Dong Hyuk Eun

Coexistence of psoriasis and epidermolysis bullosa acquisita: Evaluation of the integrity of the basement membrane

1. Roh NK, Hahn HJ, Lee YW, Choe YB, Ahn KJ. Clinical and histopathological investigation of seborrheic keratosis. Ann Dermatol. 2016; 28:152-158. 2. Neuhaus IM, LeBoit PE, McCalmont TM. Seborrheic keratosis with basal clear cells: a distinctive microscopic mimic of melanoma in situ. J Am Acad Dermatol. 2006;54:132-135. 3. Haspeslagh M, De Schepper S, De Wispelaere I, Degryse N. Seborrheic keratosis with basal clear cells: a peculiar microscopic mimic of melanoma in situ. J Cutan Pathol. 2013;40:768-769. 4. Takashi A, Takaya F, Tetsunori K. Two cases of seborrheic keratosis with basal clear cells. J Dermatol. 2017;44(3):339-342. https://doi.org/ 10.1111/1346-8138.13641. 5. Barr RJ, Alpern KS, Santa Cruz DJ, Fretzin DF. Clear cell basal cell carcinoma: an unusual degenrative variant. J Cutan Pathol. 1993; 20:308-316. 6. Gaertner EM. Incidental cutaneous reaction patterns: epidermolytic hyperkeratosis, acantholytic dyskeratosis, and Hailey-Hailey-like acantholysis: a potential marker of premalignant skin change. J Skin Cancer. 2011;2011:645743. https://doi.org/10.1155/2011/645743. 7. Lacz NL, Schwartz RA, Kihiczak G. Epidermolytic hyperkeratosis: a keratin 1 or 10 mutational event. Int J Dermatol. 2005;44:1-6.

Long-Term Prognosis of Alopecia Totalis and Alopecia Universalis: A Longitudinal Study with More than 10 Years of Follow-Up: Better than Reported

Background: In alopecia totalis (AT) and alopecia universalis (AU), the chance of full hair regrowth is known to be less than 10%. However, this information is based on a few older studies conducted in the 1950s and 1960s. Objective: We investigated the current long-term prognosis of individuals with AT/AU. Methods: A retrospective chart review was performed in patients with AT/AU between 1994 and 2005. Outcome data were collected by reviewing outpatient clinical files or by phone interviews. Finally, the long-term assessment of 70 patients with valid outcome data was performed. Results: Twelve out of 70 patients with AT/AU (17.1%) had complete hair regrowth. Five out of 24 patients with AT (20.8%) showed complete hair regrowth, and 7 of 46 patients with AU (15.2%) achieved complete regrowth. Seventeen out of 70 patients with AT/AU (24.2%) reported hair regrowth greater than or equal to 90%. Thirty patients with AU (65.2%) remained in an alopecic state without improvement, while 5 patients with AT (20.8%) showed no hair regrowth. Conclusion: Our results suggest that the long-term prognosis of AT/AU is more favorable than previously thought. However, the clinical burden of AT/AU is still substantial.

Treatment of paediatric facial pyogenic granuloma with topical ingenol mebutate.

Pyogenic granuloma (PG), also known as lobular capillary haemangioma, is a relatively common benign vascular lesion of the skin and mucosa. Although spontaneous resolution may occur, treatment is often recommended to avoid ulceration and recurrent bleeding. In young children, local ablative therapies for PG include cryosurgery and laser treatment, but their use in dangerous or problematic lesions in areas such as the face may lead to cosmetic complications. Therefore, safe and effective options for treatment of facial PG in children are needed. A 4-year-old boy presented with a 3-month history of a solitary, vivid red, matchhead-sized, pedunculated papule on his left cheek, which was clinically diagnosed as PG. The patient was prescribed ingenol mebutate 0.015% cream, to be applied to the lesion once daily for 3 days. The patient returned to the clinic after 1 week with minor redness and irritation of the skin, but improvement of the lesion. The patient continued treatment once daily for another 3 days, with resolution of the lesion (Fig. 1). There were no signs of recurrence after 5 months of follow-up. Topical application of ingenol mebutate induces both chemoablative and immunostimulatory effects. A previous study also showed that the use of ingenol mebutate led to a reduction of vascularization in the lesion, as demonstrated by a decrease in median haemoglobin levels in treated areas. These immunomodulatory and antiangiogenetic properties of ingenol mebutate suggest that a therapeutic effect is likely in PG. The most consistently reported adverse effects of ingenol mebutate are erythema, flakiness, crusting, pruritus, and pain, with effects peaking between days 3 and 8 and mostly resolving by day 15. Severe skin reactions may include swelling, postulation, and ulceration. No persistent systemic absorption was reported during long-term followup. Our patient had minor redness and irritation at the site of application, which resolved spontaneously without any other treatment. Application of ingenol mebutate to children requires medical supervision or it can be done at home by the parents. Although the precise cost analysis of relevant comparators for PG treatment may be difficult due to differences between countries, topical ingenol mebutate is more expensive than topical timolol; however, relatively longterm treatment with a month of twice-daily use is required with timolol. Ingenol mebutate is also more expensive than cryotherapy and laser therapy; however, these treatments are associated with pain, scarring and local adverse effects, which can represent a challenge when dealing with paediatric patients. In conclusion, we report a patient with facial PG successfully treated with ingenol mebutate. Our case suggests that because of its short-term application, ingenol mebutate may be considered as a meaningful option for uncooperative paediatric patients who may be afraid of treatment, especially on facial and other exposed lesions causing unexpected cosmetic complications. Further studies are needed to clarify the underlying mechanism of action of ingenol mebutate, and to confirm its effectiveness in PG.

Tinea Faciei in a Mother and Daughter Caused by Arthroderma benhamiae

Vol. 30, No. 2, 2018 241 Received December 27, 2016, Revised March 15, 2017, Accepted for publication April 9, 2017 Corresponding author: Weon Ju Lee, Department of Dermatology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5838, Fax: 82-53-426-0770, E-mail: weonju@knu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

Facial Eruptive Vellus Hair Cysts Occurred after 3% Minoxidil Application

Vol. 30, No. 1, 2018 95 Received November 29, 2016, Revised December 19, 2016, Accepted for publication December 23, 2016 Corresponding author: Weon Ju Lee, Department of Dermatology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5838, Fax: 82-53-426-0770, E-mail: weonju@knu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

The Polyonychia and Distal Phalangeal Bone Underdevelopment on Right Second Toe

Vol. 30, No. 1, 2018 105 Received September 19, 2016, Revised December 26, 2016, Accepted for publication January 18, 2017 Corresponding author: Weon Ju Lee, Department of Dermatology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5838, Fax: 82-53-426-0770, E-mail: weonju@knu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

A Case of Phaeohyphomycosis on the Wrist: Identification of Exophiala spinifera in Korea

232 Ann Dermatol Received December 27, 2016, Revised March 26, 2017, Accepted for publication March 28, 2017 Corresponding author: Weon Ju Lee, Department of Dermatology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5838, Fax: 82-53-426-0770, E-mail: weonju@knu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright

Foreign body reaction three years after injection with polycaprolactone (Ellanse

Filler injections are commonly performed for facial rejuvenation and volume replacement. Injectable polycaprolactone (PCL) derivatives are widely used as soft tissue fillers for aesthetic facial enhancement. PCL is a synthetic linear polyester with almost 50% crystallinity, and consists of 6-hydroxyhexanoates. PCL is a soft dermal filler based on PCL microspheres (range: 25-50 μm); it is non-toxic and biodegradable, and is completely excreted from the human body in two stages. The first stage starts [...]

Primary Angiosarcoma of the Skin Presenting as Mild Erythema

Vol. 29, No. 6, 2017 809 Received August 5, 2016, Revised November 7, 2016, Accepted for publication November 9, 2016 Corresponding author: Weon Ju Lee, Department of Dermatology, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5838, Fax: 82-53-426-0770, E-mail: weonju@knu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright