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[P533] Cheilitis granulomatosa successfully treated with roxithromycin
( Kihyuk Shin ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Cheilitis granulomatosa (CG) is characterized by chronic painless swelling of the lip due to non-necrotizing granulomatous inflammation. The treatment of CG is exceedingly difficult. While several therapeutic methods have been applied to CG, there has been no reliable treatment option. A 27-year-old male presented with swelling of the lower lip. The lesion began to develop 1 year previously in the absence of any specific provoking factor and the patient reported no subjective symptom. Histopathology revealed non-caseating granulomas surrounded by lymphocytes and plasma cells, and these findings were consistent with CG. However, no improvement was observed within 1 month of methylprednisolone (8mg/day) or oral cyclosporine (200mg/day). Subsequently, oral roxithromycin (150mg/day) and intralesional corticosteroid therapy (triamcinolone, 10mg, 1-month interval) were initiated and lesions completely subsided within 2 months. However, after the discontinuation of roxithromycin, the lower lip swelling recurred. Readministration of oral roxithromycin (150mg/day) was done, the swelling disappeared gradually. To our knowledge, this is the first report of CG successfully treated with roxithromycin in the Korean dermatologic literature.
[P069] A case of generalized eruptive histiocytosis in an adult
( Kihyuk Shin ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Gun-wook Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Generalized eruptive histiocytosis (GEH) is a rare, generalized, self-limiting cutaneous non-Langerhans cell histiocytosis. It is characterized by an asymptomatic, symmetrical eruption of small tan to reddish papules on the face, trunk, and proximal extremities, which may involute spontaneously. Histology shows a monomorphous histiocytic infiltration without deposition of lipids, iron or mucin. A 36-year-old male presented with a 3-month history of painless, non-pruritic, brown to reddish papules on the face, trunk, and extremities. The patient stated that multiple papules initially appeared on the trunk, subsequently spreading to the face and both extremities. He had been treated with antibiotics and topical steroid under the impression of guttate psoriasis at a local dermatology clinic, but showed no clinical improvement. Histological and immunohistochemical investigation revealed extensive dermal infiltration of monomorphic histiocytes which were positive for CD68, but negative for CD1a and S100. A diagnosis of GEH was established with consideration for clinical, histopathological, and immunohistochemical features. Without any treatment, resolution was observed 10 months after the initial eruption. Although most of GEH is self-limiting, careful follow-up is recommended, as more severe forms of histiocytoses could develop in patients with GEH.
Efficacy and safety of ingenol mebutate gel for the treatment of molluscum contagiosum
( Kihyuk Shin ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyun-chan 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: Conventional treatment options for molluscum contagosum induce some degree of pain and discomfort to the patient with accompanying distress of the parents. Thus, the demand exists for a less painful, rapid, and safe treatment option. Objectives: To evaluate the efficacy and safety of ingenol mebutate gel on molluscum contagiosum. Methods: A total of 10 patients harboring 371 lesions of molluscum contagiosum enrolled. Ingenol mebutate gel 0.015% was applied to the top of the lesion once daily for 3 consecutive days per week until the lesion disappeared. The number of molluscum contagiosum lesions was counted and adverse symptoms were evaluated at all time points. Results: Molluscum contagiosum lesions located on face (30.2%), trunk (32.3%), extremities (34.0%), and genitalia (3.5%) at baseline. The significant reduction in mean number of lesions was observed at week 2 (9.6±13.4) and week 4 (6.6±12.8) compared to baseline (37.1±24.0). Complete regression of lesions was observed in 80% (8/10) of patients within 1.6±0.8 months following treatment. 60% (6/10) of patients experienced postinflammatory hyperpigmentation, however, no significant adverse effects were noted by patients. Conclusion: Destructive treatment such as curettage could be associated with pain and is not well endurable by children, therefore in this case, ingenol mebutate could be a good treatment option.
Shin, Kihyuk,Hong, SeokChan,Choi, Eun-Hye,Lim, Mi-Kyoung,Shim, Seung-Cheol,Ju, Ji-Hyeon,Lee, Seung-Hyo The Korean Association of Immunobiologists 2013 Immune Network Vol.13 No.4
This study was conducted to determine whether CD4 T cell responses to citrullinated fibrinogen occur in patients with rheumatoid arthritis (RA), especially in HLA-DR4-positive subjects. Whole peripheral blood mononuclear cells (PBMCs) of RA patients and control subjects were stimulated with citrullinated fibrinogen peptides, and T-cell production of proliferation and proinflammatory cytokines, such as interferon-${\gamma}$(IFN-${\gamma}$) and interleukin-17A (IL-17A), were measured. In addition, CD4 T cells from RA patients were stimulated with the citrullinated fibrinogen peptide, $Fib-{\alpha}$ R84Cit, identified as a DRB1*0401-restricted T cell epitope in HLA-DR4 transgenic mice, and the degree of T cell activation was examined similarly. No proliferative responses to the citrullinated fibrinogen peptides were observed in whole PBMCs or CD4 T cells from RA patients. Furthermore, no increased production of IFN-${\gamma}$ or IL-17A was found in whole PBMCs or CD4 T cells stimulated with the citrullinated fibrinogen peptides, although these cells responded to recall antigen, a mixture of tetanus toxoid, purified protein derivative (PPD) from Mycobacterium tuberculosis, and Candida albicans. The results of this study indicate that anti-citrulline immunity in RA patients may be mediated by fibrinogen because there is no evidence of CD4 T cell-mediated immune responses to citrullinated fibrinogen peptides.
( Kihyuk Shin ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Congenital melanocytic nevi (CMNs) are melanocytic neoplasm which often exhibit extensive nevomelanocytic infiltration in the dermis. CMN can creates cosmetic disfigurements and there are several treatment options for CMN, including laser treatment, surgical excision, dermabrasion, and chemical peels. The treatment strategy for CMN depends on the location, size, thickness, risk for developing melanoma, and the cosmetic component. Therefore, the management of CMNs is highly dependent on the individual patient. Herein, we report two cases of medium-sized CMNs successfully excised and reconstructed with artificial dermis and split-thickness skin graft (STSG). The first case is a 15-year-old man presented with a 13.4 x 11.5-cm pigmented patch on the left hand dorsum which had been present since birth. Histopathologic findings were consistent with CMN. Even after several times of intense pulsed light treatment, the response was minimal. The second case is a 25-year-old woman with a 8.0 x 4.6-cm pigmented patch on her forehead. The lesion has existed since birth and a biopsy specimen showed features of CMN. In both cases, lesions were surgically removed and skin defects were covered by artificial dermis and STSG. The patients reported satisfaction with the postsurgical cosmetic outcome. We suggest that combined excision and reconstruction with artificial dermis and STSG method will be a good treatment option for managing medium-sized CMNs.
Cuticle as a predictor of the thumbnail growth rate
( Kihyuk Shin ),( Jun-oh Shin ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Growth rate of nails is affected by various conditions. However, little is known about the anatomic factor which can predict the nail growth rate. Objectives: To investigate the anatomic factors that could predict the growth rate of thumbnails. Methods: Twenty-four healthy young adults were enrolled in the study. We marked a line with ultrapulse CO<sub>2</sub> laser on thumbnails at the baseline. Thumbnails were photographed with ruler at the baseline and six weeks after marking. The distance from the mark to the proximal nailfold, and the length of lunula and cuticle was measured by analyzing magnified photos with ImageJ. Results: The female to male ratio was 1.4:1 and the mean age was 30.3 years (24-39 years). Growth rate of dominant hand thumbnails was faster than that of non-dominant hand thumbnails (3.85 vs. 3.28 mm/ month, P < 0.0001). Cuticle length was positively correlated with thumbnail growth rate (r=0.3946 and P=0.0055), and cuticle length of dominant hand thumbnails was longer than that of non-dominant hand thumbnails (P=0.0002). Age, sex, height, weight, body mass index (BMI), length of lunula were not significantly associated with thumbnail growth rate. Conclusion: This study highlights the role of cuticle in predicting thumbnail growth rate. These results could be helpful in the treatment of nail disorders as well as for investigation on medication affecting nail growth rate.
Interplay between Inflammatory Responses and Lymphatic Vessels
Shin, Kihyuk,Lee, Seung-Hyo The Korean Association of Immunobiologists 2014 Immune Network Vol.14 No.4
Lymphatic vessels are routes for leukocyte migration and fluid drainage. In addition to their passive roles in migration of leukocytes, increasing evidence indicates their active roles in immune regulation. Tissue inflammation rapidly induces lymphatic endothelial cell proliferation and chemokine production, thereby resulting in lymphangiogenesis. Furthermore, lymphatic endothelial cells induce T cell tolerance through various mechanisms. In this review, we focus on the current knowledge on how inflammatory cytokines affect lymphangiogenesis and the roles of lymphatic vessels in modulating immune responses.
A novel combination of heterozygous SERPINB7 mutations-induced Nagashima-type palmoplantar keratosis
( Kihyuk Shin ),( Hyunju Jin ),( Hyang Suk You ),( Woo Haing Shim ),( Jeong Min Kim ),( Gun Wook Kim ),( Hoon Soo Kim ),( Byung Soo Kim ),( Moon Bum Kim ),( Hyun Chang Ko ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Nagashima-type palmoplantar keratosis (NPPK) is an autosomal recessive diffuse transgressive palmoplantar keratoderma (PPK). Loss-of-function mutations in SERPINB7 gene have been identified as a cause of NPPK. Until now, seven mutations in the SERPINB7 gene were reported to be responsible for NPPK. Recently, it was reported that NPPK is a common type of PPK in East Asian populations. A 7-month-old male patient exhibited diffuse erythematous hyperkeratotic patch on his palms and soles since he was one month old. The lesions extended onto the dorsal aspect of the hands and feet. A histopathological examination of the skin showed hyperkeratosis and acanthosis. He was suspected to have NPPK and underwent genetic analysis. In SERPINB7 gene, the patient had c.336+2T>G which was reported as a pathogenic mutation. On the other allele, he had c.455-1G>A which was also known as a pathogenic mutation. Herein, we report NPPK with a novel combination of heterozygous mutations in SERPINB7 gene.
Clinical features of nail lichen striatus
( Kihyuk Shin ),( Tae-wook Kim ),( Sung-min Park ),( Hyun-joo Lee ),( Hyunju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2
Background: Lichen striatus is an uncommon, self-limiting linear dermatosis which usually occurs along Blaschko’s lines. Because nail involvement is rare in lichen striatus, nail lichen striatus has not been investigated extensively. Objectives: To investigate the clinical features of nail lichen striatus Methods: We reviewed 16 cases of pathologically confirmed nail lichen striatus from 2007 to 2017 at dermatology department of Pusan National University Hospitals (Busan and Yangsan). Results: The female to male ratio was 1:0.6 and the mean age of onset was 7.2 years (1.5-33 years). All patients had both nail abnormalities and typical skin lesions. In these cases, lichen striatus usually involved a single digit (68.8%, 11/16). The most common nail deformity was longitudinal ridging (87.5%, 14/16) followed by onychoschizia (8/16, 50%), nail thickening (3/16, 18.8%), onychomadesis (3/16, 18.8%), and onycholysis (1/16, 6.3%). We treated both skin and nail lesions with topical tacrolimus ointment. Half of the nail lesions resolved within a mean of 8.3 months (1-16 months) from the initiation of treatment. Conclusion: This study highlights the clinical features of nail lichen striatus on the largest scale until now. These results might be helpful to differentiate nail lichen striatus from other nail disorder.