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Gerami P, Chen A, Sharma N, Patel P, Hagstrom M, Kancherla P, Geraminejad T, Olivares S, Biswas A, Bosenberg M, Busam KJ, de La Fouchardière A, Duncan LM, Elder DE, Ko J, Landman G, Lazar AJ, Lowe L, Massi D, Mihic-Probst D, Parker DC, Scolyer RA, Shea CR, Zembowicz A, Yun SJ, Blokx WAM, Barnhill RL. BRAF Mutated and Morphologically Spitzoid Tumors, a Subgroup of Melanocytic Neoplasms Difficult to Distinguish From True Spitz Neoplasms. Am J Surg Pathol 2024; 48:538-545. [PMID: 38525831 DOI: 10.1097/pas.0000000000002194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Drivers of Spitz neoplasms include activating point mutations in HRAS and Spitz-associated genomic fusions. It has become evident that some BRAF -mutated melanocytic neoplasms can morphologically mimic Spitz tumors (STs). These have been termed BRAF mutated and morphologically spitzoid (BAMS). In this study, 17 experts from the International Melanoma Pathology Study Group assessed 54 cases which included 40 BAMS and 14 true STs. The participants reviewed the cases blinded to the genomic data and selected among several diagnostic options, including BAMS, ST, melanoma, and other. A total of 38% of all diagnostic selections in the BAMS cases were for BAMS, whereas 32% were for ST. In 22 of the BAMS cases, the favored diagnosis was BAMS, whereas in 17 of the BAMS cases, the favored diagnosis was ST. Among the 20 cases in the total group of 54 with the highest number of votes for ST, half were BAMS. Of BAMS, 75% had a number of votes for ST that was within the SD of votes for ST seen among true ST cases. There was poor interobserver agreement for the precise diagnosis of the BAMS (kappa = 0.16) but good agreement that these cases were not melanoma (kappa = 0.7). BAMS nevi/tumors can closely mimic Spitz neoplasms. Expert melanoma pathologists in this study favored a diagnosis of ST in nearly half of the BAMS cases. There are BAMS cases that even experts cannot morphologically distinguish from true Spitz neoplasms.
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Affiliation(s)
- Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Alice Chen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Natasha Sharma
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Pragi Patel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Michael Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Pranav Kancherla
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Tara Geraminejad
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Asok Biswas
- Department of Pathology, Western General Hospital, Edinburgh, UK
| | | | - Klaus J Busam
- Department of Pathology, Dermatopathology Service, Memorial Sloan Kettering Cancer Center, New York City, NY
| | | | - Lyn M Duncan
- Department of Dermatopathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - David E Elder
- Department of Pathology and Laboratory Medicine, Division of Anatomic Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Jennifer Ko
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH
| | - Gilles Landman
- Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Alexander J Lazar
- Department of Pathology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Lori Lowe
- Department of Dermatology and Pathology, University of Michigan Medical School, Ann Arbor, MI
| | - Daniela Massi
- Department of Health Sciences, Section of Anatomic Pathology, University of Florence, Florence, Italy
| | - Daniela Mihic-Probst
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Douglas C Parker
- Departments of Pathology and Dermatology, Emory University School of Medicine, Atlanta, GA
| | - Richard A Scolyer
- Department of Tissue Pathology, Royal Prince Alfred Hospital, and NSW Health Pathology, North Sydney, NSW, Australia
- Department of Dermatopathology, The University of Sydney, Sydney, NSW, Australia
- Melanoma Institute Australia, North Sydney, NSW, Australia
| | - Christopher R Shea
- Department of Medicine, Section of Dermatology, University of Chicago, Chicago, IL
| | - Artur Zembowicz
- Department of Anatomic and Clinical Pathology, Tufts Medical School, Boston, MA
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Willeke A M Blokx
- Department of Pathology, Division Laboratories, Pharmacy and Biomedical Genetics University Medical Center Utrecht, The Netherlands
| | - Raymond L Barnhill
- Department of Translational Research, Curie Institute, Paris Sciences & Letters University, and UFR of Medicine, University of Paris Cité, Paris, France
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Chen A, Sharma N, Patel P, Olivares S, Bahrami A, Barnhill RL, Blokx WAM, Bosenberg M, Busam KJ, de La Fouchardière A, Duncan LM, Elder DE, Ko JS, Landman G, Lazar AJ, Lezcano C, Lowe L, Maher N, Massi D, Messina J, Mihic-Probst D, Parker DC, Redpath M, Scolyer RA, Shea CR, Spatz A, Tron V, Xu X, Yeh I, Jung Yun S, Zembowicz A, Gerami P. The Impact of Next-generation Sequencing on Interobserver Agreement and Diagnostic Accuracy of Desmoplastic Melanocytic Neoplasms. Am J Surg Pathol 2024:00000478-990000000-00332. [PMID: 38590014 DOI: 10.1097/pas.0000000000002226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Next-generation sequencing (NGS) is increasingly being utilized as an ancillary tool for diagnostically challenging melanocytic neoplasms. It is incumbent upon the pathology community to perform studies assessing the benefits and limitations of these tools in specific diagnostic scenarios. One of the most challenging diagnostic scenarios faced by skin pathologists involves accurate diagnosis of desmoplastic melanocytic neoplasms (DMNs). In this study, 20 expert melanoma pathologists rendered a diagnosis on 47 DMNs based on hematoxylin and eosin sections with demographic information. After submitting their diagnosis, the experts were given the same cases, but this time with comprehensive genomic sequencing results, and asked to render a diagnosis again. Identification of desmoplastic melanoma (DM) improved by 7%, and this difference was statistically significant (P<0.05). In addition, among the 15 melanoma cases, in the pregenomic assessment, only 12 were favored to be DM by the experts, while after genomics, this improved to 14 of the cases being favored to be DM. In fact, some cases resulting in metastatic disease had a substantial increase in the number of experts recognizing them as DM after genomics. The impact of the genomic findings was less dramatic among benign and intermediate-grade desmoplastic tumors (BIDTs). Interobserver agreement also improved, with the Fleiss multirater Kappa being 0.36 before genomics to 0.4 after genomics. NGS has the potential to improve diagnostic accuracy in the assessment of desmoplastic melanocytic tumors. The degree of improvement will be most substantial among pathologists with some background and experience in bioinformatics and melanoma genetics.
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Affiliation(s)
- Alice Chen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Natasha Sharma
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Pragi Patel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Armita Bahrami
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
| | - Raymond L Barnhill
- Department of Translational Research, Institut Curie, Paris Sciences and Lettres Research University, and UFR of Medicine, University of Paris Cité, Paris
| | - Willeke A M Blokx
- Department of Pathology, Division Laboratories, Pharmacy and Biomedical Genetics University Medical Center Utrecht, The Netherlands
| | | | - Klaus J Busam
- Department of Pathology, Dermatopathology Service, Memorial Sloan Kettering Cancer Center, New York City, NY
| | | | - Lyn M Duncan
- Department of Dermatopathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - David E Elder
- Department of Pathology and Laboratory Medicine, Division of Anatomic Pathology, Hospital of the University of Pennsylvania
| | - Jennifer S Ko
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH
| | - Gilles Landman
- Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Alexander J Lazar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Cecilia Lezcano
- Department of Pathology, Dermatopathology Service, Memorial Sloan Kettering Cancer Center, New York City, NY
| | - Lori Lowe
- Departments of Dermatology and Pathology, University of Michigan Medical School, Ann Arbor, MI
| | - Nigel Maher
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, and NSW Health Pathology, Sydney, NSW, Australia
- Faculty of Medicine and Health
- Melanoma Institute Australia
| | - Daniela Massi
- Department of Health Sciences, Section of Anatomic Pathology, University of Florence, Florence, Italy
| | - Jane Messina
- Departments of Pathology and Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL
| | - Daniela Mihic-Probst
- Institute for Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Douglas C Parker
- Departments of Pathology and Dermatology, Emory University School of Medicine, Atlanta, GA
| | | | - Richard A Scolyer
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, and NSW Health Pathology, Sydney, NSW, Australia
- Faculty of Medicine and Health
- Melanoma Institute Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Christopher R Shea
- Department of Medicine, Section of Dermatology, University of Chicago, Chicago, IL
| | - Alan Spatz
- Department of Pathology, McGill University, Montreal, QC
| | - Victor Tron
- Department of Dermatopathology, University of Toronto, Toronto, ON, Canada
| | - Xiaowei Xu
- Departments of Pathology and Dermatology, University of Pennsylvania, Philadelphia, PA
| | - Iwei Yeh
- Departments of Dermatology and Pathology, University of California, San Francisco, San Francisco, CA
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Artur Zembowicz
- Dermatopathology Consultations LLC, Lahey Clinic and Tufts Medical School, Boston, MA
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Yeo H, Ahn SS, Ou S, Yun SJ, Lim Y, Koh D, Lee YH, Shin SY. The EGR1-Artemin Axis in Keratinocytes Enhances the Innervation of Epidermal Sensory Neurons during Skin Inflammation Induced by House Dust Mite Extract from Dermatophagoidesfarinae. J Invest Dermatol 2024:S0022-202X(24)00090-3. [PMID: 38302010 DOI: 10.1016/j.jid.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 02/03/2024]
Abstract
Epidermal hyperinnervation is a critical feature of pruritus during skin inflammation. However, the mechanisms underlying epidermal hyperinnervation are unclear. This study investigates the role of the transcription factor EGR1 in epidermal innervation by utilizing wild-type (Egr1+/+) and Egr1-null (Egr1‒/‒) mice topically applied Dermatophagoides farinae extract from dust mite. Our findings revealed that Egr1‒/‒ mice exhibited reduced scratching behaviors and decreased density of epidermal innervation compared with Egr1+/+ mice. Furthermore, we identified artemin, a neurotrophic factor, as an EGR1 target responsible for Dermatophagoides farinae extract-induced hyperinnervation. It has been demonstrated that Dermatophagoides farinae extract stimulates toll-like receptors in keratinocytes. To elucidate the cellular mechanism, we stimulated keratinocytes with Pam3CSK4, a toll-like receptor 1/2 ligand. Pam3CSK4 triggered a toll-like receptor 1/2-mediated signaling cascade involving IRAK4, IκB kinase, MAPKs, ELK1, EGR1, and artemin, leading to increased neurite outgrowth and neuronal migration. In addition, increased expression of EGR1 and artemin was observed in the skin tissues of patients with atopic dermatitis. These findings highlight the significance of the EGR1-artemin axis in keratinocytes, promoting the process of epidermal innervation and suggesting it as a potential therapeutic target for alleviating itch and pain associated with house dust mite-induced skin inflammation.
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Affiliation(s)
- Hyunjin Yeo
- Department of Biological Sciences, Sang-huh College of Life Science, Konkuk University, Seoul, Republic of Korea
| | - Sung Shin Ahn
- Department of Biological Sciences, Sang-huh College of Life Science, Konkuk University, Seoul, Republic of Korea
| | - Sukjin Ou
- Department of Biological Sciences, Sang-huh College of Life Science, Konkuk University, Seoul, Republic of Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yoongho Lim
- Division of Bioscience and Biotechnology, Konkuk University, Seoul, Republic of Korea
| | - Dongsoo Koh
- Department of Applied Chemistry, Dongduk Women's University, Seoul, Republic of Korea
| | - Young Han Lee
- Department of Biological Sciences, Sang-huh College of Life Science, Konkuk University, Seoul, Republic of Korea; Cancer and Metabolism Institute, Konkuk University, Seoul, Republic of Korea
| | - Soon Young Shin
- Department of Biological Sciences, Sang-huh College of Life Science, Konkuk University, Seoul, Republic of Korea; Cancer and Metabolism Institute, Konkuk University, Seoul, Republic of Korea.
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Kim HE, Kim J, Park HK, Lee JB, Yun SJ. Correlations between inflammatory cytokine levels and degree of pigmentation in acral melanomas. Melanoma Res 2024; 34:38-43. [PMID: 37924528 DOI: 10.1097/cmr.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
Cutaneous melanoma, a highly aggressive skin tumor, is characterized by complex signaling pathways in terms of its pathogenesis and progression. Although the degree of pigmentation in melanoma determines its progression, metastasis, and prognosis, its association with inflammatory cytokines remains unclear. Thus, we evaluated the associations between melanoma pigmentation and plasma levels of inflammatory cytokines; furthermore, we investigated the potential variations in this relationship across the primary anatomic sites of melanoma. We enrolled patients with cutaneous melanoma who visited Chonnam National University Hwasun Hospital between January 2021 and December 2021. The anatomical sites of melanoma were categorized as acral and non-acral sites. The degree of pigmentation was quantified using computer software. In total, nine inflammatory cytokines were analyzed, including interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12, IL-13, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α). This study included 80 melanoma patients. Of these, 53 had acral melanoma and 27 had non-acral melanoma. Overall, plasma concentrations of IL-2, IL-4, IL-5, GM-CSF, and IFN-γ demonstrated significant correlations with diminished pigmentation. Furthermore, in the acral melanoma patients group, plasma concentrations of IL-2, IL-4, IL-5, GM-CSF, IFN-γ, and TNF-α revealed significant correlations with diminished pigmentation. Our results reveal significant associations between melanoma pigmentation and various cytokine levels, particularly in acral melanoma patients; these associations can be influenced by factors related to acral melanoma, such as physical stress or trauma. These correlations may also provide directions for the treatment of acral melanoma.
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Affiliation(s)
- Hong Euy Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
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Song JY, Ryu YJ, Lee HK, Lee DH, Choi YD, Shim HJ, Yun SJ. Risk factors for sentinel lymph node metastasis in Korean acral and non-acral melanoma patients. Pigment Cell Melanoma Res 2023. [PMID: 38013393 DOI: 10.1111/pcmr.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/27/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
Breslow thickness, ulceration, and mitotic rate are well-known prognostic factors for sentinel lymph node (SLN) metastasis in cutaneous melanoma. We investigated risk factors, including especially the degree of pigmentation, for SLN metastasis in Korean melanoma patients. We enrolled 158, composed of Korean 107 acral and 51 non-acral melanoma patients who underwent SLN biopsy. Clinicopathologic features such as Breslow thickness, ulceration, mitotic rate, and the degree of pigmentation were evaluated. The recurrence-free survival (RFS) rate and date of recurrence were determined. Fifty-four patients (34.2%) had a positive SLN biopsy result. In a multivariate analysis, Breslow thickness (odds ratio [OR] 1.93; 95% confidence interval [CI], 1.12-3.47; p = .022) and heavy pigmentation (OR 13.14; 95% CI, 2.96-95.20, p = .002) were associated with SLN metastasis. Positive SLN patients had a higher rate of loco-regional and/or distant recurrence (hazard ratio 6.32; 95% CI, 3.39-11.79; p < .001). Heavy pigmentation was associated with poor RFS. Heavy pigmentation is an independent predictor of SLN metastasis in both acral and non-acral melanoma. Our results suggest the need for in-depth SLN evaluation of cutaneous melanoma patients with heavy pigmentation and provide clinicians with important information for determining patient prognosis.
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Affiliation(s)
- Jee Yong Song
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Jae Ryu
- Department of General Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Kyun Lee
- Department of General Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Hoon Lee
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Hyun Jeong Shim
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Choi JW, Kim YH, Mun JH, Jo SJ, Roh MR, Chung KY, Yun SJ, Lee JB, Yun SK, Kim MS, Kim HJ, Kim KH, Kim IH, Park JH, Li K, Kim YC. Epidemiology and survival analysis of Merkel cell carcinoma in South Korea: a nationwide, multicenter retrospective study. Int J Dermatol 2023. [PMID: 37212335 DOI: 10.1111/ijd.16716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/13/2023] [Accepted: 05/04/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer, of which most research has been conducted in Caucasians. Therefore, the clinicopathological features and prognosis of Merkel cell carcinoma in Asians are still scarce. The aim of this study is to investigate the epidemiology and survival of MCC in South Korea and provide representative information regarding MCC in Asia. METHODS This was a retrospective, nationwide, multicenter study conducted in 12 centers across South Korea. Patients with pathologically proven MCC were included in the study. The clinicopathological features and clinical outcomes of the patients were investigated. Overall survival (OS) was analyzed using the Kaplan-Meier method, and independent prognostic factors were identified using Cox regression analysis. RESULTS A total of 161 patients with MCC were evaluated. The mean age was 71 years with a female predominance. OS was significantly different among the stages. Among clinicopathological features, multivariate Cox regression analysis demonstrated that only the stage at diagnosis was associated with poorer overall survival. CONCLUSIONS The results of our study suggest that the incidence of MCC was higher in females than in males and that there was a higher rate of local disease at the time of diagnosis. Among the variable clinicopathological features, disease stage at diagnosis was the only significant prognostic factor for MCC in South Korea. The findings of this nationwide, multicenter study suggest that MCC has distinct features in South Korea compared with other countries.
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Affiliation(s)
- Jee Woong Choi
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
| | - Yul Hee Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Mi Ryung Roh
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Kee Yang Chung
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Seok-Kweon Yun
- Department of Dermatology, Jeonbuk National University Medical School, Jeonju, South Korea
| | - Min Sung Kim
- Department of Dermatology, Chosun University School of Medicine, Gwangju, South Korea
| | - Hee Joo Kim
- Department of Dermatology, Gil Medical Center, School of Medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Kwang Ho Kim
- Department of Dermatology, College of Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, South Korea
| | - Il-Hwan Kim
- Department of Dermatology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kapsok Li
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - You Chan Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
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Park HK, Yun SJ, Lee SC, Lee JB. A Case of Superficial Angiomyxoma Localized on the Nipple in a 12-Year-Old Korean Female. Ann Dermatol 2023; 35:S150-S152. [PMID: 37853894 PMCID: PMC10608393 DOI: 10.5021/ad.21.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2023] Open
Affiliation(s)
- Hyung Keon Park
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.
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Lee Y, Cho E, Park CH, Yoon JH, Choi SK, Kim HO, Park C, Yun SJ. First Case of Atypical, Generalized Skin Rash after Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma. Korean J Gastroenterol 2023; 81:173-177. [PMID: 37096438 DOI: 10.4166/kjg.2023.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/26/2023]
Abstract
Transarterial chemoembolization (TACE) is a widely used hepatocellular carcinoma (HCC) treatment. Some cases of supraumbilical skin rash after TACE in patients with HCC have been reported. To the best of the authors' knowledge, there are no reports on atypical, generalized rashes caused by doxorubicin systemic absorption after TACE. This paper presents the case of a 64-year-old male with HCC who developed generalized macules and patches one day after a successful TACE procedure. A histology examination of a skin biopsy of a dark reddish patch on the knee revealed severe interface dermatitis. He was treated with a topical steroid, and all skin rashes improved within a week with no side effects. This report presents this rare case with a literature review on skin rash after TACE.
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Affiliation(s)
- Yohan Lee
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Eunae Cho
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Chang Hwan Park
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Jae Hyun Yoon
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Sung Kyu Choi
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Hyoung Ook Kim
- Department of Radiology, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Chan Park
- Department of Radiology, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Hospital and Medical School, Gwangju, Korea
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Bae SH, Park JH, Kim SH, Yun SJ, Kim JG, Lee JB. Cutaneous Photorejuvenation of Light Emitting Diodes via the Melatonin Membrane Receptor Pathway. Ann Dermatol 2022; 34:401-411. [PMID: 36478422 PMCID: PMC9763911 DOI: 10.5021/ad.21.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/13/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Melatonin receptors are present in the human skin and retina. These receptors can be stimulated by light emitting diodes (LEDs) at specific wavelengths, thereby inducing cutaneous photorejuvenation. However, the underlying mechanism remains unclear. OBJECTIVE To evaluate the influence of LEDs at specific wavelengths on melatonin membrane receptor (MT1) and cutaneous photorejuvenation via the MT1 pathway in vitro. METHODS Normal human dermal fibroblasts (HDFs) were irradiated using LEDs at different wavelengths (410~940 nm) at a dose of 1 J/cm². MT1 activity was evaluated after melatonin stimulation and LED irradiation. Thereafter, the expressions of collagen (COL) and matrix metalloproteinases (MMPs), with and without luzindole (MT1/2 receptor antagonist), were investigated via semi-quantitative reverse transcription polymerase chain reaction (PCR), real-time PCR, western blotting, and enzyme-linked immunosorbent assay. RESULTS In HDFs, the MT1 mRNA and protein levels increased significantly in response to melatonin (dose, 50 nM) (p<0.01) and LED irradiation at 595, 630, 850, and 940 nm (p<0.01). LED irradiation up-regulated COL type I and down-regulated MMP-1. Compared to LED irradiation without luzindole, LED irradiation with luzindole produced no significant increase in COL type I mRNA and protein levels (p<0.01). CONCLUSION We found that LED irradiation induces collagen synthesis and MMP-1 inhibition in HDFs via MT1 activation. Additionally, multiple LED wavelengths (595, 630, 850, and 940 nm) stimulated MT1 in HDFs, unlike in the eyes, where only blue light induced plasma melatonin suppression. This suggests the possibility of the melatoninergic pathway in photorejuvenation.
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Affiliation(s)
- Soo Hyeon Bae
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jun Hyeong Park
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Soo-Hyun Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Gwan Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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10
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Rubin AI, Yun SJ, Haneke E. Evaluation of Large Cellular Remnants of Melanocytes (LCRM) in the Nail Plate: An Advancement in the Correlation of Diagnosis and Prognosis for Nail Unit Melanocytic Lesions. J Cutan Pathol 2022; 49:418-419. [PMID: 35023185 DOI: 10.1111/cup.14201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Adam I Rubin
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, PA.,Section of Pediatric Dermatology Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Eckart Haneke
- Department of Dermatology, Inselspital University of Berne, Bern, Switzerland.,Private dermatology practice Dermaticum Freiburg im Breisgau, Germany.,Centro de Dermatología Epidermis Instituto CUF Matosinhos, Porto, Portugal
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11
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Kim HB, Na EY, Yun SJ, Lee JB. The Effect of Capsaicin on Neuroinflammatory Mediators of Rosacea. Ann Dermatol 2022; 34:261-269. [PMID: 35948328 PMCID: PMC9365654 DOI: 10.5021/ad.21.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/15/2022] [Accepted: 03/22/2022] [Indexed: 11/08/2022] Open
Abstract
Background Rosacea is a chronic inflammatory skin disease with a pathophysiological mechanism that remains unclear. Recently, dysregulation of the sensory nerve system has been implicated in the development of this condition. Objective This study aimed to investigate the effect of capsaicin on neuroinflammatory mediators in rosacea. In addition, this study aimed to evaluate the attenuating effects of capsazepine, a transient receptor potential vanilloid type 1 (TRPV1) antagonist. Methods We obtained skin tissue from both rosacea patients and normal individuals for an in vivo study. In addition, normal human epidermal keratinocytes (NHEKs) were cultured, and treated with capsaicin and capsazepine for an in vitro study. Quantitative changes in neuroinflammatory mediators were evaluated by semi-quantitative reverse transcription-polymerase chain reaction (PCR), real-time PCR, enzyme-linked immunosorbent assay, and immunofluorescence staining. Results The data showed the increase of TRPV1, TRPV4, cathelicidin (LL37) and tumor necrosis factor-α (TNF-α) in skin tissue by real-time PCR. In addition, the data showed that cathelicidin (LL37), kallikrein-5 (KLK-5), TNF-α, vascular endothelial growth factor (VEGF), interleukin (IL)-1α, IL-1β, IL-8, and protease-activated receptor 2 (PAR2) increased in capsaicin-treated NHEKs. Capsazepine attenuated the expression of TRPV1 and other mediators, except for IL-8, in capsaicin-treated NHEKs. Conclusion We confirmed that TRPV1, TRPV4, cathelicidin (LL37) and TNF-α are increased in rosacea skin, and that capsaicin is associated with increase of neuroinflammatory mediators such as LL37, KLK-5, TNF-α, VEGF, IL-1α, IL-1β, IL-8, and PAR2. Modulators or inhibitors of neuroinflammatory mediators including TRPV1 could be potential therapeutic option in the treatment of patients with rosacea.
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Affiliation(s)
- Hyeon Bin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Eui Young Na
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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12
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Park K, Bae JM, Chung KY, Yun SJ, Seo SH, Ahn HH, Lee DY, Kim H, Sohn U, Park BC. Incidence and Prevalence of Skin Cancers in South Korea from 2008 to 2016: A Nation-Wide Population Based Study. Ann Dermatol 2022; 34:105-109. [PMID: 35450312 PMCID: PMC8989896 DOI: 10.5021/ad.2022.34.2.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/13/2021] [Accepted: 09/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background In South Korea, there have been few nationwide epidemiologic studies about premalignant actinic keratosis (AK), squamous cell carcinoma in situ (Bowen’s disease), nonmelanoma skin cancer (NMSC), malignant melanoma of the skin (MM), Kaposi’s sarcoma (KS), connective and soft tissue cancers, or mycosis fungoides (MF). Objective Using a nationwide population-based study, we attempted to measure the incidence and the prevalence of the above-mentioned tumors in South Korea. Methods The database we used included all claims in the Korean National Health Insurance program and the Korean Medical Aid program from 2008 to 2016. The International Classification of Diseases, 10th revision (ICD-10) was used to record diagnoses in this database. This data included AK, Bowen’s disease, NMSC, MM, KS, connective and soft tissue cancers, and MF. Results The age-standardized incidence and prevalence rate of AK, Bowen’s disease, NMSC, MM, KS, connective and soft tissue cancers, as well as MF increased during the periods we investigated. The incidence and prevalence rate of AK and NMSC have increased two- to three-fold. In the case of Bowen’s disease, MM, KS, connective and soft tissue cancers, or MF, we observed no significant tendency in age-standardized incidence or prevalence. Conclusion We confirmed that the age-standardized incidence and prevalence rates of NMSC and AK tended to increase. These results might contribute to developing preventive and therapeutic strategies for skin cancers and may become a source for further studies.
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Affiliation(s)
- Kyungduck Park
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kee Yang Chung
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Hong Seo
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Dong-Youn Lee
- Department of Dermatology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heesu Kim
- Department of Dermatology, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Uri Sohn
- Department of Dermatology, Dankook University College of Medicine, Cheonan, Korea
| | - Byung Cheol Park
- Department of Dermatology, Dankook University College of Medicine, Cheonan, Korea
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13
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You HR, Yun SJ, Kim SJ, Lee SC, Won YH, Lee JB. Retraction: Three Cases of Autoimmune Progesterone Dermatitis. Ann Dermatol 2022; 34:161. [PMID: 35450311 PMCID: PMC8989903 DOI: 10.5021/ad.2022.34.2.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Hye Rin You
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Jin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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14
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Kim HE, Shim HJ, Jung C, Shin IS, Kim JM, Yun SJ. Correlations of psychological distress with plasma cytokine levels and gene mutations in acral and non-acral melanoma. Front Psychiatry 2022; 13:1024206. [PMID: 36405903 PMCID: PMC9669704 DOI: 10.3389/fpsyt.2022.1024206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The presence of psychological distress has negatively affected the course and prognosis of melanoma. Psychological distress is influenced by cytokines and gene mutations, particularly in cancer, but no studies have investigated this phenomenon in melanoma patients. This study investigated the correlations of psychological distress, plasma cytokine levels, and gene mutations in melanoma patients, focusing on melanoma sites and TNM stages. METHODS This study prospectively evaluated melanoma patients who visited Chonnam National University Hwasun Hospital from September 2020 to March 2021. Melanoma sites were divided into acral and non-acral sites. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale, and quality of life was evaluated with EuroQol-5 Dimensions. Plasma cytokine levels, and depression- and cytokine-related gene mutations were analyzed. RESULTS This study included 151 melanoma patients. Anxiety was found in 14.6% of the patients, and depression in 29.8%. The melanoma sites were not significantly associated with anxiety, depression, or quality of life. However, psychological distress was significantly associated with the plasma cytokines IL-2, IL-4, IL-5, IL-10, IL-12, TNF-α and IFN-γ. COMT, SLC6A4, SLC6A3, and IL-12b gene mutations were also associated with melanoma sites and TNM stage, anxiety, and QOL. CONCLUSION Psychological distress was associated with plasma cytokine levels and depression- and cytokine-related gene mutations. Using psychiatric intervention and emotional support, cytokine levels related to melanoma can be changed, which may have positive effects on the prognosis and treatment of melanoma. More careful follow-up, evaluation, and management are needed for patients with gene mutations.
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Affiliation(s)
- Hong Euy Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Hyun Jung Shim
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, South Korea
| | - Chaeyong Jung
- Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
| | - Il Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
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15
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Ryu GW, Choi YD, Jin S, Chung IJ, Shin MH, Yun SJ. Volar location and degree of pigmentation are associated with poor survival and first metastasis pattern in acral melanoma. Pigment Cell Melanoma Res 2021; 34:1094-1104. [PMID: 33934532 DOI: 10.1111/pcmr.12983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/01/2021] [Accepted: 04/27/2021] [Indexed: 12/17/2022]
Abstract
The risk factors affecting acral melanoma metastasis and prognosis remain unclear. The study included 168 patients with invasive acral melanoma who were followed for ≥3 years. We evaluated patient demographics, stages, clinicopathological features, anatomic site of melanoma including nail versus volar surface, and degree of melanoma pigmentations, sentinel lymph node biopsy results, and the first metastasis sites. Of the 168 patients (mean age 64.5 years; 52.4% male), 43 (25.6%) had invasive melanoma without metastasis, 113 (67.3%) had invasive melanoma with a first lymph node metastasis, and 12 (7.1%) had invasive melanoma with invasive melanoma with a first distant metastasis. Advanced T stage, high mitotic rate, ulceration, and the degree of pigmentation were significant risk factors for metastasis. Amelanotic and mild pigmentation of acral melanoma was associated with first distant metastasis, whereas heavy pigmentation was associated with first lymph node metastasis. Advanced TNM stages, high mitotic rate, volar location (hazard ratio = 2.24, 95% confidence interval 1.18-4.26), and low-pigmentation (hazard ratio = 2.02, 95% confidence interval 1.17-3.49) were associated with melanoma-specific mortality.
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Affiliation(s)
- Geon Wook Ryu
- Departments of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Departments of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Suna Jin
- Departments of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Ik-Joo Chung
- Departments of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea
| | - Min-Ho Shin
- Departments of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Departments of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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16
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Park HK, Choi YD, Yun SJ. Clinical characteristics and differences among 802 acral tumors by anatomical sites. Clin Exp Dermatol 2021; 47:312-318. [PMID: 34388274 DOI: 10.1111/ced.14885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acral skin tumors are common, but there are few literature reviews regarding their incidence. OBJECTIVES To investigate the clinical characteristics and differences in incidence of benign and malignant acral tumors by anatomical site. METHODS A retrospective review of 802 patients with acral skin tumors confirmed by skin biopsy between January 2010 and December 2019 was conducted. Age, sex, duration, symptoms, and sites were obtained from medical records and photographs. RESULTS The mean age of onset was 43.8 years with a male-to-female ratio of 1:1.41, and the mean duration was 68.8 months. Most were asymptomatic (66.7%). In total, 802 acral tumors were identified: 512 (63.8%) were benign and 290 (36.2%) were malignant. The most common benign tumors were benign melanocytic lesions (n = 239), and the most common malignant tumors were melanoma (n = 234). The most common site was the sole (n = 408). Benign melanocytic lesions, melanoma, and epidermal cyst were more frequent on the foot, and pyogenic granuloma, glomus tumor, hemangioma, and mucous cyst were more frequent on the hand. Glomus tumor, fibroma, mucous cyst, and osteoma were more frequent on the nail portion, and benign melanocytic lesions and epidermal cyst were more frequent on the non-nail portion. CONCLUSIONS This study reports the incidence of various benign and malignant acral tumors according to site, and we believe the results will be helpful in making a diagnosis in the clinic.
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Affiliation(s)
- H K Park
- Departments of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Y D Choi
- Departments of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - S J Yun
- Departments of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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17
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Lee HJ, Park HM, Ki SY, Choi YD, Yun SJ, Lim HS. Blastic plasmacytoid dendritic cell neoplasm of the breast: A case report and review of the literature. Medicine (Baltimore) 2021; 100:e25699. [PMID: 34106594 PMCID: PMC8133119 DOI: 10.1097/md.0000000000025699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/08/2021] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an uncommon and aggressive hematologic malignancy that arises from plasmacytoid dendritic cells. BPDCN typically presents with skin lesions with or without involvement of lymph nodes, peripheral blood, or bone marrow. However, breast involvement of BPDCN is rare and there has been no report describing the radiologic features of BPDCN within breast parenchyma. PATIENT CONCERNS We report a case of a 47-year-old woman who presented with an incidentally detected hypermetabolic breast lesion on PET/CT with concurrent right cheek plaque. DIAGNOSES Skin biopsy was performed for the right cheek plaque. Mammography and breast ultrasonography were performed to evaluate the breast lesion. The lesion was depicted as a 2.5 cm sized focal asymmetry on mammogram and an irregular heterogeneous echoic mass within the mammary zone of the right upper outer breast. Core needle biopsy was performed for the breast lesion. Histologic diagnosis of the two lesions was BPDCN. INTERVENTIONS The patient was treated with induction and consolidation chemotherapy and received allogenic peripheral blood stem cell transplantation. OUTCOMES The patient remains in complete remission state without relapse at 34 months since initial diagnosis. LESSONS This is the first case of BPDCN manifested as a breast parenchymal mass and assessed by diagnostic breast imaging tools (mammography and ultrasonography). This case report is significant for BPDCN within the breast parenchyma and presenting rare radiologic description of BPDCN.
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Affiliation(s)
| | | | | | | | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun-gun, Jeollanam-do, Republic of Korea
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18
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Lee JH, Choi YD, Hwang JH, Shin MH, Yun SJ. Frequency of Trauma, Physical Stress, and Occupation in Acral Melanoma: Analysis of 313 Acral Melanoma Patients in Korea. Ann Dermatol 2021; 33:228-236. [PMID: 34079182 PMCID: PMC8137324 DOI: 10.5021/ad.2021.33.3.228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/01/2020] [Accepted: 10/12/2020] [Indexed: 11/08/2022] Open
Abstract
Background Traumatic events are thought to be a cause of acral melanoma. However, little is known about the role of mechanical trauma or physical stress in the development of acral melanoma. Objective In our study, we evaluated the frequency of trauma, physical stress, and occupation in patients with acral melanoma and aimed to identify any pathological correlates of these factors. Methods We conducted a retrospective study of 313 acral melanoma patients from Chonnam National University Hospital. We mapped melanoma-developed anatomical sites of acral areas and assessed patients' history of trauma, physical stress, and occupation. Results Among the 313 acral melanoma patients, many reported a traumatic event (84 of 313; 26.8%) or physical stress (91 of 313; 29.1%) before the melanoma developed. The most common anatomical sites in these patients were on the borders of the foot (136 of 313; 43.5%). Trauma was more commonly associated with the fingernails and toenails than other sites. The frequency of each type of physical stress depended on the site of the lesion. Farmer and fisherman were the most common occupations (130 of 313; 41.5%) of the acral melanoma patients. Conclusion Our results demonstrate that traumatic events, physical stress, and certain occupations are common in acral melanomas. Further studies are needed to establish whether these are risk factors for acral melanomas.
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Affiliation(s)
- Ji Hong Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Ha Hwang
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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19
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Joo JS, Yun SJ, Lee SC, Lee JB. Incidence of Bullous Pemphigoid and Pemphigus in Korea. Ann Dermatol 2021; 33:193-195. [PMID: 33935464 PMCID: PMC8081997 DOI: 10.5021/ad.2021.33.2.193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Jae Seong Joo
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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20
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Yun SJ, Kim HB, Lee JB. 16248 Vitiligo as a chronic cutaneous graft-versus-host disease. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Lee JB, Yun SJ, Lee JH. 16798 Clinical significance of lactic acid stinging test in the patients with rosacea. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Li H, Masieri FF, Schneider M, Kottek T, Hahnel S, Yamauchi K, Obradović D, Seon JK, Yun SJ, Ferrer RA, Franz S, Simon JC, Lethaus B, Savković V. Autologous, Non-Invasively Available Mesenchymal Stem Cells from the Outer Root Sheath of Hair Follicle Are Obtainable by Migration from Plucked Hair Follicles and Expandable in Scalable Amounts. Cells 2020; 9:E2069. [PMID: 32927740 PMCID: PMC7564264 DOI: 10.3390/cells9092069] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Regenerative therapies based on autologous mesenchymal stem cells (MSC) as well as stem cells in general are still facing an unmet need for non-invasive sampling, availability, and scalability. The only known adult source of autologous MSCs permanently available with no pain, discomfort, or infection risk is the outer root sheath of the hair follicle (ORS). METHODS This study presents a non-invasively-based method for isolating and expanding MSCs from the ORS (MSCORS) by means of cell migration and expansion in air-liquid culture. RESULTS The method yielded 5 million cells of pure MSCORS cultured in 35 days, thereby superseding prior art methods of culturing MSCs from hair follicles. MSCORS features corresponded to the International Society for Cell Therapy characterization panel for MSCs: adherence to plastic, proliferation, colony forming, expression of MSC-markers, and adipo-, osteo-, and chondro-differentiation capacity. Additionally, MSCORS displayed facilitated random-oriented migration and high proliferation, pronounced marker expression, extended endothelial and smooth muscle differentiation capacity, as well as a paracrine immunomodulatory effect on monocytes. MSCORS matched or even exceeded control adipose-derived MSCs in most of the assessed qualities. CONCLUSIONS MSCORS qualify for a variety of autologous regenerative treatments of chronic disorders and prophylactic cryopreservation for purposes of acute treatments in personalized medicine.
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Affiliation(s)
- Hanluo Li
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
| | - Federica Francesca Masieri
- School of (EAST) Engineering, Arts, Science & Technology, University of Suffolk, Ipswich, Suffolk IP41QJ, UK;
| | - Marie Schneider
- Clinic for Hematology, Cell Therapy and Hemostaseology, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Tina Kottek
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
| | - Sebastian Hahnel
- Polyclinic for Dental Prosthetics and Material Sciences, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Kensuke Yamauchi
- Kensuke Yamauchi, Department of Oral & Maxillofacial Surgery, Tohoku University, Sendai 980-8577, Japan;
| | | | - Jong-Keun Seon
- Chonnam National University Hwasun Hospital, Hwasun-gun 58128, Korea; (J.-K.S.); (S.J.Y.)
| | - Sook Jung Yun
- Chonnam National University Hwasun Hospital, Hwasun-gun 58128, Korea; (J.-K.S.); (S.J.Y.)
| | - Rubén A. Ferrer
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103 Leipzig, Germany; (R.A.F.); (S.F.); (J.-C.S.)
| | - Sandra Franz
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103 Leipzig, Germany; (R.A.F.); (S.F.); (J.-C.S.)
| | - Jan-Christoph Simon
- Clinic for Dermatology, Venereology and Allergology, University Hospital Leipzig, 04103 Leipzig, Germany; (R.A.F.); (S.F.); (J.-C.S.)
| | - Bernd Lethaus
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
| | - Vuk Savković
- Department of Cranial Maxillofacial Plastic Surgery, University Clinic Leipzig, 04103 Leipzig, Germany; (H.L.); (T.K.); (B.L.)
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23
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Ryu GW, Choi YD, Ryu YJ, Lee JB, Shin MH, Yun SJ. Risk factors affecting the first metastasis of acral melanoma: Low- pigmentation independently predicts a first lung metastasis. J Am Acad Dermatol 2020; 84:1739-1742. [PMID: 32891781 DOI: 10.1016/j.jaad.2020.08.108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/04/2020] [Accepted: 08/31/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Geon Wook Ryu
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Jae Ryu
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.
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Yun SJ, Oh IJ, Park CK, Kim YC, Kim HB, Kim HK, Hong AR, Kim IY, Ahn SJ, Na KJ, Choi YD. Vitiligo-like depigmentation after pembrolizumab treatment in patients with non-small cell lung cancer: a case report. Transl Lung Cancer Res 2020; 9:1585-1590. [PMID: 32953529 PMCID: PMC7481606 DOI: 10.21037/tlcr-20-386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Immune checkpoint inhibitors (ICIs) targeting programmed death-1 (PD-1) pathway have significantly improved outcomes for patients with a variety of malignancies, including non-small cell lung cancer (NSCLC). In contrast, the incidence of immune-related cutaneous adverse events such as vitiligo have been on the rise because of the increasing use of ICIs. Vitiligo-like depigmentation has been reported in only 2.0% to 8.3% of patients with melanoma and is considered a favorable prognostic factor. However, it has been rarely reported in patients with non-melanoma malignancies. We describe a case of vitiligo-like skin depigmentation after pembrolizumab use in a patient with stage IV NSCLC. Multiple ill-defined painless and non-pruritic depigmented patches appeared on the patient’s hands, scrotum, and lower lip after five months of pembrolizumab. We continued treatment with pembrolizumab 2 mg/kg for 14 months with close monitoring of vitiligo lesions until the progression of brain metastasis, but the vitiligo-like depigmentation did not improve by the combined excimer laser and topical corticosteroid therapy. Clinicians should be aware that immune-related cutaneous adverse events such as vitiligo-like depigmentation are not limited to cases of melanoma but arise as a direct result of anti-PD-1 therapy.
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Affiliation(s)
- Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - In-Jae Oh
- Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Cheol Kyu Park
- Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Chul Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hyeon Bin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Hee-Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - A Ram Hong
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - In-Young Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea.,Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Ja Ahn
- Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea.,Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea
| | - Kook-Joo Na
- Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo-Duk Choi
- Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea.,Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
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25
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Jung IS, Yun SJ, Lee JB. The Difference in Sebum Secretion Affecting Development of Acne. Ann Dermatol 2019; 31:426-433. [PMID: 33911621 PMCID: PMC7992743 DOI: 10.5021/ad.2019.31.4.426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/05/2019] [Accepted: 03/09/2019] [Indexed: 01/20/2023] Open
Abstract
Background Although sebum secretion is crucial for acne development, acne lesion distribution is not always similar to the topographic differences of sebum secretion. Objective To analyze whether sebum secretion affects acne development and distribution and to assess other factors possibly influencing the relationship between acne and sebum secretion. Methods This single-center retrospective study included 67 acne patients and 50 controls. Acne patients were divided into 3 groups based on acne lesion distribution: T-zone dominant, U-zone dominant, and mixed groups. The secreted sebum level in each zone of acne patients was compared with that of controls. We also conducted correlation analysis between secreted sebum level and acne number, depending on the facial zone. Results No significant difference was found between acne patients and controls regarding age and sex ratio. The U-zone dominant group showed increased sebum levels compared with controls in the U-zone and whole face, but a similar result was not obtained in the T-zone dominant group. Moreover, there was a significant correlation between the number of lesions and secreted sebum level in the U-zone, but not in the T-zone. Further, there was a more significant relation in the U-zone of male and young patients. Conclusion We found that increased sebum secretion compared with the condition may affect acne development, especially in the U-zone. Sex and age may also influence the relationship between acne and increased sebum secretion. Acne lesion distribution may vary from patient to patient because sebum secretion affects acne differently depending on multiple factors.
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Affiliation(s)
- In Soon Jung
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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26
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Suh MS, Yun SJ, Lee JB, Kim SJ, Lee SC, Won YH. Extranodal NK/T-Cell Lymphoma Mimicking an Infectious Granuloma. Ann Dermatol 2019; 31:S14-S16. [PMID: 33911681 PMCID: PMC7997061 DOI: 10.5021/ad.2019.31.s.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Min Song Suh
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seong-Jin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Yun SJ, Liu S, Buckley M, Wang T, Jin S, Karakousis G, Peters MG, Elder DE, Gimotty PA, Xu X. Stromal inflammatory cells are associated with poorer prognosis in primary cutaneous melanoma. Hum Pathol 2019; 88:78-86. [PMID: 30965022 DOI: 10.1016/j.humpath.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 11/19/2022]
Abstract
We observed that non-tumor-infiltrating inflammatory cells are often present in the stroma of melanoma. The role of these stromal inflammatory cells (SIC) in cancer has not been studied. We evaluated the prognostic significance of SIC in 299 patients with vertical growth phase primary melanomas with at least 10 years of clinical follow-up. Lymphatic density and lymphatic invasion in the areas with SIC was quantified. The prognostic significance of these factors was evaluated using univariable and multivariable Cox models for melanoma-specific death and the time to first recurrence. Of the 299 melanomas, 161 exhibited areas with SIC. Percentages of vertical growth phase tumor-infiltrating lymphocytes and radial growth phase regression were significantly higher in cases with SIC compared to those without SIC (P = .005); lymphatic invasion was also detected more frequently in cases with SIC (P = .001). Lymphatic density in SIC areas was higher than that in other areas of the melanomas. Patients with SIC had poorer clinical outcome. Vascular endothelial growth factor-C (VEGFC) staining in a subset of these melanoma patients showed that VEGFC expression in the stromal macrophages was associated with lymphatic invasion in SIC areas. In conclusion, SIC in melanoma is associated with poorer prognosis, and the prognostic effect is partially mediated through induction of lymphangiogenesis with increased lymphatic invasion.
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Affiliation(s)
- Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Shujing Liu
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Meghan Buckley
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tao Wang
- Office of Biotechnology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, USA
| | - Suna Jin
- Department of Dermatology, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Giorgos Karakousis
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Madalyn G Peters
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David E Elder
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Phyllis A Gimotty
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Xiaowei Xu
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Bae JM, Chung KY, Yun SJ, Kim H, Park BC, Kim JS, Seo SH, Ahn HH, Lee DY, Kim YC, Park HJ, Kim M. Markedly Reduced Risk of Internal Malignancies in Patients With Vitiligo: A Nationwide Population-Based Cohort Study. J Clin Oncol 2019; 37:903-911. [PMID: 30785828 DOI: 10.1200/jco.18.01223] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Recent studies indicated that the autoimmunity of vitiligo exerts effects on cells other than melanocytes, which confer reduced risks of both melanoma and nonmelanoma skin cancers in patients with vitiligo. However, the risk of internal malignancy in patients with vitiligo has not been elucidated. PATIENTS AND METHODS We conducted a population-based retrospective cohort study using data from the Korean National Health Insurance claims database obtained from January 2007 to December 2016. All patients age 20 years or older with vitiligo who had at least two contacts with a physician from 2009 to 2016, during which a principal diagnosis was made, were identified (vitiligo group). Controls were randomly selected (two per patient with vitiligo) after frequency matching with the vitiligo group for age and sex during the same period (control group). RESULTS A total of 101,078 patients with vitiligo and 202,156 controls without vitiligo were included. The incidence rates of internal malignancies were 612.9 and 708.9 per 100,000 person-years in the vitiligo and control groups, respectively. Patients with vitiligo showed a significantly reduced risk of overall internal malignancies (hazard ratio [HR], 0.86; 95% CI, 0.82 to 0.89; P < .001) compared with controls without vitiligo after adjustments for age, sex, and comorbidities. With regard to organ-specific malignancies, patients with vitiligo showed a remarkably decreased risk of cancer in the colon and rectum (HR, 0.62; 95% CI, 0.55 to 0.69; P < .001), ovary (HR, 0.62; 95% CI, 0.46 to 0.83; P < .001), and lung (HR, 0.75; 95% CI, 0.65 to 0.86; P < .001). CONCLUSION Vitiligo was associated with a reduced risk of overall internal malignancies. These findings suggest that autoimmune diseases, including vitiligo, may provide immune surveillance for the development of cancer beyond the targeted organ.
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Affiliation(s)
- Jung Min Bae
- 1 St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Sook Jung Yun
- 3 Chonnam National University School of Medicine, Gwangju, Korea
| | - Heesu Kim
- 4 Catholic Kwandong University College of Medicine, Incheon, Korea
| | | | - Joung Soo Kim
- 6 Hanyang University College of Medicine, Guri, Korea
| | - Soo Hong Seo
- 7 Korea University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- 7 Korea University College of Medicine, Seoul, Korea
| | - Dong-Youn Lee
- 8 Sungkyunkwan University School of Medicine, Seoul, Korea
| | - You Chan Kim
- 9 Ajou University School of Medicine, Suwon, Korea
| | | | - Miri Kim
- 11 Yeouido St Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Korea
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29
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Lee MY, Jin S, Lee KH, Park MH, Jung ST, Rubin A, Yun SJ. A cellular blue nevus with pigmented epithelioid melanocytoma-like pattern on the ipsilateral upper arm associated with a congenital plaque-type blue nevus on the hand. J Cutan Pathol 2019; 46:383-388. [PMID: 30719746 DOI: 10.1111/cup.13435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/11/2019] [Accepted: 01/24/2019] [Indexed: 12/16/2022]
Abstract
A 36-year-old man presented with a subcutaneous nodule on the right upper arm. A small nodule had developed 8 years earlier, and grew in size, accompanied by a tingling sensation and numbness. In addition, he had a bluish irregular patch on the right hand since birth, which crossed from the palm to the dorsal hand. Skin biopsies from the hand showed a heavily pigmented melanocyte proliferation in the dermis with perieccrine, perivascular, and perineural involvement, and a diagnosis of congenital plaque-type blue nevus was made. The tumor on the arm was located closely along the median nerve, and was observed as a large black pedunculated round tumor. Histopathologically, the tumor on the arm consisted of densely packed tissue with nevoid cells without atypia in the larger nodular part, and heavily pigmented spindle and epithelioid melanocytes in the slender stalk area, which was diagnosed as cellular blue nevus with pigmented epithelioid melanocytoma-like pattern. Next-generation sequencing revealed GNAQ mutations in the hand lesion, and in the lesions on the arm. This case suggests that the areas of skin following the same neural distribution of a congenital plaque-type blue nevus on the extremities should be followed up for secondary changes.
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Affiliation(s)
- Min Young Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Suna Jin
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung-Hwa Lee
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Min Ho Park
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Taek Jung
- Department of Orthopedic Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Adam Rubin
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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30
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Lee MY, Yun SJ, Lee SC, Won YH, Lee JB. A Case of Ochronosis with Atypical Manifestations Involving the Perioral Area and Sclera. Ann Dermatol 2019; 31:106-107. [PMID: 33911553 PMCID: PMC7992717 DOI: 10.5021/ad.2019.31.1.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/14/2018] [Accepted: 02/05/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Min Young Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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31
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Jung IS, Yun SJ, Lee JB, Lee SC, Won YH. A Case of Recalcitrant Erythema Nodosum Associated with Pancreatic Cancer. Ann Dermatol 2019; 31:685-686. [PMID: 33911673 PMCID: PMC7992598 DOI: 10.5021/ad.2019.31.6.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/07/2019] [Accepted: 06/01/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- In Soon Jung
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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32
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Jeon HW, Na EY, Yun SJ, Lee SC, Lee JB. Citron Essential Oils Alleviate the Mediators Related to Rosacea Pathophysiology in Epidermal Keratinocytes. Ann Dermatol 2018; 30:653-661. [PMID: 33911504 PMCID: PMC7992447 DOI: 10.5021/ad.2018.30.6.653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 12/14/2022] Open
Abstract
Background Citron is well known for an abundance of antioxidative and anti-inflammatory ingredients such as vitamin C, polyphenol compounds, flavonoids, and limonoids. Objective In this study, we aimed to evaluate the effects of citron essential oils on rosacea mediators in activated keratinocytes in vitro. Methods Normal human epidermal keratinocytes (NHEKs) were stimulated with 1α, 25-dihydroxyvitamin D3 (VD3) and interleukin 33 (IL-33) with LL-37 to induce rosacea mediators such as kallikrein 5 (KLK5), cathelicidin, vascular endothelial growth factor (VEGF), and transient receptor potential vanilloid 1 (TRPV1). These mediators were analyzed by performing reverse-transcription polymerase chain reaction (PCR), quantitative real-time PCR, immunocytofluorescence and enzyme-linked immunosorbent assay after NHEKs were treated with citron seed and unripe citron essential oils. Results The messenger RNA (mRNA) and protein levels of KLK5 and LL-37 induced by VD3 were suppressed by citron seed and unripe citron essential oils. Furthermore, the mRNA and protein levels of VEGF and TRPV1 induced by IL-33 with LL-37 were also suppressed by citron essential oils. Conclusion These results show that citron essential oils have suppressive effects on rosacea mediators in activated epidermal keratinocytes, which indicates that the citron essential oils may be valuable adjuvant therapeutic agents for rosacea.
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Affiliation(s)
- Hyeon Woo Jeon
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Eui Young Na
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Suh MS, Choi YD, Lee JB, Lee SC, Won YH, Yun SJ. Sensitivity and Usefulness of VE1 Immunohistochemical Staining in Acral Melanomas with BRAF Mutation. Ann Dermatol 2018; 30:556-561. [PMID: 33911478 PMCID: PMC7992489 DOI: 10.5021/ad.2018.30.5.556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 05/08/2018] [Accepted: 06/07/2018] [Indexed: 12/30/2022] Open
Abstract
Background Acral melanomas are known to have a low frequency of BRAF mutation, in contrary to higher KIT mutation. Recently, VE1 immunostaining was reported to have a good correlation with BRAF mutation status. Objective We aimed to evaluate the clinicopathological features of BRAF-mutated acral melanomas and validate the correlation of the VE1 immunohistochemical stains in those cases. Methods The clinical features (age, sex, anatomical site), and histopathological characteristics of 41 patients with acral melanoma were evaluated. We performed a next-generation sequencing to detect BRAF mutation status. We also determined the correlation of VE1 immunohistochemical staining with BRAF mutation status. Results Among 19 acral melanomas with BRAF mutation, common histopathological subtype was acral lentiginous melanoma (8/19, 42%) and nodular melanoma (8/19, 42%) and superficial spreading melanoma (3/19, 16%) followed. VE1 immunostaining results were positive in all 15 cases with BRAF V600E mutation (sensitivity 100%), and negative in 4 cases of BRAF non-V600E mutation. However, VE1 immunostaining was negative in all 22 patients with BRAF wild-type. Conclusion VE1 immunostaining had a good correlation with BRAF V600E mutation status.
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Affiliation(s)
- Min Song Suh
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Kim NH, Lee JB, Yun SJ. Development of Vitiligo-Like Depigmentation after Treatment of Lentigo Maligna Melanoma with 5% Imiquimod Cream. Ann Dermatol 2018; 30:454-457. [PMID: 30065586 PMCID: PMC6029957 DOI: 10.5021/ad.2018.30.4.454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/24/2017] [Accepted: 08/28/2017] [Indexed: 11/08/2022] Open
Abstract
A 69-year-old man presented with a black irregular patch on his left cheek. Skin biopsy revealed lentigo maligna melanoma in situ. He was treated via partial excision of the melanoma, followed by the application of 5% imiquimod cream every other night for 6 to 8 hours. The patient experienced severe local inflammation accompanied by burning, edema, and erythema, as well as oozing and crusting. The patient discontinued using the imiquimod cream after 15 applications because of the inflammation. Depigmentation was noted in the treated area 3 months after the initiation of treatment with imiquimod cream. Histological examination using Melan-A staining of the depigmented area revealed an absence of melanocytes, which is consistent with vitiligo. The depigmented lesions improved considerably after a 5-year follow-up, and there was no recurrence of melanoma.
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Affiliation(s)
- Na Hee Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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35
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Fix WC, Yun SJ, Groft MacFarlane CM, Jambusaria A, Elenitsas R, Chu E, Etzkorn JR, Sobanko JF, Shin TM, Miller CJ. MART-1-labeled melanocyte density and distribution in actinic keratosis and squamous cell cancer in situ: Pagetoid melanocytes are a potential source of misdiagnosis as melanoma in situ. J Cutan Pathol 2018; 45:734-742. [PMID: 29943494 DOI: 10.1111/cup.13309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/15/2018] [Accepted: 06/21/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Actinic keratosis (AK) and squamous cell carcinoma in-situ (SCCIS) within or near melanoma in situ (MIS) can complicate diagnosis due to overlapping clinical and microscopic features. This study aimed to describe basilar melanocyte density and pagetoid spread in AK and SCCIS for improved diagnostic accuracy. METHODS A total of 22 AK and 22 SCCIS biopsies containing a margin of uninvolved epidermis were immunostained with MART-1 (melanoma antigen recognized by T-cells 1). The basilar melanocyte:keratinocyte ratio and the number and distribution of pagetoid melanocytes were compared in AK, SCCIS, and uninvolved epidermis. An in-vitro human skin model was created to assess the impact of keratinocyte atypia on melanocyte distribution. RESULTS The median basilar melanocyte:keratinocyte ratio in SCCIS (1:11.49) was lower than in uninvolved epidermis (1:5.59, P = 0.0011), and the ratio in AK (1:6.94) was similar to uninvolved epidermis (P = 0.987). Pagetoid melanocytes were absent in perilesional skin but common in AK (21/22, P < 0.0001) and SCCIS (22/22, P < 0.0001). Pagetoid melanocytes at or above the mid-spinous layer were more common in SCCIS (21/22) vs AK (7/22, P < 0.0001). Pagetoid melanocytes were present in the in-vitro skin model made with neoplastic but not normal keratinocytes. CONCLUSIONS Pagetoid melanocytes in AK and SCCIS should be interpreted with caution to avoid overdiagnosis of MIS.
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Affiliation(s)
- William C Fix
- Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | | | - Anokhi Jambusaria
- Division of Dermatology, Department of Internal Medicine, University of Texas Austin, Dell Medical School, Austin, Texas
| | - Rosalie Elenitsas
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily Chu
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeremy R Etzkorn
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Thuzar M Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christopher J Miller
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Lee TK, Jung TY, Baek HJ, Kim SK, Lee KH, Yun SJ. Disseminated juvenile xanthogranuloma occurring after treatment of Langerhans cell histiocytosis: a case report. Childs Nerv Syst 2018; 34:765-770. [PMID: 29209883 DOI: 10.1007/s00381-017-3675-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
Abstract
CASE PRESENTATION An 11-year-old boy presented with a complaint of a painful temporal mass. Brain magnetic resonance imaging (MRI) showed a 3-cm-sized, homogeneously enhancing mass in the greater wing of the left sphenoid bone, which was diagnosed as Langerhans cell histiocytosis (LCH). Chemotherapy with vincristine and prednisolone was performed for 1 year. After 1 year and 11 months off treatment, he developed symptoms such as polydipsia and polyuria. Brain MRI showed thickening of the pituitary stalk with enhancement, suggestive of LCH involvement, and no recurrence in the sphenoid bone. After 4 years and 4 months off treatment, he developed multiple, subcutaneous, asymptomatic, and yellowish variable-sized papules on his face, posterior neck, and back, which were pathologically diagnosed as juvenile xanthogranuloma (JXG). Brain MRI revealed multifocal enhancing skull lesions in the left parietal, right frontal, and left occipital bones, which were also diagnosed as JXG. After 5 years and 8 months off treatment, the number of variable-sized skin lesions was increased without changes in the lesions in the skull and pituitary stalk. CONCLUSION We report a case of disseminated JXG occurring after treatment of LCH. These clinical co-presentations suggested a close relationship between their pathogenesis.
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Affiliation(s)
- Tae-Kyu Lee
- Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea
| | - Tae-Young Jung
- Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea.
| | - Hee-Jo Baek
- Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea.
| | - Seul-Kee Kim
- Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung-Hwa Lee
- Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
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Moon KR, Choi YD, Kim JM, Jin S, Shin MH, Shim HJ, Lee JB, Yun SJ. Genetic Alterations in Primary Acral Melanoma and Acral Melanocytic Nevus in Korea: Common Mutated Genes Show Distinct Cytomorphological Features. J Invest Dermatol 2018; 138:933-945. [PMID: 29191620 DOI: 10.1016/j.jid.2017.11.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/31/2017] [Accepted: 11/14/2017] [Indexed: 12/18/2022]
Abstract
Acral melanoma occurring on the palms, soles, and nails is the most common subtype of cutaneous melanoma in Asians. Genetic alterations in acral melanoma and acral melanocytic nevus are not well known. We performed next-generation sequencing and evaluated the correlations between genetic information and the clinicopathologic characteristics from 85 Korean patients with acral melanocytic neoplasms. Of the 64 patients with acral melanoma, most had lesions at the T2 stage or higher, and the heel was the most common anatomical site of melanoma (n = 34 [53.1%]). The five most common mutations were BRAF (22 [34.4%]), NRAS (14, [21.9%]), NF1 (11, [17.2%]), GNAQ (12, [17.2%]), and KIT (7, [10.9%]). In the 21 acral melanocytic nevi, those five gene mutations were also common. Copy number variations were also frequently detected in 75% of acral melanomas and 47.6% of acral melanocytic nevi, and amplification was more common than deletion in both lesions. BRAF mutation was associated with round epithelioid cells and NRAS and NF1 mutations with bizarre cells. NF1 and GNAQ mutations showed elongated and spindle cells with prominent dendrites in acral melanomas. KIT mutations were common in amelanotic acral melanoma. This study suggests that common mutated genes are associated with distinct cytomorphological features in acral melanocytic lesions.
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Affiliation(s)
- Ki Rang Moon
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Jung Min Kim
- Department of Pharmacology, Chonnam National University Medical School, Gwangju, South Korea
| | - Suna Jin
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Hyun-Jeong Shim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea.
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Kim SK, You HR, Kim SH, Yun SJ, Lee SC, Lee JB. Skin photorejuvenation effects of light-emitting diodes (LEDs): a comparative study of yellow and red LEDs in vitro and in vivo. Clin Exp Dermatol 2018; 41:798-805. [PMID: 27663159 DOI: 10.1111/ced.12902] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Red-coloured light-emitting diodes (LEDs) can improve skin photorejuvenation and regeneration by increasing cellular metabolic activity. AIM To evaluate the effectiveness of visible LEDs with specific wavelengths for skin photorejuvenation in vitro and in vivo. METHODS Normal human dermal fibroblasts (HDFs) from neonatal foreskin were cultured and irradiated in vitro by LEDs at different wavelengths (410-850 nm) and doses (0-10 J/cm(2) ). In vivo experiments were performed on the skin of hairless mice. Expression of collagen (COL) and matrix metalloproteinases (MMPs) was evaluated by semi-quantitative reverse transcription PCR (semi-qRT-PCR), western blotting and a procollagen type I C-peptide enzyme immunoassay (EIA). Haematoxylin and eosin and Masson trichrome stains were performed to evaluate histological changes. RESULTS In HDFs, COL I was upregulated and MMP-1 was downregulated in response to LED irradiation at 595 ± 2 and 630 ± 8 nm. In the EIA, a peak result was achieved at a dose of 5 J/cm(2) with LED at 595 ± 2 nm. In vivo, COL I synthesis was upregulated in a dose-dependent manner to both 595 and 630 nm LED irradiation, and this effect was prolonged to 21 days after a single irradiation with a dose of 100 J/cm(2) . These histological changes were consistent with the results of semi-qRT-PCR and western blots. CONCLUSION Specific LED treatment with 595 ± 2 and 630 ± 8 nm irradiation was able to modulate COL and MMPs in skin, with the effects persisting for at least 21 days after irradiation. These findings suggest that yellow and red LEDs might be useful tools for skin photorejuvenation.
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Affiliation(s)
- S K Kim
- Namak Oracle Dermatology Clinic, Gwangju, Jeollanam-do, Korea
| | - H R You
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - S H Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - S J Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - S C Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - J B Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.
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You HR, Ju JK, Yun SJ, Lee JB, Kim SJ, Won YH, Lee SC. Paraneoplastic Pyoderma Gangrenosum Associated with Rectal Adenocarcinoma. Ann Dermatol 2018; 30:79-82. [PMID: 29386837 PMCID: PMC5762481 DOI: 10.5021/ad.2018.30.1.79] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/05/2017] [Accepted: 06/08/2017] [Indexed: 11/08/2022] Open
Abstract
Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis characterized by painful necrotic ulceration. The most common diseases associated with PG are inflammatory bowel disease, certain rheumatologic and hematologic diseases, and malignancy. Here, we describe the case of a 60-year-old man who presented with pruritic and painful erythematous ulcerative macules and patches on both lower extremities, and was diagnosed with PG based on his clinical and histologic features. His PG became exacerbated despite standard therapy with a high-dose systemic steroid in combination with dapsone and cyclosporine. Systemic evaluation of underlying conditions revealed rectal adenocarcinoma at the rectosigmoid junction (T3N0M0), which was completely removed via Hartmann's procedure followed by adjuvant chemotherapy. Two months after anticancer therapy, his PG was completely healed with hypertrophic scarring. Herein, we present the first case of paraneoplastic PG caused by rectal adenocarcinoma in Korea.
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Affiliation(s)
- Hye Rin You
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Kyun Ju
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seong-Jin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Lee SS, Ahn JS, Yun SJ, Park DJ. Successful treatment of a patient with myelodysplastic syndrome accompanied by pyoderma gangrenosum and Behçet's disease using allogeneic stem cell transplantation. Blood Res 2017; 52:319-321. [PMID: 29333411 PMCID: PMC5762745 DOI: 10.5045/br.2017.52.4.319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/05/2017] [Accepted: 05/25/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Seung-Shin Lee
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jae-Sook Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Dong-Jin Park
- Division of Rheumatology, Chonnam National University Hwasun Hospital, Hwasun, Korea
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Jeon HW, Yun SJ, Lee SC, Won YH, Lee JB. Mortality and Comorbidity Profiles of Patients with Bullous Pemphigoid in Korea. Ann Dermatol 2017; 30:13-19. [PMID: 29386827 PMCID: PMC5762471 DOI: 10.5021/ad.2018.30.1.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/18/2017] [Accepted: 05/02/2017] [Indexed: 12/26/2022] Open
Abstract
Background Bullous pemphigoid (BP) is a common autoimmune-mediated blistering skin disease that is significantly associated with mortality and morbidity. However, few studies regarding the mortality and comorbidity profiles of BP have been reported in Korea. Objective To evaluate and compare the mortality, comorbidity profiles, and risk factors between patients with BP who visited our clinic and an age-matched general population of Korea. Methods We retrospectively evaluated 103 patients diagnosed with BP between 2006 and 2013 at Chonnam National University Hospital in Gwangju, Korea. Results The 1-year, 2-year, and 5-year mortality rates of the patients were 18.44%, 28.16%, and 42.00%, respectively. The median age was 76 years (range, 41~96 years). The standardized mortality ratio of patients with BP was 1.83 times that of the age- and sex-matched general population of Korea. Old age at the time of diagnosis, cardiac disease and renal disease were associated with increased 5-year mortality. In addition, the prevalence of diabetes, stroke, dementia, and Parkinson's disease was higher among BP patients than in the general population. Conclusion The mortality rate of patients with BP is higher than that of the general Korean population. Korean patients with BP are more likely to have dementia, Parkinson's disease, diabetes, and stroke. Risk factors for increased 5-year mortality include old age at the time of diagnosis and medical comorbidities, especially cardiac disease and renal disease.
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Affiliation(s)
- Hyeon Woo Jeon
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Kim NH, Choi YD, Seon HJ, Lee JB, Yun SJ. Anatomic mapping and clinicopathologic analysis of benign acral melanocytic neoplasms: A comparison between adults and children. J Am Acad Dermatol 2017; 77:735-745. [DOI: 10.1016/j.jaad.2017.02.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 11/15/2022]
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Kim JY, Kim MB, Park BC, Chung KY, Kim YC, Yun SJ, Won CH, Han MH, Lee WK, Lee SJ. Proximal nail plate destruction in subungual melanoma could be a possible predictor of invasiveness thicker than 1.25 mm. J Dermatol 2017; 45:83-86. [DOI: 10.1111/1346-8138.14027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 07/30/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Jun Young Kim
- Department of Dermatology; Kyungpook National University School of Medicine; Daegu Korea
| | - Moon-Bum Kim
- Department of Dermatology; Pusan National University School of Medicine; Busan Korea
| | - Byung Cheol Park
- Department of Dermatology; College of Medicine; Dankook University; Cheonan Korea
| | - Kee Yang Chung
- Department of Dermatology; Severance Hospital; Yonsei University College of Medicine; Seoul Korea
| | - You Chan Kim
- Department of Dermatology; Ajou University School of Medicine; Suwon Korea
| | - Sook Jung Yun
- Department of Dermatology; Chonnam National University Medical School; Gwangju Korea
| | - Chong Hyun Won
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Man-Hoon Han
- Department of Pathology; Kyungpook National University School of Medicine; Daegu Korea
| | - Won Kee Lee
- Center of Biostatistics; Kyungpook National University School of Medicine; Daegu Korea
| | - Seok-Jong Lee
- Department of Dermatology; Kyungpook National University School of Medicine; Daegu Korea
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You HR, Yun SJ, Kim SJ, Lee SC, Won YH, Lee JB. Three Cases of Autoimmune Progesterone Dermatitis. Ann Dermatol 2017; 29:479-482. [PMID: 28761298 PMCID: PMC5500715 DOI: 10.5021/ad.2017.29.4.479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 09/30/2016] [Accepted: 10/28/2016] [Indexed: 11/25/2022] Open
Abstract
Autoimmune progesterone dermatitis is a rare cyclic premenstrual reaction to progesterone produced during the luteal phase of the menstrual cycle. The clinical symptoms of autoimmune progesterone dermatitis overlap with other forms of dermatosis such as erythema multiforme, eczema, fixed drug eruption, urticaria, and angioedema. We experienced 3 cases of autoimmune progesterone dermatitis. All patients had a recurrent history of monthly skin eruptions. Skin lesions normally began a few days before menstruation and resolved a few days later. Patients were confirmed to have autoimmune progesterone dermatitis by the results of the progesterone intradermal test. All three patients had different clinical findings such as erythema annulare centrifugum, urticaria, contact dermatitis, and rosacea. Because patients presented with variable clinical manifestations, they could have been easily misdiagnosed. The patients were treated with oral contraceptive, antihistamine and steroids for symptom control. We propose that dermatologists should consider autoimmune progesterone dermatitis in cases of recurrent cyclic skin eruptions in female patients. Further, if this condition is suspected, thorough history taking including that on menstrual cycle and intradermal progesterone test should be performed.
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Affiliation(s)
- Hye Rin You
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Jin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Bae SH, Yun SJ, Lee JB, Kim SJ, Lee SC, Won YH. Papulonecrotic Tuberculid: A Rare Skin Manifestation in a Child with Mesenteric Tuberculous Lymphadenopathy. Acta Derm Venereol 2017; 97:137-138. [PMID: 27304887 DOI: 10.2340/00015555-2486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Soo Hyeon Bae
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Abstract
Rhinophyma results from hyperplasia of the sebaceous glands and connective tissue. Clinical features in Asian rhinophyma patients are largely underreported. In this study, we aimed to evaluate the clinical features of rhinophyma in Korean patients. We reviewed clinical photos and medical records of 39 Korean patients diagnosed with rhinophyma and assessed the severity and clinical course by using the classical National Rosacea Society index. The male : female ratio was 6.8:1, and over 90% of the patients were older than 40 years. The mild-grade rhinophyma was the most dominant (46.1%), followed by the moderate (41.0%) and severe (12.8%) grades. Disease progression to severe grade occurred over an average of 8.2 years. Furthermore, 70% of all cases revealed lesion distribution limited to the nose. As disease severity progressed to higher grades, the extent of nasal involvement increased (Pearson correlation coefficient, 0.685). Rhinophyma is a slowly progressing disease showing male predominance unrelated to specific trigger factors. In many cases, this disease often exclusively affects the nose in Asian patients.
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Affiliation(s)
- Na Hee Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Kim YJ, Yun SJ, Lee JB, Kim SJ, Won YH, Lee SC. Four Years Prospective Study of Natural History of Atopic Dermatitis Aged 7~8 Years at an Individual Level: A Community-Based Survey by Dermatologists' Skin Examination in Childhood. Ann Dermatol 2016; 28:684-689. [PMID: 27904266 PMCID: PMC5125948 DOI: 10.5021/ad.2016.28.6.684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/11/2016] [Accepted: 02/29/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The age-dependent change in atopic dermatitis (AD) at an individual level has mostly performed in a hospital-setting. OBJECTIVE We evaluated the age-dependent change of AD symptoms at an individual level in a community-setting. METHODS For the diagnostic accuracy, all participants of schoolchildren were received skin examination by dermatologists (twice a year for the same group), instead of questionnaire-based surveys. For this study, sequential check-ups of 273 elementary school children, aged 7~8 years, were performed for 4 years up to the age of 10~11 years. RESULTS Among the 47 AD children, who had been diagnosed as having AD at the first-year check-up, spontaneous remission was detected in nine children during the follow-up periods (remission rate of 19.1%). As a consequence, the one-year AD prevalence was decreased by 5.9% in the elementary schoolchildren over four years. Unexpectedly, late onset (after 8 years of age) AD was observed in 21.7% of AD children. There was no statistically significant relationship between spontaneous remission and host factors including sex and family history of atopic diseases. CONCLUSION We observed that 19.1% of AD children in the age group of 7~11 years showed spontaneous remission based on skin examination by dermatologists. There might be an increase in the prevalence of late onset AD in Korea.
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Affiliation(s)
- Young Jee Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seong Jin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Lee HJ, Yun SJ, Lee SC, Lee JB. A Case of Linear IgA Bullous Dermatosis Associated with Systemic Lupus Erythematosus. Ann Dermatol 2016; 28:660-662. [PMID: 27746656 PMCID: PMC5064206 DOI: 10.5021/ad.2016.28.5.660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/20/2015] [Accepted: 09/23/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ho-June Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung-Chul Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Jee-Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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Lee JB, Bae SH, Moon KR, Na EY, Yun SJ, Lee SC. Light-emitting diodes downregulate cathelicidin, kallikrein and toll-like receptor 2 expressions in keratinocytes and rosacea-like mouse skin. Exp Dermatol 2016; 25:956-961. [DOI: 10.1111/exd.13133] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Jee-Bum Lee
- Department of Dermatology; Chonnam National University Medical School; Gwangju South Korea
| | - Soo Hyeon Bae
- Department of Dermatology; Chonnam National University Medical School; Gwangju South Korea
| | - Ki Rang Moon
- Department of Dermatology; Chonnam National University Medical School; Gwangju South Korea
| | - Eui Young Na
- Department of Dermatology; Chonnam National University Medical School; Gwangju South Korea
| | - Sook Jung Yun
- Department of Dermatology; Chonnam National University Medical School; Gwangju South Korea
| | - Seung-Chul Lee
- Department of Dermatology; Chonnam National University Medical School; Gwangju South Korea
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Abstract
Malignant melanoma is a rare disease in Asians but potentially the most aggressive form of skin cancer worldwide. It can occur in any melanocyte-containing anatomic site. Four main cutaneous melanoma subtypes are recognized: lentigo maligna melanoma, superficial spreading melanoma, acral lentiginous melanoma (ALM), and nodular melanoma. Generally, excessive exposure to ultraviolet (UV) radiation increases the risk of melanoma. The exception is ALM, which is the most common melanoma subtype in Asians and is not associated with UV radiation. ALM presents as dark brownish to black, irregular maculopatches, nodules, or ulcers on the palms, soles, and nails. The lesions may be misdiagnosed as more benign lesions, such as warts, ulcers, hematomas, foreign bodies, or fungal infections, especially in amelanotic acral melanomas where black pigments are absent. The aim of this brief review is to improve understanding and the rate of early detection thereby reducing mortality, especially regarding cutaneous melanoma in Asians.
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Affiliation(s)
- Sang Yub Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
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