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대한피부과학회> 대한피부과학회지> 원저 : 건선 환자에서 경구 Cyclosporine 치료 후 재발인자에 대한 연구

KCI등재SCOUPUS

원저 : 건선 환자에서 경구 Cyclosporine 치료 후 재발인자에 대한 연구

Original Article : A Study on the Factors Causing Recurrence of Psoriasis after Cyclosporine Treatment

문성훈 ( Seong Hun Moon ) , 김정은 ( Jeong Eun Kim ) , 고주연 ( Joo Yeon Ko ) , 노영석 ( Young Suck Ro )
  • : 대한피부과학회
  • : 대한피부과학회지 53권4호
  • : 연속간행물
  • : 2015년 05월
  • : 277-283(7pages)

DOI


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Background: Cyclosporine, which is one of the effective systemic treatments for psoriasis, has a rapid therapeutic effect. However, despite the efficacy of cyclosporine, the recurrence of psoriasis may still occur if treatment with this drug is discontinued. Several studies on the efficacy and safety of cyclosporine for psoriasis have already been conducted. However, studies on the factors causing psoriasis recurrence after cyclosporine treatment are rare. Objective: The aim of this study was to identify the factors that cause recurrence of psoriasis in patients treated with cyclosporine. Methods: We performed a retrospective study of the medical records obtained between January 2007 and March 2014 of 174 patients diagnosed with psoriasis and followed up for at least 6 months after treatment. We analyzed the differences in the demographic characteristics, body surface area, psoriasis area and severity index (PASI) score, psoriasis type, accompanying psoriatic nail, involvement of exposed areas, and several treatment-related factors (starting dose, last dose, maximal dose, cumulative dose, mean daily dose, and treatment duration) between the group that experienced a recurrence and the group that did not. Additionally, we analyzed the effects of these factors on the recurrence and the time to recurrence. Results: Of the 174 patients, 57 (32.8%) reported a recurrence of the disease. There were statistically significant differences between the two groups in terms of their PASI score (p=0.031) and mean daily dose (p=0.014). In the multiple logistic regression analysis, the PASI score (p=0.017, odds ratio=1.057) and treatment duration (p=0.035, odds ratio=0.984) showed a significant relation with relapse. Conclusion: This study suggests that long-term treatment with cyclosporine is necessary for high-severity psoriasis in patients to prevent recurrence. However, as this study is retrospective, further prospective and large-scale studies are necessary to confirm this fact. (Korean J Dermatol 2015;53(4):277∼283)

ECN

ECN-0102-2015-500-001976045


UCI

I410-ECN-0102-2015-500-001976045

간행물정보

  • : 의약학분야  > 피부과학
  • : KCI 등재
  • : - / SCOPUS
  • : 월간
  • : 0494-4739
  • :
  • : 학술지
  • : 연속간행물
  • : 1960-2018
  • : 9049


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1종설 : 피부과 PA (Physician Assistant)의 역할과 한계

저자 : 정영인 ( Young-in Jeong ) , 주민숙 ( Mihn-sook Jue ) , 박향준 ( Hyang-joon Park ) , 최광현 ( Kwang-hyun Choi )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 265-269 (5 pages)

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In Korea, physician assistants (PAs) have emerged owing to the shortage of medical residents, especially in the surgical departments of tertiary hospitals. In addition, the Korean Ministry of Health and Welfare has been planning to reduce the number of medical residents. Hence, training hospitals decided to hire PAs to replace medical residents. PAs can perform a large part of residents' time-consuming job. However, PAs are not a common type of workforce in the field of dermatology. The aim of this study is to compare the roles of dermatology specialist, resident, PAs, and registered nurse (RN), and discuss the limitations and futures of PAs in the field of dermatology. Moreover, in Korea, the legal definition and status of PAs are absent or, if present, inconsistent. Between PAs and other positions such as residents, registered nurses, and nurse specialists, lies an unsettled conflict. Therefore, if PAs are employed, a more precise complement is needed. (Korean J Dermatol 2015;53(4):265∼269)

2원저 : 건선환자의 말초혈액 내 CD4+CD25+Foxp3+ Regulatory T 세포와 CD4+CD25.Foxp3+ T 세포 수에 관한 연구

저자 : 송상현 ( Sang Hyun Song ) , 김동진 ( Dong Jin Kim ) , 나찬호 ( Chan Ho Na ) , 김민성 ( Min Sung Kim ) , 신봉석 ( Bong Seok Shin )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 270-276 (7 pages)

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Background: Regulatory T cells (Treg) are able to inhibit the immunological response and maintain cutaneous immunological homeostasis, thus preventing autoimmunity against itself. In several studies, the importance of CD4+CD25+Foxp3+ Treg in psoriasis has been examined, using the peripheral blood of patients. However, limited studies on Treg are available and shows conflicting results. Recently, CD4+CD25.Foxp3+ T cells were identified as being the peripheral reservoir of CD4+CD25+Foxp3+ Treg. Objective: The purpose of this study was to investigate differences in the CD4+CD25+Foxp3+ Treg and CD4+CD25. Foxp3+ T cell counts between patients with psoriasis and normal controls. Methods: For phenotypic analysis, the proportions and absolute cell numbers of CD4+CD25+Foxp3+ Treg and CD4+CD25.Foxp3+ T cells in the peripheral blood were examined by flow cytometry. The correlation between the CD4+CD25+Foxp3+ Treg count and other parameters (age of onset, disease duration, BSA, psoriasis area and severity index score, and clinical stage) was also analyzed. Results: Although the CD4+CD25+Foxp3+ Treg count was slightly increased while the number of CD4+CD25. Foxp3+ T cells was slightly decreased in psoriasis patients than that of the controls, the differences between the groups were not statistically significant (5.27±2.60 vs. 4.70±1.35, p>0.05; 1.56±1.07 vs. 1.93±1.08, p>0.05). The CD4+CD25+Foxp3+ Treg count did not correlate with the tested parameters except for the clinical stage of psoriasis. The mean±SD number of CD4+CD25+Foxp3+ Treg in the stable phase was higher than that in the progressive phase (7.26±2.58 vs. 4.35±2.10, p<0.05). The CD4+CD25.Foxp3+ T cell count did not show any significant correlation with all the parameters tested (p>0.05). Conclusion: These findings suggest that the CD4+CD25+Foxp3+ Treg count alone is insufficient to explain the pathogenesis and severity of psoriasis. However, a decrease in circulating CD4+CD25+Foxp3+ Treg is likely to be correlated with an aggravation of psoriasis. (Korean J Dermatol 2015;53(4):270∼276)

3원저 : 건선 환자에서 경구 Cyclosporine 치료 후 재발인자에 대한 연구

저자 : 문성훈 ( Seong Hun Moon ) , 김정은 ( Jeong Eun Kim ) , 고주연 ( Joo Yeon Ko ) , 노영석 ( Young Suck Ro )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 277-283 (7 pages)

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Background: Cyclosporine, which is one of the effective systemic treatments for psoriasis, has a rapid therapeutic effect. However, despite the efficacy of cyclosporine, the recurrence of psoriasis may still occur if treatment with this drug is discontinued. Several studies on the efficacy and safety of cyclosporine for psoriasis have already been conducted. However, studies on the factors causing psoriasis recurrence after cyclosporine treatment are rare. Objective: The aim of this study was to identify the factors that cause recurrence of psoriasis in patients treated with cyclosporine. Methods: We performed a retrospective study of the medical records obtained between January 2007 and March 2014 of 174 patients diagnosed with psoriasis and followed up for at least 6 months after treatment. We analyzed the differences in the demographic characteristics, body surface area, psoriasis area and severity index (PASI) score, psoriasis type, accompanying psoriatic nail, involvement of exposed areas, and several treatment-related factors (starting dose, last dose, maximal dose, cumulative dose, mean daily dose, and treatment duration) between the group that experienced a recurrence and the group that did not. Additionally, we analyzed the effects of these factors on the recurrence and the time to recurrence. Results: Of the 174 patients, 57 (32.8%) reported a recurrence of the disease. There were statistically significant differences between the two groups in terms of their PASI score (p=0.031) and mean daily dose (p=0.014). In the multiple logistic regression analysis, the PASI score (p=0.017, odds ratio=1.057) and treatment duration (p=0.035, odds ratio=0.984) showed a significant relation with relapse. Conclusion: This study suggests that long-term treatment with cyclosporine is necessary for high-severity psoriasis in patients to prevent recurrence. However, as this study is retrospective, further prospective and large-scale studies are necessary to confirm this fact. (Korean J Dermatol 2015;53(4):277∼283)

4원저 : 표피낭종의 파열여부 감별에 있어 초음파 검사의 유용성

저자 : 김상태 ( Sang Tae Kim ) , 이강훈 ( Kang Hoon Lee ) , 김준희 ( Joon Hee Kim ) , 한상화 ( Sang Hwa Han ) , 박종빈 ( Jong Bin Park ) , 서기석 ( Kee Suck Suh ) , 장민수 ( Min Soo Jang ) , 김근태 ( Geun Tae Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 284-289 (6 pages)

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Background: An epidermal cyst is a common keratin-filled epithelial-lined cyst. The treatment of choice for epidermal cysts is surgical excision. If the cyst becomes ruptured, inflamed, or infected, then incision and drainage together with oral antibiotic therapy or intralesional steroid injection treatment is required. Identification of ruptured and unruptured cysts is important for treatment decisions. Objective: The purpose of this study was to evaluate the usefulness of ultrasonography in the diagnosis of epidermal cysts, and to analyze distinctive features that can differentiate between ruptured and unruptured epidermal cysts. Methods: We reviewed the clinical and sonographic features of pathologically confirmed epidermal cysts from 2 subgroups of 66 patients: 30 with unruptured cysts and 36 with ruptured cysts. The sonographic features used in the analysis included tumor size, margin, shape, tumor texture, posterior echo, internal debris, and lesion vascularity on color Doppler sonography. Results: The mean long diameter of the cysts was 10.95 mm in the unruptured cyst group and 12 mm in the ruptured cyst group. Some sonographic features, including heterogenous and hypoechoic echo texture, posterior echo enhancement, and internal hyperechoic and hypoechoic debris, showed no significant differences between the groups (p>0.05). The unruptured cyst group showed cysts with significantly higher frequencies of a well-circumscribed margin, an ovoid shape, and no vascular flow (p<0.05). In contrast, the ruptured cyst group usually had cysts with a poorly defined or slightly poorly defined margin, an irregular shape, peripheral vascular flow, and mild or moderate flow vascularity. Conclusion: The results of this study indicate that ultrasonography is helpful in differentiating between ruptured and unruptured epidermal cysts. (Korean J Dermatol 2015;53(4):284∼289)

5원저 : 혈소판 풍부혈장을 처치한 섬유아세포에서 제 1형 교원질, MMP-1 및 MMP-2 발현 증가

저자 : 한길 ( Gil Han ) , 김상표 ( Sang-pyo Kim ) , 조재위 ( Jae-we Cho )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 290-297 (8 pages)

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Background: Platelet-rich plasma (PRP) treatment is a promising tool for dermal tissue regeneration. PRP combined with subcision can synergistically induce dermal tissue regeneration. Objective: The purpose of this study was to investigate the effects of PRP on the proliferation and migration of skin fibroblasts, as well as on the type I collagen, matrix metalloproteinase (MMP)-1, and MMP-2 expression in these skin cells. The effect of PRP with subcision on the expression of TGF-β1 was also investigated in an animal model. Methods: Human skin fibroblasts were treated with various concentrations of PRP. The proliferation and migration rate of the cells were evaluated by the trypan blue exclusion method and scratch assay, respectively. The expression levels of type I collagen, MMP-1, and MMP-2 were analyzed by western blot or RT-PCR. In addition, the activity levels of MMP-1 and MMP-2 were studied by zymography. Finally, we treated the animal back with PRP, subcision, or PRP with subcision. The specimens were evaluated by H&E, Masson-trichrome, and TGF-β1 immunohistochemical staining. Results: Data from this study showed that PRP more effectively promoted the migration and proliferation of cells in a dose-dependent manner. The expression levels of type I collagen, MMP-1, and MMP-2 were increased in PRP-treated fibroblasts at the protein and mRNA levels. The in vivo study revealed that the expression of TGF-β1 was prominently increased by co-treatment with PRP and subcision rather than by treatment with either PRP or subcision alone. Conclusion: PRP treatment promoted fibroblast migration and proliferation, and increased the expression of type I collagen, MMP-1, MMP-2, and TGF-β1. Therefore, PRP co-application with subcision is an effective method for dermal remodeling and can be a good treatment option for depressed acne scars. (Korean J Dermatol 2015;53(4): 290∼297)

6원저 : 부산지역 여드름 환자를 대상으로 한 인식도 조사

저자 : 박인호 ( In Ho Park ) , 설정은 ( Jung Eun Seol ) , 김효진 ( Hyojin Kim ) , 서종근 ( Jong Keun Seo ) , 이숙경 ( Sook Kyung Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 298-303 (6 pages)

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Background: Acne vulgaris is a common dermatologic disease that can largely affect psychosocial aspects of the patient. Objective: This study was performed to survey the perception of acne vulgaris, including the cause of acne vulgaris, and patient attitude towards the disease, as well as preference for treatment methods in Busan. Methods: A total of 170 patients with acne vulgaris, seeking treatment at 1st-, 2nd-, and 3rd-grade hospitals in Busan, were surveyed by questionnaire. Patient informed consent was obtained. Results: With regards to the cause of acne, increased sebum secretion was the most selected answer, followed by stress and eating habits. Most of the patients believed that all of the acne treatment modalities were effective; however, negative recognition about the safety and durability of each treatment was also reported by a majority of the patients. Acne extraction and laser therapy were the most preferred treatment methods, and the most important reason to choose the treatment method was effectiveness. Conclusion: In this study, we could recognize a patients' overall perception about acne vulgaris. It is suggested that dermatologists should try not only to help patients gain a better understanding about acne but also to cope with their demands. (Korean J Dermatol 2015;53(4):298∼303)

7증례 : 소세포아형 원발성 피부 CD30 양성 역행성 대세포 림프종 1예

저자 : 민정 ( Jung Min ) , 김한샘 ( Han Saem Kim ) , 황상현 ( Sang Hyeon Hwang ) , 이현주 ( Heun Joo Lee ) , 남재희 ( Jae Hui Nam ) , 정호주 ( Ho-joo Jung ) , 박지혜 ( Ji-hye Park ) , 이가영 ( Ga-young Lee ) , 김원석 ( Won-serk Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 304-309 (6 pages)

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Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare cutaneous T-cell lymphoma. Most cases are composed of large anaplastic cells. However, it presents a wide spectrum of histologic patterns. In the small cell variant, a small-sized pleomorphic cell morphology can be seen. A 74-year-old woman presented with an 8-month history of asymptomatic ulcerative plaque and satellite nodule on the right calf. Her past medical history was not specific. The histologic findings on punch biopsy specimens showed a malignant small round cell tumor on both lesions. The tumor cells had large pleomorphic nuclei with multinucleation and some eosinophilic cytoplasm. We performed immunohistochemical staining to rule out neuroectodermal tumor, neuroendocrine tumor, melanoma, lymphoma, and so on. However, the staining results were negative for pancytokeratin, CD3, CD20, CD99, chromogranin A, synaptophysin, CD56, ALK, HMB45, desmin, kappa, lambda, myoglobin, and S-100 protein. CT, MRI, and PET-CT were negative for extracutaneous involvement. Total excision was done, and additional immunohistochemical staining was performed to confirm the origin of the tumor. Staining results for vimentin, LCA, CD4, and CD30 were positive. We c oncluded that these findings were consistent with the small cell variant CD30+PCALCL, which occurs rarely. (Korean J Dermatol 2015;53(4):304∼309)

8증례 : 홍반성 판의 양상을 보인 소아기 육아종성 입주위 피부염 2예

저자 : 성준영 ( Jun Young Seong ) , 채웅석 ( Woong Suk Chae ) , 정하나 ( Ha Na Jung ) , 공숙현 ( Sook Hyun Kong ) , 서호석 ( Ho Seok Suh ) , 최유성 ( Yu Sung Choi )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 310-314 (5 pages)

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Childhood granulomatous periorificial dermatitis (CGPD) is a distinctive granulomatous form of perioral dermatitis. It is characterized by papular eruptions located around the mouth, nose, and eyes, and rarely present eczematous patches or plaques. Histopathologic examination shows upper dermal and perifollicular granulomatous infiltrates. Herein, we report two cases of CGPD that were presented with erythematous plaques. One patient was treated with 0.03% topical tacrolimus and the other patient with oral metronidazole. The patients responded well to their respective therapies, showing resolution of the lesions. (Korean J Dermatol 2015;53(4):310∼314)

9증례 : 1064 nm Nd:YAG Laser와 595 nm Pulsed Dye Laser로 치료한 철분 주사 후 색소침착

저자 : 임은화 ( Eun Hwa Lim ) , 김수정 ( Sue-jeong Kim ) , 이영 ( Young Lee ) , 서영준 ( Young Joon Seo ) , 김창덕 ( Chang-deok Kim ) , 이증훈 ( Jeung Hoon Lee ) , 임명 ( Myung Im )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 315-318 (4 pages)

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Ferric carboxymaltose is a non-dextraniron complex used in patients with iron deficiency. However, iron injections may lead to long-lasting brown discoloration secondary to extravasation at the injection site. We herein report a case involving a patient who developed pigmentation after intravenous iron injection and was successfully treated with combined laser therapy. A 36-year-old woman presented with circumscript pigmentation on her left arm after having undergone intravenous iron injection for the treatment of iron deficiency anemia. Histopathologic examination revealed basal hypermelanosis and dermal infiltration of siderophages. Combined therapy with 1064 nm Nd:YAG laser and 595 nm pulsed dye laser was performed to treat the lesion, and marked improvement was noted after five sessions. (Korean J Dermatol 2015;53(4):315∼318)

10증례 : 류마티스 관절염 환자에서 Adalimumab 사용 후 발생한 심부홍반루푸스

저자 : 한길 ( Gil Han ) , 김성애 ( Sung-ae Kim ) , 조재위 ( Jae-we Cho ) , 이규석 ( Kyu-suk Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 4호 발행 연도 : 2015 페이지 : pp. 319-323 (5 pages)

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The clinical manifestations and immunohistologic findings of drug-induced lupus erythematosus (DILE) are similar to those of idiopathic lupus. However, DILE is different from idiopathic lupus because it is induced after continuous drug exposure and resolves after discontinuation of the causative drug. DILE can be divided into systemic lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus (CCLE). Lupus erythematosus profundus is a subtype of CCLE, and drug-induced CCLE is very rarely reported in the literature. Herein, we report a rare case of adalimumab-induced lupus erythematosus profundus developed in a rheumatoid arthritis patient. The patient is a 43-year-old Korean woman who had multiple tender nodules and plaques on her face, trunk, and both extremities after using adalimumab for rheumatoid arthritis. She was diagnosed with adalimumab-induced lupus erythematosus profundus, and her condition improved after discontinuation of adalimumab. (Korean J Dermatol 2015;53(4):319∼323)

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70권 2호 ~ 70권 2호

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대한피부과학회지
56권 8호 ~ 56권 8호

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Annals of Dermatology
30권 5호 ~ 30권 5호

KCI등재 SCOUPUS

대한피부과학회지
56권 7호 ~ 56권 7호

KCI등재 SCOUPUS

대한피부과학회지
56권 6호 ~ 56권 6호

한국피부장벽학회지
20권 1호 ~ 20권 1호

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Annals of Dermatology
30권 4호 ~ 30권 4호

KCI등재 SCOUPUS

대한피부과학회지
56권 5호 ~ 56권 5호

KCI등재 SCOUPUS

대한피부과학회지
56권 4호 ~ 56권 4호

KCI등재 SCI SCOUPUS

Annals of Dermatology
30권 3호 ~ 30권 3호

프로그램북(구 초록집)
70권 1호 ~ 70권 1호

KCI등재 SCI SCOUPUS

Annals of Dermatology
30권 2호 ~ 30권 2호

KCI등재 SCOUPUS

대한피부과학회지
56권 3호 ~ 56권 3호

KCI등재 SCOUPUS

대한피부과학회지
56권 2호 ~ 56권 2호

한국피부장벽학회지
19권 2호 ~ 19권 2호

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Annals of Dermatology
30권 1호 ~ 30권 1호

KCI등재 SCOUPUS

대한피부과학회지
55권 10호 ~ 56권 1호

프로그램북(구 초록집)
69권 2호 ~ 69권 2호

KCI등재 SCI SCOUPUS

Annals of Dermatology
29권 6호 ~ 29권 6호

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대한피부과학회지
55권 9호 ~ 55권 9호
발행기관 최신논문
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