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대한피부과학회> 대한피부과학회지> 원저 : 광범위한 탈모범위를 지닌 난치성 원형 탈모증 환자의Anthralin 국소 치료의 효과

KCI등재SCOUPUS

원저 : 광범위한 탈모범위를 지닌 난치성 원형 탈모증 환자의Anthralin 국소 치료의 효과

Original Article : Therapeutic Effect of Topical Anthralin for Treatment-Resistant Extensive Alopecia Areata

홍원규 ( Won Kyu Hong ) , 신정현 ( Jeong Hyun Shin ) , 최광성 ( Gwang Seong Choi )
  • : 대한피부과학회
  • : 대한피부과학회지 46권5호
  • : 연속간행물
  • : 2008년 05월
  • : 641-647(7pages)
대한피부과학회지

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Background: Extensive alopecia areata (EAA) is resistant to multiple individual treatment modalities and has poor prognosis for cosmetically adequate regrowth. Anthralin is a widely used topical anti-psoriatic drug that may have an immunomodulating effect on AA as is does in psoriasis. But, there has only been small number of clinical trials of anthralin in the treatment of AA. Objective: The purposes of the study were to evaluate the efficacy, prognostic factor, side effects and recurrence rate of topical anthralin therapy in treatment-resistant EAA. Methods: A total of 16 cases of EAA (>50% scalp hair loss) who had failed in previous treatments were subjected in this study. Anthralin in 0.5% concentrations was applied to alopectic lesions for 1 hour daily over 4 weeks, gradually increasing anthralin concentration until low-grade erythema and pruritus develops. Treatment was withdrawn after complete response or if there were no signs of improvement at 6 months. Responders were followed up for 6 months after discontinuation of therapy. Results: The overall response rate was 62.5%, complete response (>90% regrowth or cosmetically acceptable appearance) was obtained in 25% of cases and, good response (50∼99% regrowth) in 39.5% of cases. In this study, among the investigated prognostic factors, there were no statistically significant factors (p<0.05, Fisher exact test). The most frequent side effects were therapeutically induced mild pruritus (93.8%), erythema (93.8%) and scale (56.3%). Other side-effects were transient folliculitis (31.3%) and regional lymph adenopathy (12.5%). Relapse was observed in 60% of responders after 6 month of follow up. Conclusion: Topical anthralin for treatment-resistant EAA is an effective therapy with tolerable side effects. Therefore, we propose the topical anthralin as a reasonable therapeutic option for treatment-resistant EAA. (Korean J Dermatol 2008;46(5):641∼647)

UCI(KEPA)

I410-ECN-0102-2009-510-008734006

간행물정보

  • : 의약학분야  > 피부과학
  • : KCI등재
  • : SCOPUS
  • : 월간
  • : 0494-4739
  • : 2713-7627
  • : 학술지
  • : 연속간행물
  • : 1960-2021
  • : 9544


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59권5호(2021년 06월) 수록논문
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1한국인 건선 환자의 경제적 비용 부담

저자 : 한별 ( Byeol Han ) , 정기헌 ( Ki-heon Jeong ) , 김태균 ( Tae-gyun Kim ) , 김광중 ( Kwang Joong Kim ) , 김동현 ( Dong Hyun Kim ) , 김병수 ( Byung-soo Kim ) , 박경덕 ( Kyung Duck Park ) , 박철종 ( Chul Jong Park ) , 박혜진 ( Hai-jin Park ) , 방철환 ( Chul Hwan Bang ) , 신봉석 ( Bong Seok S

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 321-331 (11 pages)

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Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high.
Objective: To investigate the economic burden of psoriasis in Korea.
Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results.
Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost.
Conclusion: This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed. (Korean J Dermatol 2021;59(5):321∼ 331)

KCI등재 SCOPUS

2신생아 집중치료실 환아에서 유아혈관종의 위험인자 분석

저자 : 오재홍 ( Jae Hong Oh ) , 김병윤 ( Byung Yoon Kim ) , 최미라 ( Mira Choi )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 332-340 (9 pages)

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Background: Infantile hemangioma (IH) is one of the most common tumors in infants. IH occurs more commonly in premature and low birth weight infants, but only a few studies have analyzed the risk factors for IH in neonatal intensive care units (NICUs) in Korea.
Objective: We investigated the risk factors for IH in patients admitted to the NICU at a single institution.
Methods: A single-center retrospective case-control study was conducted in 37 patients with hemangioma and 185 matched-control babies who were admitted to the NICU between 2013 and 2020. Odds ratios (ORs) and multivariate conditional logistic regression models were used to determine the associations between IH and the potential risk factors.
Results: Of the 1,206 neonates admitted to the NICU, 37 had IH, and the prevalence was 3.1%. IH was most commonly found on the trunk (33.3%), followed by the head and neck (29.4%). After adjustment, the risk factors found to be significantly associated with IH were female sex (OR=3.0, 95% confidence interval [CI]=1.4∼6.8), extreme preterm (OR=6.9, 95% CI=1.3∼38.0), very low birth weight (OR=11.9, 95% CI=2.9∼49.3), low 1-minute Apgar scores of <7 (OR=2.3, 95% CI=1.1∼4.9), and multiple gestation (OR=5.0, 95% CI=1.7∼14.9).
Conclusion: This matched case-control study revealed that risk factors such as female sex, extremely preterm birth, very low birth weight, low 1-minute Apgar score, and multiple gestations may affect the occurrence of IH. Therefore, if these risk factors are present, they need to be actively managed at an early stage through close physical examination to prevent complications. (Korean J Dermatol 2021;59(5):332∼340)

KCI등재 SCOPUS

3비전형적 피부섬유종의 임상적 특징과 더모스코피 소견에 관한 연구

저자 : 오하늘 ( Haneul Oh ) , 문혜림 ( Hye-rim Moon ) , 유화정 ( Hwa-jung Ryu ) , 김일환 ( Il-hwan Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 341-347 (7 pages)

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Background: Dermatofibroma is a common benign skin neoplasm that is usually easy to recognize; however, in some cases, it is difficult to differentiate it from atypical dermatofibroma. Atypical dermatofibroma is a rare variant of a more aggressive nature and requires complete excision due to its tendency to recur.
Objective: To describe the clinical and dermoscopic features of dermatofibromas with special emphasis on the characteristics of atypical subtypes and to differentiate them from typical subtypes on the basis of results.
Methods: We retrospectively searched the databases of patients of Korea University Ansan Hospital from January 2010 to December 2019 who underwent skin biopsies or excision surgeries and had pathological reports of dermatofibroma. Analyses of the clinical characteristics (age, sex, number of lesions, anatomical site) and dermoscopic patterns were performed.
Results: Dermoscopic patterns were analyzed in 148 cases of dermatofibroma; peripheral delicate pigment networks and central white scar-like patches were the most common patterns found in 45 cases (30.4%). In eight cases of atypical dermatofibroma, three cases (37.5%) showed peripheral homogenous areas and central white networks, followed by multiple white scar-like patches in 2 cases (25.0%), peripheral delicate pigment networks, and central white scar-like patches in 2 cases (25.0%). Dermoscopy revealed a statistically significant difference in the peripheral homogenous area and the central white network pattern between the two groups.
Conclusion: In this study, we analyzed the dermoscopic findings of 148 patients with dermatofibroma and found that the peripheral homogenous area and central white network patterns were significantly more in atypical dermatofibroma. (Korean J Dermatol 2021;59(5):341∼347)

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4세균에 의한 피부 감염증에서 항생제 감수성과 임상적 특징에 관한 연구

저자 : 이재호 ( Jae-ho Lee ) , 이수경 ( Soo-kyung Lee ) , 김명신 ( Myoung-shin Kim ) , 이운하 ( Un-ha Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 348-362 (15 pages)

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Background: Bacterial skin soft-tissue infection is a common clinical manifestation in dermatology. The treatment of bacterial skin infections is often challenging due to antibiotic resistance, including methicillin resistance.
Objective: The aim of this study was to investigate the isolation rate of bacteria, antibiotic susceptibility, clinical features, and factors associated with treatment response in bacterial skin infections.
Methods: We retrospectively reviewed the medical records of patients who underwent ordinary bacterial skin cultures of the site of superficial skin infections between 2010 and 2019.
Results: A total of 1,298 patients were included in the study. The most commonly isolated bacteria were Staphylococcus aureus (31.3%), followed by coagulase-negative staphylococci (22.0%) and Pseudomonas species (4.2%). The methicillin-resistance rate of S. aureus was 22.7%. Crusted lesions (p=0.025), treatment with steroids (p=0.035), duration over 7 days (p=0.009), and isolation of Pseudomonas (p<0.001) or other uncommon species (non-Staphylococcus, Streptococcus, and Pseudomonas species, p<0.001) were significantly associated with treatment response.
Conclusion: The methicillin-resistance rate of S. aureus was similar to that of the past 5 years, but the mupirocin-resistance rate significantly increased. Lesions with crust or those that were treated with steroids showed good treatment responses, but longer disease durations of over 7 days and skin infections caused by Pseudomonas or other uncommon species were poor prognostic factors that should receive more attention. (Korean J Dermatol 2021;59(5):348∼362)

KCI등재 SCOPUS

5색소접촉피부염의 임상적 고찰 및 위험인자: 색소접촉피부염과 알레르기접촉피부염의 비교 분석

저자 : 김현빈 ( Hyeon Bin Kim ) , 윤숙정 ( Sook Jung Yun ) , 이승철 ( Seung-chul Lee ) , 이지범 ( Jee-bum Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 363-369 (7 pages)

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Background: Pigmented contact dermatitis (PCD) is a non-eczematous contact dermatitis characterized by hyperpigmentation with few or no signs of dermatitis. The pathomechanism of PCD is still unknown; there are few case reports of PCD caused by hair dye, henna, and cosmetics.
Objective: This study aimed to analyze the clinical features and the significance of risk factors in adult Korean patients with PCD.
Methods: We retrospectively reviewed 75 patients with PCD. Clinical features including age, sex, duration, location, and risk factors were obtained from electronic medical records. To determine the significance of the risk factors of PCD, we compared these patients with 155 patients diagnosed with allergic contact dermatitis (ACD) without hyperpigmentation.
Results: The mean age of onset of PCD in patients was 55.5 years, and the male:female ratio was 1:14. The mean duration of PCD was 16.3 months. The number of patients with PCD who had histories of hair dye use (n=67, 89.3%) and health supplement consumption (n=18, 24.0%) was significantly higher than that of patients with ACD. There were no significant differences in medication, cosmetic changes, stress history, results of patch test, patch testing with the patient's own products, immunoglobulin E (kU/L), and eosinophils (cells/μL).
Conclusion: This study analyzed the clinical features and risk factors of PCD and ACD in adult Korean patients, and it suggests that PCD may be caused by irritation induced by variable factors and not allergic reactions. (Korean J Dermatol 2021;59(5):363∼369)

KCI등재 SCOPUS

6어루러기에서 경구 아졸계 항진균제의 치료 효과 비교: 체계적 문헌고찰 및 메타분석

저자 : 권륭 ( Ryung Kwon ) , 이설희 ( Sul Hee Lee ) , 박영립 ( Young Lip Park ) , 이상훈 ( Sang Hoon Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 370-378 (9 pages)

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Background: In pityriasis versicolor, systemic antifungal agents may be indicated for widespread or refractory lesions rather than topical treatment. Oral ketoconazole is an effective treatment for pityriasis versicolor. To our knowledge, this is the first meta-analysis to compare antifungal agents one-to-one.
Objective: To compare the effectiveness of oral azole antifungal agents (fluconazole, itraconazole, and ketoconazole) one-to-one in pityriasis versicolor.
Methods: A computerized search was performed in different databases, including PubMed, Cochrane, EMBASE, OVID Medline, KoreaMed, KISS, and MedRIC. Seven randomized controlled trials were included. Further, statistical analyses of the extracted outcome data from the studies were performed using Rex Software (ver. 3.0.1).
Results: A total of 1,828 records were identified. The results of the meta-analysis including seven studies revealed no significant differences in the mycological cure rates between fluconazole and ketoconazole (risk ratio [RR]: 1.01, 95% confidence interval [CI]: 0.93∼1.09, p=0.8246), fluconazole and itraconazole (RR: 1.14, 95% CI: 0.81∼1.60, p=0.4512), and ketoconazole and itraconazole (RR: 1.07, 95% CI: 0.96∼1.20, p=0.2265).
Conclusion: There was no superiority in the therapeutic effect of any drug among the oral azole antifungals used in pityriasis versicolor. (Korean J Dermatol 2021;59(5):370∼378)

KCI등재 SCOPUS

7만성광선피부염 환자에서 유병기간, 첩포검사 및 광첩포검사 결과와 최소홍반량 값과 임상적 중등도와의 상관관계

저자 : 김정환 ( Jung-hwan Kim ) , 김기호 ( Ki-ho Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 379-388 (10 pages)

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Background: Chronic actinic dermatitis (CAD) is an uncommon eczematous photosensitivity disorder having a well-known relationship with allergic or photoallergic contact dermatitis. Moreover, the prognosis of CAD is worse in patients with lower minimal erythema doses (MEDs). However, the correlations between disease duration, contact and photocontact allergens, and MED values in CAD have not been reported.
Objective: To investigate the correlations among MED values, disease duration, and allergic patch/photopatch testing results and to elucidate the correlation between clinical severity and contact/photocontact allergens.
Methods: This study included 121 patients with CAD. Clinical data were analyzed according to the MED values, disease durations, and contact/photocontact allergens. Phototesting and patch/photopatch testing was performed in all the patients.
Results: The MED value was inversely correlated with disease duration for both MED-ultraviolet A and MED-ultraviolet B, with lower MED values for higher numbers of positive items in the patch/photopatch test. The most frequently detected allergens in the patch and photopatch tests were p-phenylenediamine (n=36, 9.3%) and Balsam of Peru (n=29, 21.3%). Clinically, patients demonstrating a greater number of detected allergens show poorer clinical severities (p<0.05).
Conclusion: The number of contact/photocontact allergens correlates with the severity of CAD. (Korean J Dermatol 2021;59(5):379∼388)

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8Reinfection Rate of Cutaneous Warts in Korea: A Nationwide Cross-Sectional Population-Based Study

저자 : Yeong Ho Kim , Kyungdo Han , Chul Hwan Bang , Ji Hyun Lee , Jun Young Lee , Yong Gyu Park , Young Min Park

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 389-393 (5 pages)

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Background: Cutaneous warts tend to recur despite of various treatment modalities. However, previous studies provided few data on their reinfection rate.
Objective: In this study, we investigated the reinfection rate along with the incidence and prevalence rates of cutaneous warts.
Methods: We conducted a nationwide, cross-sectional population-based study using the Korean National Health Insurance Service database from January 2006 through December 2016. Patients who visited outpatient clinics with an International Classification of Disease-10 code of viral warts (B07) were included. The reinfection rate was calculated as a percentage of patients with an initial visit in 2010 and subsequent visits for cutaneous warts with at least a six-month interval from last visit until 2016.
Results: From 2006 to 2016, the overall incidence and prevalence rates of cutaneous warts increased from 2.99 to 7.69 per 1,000 population and from 3.45 to 10.94 per 1,000 population, respectively. The overall reinfection rate of cutaneous warts was 30.9%. The reinfection rate of males and females was 31.6% and 30.0%, respectively. Children under ten years old had the highest reinfection rate (34.3%).
Conclusion: These results demonstrate that the reinfection rate of cutaneous warts is the highest in male children under ten years old. Therefore, these patients should be monitored closely after treatment. (Korean J Dermatol 2021;59(5):389∼393)

KCI등재 SCOPUS

9Pustular Eruption Induced by Adalimumab in a Patient with Ankylosing Spondylitis: A Case Report

저자 : Ji-hoon Lim , Soon-hyo Kwon , Woo-young Sim , Bark-lynn Lew

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 394-397 (4 pages)

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Many cutaneous adverse reactions including eczematoid dermatitis and lichenoid eruption have been reported with the increased usage of tumor necrosis factor-α inhibitors. However, there are very few reports of generalized pustular eruptions with adalimumab administration. A 44-year-old woman visited our clinic with multiple skin lesions scattered across her body. The patient developed these lesions three days after the initiation of adalimumab treatment. At the time of the patient's visit, physical examination revealed multiple erythematous papules and pustules across the body. Histopathological findings revealed subcorneal neutrophilic microabscess formation with dense perivascular and perifollicular infiltration that was mainly composed of lymphocytes and neutrophils. We diagnosed the patient with cutaneous pustular eruptions due to adalimumab exposure and initiated treatment with prednisolone and discontinued adalimumab injections. After 1 month of treatment, the patient's skin lesions improved. Herein, we report a case of generalized pustular eruptions, a rare cutaneous adverse reaction to adalimumab. (Korean J Dermatol 2021;59(5):394∼397)

KCI등재 SCOPUS

10A Case of Alopecia Areata in a Patient with Type I Pityriasis Rubra Pilaris

저자 : Dong Geon Lee , Hoon Kang , Jung Eun Kim

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 5호 발행 연도 : 2021 페이지 : pp. 398-400 (3 pages)

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There have been a few cases of alopecia areata (AA) patients with pityriasis rubra pilaris (PRP), but the relationship between them is unclear. To the best of our knowledge, there have been no cases of co-occurrence reported in Korea. A 58-year-old male presented with multiple erythematous follicular papules and scaly plaques on the both legs with diffuse keratotic thickening on both palms and soles for several months. After skin biopsy, he was diagnosed with type I PRP. After treatment with oral and topical steroid, vitamin D3 analogue, oral alitretinoin, and urea cream for one week, multiple, diffuse alopecic patches appeared. He was diagnosed with AA after skin biopsy and we added topical minoxidil. Herein, we report a case of AA in a patient with type I PRP. (Korean J Dermatol 2021;59(5):398∼400)

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KCI등재SCOUPUS

1원저 : 백반증의 감별진단을 위한 조직학적 염색법의 유용성

저자 : 김형성 ( Hyung Sung Kim ) , 박미선 ( Mei Shan Piao ) , 윤숙정 ( Sook Jung Yun ) , 이지범 ( Jee Bum Lee ) , 김성진 ( Seong Jin Kim ) , 원영호 ( Young Ho Won ) , 이승철 ( Seung Chul Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 569-577 (9 pages)

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Background: Vitiligo is a depigmented disorder, causing serious cosmetic problems for patients. In diagnostic and therapeutic aspects, vitiligo should be differentiated from other hypopigmented disorders as the therapeutic approach and prognosis are different for each disease. Objective: This study aimed to compare the usefulness of several markers for melanocytes or melanin in differential diagnosis of vitiligo. Methods: Twenty-eight patients were studied, who were diagnosed clinically as suffering from one of the following diseases: vitiligo, nevus depigmentosus, pityriasis alba, postinflammatory hypopigmentation, and idiopathic guttate hypomelanosis. Skin samples (frozen or paraffin-fixed) were obtained from depigmented patches and normal neighboring skin (control). Histological staining was performed by using Fontana-Masson, S-100, MART-1, and DOPA. The staining level of lesional skin was compared with that of normal skin. Results: When the staining level of vitiligo was compared with that of others, vitiligo was significantly lower in Fontana-Masson (13.3±17.2% vs 44.4±23.7%), S-100 (49.5±14.9% vs 74.7±24.2%), MART-1 (7.4±8.7% vs 68± 33.9%), and DOPA (9.5±11.3% vs 58.2±29.5%) (p<0.0001). Conclusion: MART-1 and DOPA are valuable markers in differential diagnosis of vitiligo. However, Fontana- Masson, a marker of melanin, had some limits in detecting melanocytes, and S-100 showed non-specific staining other than melanocytes. (Korean J Dermatol 2008;46(5):569∼577)

KCI등재SCOUPUS

2원저 : 원형 탈모증 환자의 삶의 질

저자 : 백승주 ( Seung Ju Back ) , 박영옥 ( Young Ok Park ) , 김계정 ( Kae Jeung Kim ) , 김창덕 ( Chang Deok Kim ) , 서영준 ( Young Joon Seo ) , 이증훈 ( Jeung Hoon Lee ) , 박장규 ( Jang Kyu Park )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 578-586 (9 pages)

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Background: Hair constitutes an integral part of our self and our self-identity, which is why hair loss may cause a broad range of psychological problems related to our identity. However, the association between quality of life (QOL) in alopecia areata (AA) patients and their clinical characteristics has not yet been investigated in Korea. Objective: The purpose of this study is to compare the QOL in patients with AA and healthy controls by using Hairdex scale. The relationship between their QOL and their clinical characteristics will be investigated. Methods: 102 AA patients and 82 healthy controls were recruited in this study and compared by use of Hairdex. Correlation analysis was performed to examine the relationship between the QOL and the clinical characteristics of patients with AA. Results: The total Hairdex scores and all domain scores, except those of the symptomatic domain, of the Hairdex scales in AA were higher than those of the healthy controls. Clinical characteristics, including the age, disease duration, AA type, AA area, treatment satisfaction, treatment history, anxiety and depression, showed significant correlation with QOL. Of these characteristics, the depression and treatment satisfaction showed strong association with QOL. Conclusion: AA can a impair patient`s quality of life and has a significant psychological impact. (Korean J Dermatol 2008;46(5):578∼586)

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3원저 : 선상 편평태선의 경구 스테로이드 치료

저자 : 강유석 ( Yoo Seok Kang ) , 이운하 ( Un Ha Lee ) , 박현수 ( Hyun Su Park ) , 장상재 ( Sang Jai Jang )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 587-595 (9 pages)

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Background: Lichen planus is a chronic papulosquamous disease characterized by various clinical manifestations of the skin, mucosa, hair, and nails. Various drugs or physical treatments for lichen planus have been proposed, but the efficacies are often disappointing and controversial. Linear lichen planus is a rare variant of lichen planus, which accounts for 0.2∼0.6% of all patients with lichen planus. Systemic corticosteroids remain the most widely used treatment for lichen planus. However, there have been no clinical studies on the effectiveness of this therapy on linear lichen planus despite the fact that linear lichen planus usually lasts for more than 1 year and occasionally results in cosmetic problems. Objective: This study evaluated the efficacy and safety of oral methylprednisolone therapy for linear lichen planus. Methods: Retrospective study was performed by reviewing the medical records and clinical photographs of 12 linear lichen planus patients treated with oral methylprednisolone. The analyses of treatment response to oral methylprednisolone therapy, adverse effects, and recurrence were performed. Results: All the 12 patients who completed the oral methylprednisolone therapy achieved complete response. Most patients showed a marked improvement 1 to 2 weeks after starting oral methylprednisolone therapy. Three of the 12 patients showed recurrence at 9 to 14 weeks after cessation of the treatment. Oral methylprednisolone therapy was generally well-tolerated and no serious adverse effects were observed. Conclusion: Oral methylprednisolone therapy is an efficacious, safe, and tolerable treatment modality for linear lichen planus. (Korean J Dermatol 2008;46(5):587∼595)

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4원저 : 이동성 홍반의 피부 병변으로 내원한 환자들에 대한 고찰

저자 : 오윤석 ( Yoon Seok Oh ) , 엄민섭 ( Min Seob Eom ) , 조미연 ( Mee Yon Cho ) , 김종배 ( Jong Bae Kim ) , 최응호 ( Eung Ho Choi )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 596-603 (8 pages)

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Background: Lyme disease, an infection caused by Borrelia(B.) burgdorferi, has been reported in many countries. But in Korea, only 5 cases of serologically diagnosed lyme disease have been reported. Because several strains of B. burgdorferi were isolated from Ixodes ticks which were captured in Kangwon and Chungbuk province, there might be more cases of serologically undiagnosed lyme diseases presenting with erythema migrans. Objective: To understand the clinical patterns and laboratory findings of erythema migrans in Korea. Methods: A clinical survey was retrospectively performed on 9 patients with erythema migrans which occurred after tick bites. Results: Among 9 patients with erythema migrans, 3 patients were male and 6 patients were female. The onset age of erythema migrans ranged from 26 to 71 years old (mean, 51.3 years old). The mean duration of erythema migrans after tick bite was 26.4 days and the diameter of the lesion ranged from 6 to 34 cm (mean, 18.3 cm). All cases developed from May to September and systemic symptoms such as fatigue, fever and/or chills, myalgia, palpitation, headache, arthralgia and dyspnea were present at the time of hospital visits of 3 patients. Clinically, 3 patterns of erythema migrans were seen; typical target pattern, homogenous and erythematous plaque pattern, and linear solitary plaque pattern with central postinflammatory pigmentation. Only 2 of the 7 patients (28.6%) were seropositive for IgM and IgG antibody titers by enzyme-linked immunosorbent assay in consecutive serologic tests. PCR for Borrelia DNA in paraffin-embedded tissue showed full negativity in 6 patients with erythema migrans. Conclusion: Although lyme disease is not endemic in Korea, some patients with erythema migrans might be undiagnosed as lyme disease serologically with erythema migrans. To take into consideration false negative serelogic results in early erythema migrans, early oral tetracycline therapy should be included through clinical and historical diagnosis. (Korean J Dermatol 2008;46(5):596∼603)

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5원저 : 켈로이드와 비후성 반흔 환자에서 Bleomycin 병변내 주사의 치료 경험

저자 : 박상영 ( Sang Young Park ) , 김성언 ( Seong Eon Kim ) , 윤태진 ( Tae Jin Yoon )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 604-610 (7 pages)

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Background: Keloids and hypertrophic scars are benign growths of dermal collagen that usually cause major physical, psychological, and cosmetic problems. Numerous treatment modalities have been used to treat keloids and hypertrophic scars, but the optimal treatment has not been established. Objective: The purpose of this study is to investigate whether bleomycin intralesional injection has an therapeutic effect on both keloids and hypertrophic scars. Methods: Thirteen patients with keloids or hypertrophic scars were administered with intralesional injection of bleomycin (1.5 IU/ml). Scar height was measured, and scar pliability and erythema were scored at baseline and then monthly during the treatment and follow-up period. Patient`s self-assessments of subjective symptoms (pruritus and pain) were also scored. Pre- and post-treatment mean values for scar height, scar pliability, erythema, pruritus and pain were statistically compared. Results: The clinical response was positive in all cases: highly significant flattening in one case, significant flattening in one case, moderate flattening in five cases and minimal flattening in six cases. The mean scores for pruritus and pain also improved. The observed side-effects were hyperpigmentation (two cases), hypopigmentation (one case) and skin infection (one case). No exacerbation was noted during follow-up period of 4 months. Conclusion: Bleomycin intralesional injecton may be one of the effective and safe method of treating keloids and hypertrophic scars. (Korean J Dermatol 2008;46(5):604∼610)

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6원저 : 베체트병에서 MIF 발현에 대한 연구

저자 : 인성일 ( Sung Il In ) , 백진아 ( Jin Ah Baek ) , 박경숙 ( Kyung Sook Park ) , 방동식 ( Dong Sik Bang ) , 이은소 ( Eun So Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 611-618 (8 pages)

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Background: Macrophage migration inhibitory factor (MIF) is a unique protein, participating in inflammation, immune response, and cell growth. Previous reports showed that MIF-polymorphisms are associated with an increased risk for various inflammatory diseases. Objective: This study was designed to investigate the effect of MIF polymorphisms on Behcet`s disease (BD). Methods: A total of 362 patients with BD and 290 healthy controls were genotyped. We also performed RT-PCR analysis, ELISA, and immunohistochemical stain for MIF. Results: We could not find statistically significant differences in the genotype frequencies of the MIF-794[CATT]5-8 repeat polymorphism or MIF-173 G>C polymorphism between BD patients and controls. Immunohistochemical analysis showed that MIF protein was diffusely distributed throughout epidermis and subcutaneous fat tissue from the skin lesions of patients with BD and erythema nodosum. Conclusion: Contrary to earlier reports, serum MIF levels were decreased in patients with BD, and the prescence of polymorphisms in the MIF promoter region was not associated with disease susceptibility. Nevertheless, MIF may play a role in cutaneous inflammation in BD. (Korean J Dermatol 2008;46(5):611∼618)

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7원저 : 성인기 여드름의 임상양상과 혈청 IGF-1의 상승

저자 : 신민경 ( Min Kyung Shin ) , 김낙인 ( Nack In Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 619-626 (8 pages)

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Background: Acne has been recognized as a common disorder amongst adolescents but recent studies have documented increased prevalence of post-adolescent acne. Objective: The purpose of this study was to demonstrate insulin resistance in post-adolescent acne by examining insulin, insulin like growth factor-1 (IGF-1), and insulin like growth factor binding protein-3 (IGFBP-3) compared to those in normal controls. Methods: Twenty-eight patients with acne between 25 and 45 years and 10 control individuals were studied. We classified the post-adolescent acne into persistent and late-onset types according to onset ages. We compared clinical features and the levels of fasting insulin, IGF-1, and IGFBP-3 in persistent and late-onset type of post-adolescent acne. Results: Among the post-adolescent group, there were few patients of metabolic syndrome. But, the mean serum levels of IGF-1 were significantly increased in post-adolescent acne compared to those in controls. Mean serum levels of IGFBP-3 were decreased in post-adolescent acne. Compared to persistent type, late-onset type showed more inflammatory acne lesions. Increased fasting insulin, IGF-1, and decreased IGFBP-3 in late-onset type compared to those in persistent type were observed. Conclusion: Results of this study indicate that insulin resistance could have a role in pathogenesis of post-adolescent acne. (Korean J Dermatol 2008;46(5):619∼626)

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8원저 : 기미 병변에서 신경 펩티드와 그 수용체의 발현에 대한 연구

저자 : 이현주 ( Hyun Ju Lee ) , 박하나 ( Ha Na Bak ) , 장성은 ( Sung Eun Chang ) , 최지호 ( Jee Ho Choi ) , 김명남 ( Myeung Nam Kim ) , 김범준 ( Beom Joon Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 627-632 (6 pages)

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Background: The pathogenesis of melasma has not yet been clearly demonstrated. But, clinical manifestations such as remarkable lesional symmetry and the distribution related to trigeminal nerves, suggest that the neural system could play a pathogenic role in melasma. Objective: This study was carried out to examine the expression of some neuropeptides and their receptors, which are well known to be major contributors of neuroinflammation in many dermatoses, in melasma lesions. Methods: Skin biopsies were obtained from the lesional and non-lesional facial skin of 6 Korean women with melasma. Immunofluorecence staining and confocal laser scanning microscopy were performed. Results: In our results, no difference could be detected with regard to the intensity of immunoreactivity for vasoactive intestinal peptide (VIP), calcitonin gene-related peptide (CGRP), calcitonin gene-related peptide receptor (CGRPR), substance P (SP), substance P receptor (SPR), somatostatin (SOM), pituitary adenylate cyclase activating peptide (PACAP) and pituitary adenylate cyclase activating peptide receptor (PACAPR) in the lesional skins compared with the non-lesional skins. Conclusion: These results suggest that neuroinflammation induced by neuropeptides such as substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and somatostatin and their receptors included in this study, are not directly associated with melasma pathogenesis. (Korean J Dermatol 2008;46(5):627∼632)

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9원저 : 성기 부위와 성기외 부위 경화 위축성 태선의 임상적, 조직학적 비교

저자 : 오상호 ( Sang Ho Oh ) , 류동진 ( Dong Jin Ryu ) , 이광훈 ( Kwang Hoon Lee ) , 이주희 ( Ju Hee Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 633-640 (8 pages)

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Background: Lichen sclerosus et atrophicus is a persistent inflammatory dermatosis of unknown etiology with a predilection for the genital area. Although there were many case reports in Korea, there are no studies regarding the clinicopathologic comparison of genital and extragenital lichen sclerosus et atrophicus. Objective: The aim of our study was to evaluate the clinicopathologic characteristics and differences between genital and extragenital lichen sclerosus et atrophicus. Methods: Retrospective analysis was performed by reviewing the clinicopatholgic records of 33 patients who were diagnosed with lichen sclerosus et atrophicus from 2000 to 2006 in Yonsei University Severance Hospital. Results: The most common clinical manifestation is a whitish patch with pruritus on labia minor. The ratio of male to female patients in genital and extragenital lichen sclerosus et atrophicus were 1:10.5 and 1:2.3 respectively. Disease onset ages were 49.9 years and 44.2 years respectively. The most common subjective symptom was pruritus. However, no symptom was more significant in extragenital lichen sclerosus et atrophicus compared to genital lichen sclerosus et atrophicus. Most of the lesions presented as whitish patches and plaques but atrophy, erythema and lichenification could also occur. Histopathologic findings of the extragenital lichen sclerosus et atrophicus showed more significant epidermal thinning and cleft formation compared to genital lichen sclerosus et atrophicus, which suggests that extragenital lichen sclerosus et atrophicus shows more evolved lesions. A few cases of genital lichen sclerosus et atrophicus showed spongiotic dermatitis, lichen simplex chronicus-like and lichen planus-like features in addition to typical pathology, which were suspected as secondary features or early lesions. All the patients were treated with high to mid-potency topical corticosteroid which were effective in both the genital and extragenital lichen sclerosus et atrophicus. There was no cases of squamous cell carcinoma arising in lichen sclerosus et atrophicus during the follow-up. Conclusion: Clinically, there were no symptoms significant to extragenital lichen sclerosus et atrophicus and pathologically extragenital lichen sclerosus et atrophicus showed more significant epidermal thinning and cleft formation. Further research regarding the characteristics and differences between genital and extragenital lichen sclerosus et atrophicus should be performed on larger number of cases. (Korean J Dermatol 2008;46(5):633∼640)

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10원저 : 광범위한 탈모범위를 지닌 난치성 원형 탈모증 환자의Anthralin 국소 치료의 효과

저자 : 홍원규 ( Won Kyu Hong ) , 신정현 ( Jeong Hyun Shin ) , 최광성 ( Gwang Seong Choi )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 46권 5호 발행 연도 : 2008 페이지 : pp. 641-647 (7 pages)

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Background: Extensive alopecia areata (EAA) is resistant to multiple individual treatment modalities and has poor prognosis for cosmetically adequate regrowth. Anthralin is a widely used topical anti-psoriatic drug that may have an immunomodulating effect on AA as is does in psoriasis. But, there has only been small number of clinical trials of anthralin in the treatment of AA. Objective: The purposes of the study were to evaluate the efficacy, prognostic factor, side effects and recurrence rate of topical anthralin therapy in treatment-resistant EAA. Methods: A total of 16 cases of EAA (>50% scalp hair loss) who had failed in previous treatments were subjected in this study. Anthralin in 0.5% concentrations was applied to alopectic lesions for 1 hour daily over 4 weeks, gradually increasing anthralin concentration until low-grade erythema and pruritus develops. Treatment was withdrawn after complete response or if there were no signs of improvement at 6 months. Responders were followed up for 6 months after discontinuation of therapy. Results: The overall response rate was 62.5%, complete response (>90% regrowth or cosmetically acceptable appearance) was obtained in 25% of cases and, good response (50∼99% regrowth) in 39.5% of cases. In this study, among the investigated prognostic factors, there were no statistically significant factors (p<0.05, Fisher exact test). The most frequent side effects were therapeutically induced mild pruritus (93.8%), erythema (93.8%) and scale (56.3%). Other side-effects were transient folliculitis (31.3%) and regional lymph adenopathy (12.5%). Relapse was observed in 60% of responders after 6 month of follow up. Conclusion: Topical anthralin for treatment-resistant EAA is an effective therapy with tolerable side effects. Therefore, we propose the topical anthralin as a reasonable therapeutic option for treatment-resistant EAA. (Korean J Dermatol 2008;46(5):641∼647)

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