• Archives of Plastic Surgery
• /
• v.50 no.4
• /
• pp.384-388
• /
• 2023

Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant disease characterized by multisystemic developmental defects caused by pathogenic variants such as patched-1 (PTCH1) gene variants and/or SUFU gene variants. The presence of either two main criteria or one major and two minor criteria are required for the diagnosis of Gorlin-Goltz syndrome. Recently, a major criterion for molecular confirmation has also been proposed. In this article, we report the case of an 80-year-old male who was admitted at our department for multiple brown-to-black papules and plaques on the entire body. He was diagnosed with Gorlin-Goltz syndrome with clinical, radiologic, and pathologic findings. While the diagnosis was made based on the clinical findings in general, confirmation of the genetic variants makes an ideal diagnosis and suggests a new treatment method for target therapy. We requested a genetic test of PTCH1 to ideally identify the molecular confirmation in the hedgehog signaling pathway. However, no pathogenic variants were found in the coding region of PTCH1, and no molecular confirmation was achieved.

• Archives of Craniofacial Surgery
• /
• v.24 no.3
• /
• pp.139-142
• /
• 2023

Fibrofolliculoma is a benign, perifollicular, connective tissue tumor that usually arises in the form of multiple lesions; it is rarely seen as a solitary lesion. The lesions are clinically asymptomatic, 2 to 4 mm skin-colored, soft dome-shaped papules. Here, we report a patient who visited our hospital with a palpable lesion on the nasal septum. The lesion did not cause pain upon palpation, and nasal endoscopy confirmed an irregular wart-like lesion measuring 6×6 mm in the left anterior nasal septum near the columella. Other otolaryngology findings were normal, and there were no similar lesions in other parts of the body. None of the patient's family members were known to have had such lesions. An excisional biopsy was performed on the mass for removal of the lesion, and histological examination confirmed the lesion as fibrofolliculoma. We report the first case of solitary fibrofolliculoma in the nasal septum in a healthy 62-year-old woman along with a review of the relevant literature.

• Clinical Pain
• /
• v.18 no.1
• /
• pp.48-51
• /
• 2019

Symmetrical proximal weakness and characteristic dermatologic manifestations are important in the diagnosis of dermatomyositis. We report a case of atypical presentation of dermatomyositis due to previous steroid use and also report steroid-induced myopathy which may occur from steroid administration during the course of treatment. A 77-year-old man, previous steroid user, showed rapidly progressing weakness after abruptly stopped medication. He has presented erythematous papule on face and anterior chest but no heliotrope rash and Gottron's papules were observed. Muscle enzyme (creatine kinase) concentration is increased, and needle electromyography shows increased spontaneous activity on proximal limb muscle. The muscle biopsy confirmed dermatomyositis. During the course of treatment, he revealed persistent weakness despite the continuous steroid use and stable creatine kinase level. Electrodiagnostic study suggests steroid-induced myopathy and after tapering steroid, proximal muscle strength improved. This case reports the effect of steroid use on dermatomyositis patients and a process of diagnosing coexisting steroid induced myopathy during treatment.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.22 no.3
• /
• pp.228-236
• /
• 2009

Objectives : Acne, one of the most common disorders in dermatology clinic, is a chronic inflammatory disease which has the symptoms of comedones, papules, pustules, cysts, nodules and scars mainly on the face. Although some of pathologic findings are suggested, but the exact causes and mechanisms are not yet known in Western Medicine. Hwangryeonhaedok-Tang(HRHDT) is an antiinflammatory, antipyretic and detoxifying herb decoction. In this report, we would like to share our experience of acne treatment with HRHDT. Methods : We had treated several patients with acne, facial flushing and uprising febrile sensation on face using oral administration and external application of HRHDT. HRHDT is basically made up with Scutellariae Radix, Coptidis Rhizoma, Phellodendri Cortex and Gardeniae Fructus. In this trial, several other herbs were added according to the individual patient's accompanying symptoms. After the decoction of herbs in amount for 10 days, $Yogourmet^{(R)}$ Kefir Starter 10 g was added to the herbal solution that was then fermented in an incubator at $25^{\circ}C$ for 72 hours, and divided into 30 doses. Results : Photographies were taken before and after the treatment. The severities of acne were evaluated with these photos according to the Korean Acne Grading System(KAGS). As results, we observed dramatic clinical improvements and the decreases of KAGS grades after the average treatment period of 8 weeks. The medication was orally administered 3 times a day and the external treatment was applied average twice a week during the whole treatment period. Conclusions : From these results, HRHDT may be considered as a good prescription for the febrile and toxic type of acne patients.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.13 no.2
• /
• pp.140-151
• /
• 2000

Acne is a common chronic disease which most frequently affects the face, appearing in both males and females near puberty, and in most cases becomes less active as adolescence ends. The intensity and duration of activity vary for each individual. The disease may be minor, with only a few comedones or papules, or it may occur as the highly inflammatory and diffusely scarring acne conglobation. Permanent scarring of the skin and psyche can result from such inaction. The disease, however, has implications far beyond the few marks that may appear on the face. The lesions cannot be hidden under clothing; each is prominently displayed and detracts significantly from one's personal appearance and self-esteem. Recently many of acne patients are visiting to Oriental Medicine Hospitals. They want to receive the treatment of acne related another disease and causes, or worry about side effects of antibiotics and hormone therapy. This study was performed at Pundang Cha Oriental Medicine Hospital Department of Dermatology from March 1, 1997 to February 29, 2000 in 31 patients with recurrent acne. We investigated the clinical findings, included distribution of age & sex, severity of acne, sites on face, related causes, duration of disease and causes of visiting Oriental Medicine Hospital and so on. The results were as follows : The peak age at onset was 20-29 years old in females with 16 cases reported. The 22 total cases patients had severe signs with most frequently sites being forehead & chin. They visited Oriental Medicine Hospital because they want to take the treatment of acne related with another body problems(12 cases) and worry about side effects of antibiotics. Twenty cases were diagnosed 肺熱血熱(20 cases). And given acupuncture treatment, herb-medication and sometimes we used external applications. Relatively, their satisfaction grade was high. Dermatologists are trying to treat new methods in order to remove scar and decrease sebaceous gland secretion,. And we, Oriental Medicine doctors, have to develop and offer to patients the most effective management and successful treatment of this disease.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.34 no.1
• /
• pp.45-52
• /
• 2020

This paper suggested MyeonGu(面垢), symptom of Baekho-tang(白虎湯) in text 219 of Shang-Han-Lun(傷寒論), could be reinterpreted. There were 4 cases, 1 case on atopic dermatitis and 3 cases on psoriasis. All of them were diagnosed by Ying-Ming-Bing(陽明病) symptom. After taking Baekho-tang, SCORAD index of atopic dermatitis in case 1 improved 62.8 to 12.8 and PASI score of psoriasis in case 2, 3, and 4 improved 13.0 to 2.4, 10.8 to 0.8, and 8.6 to 1.0 respectively. Since Baekho-tang was effective for certain skin disease with Ying-Ming-Bing(陽明病) symptom, MyeonGu could be related on skin problem. MyeonGu was mainly translated in 'someone's face seems to be covered with dirt'. However if Myeon(面) is translated in 'surface of the body' and Gu(垢) is translated in 'inflammation', it means the surface of the body suffered from papules, erythema, white scales, etc. These are features of chronic inflammatory cutaneous disease like atopic dermatitis and psoriasis. This study is meaningful in case of giving specific clinical case of MyeonGu of Baekhotang text of Shanghanlun.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.18 no.1
• /
• pp.199-220
• /
• 2005

Objective : This study was performed to investigate the effects of Sophorae Radix and Coptidis Rhizoma-iontophoresis in allergic contact dermatitis. Methods : Contact hypersensitivity assay, video microscope, melanin-erythema levels, pH levels, hydration levels, WBC count, RBC count, neutrophil ratio, lymphocyte ratio and total IgE levels were measured. Results : At contact hypersensitivity assay, the right ear swellings in Sophorae Radix and Coptidis Rhizoma-iontophoresis group were decreased compared with control group, but have no statistical significance. At observation of skin morphologic change, many papules were seen in control group and keratins were seen in Sophorae Radix-iontophoresis group. At melanin levels, Sophorae Radix and Coptidis Rhizoma-iontophoresis groups showed no significant difference compared with control group. At pH levels, Sophorae Radix-iontophoresis group showed significant decreased with control group. At hydration levels, Sophorae Radix and Coptidis Rhizoma-iontophoreses groups showed to significant difference compared with control group. WBC count, RBC count and neutrophil ratio were significantly increased in Sophorae Radix and Coptidis Rhizoma-iontophoresis group compared with control group. Lymphocyte ratio and total IgE levels were significantly decreased in Sophorae Radix and Coptidis Rhizoma-iontophoresis groups compared with control group. At morphology of skin, inflammation was decreased and the thickness of epidermis was well preserved in Sophorae Radix and Coptidis Rhizoma-iontophoresis group. Conclusion : Sophorae Radix and Coptidis Rhizoma-iontophoresis had some anti-allergy, anti-inflammatory effects on allergic contact dermatitis, but had no effects on melanin-erythema levels, pH levels and hydration levels of skin.

• Tuberculosis and Respiratory Diseases
• /
• v.62 no.6
• /
• pp.536-539
• /
• 2007

Lymphadenitis is a common manifestation in tuberculous diseases. However, papulonecrotic tuberculid is an uncommon cutaneous manifestation, and is considered an allergic reaction against tuberculous bacilli in tuberculous lesions other than the lymph nodes. A wide great variety of cutaneous manifestations arise over a period of a few weeks - i.e., papules, necrosis, crusted and atrophic scars. We described a 27-year-old woman with right cervical tuberculous lymphadenitis and skin lesions involving her arms, legs and both fingers. Histopathologically, a leukocytoclastic vasculitis with V-shaped epidermal necrosis was observed in the upper and deep dermis, including the good response to anti-tuberculosis therapy support the diagnosis of papulonecrotic tuberculid.

• Journal of Veterinary Clinics
• /
• v.22 no.2
• /
• pp.153-156
• /
• 2005

A 5-year-old, female Poodle and her daughter, 2-year-old, were referred to Konkuk University Veterinary Teaching Hospital (KVTH) due to discoloration of hair on dorsum, and generalized alopecia following clipping. Some papules and pustules are found on patch area. Complete blood counts and serum chemistry profiles were not remarkable. Trichogram revealed that melanin-granule was pigmented on hair bulb and shaft in affected area and no melanin pigmentation was noted in non-patch area. And skin biopsy showed mild epidermal hyperplasia and mild inflammation in dermis of the patch area. This case report indicates that melanotrichia can be occurred by postclipping inflammation. However, the mechanism of melanocyte proliferation and rates of melanogenesis in response to postclipping remains to be unclear in these cases.

• Journal of Veterinary Clinics
• /
• v.28 no.5
• /
• pp.538-541
• /
• 2011

An 8-year-old spayed Yorkshire Terrier Dog was presented to the Veterinary Teaching Hospital of Kyungpook National University because of the recurrent superficial pyoderma. At the presentation, pustules and papules were present throughout the body. Numerous rods with a few cocci were observed on impression smears and they were confirmed to be Proteus mirabilis and Staphylococcus pseudointermedius consecutively. The patient was treated with systemic enrofloxacin and amoxicillin-clavulanic acid based on the results of antimicrobial sensitivity tests with once a week basis 4% chlorhexidine shampoo. An excellent clinical response was achieved in 2 weeks of therapy and the lesions were fully resolved in 6 weeks. The possibility of P. mirabilis infection should not be overlooked by clinicians in dogs with recurrent superficial pyoderma although it's been considered to be rare.