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대한피부과학회> 대한피부과학회지> 일측성 전신형 선땀구멍각화증에서 발생한 보웬병

KCI등재SCOUPUS

일측성 전신형 선땀구멍각화증에서 발생한 보웬병

Letter to the Editor : Bowen Disease Arising from Unilateral Systematized Linear Porokeratosis

김은진 , 김현우 , 박현철 , 박찬금 , 김정은 , 노영석 , 고주연
  • : 대한피부과학회
  • : 대한피부과학회지 53권1호
  • : 연속간행물
  • : 2015년 01월
  • : 69-70(2pages)
대한피부과학회지

DOI


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초록 보기

땀구멍각화증(porokeratosis)은 임상적으로 중앙부에는 피부위축을 보이고 경계부는 다소 융기되어 나타나며 조직학적으로 특징적인 뿔층판(cornoid lamellae)이 관찰되는 질환이다1. 환자는 73세 남자로 2년 전부터 왼쪽 겨드랑이에 미란을 동반한 5×7 cm 크기의 홍반성 판을 주소로 내원하였다. 환자는 15세부터 갈색의 과각화성 반이 발생하였고, 약 40년 전 조직검사를 통해 선땀구멍각화증을 진단 받았다. 신체검사 상 왼쪽 팔, 다리와 체간에 과각화성 색소성 반이 Blaschko 선을 따라 선상으로 배열되어 있었다(Fig. 1). 겨드랑이의 병변은 땀구멍각화증 부위와 일치하였고, 초기에 홍반성 구진으로 발생하여 점차 크기가 커졌다고 하였다. 완전절제술과 함께 시행한 조직생검상 표피에는 뿔층판과 함께 하부로 다양한 모양과 크기의 핵을 가진 이형성세포가 관찰되었다(Fig. 2). 표피전층에 다양한 크기와 염색성을 보이는 비정형 편평상피세포가 매우 불규칙하게 배열되어 있었고 기저막은 잘 유지되어 있었다. 면역조직화학염색상 종양세포는 p53에서 일부 양성소견을 보였고, periodic acid Schiff (PAS) 염색에서 음성소견이었다(Fig. 2). 땀구멍각화증은 양성병변으로 알려져 있지만, 일부에서 보웬병, 기저세포암, 편평세포암으로 진행된 경우가 보고되고 있다2,3. 그 중 선땀구멍각화증이 다른 아형 보다 악성병변이 잘 동반되는 것으로 보고되었다. 현재까지 국내 문헌에는 편평세포암 1예와 기저세포암 1예가 보고된 바 있다4,5. 이번 증례는 선땀구멍각화증 환자에서 약 60년이 지난 다음 비노출부위인 겨드랑이 부위에서 악성변화가 나타나 간찰부위의 특성상 마찰에 의한 반복적인 외상이 보웬병 발병에 영향을 주었을 가능성이 있다고 생각한다. 따라서 땀구멍각화증 환자 진료 시 환자에게 악성변화의 가능성을 항상 설명하고 비노출부위를 포함한 전신 병변을 정기적으로 추적관찰 할 필요가 있겠다. 이번 증례에서는 흥미롭게도 뿔층판 하부의 표피에 투명세포변화를 보이는 세포와 함께 이상각화세포가 좀 더 명확히 나타났다. 그러나 악성 변화가 뿔층판 하부로부터 시작되는 지에 대해서는 추가적인 고찰이 필요할 것으로 생각된다. 이상각화증이 표피 전층에 걸쳐 나타나는 점과 PAS에 음성을 보였다는 점으로 보웬양 유방외파제트병 및 투명세포 편평세포암과 감별할 수 있었다. 저자들은 선땀구멍각화증 환자에서 발생한 보웬병 환자를 경험하고 교육적이고 흥미로운 증례로 생각하여 보고한다.

UCI(KEPA)

I410-ECN-0102-2015-500-002200168

간행물정보

  • : 의약학분야  > 피부과학
  • : KCI등재
  • : SCOPUS
  • : 월간
  • : 0494-4739
  • : 2713-7627
  • : 학술지
  • : 연속간행물
  • : 1960-2022
  • : 9674


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60권4호(2022년 05월) 수록논문
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KCI등재 SCOPUS

1한국인 50세 이상 여성의 안면 피부 노화와 생활습관 간의 상관관계

저자 : 김승미 ( Seung-mee Kim ) , 이영윤 ( Young Yoon Lee ) , 황초롱 ( Cho-long Hwang ) , 신정민 ( Jung-min Shin ) , 권인선 ( In-sun Kwon ) , 박상현 ( Sang-hyun Park ) , 정경은 ( Kyung Eun Jung ) , 김창덕 ( Chang-deok Kim ) , 서영준 ( Young-joon Seo ) , 홍동균 ( Dongkyun Hong ) , 이영 ( Young L

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 201-208 (8 pages)

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Background: Skin aging can be divided into intrinsic and extrinsic processes, and occur due to several factors. Although the interest in skin youthfulness is increasing globally, research on facial skin youthfulness and lifestyle is limited.
Objective: This study aimed to evaluate the association between facial skin youthfulness and biophysical facial skin parameters in Korean women over 50 years of age. We further investigated lifestyle factors that make people appear younger than their chronological age.
Methods: We surveyed the essential information and lifestyle of subjects by questionnaires, and measured the biophysical parameters of the facial skin. We then performed clinical facial assessments, and the values were compared with the chronologic age. The associations between age differences, biophysical parameters, and living habits were evaluated.
Results: We identified a positive correlation between age and melanin index (r=0.245, p<0.001) and erythema index (r=0.119, p=0.002). The melanin index was statistically significantly lower in the group without regular outdoor activities (144.66±43.24 vs. 137.00±55.48, p=0.043). The melanin index and erythema index were the significant differences that defined younger perceived age than chronological age. The perceived age was younger in the group who wore a hat when performing outdoor activities than the group who did not (3.70±1.84 vs. 3.40±1.94, p=0.034).
Conclusion: To retain youthful skin, it is essential to reduce sun exposure, as this factor can affect the melanin and erythema indices by inducing photoaging. Therefore, avoiding the sun bia proper methods, such as wearing a hat and sunscreen during outdoor activities, is recommended to maintain skin youthfulness. (Korean J Dermatol 2022;60(4): 201∼208)

KCI등재 SCOPUS

2대상포진 예방접종이 고령에서 발생하는 대상포진의 임상양상 및 경과에 미치는 영향: 단일기관의 5년간 후향적 연구

저자 : 김중호 ( Joong Ho Kim ) , 이수경 ( Soo Kyung Lee ) , 김명신 ( Myoung Shin Kim ) , 이운하 ( Un Ha Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 209-219 (11 pages)

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Background: Herpes zoster (HZ) is a neurocutaneous disease caused by reactivation of the varicella zoster virus after primary infection. In Korea, it is recommended that all adults aged >60 be vaccinated against HZ. However, breakthrough infection with HZ can occur infrequently in vaccinated individuals.
Objective: This study aimed to investigate the effects of the HZ vaccine on the clinical manifestations and courses of HZ in immunocompetent elderly individuals aged 60 years and older.
Methods: Among 848 immunocompetent HZ patients, 52 were vaccinated and 796 were unvaccinated. From this cohort, we chose 156 unvaccinated patients through a 1:3 propensity score matching analysis using three parameters; age, sex, and involved dermatome. We subsequently compared the clinical manifestations and courses between the vaccinated (n=52) and unvaccinated (n=156) groups.
Results: The vaccinated group had a lower peak numeric rating scale pain score and a lower rate of consultation with the pain control clinic than the opposite. Additionally, mild skin lesions without vesicles were more frequent in the vaccinated group than in the opposite. The vaccinated group had a shorter duration of total follow-up, shorter antiviral treatment period, lower admission rate, and shorter hospital stay than the opposite. Although postherpetic neuralgia occurred more frequently in the unvaccinated group than in the unvaccinated group, the incidences of other HZ-related complications showed no significant difference between the two groups.
Conclusion: Despite the possibility of breakthrough infection, the HZ vaccine should be recommended in the elderly as it can weaken the clinical features and course of the disease. (Korean J Dermatol 2022;60(4):209∼219)

KCI등재 SCOPUS

3건선관절염을 동반한 중등증 및 중증 건선 환자에서 Secukinumab의 건강관련 삶의 질 개선 효과에 관한 후향적 연구

저자 : 홍용준 ( Yong Jun Hong ) , 고강민 ( Gang Min Go ) , 김미리 ( Miri Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 220-227 (8 pages)

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Background: Psoriasis is a relapsing inflammatory skin disorder that can affect the nails and joints. Psoriatic arthritis (PsA) occurs in up to 30% of patients with psoriasis, leading to chronic articular pain, and impairing quality of life. Secukinumab is a human monoclonal antibody targeting interleukin-17A that has been shown to effectively improve the clinical signs and symptoms of PsA.
Objective: To evaluate the effect of secukinumab on health-related quality of life (HRQOL) in Korean PsA patients.
Methods: We retrospectively investigated the medical records and psoriasis area and severity index (PASI) scores of 13 patients with PsA who completed the psoriatic arthritis impact of disease 12-item questionnaire (PsAID-12) before and 3 months after receiving secukinumab treatment between October 2019 and August 2021 in Yeouido St. Mary's Hospital.
Results: At week 12, significant reductions in the total and each item PsAID-12 and mean PASI score were observed (p<0.01). The mean decrease of total PsAID-12 score was 4.8 (95% confidence interval [CI], 3.74∼5.86), with the greatest improvement observed in the item of 'embarrassment' (7.15; 95% CI, 5.59∼8.72). Of the 13 patients, 11 (84.6%) and 5 (38.5%) achieved PASI75 and PASI90 response, respectively.
Conclusion: This study showed that secukinumab improves the HRQOL of patients with PsA, implying a positive influence of secukinumab on patients' physical and mental status in a real-world clinical setting. (Korean J Dermatol 2022;60(4):220∼227)

KCI등재 SCOPUS

4The Importance of Ultrasonography in the Diagnosis of Epidermal Cysts and Lipomas in the Field of Dermatology

저자 : Kihyuk Shin , Sang-hyeon Won , Chankue Park , Gun-wook Kim , Hoon-soo Kim , Hyun-chang Ko , Moon-bum Kim , Byung-soo Kim

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 228-234 (7 pages)

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Background: Ultrasonography (US) is a simple and reliable tool that can aid in the diagnosis of benign subcutaneous lesions such as epidermal cysts and lipomas.
Objective: This study aimed to determine the efficacy of US for the differential diagnosis of epidermal cysts and lipomas.
Methods: A retrospective study of 100 patients with epidermal cysts (n=45) or lipomas (n=55) who underwent US and then received a pathological diagnosis in the dermatology department of Pusan National University Hospital was conducted.
Results: US and clinical impressions accurately diagnosed the epidermal cysts in 90.0% and 88.0% of the patients, respectively, and the lipomas in 92.0% and 88.0% of the patients, respectively. US combined with clinical impression significantly increased the diagnostic yield of epidermal cysts (98%) and lipomas (99%). On US, the frequency of posterior acoustic enhancement was higher for the epidermal cysts than for the lipomas (82.2% and 29.1%, respectively; p<0.001), and striated echoes such as internal linear echogenic reflections and dark clefts were more frequently found in the lipomas than in the epidermal cysts (90.9% and 6.7%, respectively; p<0.001).
Conclusion: This study implies that the diagnostic role of US can be greatly enhanced by knowledge of the clinical presentation. (Korean J Dermatol 2022;60(4):228∼234)

KCI등재 SCOPUS

5Anxiety Sensitivity and Psychological Distress in Patients with Rosacea: A Questionnaire-Based Study

저자 : Hyo-eun Kwon , Hye-jin Ahn , Min Kyung Shin

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 235-241 (7 pages)

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Background: Rosacea is a common chronic inflammatory disorder that affects the skin of the central face. Anxiety sensitivity (AS) refers to the fear of sensations and symptoms arising from an expected experience of anxiety. High AS can cause anxiety disorders. Several studies have evaluated depression in patients with rosacea; however, AS has not yet been investigated.
Objective: We aimed to investigate AS, depression, and quality of life in patients with rosacea.
Methods: Eighty-five patients with rosacea and 85 controls (aged>18 years) were enrolled in the study. The severity of rosacea was evaluated according to the standard guidelines of the National Rosacea Society. Patients with rosacea and controls were asked to complete the Korean version of the anxiety sensitivity index-revised (ASI-R), beck depression inventory (BDI), and dermatology life quality index (DLQI).
Results: The ASI, BDI, and DLQI scores were significantly higher in patients with rosacea than in controls (p< 0.001). In particular, the cardiovascular subscale of the ASI was significantly increased in patients with rosacea. The ASI and BDI scores were significantly correlated. DLQI scores were weakly correlated with ASI compared with BDI scores in patients with rosacea.
Conclusion: Our study is the first to report that AS is elevated in patients with rosacea. It is necessary to consider the anxiety-related symptoms of patients with rosacea, as they may benefit from psychological intervention to alleviate distress. (Korean J Dermatol 2022;60(4):235∼241)

KCI등재 SCOPUS

6A Study on the Correlation of Skin Types with Genetic Factors and Environmental Factors in Koreans

저자 : Kui Young Park , Jun Ki Hong , Sun Hye Shin , Young Gue Koh , Hye Sung Han , Nam Ju Moon , Gun Young Ahn , Seong Jun Seo

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 242-253 (12 pages)

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Background: The Baumann skin type (BST) classification provides a new approach for clinical care of dermatologic patients.
Objective: To investigate the correlation of skin types with genetic factors and environmental factors that have an important influence on Korean skin by comparing and analyzing the correlation between phenotype and genotype.
Methods: From July to October 2016, 774 adults who visited the one online shopping mall were subjected to skin BST questionnaire and gene single-nucleotide polymorphism (SNP) tests. Oral epithelial cells of the subjects were collected using a Genoplan DNA analysis kit, and 14 genes were analyzed by a genetic analysis agency (Genoplan Inc., Fukuoka, Japan).
Results: The most abundant skin type was OSNT (oily, sensitive, non-pigmented, tight) observed in 205 participants (26.5%). Of the filaggrin (FLG) SNPs, 143 participants (18.5%) had the GG (good) SNP; 391 (50.5%), GA (normal) SNP; and 240 (31.0%), AA (poor) SNP. Among those whose FLG SNP was GG (good), 121 (84.6%) were sensitive and 22 (15.4%) were resistant. Of those whose filaggrin (FLG) SNP was GA (normal), 337 (86.2%) were sensitive and 54 (13.8%) were resistant. Of those whose FLG SNP was AA (poor), 213 (88.8%) were sensitive and 27 (11.3%) were resistant. There was also a statistically significant difference in the fruit-vegetable consumption and use of a sunbathing bed between sensitive and resistant type in the groups that classified the FLG SNP as GA.
Conclusion: This is the first study to investigate the association of BST with genetic factors and environmental factors. (Korean J Dermatol 2022;60(4):242∼253)

KCI등재 SCOPUS

7전완부의 덩이로 발견된 근육내 전이성 투명세포신세포암 1예

저자 : 최연구 ( Yeon-gu Choi ) , 이현주 ( Heun Joo Lee ) , 김원석 ( Won-serk Kim ) , 이가영 ( Ga-young Lee ) , 최영준 ( Young Jun Choi )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 254-257 (4 pages)

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Cutaneous metastases from renal cell carcinoma (RCC) present as rapidly growing erythematous or purple-round nodules. An 88-year-old male presented with a solitary, deep-seated firm mass on his left forearm that had persisted for 3 years. Ultrasonography revealed an hypervascular mass with rich vessels. Magnetic resonance imaging revealed a 1.6×1.6×3.3 cm sized, high T2-weighted signal intensity mass at brachioradialis muscle. Histopathologic examination revealed cells with atypical, pleomorphic, oval to spindle-shaped nuclei, and clear cytoplasm with an alveolar pattern within an unencapsulated, lobulated mass. Immunohistochemical analysis showed that the tumor cells were positive for PAX8, CD10, epithelial membrane antigen, and vimentin. Ultrasonography of the urinary tract revealed a lesion suspected to be RCC, which was thought to be the primary tumor. As our patient showed peculiar clinical symptoms and the primary tumor was later diagnosed as a metastatic lesion inversely, we report a rare case of metastatic RCC with an intramuscular mass on the forearm. (Korean J Dermatol 2022;60(4):254∼257)

KCI등재 SCOPUS

8가족력이 있으면서 임상적 진단이 어려웠던 결절흑색종 1예

저자 : 정서미곤 ( Seo Mi Gon Jeong ) , 윤태진 ( Tae Jin Yoon )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 258-261 (4 pages)

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Nodular melanoma is a malignant melanoma which presents as blackish-brown or colorless nodules. Nodular melanoma shows rapid growth compared to other melanoma subtypes, and often exhibits clinical features that do not correspond to the ABCD rules, which is key in differentiating melanoma. This makes nodular melanoma difficult to differentiate from the initially suspected melanoma. As such, diagnosis of nodular melanoma is commonly delayed, and is therefore often identified at an advanced stage. Here, we report a case of nodular melanoma in a young man with a family history of melanoma. We emphasize the importance of early diagnosis through biopsy for malignant melanoma, which is difficult to differentiate based on clinical features. (Korean J Dermatol 2022;60(4):258∼261)

KCI등재 SCOPUS

9면역기능 정상 성인에서 겨드랑 부위에 발생한 모낭염 양상의 전염성 연속종

저자 : 김동성 , 허재영 , 박태흠 , 김우일 , 조문균 , 김수영

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 262-263 (2 pages)

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KCI등재 SCOPUS

10저절로 호전된 원인 불명의 붉은 에크린색한증 1예

저자 : 이상균 , 홍승필

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 4호 발행 연도 : 2022 페이지 : pp. 264-265 (2 pages)

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1원저 : 주사 환자 278예에 대한 임상적 병리조직학적 고찰

저자 : 정화영 ( Hwa Young Jung ) , 김미리 ( Mi Ri Kim ) , 박영민 ( Young Min Park ) , 박철종 ( Chul Jong Park ) , 김진우 ( Jin Woom Kim ) , 김경문 ( Kyung Moon Kim ) , 이정덕 ( Jeong Deuk Lee ) , 강훈 ( Hoon Kang ) , 조백기 ( Baik Kee Cho ) , 박현정 ( Hyun Jeong Park )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 1-9 (9 pages)

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Background: Rosacea is characterized by erythema of the central face that persists for several months or longer. Reports of the histological changes in rosacea are scarce, and few attempts have been made to correlate suchchanges with clinical findings and pathophysiology. Objective: This study aimed to elucidate the clinical manifestations of rosacea and investigate its histologicalfeatures. Methods: We performed a retrospective analysis of 278 patients with histologically confirmed rosacea who visitedthe Department of Dermatology at the Catholic Medical Center between January 2008 and May 2013. Clinicalsubtypes, disease severity, and precipitating factors were evaluated. In 115 randomly selected patients, histopathologicalfeatures were evaluated as well. Results: The ratio of males to females was 1:1.8. The age distribution showed a peak incidence in the fifthdecade. The most common subtype was papulopustular rosacea (52.9%) followed by erythematotelangiectatic rosacea(34.9%), ocular rosacea (4.0%), and phymatous rosacea (2.9%). Granulomatous rosacea accounted for 5.4% ofrosacea cases. Precipitating factors included hot weather (54.7%), stress (51.8%), sun exposure (37.4%), alcohol(37.4%), and hot baths (33.1%). Histological analysis of skin biopsies from 115 patients revealed solar elastosis in62 patients (53.9%) and telangiectasia in 85 patients (73.9%).Conclusion: In this study, Korean rosacea patients were predominantly female with a peak age in the fifth decadeand the majority suffered from the papulopustular and erythematotelangiectatic types of rosacea. Histologicalobservations pertaining to each rosacea type were also discussed. (Korean J Dermatol 2015;53(1):1∼9)

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2원저 : 최근 3년간 피부질환으로 응급실에 내원한 환자에 대한 통계학적 고찰(2010∼2012)

저자 : 이현주 ( Heun Joo Lee ) , 정호주 ( Ho Joo Jung ) , 남재희 ( Jae Hui Nam ) , 박지혜 ( Ji Hye Park ) , 이가영 ( Ga Young Lee ) , 김원석 ( Won Serk Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 10-15 (6 pages)

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Background: An increasing number of patients visit the emergency department (ED) for dermatological complaints. However, there is a paucity of data regarding the skin conditions presenting to the ED. Objective: This study aimed to describe the characteristics of skin complaints seen in the ED of a tertiary hospitalin Korea. Methods: We retrospectively reviewed 1,663 new dermatological emergency patients who visited the ED of ourhospital from January 2010 to December 2012. All skin conditions were diagnosed by a dermatologist and not byan emergency medicine specialist. Results: A total of 1,663 patients with skin problem were seen, corresponding to 1.5% of total ED visits. The meanage was 41.8 years and there was a slight female predominance (61.2%). The peak arrival time was between 9 pmand midnight. In terms of visit length, 68.9% of patients stayed less than 2 hours. Patients most commonly presentedwith urticaria/angioedema (53.8%) followed by herpes zoster (14.0%), contact dermatitis (7.2%), drug eruption(6.5%), and cellulitis/erysipelas (4.0%). Urticaria/angioedema patients were most commonly aged 21 to 40 years andherpes zoster patients were most commonly aged 51 to 70 years. Admissions occurred in 8.1% of cases, mostfrequently for herpes zoster. Conclusion: This retrospective study provides insight into the types of cases being evaluated by dermatologists inthe ED of a tertiary hospital. An awareness of these characteristics may assist physicians working in the ED inevaluating patients who present to the ED with skin disease. (Korean J Dermatol 2015;53(1):10∼15)

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3원저 : 한국인에서 일광노출과 자외선차단제에 대한 인식과 사용 행태 연구

저자 : 장시혁 ( Si Hyeok Jang ) , 박현선 ( Hyun Sun Park ) , 조소연 ( So Yun Cho ) , 윤현선 ( Hyun Sun Yoon )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 16-22 (7 pages)

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Background: Although sunscreen is used as a primary strategy for the prevention of sunburn, photoaging, and skincancer, few people regularly use sunscreen. Objective: To investigate awareness regarding the effects of sunlight, the extent of sun exposure, and sunscreen usebehaviors in Korean subjects. Methods: A questionnaire was administered to 467 adult patients who visited the Dermatology Department at SeoulNational University Boramae Hospital. The questionnaire covered demographic characteristics, causes of wrinkles,sunspots, and skin cancer, awareness of the harmful effects of sun exposure, perceived and actual extent of sunexposure, and the use of sun-protective methods including sunscreen. Results: Sun exposure was selected as the major cause of age spots (60.6%), skin cancer (60.9%), and wrinkles(25.9%). Respondents were likely to underestimate the extent of sun exposure. On average, quite a few respondentsstated that they were exposed to sunlight for more than one hour per day (22.7% on weekdays, 52.4% onweekends). However, only 9.4% of respondents thought that their sun exposure was problematic and 62.7% ofrespondents considered moderate sunlight exposure healthy. Respondents`` sun-protective behaviors were inadequate:only 29.8% used sunscreen regularly, and 16.5% have never used sunscreen. SPF was the most important factor inchoosing sunscreen, and 83.3% used a sunscreen with a labeled SPF over 30. By contrast, only 34.6% ofrespondents used PA+++ sunscreen. Conclusion: Despite fairly good knowledge regarding the harmful effects of sunlight, subjects underestimated therisks of their sun exposure and sun-protective behaviors were suboptimal. Education on the risk of UV exposure andeffects of sunscreen is still needed. (Korean J Dermatol 2015;53(1):16∼22)

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4원저 : 위축성 여드름 흉터의 치료에 따른 피부 확대경 소견의 차이 고찰: Pilot Study

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

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 23-29 (7 pages)

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Background: Dermoscopy has been suggested as a useful tool for diagnosing various skin diseases. Recently, thepossibility of using dermoscopy to predict the response to treatment has emerged. Objective: The purpose of this study was to determine whether dermoscopic findings corresponded to clinical acnescar types. This study also aimed to discover which dermoscopic findings predict the response to acne scartreatment. Methods: The dermoscopic findings of 39 participants undergoing atrophic acne scar treatment with fractionalphotothermolysis were evaluated. Patients were divided into two groups according to the duration of acne scarpersistence. Results: Patients with a relatively short duration of acne scar persistence usually achieved better treatment outcomes. Dermoscopic findings showed no obvious differences according to clinical acne scar type. But high hair follicledensity can be considered a predictive factor of treatment effects. Conclusion: Our study indicated that acne scar improvements can be predicted by dermoscopically observing hairfollicle density. (Korean J Dermatol 2015;53(1):23∼29)

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5Original Article : Histological Findings in Korean Patients with Rosacea

저자 : Sang Yeon Park , Jin Wook Lee , Sung Ku Ahn

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 30-37 (8 pages)

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Background: Rosacea is characterized by erythema of the face that persists for several months or longer. Rosaceais usually diagnosed based on clinical presentation and a biopsy is rarely performed for diagnostic purposes. However,a biopsy may be helpful when the symptoms are atypical. Objective: We identified commonly appearing histological characteristics of rosacea such as inflammation, sebaceoushyperplasia, granulomatous reaction, epidermal hyperplasia, Demodex, pustules, and fibrosis. In addition, we evaluatedthese according to clinical subtype. Methods: We examined the histological findings of 200 rosacea patients who visited our hospital. Histologicalfindings were evaluated according to clinical subtype. The standard classification and staging method published bythe National Rosacea Society was used for clinical classification. Results: The erythematotelangiectatic and papulopustular types of rosacea were the most common. Mild inflammationwas found in 56.0% of the patients (1 and 1+) and 49.0% showed inflammation greater than 2 degrees. Themost commonly observed histological features across all subtypes were sebaceous hyperplasia followed by epidermalhyperplasia and Demodex. However, sebaceous hyperplasia and Demodex were not observed in ocular rosacea. Conclusion: Some histological findings such as inflammation, granulomatous reaction, sebaceous hyperplasia,pustule, Demodex, epidermal hyperplasia, and fibrosis were commonly observed in rosacea. There were no distinctivesubtype-specific characteristics, but various histological characteristics were observed in a single clinical subtype. (Korean J Dermatol 2015;53(1):30∼37)

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6Original Article : Immunohistochemical Differentiation between Actinic Cheilitis and Lichen Planus of the Lips

저자 : Soo Eun Jung , Yong Hyun Jang , Hee Young Kang , Eun So Lee , You Chan Kim

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 38-44 (7 pages)

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Background: It is difficult to distinguish between actinic cheilitis and lichen planus histologically, because bothtypes of lesions exhibit variable degrees of epidermal dysplasia and dermal lichenoid inflammation. There iscurrently no consensus on suitable immunohistochemical markers for distinguishing these 2 conditions. Objective: This study aims to determine histological features and immunohistochemical markers that could be usedto differentiate actinic cheilitis from lichen planus. Methods: Fifteen cases of actinic cheilitis and 11 cases of lichen planus of the lips were included in the study. Histological changes such as parakeratosis, hyperkeratosis, atrophy, acanthosis, ulceration, necrosis, dermal solarelastosis, degrees of epidermal dysplasia and dermal inflammatory cell infiltration were examined. Verhoeff-vanGieson stained sections were quantified for the degree of elastosis using computer software. The followingimmunohistochemical markers were stained for: bcl-2, Ki-67, proliferating cell nuclear antigen, indoleamine 2,3-dioxygenase, matrix metalloproteinase-3, matrix metalloproteinase-9, CD4, CD8, c-kit, and prolyl-4-hydroxylase. Results: The only histologically appreciable difference between the diseases was the degree of epidermal dysplasia. No differences were observed with respect to solar elastosis using the Verhoeff-van Gieson stain. We found that cellproliferation markers such as proliferating cell nuclear antigen and Ki-67 were more highly expressed in actiniccheilitis than in lichen planus. In addition, the number of c-kit-positive cells observed in actinic cheilitis wassignificantly higher than in lichen planus. The expression levels of the other tested markers were not significantlydifferent between the 2 diseases. Conclusion: The immunohistochemical markers proliferating cell nuclear antigen, Ki-67, and c-kit may help todifferentiate actinic cheilitis from lichen planus of the lips. (Korean J Dermatol 2015;53(1):38∼44)

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7증례 : 담낭암에서 전이된 Sister Mary Joseph 결절 1예

저자 : 하지민 ( Ji Min Ha ) , 윤종현 ( Jong Hyun Yoon ) , 조은별 ( Eun Byul Cho ) , 박경훈 ( Gyeong Hun Park ) , 박은주 ( Eun Joo Park ) , 권인호 ( In Ho Kwon ) , 김광호 ( Kwang Ho Kim ) , 김광중 ( Kwang Joong Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 45-48 (4 pages)

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Cutaneous metastasis into the umbilicus, known as a Sister Mary Joseph nodule, is quite rare. Gastric adenocarcinoma is the most common primary origin overall, whereas gynecologic tumors such as ovarian cancer are the leading cause in women. In most cases, the nodule manifests after the primary tumor had been diagnosed. In rare cases, however, it serves as the first sign of the underlying malignancy. Here, we report the case of a 59-year-old woman who presented with a nodule on the umbilicus and was diagnosed with metastatic adenocarcinoma originating in the gallbladder. (Korean J Dermatol 2015;53(1):45∼48)

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8증례 : Narrowband Ultraviolet B 광선치료에 의해 치유된 소아의 전신성 색소침착자색반 1예

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

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 49-52 (4 pages)

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Pigmented purpuric dermatosis (PPD) represents a group of cutaneous lesions exhibiting petechiae, pigmentation, andoccasionally telangiectasia in the absence of an associated venous insufficiency or hematological disorder. PPD mayresolve spontaneously but tends to persist for months to years. Various treatment modalities such as oralgriseofulvin, pentoxifylline, cyclosporine, ascorbic acid, topical corticosteroids, and PUVA therapy have been usedwith unsatisfactory results. Recently, some studies reported that PPD showed a dramatic response to narrowbandultraviolet B (UVB) phototherapy. In these studies, narrowband UVB phototherapy was an effective treatmentmethod with few side effects. Here, we present the case of a 7-year-old boy with generalized PPD that improvedrapidly following narrowband UVB phototherapy. (Korean J Dermatol 2015;53(1):49∼52)

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9증례 : 표피지향성 전이악성흑색종

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

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 53-57 (5 pages)

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Cutaneous metastases of malignant melanoma are usually confined to the dermis or subcutaneous fat. In someinstances, however, they may involve the epidermis. A 68-year-old woman with a malignant melanoma on thesubungual area of the right great toe presented with multiple blackish pinhead-sized macules surrounding anulcerative lesion on the right great toe. Histopathological study of the macules showed atypical melanocytes andmelanocytic nests in the papillary dermis and the dermoepidermal junction. A thinning of the epidermis, wideningof the dermal papillae by aggregated atypical melanocytes, epidermal collarette formation, and angiotropism werealso seen. A diagnosis of epidermotropic metastatic malignant melanoma (EMMM) was made. EMMM is a specificform of metastatic malignant melanoma that is associated with epidermotropism of melanoma cells and severalhistopathological features. The differential diagnosis between primary malignant melanoma and EMMM can bedifficult because of their similar clinical and histological features. Here, we report a case demonstrating EMMM. (Korean J Dermatol 2015;53(1):53∼57)

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10증례 : Methyl-Aminolevulinate를 이용한 광역동치료로 치료한 단발성 균상식육종 1예

저자 : 장시혁 ( Sihyeok Jang ) , 황은정 ( Eun Jung Hwang ) , 류형호 ( Hyeong Ho Ryu ) , 조광현 ( Kwang Hyun Cho ) , 조성진 ( Seong Jin Jo )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 53권 1호 발행 연도 : 2015 페이지 : pp. 58-61 (4 pages)

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Various treatment modalities are available for mycosis fungoides including topical steroids, topical chemotherapy,phototherapy, and spot radiation therapy. However, these modalities do not always result in optimal effects, withefficacy depending on lesion size, number, and location. Photodynamic therapy (PDT) is a recently introducedtherapeutic modality that proved effective in patients with unilesional mycosis fungoides. A 58-year-old womanpresented with a seven-year history of a pruritic erythematous scaly patch on her right thigh. Through skin biopsy,we verified the lesion as mycosis fungoides. The lesion did not respond well to a topical steroid. We opted fortopical PDT with methyl-aminolevulinate (MAL). MAL cream was applied for 4 hours following irradiation with ared light. Four sessions were administered, separated by five weeks. The lesion clinically improved after treatmentwithout severe side effects. PDT using MAL could be considered an effective and tolerable treatment for mycosisfungoides. (Korean J Dermatol 2015;53(1):58∼61)

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