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백반증 환자에서 PUVA 치료후 나타난 부작용에 대한 임상적 고찰
김영숙,강형철 ( Young Sook Kim,Hyung Chul Kang ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.4
Background: Oral of topical psoralen photochemotherapy is the most popular arid efficacious treatment, available for repigmentation of vitiliginous patches. However this therapy is often used for prolonged periods and various types of pigmentary changes can be observed and sometimes, may be carcinogenic. The safety of PUVA therapy has been an issue of debate. Objective .' The purpose of the study was to describe in more detail the complications of PUVA treatment and to investigate a possible relation with multiple factors. Patients and Method: We studied 137 vitiligo patients who received PUVA therapy(using oral 8-MOP) for more than six months in our department between March 1990 and June 1996. Resulte . The results are summarized as follows 1. Among 137 cases of vitiligo, the numbers of male and female patients were 40(29.2%) and 97(70.8%) respectively. The mean age at the start of PUVA was 39 years and the mean duration of treatment was 31 months. There were no patients with skin type I and II. Forty cases had skin type III, 68 skin type IV, 29 skin type V. 2. Acute side effects were nausea(35.8%), pruritus(32:8% ), erythema(30.7%), headache(21.2 %), dizziness(18.8%), burning sensation(16.8%), fatigue(8.8%) and the Koebner phenomenon(1.5 %). These are all reversible and disappear on discontinuation of treatment.. 3. PUVA-induced pigmentary changes were PUVA lentigines(39 cases;26.3%), hypopigmented confetti macules(36 cased;26.3%), mottling(31 cases,22.6%), nail pigmentation(8 cases,5.8%) and PUVA keratosis(7 cases;5.1%) 4. The mean cumulative UVA dose was 1833J/cm and the mean number of treatments was 171. In the high-dose group and the patients who had the most number of treatments, we observed an increased number of patients with PUVA lentigiens and mottling. However, no relationship was observed between the development of PUVA-induced pigmentary changes and sex or age at the start, of PUVA or in relation to skin type. 5. We did not see any patients with melanoma, nonmelanoma skin cancer or systemic cancer. Conclusion : Long term exposure to PUVA significantly increases chronic clinical side effects of PUVA. Therefore carefuI clinical follow-up of patients who receive long term PUVA therapy in necessary. This risk shoud be considered in selection of treatment. (Kor J Dermatol 1997;35(4): 684-692)
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수포성 피부 병변으로 시작된 수포성 전신성 홍반성 루프스
김영숙,강호정,최혜영,강형철 ( Young Sook Kim,Ho Jung Kang,Hae Young Choi,Hyung Chul Kang ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4
We describe a 19-year-old girl showing typical laboratory and clinical features of bullous systemic lupus erythematosus(BSLE). Clinically she has suffered from recurrent vesiculobullous skin eruptions for 7 years. The bullous eruption has not been known as the initial manifestation of SLE until she was diagnosed as SLE. These cutaneous lesions have waxed and waned with oral prednisolone with or without dapsone. Bullous SLE should be considered in the differential diagnosis of children presenting with generalized bullous eruptions. (Kor J Dermatol 1997;35(4): 767-771)
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