Purpose: The role of allogeneic stem cell transplantation (alloSCT) in multiple myeloma (MM) treatment remains controversial. We conducted a retrospective, multicenter, nationwide study in Korea to evaluate the outcomes of alloSCT in Asian patients with MM. Materials and Methods: Overall, 109 patients with MM who underwent alloSCT between 2003 and 2020 were included in this study. Data were collected from the Korean Multiple Myeloma Working Party Registry. Results: The overall response rate and stringent complete response plus complete response (CR) rates were 67.0 and 46.8%, respectively, after alloSCT. At a median follow-up of 32.5 months, the 3-year probability of progression-free survival (PFS) and overall survival (OS) rates were 69.3% and 71.8%, respectively. The 3-year probabilities of OS rates in the upfront alloSCT, tandem auto-alloSCT, and later alloSCT groups were 75.0%, 88.9%, and 61.1%, respectively. Patients who achieved CR before or after alloSCT had significantly longer OS (89.8 vs. 18 months and 89.8 vs. 15.2 months, respectively). Even though patients who did not achieve CR prior to alloSCT, those who achieve CR after alloSCT had improved PFS and OS compared to those who had no achievement of CR both prior and after alloSCT. Patients who underwent alloSCT with 1-2 prior treatment lines had improved PFS (22.4 vs. 4.5 months) and OS (45.6 vs. 15.3 months) compared to those with three or more prior treatment lines. Conclusion AlloSCT may be a promising therapeutic option especially for younger, chemosensitive patients with earlier implementation from relapse.

Background: Glomus tumors are benign vascular tumors derived from the glomus body, a neuromuscular vascular tissue responsible for regulating the temperature and blood flow of the skin. Ultrasonography (USG) is a useful tool for diagnosing glomus tumors; nevertheless, data on Korean patients with glomus tumors are limited. Objective: This study aimed to describe USG findings of subungual glomus tumors in Korean patients. Methods: We retrospectively reviewed the medical records and USG readings of 20 cases of glomus tumors in the nail apparatus diagnosed from January 2015 to December 2021. Results: Twenty patients were included in this study. Four patients (20.0%) were male and 16 (80.0%) were female. The age of onset ranged from 18∼86 years, with a mean of 45.2 years. USG findings showed hypoechoic echogenicity in all cases. Tumor size ranged from 2.3∼10 mm (mean±standard deviation, 5.5±1.9 mm). The tumor shape observed on USG was oval in 16 cases (80.0%), lobulated in three cases (15.0%), and round in one case (5.0%). Tumor boundaries were well-defined in 18 cases (90.0%) and ill-defined in two cases. Posterior acoustic enhancement and cortical erosion were observed in 19 (95.0%) and 17 cases (85.0%), respectively. Increased vascularity was observed in 19 cases (95.0%). Conclusion This study revealed characteristic USG features of glomus tumors. USG is a helpful tool for the diagnosis and management of glomus tumors.

Background: Eosinophilic cellulitis, also known as Wells’ syndrome, is an uncommon skin disease characterized by recurrent pruritic polymorphous plaques or nodules. There is limited knowledge in the Korean literature regarding the clinical characteristics and course of eosinophilic cellulitis. Objective: To investigate the clinical and histological features of eosinophilic cellulitis in Korean patients. Methods: In this case series study, we retrospectively reviewed the electronic medical records of patients diagnosed with eosinophilic cellulitis at our institutions from 2004 to 2022. We also analyzed the literature published in dermatology and internal medicine journals in Korea. Results: A total of 17 patients were included in this study (age, 39.4±21.8 years; 12 male [70.6%]), with an average disease duration of 4.4 months. We identified six clinical variants, with the typical plaque type being the most common (33.3%), followed by the papulonodular type (22.2%). Eosinophilia was observed in 78.6% of patients, and a flame figure, which is a typical histopathological feature of eosinophilic cellulitis, was observed in 52.9% of patients. Systemic and topical steroids and antihistamines were used as first-line treatment with generally favorable results (82.4%), followed by antibiotics (35.3%), cyclosporine (23.5%), and topical calcineurin inhibitors (23.5%).The recurrence rate during the mean follow-up period of 21.8 months was 29.4%. Conclusion Eosinophilic cellulitis can present with various clinical manifestations, and flame figures do not appear in all cases; therefore, clinical and histological correlations are critical for accurate diagnosis of patients with eosinophilic cellulitis.

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disorder characterized by uncontrolled terminal complement activation. Eculizumab, a monoclonal antibody C5 inhibitor was introduced in Korea in 2009 and has been the standard treatment option for PNH. Methods: This study assessed the long-term efficacy/safety of eculizumab in PNH using real-world data from the Korean Health Insurance Review and Assessment Service. Eighty patients who initiated eculizumab from 2009–2020 were enrolled. Results: At eculizumab initiation, the median age was 51.5 years, lactate dehydrogenase (LDH) 6.8 × upper limit of normal, and granulocyte clone size 93.0%. All patients had at least one PNH-related complication before eculizumab initiation, including renal failure (n = 36), smooth muscle spasm (n = 24), thromboembolism (n = 20), and pulmonary hypertension (n = 15). The median (range) duration of eculizumab treatment was 52.7 (1.0, 127.3) months (338.6 total treated patient-years). Despite high disease activity in the study population before treatment initiation, overall survival was 96.2% and LDH levels were stabilized in most patients during treatment. PNH-related complications at treatment initiation were resolved in 44.4% of patients with renal failure, 95.8% with smooth muscle spasm, 70.0% with thromboembolism, and 26.7% with pulmonary hypertension. Extravascular hemolysis occurred in 28.8% of patients (n = 23; 0.09 per patient-year) and breakthrough hemolysis in 18.8% (n = 15; 0.06 per patient-year). No treatment discontinuation cases related to eculizumab were observed. Conclusion These data provided evidence for the long-term efficacy and safety of eculizumab in Korean PNH patients with high disease burdens.

Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis characterized by an accumulation of activated histiocytes within the affected tissues. It is a heterogeneous disease that includes the classical (nodal) and extra-nodal variants. The cutaneous form of the disease without the characteristic lymphadenopathy is rare and is often misdiagnosed as other dermatologic diseases. Misdiagnosis as lymphoproliferative and infectious diseases such as lymphoma and tuberculosis have been reported in the literature. Herein, we report a case of facial cutaneous RDD with successful surgical treatment. In addition, we provide dermoscopic findings and literature review as dermoscopy can be a useful adjuvant tool in the diagnosis of cutaneous RDD.

Peutz-Jeghers syndrome (PJS; MIM 175200) is an autosomal dominant multiple-organ cancer syndrome. It is characterized by brown macules distributed in the perioral skin, oral mucosa, hands and feet, and hamartomatous gastrointestinal polyps that can eventually lead to intestinal obstruction, abdominal pain, bleeding, and anemia. Patients with PJS are at a higher risk of ovarian, testicular, breast, lung, and pancreatic cancers. This predisposition is due to the pathogenic variant in serine/threonine kinase 11 (STK11) gene located on chromosome 19p13.3. Here, we present the dermoscopic findings, histopathologic features of acral pigmentation, and DNA sequencing results of the patient with PJS. We also report a successful removal of acral pigmentation using the Q-switched Nd:YAG laser (QSNYL) treatment. Our results suggest that QSNYL therapy could be a treatment option for acral pigmentation in patients with PJS.

Background: Disseminating public knowledge on malignant melanoma through YouTube is an important way to bridge the gap between physicians and patients. However, videos recorded on this topic in Korea are yet to be evaluated. Objective: We aimed to evaluate the quality of YouTube videos on malignant melanoma recorded in Korea. We also investigated whether there was a difference in the quality of videos made by medical professionals (subdivided into dermatologists and non-dermatologists) and non-medical personnel. Methods: We included all videos recorded in Korean by searching YouTube using the keywords “melanoma” or “malignant melanoma”. The search was performed on March 22, 2021. The inclusion criterion was videos in Korean language that contained medical information about malignant melanoma. The characteristics and content information were collected for each video. Video quality (DISCERN, Global Quality Scale [GQS], Journal of the American Medical Association [JAMA] benchmark criteria) was analyzed. Results: Eighty-five videos met the inclusion criterion for the analysis. Fifty-six (66%) and 29 videos (34%) were made by medical and non-medical personnel, respectively. The videos made by medical professionals significantly contained more of the following information than those made by non-medical personnel: clinical information (p＜ 0.001), symptoms and signs (p=0.001), risk factors (p＜0.05), diagnosis (p＜0.001). Videos made by medical professionals, videos with a length of more than 5 minutes, or videos with more than 10,000 views had significantly higher quality scores (DISCERN, GQS, JAMA). Conclusion Considering that YouTube is being used as a portal for medical information, the participation of medical professionals is essential for providing more accurate information.

Accurate diagnosis and management of a femoral vascular injury is important as it is a life-threatening injury with high morbidity and mortality. This is the case of a 75-year-old man admitted to the emergency room with trauma to the right groin due to a horse fall. Computed tomography showed active bleeding of the femoral artery without pelvic or femoral fracture. We inserted a stent-graft, but hypotension persisted. Exploration of the groin was completed, and the bleeding from the external iliac vein was identified and repaired. In conclusion, vascular injury is rare in groin trauma without associated fracture, however, arterial and venous injury should not be completely ruled out. Endovascular therapy is worth recommending as a quicker and safer management than surgery in patients with active bleeding in the femoral artery. However, the possibility of combined injury of the femoral vein should be suspected in case of ongoing hemodynamic instability.