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대한피부과학회> 대한피부과학회지> Lichen Planus Developed During the Treatment with Nivolumab in a Patient with Lung Cancer: A Case Report and Literature Review

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Lichen Planus Developed During the Treatment with Nivolumab in a Patient with Lung Cancer: A Case Report and Literature Review

Eunjung Park , Taehan Koo , Mingyul Jo , Jisook Yoo , Jiho Park
  • : 대한피부과학회
  • : 대한피부과학회지 57권9호
  • : 연속간행물
  • : 2019년 11월
  • : 551-555(5pages)
대한피부과학회지

DOI


목차

INTRODUCTION
CASE REPORT
DISCUSSION
CONFLICTS OF INTEREST
ORCID
REFERENCES

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Nivolumab is a fully-humanized IgG4 monoclonal antibody that competitively binds to the programmed cell death receptor-1 protein (an immune check-point molecule) present on activated T cells. Nivolumab is approved for the treatment of advanced melanoma, lung cancer, and renal cell carcinoma. It attenuates the inactivation of cytotoxic CD8+ T cells and, produces an antitumor effect; however it may be associated with immune-related adverse events, including the development of lichen planus (LP). A 72-year-old man presented with a 2-month history of multiple, polygonal, purplish papules on the dorsal aspect of both hands. He was diagnosed with large cell neuroendocrine carcinoma (LCNEC) of the lung 4 years earlier and was treated with nivolumab (3 mg/kg every 2 weeks) for 9 months. By the 14th course of nivolumab therapy, the patient developed multiple rashes on the dorsal aspect of both hands, and biopsy was consistent with findings of LP. We report a rare case of LP in a patient with lung cancer treated with nivolumab. (Korean J Dermatol 2019;57(9):551∼555)

UCI(KEPA)

I410-ECN-0102-2021-500-000122759

간행물정보

  • : 의약학분야  > 피부과학
  • : KCI등재
  • : SCOPUS
  • : 월간
  • : 0494-4739
  • : 2713-7627
  • : 학술지
  • : 연속간행물
  • : 1960-2022
  • : 9752


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60권9호(2022년 11월) 수록논문
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1물집유사천포창 환자의 말초혈액 호산구 수치와 질환의 중증도 간의 상관관계: 20년간 단일기관 후향적 연구

저자 : 권혁진 ( Hyeok-jin Kwon ) , 윤정호 ( Jung-ho Yoon )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 549-558 (10 pages)

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Background: Bullous pemphigoid (BP) is an autoimmune blistering disease. Studies have focused on eosinophils for their significant role in the pathogenesis of BP, as they not only secrete proteases and proinflammatory cytokines but also recruit other inflammatory cells.
Objective: To investigate the correlation among peripheral eosinophil count, clinical severity, and laboratory findings in patients with BP.
Methods: A total of 59 patients with BP were included in this study. Correlation analyses between peripheral eosinophil count and bullous pemphigoid disease activity index (BPDAI) score, duration of hospitalization, anti-bullous pemphigoid antigen 180 (anti-BP180) immunoglobulin G (IgG) antibody, anti-bullous pemphigoid antigen 230 (anti-BP230) IgG antibody, immunoglobulin E (IgE), C-reactive protein, and procalcitonin levels were performed. Simple and multiple linear regression analyses were conducted to evaluate whether peripheral eosinophil counts could independently affect the BPDAI score and hospitalization duration.
Results: The peripheral eosinophil count was positively correlated with the initial skin, mucosa, total BPDAI score (p<0.001, p=0.027, and p<0.001, respectively), hospitalization days (p=0.032), anti-BP180 IgG antibody (p <0.001), anti-BP230 IgG antibody (p<0.001), and IgE (p<0.001). Furthermore, not only peripheral eosinophil count but also anti-BP180 IgG antibody, anti-BP230 IgG antibody, and IgE levels independently affected both the initial total BPDAI score (p<0.05) and hospitalization duration (p<0.05).
Conclusion: Based on our results, the peripheral eosinophil count can influence both clinical severity and laboratory findings. Additionally, it can indicate the clinical severity and prognosis of BP. Therefore, we suggest that the peripheral eosinophil count could be a useful marker for predicting clinical outcomes in patients with BP. (Korean J Dermatol 2022;60(9):549∼558)

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2중등증-중증의 한국인 건선 환자에서 Guselkumab의 효과와 안전성에 관한 연구

저자 : 신준오 ( Jun-oh Shin ) , 배경남 ( Kyung-nam Bae ) , 손진화 ( Jin-hwa Son ) , 신기혁 ( Kihyuk Shin ) , 김훈수 ( Hoonsoo Kim ) , 고현창 ( Hyunchang Ko ) , 김문범 ( Moon-bum Kim ) , 김병수 ( Byungsoo Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 559-565 (7 pages)

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Background: Guselkumab, a human immunoglobulin-G1λ monoclonal antibody, selectively blocks the interleukin-23-mediated signaling pathway. It has emerged as a promising treatment option for moderate-to-severe psoriasis. However, no studies have reported real-world clinical data on guselkumab in patients with psoriasis in Korea.
Objective: To investigate the effectiveness and safety of guselkumab in Korean patients with moderate to severe plaque psoriasis.
Methods: We retrospectively reviewed patients with moderate-to-severe psoriasis who were treated with guselkumab at Pusan National University Hospital (Busan and Yangsan) from January 2019 to May 2021. Fifty-six patients with psoriasis who were treated with guselkumab were included in the study. Patient demographics, psoriasis area and severity index (PASI) scores, investigator's global assessment scores, and adverse events were assessed.
Results: The mean baseline PASI score (16.2±7.6) significantly decreased after 20 weeks of guselkumab treatment (p<0.05). In total, 76.8%, 78.6%, and 88.1% of patients achieved a PASI90 response at 20, 28, and 52 weeks, respectively. Of 56 patients, 52 had a PASI90 response at the last follow-up visit. No serious adverse events were observed. Four patients (7.1%) experienced mild adverse events, such as injection site reaction, upper respiratory tract infection, and headache.
Conclusion: This study reconfirmed the efficacy and safety of guselkumab in Korean patients with moderateto- severe psoriasis. (Korean J Dermatol 2022;60(9):559∼565)

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3두드러기 혈관염의 임상조직학적 연구: 65명의 환자를 대상으로 한 한국의 단일 기관 연구

저자 : 김지선 ( Ji Sun Kim ) , 구대원 ( Dae Won Koo ) , 이중선 ( Joong Sun Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 566-575 (10 pages)

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Background: Urticarial vasculitis (UV) is a rare disorder that can be diagnosed with clinical and histopathologic studies. There are classical clinical criteria; however, histopathological evidence is required for a definite diagnosis. Few studies have reported on the clinical and histological features of UV.
Objective: To analyze the clinical and histopathologic features of patients diagnosed with UV at a single center in the Republic of Korea.
Methods: We performed a retrospective study of the medical records, clinical photographs, and histopathological slides of patients who visited the Department of Dermatology at Daejeon Eulji Medical Center for urticarial wheals or purpuric plaques lasting more than 24 hours from January 2013 to October 2021.
Results: A total of 65 patients and 95 slides were analyzed. Clinically, most patients had wheal-like plaquedominant lesions (55 patients, 84.6%) rather than purpura and presented with pruritus. In the histopathological study, lymphocytic vasculitis (65 of 69 slides, 94.2%) was more dominant than leukocytoclastic vasculitis. However, its severity was milder than that of leukocytoclastic vasculitis.
Conclusion: This study performed a more in-depth clinical and histological analysis of UV, and histologically, it showed more diversity than previously known leukocytoclastic vasculitis. This might be used as basic research data for more large-scale studies of UV in the future. (Korean J Dermatol 2022;60(9):566∼575)

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4COVID-19 백신 접종 이후 발생한 피부증상: 국내 다기관 사례군 연구

저자 : 윤희정 ( Hee Jung Yoon ) , 권민정 ( Min Jung Kwon ) , 홍은지 ( Eun Ji Hong ) , 은윤수 ( Yun Su Eun ) , 정의현 ( Euy Hyun Chung ) , 김정은 ( Jung Eun Kim ) , 이상훈 ( Sanghoon Lee ) , 박영립 ( Young Lip Park ) , 이설희 ( Sul Hee Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 576-584 (9 pages)

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Background: During the coronavirus disease 2019 (COVID-19) pandemic, large-scale vaccinations have been performed worldwide without sufficient verification of safety profiles. So far, little is known about skin manifestations following COVID-19 vaccination in Korean patients.
Objective: We investigated the epidemiological and clinical characteristics of patients who had skin manifestations following COVID-19 vaccination in Korea.
Methods: We retrospectively reviewed the data of 123 patients that presented with skin manifestations within 1 month after COVID-19 vaccination from two tertiary referral hospitals in Korea. The types of COVID-19 vaccinations administered to the patients, demographics, comorbidities, and clinical course of the patients were obtained from the data. Statistical analyses of the extracted data were performed using Microsoft Excel.
Results: Skin manifestations following COVID-19 vaccination were mostly observed in patients in their 40s (23.6%), according to our data. Urticarial eruption was the most common manifestation, followed by macular rash (17.1%) and papulosquamous eruption (17.1%). Notably, 70% of the patients showed delayed reactions. More than half of the patients showed a good prognosis, and their symptoms were relieved with conservative treatment, including corticosteroids and antihistamines, even after additional vaccination.
Conclusion: We statistically analyzed the prevalence and characteristics of skin manifestations after COVID-19 vaccination. Urticarial eruptions are the most common skin manifestations associated with the COVID-19 vaccination. We believe that this real-world retrospective study will provide valuable information for doctors who treat patients with skin manifestations after COVID-19 vaccination by providing real-world experience in Korea. (Korean J Dermatol 2022;60(9):576∼584)

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5Expression of Antimicrobial Peptides in Psoriasiform Mouse Models

저자 : Song-ee Kim , Sang Eun Lee , Soo-chan Kim , Jong Hoon Kim

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 585-592 (8 pages)

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Background: Psoriasis is a chronic inflammatory skin disease. Despite the current focus on T cells in the pathogenesis of psoriasis, keratinocytes within the psoriatic epidermis are also abnormal in many respects including excessive production of antimicrobial peptides (AMPs). Recently, several studies have used imiquimod (IMQ)- and interleukin (IL)-23-induced mouse models to explore the immunological significance of psoriasis. However, the expression of AMPs in these models remains unclear.
Objective: In this study, we evaluated the protein and mRNA expression of AMPs, including cathelicidin-related antimicrobial peptides (CRAMP), mouse β-defensin 3 (mBD3), and psoriasin (S100 calcium-binding protein A7, S100A7) in IMQ- and IL-23-induced psoriasiform mouse models. In addition, we investigated whether ustekinumab, an inhibitor of IL-12 and IL-23, reduces the expression levels of AMPs in these mouse models.
Methods: We used IMQ- and IL-23-induced psoriasiform mouse models. Gene and protein expression levels of AMPs were evaluated using quantitative real-time polymerase chain reaction and immunofluorescence staining, respectively.
Results: We found that the protein and mRNA expression levels of CRAMP, mBD3, and S100A7 were increased in both mouse models. Ustekinumab decreased AMP expression levels in the two mouse models.
Conclusion: These data showed that the elevated expression of AMPs in the epidermis decreased following ustekinumab treatment in both psoriasiform mouse models. Therefore, AMP expression levels may be used as an indicator of treatment efficacy. (Korean J Dermatol 2022;60(9):585∼592)

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6다발성 전이를 동반한 투명세포육종 1예

저자 : 장현준 ( Hyun Joon Chang ) , 우유리 ( Yu Ri Woo ) , 조상현 ( Sang Hyun Cho ) , 이정덕 ( Jeong Deuk Lee ) , 김혜성 ( Hei Sung Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 593-596 (4 pages)

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Clear cell sarcoma is a rare malignant soft tissue tumor that grows slowly; however, recurrence and metastasis are common. Metastases to the lymph nodes, lungs, and bones are the most frequent; however, multiple metastases to the lungs and bones have not been reported in Korea. A 41-year-old man was referred for an erythematous hard mass measuring 5 cm on his left sole that appeared 5 years ago and gradually grew while he was hospitalized at the Department of Pulmonology for multiple lung nodules. Histopathological examination of the lesions on the sole and pleura revealed clear cell sarcoma. In addition to the lungs and pleurae, bony metastases to the sternum, cervical-thoracic-lumbar vertebrae, sacrum, scapulae, clavicles, pelvic bones, femurs, and humeri, with extensive lymph node metastases were also present. Herein, we report a rare case of a clear cell sarcoma with multiple metastases. (Korean J Dermatol 2022;60(9):593∼596)

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7우측 제1족지에 발생한 공격성 수지 유두상 선종

저자 : 노형래 ( Hyungrye Noh ) , 김희연 ( Hee Yeon Kim ) , 신동민 ( Dong Min Shin ) , 장동휘 ( Donghwi Jang ) , 심준호 ( Joonho Shim ) , 오세진 ( Se Jin Oh ) , 이종희 ( Jong Hee Lee ) , 이동윤 ( Dong-youn Lee ) , 이주흥 ( Joo-heung Lee ) , 박지혜 ( Ji-hye Park )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 597-600 (4 pages)

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Aggressive digital papillary adenoma (ADPA) is a rare tumor of the sweat glands. They usually present as solitary masses, with or without pain, and are most commonly observed in the fingers. A 19-year-old man presented with a solitary, protruding lesion on the right big toe that had enlarged 6 months previously. The biopsy specimen revealed a well-marginated mass with papillary projections and tubular structures. On foot magnetic resonance imaging, there was no invasion, and chest radiography showed no metastasis. Based on these findings, the tumor was diagnosed as ADPA, and wide excision was performed. Herein, we report a rare sweat gland tumor on the toe that was diagnosed as an ADPA. (Korean J Dermatol 2022;60(9):597∼600)

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8케톤형성 식이요법으로 인해 발생한 색소침착가려움발진 2예

저자 : 양나경 ( Na Gyeong Yang ) , 김재윤 ( Jae Yun Kim ) , 은윤수 ( Yun Su Eun ) , 이성열 ( Sung Yul Lee ) , 정의현 ( Euy Hyun Chung ) , 이현주 ( Hyun Ju Lee ) , 김정은 ( Jung Eun Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 601-605 (5 pages)

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Prurigo pigmentosa (PP) is a rare inflammatory skin disease that commonly affects Asian women. It is characterized by symmetric pruritic eruptions in a reticular pattern, primarily on the back, chest, or neck. The etiology of PP is unclear; however, it is estimated that neutrophil-mediated inflammation of the skin is induced by various exogenous stressors, such as friction from clothing and sweating. In addition to exogenous factors, some cases are thought to be related to ketosis, diabetes mellitus, fasting, or dieting to lose weight. With the increasing popularity of ketogenic diets, cases of PP are being more commonly reported. To raise awareness of this disease, we present two cases of PP that occurred after following a ketogenic diet. (Korean J Dermatol 2022;60(9):601∼605)

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9인터루킨-12/23 (Interleukin-12/23) 억제제로 치료 중인 건선 환자에서 발생한 전신형 고리육아종 1예

저자 : 김종욱 ( Jongwook Kim ) , 장봉석 ( Bongseok Jang ) , 김연아 ( Yeona Kim ) , 원상현 ( Sang-hyeon Won ) , 배경남 ( Kyung-nam Bae ) , 이정수 ( Jungsoo Lee ) , 신기혁 ( Kihyuk Shin ) , 김훈수 ( Hoonsoo Kim ) , 고현창 ( Hyunchang Ko ) , 김문범 ( Oon-bum Kim ) , 김병수 ( Byungsoo Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 606-610 (5 pages)

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Granuloma annulare is a relatively common inflammatory skin disease. The etiology is unknown; however, drugs have been considered as one of the predisposing conditions, and a few cases of granuloma annulare related to biologics have been recently reported. A 48-year-old man with a 25-year history of psoriasis visited our dermatological clinic. Ustekinumab was administered for the treatment of psoriasis. After 5 years of ustekinumab therapy, erythematous papules with an annular distribution appeared on his trunk and extremities. Skin biopsy supported the diagnosis of generalized granuloma annulare, and the patient continued to receive ustekinumab with oral methotrexate, cyclosporine, and steroids for 9 months. However, as the skin lesions aggravated, oral steroid treatment was continued, and secukinumab was administered instead of ustekinumab. The skin lesions improved and remained stable with the intermittent administration of oral steroids thereafter. (Korean J Dermatol 2022;60(9):606∼610)

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10Eczematous Vesicular Rruption and Exacerbation of Chronic Spontaneous Urticaria Associated with Secukinumab

저자 : Sang-min Choi , Bark-lynn Lew , Woo-young Sim , Soon-hyo Kwon

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 60권 9호 발행 연도 : 2022 페이지 : pp. 611-614 (4 pages)

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The pathogenesis of chronic spontaneous urticaria (CSU) is complex. Though the involvement of functional autoantibodies and imbalance of T helper (Th) cell subsets have been reported, the exact mechanism remains elusive. We report a case of eczematous vesicular eruption and exacerbation of CSU in a patient with psoriasis after treatment with secukinumab, an anti-interleukin (IL)-17 monoclonal antibody. The eczematoid eruption subsided after the administration of systemic steroids, but the exacerbation of CSU was not controlled. After switching the therapy to guselkumab, an anti-IL-23 monoclonal antibody, to supplement the control of the psoriasis lesions, the patient's urticaria flare-ups were well controlled with only H1 antihistamines. We hypothesize that the Th2-skewed immune response induced by anti-IL-17 treatment in predisposed patients might have resulted in the eczematous eruption and exacerbation of CSU. (Korean J Dermatol 2022;60(9):611∼614)

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1두피 건선 환자의 삶의 질에 미치는 국소 스테로이드제 단독 요법과 경구 사이클로스포린 병합 요법의 효과 비교

저자 : 김민수 ( Minsu Kim ) , 양승걸 ( Seungkeol Yang ) , 김보리 ( Bo Ri Kim ) , 윤상웅 ( Sang Woong Youn )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 513-518 (6 pages)

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Background: Scalp psoriasis severely affects patients' quality of life, and patients may occasionally be refractory to topical steroid application. Although systemic therapy combined with topical steroid application is recommended for treatment-resistant scalp psoriasis, previous research has not reported whether such combination treatment improves patients' quality of life.
Objective: This study investigated whether combination therapy using oral cyclosporine and topical steroid reduces the severity of scalp psoriasis and improves patients' quality of life compared with the use of topical steroid alone.
Methods: The study included 23 patients with scalp psoriasis who were categorized as patients who received topical steroid therapy alone vs. those who received combination therapy with topical steroid and oral cyclosporine for 12 weeks. The severity of psoriasis and quality of life were evaluated at 4, 8, and 12 weeks of treatment.
Results: No significant improvement was observed in the severity of psoriasis or in patients' quality of life during the treatment period in patients receiving topical steroid alone. Patients treated with a combination of topical steroid and oral cyclosporine showed a reduction in the severity of psoriasis from the 4th week of treatment and their quality of life improved from the 12th week of treatment.
Conclusion: Combination therapy with oral cyclosporine and topical steroid may reduce the severity of scalp psoriasis and improve patients' quality of life. (Korean J Dermatol 2019;57(9):513∼518)

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2재발성 카포시수두양발진의 임상적 특징과 유발요인에 대한 분석

저자 : 배경남 ( Kyung-nam Bae ) , 김태욱 ( Taewook Kim ) , 박성민 ( Sungmin Park ) , 이현주 ( Hyun Joo Lee ) , 진현주 ( Hyunju Jin ) , 유향석 ( Hyangsuk You ) , 심우행 ( Woo-haing Shim ) , 김건욱 ( Gun-wook Kim ) , 김훈수 ( Hoon-soo Kim ) , 고현창 ( Hyun-chang Ko ) , 김병수 ( Byung Soo Kim ) , 김

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 519-526 (8 pages)

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Background: Kaposi varicelliform eruption (KVE) is a disseminated viral infection primarily caused by the herpes simplex virus in the setting of an underlying chronic skin disease. Few studies have reported the clinical characteristics and predisposing factors for recurrent KVE.
Objectives: To characterize the clinical features and predisposing factors for recurrent KVE.
Methods: This retrospective comparative study of recurrent vs. single-episode KVE was performed at the Pusan National University Hospital between 2004 and 2017.
Results: A total of 84 episodes occurred in 60 patients, and of these, 13 patients developed recurrence (21.7%). No statistically significant intergroup difference was observed in the mean age and sex distribution. The face was the most common site of involvement in both groups, followed by the trunk and the upper and lower extremities. Atopic dermatitis was the most common pre-existing disease in both groups; however, Darier's disease was more common in the recurrent KVE group, and this difference was statistically significant. Most patients with KVE (66.7%) showed aggravation of the underlying skin disease within 3 months of KVE onset. This finding was more prominent in patients with recurrent episodes (91.7%) than in those with single-episode KVE (58.3%), (p=0.040).
Conclusion: This study can contribute to a better understanding of recurrent KVE and guide clinicians in treating patients with conditions predisposing to KVE. (Korean J Dermatol 2019;57(9):519∼526)

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3Clinical Analysis of Serial (Staged) Excision for Congenital Melanocytic Nevi: A Single-center Experience

저자 : Min Young Lee , Ji Yeon Byun , Kyu Kwang Whang

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 527-531 (5 pages)

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Background: Serial (staged) excision of congenital melanocytic nevi (CMN) is an important treatment option for medium-sized CMN. However, few studies have investigated the outcomes of serial excision in detail.
Objective: We report our experience regarding serial excision of CMN, including methods to effectively reduce the procedural stages and scar length. Methods: We retrospectively reviewed medical records of patients with CMN treated between 2008 and 2015; 33 patients (7 men and 26 women) underwent serial excision.
Results: The CMN were located on the face (n=11), arms (n=6), legs (n=11), and other areas of the body (n=11), including the back (n=2), chest (n=1), deltoid region (n=1), and buttocks (n=1). The mean CMN area was 19.7 cm2. The mean number of surgical stages was 2.2. The mean interval between surgeries was 10.6 months. A marginal S-shaped incision along both edges of the nevus was preferred over elliptical excision, to reduce scarring. Pulsed dye, erbium:yttrium-aluminum-garnet (YAG), neodymium-doped:YAG, and carbon dioxide fractional lasers were used to improve the final outcomes and minimize scarring.
Conclusion: Serial excision is an effective treatment option associated with greater patient satisfaction, particularly for medium-sized and hairy CMN. Conventional elliptical serial excision is associated with the formation of elongated scars and sacrifices normal skin adjacent to the lesion. The marginal S-shaped incision reduces scarring by dispersing mechanical tension on the scar without skin wastage. Compared with the elliptical excision method, the marginal S-shaped incision reduces the number of surgical stages and results in a cosmetically superior scar. Performing a marginal S-shaped incision is technically challenging in certain anatomical locations, such as the eyes, nose, and mouth. Therefore, it is necessary to combine this procedure with erbium:YAG and neodymium-doped:YAG ablation. (Korean J Dermatol 2019;57(9):527∼531)

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4급속소퇴성 선천혈관종 5예

저자 : 한만훈 ( Man-hoon Han ) , 정호윤 ( Ho Yun Chung ) , 이종민 ( Jong Min Lee ) , 허승 ( Seung Huh ) , 김준영 ( Jun Young Kim ) , 이원주 ( Weon Ju Lee ) , 이석종 ( Seok-jong Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 532-537 (6 pages)

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Rapidly involuting congenital hemangioma (RICH), a subtype of congenital hemangioma (CH), is fully developed at birth and undergoes rapid involution by 6-14 months of age. Clinically, this vascular lesion differs from both non-involuting CH and infantile hemangiomas. It is important to distinguish between this rare condition and other vascular lesions to ensure appropriate management (active intervention vs. non-intervention). We describe 5 patients diagnosed with RICH based on clinicopathological and/or imaging studies. Three patients showed red-stippled bluish to purplish tense plaques and two showed slightly depressed red-stippled hypopigmented rubbery patches at their initial visit. Spontaneous involution commenced shortly after birth, and complete involution occurred by 16.0±9.9 months of age. Doppler ultrasonography and magnetic resonance imaging were performed for further evaluation. Histopathological examination revealed vascular lobules of various sizes without true arteriovenous microfistulae, and thickened intra- and interlobular vessels were prominent with glucose transporter isoform-1 protein negativity. (Korean J Dermatol 2019;57(9):532∼537)

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5다수의 경부림프절과 연부조직을 동시에 침범한 두피의 랑게르한스세포육종 1예

저자 : 한만훈 ( Man-hoon Han ) , 김준영 ( Jun Young Kim ) , 이원주 ( Weon Ju Lee ) , 이석종 ( Seok-jong Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 538-543 (6 pages)

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Currently, the World Health Organization classifies Langerhans cell tumors into Langerhans cell histiocytosis and Langerhans cell sarcoma (LCS). LCS is a neoplastic proliferation of Langerhans cells showing malignant cytological features and aggressive clinical behavior with grave prognosis. Only a few cases have been reported in the available literature; therefore, to date, no definitive treatment has been established. A 64-year-old woman presented with a 1-year history of an asymptomatic, slow-growing erythematous nodule measuring 0.7 cm on her scalp. The patient also reported a 3-month history of a painful swelling on the right side of her neck. Histopathological examination of a scalp biopsy specimen revealed sheets of atypical cells with hyperchromatic nucleoli and clear cytoplasm. Immunohistochemical studies revealed malignant cells positive for CD1a, CD31, CD68, and S-100 expression. Additionally, positron emission tomography-computed tomography and fine-needle aspiration revealed LCS of the cervical lymph nodes and surrounding soft tissue. We recommended surgical excision and adjunctive chemotherapy; however, the patient refused treatment and died of the disease 28 months later. (Korean J Dermatol 2019;57(9):538∼543)

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6Eruptive Keratoacanthoma en Plaque Confirmed by Complete Spontaneous Regression: A Case Report and Review of the Literature

저자 : Seok-jong Lee , Tae In Park , Joon Soo Park , Jae Bok Jun , Hye Won Lee

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 544-547 (4 pages)

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Here we present a case of an unusual variant of keratoacanthoma, eruptive keratoacanthoma en plaque, occurring on the upper lip of a 58-year-old man. The lesion was a flesh-colored nodular plaque measuring 1.5×1.0 cm that rapidly grew within 2 months. After two biopsies, the cutaneous lesion grew more rapidly for 1 month, covering the entire cutaneous surface of the upper lip and measuring 6.0×2.0 cm. Thereafter, it disappeared without any treatment within 3 months, resulting in mild scarring with a cobblestone-like surface similar to the stereotypical involuting course of ordinary keratoacanthoma. In addition to the clinical features, the present case displayed essential diagnostic features of eruptive keratoacanthoma by showing typical spontaneous involution not reported in previous reports. Furthermore, it also revealed histopathology suggestive of squamous cell carcinoma, at least focally in addition to that of keratoacanthoma, which may evoke the potential for a misdiagnosis of malignancy. (Korean J Dermatol 2019;57(9):544∼547)

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7Severe Hyperhidrosis in Apert Syndrome: A Case Report

저자 : Hanjae Lee , Sungjun Choi , Ji Hoon Yang , Jungyoon Moon , Dae Hun Suh

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 548-550 (3 pages)

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Apert syndrome is a rare genetic disorder characterized by malformations of the skull, face, hands, and feet. We report a case of severe hyperhidrosis in a 13-month-old female infant with Apert syndrome who was born with craniosynostosis, midface hypoplasia, and syndactyly of both hands. She had a history of excessive sweating since birth and this was confirmed using the iodine-starch test. Hyperhidrosis was first reported as a key cutaneous manifestation of Apert syndrome in 1993. However, the main focus in the field of dermatology is on antibiotic-refractory acne, which serves as another cutaneous hallmark of the disease. This is the first report in the Korean literature that describes hyperhidrosis in Apert syndrome. We highlight the presentation of hyperhidrosis as a key cutaneous manifestation in Apert syndrome. (Korean J Dermatol 2019;57(9):548∼550)

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8Lichen Planus Developed During the Treatment with Nivolumab in a Patient with Lung Cancer: A Case Report and Literature Review

저자 : Eunjung Park , Taehan Koo , Mingyul Jo , Jisook Yoo , Jiho Park

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 551-555 (5 pages)

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Nivolumab is a fully-humanized IgG4 monoclonal antibody that competitively binds to the programmed cell death receptor-1 protein (an immune check-point molecule) present on activated T cells. Nivolumab is approved for the treatment of advanced melanoma, lung cancer, and renal cell carcinoma. It attenuates the inactivation of cytotoxic CD8+ T cells and, produces an antitumor effect; however it may be associated with immune-related adverse events, including the development of lichen planus (LP). A 72-year-old man presented with a 2-month history of multiple, polygonal, purplish papules on the dorsal aspect of both hands. He was diagnosed with large cell neuroendocrine carcinoma (LCNEC) of the lung 4 years earlier and was treated with nivolumab (3 mg/kg every 2 weeks) for 9 months. By the 14th course of nivolumab therapy, the patient developed multiple rashes on the dorsal aspect of both hands, and biopsy was consistent with findings of LP. We report a rare case of LP in a patient with lung cancer treated with nivolumab. (Korean J Dermatol 2019;57(9):551∼555)

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9광선 치료 후 박탈피부염으로 진행된 농포건선 1예

저자 : 박수정 ( Su Jung Park ) , 정국진 ( Guk Jin Jeong ) , 홍준기 ( Jun Ki Hong ) , 서성준 ( Seong Jun Seo )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 556-557 (2 pages)

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10Oxybutynin 치료에 상반된 반응을 보인 국소 다한증: 증례 보고

저자 : 김민성 ( Min Sung Kim ) , 배인호 ( In Ho Bae ) , 최훈 ( Hoon Choi ) , 나찬호 ( Chan Ho Na ) , 신봉석 ( Bong Seok Shin )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 57권 9호 발행 연도 : 2019 페이지 : pp. 558-559 (2 pages)

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