ABSTRACT
Background@#Ultrasonography (US) is a simple and reliable tool that can aid in the diagnosis of benign subcutaneous lesions such as epidermal cysts and lipomas. @*Objective@#This study aimed to determine the efficacy of US for the differential diagnosis of epidermal cysts and lipomas. @*Methods@#A retrospective study of 100 patients with epidermal cysts (n=45) or lipomas (n=55) who underwent US and then received a pathological diagnosis in the dermatology department of Pusan National University Hospital was conducted. @*Results@#US and clinical impressions accurately diagnosed the epidermal cysts in 90.0% and 88.0% of the patients, respectively, and the lipomas in 92.0% and 88.0% of the patients, respectively. US combined with clinical impression significantly increased the diagnostic yield of epidermal cysts (98%) and lipomas (99%). On US, the frequency of posterior acoustic enhancement was higher for the epidermal cysts than for the lipomas (82.2% and 29.1%, respectively; p＜0.001), and striated echoes such as internal linear echogenic reflections and dark clefts were more frequently found in the lipomas than in the epidermal cysts (90.9% and 6.7%, respectively; p＜0.001). @*Conclusion@#This study implies that the diagnostic role of US can be greatly enhanced by knowledge of the clinical presentation.
ABSTRACT
Erosive adenomatosis of the nipple (EAN), also known as nipple adenoma, florid papillomatosis, or papillary adenoma of the nipple, is a benign neoplasm originating from a lactiferous duct of the breast. Although the potential for malignant change is invariably negligible, the nature of the disease is quite intractable despite several treatment methods. Surgical excision is known as the treatment of choice, but this invasive approach is generally not acceptable to the vast majority of patients due to the cosmetic outcomes. Cryosurgery could be an alternative choice to preserve the structure of the nipple-areola complex, though its application has not been studied due to the paucity of cases. A 22-year-old female presented with a unilateral, crater-like erosion of the left nipple with serosanguineous discharge. The skin biopsy revealed proliferation of tubular structures, which corresponded to EAN. She was treated with 4 sessions of cryosurgery (open cryospray with liquid nitrogen) over 6 months, and the skin lesion resolved completely without any recurrence for 12 months. Although further study is required to determine the optimal treatment regimen for EAN, cryosur-gery should be considered as an effective option to surgical excision.
ABSTRACT
Background@#Fungal melanonychia (FM) is a rare nail disorder that presents as dark pigmentation in the nail plate because of fungal nail infection. The diagnosis of FM is occasionally confusing because its appearance is similar to melanonychia due to other causes including malignant melanoma. Dermoscopy could help increase the accuracy of diagnosing the cause of pigmented nail lesions. However, dermoscopic features of FM are not well elucidated. @*Objective@#This study aimed to investigate clinical and dermoscopic characteristics of FM. @*Methods@#The clinical features and dermoscopic findings of 20 patients diagnosed with FM and 14 patients diagnosed with subungual melanoma the Department of Dermatology of Pusan National University Hospitals (Busan and Yangsan) were retrospectively reviewed. @*Results@#FM mainly occurred as a solitary form in the toenail. Patients in the FM group were older than those in the subungual melanoma group. The most distinguishable general dermoscopic features in FM were a distal diffuse pattern, distal linear pattern, and light brown to yellowish color. FM-associated specific dermoscopic patterns such as the reverse triangular pattern, subungual hyperkeratosis, scale on the nail surface, and white or yellowish streaks were dominantly observed in the FM group compared to the subungual melanoma group. @*Conclusion@#FM-associated dermoscopic patterns and distal diffuse and linear patterns could be helpful diagnostic clues for differential diagnosis of FM from subungual melanoma.
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Subject(s)
Female , Humans , Male , Calcitonin Gene-Related Peptide , Cytokines , Histamine , Neuropeptide Y , Neuropeptides , Phenotype , Prevalence , Pruritus , Psoriasis , Substance P , Vasoactive Intestinal PeptideABSTRACT
BACKGROUND: Secukinumab, a fully human monoclonal antibody that targets interleukin (IL)-17A, which is a central cytokine in the pathogenesis of psoriasis, has emerged as a promising treatment for moderate to severe psoriasis. However, to date, there are no real-world data for secukinumab in Korean patients with psoriasis. OBJECTIVE: To assess the clinical efficacy and safety of secukinumab in Korean patients with psoriasis. METHODS: Prospective data were gathered during follow-up from 28 consecutive patients with chronic plaque-type psoriasis treated with secukinumab for minimum of 12 weeks at a single referral center. Patient demographics, Psoriasis Area Severity Index (PASI) score, Physicians' Global Assessment (PGA), Dermatologic Life Quality Index (DLQI), and adverse events were investigated. RESULTS: The mean PASI score was significantly decreased after the induction period of secukinumab treatment (paired t-test, p<0.05). Of the 28 patients, 17 (60.7%) had obtained near complete clearance (PASI 90) at the last follow-up visit. No unexpected adverse events, other than nasopharyngitis, were observed. CONCLUSION: Secukinumab can be of benefit for the treatment of Korean patients with psoriasis, as the treatment was associated with a rapid and satisfactory response and safety profile.
Subject(s)
Humans , Demography , Follow-Up Studies , Interleukins , Korea , Nasopharyngitis , Prospective Studies , Psoriasis , Quality of Life , Referral and Consultation , Treatment OutcomeABSTRACT
Urticaria multiforme is a cutaneous condition observed in children. This self-limited condition is characterized by well-circumscribed, annular, and erythematous wheals, which spontaneously disappear within a few days. Patients commonly present with acral edema and show a favorable response to antihistamines. It is frequently misdiagnosed as erythema multiforme or serum sickness-like reaction owing to distinctive annular wheals with an ecchymotic center observed in patients. This condition was previously known as acute annular urticaria. The term urticaria multiforme was introduced in 2007 to highlight this specific variant of urticaria. We describe 2 patients with acral edema and transient annular wheals with dusky red centers, which were diagnosed as urticaria multiforme lesions. To our knowledge, the Korean literature includes only a single case report describing acute annular urticaria. However, the report does not use the term ‘urticaria multiforme’ to describe this condition.
Subject(s)
Child , Humans , Edema , Erythema Multiforme , Histamine Antagonists , Pigmentation , UrticariaABSTRACT
No abstract available.
Subject(s)
Acupuncture , Foreign Bodies , Granuloma, Foreign-Body , Leprosy , Leprosy, LepromatousABSTRACT
No abstract available.
Subject(s)
Neck , Neoplasm Metastasis , Thyroid Gland , Thyroid Neoplasms , ThyroidectomyABSTRACT
Dermatofibroma is a fibrohistiocytic tumor of the skin that commonly occurs as a solitary lesion on the lower extremities of young women. Multiple eruptive dermatofibromas (MEDFs), defined as the presence of 5 to 8 dermatofibromas appearing within a period of 4 months, are rare, and the etiology of MEDFs remains unknown. However, MEDFs are frequently thought to be associated with altered immunity, such as autoimmune diseases and immunosuppression. It is unclear why MEDFs occur in association with these conditions, but this relationship may suggest that MEDFs are the result of an abortive immunoreactive process. We herein describe a middle-aged woman who developed multiple dermatofibroma. She had myasthenia gravis for 8 years, and developed MEDFs after undergoing oral corticosteroid treatment (245 mg/week) for 3 months. Therefore, our case suggests that the use of immunosuppressants is a more dominant factor for the development of MEDFs than underlying autoimmune diseases.
Subject(s)
Female , Humans , Autoimmune Diseases , Histiocytoma, Benign Fibrous , Immunosuppression Therapy , Immunosuppressive Agents , Lower Extremity , Myasthenia Gravis , SkinABSTRACT
BACKGROUND: Kaposi varicelliform eruption (KVE) is a disseminated viral infection primarily caused by the herpes simplex virus in the setting of an underlying chronic skin disease. Few studies have reported the clinical characteristics and predisposing factors for recurrent KVE.OBJECTIVES: To characterize the clinical features and predisposing factors for recurrent KVE.METHODS: This retrospective comparative study of recurrent vs. single-episode KVE was performed at the Pusan National University Hospital between 2004 and 2017.RESULTS: A total of 84 episodes occurred in 60 patients, and of these, 13 patients developed recurrence (21.7%). No statistically significant intergroup difference was observed in the mean age and sex distribution. The face was the most common site of involvement in both groups, followed by the trunk and the upper and lower extremities. Atopic dermatitis was the most common pre-existing disease in both groups; however, Darier's disease was more common in the recurrent KVE group, and this difference was statistically significant. Most patients with KVE (66.7%) showed aggravation of the underlying skin disease within 3 months of KVE onset. This finding was more prominent in patients with recurrent episodes (91.7%) than in those with single-episode KVE (58.3%), (p=0.040).CONCLUSION: This study can contribute to a better understanding of recurrent KVE and guide clinicians in treating patients with conditions predisposing to KVE.