No abstract available.
Nevus, Pigmented* ; Vitiligo*

No abstract available.
Adenoma* ; Ear*

Background: Biologics have been increasingly used in the treatment of severe psoriasis. However, evidence regarding the results of tuberculosis (TB) screening and risk of latent tuberculosis infection (LTBI) during treatment with biologics is conflicting. Objective: We aimed to assess the prevalence of LTBI in patients with severe psoriasis who were treated with biologics (anti-tumor necrosis factor-α, interleukin [IL]-12/23, IL-17, and IL-23) and to evaluate the rate of conversion of interferon-gamma release assay (IGRA) during treatment with biologics at a single medical center. Methods: We retrospectively reviewed the medical records of patients with severe psoriasis who were treated with biologics (n=118) and had results for ≥2 IGRA (n=76). Data including demographics, age, sex, previous therapy for psoriasis, and type of ongoing treatment were collected for each patient. Results: Among the 118 patients included in the study, 30 (25.4%) were diagnosed with LTBI before the initiation of biologics, 25 (83.3%) were male, and only five patients were aged below 40 years. After treatment with biologics for an average duration of 2.4 years, there was no active tuberculosis infection in 76 patients, but eight patients (10.5%) showed positive conversion of IGRA. Conclusion Altogether, 10.5% of the patients with psoriasis who were undergoing treatment with biologics exhibited IGRA conversion. Periodic follow-up is crucial to avoid severe infectious complications during prolonged use of these agents, especially in patients with risk factors for tuberculosis or in patients aged above 50 years.

Reptiles are used for various purposes these days, including public exhibits, medicinal applications, and as laboratory animals. As the international exchange of reptiles has gradually increased, more people have had the opportunity to come in contact with these animals. Snakes typically live in the rhizosphere where various bacterial strains exist and as such they can lead to opportunistic human diseases. When snakes are encountered in veterinary medicine, it is necessary to monitor their microflora. Native microflora of reptiles imported from other countries has not yet been reported in Korea. In this study, oral and cloacae samples were collected from 18 Burmese pythons transported from Vietnam. The specimens were incubated at 37degrees C for 18 h to produce colony growth under aerobic condition and isolated colonies were then identified using a VITEK automated identification system. There were fourteen types of aerobic bacteria isolated from both oral and cloacae samples, nine from only oral specimens, and fifteen from only cloacae specimens. Most bacteria isolated were opportunistic pathogens of humans which therefore have the potential to induce disease in people. Based on the microflora and the prevalence of bacterial strains in snakes, quarantine procedures for reptiles transported internationally should be strengthened. Characterization of the microflora of reptiles with the potential to induce zoonosis should be performed in those used as laboratory animals and to prevent zoonotic outbreaks in the general population as well as among veterinarians.
Animals ; Animals, Laboratory ; Asian Continental Ancestry Group ; Bacteria ; Bacteria, Aerobic ; Boidae ; Cloaca ; Disease Outbreaks ; Humans ; Korea ; Mouth ; Opportunistic Infections ; Organothiophosphorus Compounds ; Prevalence ; Quarantine ; Reptiles ; Rhizosphere ; Snakes ; Veterinarians ; Veterinary Medicine ; Vietnam

URPOSE: To evalvate the role of double-phase spiral CT for T staging of gastric cancers with radiologic-pathologic correlation. MATERIALS AND METHODS: Double-phase spiral CT images of 44 patients of gastriccancers proved by pathologic examination were retrospectively evaluated. We retrospectively classified spiral CTimages of gastric cancers ; classification was from S 0 to S 4 and was based on the degree of change in three multilayered patterns shown in normal gastric wall and whether or not tumor cells had invaded perigastric fattissue. Pathologic classification was based on the T staging of TNM classification for gastric cancers, and wethen correlated these results. RESULTS: In group S1, all of three cases(100%) were proved to be T1 and in groupS2, five(45.5%) of 11 cases were T2. Of five cases with S3 CT findings, three(60%) were proved to be T3s andtwo(40%) were T2. Of 22 cases with S4 CT findings, 19(86.4%) were T3p. Overall sensitivity, specificity, and accuracy were 60.3%, 88. 5%, and 86.9%, respectively. In 35 (79.5%) of the total of 44 cases, the lesions were more enhanced on venous than on arterial phase. CONCLUSION: The accuracy of double-phase spiral CT for T staging of gastric cancers was 86.9%, and in contrast to previous results for conventional or dynamic CT, this level of accuracy was thought to be relatively high. In conclusion, double-phase spiral CT images of gastric cancers were helpful in the diagnosis of T staging.
Classification ; Diagnosis ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, Spiral Computed*

Background: The metastatic brain tumor is the most common brain tumor. The aim of this study was to demonstrate the clinicopathological and molecular pathologic features of brain metastases (BM). Methods: A total of 269 patients were diagnosed with BM through surgical resection at Seoul St. Mary’s Hospital from January 2010 to March 2020. We reviewed the clinicopathological features and molecular status of primary and metastatic brain tissues using immunohistochemistry and molecular pathology results. Results: Among 269 patients, 139 males and 130 females were included. The median age of primary tumor was 58 years (range, 13 to 87 years) and 86 patients (32.0%) had BM at initial presentation. Median BM free interval was 28.0 months (range, 1 to 286 months). The most frequent primary site was lung 46.5% (125/269), and followed by breast 15.6% (42/269), colorectum 10.0% (27/269). Epidermal growth factor receptor (EGFR) mutation was found in 50.8% (32/63) and 58.0% (40/69) of lung primary and BM, respectively. In both breast primary and breast cancer with BM, luminal B was the most frequent subtype at 37.9% (11/29) and 42.9% (18/42), respectively, followed by human epidermal growth factor receptor 2 with 31.0% (9/29) and 33.3% (14/42). Triple-negative was 20.7% (6/29) and 16.7% (7/42), and luminal A was 10.3% (3/29) and 7.1% (3/42) of breast primary and BM, respectively. In colorectal primary and colorectal cancer with BM, KRAS mutation was found in 76.9% (10/13) and 66.7% (2/3), respectively. Conclusions We report the clinicopathological and molecular pathologic features of BM that can provide useful information for understanding the pathogenesis of metastasis and for clinical trials based on the tumor’s molecular pathology.

BACKGROUND: Odontogenic cutaneous fistula appears as dimpling or a nodule with purulent discharge, usually in the chin or jaw. Affected patients usually seek help from dermatologists or surgeons rather than from dentists. However, clinical symptoms of facial skin fistula without dental problems can lead to misdiagnosis. OBJECTIVE: The purpose of this study was to investigate the clinical characteristics of patients with odontogenic cutaneous fistulas. METHODS: This retrospective observational study was performed at Chungbuk National University Hospital by analyzing patients who visited from April 1994 to September 2014. Following clinical and radiographic examinations, the paths and origins of sinus fistulas were determined. Investigated factors were gender, age, morphology, location, originating tooth, time to evolution, recurrence, and treatment method. RESULTS: Thirty-three patients (22 males, 11 females; average age 49.2 years) were examined during the investigation period. Thirty-four fistulas were diagnosed as odontogenic cutaneous fistulas. The most common morphology was dimpling (n=14, 41.2%). The various locations observed were related to the originating tooth. The most common site was the mandibular body related to mandibular molars. The referral clinical diagnosis was of odontogenic origin in 6 cases (18.2%). The majority of patients had experienced recurrence after treatment in previous clinics that had failed to diagnose odontogenic cutaneous fistula. Surgical fistulectomy and/or tooth treatment were performed in all cases. All patients were followed-up for 1 year. None showed signs of recurrence. CONCLUSION: Extraoral and dental examinations are required to make a diagnosis of odontogenic cutaneous fistula. Thus, cooperation between dermatologists and dentists is essential.
Chin ; Chungcheongbuk-do ; Cutaneous Fistula* ; Dentists ; Diagnosis ; Diagnostic Errors ; Female ; Fistula ; Humans ; Jaw ; Male ; Methods ; Molar ; Observational Study ; Recurrence ; Referral and Consultation ; Retrospective Studies ; Surgeons ; Tooth

A 64-year-old female presented with a 1-year history of livedo-like erythematous patches and plaques around the surgical scar on the left knee. Examinations revealed poorly demarcated, erythematous, indurated patches and plaques, with mild tenderness overlying the medial and inferior portion of the surgical scar. Histopathology revealed a mixed dermal infiltrate with glomeruloid intravascular accumulation of histiocytes and neutrophils. Histiocytes were identified by immunostaining for CD68. Immunostains for CD31 and D2-40 confirmed the intra-lymphatic location of the histiocytes. Recently, there have been several case reports of erythematous patches around the joints, which histopathologically show histiocytic aggregations in dermal vessels. Intra-lymphatic histiocytosis is a rare group of skin diseases characterized by the proliferation of histiocytes in the vessel lumen. Although the pathogenesis of intra-lymphatic histiocytosis is unknown, a role for lymphatic stasis secondary to chronic inflammation or surgery has been suggested. We present the case of a 64-year-old female who developed a tender rash on her left knee 1 year after orthopedic metal implants. To our knowledge, this is the first case of intra-lymphatic histiocytosis reported in association with a metal implant in the Korean dermatologic literature.
Cicatrix ; Exanthema ; Female ; Histiocytes ; Histiocytosis* ; Humans ; Inflammation ; Joints ; Knee ; Middle Aged ; Neutrophils ; Orthopedics* ; Skin Diseases

Bowen's disease usually manifests as a slowly enlarging erythematous scaly patch or plaque. An uncommon variant of Bowen's disease showing a verrucous appearance has been reported and a distinct variant with a prominent clear cell change on histopathology, in addition to a verrucous surface change, was also reported. We describe novel form of Bowen's disease having a cerebriform appearance and showing histopathologically a significant clear cell change and propose that the clinical term “lobulated Bowen's disease” would be compatible for the description of this unique clinical variant. From a histopathological point of view, the precise definition and etiopathogenesis of the clear cell change in Bowen's disease should be elucidated.
Bowen's Disease*

BACKGROUND: Prurigo pigmentosa is a rare recurrent inflammatory disease of the skin, and this is characterized by an abrupt onset of erythematous papules that usually resolve with leaving reticular hyperpigmentation. Although its incidence has increased in Korea as well as in the international community, there are few comprehensive studies on this malady in the Korean dermatologic literature. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathological features of prurigo pigmentosa. METHODS: We reviewed all the medical records, photographs and histopathological slides of 27 patients who had been diagnosed with prurigo pigmentosa at 3 hospitals between 1998 and 2009. Additionally, we also reviewed the clinical findings of the 37 cases that have been reported in the Korean dermatologic literature. RESULTS: The ratio of males to females was 1:2.4 and the mean age of onset was 24.6+/-8.2 years old. Twenty six patients (96.3%) complained of pruritus that was usually moderate to severe and the most commonly involved site was the back (63.0%). Although all 27 patients presented with erythematous papules, the skin lesions were accompanied with reticulated hyperpigmentation in 17 patients (63.0%) at the time of diagnosis. Fourteen patients were treated with minocycline alone or in combination therapy, and two pregnant women were treated with topical steroid alone. The major microscopic features of the lesions of prurigo pigmentosa were mild to moderate acanthosis and spongiosis in the epidermis, extravasation of erythrocytes and a mild to moderate perivascular lymphohistiocytic infiltrate in the dermis. A neutrophilic infiltrate tended to be observed in the relatively early lesions rather than in the fully developed lesions. CONCLUSION: Clinicopathologic correlation and thorough long-term follow-up are necessary to establish a diagnosis of prurigo pigmentosa because a pathologic examination does not show pathognomonic features. Our data suggest that neutrophils may play a role in the pathogenesis of prurigo pigmentosa, based upon finding them in the early lesion and the efficacy of the agents that inhibit neutrophil function, such as dapsone or minocycline.
Age of Onset ; Dapsone ; Dermis ; Epidermis ; Erythrocytes ; Female ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Incidence ; Korea ; Male ; Medical Records ; Minocycline ; Neutrophils ; Pregnant Women ; Prurigo ; Pruritus ; Skin