1.A Case of Generalized Keratosis Pilaris Induced by Imatinib Mesylate
Seungjin SON ; Kyung Eun JUNG ; Young LEE ; Young-Joon SEO ; Dongkyun HONG
Korean Journal of Dermatology 2024;62(10):554-557
Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.
2.Identification of Viral Particles in Infant Cutaneous Tissue in Cases of Covid Toes
Kyungmin KIM ; Seungjin SON ; Tae-Jong KANG ; Dongkyun HONG ; Kyung Eun JUNG ; Jin-Man KIM ; Jung-Min SHIN ; Jin PARK ; Young LEE
Korean Journal of Dermatology 2024;62(7):412-417
Coronavirus disease 2019 (COVID-19), a multi-organ disease impacting the respiratory system and various organs, has recently been linked to diverse cutaneous manifestations. COVID toes, a cutaneous sign of COVID-19 infection, is relatively common in children and young adults, although its clear association with COVID-19 has not been widely reported. This report presents the case of a 1-year-old infant with COVID toes. The patient exhibited violaceous discoloration in the distal toes. Further, the patient exhibited no symptoms of COVID-19 infection and the enzyme-linked immunosorbent assay was negative for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2); therefore, the patient was initially diagnosed with frostbite. However, the infant’s condition deteriorated despite treatment with nonsteroidal anti-inflammatory drugs and a warm-water bath. After a skin biopsy and serum SARS-CoV-2 test, the patient was diagnosed with COVID toes and treated with systemic steroids, photobiomodulation therapy, and dressing. This case underscores the importance of recognizing chilblain-like lesions in pediatric patients during the COVID-19 pandemic, emphasizing the need for awareness of COVID toes among healthcare professionals.
3.KRT5 Gene Mutation in Patient with Epidermolysis Bullosa Simplex with Mottled Pigmentation
Seungjin SON ; Dongkyun HONG ; Kyung Eun JUNG ; Young-Joon SEO ; Seon Young KIM ; Young LEE
Korean Journal of Dermatology 2024;62(2):101-105
Epidermolysis bullosa simplex with mottled pigmentation (EBS-MP) is an autosomal dominant disease characterized by nonscarring blistering after minor trauma, reticulated pigmentation, and palmoplantar hyperkeratosis. EBS-MP is caused by a mutation in the KRT5 or KRT14 gene encoding the keratinocyte intermediate filament. A 14-year-old girl presented with reticulated hyperpigmentation of the trunk and both extremities, which was observed 9 years ago.Additionally, punctate hyperkeratotic papules were observed on both the palms and soles. She had a history of being diagnosed with EBS as a baby. Skin biopsies were performed on both the hyperpigmented and hyperkeratotic papules. Based on the clinical and histopathological findings, the patient was diagnosed with EBS-MP, and next-generation sequencing was performed. Genetic screening identified a p.P25L mutation in the KRT5 gene.Herein, we report a case of p.P25L mutation in the KRT5 gene in a patient with EBS-MP.
4.A Case of Generalized Keratosis Pilaris Induced by Imatinib Mesylate
Seungjin SON ; Kyung Eun JUNG ; Young LEE ; Young-Joon SEO ; Dongkyun HONG
Korean Journal of Dermatology 2024;62(10):554-557
Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.
5.A Case of Generalized Keratosis Pilaris Induced by Imatinib Mesylate
Seungjin SON ; Kyung Eun JUNG ; Young LEE ; Young-Joon SEO ; Dongkyun HONG
Korean Journal of Dermatology 2024;62(10):554-557
Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.
6.A Case of Generalized Keratosis Pilaris Induced by Imatinib Mesylate
Seungjin SON ; Kyung Eun JUNG ; Young LEE ; Young-Joon SEO ; Dongkyun HONG
Korean Journal of Dermatology 2024;62(10):554-557
Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.
7.Clinical Manifestation of Alopecia Areata After COVID-19 Infection or Vaccination
Seungjin SON ; Soyoung JIN ; Ji Yeon HONG ; Jung-Min SHIN ; Kyung Eun JUNG ; Young-Joon SEO ; Chang-Deok KIM ; Dongkyun HONG ; Young LEE
Annals of Dermatology 2024;36(6):361-366
Background:
Alopecia areata (AA) is characterized by an autoimmune inflammatory response to hair follicles. Several studies have suggested that infection and vaccination can trigger an autoimmune process around hair follicles. Moreover, reports of AA and various other autoimmune diseases have increased since the coronavirus disease 2019 (COVID-19) pandemic became established.
Objective:
We assessed the clinical characteristics and treatment response in patients who developed AA following COVID-19 infection or vaccination.
Methods:
This retrospective study involved patients who had developed COVID-19 or received a COVID-19 vaccination within 3 months before the onset or aggravation of AA from January 2020 to December 2022.
Results:
Fifty patients met the inclusion criteria. Eighteen patients had a history of COVID-19 infection, and 32 had a history of COVID-19 vaccination. The mean onset of AA after COVID-19 infection and vaccination was 5.22±3.35 and 4.13±2.73 weeks, respectively. The most common COVID-19-associated symptoms before AA were fever (88.9%) in the infection group and myalgia (50.0%) in the vaccination group. In the vaccination group, AA most commonly occurred after receiving the Pfizer-BioNTech vaccine (BNT162b2, 46.9%) or Moderna vaccine (mRNA-1273, 34.4%). The vaccination group showed more rapid improvement than the infection group;however, both showed significant improvement after 6 months of treatment of AA.
Conclusion
We examined the clinical characteristics and treatment responses of patients who developed AA after COVID-19 infection or vaccination. Further research is needed to evaluate the detailed pathogenesis and association between COVID-19 and AA.
8.An outbreak of hepatitis A associated with salted clams in Busan, Korea
Hyunjin SON ; Miyoung LEE ; Youngduck EUN ; Wonseo PARK ; Kyounghee PARK ; Sora KWON ; Seungjin KIM ; Changhoon KIM
Epidemiology and Health 2022;44(1):e2022003-
OBJECTIVES:
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Busan. The current study presents the results of an epidemiological investigation and outlines the supplementary measures that would help with hepatitis A control.
METHODS:
A cohort study was conducted for all 2,865 customers who visited restaurant A from June to July. Using a standardized questionnaire, participants reported the presence of hepatitis A symptoms and whether they had consumed any of 19 food items. As for participants who had visited public health centers, their specimens were collected.
RESULTS:
From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The epidemic curve was unimodal, and the median number of days from the restaurant visit to symptom onset was 31 days. A genotype analysis indicated that 89 of 90 tested patients had hepatitis A virus (HAV) genotype 1A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times (95% confidence interval [CI], 9.22 to 510.87). In an unopened package of salted clams found and secured through traceback investigation, HAV genotype 1A was detected.
CONCLUSIONS
To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams; the food sampling test standards for salted clams should also be expanded. Furthermore, a laboratory surveillance system based on molecular genetics should be established to detect outbreaks earlier.
9.Epidemiological characteristics of and containment measures for COVID-19 in Busan, Korea
Hyunjin SON ; Hyojung LEE ; Miyoung LEE ; Youngduck EUN ; Kyounghee PARK ; Seungjin KIM ; Wonseo PARK ; Sora KWON ; Byoungseon AHN ; Dongkeun KIM ; Changhoon KIM
Epidemiology and Health 2020;42():e2020035-
Objectives:
To describe and evaluate epidemiological investigation results and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21, 2020 and March 24, 2020.
Methods:
Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number was computed.
Results:
Of the total 18,303 COVID-19 tests performed between January 16, 2020 and March 24, 2020 in Busan, 108 yielded positive results (positive test rate, 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate was 8.2% (95% confidence interval [CI], 4.7 to 12.9). The mean serial interval was estimated to be 5.54 days (95% CI, 4.08 to 7.01). After February 26, (Rt) remained below 1 in Busan.
Conclusions
The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.
10.Epidemiological characteristics of and containment measures for COVID-19 in Busan, Korea
Hyunjin SON ; Hyojung LEE ; Miyoung LEE ; Youngduck EUN ; Kyounghee PARK ; Seungjin KIM ; Wonseo PARK ; Sora KWON ; Byoungseon AHN ; Dongkeun KIM ; Changhoon KIM
Epidemiology and Health 2020;42():e2020035-
Objectives:
To describe and evaluate epidemiological investigation results and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21, 2020 and March 24, 2020.
Methods:
Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number was computed.
Results:
Of the total 18,303 COVID-19 tests performed between January 16, 2020 and March 24, 2020 in Busan, 108 yielded positive results (positive test rate, 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate was 8.2% (95% confidence interval [CI], 4.7 to 12.9). The mean serial interval was estimated to be 5.54 days (95% CI, 4.08 to 7.01). After February 26, (Rt) remained below 1 in Busan.
Conclusions
The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.

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