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Propranolol to treat infantile hemangioma in patients with congenital heart disease
( Min Young Park ),( Jeong Min Kim ),( Gun Wook Kim ),( Magaret Song ),( Hoon Soo Kim ),( Byung Soo Kim ),( Moon Bum Kim ),( Hyun Chang Ko ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2
Background: Oral propranolol has been recently proposedas a novel treatment option for problematic infantile hemangioma(IH),but clinical trials to determine its safety in pediatric patients with IH are ongoing. Heart examination is essential before starting propranol and IH with congenital heart disease(CHD) was often found.But,reports of propranolol uses in patients with IHand CHD are very rare. Objectives: We want to determine the safety and therapeutic efficacy of propranolol in patients with IH and CHD. Methods: A total of 21 IH patients with CHD treated with propranolol were enrolled in this study. Before propranolol was initiated,electrocardiography and Doppler echocardiography were performed by a pediatric cardiologist to identify any pre-existing cardiac abnormality. Propranolol was started in hospital at 0.5mg/kg/d and increased to 2.0mg/kg/d. Results: All patients had 1 or more congenital heart defects including atrial septal defect, mitral regurgitation,ventricular septal defect,and pulmonary stenosis, but these are not absolute contraindications for propranolol use. During propranolol treatment, all patients had normal heart rate and blood pressure measurements. They tolerated propranolol well, and no major adverse effects were noted. Of the 21 patients, 19(90.5%) eventually showed a good to excellent response, with minimal residual lesions. Conclusion: Our experience indicates that oral propranolol can be administered to IH infants with asymptomatic cardiac abnormalities.
( Hyun Chang Ko ),( Sang Jin Cheon ),( Jeong Min Kim ),( Gun Wook Kim ),( Magaret Song ),( Hoon Soo Kim ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2
Background: Pulsed dye laser (PDL) is the standard treatment for capillary malformation, although complete resolution is rare despite multiple sessions. Timolol maleate, topical beta-blocker, has been reported to beeffective for treating infantile hemangioma. Timolol can induce apoptosis of capillary endothelial cells and also inhibit the production of VEGF in an animal model. Objectives: To determine whether the topical timolol combined with PDL versus PDL alone can improvetherapeutic outcome of capillary malformation. Methods: Nine patients with capillary malformation were recruited in this prospective, randomized, split-lesion comparison study. One side of lesion was treated with PDL followed by twice daily application of timolol maleate 0.5% solution, and the other side with PDL alone. 5 sessions of PDL were performed at 6 week intervals. Clinical responses were evaluated using erythema index of mexameter and photographs at each follow-up visit. Results: Patients treated with topical timolol and PDL were shown decrement of 26.0% (18 - 39) in erythema index and those with PDL alone were yielded decrement of 24.9% (18-31), but there was no significant difference (p=0.486). No adverse effect related to the application of topical timolol solution was found. Conclusion: Topical timolol solution does not seem to be effective adjuvant therapy in the treatment of capillary malformation using PDL.
Benign form of malignant atrophic papulosis
( Min Young Park ),( Jeong Min Kim ),( Gun Wook Kim ),( Je Ho Mun ),( Magaret Song ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Malignant atrophic papulosis (MAP) also called Degos disease is a rare, about 200 reported cases in the world. It is a primary vaso-occlusive disorder, affecting mainly the skin, the gastrointestinal tract, and the central nerve system. The benign form of MAP is a rare disorder with specific skin lesions without any other organ involvement. Cutaneous lesions consist of erythematous, dome-shaped papules that develop a central area of necrosis to leave a porcelain-like scar. Commonly, MAP has a poor prognosis: in more than 50% of cases death occurs within 2 years. Nevertheless, approximately 15% of MAP cases exhibit long-term survival in benign cutaneous form of Degos. A 53-year-old woman presented with atrophic papulosis on trunk and extremities with no evidence of systemic involvement so far. Clinically it manifests typical pathognomonic papules of Degos as slightly depressed, porcelain-white atrophic center, surrounded by a slightly raised reddish rim. Histopathologically, it shows generalized atrophic epidermis with hyperkeratosis. Also, slightly thickened vessel walls and collagen degeneration were observed in dermis. The clinical and histopathological findings supported a diagnosis of benign form of Degos disease. To the best of our knowledge, this case is the second report of benign form of MAP in Korean literature. Therefore, we report a rare case of benign form of Degos disease.
Basal cell carcinoma on the scalp -The distinguishing features compared with that on the face-
( Hoon Soo Kim ),( Ki Hyuk Shin ),( Jeong Min Kim ),( Gun Wook Kim ),( Magaret Song ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2
Background: Basal cell carcinoma(BCC) usually develops on sun-exposed skin. Scalp is exposed to the outside but tends to be classified as non-exposed area because the hair blocks the sunlight. Scalp is the most commonly affected site except face, but clinical studies for BCC on the scalpare not well elucidated. Objectives: To investigate the incidence and features of the patients with BCC on the scalp Methods: Forty two patients with BCC on the scalp for 16 years in Pusan National University Hospital were included in this study. We reviewed the clinical records of these patients. Results: Among a total of 933 patients with BCC in our hospital for 16 years, 42 patients (4.5%) had BCC on the scalp. Female(76%) was more predominant and mean age at diagnosis was 62.5 years. The most common clinical subtype was nodular type(47.6%) but incidence of superficial type(28.6%) was remarkable compared with that on the face. The rate of patients with multiple lesions(28.6%) and chronic arsenic poisoning(16.7%) was relatively high. In histologic subtypes, The superficial type(40.5%) was the most common. Conclusion: Based on our study, BCC on the scalp tended to have features of the BCC occurred on non-exposedarea and especially showed the remarkable rate of multiple lesions and superficial subtype.
Photodrug dermatitis induced by lomefloxacin
( Min Young Park ),( Jeong Min Kim ),( Gun Wook Kim ),( Won Jeong Kim ),( Je Ho Mun ),( Magaret Song ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Moon Bum Kim ),( Byung Soo Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Photosensitivity is an uncommon but characteristic side effect of quinolones and photodrug dermatitis is a type photoallergic reaction evoked by ingestion or injection some drugs. Several cases of quinolone-induced photosensitivity have been described with the chemically related fluoroquinolones, such as enoxacin, pefloxacin, ofloxacin, ciprofloxacin, and also, lomefloxacin. Lomefloxacin is a difluorinated quinolone that combined excellent pharmacokinetics with a broad spectrum antimicrobial activity. A 83-year-old male without previous drug allergies presented with maculopapular pruritic eruption on the sun-exposed areas including his face, neck and both dorsum of hands. He had been taking oral lomefloxacin for 2 months to prevent urinary tract infection. The lesion was clinically eczematous and a skin biopsy demonstrated spongiotic tissue reaction. On phototest, minimal erythema dose of UVA was 5J/cm definitely decreased comparing with normal range (60-100 J/cm2). The results of patch and photopatch test were both negative. We suspected that lomefloxacin was the cause of photodrug dermatitis. After stopping lomefloxacin, there was a progressive improvement of the skin lesions and no recurrence. To the best our knowledge, this is the first case report of a patients with lomefloxacin induced photodrug dermatitis in the Korean literature.
P273 : Tuberous sclerosis presented only with connective tissue nevi: usefulness of genetic testing
( Sung Min Park ),( Gun Wook Kim ),( Hyun Ho Cho ),( Won Jeong Kim ),( Je Ho Mun ),( Magaret Song ),( Hoon Soo Kim ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bun Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.1