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안면부 대상포진의 임상적 특징에 따른 안과적 합병증과 포진 후 신경통의 위험인자 분석
정한힘 ( Han Him Jeong ),오신엽 ( Shin Yeop Oh ),이현주 ( Hyun Joo Lee ),허은필 ( Eun Phil Heo ),고재완 ( Jae Wan Go ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.4
Background: Facial herpes zoster can be accompanied by several complications. In particular, postherpetic neuralgia (PHN) and ocular complications (OCs) are relatively common. Both PHN and OC are of interest because they can lower the quality of life. Objective: This study aimed to evaluate the clinical features of facial herpes zoster and to assess the risk factors of OCs and PHN. Methods: We analyzed the medical records of 146 patients with facial herpes zoster from January 2014 to May 2019. We assessed the proportion of OCs and PHN in patients with facial herpes zoster according to several clinical factors, including age, sex, dermatomal distribution, delayed time to treatment, and associated systemic conditions. OCs were divided into mild and severe ocular complications (SOC) by ophthalmologic diagnosis. Results: The incidence rate of OCs (83.8%) and SOC (37.8%) were highest in patients in their 70s. Herpes zoster involving the ophthalmic and maxillary branches of the trigeminal nerves showed a significantly higher incidence rate of OCs and SOC than those involving only the ophthalmic branch (p=0.031, p=0.025). Patients who received antiviral treatment within 4 days showed lower rates of OCs and SOC than patients who received treatment after 5 days (p<0.001, p=0.003). The incidence of PHN was significantly higher in those over 60 years old, when both the ophthalmic and maxillary branches were involved, and for those treated more than 4 days after the onset. Conclusion: To decrease the risk of OCs and PHN in facial herpes zoster, it is important to provide early antiviral treatment and appropriate ophthalmologic consultation. (Korean J Dermatol 2020;58(4):245∼253)
정한힘 ( Han Him Jeong ),김창일 ( Chang Il Kim ),정홍필 ( Hong Pil Jeong ),조선영 ( Sun Young Jo ),고재완 ( Jae Wan Go ),허은필 ( Eun Phil Heo ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.10
Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made. (Korean J Dermatol 2020;58(10):697∼700)
A case of erythema nodosum leprosum presenting with weakness of lower extremities
( Seung Gi Hong ),( Sun Young Jo ),( Han Him Jeong ),( Eun Phil Heo ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Erythema nodosum leprosum (ENL) is an immune complex-mediated type 2 leprosy reaction, and characterized by tender erythematous nodules involving the skin and peripheral nerves. In our case, 78-years-old man had weakness of extremities along with fever, arthralgia, numbness, and malaises from one month before visiting our hospital. He has several ulcerative plaques on the trunk, painful tender subcutaneous nodules on post-auricular area, and facial palsy. Eyebrow and eyelash alopecia were seen. Glove and stocking anesthesia was also evident. Both greater auricular nerves were thickened without tenderness. In histopathologic examination, neutrophilic infiltration diffusely scattered around blood vessels. The acid fast bacillus test showed bacillus and M. leprae PCR was positive. PGL-1 antibody level was 80. At presentation, he did not recognize that he had been diagnosed with leprosy in 1989. He arbitrarily discontinued the multiple drug therapy (MDT) of rifampin, dapsone and clofazimine a few months ago. The patient’s condition had improved with methylprednisolone administration. MDT had been maintained for about 12 months. With this case, we highlight the unusual presentation of lepromatous leprosy in erythema nodosum leprosum reaction and the need to exclude other infectious diseases after arbitrarily discontinued MDT.
Histopathologic review of longitudinal melanonychia: single secondary referral center
( Seung Gi Hong ),( Sun Young Jo ),( Han Him Jeong ),( Hong Pil Jeong ),( Hyun Joo Lee ),( Jae Wan Go ),( Eun Phil Heo ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Longitudinal melanonychia is characterized by pigmented bands on the nail plate. It caused by deposition of either melanin or other substances, and associated with activation or proliferation of nail matrix melanocytes. Objectives: We aimed to evaluate the histopathological findings of longitudinal melanonychia in Korean single secondary referral center patients. Methods: In our study, 46 patients with longitudinal melanonychia who visited our clinic from January 2012 to December 2018 were included. We retrospectively reviewed the histopathologic findings that confirmed by biopsy in 47 cases of longitudinal melanonychia. Results: Of the 47 affected nail plates, 33 (70.2%) were fingernails, and longitudinal melanonychia was detected most frequently in the left 1st fingernail (25.5%). Nail matrix nevus was most common (28.3%), followed by subungual melanoma (26.1%), and nail apparatus lentigo (21.7%). 13 patients (28.3%) diagnosed with malignancy, including one with basal cell carcinoma, and 76.9% (10/13 patients) showed a positive Hutchinson’s sign were diagnosed with malignancy. There were 4 patients with accompanying nail plate deformation or ulcers, and of these, 2 patients (50%) were diagnosed with malignancy. Conclusion: This study presented variable histopathologic features of longitudinal melanonychia. We should be considering various conditions as well as melanoma, and determine the appropriate management in patients with longitudinal melanonychia.