1.Basal Cell Carcinoma Emerging from Nevus Unius Lateris
Jong Heon PARK ; Ju Young JO ; Hyunwoo PARK ; Hyo Yoon KIM ; Il-Hwan KIM
Korean Journal of Dermatology 2024;62(1):50-52
Nevus unius lateris (NUL) is a variant of an epidermal nevus that involves a widespread body surface, especially half of the body, and its onset usually occurs at birth or early life. An increased risk of basal cell carcinoma (BCC) in epidermal nevus has also been reported. However, the exact incidence remains unknown. A 67-year-old female patient visited our dermatology clinic with black nodules protruding over multiple verrucous brownish patches and plaques on the right side of the trunk. The patient had congenital NUL. Black nodules were observed to develop several months previously and gradually enlarged. The skin biopsy of one black nodule was consistent with BCC. Subsequently, Mohs micrographic surgery was performed for the BCC. To date, there have been few reports of BCC arising within the nevus unius lateri. Herein, we report a rare case of BCC considered to originate from a congenital NUL.
2.Two Cases of Erosive Adenomatosis of the Nipple
Jong Heon PARK ; Tae Woong SEUL ; Hyunwoo PARK ; Su Ji CHAE ; Hwa Jung RYU
Korean Journal of Dermatology 2024;62(1):46-49
Erosive adenomatosis of the nipple (EAN) is a rare benign entity that involves abnormal proliferation of the lactiferous ducts of the nipple and often presents with visible erosive lesions, erythema, or discharge. A 34-year-old female patient visited our clinic with erythematous patches and bloody discharge from the right nipple.Ultrasonography revealed a hypervascular lesion. A punch biopsy was performed, and histopathological examination confirmed the diagnosis of EAN. A 22-year-old female patient presented with a 4-year history of itchy erythematous eczematous patches with telangiectasia, crust, and bloody discharge in the areolar region. The punch biopsy results were consistent with those of EAN. The patient underwent total excision surgery. Herein, we report cases of EAN, which were difficult to differentiate from Paget's disease or nipple eczema, highlighting the need for clinicians to pay close attention.
3.Scar folding for the treatment of nostril stenosis after open rhinoplasty: a case report
Joo-Hak KIM ; Yunsung PARK ; Ho Jik YANG ; Sang-Ha OH ; Seung Han SONG ; Yooseok HA ; Sunje KIM ; Hyunwoo KYUNG
Archives of Aesthetic Plastic Surgery 2023;29(3):158-160
A 25-year-old woman was referred for discomfort when breathing through her left nose. The patient had undergone augmentation rhinoplasty 5 years ago, after which hypertrophic scarring occurred in the left nostril. Several corticosteroid injections were administered as the first line of treatment, but with no symptom improvement. Therefore, we proceeded with surgical scar removal, with the use of a nasal conformer. However, scarring in the left nostril recurred. Accordingly, we proceeded with further surgical treatment using the scar folding technique. After scar folding, neither scarring nor nostril stenosis recurred during 1 year of postoperative follow-up. To summarize, herein, we report a case of hypertrophic scarring in the nostril that was successfully treated with the scar folding technique.
4.Cost-Effectiveness of Age-Expanding Strategy of Latent Tuberculosis Infection Treatment in Household Contacts in South Korea
Hyunwoo CHO ; Jeongjoo SEOK ; Youngmok PARK ; Hee Jin KIM ; Eun Hye LEE ; Jungeun PARK ; Dong Ah PARK ; Young Ae KANG ; Jeehyun LEE
Yonsei Medical Journal 2023;64(6):366-374
Purpose:
The strategy of latent tuberculosis infection (LTBI) treatment in household tuberculosis (TB) contacts has been expanding in South Korea. However, there is little evidence of the cost-effectiveness of LTBI treatment in patients over 35 years of age. This study aimed to evaluate the cost-effectiveness of LTBI treatment among household TB contacts in different age groups in South Korea.
Materials and Methods:
An age-structured model of TB was developed based on the reports from the Korea Disease Control and Prevention Agency and the National Health Insurance Service. Quality-adjusted life-years (QALY) and the averted number of TBrelated deaths were estimated along with discounted costs for a measure of incremental cost-effectiveness ratios.
Results:
The number of cumulative active TB cases would decrease by 1564 and 7450 under the scenario of LTBI treatment for those aged <35 years and <70 years, respectively, relative to the no-treatment scenario. The treatment strategies for patients aged 0 to <35 years, <55 years, <65 years, and <70 years would add 397, 1482, 3782, and 8491 QALYs at a cost of $660, $5930, $4560, and $2530, respectively, per QALY. For the averted TB-related deaths, LTBI treatment targeting those aged 0 to <35 years, <55 years, <65 years, and <70 years would avert 7, 89, 155, and 186 deaths at a cost of $35900, $99200, $111100, and $115700 per deaths, respectively, in 20 years.
Conclusion
The age-specific expansion policy of LTBI treatment not only for those under 35 years of age but also for those under 65 years of age among household contacts was cost-effective in terms of QALYs and averted TB deaths.
5.Dermoscopic and Histopathologic Analysis of the Correlation between the Pigmentation of Basal Cell Carcinoma and Tumor Aggressiveness
Jong Heon PARK ; Ju Young JO ; Hyunwoo PARK ; Il-Hwan KIM
Annals of Dermatology 2023;35(6):451-460
Background:
Basal cell carcinoma (BCC) is the most common type of skin cancer. In patients with darker skin, most BCCs are pigmented. Studies suggest that increased pigmentation in BCC may be inversely associated with tumor aggressiveness.
Objective:
This study analyzed the dermoscopic features and histopathologic patterns of BCCs to evaluate the correlation between BCC pigmentation and tumor aggressiveness.
Methods:
A total of 76 BCC lesions were included in this retrospective study. The Mohs micrographic surgery (MMS) stage and tumor depth were measured as indices of tumor aggressiveness. The Fontana–Masson stain was performed for the identification of melanin, and immunohistochemical analysis was performed using Melan-A and HMB-45 to identify melanocytes.
Results:
In MMS stage 1, the dermoscopic pigmentation value was 34.48%±14.22% (mean±standard deviation). In MMS stages 2 and 3, dermoscopic pigmentations were 13.72%±7.54% and 15.50%±17.52%, respectively. In the logistic regression model, higher dermoscopic pigmentation (95% confidence interval [CI], 0.68~0.99), melanin (95% CI, 0.63~0.89), and melanocyte-stained areas (95% CI, 0.70~0.92) were associated with a lower possibility of BCC tumor infiltration over the middle and lower layers.
Conclusion
We found an inverse correlation between the pigmentation and aggressiveness of BCCs. Clinicians can predict the subclinical infiltration depth of BCC on the basis of the pigmentation observed on dermoscopy. Pigmentation can be considered a favorable prognostic factor for BCC.
6.First Case of ETV6–RUNX1 Fusion in Adult De Novo Acute Myeloid Leukemia Detected Using Targeted RNA Sequencing
Seong-Jun JEON ; Joo-Heon PARK ; HaJin LIM ; Eun Jeong WON ; HyunWoo CHOI ; Hyun-Jung CHOI ; Seung-Jung KEE ; Soo Hyun KIM ; Jong Hee SHIN ; Myung-Geun SHIN
Annals of Laboratory Medicine 2023;43(1):92-95
7.Alar crease as a donor site for the extension limb of modified nasolabial V-Y advancement flap
Yooseok HA ; Yunsung PARK ; Hyunwoo KYUNG ; Sang-Ha OH
Archives of Craniofacial Surgery 2023;24(6):260-265
Background:
The traditional nasolabial V-Y advancement flap is widely used for midface reconstruction, particularly for the lower third of the nose and upper lip, as its color and texture are similar to these areas. However, it provides insufficient tissue to cover large defects and cannot restore the nasal convexity, nasal ala, and adjacent tissues. The purpose of this study is to investigate the modified nasolabial V-Y advancement flap with extension limbs the along alar crease for the reconstruction of complex midface defects.
Methods:
A retrospective analysis of 18 patients, who underwent reconstruction with the modified nasolabial V-Y advancement flap, was performed between September 2014 and December 2022. An extension limb was added along the alar crease, adjacent to the defect area, and was hinged down as a transposition flap at the end of the advancement flap.
Results:
The extension limb along the alar crease successfully covered large and complicated defects, including those of the ala, the alar rim, the alar base, the nostrils, and the upper lip, with minor complications.
Conclusion
The alar crease is a good donor site for the reconstruction of large and complex nasal and upper lip defects.
8.Prediction of Helicobacter pylori Infection by Endoscopic Severity of Erythematous/exudative Gastritis in Asymptomatic Adults
One Zoong KIM ; Kyoung Hoon RHEE ; Hyunwoo OH ; Byoung Kwan SON ; Kwang Hyun Ch CHUNG ; Hyo Young LEE ; Il Hwan OH ; Jiyoung YOON ; Soo Hyung KIM ; Chan Hyuk PARK
The Korean Journal of Gastroenterology 2022;80(3):135-141
Background/Aims:
Helicobacter pylori (H. pylori) infection highly correlates with erythematous/exudative gastritis, which is one of the endoscopic findings of the Sydney classification system. The present study aimed to evaluate the association between endoscopic severity of erythematous/exudative gastritis and H. pylori infection.
Methods:
We prospectively enrolled asymptomatic adults who were diagnosed with erythematous/exudative gastritis during screening esophagogastroduodenoscopy. A rapid urease test was performed in all participants to diagnose H. pylori infection. The severity of erythematous/exudative gastritis was determined based on the Sydney classification system. Two investigators independently evaluated the endoscopic findings. The primary endpoint was H. pylori infection rate according to the severity of erythematous/exudative gastritis (mild vs. moderate-to-severe).
Results:
A total of 177 patients with erythematous/exudative gastritis were included. The rate of H. pyloriinfection was 86.4% in all patients. Of 177 included patients, 78 were at mild degree, 48 were at moderate degree, and 51 were at severe degree. The inter-observer variation was 4.6% and kappa value was 0.593. H. pylori infection rate was similar between patients with mild erythematous/exudative gastritis and those with moderate-to-severe erythematous/exudative gastritis (91.0% vs. 82.8%, p=0.115). Even after adjusting potential confounding variables, the severity of erythematous/exudative gastritis was not associated with H. pylori infection rate.
Conclusions
H. pylori infection is commonly observed in patients with erythematous/exudative gastritis. However, the severity of erythematous/exudative gastritis is not associated with H. pylori infection rate.
10.Effect of Cadherin-11 Expression on the Prognosis of a Newly Diagnosed Primary Glioblastoma
Hyunwoo SEO ; Hye Won LEE ; Sang-Youl YOON ; Sung Hyun CHANG ; Seong-Hyun PARK ; Jeong-Hyun HWANG ; Tae In PARK ; Ki-Su PARK
Brain Tumor Research and Treatment 2021;9(2):63-69
Background:
Cadherin-11, a cell-to-cell adhesion molecule, is associated with higher tumor grade and decreased patient survival. The purpose of this study was to investigate the clinical significance of cadherin-11 expression in the progression and prognosis of a newly diagnosed primary glioblastoma (GBL).
Methods:
Between 2007 and 2016, 52 out of 178 patients diagnosed with a GBL and satisfied the following criteria: 1) a new primary GBL, 2) gross-total resection, 3) immunohistochemically-available tissue, and 4) standardized adjuvant treatment.
Results:
In terms of staining intensity, the low-intensity cadherin-11 group showed longer progression-free survival (PFS) than the high-intensity cadherin-11 group (median PFS, 12.0 months [95% CI, 11.1-12.9] vs. median PFS, 6.0 months [95% CI, 3.7-8.3]; p<0.001). The low-intensity cadherin-11 group revealed longer overall survival (OS) than the high-intensity cadherin-11 group (median OS, 20.0 months [95% CI, 11.8-16.6] vs. median OS, 15.0 months [95% CI, 11.8-18.2]; p=0.003). The staining intensity of cadherin-11 was a statistically significant factor in PFS and OS in terms of univariate and multivariate analyses (univariate analysis: p<0.001 and p=0.005; multivariate analysis: p<0.001 and p=0.005).
Conclusion
Our clinical study demonstrates high cadherin-11 expression may be associated with poor PFS and OS for a newly diagnosed primary GBL.

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