1.A Case of Interstitial Granulomatous Dermatitis after Unknown Filler Injection
Seong Hee CHOI ; Ga Hyun LEE ; Gil Jae PYO ; Ki Bum MYUNG ; Seung Hyun CHEONG
Korean Journal of Dermatology 2024;62(5):294-298
		                        		
		                        			
		                        			 Interstitial granulomatous dermatitis (IGD) is a rare skin condition commonly associated with autoimmune diseases.Lesions typically occur bilaterally on the lateral trunk and proximal extremities and present as variable cutaneous lesions. A 63-year-old female with a 1-year history of a skin rash on her face visited the dermatology department of our hospital. The patient had received a dermal filler injection with unidentified gradients on the face of an unlicensed practitioner 20 years before. The lesions on the left cheek were tender, violaceous, coalescing, and annular. A violaceous round nodule with tenderness was observed on the left chin and glabella. She denied having any systemic complaints. The biopsy specimen showed diffuse interstitial CD68+ histiocytic infiltration involving the reticular dermis around the degenerative collagen bundles. The patient was diagnosed with IGD. The patient was treated with systemic steroids and showed clinical improvement. Herein, we report a case of IGD after an unknown dermal filler injection, along with a literature review.  
		                        		
		                        		
		                        		
		                        	
2.Scalp Pruritus: Classification and Clinical Characteristics
Gil Jae PYO ; Seong Hee CHOI ; Ki Bum MYUNG ; Seung Hyun CHEONG
Korean Journal of Dermatology 2024;62(8):437-446
		                        		
		                        			 Background:
		                        			Chronic scalp pruritus is a common symptom in dermatology patients. However, few studies have investigated its causes and clinical characteristics. 
		                        		
		                        			Objective:
		                        			We aimed to evaluate in this study the causes of chronic scalp pruritus, classify itching, and the clinical manifestations associated with different causes and classifications. 
		                        		
		                        			Methods:
		                        			A cross-sectional study was conducted involving 179 patients with chronic scalp pruritus recruited from the Department of Dermatology at Konyang University Hospital between August 2023 to February 2024. Age, sex, clinical features, Itch Numeric Rating Scale (NRS), Dermatology Life Quality Index (DLQI), and treatment response were evaluated using a questionnaire. 
		                        		
		                        			Results:
		                        			The most common cause of chronic scalp pruritus was a dermatologic condition (n=135, 75.4%). Systemic scalp pruritus (n=15, 8.4%) was the second most common cause, followed by neuropathic pruritus (n=14, 7.8%), psychogenic scalp pruritus (n=9, 5.0%), and scalp pruritus of unknown origin (n=6, 3.4%). Patients with systemic pruritus had higher itch NRS scores compared to those with neuropathic pruritus (p=0.033). In addition, patients with dermatological pruritus experienced longer itch duration and treatment courses than patients with neuropathic pruritus (p=0.001 and p=0.005, respectively). Moreover, patients with higher itch NRS scores had higher DLQI scores among patients with dermatological pruritus (p<0.001). 
		                        		
		                        			Conclusion
		                        			In this study, we classified the causes of scalp pruritus and identified the itch severity and clinical manifestations. The severity of itching, pruritus duration, treatment duration, and aggravating factors differed for each scalp pruritus classification. Understanding the classification and clinical characteristics of scalp pruritus can facilitate the development of more effective treatments. 
		                        		
		                        		
		                        		
		                        	
3.A Case of Clear Cell Acanthoma on the Bilateral Areolae
Gil Jae PYO ; Ga Hyun LEE ; Ki Bum MYUNG ; Eun Sun KWON
Korean Journal of Dermatology 2023;61(3):187-190
		                        		
		                        			
		                        			 Clear cell acanthoma is a rare benign tumor, which usually presents as a solitary erythematous to brown colored papule or nodule, with a predilection for the lower leg of t hemiddle-aged and older individuals. An 11-year-old male presented with a 1-month history of bilateral brownish colored and exudative plaques on the both areolae.Histopathologic examination showed psoriasiform proliferation of pale keratinocytes and neutrophil exocytosis. Therefore, the patient was diagnosed with clear cell acanthoma. Typically, clear cell acanthoma occurs as a unilateral lesion on the leg in an adult. However, our case shows a bilateral lesion as well as the uncommon age and site.To our knowledge, this case of bilateral clear cell acanthoma has been rarely reported in Korea. Herein, we report a case of clear cell acanthoma that occurred on both areolae in a child. 
		                        		
		                        		
		                        		
		                        	
4.Epstein-Barr Virus Positive Diffuse Large B-Cell Lymphoma with Epidermotropism
Ga Hyun LEE ; Gil Jae PYO ; Ki Bum MYUNG ; Eun Sun KWON
Annals of Dermatology 2023;35(Suppl2):S317-S322
		                        		
		                        			
		                        			 Primary cutaneous B-cell lymphomas are rare diseases comprising nodular to diffuse lymphoid cell infiltration with an overlying grenz zone and no epidermal involvement upon histological analysis. Diagnostics can become challenging when lymphomas exhibit the characteristics of both B and T-cells. Differential diagnoses may include reactive proliferations, cutaneous composite lymphomas, and transformed mycosis fungoides. Immunohistochemistry and gene arrangement tests may be beneficial to clarify the diagnosis. Herein, we report a rare case of epidermotropic EBV-positive cutaneous B-cell lymphoma along with a literature review. 
		                        		
		                        		
		                        		
		                        	
7.Effectiveness and Safety of Codeine and Levodropropizine in Patients With Chronic Cough
Sang Pyo LEE ; Sang Min LEE ; Byung-Jae LEE ; Sung-Yoon KANG
Journal of Korean Medical Science 2022;37(36):e275-
		                        		
		                        			 Background:
		                        			Recent progress in chronic cough management includes controlling cough triggers and hypersensitivity using antitussives. Therefore, we investigated the effects and safety outcomes of antitussives, codeine and levodropropizine, in patients with chronic cough. 
		                        		
		                        			Methods:
		                        			We conducted an open-label, randomized comparative trial with newly referred patients with chronic cough. Patients were orally administered codeine (60 mg/day) and levodropropizine (180 mg/day) for 2 weeks. Cough severity, including the visual analog scale (VAS), Cough Symptom Score (CSS), Leicester Cough Questionnaire (LCQ), and safety for each treatment were assessed. The primary outcome was VAS score changes before and after 2 weeks of treatment. 
		                        		
		                        			Results:
		                        			Among the 88 participants, 45 and 43 in the codeine and levodropropizine groups, respectively, were included in the analysis. Changes in the VAS score were higher in the codeine group than in the levodropropizine group (35.11 ± 20.74 vs. 19.77 ± 24.83, P = 0.002). Patients administered codeine also had improved CSS (2.96 ± 2.35 vs. 1.26 ± 1.89, P < 0.001) and LCQ (3.28 ± 3.36 vs. 1.61 ± 3.53, P = 0.025) than those administered levodropropizine. Treatment-related adverse events, including drowsiness, constipation, and headaches, were more frequent in the codeine group than in the levodropropizine group. However, no significant differences existed in the adverse events leading to discontinuation. 
		                        		
		                        			Conclusion
		                        			Codeine is an effective and generally well-tolerated antitussive for chronic cough. However, it may induce side effects in some patients. Individual responses and adverse events should be carefully monitored when codeine is used to treat chronic cough. 
		                        		
		                        		
		                        		
		                        	
8.Expulsion of Fibroids to the Endometrial Cavity after Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound Surgery (MRgFUS) Treatment of Intramural Uterine Fibroids.
Jae Hyeok JEONG ; Gil Pyo HONG ; Yu Ri KIM ; Da Gyo HONG ; Jae Eun HA ; Jung In YEOM ; Eun Jeong KIM ; Hyung Il KIM ; Kyu Sup LEE
Journal of Menopausal Medicine 2016;22(3):139-145
		                        		
		                        			
		                        			OBJECTIVES: This report seeks to introduce some cases of the patients who received magnetic resonance imaging (MRI)-guided high intensity focused ultrasound (HIFU) surgery (MRgFUS)-based intramural uterine fibroids treatment where the post-MRgFUS intramural uterine fibroids decreased in its volume and protruded towards the endometrial cavity to be expelled by hysteroscopy. METHODS: Of the 157 patients who had received MRgFUS treatment in the Obstetrics and Gynecology of the Hospital from March, 2015 to February, 2016; this study examined 6 of the cases where, after high intensity focused ultrasound treatment, intramural uterine fibroids protruded towards the endometrial cavity to be removed by hysteroscopic myomectomy. The high intensity focused ultrasound utilized in the cases were Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, The Netherlands) and Sonalleve HIFU system. RESULTS: The volume of fibroids ranged from 26.0 cm³ to 199.5 cm³, averaging 95.6 cm³. The major axis length ranged from 4.0 cm to 8.2 cm, averaging 6.3 cm. Fibroid location in all of the patients was in intramural uterine before treatment but after the high intensity focused ultrasound treatment, the fibroids were observed to protrude towards the endometrial cavity in at least Day 5 or up to Day 73 to allow hysteroscopic myomectomy. CONCLUSIONS: In some cases, after an intramural uterine fibroid is treated with MRgFUS, fibroid volume is decreased and the fibroid protrudes towards the endometrial cavity. In this case, hysteroscopic myomectomy can be a useful solution.
		                        		
		                        		
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Gynecology
		                        			;
		                        		
		                        			High-Intensity Focused Ultrasound Ablation
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hysteroscopy
		                        			;
		                        		
		                        			Leiomyoma*
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Obstetrics
		                        			;
		                        		
		                        			Ultrasonography*
		                        			;
		                        		
		                        			Uterine Myomectomy
		                        			
		                        		
		                        	
9.Sensitization to animal allergens and allergic symptoms during exposure to them in Korean veterinary researchers.
Hong Suk PARK ; Jungwoo SHIM ; Eun Yeong CHO ; Chana MYOUNG ; Sojung LEE ; Young Jae KWON ; Sang Min LEE ; Jeong Woong PARK ; Sung Hwan JEONG ; Sang Pyo LEE
Allergy, Asthma & Respiratory Disease 2016;4(6):406-414
		                        		
		                        			
		                        			PURPOSE: Veterinary researchers are exposed to variable animal allergens. However, sensitization to them and allergic symptoms during exposure to them in this group are not sufficiently evaluated worldwide, especially in Korea. The objective of this study is to evaluate sensitization to animal allergens and allergic symptoms during exposure to them in Korean veterinary researchers. METHODS: Thirty-two veterinary researchers who participated in the 2016 annual symposium of the Korean Society of Veterinary Science were asked to answer questionnaires regarding allergic symptoms during animal exposure and underwent skin prick tests for animal allergens. Animal allergens consisted of chicken feather and 10 mammals, epithelia as well as cow's milk, hen's egg, and 7 animal types of meat. RESULTS: There were 13 subjects who complained of allergic symptoms during exposure to certain animal epithelia and 19 who did not. Between the 2 groups, there were no differences in age, sex, underlying allergic disease, family history of allergy, current occupation and its duration, numbers and specie of contact animals, or daily contact time. Meanwhile, the sensitization rates to mouse, horse, rabbit, and guinea pig were significantly higher in the symptomatic group. Rhinoconjunctivitis symptoms were the most common allergic symptoms related to animal exposure were most common followed by dermatologic symptom, and symptom of lower respiratory tract. CONCLUSION: We found that sensitizations to some animal epithelia were more frequent in Korean veterinary researchers with allergic symptoms during exposure to animal compared to those without it, and their most common symptoms were rhinoconjunctivitis symptoms.
		                        		
		                        		
		                        		
		                        			Allergens*
		                        			;
		                        		
		                        			Animals*
		                        			;
		                        		
		                        			Chickens
		                        			;
		                        		
		                        			Feathers
		                        			;
		                        		
		                        			Guinea Pigs
		                        			;
		                        		
		                        			Horses
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hypersensitivity
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Mammals
		                        			;
		                        		
		                        			Meat
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Milk
		                        			;
		                        		
		                        			Occupations
		                        			;
		                        		
		                        			Ovum
		                        			;
		                        		
		                        			Respiratory System
		                        			;
		                        		
		                        			Skin
		                        			
		                        		
		                        	
10.Clinical Consideration of Treatment to Ablate Uterine Fibroids with Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound (MRgFUS): Sonalleve.
Jae Hyeok JEONG ; Gil Pyo HONG ; Yu Ri KIM ; Jae Eun HA ; Kyu Sup LEE
Journal of Menopausal Medicine 2016;22(2):94-107
		                        		
		                        			
		                        			OBJECTIVES: Magnetic resonance imaging (MRI)-guided high intensity focused ultrasound surgery (MRgFUS) is a newly emerging non-invasive technique for the treatment of uterine fibroids. The purpose of this study is to review the clinical impact of MRgFUS. METHODS: This study examined 157 patients. The high intensity focused ultrasound (HIFU) utilized in this study was Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, the Netherlands) and Sonalleve HIFU system. The patients were followed in post-operative Month 1, Month 3, and Month 6 to investigate any change. Then, these were further classified according to the use of uterine stimulant (oxytocin) in parallel, Funaki Type of uterine fibroid, HIFU intensity, and non-perfused volume (NPV) ratio. RESULTS: When the uterine stimulant was utilized, the HIFU intensity was measured at significantly lower levels, compared with the group not using uterine stimulant, and treatment duration was significantly. The NPV ratio was found significantly higher in the group using uterine stimulant. Concerning the correlation between Funaki Type of uterine fibroid and average sonication power, it was found that the closer to Type I, the lower the sonication power, the shorter the treatment duration, and the higher the NPV ratio significantly. CONCLUSIONS: In this study, it was found that the lower the Funaki Types of uterine fibroids, and the higher the NPV ratio immediately after the operation, the larger the uterine fibroid volume decrease and SSS change were. Also, if uterine stimulant was used in parallel in treatment, treatment duration and HIFU intensity could become shorter and lower.
		                        		
		                        		
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			High-Intensity Focused Ultrasound Ablation
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Leiomyoma*
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Myoma
		                        			;
		                        		
		                        			Oxytocin
		                        			;
		                        		
		                        			Sonication
		                        			;
		                        		
		                        			Ultrasonography*
		                        			
		                        		
		                        	
            
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