation that typically presents as a rapidly growing soft tissue mass. Its relative rarity, fast growth rate, and unique histopathologic findings may lead to misdiagnosis as a malignant lesion and unnecessary radical surgical excision. A 57-year-old female presented with a non-tender, well-defined, indurated, solitary, hard papule on the median sulcus of the tongue for 2 weeks. Histologic examination revealed numerous fibroblastic or myofibroblastic spindle cells and large ganglion-like cells infiltrating between and around the muscle fascicles. Immunohistochemical staining showed positivity for vimentin, smooth muscle actin, and CD68 and negativity for S-100. Based on these characteristic clinical findings and histopathologic features, the patient was diagnosed with proliferative myositis. Here, we report a rare case of proliferative myositis on the tongue and recommend considering proliferative myositis in the differential diagnosis when a physician encounters a rapidly grown soft tissue mass.

A Case of SAPHO Syndrome Associated with Lytic Bone Lesions Resembling Metastases / 대한피부과학회지

SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome includes a variety of inflammatory bone disorders associated with dermatologic pathology. A 57-year-old female presented with pustulosis on both hands that had persisted for several months. She also had lower back pain without trauma history. On physical examination, tenderness on her lower back and left anterior chest wall pain were found, and claudication was observed. Radiological studies including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT showed endplate lytic changes in her spine, a focal hypermetabolic lesion in a left rib, and costochondral junction. These findings raised doubt on the presence of metastatic bone lesions, and there was no indication for primary cancer after a complete medical checkup. Palmoplantar pustulosis was well controlled by treatment with acitretin. The osteitis associated with SAPHO syndrome usually presents as osteosclerosis, while reports on osteolytic lesions are rare. We report herein a rare case of SAPHO syndrome associated with bone lesions resembling bone metastasis.

Treatment of Hair Loss in the Trichorhinophalangeal Syndrome

No abstract available.

The Effect of FK 506 on the Reepithelialization of Superficial Skin Wound

No abstract available.

Secondary Cutaneous Amyloidosis in a Patient with Mycosis Fungoides

Secondary cutaneous amyloidosis refers to clinically unapparent amyloid deposits within the skin in association with a pre-existing skin condition or skin tumors, such as basal cell carcinoma, porokeratosis, solar elastosis, Bowen's disease, and mycosis fungoides. A 70-year-old woman presented with a 6-month history of asymptomatic multiple yellowish plaques on both legs. She had been diagnosed with mycosis fungoides 7 years ago and was treated with psoralen and ultraviolet A radiation (PUVA) therapy, narrow-band ultraviolet B (UVB) therapy, and acitretin for 5 years. Finally, she reached complete remission of mycosis fungoides. However, new yellowish lesions started to appear 1 year after discontinuing the phototherapy. A physical examination revealed multiple yellowish plaques on both extremities. The plaques were well circumscribed and slightly elevated. All laboratory tests were normal. A biopsy specimen showed multiple nodular deposits of eosinophilic amorphous material in papillary dermis and upper reticular dermis. The deposits represented apple green birefringence on Congo red stain viewed under polarized light. Acellular small nodules in the upper dermis consisted of randomly oriented, non-branching, 6.67~12.7 nm thick amyloid fibrils on electron microscopy. We report an interesting and rare case of secondary cutaneous amyloidosis after narrow-band UVB therapy and PUVA therapy in a patient with mycosis fungoides.

Secondary Cutaneous Amyloidosis in a Patient with Mycosis Fungoides

Secondary cutaneous amyloidosis refers to clinically unapparent amyloid deposits within the skin in association with a pre-existing skin condition or skin tumors, such as basal cell carcinoma, porokeratosis, solar elastosis, Bowen's disease, and mycosis fungoides. A 70-year-old woman presented with a 6-month history of asymptomatic multiple yellowish plaques on both legs. She had been diagnosed with mycosis fungoides 7 years ago and was treated with psoralen and ultraviolet A radiation (PUVA) therapy, narrow-band ultraviolet B (UVB) therapy, and acitretin for 5 years. Finally, she reached complete remission of mycosis fungoides. However, new yellowish lesions started to appear 1 year after discontinuing the phototherapy. A physical examination revealed multiple yellowish plaques on both extremities. The plaques were well circumscribed and slightly elevated. All laboratory tests were normal. A biopsy specimen showed multiple nodular deposits of eosinophilic amorphous material in papillary dermis and upper reticular dermis. The deposits represented apple green birefringence on Congo red stain viewed under polarized light. Acellular small nodules in the upper dermis consisted of randomly oriented, non-branching, 6.67~12.7 nm thick amyloid fibrils on electron microscopy. We report an interesting and rare case of secondary cutaneous amyloidosis after narrow-band UVB therapy and PUVA therapy in a patient with mycosis fungoides.

Multiple Skin Colored Nodules on both Legs in Patient with Positive QuantiFERON®-TB Gold Test

Nodular tuberculid (NT) was originally described by Jordaan et al. in 2000 in 4 patients from South Africa. It appeared as nodules on the legs; the pathologic changes were situated in the deep dermis and adjacent subcutaneous fat. A 34-year-old woman visited our hospital with subcutaneous skin-colored or slightly erythematous round to oval nodules. Skin biopsies revealed granulomatous inflammation at the dermo-subcutaneous junction with vasculitis. Chest X-ray, tuberculosus (TB)-polymerase chain reaction and TB culture of the skin specimen were normal. A QuantiFERON®-TB Gold test (QUIAGEN, Germany) was positive, which suggested a diagnosis of latent TB infection. The patient was treated with anti-TB medication and her condition has not recurred. Herein, we report a case of a patient with latent TB diagnosed by a positive QuantiFERON®-TB Gold test whose skin lesions had the clinical and histopathologic features of NT.

Multiple Skin Colored Nodules on both Legs in Patient with Positive QuantiFERON®-TB Gold Test

Nodular tuberculid (NT) was originally described by Jordaan et al. in 2000 in 4 patients from South Africa. It appeared as nodules on the legs; the pathologic changes were situated in the deep dermis and adjacent subcutaneous fat. A 34-year-old woman visited our hospital with subcutaneous skin-colored or slightly erythematous round to oval nodules. Skin biopsies revealed granulomatous inflammation at the dermo-subcutaneous junction with vasculitis. Chest X-ray, tuberculosus (TB)-polymerase chain reaction and TB culture of the skin specimen were normal. A QuantiFERON®-TB Gold test (QUIAGEN, Germany) was positive, which suggested a diagnosis of latent TB infection. The patient was treated with anti-TB medication and her condition has not recurred. Herein, we report a case of a patient with latent TB diagnosed by a positive QuantiFERON®-TB Gold test whose skin lesions had the clinical and histopathologic features of NT.

Pili Annulati with Multiple Fragile Hairs

No abstract available.

Primary Extramammary Paget's Disease with Lymphatic Invasion Confirmed by D2-40 Immunostain / 대한피부과학회지

No abstract available.