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대한피부과학회> 대한피부과학회지> 화농성 한선염 환자의 병변 평가와 중증도 설정을 위한 초음파 검사의 유용성

KCI등재SCOUPUS

화농성 한선염 환자의 병변 평가와 중증도 설정을 위한 초음파 검사의 유용성

Usefulness of Sonographic Examination for Evaluation and Severity Assessment of Hidradenitis Suppurativa

김고은 ( Ko Eun Kim ) , 정재영 ( Jae Yeong Jeong ) , 박병근 ( Byeong Geun Park ) , 김일환 ( Il-hwan Kim )
  • : 대한피부과학회
  • : 대한피부과학회지 59권8호
  • : 연속간행물
  • : 2021년 09월
  • : 587-595(9pages)
대한피부과학회지

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Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent abscesses, nodules, and fistulous tracts. Recently, novel staging systems, including sonographic scoring system of hidradenitis suppurativa (SOS-HS), have been widely introduced in HS.
Objective: To assess the efficacy of SOS-HS compared with Hurley staging and modified sartorius scoring (MSS) system and determine the necessity of ultrasound evaluation.
Methods: A radiologist performed an ultrasound evaluation, and three dermatologists reviewed the images and videos. Clinical characteristics, including staging and demographic data, were recorded by three dermatologists. The correlation of each staging system and the significance of vascularity (Doppler mode) and lesion depth on sonography were statistically analyzed.
Results: Among the 46 patients, 34.8% were classified as stage 1 and 3, and 30.4% were classified as stage 2 in the SOS-HS system, which was statistically higher than the Hurley staging (p<0.0005). MSS score increased according to the SOS-HS stages (p<0.0005, p=0.001). Vascularity and depth of involvement also increased with SOS-HS and Hurley staging.
Conclusion: Sonographic examination can be applied in HS severity assessment and documentation of the clinical characteristics of each lesion in detail. Special tools, such as Doppler mode and depth assessment, can also be useful in HS evaluation. (Korean J Dermatol 2021;59(8):587∼595)

UCI(KEPA)

간행물정보

  • : 의약학분야  > 피부과학
  • : KCI등재
  • : SCOPUS
  • : 월간
  • : 0494-4739
  • : 2713-7627
  • : 학술지
  • : 연속간행물
  • : 1960-2021
  • : 9592


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59권8호(2021년 09월) 수록논문
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KCI등재 SCOPUS

1단기간 피부과 의료봉사와 세계보건: 기후 변화 분석을 통한 후향적 연구

저자 : 함민석 ( Min Seok Ham ) , 김대연 ( Dae Yeon Kim ) , 김대현 ( Dai Hyun Kim ) , 서수홍 ( Soo Hong Seo ) , 안효현 ( Hyo Hyun Ahn )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 581-586 (6 pages)

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Background: The coronavirus disease pandemic has directly impacted global health. In developing countries, health service problems are more serious because of the lack of healthcare infrastructure. In this situation, if medical needs could be predicted, it would be helpful to bridge the medical gap with the provision of appropriate medical support.
Objective: The aim of this study was to evaluate the association between climate change and skin diseases in developing countries to better prepare for medical missions.
Methods: From 2012 to 2016, except for 2014, we visited a mission site located in Luzon, Philippines, every July. We retrospectively reviewed 499 patient data as well as weather information.
Results: The total number of patients decreased each year. The climate change analysis using Pearson correlation showed that the temperature and ultraviolet index tended to increase every year (r2=0.99, 0.93, respectively; p< 0.05). Conversely, humidity and rainfall decreased (r2=-0.99, -0.96, respectively; p<0.05). The Cochran-Armitage test showed that the rate of infectious skin disease diagnoses decreased every year compared to that of eczematous diseases.
Conclusion: The total number of patients decreased by approximately 50% during medical service. We believe that the improvement in living standards and hygiene through continuous medical support has influenced the change in the incidence of skin diseases. Climate change was also thought to have affected the rate of skin disease diagnoses; in fact, the rate of infectious disease diagnoses tended to decrease compared to that of eczematous diseases. This analysis would be helpful for preparing for medical support. (Korean J Dermatol 2021;59(8):581∼586)

KCI등재 SCOPUS

2화농성 한선염 환자의 병변 평가와 중증도 설정을 위한 초음파 검사의 유용성

저자 : 김고은 ( Ko Eun Kim ) , 정재영 ( Jae Yeong Jeong ) , 박병근 ( Byeong Geun Park ) , 김일환 ( Il-hwan Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 587-595 (9 pages)

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Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent abscesses, nodules, and fistulous tracts. Recently, novel staging systems, including sonographic scoring system of hidradenitis suppurativa (SOS-HS), have been widely introduced in HS.
Objective: To assess the efficacy of SOS-HS compared with Hurley staging and modified sartorius scoring (MSS) system and determine the necessity of ultrasound evaluation.
Methods: A radiologist performed an ultrasound evaluation, and three dermatologists reviewed the images and videos. Clinical characteristics, including staging and demographic data, were recorded by three dermatologists. The correlation of each staging system and the significance of vascularity (Doppler mode) and lesion depth on sonography were statistically analyzed.
Results: Among the 46 patients, 34.8% were classified as stage 1 and 3, and 30.4% were classified as stage 2 in the SOS-HS system, which was statistically higher than the Hurley staging (p<0.0005). MSS score increased according to the SOS-HS stages (p<0.0005, p=0.001). Vascularity and depth of involvement also increased with SOS-HS and Hurley staging.
Conclusion: Sonographic examination can be applied in HS severity assessment and documentation of the clinical characteristics of each lesion in detail. Special tools, such as Doppler mode and depth assessment, can also be useful in HS evaluation. (Korean J Dermatol 2021;59(8):587∼595)

KCI등재 SCOPUS

3최근 8년간(2012∼2020) 단일기관 피부과에서의 연조직염 입원환자에 대한 임상적 고찰

저자 : 정홍필 ( Hong Pil Jeong ) , 김창일 ( Chang Il Kim ) , 허은필 ( Eun Phil Heo ) , 고재완 ( Jae Wan Go )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 596-603 (8 pages)

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Background: Cellulitis is one of the most common infectious skin diseases treated by hospitalization, and presents with various clinical features and treatment responses. Therefore, more detailed analysis on this condition is required.
Objective: To investigate the clinical characteristics of cellulitis among dermatology inpatients in a single center.
Methods: We retrospectively reviewed the medical records of 84 patients hospitalized with cellulitis between January 2012 and August 2020. We analyzed the differences by dividing them into <60-year-old and >60-year-old age groups.
Results: The average age of the 84 inpatients in this study was 48.8 years with the peak incidence in fifties. Cellulitis was most prevalent in the calf (39.8%). Erythrocyte sedimentation rate (ESR) and risk factors such as obesity and smoking had positive correlations with duration of hospital stay (p<0.05). There was no significant difference in duration of hospital stay between those administered first-generation cephalosporin and other antibiotics.
Conclusion: Our data showed that ESR, obesity, and smoking were correlated to the hospitalization periods. In particular, it showed positive correlation of C-reactive protein and ESR with duration of hospital stay in those below the age of 60 years. (Korean J Dermatol 2021;59(8):596∼603)

KCI등재 SCOPUS

4스티븐스 존슨 증후군 및 독성표피괴사융해증 88예의 임상적 고찰

저자 : 홍정연 ( Jeong Yeon Hong ) , 정의현 ( Euy Hyun Chung ) , 양나경 ( Na Gyeong Yang ) , 김재윤 ( Jae Yun Kim ) , 허남훈 ( Nam Hun Heo ) , 이설희 ( Sul Hee Lee ) , 김정은 ( Jung Eun Kim ) , 이성열 ( Sung Yul Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 604-610 (7 pages)

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Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal acute hypersensitivity reactions that involve the skin and mucous membranes. Because they are relatively rare diseases, it is difficult to obtain well-organized epidemiological data. The clinicodemographic characteristics, culprit drugs, and factors related to disease prognosis may vary.
Objective: To identify the characteristics of SJS/TEN by investigating patient clinicopathological characteristics, laboratory findings, suspected drugs, and mortality through a retrospective study using medical record data.
Methods: The clinical records of patients diagnosed with SJS/TEN between February 2009 and February 2019 at three medical institutions of Soonchunhyang University were retrospectively reviewed. Data pertaining to sex, age, history, suspected drugs, latent period, laboratory findings, and mortality were collected, and their correlations were analyzed.
Results: We identified SJS/TEN in 88 patients. Among the probable causative agents, antibiotics were the most common (29 cases, 33.0%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) in 20 cases (22.7%). The period between drug administration and symptom onset varied with the causative agent. Patients who died had high SCORTEN scores. In addition, hypertension, diabetes, renal failure, and cardiac disease had a statistically significant association with high SCORTEN.
Conclusion: Antibiotics, NSAIDs, antiepileptics and allopurinol were the most commonly implicated drugs in our retrospective study. There was a significant correlation between comorbidities. Because SJS/TEN is a life-threatening condition, early recognition of the suspected drug are important. The results of this study may provide insights that aid in the early diagnosis and prediction of disease outcomes of SJS/TEN in the Korean population. (Korean J Dermatol 2021;59(8):604∼610)

KCI등재 SCOPUS

5외국인 어업 노동자의 바닷물 첩포검사에 대한 보고

저자 : 서지민 ( Ji Min Seo ) , 윤소연 ( So Yeon Yoon ) , 구하예린 ( Ha Yeh Rin Koo ) , 김경문 ( Gyong Moon Kim ) , 유동수 ( Dong Soo Yu ) , 이영복 ( Young Bok Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 611-617 (7 pages)

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Background: Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported.
Objective: The aim of this study was to investigate the patch test results of seawater in foreign maritime workers.
Methods: We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary's Hospital and St. Vincent's Hospital from January 2017 to August 2020.
Results: A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years. Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater.
Conclusion: These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results. (Korean J Dermatol 2021;59(8):611∼617)

KCI등재 SCOPUS

6조갑진균증에서 병리조직검사의 진단적 가치 및 Periodic Acid-Schiff와 Gomori's Methenamine Silver 염색의 민감도 비교

저자 : 백가연 ( Gayun Baek ) , 구태한 ( Taehan Koo ) , 이동훈 ( Donghoon Lee ) , 강현지 ( Hyun Ji Kang ) , 김민수 ( Min-soo Kim ) , 김영혜 ( Younghye Kim ) , 주민숙 ( Mihn-sook Jue )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 618-623 (6 pages)

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Background: A direct potassium hydroxide (KOH) smear is used to diagnose onychomycosis despite its broad sensitivity range. For a more accurate diagnosis, histopathologic examination can be used and consistently show high sensitivity.
Objective: We investigated the value of histopathologic examination of the nail plate as a diagnostic tool for onychomycosis. We proposed effective routine diagnostic staining to compare sensitivity between periodic acid-Schiff (PAS) and Gomori's methenamine silver (GMS) staining.
Methods: This retrospective study was conducted from January 1, 2019 to May 31, 2020, and included 97 patients who showed negative results on direct KOH smear but had clinical manifestations that implied onychomycosis. We performed nail plate biopsy and PAS or GMS staining to identify fungal hyphae missed in the direct KOH smear. Sensitivity comparison between PAS and GMS was performed in co-stained samples.
Results: Among 97 patients with 102 cases, 55 cases (53.9%) of onychomycosis were confirmed by histopathologic examination. A total of 68 patients (70.1%) had a previous medical history of antifungal agents within previous six months. PAS and GMS staining were concurrently performed in 73 cases, and onychomycosis was confirmed in 41 cases. The sensitivity of PAS was 100% (41/41), while that of GMS was 87.8% (36/41); this difference was not significant.
Conclusion: This study suggests that histologic examination of the nail plate is an effective tool to diagnose onychomycosis and can be performed with a direct KOH smear. Two staining methods, PAS and GMS, are recommended for concurrent performance to enhance the identification of fungal hyphae. (Korean J Dermatol 2021;59(8):618∼623)

KCI등재 SCOPUS

7주사 환자의 임상적 고찰 및 주사의 진단 분류 체계의 비교에 대한 연구

저자 : 임준수 ( Joon Soo Lim ) , 권은선 ( Eun Sun Kwon ) , 명기범 ( Ki Bum Myung ) , 정승현 ( Seung Hyun Cheong )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 624-633 (10 pages)

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Background: Rosacea is a common chronic inflammatory skin disease, which primarily affects the central face. In 2002, the National Rosacea Society (NRS) committee developed the first diagnostic criteria for rosacea, based on its subtypes. The revised classification in 2017 prompted a proposal to transit from a subtyping to a phenotyping approach, reflecting current insights into rosacea pathogenesis, pathophysiology, and management.
Objective: This study aimed to elucidate the clinical features of rosacea and compare two diagnostic criteria in rosacea patients.
Methods: We performed a clinical study on 100 patients with rosacea diagnosed according to the 2002 NRS criteria. The age, sex, clinical features, subtypes, severity, and predisposing factors were evaluated using the questionnaire. In addition, we compared the 2002 and 2017 criteria, and evaluated patients if they met the revised criteria.
Results: According to the 2002 NRS classification, the erythematotelangiectatic type (88.0%) was the most frequent, followed by the papulopustular (43.0%), ocular (13.0%), and phymatous (6.0%) types. There were 44 overlapping cases, including 38 cases with 2 subtypes mixed and 6 cases with three subtypes. Six patients were diagnosed with rosacea using the 2002 NRS criteria but they did not satisfy the revised 2017 criteria.
Conclusion: We found that the diagnostic features of the 2002 criteria are too ambiguous for the diagnosis of rosacea. Therefore, we recommend that dermatologists recognize the necessity of a transition from a subtyping to a phenotyping approach, according to the 2017 criteria for the diagnosis of rosacea. (Korean J Dermatol 2021;59(8): 624∼633)

KCI등재 SCOPUS

8Histopathological and Immunohistochemical Differentiation between Psoriasis and Seborrheic Dermatitis of the Scalp: Based on Langerin and CD1a

저자 : Ji Ha Yoon , Hye Rim Park , Eun Joo Park , Kwang Joong Kim , Kwang Ho Kim

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 634-639 (6 pages)

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Background: Psoriasis and seborrheic dermatitis are difficult to distinguish if the lesion is localized to the scalp.
Objective: To validify the use of langerin and CD1a as markers of Langerhans cells to distinguish scalp psoriasis from seborrheic dermatitis.
Methods: We retrospectively evaluated 25 seborrheic dermatitis cases and 17 psoriasis cases diagnosed at a tertiary medical center in Korea from 2010 to 2019. The histopathological features and expression of CD1a and langerin were analyzed by dermato-pathologists.
Results: Hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound were observed more frequently in the psoriasis group than in the seborrheic dermatitis group (p=0.016, p=0.027, and p=0.021, respectively). Other features examined did not show statistically significant differences. Dermal expression of langerin occurred more frequently in the psoriasis group than in the seborrheic dermatitis group (76.5% vs. 36.0%, p=0.010). Additionally, stronger CD1a dermal expression was observed in the psoriasis group than in the seborrheic dermatitis group (p=0.049), although the difference in overall dermal CD1a expression regardless of strength was not significant. In contrast, the epidermal expressions of CD1a and langerin did not show significant differences. Similarly, the follicular expressions of CD1a and langerin did not demonstrate significant differences.
Conclusion: In this retrospective study, histopathological findings that favored psoriasis over seborrheic dermatitis included hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound. The use of Langerhans cells, CD1a, and langerin as markers could help distinguish scalp psoriasis from seborrheic dermatitis. (Korean J Dermatol 2021;59(8):634∼639)

KCI등재 SCOPUS

9아랫입술에 발생한 육종성 편평세포암

저자 : 남경화 ( Kyung-hwa Nam ) , 이일재 ( Il-jae Lee ) , 이상경 ( Sang-kyung Lee ) , 박진 ( Jin Park ) , 김한욱 ( Han-uk Kim ) , 윤석권 ( Seok-kweon Yun )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 640-643 (4 pages)

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Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months. His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy. (Korean J Dermatol 2021;59(8):640∼643)

KCI등재 SCOPUS

10Cutaneous Adverse Events of Anti-Programmed Cell Death Receptor-1 Antibody: Two Case Reports and a Literature Review

저자 : Joon Soo Lim , Hyun Hee Kim , Eun Sun Kwon , Ki Bum Myung , Seung Hyun Cheong

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 644-648 (5 pages)

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The introduction of immune checkpoint inhibitors, including anti-programmed cell death receptor-1 antibodies (anti-PD-1 Ab), such as nivolumab and pembrolizumab, represents a major breakthrough in cancer therapy. The PD-1 pathway inhibits T cell activation, maintaining a normal and balanced immune response. Anti-PD-1 Ab induces T cell activity by inhibiting the suppressive effect of PD-1 signaling on T cells. Excessive stimulation of T cells represents a potential mechanism for multiple skin lesions. To the best of our knowledge, reports on cutaneous adverse effects during treatment with anti-PD-1 Ab are limited in the dermatological literature of Korea. Herein, we report two rare cases of nivolumab-induced lichenoid drug eruption and pembrolizumab-induced psoriasis. (Korean J Dermatol 2021;59(8):644∼648)

12
권호별 보기
같은 권호 다른 논문
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KCI등재SCOUPUS

1단기간 피부과 의료봉사와 세계보건: 기후 변화 분석을 통한 후향적 연구

저자 : 함민석 ( Min Seok Ham ) , 김대연 ( Dae Yeon Kim ) , 김대현 ( Dai Hyun Kim ) , 서수홍 ( Soo Hong Seo ) , 안효현 ( Hyo Hyun Ahn )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 581-586 (6 pages)

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Background: The coronavirus disease pandemic has directly impacted global health. In developing countries, health service problems are more serious because of the lack of healthcare infrastructure. In this situation, if medical needs could be predicted, it would be helpful to bridge the medical gap with the provision of appropriate medical support.
Objective: The aim of this study was to evaluate the association between climate change and skin diseases in developing countries to better prepare for medical missions.
Methods: From 2012 to 2016, except for 2014, we visited a mission site located in Luzon, Philippines, every July. We retrospectively reviewed 499 patient data as well as weather information.
Results: The total number of patients decreased each year. The climate change analysis using Pearson correlation showed that the temperature and ultraviolet index tended to increase every year (r2=0.99, 0.93, respectively; p< 0.05). Conversely, humidity and rainfall decreased (r2=-0.99, -0.96, respectively; p<0.05). The Cochran-Armitage test showed that the rate of infectious skin disease diagnoses decreased every year compared to that of eczematous diseases.
Conclusion: The total number of patients decreased by approximately 50% during medical service. We believe that the improvement in living standards and hygiene through continuous medical support has influenced the change in the incidence of skin diseases. Climate change was also thought to have affected the rate of skin disease diagnoses; in fact, the rate of infectious disease diagnoses tended to decrease compared to that of eczematous diseases. This analysis would be helpful for preparing for medical support. (Korean J Dermatol 2021;59(8):581∼586)

KCI등재SCOUPUS

2화농성 한선염 환자의 병변 평가와 중증도 설정을 위한 초음파 검사의 유용성

저자 : 김고은 ( Ko Eun Kim ) , 정재영 ( Jae Yeong Jeong ) , 박병근 ( Byeong Geun Park ) , 김일환 ( Il-hwan Kim )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 587-595 (9 pages)

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Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent abscesses, nodules, and fistulous tracts. Recently, novel staging systems, including sonographic scoring system of hidradenitis suppurativa (SOS-HS), have been widely introduced in HS.
Objective: To assess the efficacy of SOS-HS compared with Hurley staging and modified sartorius scoring (MSS) system and determine the necessity of ultrasound evaluation.
Methods: A radiologist performed an ultrasound evaluation, and three dermatologists reviewed the images and videos. Clinical characteristics, including staging and demographic data, were recorded by three dermatologists. The correlation of each staging system and the significance of vascularity (Doppler mode) and lesion depth on sonography were statistically analyzed.
Results: Among the 46 patients, 34.8% were classified as stage 1 and 3, and 30.4% were classified as stage 2 in the SOS-HS system, which was statistically higher than the Hurley staging (p<0.0005). MSS score increased according to the SOS-HS stages (p<0.0005, p=0.001). Vascularity and depth of involvement also increased with SOS-HS and Hurley staging.
Conclusion: Sonographic examination can be applied in HS severity assessment and documentation of the clinical characteristics of each lesion in detail. Special tools, such as Doppler mode and depth assessment, can also be useful in HS evaluation. (Korean J Dermatol 2021;59(8):587∼595)

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3최근 8년간(2012∼2020) 단일기관 피부과에서의 연조직염 입원환자에 대한 임상적 고찰

저자 : 정홍필 ( Hong Pil Jeong ) , 김창일 ( Chang Il Kim ) , 허은필 ( Eun Phil Heo ) , 고재완 ( Jae Wan Go )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 596-603 (8 pages)

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Background: Cellulitis is one of the most common infectious skin diseases treated by hospitalization, and presents with various clinical features and treatment responses. Therefore, more detailed analysis on this condition is required.
Objective: To investigate the clinical characteristics of cellulitis among dermatology inpatients in a single center.
Methods: We retrospectively reviewed the medical records of 84 patients hospitalized with cellulitis between January 2012 and August 2020. We analyzed the differences by dividing them into <60-year-old and >60-year-old age groups.
Results: The average age of the 84 inpatients in this study was 48.8 years with the peak incidence in fifties. Cellulitis was most prevalent in the calf (39.8%). Erythrocyte sedimentation rate (ESR) and risk factors such as obesity and smoking had positive correlations with duration of hospital stay (p<0.05). There was no significant difference in duration of hospital stay between those administered first-generation cephalosporin and other antibiotics.
Conclusion: Our data showed that ESR, obesity, and smoking were correlated to the hospitalization periods. In particular, it showed positive correlation of C-reactive protein and ESR with duration of hospital stay in those below the age of 60 years. (Korean J Dermatol 2021;59(8):596∼603)

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4스티븐스 존슨 증후군 및 독성표피괴사융해증 88예의 임상적 고찰

저자 : 홍정연 ( Jeong Yeon Hong ) , 정의현 ( Euy Hyun Chung ) , 양나경 ( Na Gyeong Yang ) , 김재윤 ( Jae Yun Kim ) , 허남훈 ( Nam Hun Heo ) , 이설희 ( Sul Hee Lee ) , 김정은 ( Jung Eun Kim ) , 이성열 ( Sung Yul Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 604-610 (7 pages)

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Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal acute hypersensitivity reactions that involve the skin and mucous membranes. Because they are relatively rare diseases, it is difficult to obtain well-organized epidemiological data. The clinicodemographic characteristics, culprit drugs, and factors related to disease prognosis may vary.
Objective: To identify the characteristics of SJS/TEN by investigating patient clinicopathological characteristics, laboratory findings, suspected drugs, and mortality through a retrospective study using medical record data.
Methods: The clinical records of patients diagnosed with SJS/TEN between February 2009 and February 2019 at three medical institutions of Soonchunhyang University were retrospectively reviewed. Data pertaining to sex, age, history, suspected drugs, latent period, laboratory findings, and mortality were collected, and their correlations were analyzed.
Results: We identified SJS/TEN in 88 patients. Among the probable causative agents, antibiotics were the most common (29 cases, 33.0%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) in 20 cases (22.7%). The period between drug administration and symptom onset varied with the causative agent. Patients who died had high SCORTEN scores. In addition, hypertension, diabetes, renal failure, and cardiac disease had a statistically significant association with high SCORTEN.
Conclusion: Antibiotics, NSAIDs, antiepileptics and allopurinol were the most commonly implicated drugs in our retrospective study. There was a significant correlation between comorbidities. Because SJS/TEN is a life-threatening condition, early recognition of the suspected drug are important. The results of this study may provide insights that aid in the early diagnosis and prediction of disease outcomes of SJS/TEN in the Korean population. (Korean J Dermatol 2021;59(8):604∼610)

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5외국인 어업 노동자의 바닷물 첩포검사에 대한 보고

저자 : 서지민 ( Ji Min Seo ) , 윤소연 ( So Yeon Yoon ) , 구하예린 ( Ha Yeh Rin Koo ) , 김경문 ( Gyong Moon Kim ) , 유동수 ( Dong Soo Yu ) , 이영복 ( Young Bok Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 611-617 (7 pages)

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Background: Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported.
Objective: The aim of this study was to investigate the patch test results of seawater in foreign maritime workers.
Methods: We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary's Hospital and St. Vincent's Hospital from January 2017 to August 2020.
Results: A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years. Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater.
Conclusion: These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results. (Korean J Dermatol 2021;59(8):611∼617)

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6조갑진균증에서 병리조직검사의 진단적 가치 및 Periodic Acid-Schiff와 Gomori's Methenamine Silver 염색의 민감도 비교

저자 : 백가연 ( Gayun Baek ) , 구태한 ( Taehan Koo ) , 이동훈 ( Donghoon Lee ) , 강현지 ( Hyun Ji Kang ) , 김민수 ( Min-soo Kim ) , 김영혜 ( Younghye Kim ) , 주민숙 ( Mihn-sook Jue )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 618-623 (6 pages)

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Background: A direct potassium hydroxide (KOH) smear is used to diagnose onychomycosis despite its broad sensitivity range. For a more accurate diagnosis, histopathologic examination can be used and consistently show high sensitivity.
Objective: We investigated the value of histopathologic examination of the nail plate as a diagnostic tool for onychomycosis. We proposed effective routine diagnostic staining to compare sensitivity between periodic acid-Schiff (PAS) and Gomori's methenamine silver (GMS) staining.
Methods: This retrospective study was conducted from January 1, 2019 to May 31, 2020, and included 97 patients who showed negative results on direct KOH smear but had clinical manifestations that implied onychomycosis. We performed nail plate biopsy and PAS or GMS staining to identify fungal hyphae missed in the direct KOH smear. Sensitivity comparison between PAS and GMS was performed in co-stained samples.
Results: Among 97 patients with 102 cases, 55 cases (53.9%) of onychomycosis were confirmed by histopathologic examination. A total of 68 patients (70.1%) had a previous medical history of antifungal agents within previous six months. PAS and GMS staining were concurrently performed in 73 cases, and onychomycosis was confirmed in 41 cases. The sensitivity of PAS was 100% (41/41), while that of GMS was 87.8% (36/41); this difference was not significant.
Conclusion: This study suggests that histologic examination of the nail plate is an effective tool to diagnose onychomycosis and can be performed with a direct KOH smear. Two staining methods, PAS and GMS, are recommended for concurrent performance to enhance the identification of fungal hyphae. (Korean J Dermatol 2021;59(8):618∼623)

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7주사 환자의 임상적 고찰 및 주사의 진단 분류 체계의 비교에 대한 연구

저자 : 임준수 ( Joon Soo Lim ) , 권은선 ( Eun Sun Kwon ) , 명기범 ( Ki Bum Myung ) , 정승현 ( Seung Hyun Cheong )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 624-633 (10 pages)

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Background: Rosacea is a common chronic inflammatory skin disease, which primarily affects the central face. In 2002, the National Rosacea Society (NRS) committee developed the first diagnostic criteria for rosacea, based on its subtypes. The revised classification in 2017 prompted a proposal to transit from a subtyping to a phenotyping approach, reflecting current insights into rosacea pathogenesis, pathophysiology, and management.
Objective: This study aimed to elucidate the clinical features of rosacea and compare two diagnostic criteria in rosacea patients.
Methods: We performed a clinical study on 100 patients with rosacea diagnosed according to the 2002 NRS criteria. The age, sex, clinical features, subtypes, severity, and predisposing factors were evaluated using the questionnaire. In addition, we compared the 2002 and 2017 criteria, and evaluated patients if they met the revised criteria.
Results: According to the 2002 NRS classification, the erythematotelangiectatic type (88.0%) was the most frequent, followed by the papulopustular (43.0%), ocular (13.0%), and phymatous (6.0%) types. There were 44 overlapping cases, including 38 cases with 2 subtypes mixed and 6 cases with three subtypes. Six patients were diagnosed with rosacea using the 2002 NRS criteria but they did not satisfy the revised 2017 criteria.
Conclusion: We found that the diagnostic features of the 2002 criteria are too ambiguous for the diagnosis of rosacea. Therefore, we recommend that dermatologists recognize the necessity of a transition from a subtyping to a phenotyping approach, according to the 2017 criteria for the diagnosis of rosacea. (Korean J Dermatol 2021;59(8): 624∼633)

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8Histopathological and Immunohistochemical Differentiation between Psoriasis and Seborrheic Dermatitis of the Scalp: Based on Langerin and CD1a

저자 : Ji Ha Yoon , Hye Rim Park , Eun Joo Park , Kwang Joong Kim , Kwang Ho Kim

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 634-639 (6 pages)

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Background: Psoriasis and seborrheic dermatitis are difficult to distinguish if the lesion is localized to the scalp.
Objective: To validify the use of langerin and CD1a as markers of Langerhans cells to distinguish scalp psoriasis from seborrheic dermatitis.
Methods: We retrospectively evaluated 25 seborrheic dermatitis cases and 17 psoriasis cases diagnosed at a tertiary medical center in Korea from 2010 to 2019. The histopathological features and expression of CD1a and langerin were analyzed by dermato-pathologists.
Results: Hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound were observed more frequently in the psoriasis group than in the seborrheic dermatitis group (p=0.016, p=0.027, and p=0.021, respectively). Other features examined did not show statistically significant differences. Dermal expression of langerin occurred more frequently in the psoriasis group than in the seborrheic dermatitis group (76.5% vs. 36.0%, p=0.010). Additionally, stronger CD1a dermal expression was observed in the psoriasis group than in the seborrheic dermatitis group (p=0.049), although the difference in overall dermal CD1a expression regardless of strength was not significant. In contrast, the epidermal expressions of CD1a and langerin did not show significant differences. Similarly, the follicular expressions of CD1a and langerin did not demonstrate significant differences.
Conclusion: In this retrospective study, histopathological findings that favored psoriasis over seborrheic dermatitis included hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound. The use of Langerhans cells, CD1a, and langerin as markers could help distinguish scalp psoriasis from seborrheic dermatitis. (Korean J Dermatol 2021;59(8):634∼639)

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9아랫입술에 발생한 육종성 편평세포암

저자 : 남경화 ( Kyung-hwa Nam ) , 이일재 ( Il-jae Lee ) , 이상경 ( Sang-kyung Lee ) , 박진 ( Jin Park ) , 김한욱 ( Han-uk Kim ) , 윤석권 ( Seok-kweon Yun )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 640-643 (4 pages)

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Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy with distinct carcinomatous and sarcomatous features. SSCCs involving the lung, esophagus bladder, and skin have been reported as rare case reports. It may also occur infrequently in the oral region. Moreover, the lower lip is still one of the rare sites, and such a case has not been reported in Korean literature. An 82-year-old man presented an exophytic protruding, huge, warty crusted lesion on the entire lower lip. The lesion started as a small, tender, erosive papule and suddenly enlarged in recent months. His medical history was unremarkable. A biopsy revealed atypical squamous and sarcomatous components with transition zones between the two cell types. These two cell types also showed characteristic immunohistochemical features. Based on these findings, the lesion was diagnosed as SSCC. The study, including positron emission tomography-computed tomography, showed no metastasis. We recommended surgical excision, but the patient refused therapy. (Korean J Dermatol 2021;59(8):640∼643)

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10Cutaneous Adverse Events of Anti-Programmed Cell Death Receptor-1 Antibody: Two Case Reports and a Literature Review

저자 : Joon Soo Lim , Hyun Hee Kim , Eun Sun Kwon , Ki Bum Myung , Seung Hyun Cheong

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 59권 8호 발행 연도 : 2021 페이지 : pp. 644-648 (5 pages)

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The introduction of immune checkpoint inhibitors, including anti-programmed cell death receptor-1 antibodies (anti-PD-1 Ab), such as nivolumab and pembrolizumab, represents a major breakthrough in cancer therapy. The PD-1 pathway inhibits T cell activation, maintaining a normal and balanced immune response. Anti-PD-1 Ab induces T cell activity by inhibiting the suppressive effect of PD-1 signaling on T cells. Excessive stimulation of T cells represents a potential mechanism for multiple skin lesions. To the best of our knowledge, reports on cutaneous adverse effects during treatment with anti-PD-1 Ab are limited in the dermatological literature of Korea. Herein, we report two rare cases of nivolumab-induced lichenoid drug eruption and pembrolizumab-induced psoriasis. (Korean J Dermatol 2021;59(8):644∼648)

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