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대한피부과학회> 대한피부과학회지> Eczematous Vesicular Rruption and Exacerbation of Chronic Spontaneous Urticaria Associated with Secukinumab

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

Sang-min Choi , Bark-lynn Lew , Woo-young Sim , Soon-hyo Kwon
  • : 대한피부과학회
  • : 대한피부과학회지 60권9호
  • : 연속간행물
  • : 2022년 11월
  • : 611-614(4pages)
대한피부과학회지

DOI


목차

INTRODUCTION
CASE REPORT
DISCUSSION
CONFLICTS OF INTEREST
ORCID
REFERENCES

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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)

UCI(KEPA)

간행물정보

  • : 의약학분야  > 피부과학
  • : KCI등재
  • : SCOPUS
  • : 월간
  • : 0494-4739
  • : 2713-7627
  • : 학술지
  • : 연속간행물
  • : 1960-2023
  • : 9785


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61권1호(2023년 01월) 수록논문
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1한국인 호산구성 연조직염 환자의 임상 및 조직학적 특징: 환자 사례군 연구 및 문헌 고찰

저자 : 김민재 ( Min Jae Kim ) , 송원지 ( Won Ji Song ) , 이수란 ( Soo Ran Lee ) , 조소연 ( Soyun Cho ) , 문제호 ( Je-ho Mun ) , 허창훈 ( Chang Hun Huh ) , 나정임 ( Jung-im Na ) , 신정원 ( Jung Won Shin )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 1-12 (12 pages)

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Background: Eosinophilic cellulitis, also known as Wells' syndrome, is an uncommon skin disease characterized by recurrent pruritic polymorphous plaques or nodules. There is limited knowledge in the Korean literature regarding the clinical characteristics and course of eosinophilic cellulitis.
Objective: To investigate the clinical and histological features of eosinophilic cellulitis in Korean patients.
Methods: In this case series study, we retrospectively reviewed the electronic medical records of patients diagnosed with eosinophilic cellulitis at our institutions from 2004 to 2022. We also analyzed the literature published in dermatology and internal medicine journals in Korea.
Results: A total of 17 patients were included in this study (age, 39.4±21.8 years; 12 male [70.6%]), with an average disease duration of 4.4 months. We identified six clinical variants, with the typical plaque type being the most common (33.3%), followed by the papulonodular type (22.2%). Eosinophilia was observed in 78.6% of patients, and a flame figure, which is a typical histopathological feature of eosinophilic cellulitis, was observed in 52.9% of patients. Systemic and topical steroids and antihistamines were used as first-line treatment with generally favorable results (82.4%), followed by antibiotics (35.3%), cyclosporine (23.5%), and topical calcineurin inhibitors (23.5%). The recurrence rate during the mean follow-up period of 21.8 months was 29.4%.
Conclusion: Eosinophilic cellulitis can present with various clinical manifestations, and flame figures do not appear in all cases; therefore, clinical and histological correlations are critical for accurate diagnosis of patients with eosinophilic cellulitis. (Korean J Dermatol 2023;61(1):1∼12)

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2암전문 3차의료기관 피부과에 내원한 고형암에 의한 전이피부암 191예의 임상 및 조직병리학적 고찰

저자 : 박형건 ( Hyung Keon Park ) , 윤숙정 ( Sook Jung Yun )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 13-21 (9 pages)

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Background: Metastatic skin cancers occur when cancer cells metastasize to the skin as the primary cancer progresses, but few studies in Korea have included a large number of patients.
Objective: To analyze the clinicopathological characteristics of metastatic skin cancers originating from solid cancers.
Methods: A total of 191 patients with metastatic skin cancer diagnosed by skin biopsy from April 2004 to December 2021 were retrospectively analyzed. Data on age, sex, duration, symptoms, clinical manifestations, metastatic sites, and histopathological findings were obtained from medical records and photographs.
Results: The mean age of onset was 65.3 years, the male/female ratio was 80:111, and the mean duration was 3.3 months. Most patients were asymptomatic (65.4%), and the most frequent manifestation was nodular lesions (64.4%). Among the 191 metastatic skin cancers, the most common primary cancers were breast cancer (31.9%), lung cancer (25.7%), and melanoma (18.8%). The most common primary cancer in males was lung cancer (52.5%), and that in females was breast cancer (54.1%). The most common sites of metastatic skin cancer were the chest (26.6%), scalp (17.9%), abdomen (10.6%), and back (9.2%). The most common histopathological finding of metastatic skin cancer was adenocarcinoma (53.4%), followed by melanoma (18.8%) and squamous cell carcinoma (14.7%).
Conclusion: We believe that this study will be helpful in diagnosing metastatic skin cancer in patients with a history of cancer or a newly diagnosed primary cancer. (Korean J Dermatol 2023;61(1):13∼21)

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3손발톱 사구종양의 초음파 소견: 20예 분석

저자 : 김성범 ( Sungbum Kim ) , 이지원 ( Ji Won Lee ) , 이수란 ( Soo Ran Lee ) , 오지선 ( Jiseon Oh ) , 문제호 ( Je-ho Mun )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 22-28 (7 pages)

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Background: Glomus tumors are benign vascular tumors derived from the glomus body, a neuromuscular vascular tissue responsible for regulating the temperature and blood flow of the skin. Ultrasonography (USG) is a useful tool for diagnosing glomus tumors; nevertheless, data on Korean patients with glomus tumors are limited.
Objective: This study aimed to describe USG findings of subungual glomus tumors in Korean patients.
Methods: We retrospectively reviewed the medical records and USG readings of 20 cases of glomus tumors in the nail apparatus diagnosed from January 2015 to December 2021.
Results: Twenty patients were included in this study. Four patients (20.0%) were male and 16 (80.0%) were female. The age of onset ranged from 18∼86 years, with a mean of 45.2 years. USG findings showed hypoechoic echogenicity in all cases. Tumor size ranged from 2.3∼10 mm (mean±standard deviation, 5.5±1.9 mm). The tumor shape observed on USG was oval in 16 cases (80.0%), lobulated in three cases (15.0%), and round in one case (5.0%). Tumor boundaries were well-defined in 18 cases (90.0%) and ill-defined in two cases. Posterior acoustic enhancement and cortical erosion were observed in 19 (95.0%) and 17 cases (85.0%), respectively. Increased vascularity was observed in 19 cases (95.0%).
Conclusion: This study revealed characteristic USG features of glomus tumors. USG is a helpful tool for the diagnosis and management of glomus tumors. (Korean J Dermatol 2023;61(1):22∼28)

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4한국에서의 단일 병변 광선 각화증 환자에 있어 국소 5-Fluorouracil 도포, 국소 Imiquimod 도포와 냉동외과술의 치료 효용성 비교에 관한 연구

저자 : 박성진 ( Sung Jin Park ) , 김윤재 ( Yoon Jae Kim ) , 조준혁 ( Jun Hyuk Cho ) , 김대현 ( Dai Hyun Kim ) , 안효현 ( Hyo Hyun Ahn ) , 서수홍 ( Soo Hong Seo )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 29-35 (7 pages)

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Background: Actinic keratosis (AK) is a common precancerous cutaneous lesion. There are various AK treatment methods; however, no specific method is considered superior. Most existing studies on AK treatment are Caucasian-based and include patients with multiple lesions.
Objective: This study aimed to compare the treatment duration, financial costs, and success rates of topically applied 5% 5-fluorouracil (5-FU) solution, 5% imiquimod (IMIQ) cream, and cryosurgery in the treatment of histologically proven single-lesion AK in Korean patients.
Methods: We retrospectively reviewed the medical records of patients with single-lesion AK at a single Korean center from January 2018 to February 2021. Each patient was treated using the three aforementioned local treatments.
Results: The study included 58 patients. Nineteen of 23 (82.6%), 27 of 27 (100%), and eight of eight patients (100%) were successfully treated after topical 5-FU, topical IMIQ, and cryosurgery, respectively. Further analysis on treatment success by subgroup revealed the following: mean number of outpatient visits, 3.78 vs. 4.41 vs. 3.75; mean treatment duration, 5.79 vs. 6.00 vs. 9.38 weeks; and mean total treatment cost, 79,380 vs. 170,023 vs. 173,116 won; for the 5-FU, IMIQ, and cryosurgery subgroups, respectively. The total treatment cost was significantly different among the subgroups (p≤0.001).
Conclusion: Topical IMIQ and cryosurgery were superior in terms of treatment efficacy, but considering its low cost, 5-FU may also be a reasonable option. Hence, an individualized approach to treating localized AK should be taken. (Korean J Dermatol 2023;61(1):29∼35)

KCI등재 SCOPUS

5Anti-Melanogenic Effect of Adiponectin on Co-Culture Models and Human Skin Tissues Ex Vivo

저자 : Youngkyoung Lim , Myoung Eun Choi , Mi Young Lee , Hyesoo Cho , Seunghyun Bang , Sung Eun Chang

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 36-42 (7 pages)

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Background: Adiponectin is an adipose-derived hormone that plays a role in various metabolic diseases. We previously demonstrated that adiponectin inhibits melanin synthesis through adenosine monophosphate-activated protein kinase (AMPK) activation in melanocytes. However, melanocytes can be affected by neighboring keratinocytes, and the effect of adiponectin on these functional units has not been investigated.
Objective: We investigated the effect of adiponectin on melanogenesis in co-cultured models of normal human melanocytes (NHMs), normal human keratinocytes (NHKs), and human dermal fibroblasts (HDFs), and the effect of adiponectin on melanin content in human skin tissues.
Methods: Quantitative real-time polymerase chain reaction (qPCR) was performed for tyrosinase and microphthalmia-associated transcription factor (MITF). The degree of phosphorylation of AMPK, cAMP response element binding protein (CREB), and AKT was evaluated by western blot assay, and Fontana-Masson staining was performed on cultured human skin tissues.
Results: Adiponectin decreased the melanin content in the co-culture models of NHMs with NHKs, NHMs with HDFs, and NHMs with both NHKs and HDFs. qPCR revealed that both tyrosinase and MITF were decreased after adiponectin treatment in the co-culture system. Following adiponectin treatment, AMPK was activated in all cell groups; however, the phosphorylation of CREB was decreased in HDFs and NHKs. The phosphorylation of AKT was decreased in only NHMs. In the experiment with human skin tissues cultured ex vivo, the densitometric analysis of Fontana-Masson staining revealed that adiponectin treatment reduced the melanin level of ultraviolet-irradiated human skin tissues.
Conclusion: Adiponectin inhibited melanogenesis in both co-culture models and human skin tissues ex vivo. (Korean J Dermatol 2023;61(1):36∼42)

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6The Prognosis of Post-Scabetic Itch

저자 : Jin Cheol Kim , Bo Young Chung , So Yeon Lee , Jin Seo Park , Seok Young Kang , Soo Ick Cho , Chun Wook Park , Hye One Kim

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 43-51 (9 pages)

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Background: The primary goal of scabies treatment is to eliminate mites; however, but post-scabetic itch persists in many patients. Since long-standing itching can lead to the development of other comorbidities, appropriate interventions are necessary.
Objective: This study aimed to investigate the effects of inappropriate (continuous or prolonged) scabicide use and oral steroids on the duration of pruritus in patients with scabies.
Methods: The duration of pruritus, use of oral corticosteroids, total immunoglobulin E (IgE) levels, specific IgE levels for house dust mites, and eosinophil counts were evaluated. Post-scabetic itch was defined as itching that persisted for more than 3 weeks, although scabies was no longer detected; 208 participants with post-scabetic itch were included.
Results: We recruited 265 participants with confirmatory diagnosis of scabies and 116 with clinical diagnosis. We treated 124 participants with scabicides based on the guidelines, whereas 257 participants were not. The type of scabicide did not affect the duration of pruritus. Scabicide overuse did not shorten the duration of pruritus; however, its prolonged use lengthened the treatment period. Although oral corticosteroids did not shorten the duration of pruritus in the patients, they were effective when the patient had post-scabetic itch. In addition, a positive correlation between the total IgE level and duration of pruritus was observed.
Conclusion: This study investigated the effect of treatment modality on the clinical course of scabies. Our findings suggest that overuse of scabicides might be associated with post-scabetic itch, and short-term use of oral corticosteroids may be effective in reducing its duration. (Korean J Dermatol 2023;61(1):43∼51)

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7융모양막염 산모로부터 출생한 극소저체중아에서 발생한 선천성 피부 칸디다증 1예

저자 : 김경민 ( Kyungmin Kim ) , 김도연 ( Doyeon Kim ) , 홍동균 ( Dongkyun Hong ) , 정경은 ( Kyung Eun Jung ) , 서영준 ( Young-joon Seo ) , 장미영 ( Meayoung Chang ) , 이영 ( Young Lee )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 52-56 (5 pages)

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Congenital cutaneous candidiasis (CCC) is a rare disease caused by Candida spp. that occurs within the first six days of life. Its exact pathogenesis remains unclear; however, the suspected pathomechanisms include maternal vulvovaginal candidiasis and ascending infections. A preterm, 1,550-g male infant presented with generalized maculopapules and pustules on his whole body. The patient's mother had undergone cervical cerclage at a gestational age (GA) of 29 weeks due to an incompetent internal os of the cervix. The pregnancy was terminated at GA 37-week because the mother developed chorioamnionitis. We performed a potassium hydroxide microscopic examination, skin biopsy, and fungal culture test on the baby. Microscopic examination of the skin scrapings revealed pseudohyphae with yeasts, and Candida albicans was identified in the culture test. Maternal placental biopsy revealed fungal organisms, and the baby was diagnosed with CCC due to an ascending infection. The skin lesions completely disappeared after intravenous liposomal amphotericin B treatment. (Korean J Dermatol 2023;61(1):52∼56)

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8유전자 돌연변이가 확인된 모구 형질세포양 수지상세포 종양 1예

저자 : 유동화 ( Dong-wha Yoo ) , 박경덕 ( Kyung-deok Park ) , 권혁진 ( Hyeok-jin Kwon ) , 김기호 ( Ki-ho Kim ) , 윤정호 ( Jung-ho Yoon )

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 57-61 (5 pages)

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Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive lymphoma with an overall incidence of 0.04 cases per 100,000 people. BPDCN is a hematopoietic clonal neoplasm that originates from plasmacytoid dendritic cell precursors. A 63-year-old man presented with multiple erythematous nodules over his whole body, including his face, trunk, and both upper and lower extremities that appeared 1 month ago. Skin biopsy showed diffuse dermal infiltration by monomorphic atypical lymphocytes with large, irregular nuclei and scant cytoplasms. Immunohistochemical staining was positive for CD4, CD56, and CD123. The karyotype test showed abnormalities in male chromosomes 47, XY, +8 [2]/46, and XY [25], and mutations in DNMT3A, TET2, SRSF2, and ATRX genes were identified in a next-generation sequencing (NGS)-based acute myeloid leukemia gene panel test. The patient was diagnosed with BPDCN and treated with a KALLA 1406 regimen; however, he died on the 17th day of treatment. (Korean J Dermatol 2023;61(1):57∼61)

KCI등재 SCOPUS

9A Case of Bullous Pemphigoid in a Metastatic Melanoma Patient Treated with Pembrolizumab, Dabrafenib, and Trametinib

저자 : Donghwi Jang , Jongeun Lee , Jaihee Bae , Yeonjoo Jung , Heeyeon Kim , Se Jin Oh , Jong Hee Lee , Dong-youn Lee , Ji-hye Park

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 62-65 (4 pages)

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Bullous pemphigoid (BP) is a chronic and recurrent bullous disorder that may be associated with the administration of certain drugs. Recently, bullous cutaneous adverse events after immunotherapy (IT) or targeted therapy have been increasingly reported. Here, we report a case of BP in a patient diagnosed with metastatic melanoma after treatment with pembrolizumab, dabrafenib, and trametinib. Histopathological examination showed a subepidermal blister with perivascular lymphocytic and eosinophilic infiltration; the accompanying findings of linear immunoglobulin G and C3 deposition by immunofluorescence microscopy were consistent with BP. Since IT agents may initiate immune dysregulation and pathologic autoantibody production, which are required for the pathogenesis of BP, the lesions were thought to be cutaneous adverse events caused by IT. (Korean J Dermatol 2023;61(1):62∼65)

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10AZD1222 COVID-19 백신 접종 후 발생한 급성국소발진농포증

저자 : 허연우 , 이상훈 , 홍승필

발행기관 : 대한피부과학회 간행물 : 대한피부과학회지 61권 1호 발행 연도 : 2023 페이지 : pp. 66-67 (2 pages)

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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)

KCI등재SCOUPUS

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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