1.A Case of Improvement of Refractory Acrodermatitis Continua of Hallopeau with Guselkumab
Jin Ho KIM ; Dae-Lyong HA ; Yong Hyun JANG
Korean Journal of Dermatology 2024;62(1):53-57
Acrodermatitis continua of Hallopeau (ACH) is a rare type of pustular psoriasis that causes periungual sterile pustules, paronychia, onychodystrophy, osteolysis, and atrophic skin. This condition is known for being resistant to conventional anti-psoriatic treatments. Therefore, biologics have been explored as potential management options for ACH. A 48-year-old male presented with erythematous swelling, pustular eruptions, desquamation, and nail dystrophy on his left third fingertip for a year. Despite various anti-psoriatic treatments, including 308 nm excimer laser, oral cyclosporine, acitretin, and methotrexate, the symptoms persisted. After 9 years of experiencing this condition, the patient was started on guselkumab (an interleukin-23 inhibitor), and showed significant improvement after eight injections. The patient was in good health without any adverse effects. This case report highlights the potential effectiveness of guselkumab in the treatment of refractory ACH.
2.A Case of Multiple Necrotic Dyskeratotic Cells within the Upper Epidermis and Horny Layer Revealing Persistent Papules and Plaques of Adult-Onset Still’s Disease
Dae-Lyong HA ; Gi Ung HA ; Man-Hoon HAN ; Seok-Jong LEE
Annals of Dermatology 2023;35(Suppl1):S84-S87
It is important to differentiate violaceous to dusky red papules and plaques that widely persist on the trunk and extremities because there are dermatoses that could be fatal, such as lupus erythematosus, dermatomyositis, drug eruptions, and graft-versus-host disease.Dyskeratotic cells only in the upper epidermis and horny layer are not well known, but it is a distinctive histopathological pattern of atypical type of rash of adult-onset Still’s disease (AOSD). AOSD rash is a transient salmon-colored rash that occurs and disappears with fever; however, an atypical type of rash called “persistent dermal plaque” or “persistent pruritic eruptions” has also been reported. It occurs and persists even after fever subsides.Herein, we describe a case with necrotic dyskeratotic cells in the upper epidermis and horny layer without AOSD symptoms lasting for five years.
3.Centennial History of Kyungpook National University Dermatology
Gi Ung HA ; Seok-Jong LEE ; Yong Hyun JANG ; Kyung Duck PARK ; Jun Young KIM ; Dae-Lyong HA ; Weon Ju LEE
Korean Journal of Dermatology 2023;61(9):529-535
The Department of Dermatology at Kyungpook National University School of Medicine, initially the Dermatology Department of the Private Daegu Medical Training School in 1924, commemorated its 100th anniversary in 2023.Throughout its rich history, the department has been dedicated to advancing contemporary dermatology and enhancing the well-being of local communities through exceptional research, education, and social contributions.Initially tasked with the diagnosis, treatment, and education of patients with dermatological and urological disorders, the department evolved over time. In 1958, it separated from the Urology Department to focus solely on the diagnosis, research, and education of dermatological disorders. In 1962, Dr. Soon Bong Suh became the inaugural Chief of the Dermatology Department, marking the foundation of the Kyungpook National University School of Medicine’s Dermatology Department. Our legacy of pioneering contributions extends to dermatophytic diseases, which account for a large proportion of skin disorders in Korea, where we have excelled in basic research and treatment. These achievements have played a crucial role in the advancement of dermatophytic diseases.Subsequently, we have demonstrated expertise in blistering diseases and dermatopathology, making substantial contributions to the diagnosis and treatment of refractory skin conditions. Recently, we have been at the forefront of research and interventions for chronic inflammatory skin conditions that cause significant distress in many individuals, including atopic dermatitis and psoriasis. Our influence has also extended to severe and refractory skin disorders, including skin cancer and vascular anomalies. Striving to stay contemporary, our achievements now encompass aesthetics, including acne, pigmentation, and laser treatments. Our accomplishments have garnered widespread recognition nationwide, engendering high expectations for future advancements.
4.A Case of Lymphomatoid Papulosis, Type F
Dae-Lyong HA ; Jin Seon BANG ; Ji Yun JEONG ; Man-Hoon HAN ; Seok-Jong LEE
Korean Journal of Dermatology 2023;61(2):137-139
Lymphomatoid papulosis (LyP) is a relatively uncommon CD30+ lymphoproliferative disorder with a good prognosis. However, it is important to be cautious because 4%∼25% of the cases are accompanied by secondary lymphoma. LyP is divided into subtypes of infiltrate-descriptive categories based on the histological findings. Classically, LyP shows a patchy, wedge-shaped, dermal infiltrate of small to intermediate-sized lymphocytes, with atypical lymphoid cells and a variable mixture of neutrophils, histiocytes, and eosinophils. Follicular LyP (type F LyP), which was recently described and is not yet included as an official subtype in the World Health Organization classification, shares these characteristics, although its infiltrate is folliculocentric. Variable folliculotropism, follicular dilation, rupture, and mucinosis can occur. This entity is commonly misdiagnosed and is possibly underreported because its histopathologic features can masquerade as more common follicular-based entities. Herein, we report the case of follicular type LyP, which has not been reported in in Korean dermatology literature.
6.Survival Rate and Prognostic Factors of 26 Cases of Angiosarcoma and 26 Cases of Kaposi Sarcoma: A Korean Single-Center Experience
Jin Seon BANG ; Nam Gyoung HA ; In Hee LEE ; Man-Hoon HAN ; Jeong Eun LEE ; Ho Yun CHUNG ; Dae-Lyong HA ; Seok-Jong LEE
Korean Journal of Dermatology 2023;61(8):472-480
Background:
Angiosarcoma (AS) and Kaposi sarcoma (KS) are rare malignant and borderline malignant vascular tumors that may first present to a dermatologist. There are few Korean studies that particularly focus on their survival due to low incidence.
Objective:
To investigate the survival and prognostic factors among patients with AS and KS, in addition to their clinical features.
Methods:
Between 2000∼2021, medical records of 26 AS and 26 KS patients at a single center were analyzed retrospectively. Additionally, we calculated the disease specific survival (DSS) and overall survival (OS) of two diseases.
Results:
The mean age of patients with AS was 72.9 years and 67.3 years for KS. The most common tumor location was the scalp in patients with AS (80.8%) and the foot (65.4%) in those with KS. In patients with AS, 1-year DSS and OS rates were 36.0% and 34.6%, respectively. Five-year DSS and OS rates were 24.0% and 20.2%, respectively. In patients with KS, the 1-year DSS and OS rates were 96.2% and 84.6%, respectively. The 5-year DSS and OS were 91.6% and 58.0%, respectively. Patients who were older or had larger lesions than average had decreased DSS and OS in AS. Among the patients with KS, immunosuppressed status, including human immunodeficiency virus infection, showed reduced OS.
Conclusion
Apart from confirming grave survival of AS and favorable survival of KS, patient’s age and size of lesion affect survival outcomes in patients with AS. Otherwise, immunosuppressed status affects survival outcomes in patients with KS.
7.Diagnostic Process of Subcorneal Pustular Dermatosis: A Case Report
Gi Ung HA ; Seok-Jong LEE ; Weon Ju LEE ; Yong Hyun JANG ; Jun Young KIM ; Dae-Lyong HA ; Kyung Duck PARK
Korean Journal of Dermatology 2024;62(3):169-171
A 54-year-old man presented to our outpatient clinic with generalized pruritic millet-sized vesicles, pustules, and crusts on the whole body over the past 10 years, which were more dominant in the lower extremities. Due to the difficulty in diagnosis, a series of histopathologic examinations were conducted during the treatment course, and the findings were similar: subcorneal pustules with neutrophils, superficial perivascular and dermal infiltration of lymphocytes, neutrophils, and eosinophils, with no sign of acantholysis. The patient was treated with cyclosporine, prednisolone, doxycycline, colchicine, sulfasalazine, and acitretin; however, his condition did not improve. After showing a dramatic improvement with dapsone, he was finally diagnosed with subcorneal pustular dermatosis (SPD).Various medications commonly used in inflammatory and immunobullous skin diseases were tried but failed to improve the condition; the patient showed a dramatic response only to dapsone. Due to its rarity, careful attention and repeated biopsies are required for diagnosing SPD.
8.Cutaneous Nontuberculous Mycobacterial Infection Misdiagnosed as Rheumatoid Nodule in a Patient with Rheumatoid Arthritis
Nam Gyoung HA ; Dae-Lyong HA ; Jun Young KIM ; Yong Hyung JANG ; Weon Ju LEE ; Seok Jong LEE ; Kyung Duck PARK
Korean Journal of Dermatology 2024;62(4):242-246
Owing to advances in diagnostics and the increase in invasive procedures, and immunocompromised patients, cutaneous nontuberculous mycobacteria (NTM) infection is rising. NTM should be suspected in patients with persistent skin lesions refractory to treatment with a history of immunosuppression or skin injury. A 59-year-old woman presented with a 4-week history of multiple erythematous tender nodules on left arm. A year prior, multiple nodules appeared on left hand dorsum, followed by recurrent suppurative nodules in left arm. She has been taking methotrexate and leflunomide for 7 years due to rheumatoid arthritis (RA). Skin biopsy revealed granulomatous inflammation, and NTM polymerase chain reaction test was positive. Furthermore, she had cut her left finger with a knife 14 months ago. Based on these findings, cutaneous NTM infection was diagnosed. Herein, we report a case of cutaneous NTM infection in an immunosuppressed patient with RA, emphasizing differentiating subcutaneous nodules from rheumatoid nodules in RA.
9.A Case of Hyperimmunoglobulin E Syndrome Presenting as Infantile Eosinophilic Pustular Folliculitis.
Dae Lyong HA ; Taewook KIM ; Sungmin PARK ; Hyun Joo LEE ; Hyunju JIN ; Hyangsuk YOU ; Woo Haing SHIM ; Gun Wook KIM ; Hoon Soo KIM ; Byung Soo KIM ; Moon Bum KIM ; Hyun Chang KO
Korean Journal of Dermatology 2018;56(9):573-575
No abstract available.
Eosinophils*
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Folliculitis*
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Humans
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Infant
10.Three Cases of Unilateral Linear Capillaritis.
Dae Lyong HA ; Hyunju JIN ; Hyang Suk YOU ; Woo Haing SHIM ; Jeong Min KIM ; Gun Wook KIM ; Hoon Soo KIM ; Hyun Chang KO ; Byung Soo KIM ; Moon Bum KIM
Korean Journal of Dermatology 2018;56(4):273-275
Unilateral linear capillaritis (ULC) is a rare variant of pigmented purpuric dermatosis (PPD). ULC is clinically characterized by unilateral linear macules on the lower extremities, which fade spontaneously. We present three patients with linearly distributed purpuric macules on only one side of the lower extremities. Skin biopsy showed histopathological features of PPDs. We diagnosed ULC based on these clinicopathological findings. For all patients, the skin lesions began to fade spontaneously within several months to a few years after onset. ULC has been reported rarely, with only about 20 cases worldwide and no cases described in the Korean literature.
Biopsy
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Humans
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Lower Extremity
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Skin
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Skin Diseases