Annular pustular psoriasis(APP) is a rare variant of the generalized pustular psoriasis characterized by subacute onset of annular lesion with peripheral advancing pustules. Histologically, it is characterized by spongiform and/or subcorneal pustules which are also found in subcorneal pustular dermatosis(SPD). SPD is very difficult to differentiate from APP, although SPD is thought to be a separate and distinctive entity because of its clinical appearance, characteristic histology, and response to dapsone. We herein report a case of APP showing clinical and histologic features of SPD developed in a patient who had a history of generalized pustular psoriasis.
Dapsone ; Humans ; Psoriasis* ; Skin Diseases, Vesiculobullous*

A paranasal sinus mucocele is an epithelial-lined, mucus-containing sac that completely fills the sinus and forms an expandable cystic structure. It most commonly affects the frontal and ethmoidal sinuses, and rarely the maxillary and sphenoid sinuses. Orbital displacement or external disfigurement resulting from the expansion of the frontal or ethmoid sinuses is common; however, facial asymmetry caused by maxillary bone remodeling is rare. We describe a case of large maxillary sinus mucocele that destroyed the maxillary sinus bony wall, resulting in notable left cheek swelling and disfigurement, and review the relevant literature.

Neoplasm from the accessory parotid glands (APG) rarely occurs, and its malignancy rate is higher than other salivary glands. The B-cell lymphoma from APG is rare, with less than 2% of all malignancy in APG. The mucosa-associated lymphoid tissue (MALT) lymphoma, a subtype of B-cell lymphoma, tends to be a localized disease with an indolent clinical course. It is very rare for MALT lymphoma to develop bilaterally in the APG and the parotid glands without an autoimmune disease. A 43-year-old male presented with superficial masses in the bilateral infra-zygomatic regions, and was pathologically confirmed as MALT lymphoma by excisional biopsy. We report this very rare and interesting case with a brief literature review.

The coronavirus disease (COVID-19) by severe acute syndrome coronavirus-2 (SARS-CoV-2) occurs the unprecedented pandemic during recent two years and the WHO declared a global pandemic of COVID-19 in March 2020. The most common sampling sites in COVID-19 test are the oropharynx and nasopharynx. We recently encountered a total laryngectomee who had a positivity COVID-19 diagnostic test from the tracheostoma, on the other hand, false negativity from the nasal cavity. The meaning of this case is that accurate screening test could be achieved by performing a test through the tracheostoma as well as nasal cavity or oropharynx. We also would like to discuss the accurate testing methods of patients whose airflow has distorted due to surgery, the management method of these patients, and the need of further research in the COVID-19 pandemic period with relevant literature reviews.

Neurocardiogenic syncope is a relatively common cause of syncope and is diagnosed by head-up tilt test. A wide variety of medical treatment has been proposed, such as beta-blocker, vasoconstrictor, fludrocortisone, and serotonin re-uptake inhibitors. But there are some cases in which these therapies have failed to prevent syncope. Recent report has shown that tilt training is a very effective therapy for recurrent neurocardiogenic syncope. Thus, to determine whether tilt training could prevent symptoms in the patients with recurrent neurocardiogenic syncope, the following study was taken. Five patients diagnosed with neurocardiogenic syncope by head-up tilt test were included. After hospital admission, they were tilted daily until negative response occurred. Negative response was noted in four patients. But tilt training was stopped in one patient because of no response of tilt training. After hospital discharge, the four patients performed tilt training at home by leaning against wall. They were interviewed on the phone eight to eleven months later. They have not experienced any symptoms during the follow-up period. This is the first domestic report of tilt training in patients with neurocardiogenic syncope.
Fludrocortisone ; Follow-Up Studies ; Humans ; Serotonin ; Syncope ; Syncope, Vasovagal*

Background and objectives: Takotsubo cardiomyopathy (TTC) occasionally causes life-threatening ventricular arrhythmia. J wave on surface electrocardiography (sECG) has also been associated with idiopathic ventricular fibrillation and cardiac events; therefore, we investigated whether the presence of J wave on sECG is a potential risk factor for ventricular arrhythmia in patients with TTC. Subjects and methods: We performed a retrospective study in 79 patients who were diagnosed with TTC from 2010 to 2014. Among them, 20 (25.3%) were diagnosed with ventricular tachycardia (VT). The J wave on the sECG was defined as J point elevation manifested through QRS notching or slurring at least 1 mm above the baseline in at least two leads. Results: A higher prevalence of ventricular tachycardia was observed in patients with J wave. The corrected QT interval (QTc) was significantly longer in the VT group than in the non-VT group. In a multivariate analysis, the presence of J wave appeared to be the only independent predictors of VT [Hazard Ratio (HR) 3.5, p = 0.019]. Conclusion Our results suggest that the presence of J wave on the sECG is significantly associated with VT, and appear to indicate that the presence of J wave is a strong and independent predictor of VT in patients with TTC.