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RISS 인기검색어
- 검색키워드
- 저자 : ( Dae San Yoo ) (검색결과 38 건)
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( Dae San Yoo ),( Ahreum Song ),( Byung Ho Oh ),( Mi Ryung Roh ),( Kee Yang Chung ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Keloids impair the quality of life of patients by causing cosmetic disfigurement and may accompany pain and pruritus. In keloids of the earlobes and the helix of the auricle, surgical excision with postoperative radiation therapy is considered the most efficacious treatment. However, surgical treatment is hesitated for keloids in other parts of the body due to high possibility of recurrence. Objectives: To analyse the effectiveness of surgical excision of keloids in different parts of the body followed by postoperative radiation therapy. Methods: We evaluated 22 patients with keloids treated with surgical resection followed by radiation therapy from 2017 to 2019. Variables such as age, sex, treatment history, site of lesion and prognosis were analysed. Results: Surgical resection was performed in all patients. External beam radiation therapy was initiated within 12 hours of operation. The keloids were located predominantly in earlobe and helix (n=11), chest wall (n=5), arm (n=3), shoulder (n=2) and axilla(n=1). The recurrence rate for the entire cohort was 27%(6/22); for the keloids located in ear, the recurrence rate was 9.1%(2/11), while the rate for keloids in the other parts was 36%(4/11). Conclusion: Keloids of various parts of the body can be successfully treated by customized plan which involves appropriate surgical modalities to minimize the tension of the resection site, including z-plasty, pulley suture and keloid fillet flap followed by postoperative radiation therapy.
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Long-term survival of patients with bullous pemphigoid after rituximab treatment
( Dae San Yoo ),( Ji Hye Lee ),( Soo-chan Kim ),( Jong Hoon Kim ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1
Background: Bullous pemphigoid (BP) is one of the most common autoimmune bullous diseases. Rituximab, a monoclonal antibody targeting CD20, has been used in patients with refractory BP and has been demonstrated to be effective in rapidly achieving remission. However, long-term survival of BP patients receiving rituximab remains unknown. Objectives: To evaluate long-term survival and clinical outcome of BP patients treated with rituximab and to identify prognostic factors associated with survival. Methods: A retrospective cohort study was conducted on 52 patients diagnosed with BP treated with rituximab therapy between 2017 and 2020 at Gangnam Severance Hospital. We compared this cohort with our previous cohort from the published study in BP patients treated with conventional therapy without rituximab. Results: Of 52 patients, 37 patients have been given two doses of rituximab with 1,000 mg at 2-week intervals. Remission rate is 75.7% and the median time to remission was 5.4 months. The 1-, 2-, and 5-year mortality rates were 11%, 18%, and 35% which were lower than the previous cohort showing 19%, 29%, and 58%, respectively, but statistical significance of mortality between two cohorts was not seen. Dementia, neurologic diseases and failure of remission were associated with increased mortality in multivariate analysis. Conclusion: Rituximab can increase long-term survival and clinical efficacy in patients with BP.
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A case of poikilodermatous mycosis fungoides: rare disease entity and a diagnostic challenge
( Dae San Yoo ),( Seong Hoon Seo ),( Jee Eun Kim ),( Ji Young Choi ),( Soo-chan Kim ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Poikilodermatous mycosis fungoides (MF) is a rare variant of MF. Clinically, poikilodermatous MF presents as reticulated hypo- and hyperpigmentaed patches that accompany atrophy and telangiectasia. Histopathological features resemble those of classic MF, such as epidermotropism. Additional features such as epidermal atrophy, basal hydrophic changes, lichenoid lymphocytic infiltration with pigment incontinence and telangiectasia are more prominent in poikilodermatous MF. Immunohistochemical studies for CD3 and CD45RO show positive results while stains for CD2, CD5 and CD7 may show loss of positivity. Herein, we report a case of poikilodermatous MF in a 31-year-old Korean man. The patient visited our clinic with reticulated violaceous patches with atrophy on the axillae, lower back and inguinal areas. The skin biopsy revealed epidermal atrophy with severe basal hydropic degeneration, and some epidermotropic atypical lymphocytes on the dermo-epidermal junction. Dense lichenoid lymphocytic infiltration, dilated capillaries and dermal melanophages were also found in the upper dermis. Immunohistochemical stains for CD3, 4, 5 and 8 were positive. Although T cell receptor-gamma gene rearrangement did not showed clonal gene rearrangement, the diagnosis of poikilodermatous MF was made based on the clinical and histopathological features. The patient showed good response to narrow band UVB (311nm) phototherapy with topical potent steroid.
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A rare case of anti-laminin 332 mucous membrane pemphigoid
( Dae San Yoo ),( Jong Hoon Kim ),( Soo-chan Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
A 69-year-old Korean man visited our clinic with diffuse erythematous bullae and erosions on the whole body including oral cavity accompanied with laryngeal stricture and conjunctivitis. Direct immunofluorescence (IF) revealed IgG deposition on the basement membrane zone and indirect IF revealed IgG deposition on the dermal side. In further study, IgG autoantibodies to laminin 332 were detected by immunoblotting and ELISA of laminin 332 for IgG antibodies was not performed. The patient has been treated for 9 months with systemic corticosteroids, colchicine and dapsone with a disease controlled status. Mucous membrane pemphigoid (MMP), an autoimmune subepithelial blistering disease that predominantly affects the mucous membranes and lead to scarring, is usually diagnosed in elderly adults. Many antigens of MMP have been detected including BP180 antigens, BP230 antigens, 97/120-kDa linear IgA bullous disease antigen, type VII collagen, integrin β4 antigen and laminin 332 antigens. MMP with anti-laminin 332 autoantibody is a rare type of blistering disorder and rates ranged from approximately 20% among the patients with MMP clinical phenotype. According to retrospective study of anti-laminin 332 in MMP patients, patients with anti-laminin 332 autoantibodies had more severe MMP frequently accompanied by esophageal involvement. This is the first case of anti-laminin 332 MMP reported in Korean as an educational case.
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A case of neutrophilic urticarial dermatosis: a rare entity of neutrophilic dermatosis
( Dae San Yoo ),( Jong Hoon Kim ),( Soo-chan Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Neutrophilic urticarial dermatosis (NUD) clinically resembles urticarial but histopathologically represents a neutrophilic dermatosis. Affected patients develop erythematous macules, papules or slightly raised plaques on the skin that resolve within 24 to 48 hours. Trunk and extremity involvement is most common. Histopathologic examination of NUD reveals an intense neutrophilic infiltrate in the dermis with leukocytoclasia, but without significant edema in dermis or fibrinoid necrosis of vessel walls which is usually seen in vasculitis. Clinical manifestations of NUD are similar with urticarial but skin lesions of NUD frequently last more than 24 hours and accompany with systemic symptoms such as fever and joint pain. NUD differ from Sweet’s syndrome in terms of no lesional pain and the lesions of NUD are clinically far less edematous and raised than in Sweet’s syndrome. In histologic terms, major derma edema with a denser neutrophilic infiltrate is seen in Sweet’s syndrome than NUD. A 69-year-old female patient came to emergency room for fever and spreading erythematous patches and plaques on the face, trunk and both extremities for 1 week. Skin biopsy showed mild upper dermal edema and interstitial neutrophilic infiltrate in dermis. Direct immunofluorescence showed C3 deposition on the blood vessels. Skin lesions and fever were cleared without recurrence after the treatment of systemic corticosteroid and colchicine.
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( Dae San Yoo ),( Mi Ryung Roh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Pityriasis lichenoides et varioliformis acuta (PLEVA) is a disease of the immune system usually presenting as an acute eruption of inflammatory papules. A lot of studies about the PLEVA were reported worldwide, but there is no research yet about PLEVA in Korean patients. Objectives: To evaluate the clinical characteristics of PLEVA in Korea population and compare to previous studies already reported. Methods: We retrospectively reviewed 39 cases of PLEVA diagnosed with skin biopsy from single, tertiary hospital from 2007, to 2019 May. All patients’ clinical manifestations, treatment, and prognosis were analyzed. Long-term follow up via telephone interviews were performed. Results: Mean age at onset was 31 years. An equitable distribution was shown from children to mid-aged adults and there were no senior patients (age>65). There was a more male distribution (74%, 29/39) than female. Mean follow up period was 9 months which was shorter in pediatrics (6 months). Almost patients (95%, 37/39) showed whole body invasion. Lots of patients presented short period hyperpigmentation after all lesions resolved. The effective treatments are topical steroids, systemic steroids, phototherapy and antibiotics. Conclusion: PLEVA is an acute, short-lasting inflammatory popular disorder. PLEVA clinically exhibits mild maculopapular lesion to severe ulcerative and crusted lesions. The treatment response varied and almost of patients recovered without sequela except pruritus and pigmentation.
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Hepatitis B virus reactivation with pemphigus vulgaris after rituximab therapy : Report of two cases
( Dae San Yoo ),( Jong Hoon Kim ),( Soo-chan Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Pemphigus is a potentially fatal autoimmune blistering disease. Rituximab therapy is increasingly being used with pemphigus patients failed with conventional therapies since it has tolerate side effects and recently, there was an experts’ consensus about considering rituximab therapy as a first-line treatment for moderate to severe pemphigus. There have been reports of rituximab induced hepatitis virus reactivation in the patients with hematologic, oncologic and rheumatologic diseases, but there is no report of hepatitis virus reactivation during or after rituximab therapy in pemphigus patients. Herein, we firstly report 2 cases of hepatitis B virus reactivations with pemphigus vulgaris after rituximab therapy. The patients were diagnosed with pemphigus vulgaris by skin biopsy, direct and indirect immunofluorescence. The patients received rituximab 1,000mg twice time at 2 weeks interval with systemic high dose of corticosteroid. One patient suffered from acute hepatic failure followed by a liver transplantation after 2 months of rituximab therapy with serum HBV DNA 21,400,000 IU/mL and has been treated in intensive care unit. The other patient was hospitalized for HBV reactivation after 4 months of rituximab therapy with serum HBV DNA 75,500,000 IU/mL and treated for 1 week with healthy condition.
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