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구본석 ( Bon Seok Ku ),이영규 ( Yeong Kyu Lee ),권오언 ( Oh Eon Kwon ),이채욱 ( Chae Wook Lee ),김기호 ( Ki Ho Kim ) 대한피부과학회 2006 大韓皮膚科學會誌 Vol.44 No.12
Nicolau syndrome or embolia cutis medicamentosa is an acute necrotic condition of skin that follows intramuscular injection of drugs. A 36-year-old man developed a painful, purpuric and erythematous patch on his left buttock following an intramuscular injection of diclofenac sodium. Histologically, the patch lesion displayed epidermal necrosis, dermal degeneration, and vascular thrombosis. We report a rare case of Nicolau syndrome following intramuscular injection of diclofenac sodium. In our case, the patient was successfully treated by surgical excision with primary closure. (Korean J Dermatol 2006;44(12):1464~1466)
건선에서 Tazarotene의 치료 효과와 염증성 혈관형성에서의 작용기전
구본석 ( Bon Seok Ku ),이채욱 ( Chae Wook Lee ),김기호 ( Ki Ho Kim ) 대한피부과학회 2007 大韓皮膚科學會誌 Vol.45 No.9
Background: Psoriasis is characterized by chronic recurrent erythematous skin plaques that exhibit epidermal hyperplasia, inflammatory cell accumulation and abnormalities of the papillary dermal vasculature. Psoriatic skin lesions show enlargement and increased tortuosity of cutaneous microvessels without formation of new vessel sprouts, that is, inflammatory angiogenesis. Placental growth factor (PIGF) and Tie-2 were reported to be up-regulated during inflammatory angiogenesis. Tazarotene is the first receptor-selective retinoid and its effects include normalizing keratinocyte differentiation, reducing keratinocyte proliferation and reducing inflammation. Objective: Our study evaluated the clinical efficacy of topical tazarotene treatment and clarified histological changes and possible action mechanisms of this agent in respect of inflammatory angiogenesis. Methods: We selected patients with symmetric psoriatic lesions and applied 0.1% tazarotene gel (Tazorac(R)) versus calcitriol 3μg/g gel (Silkis(R)) twice a day for 12 weeks with a right-left comparison. We grouped the patients with treatment modalities. Clinical efficacy, which was measured by the overall lesional assessment (OLA) scores, was assessed at each visit in 2 week` intervals until treatment closed. Skin biopsies were performed before the treatment started and again at 4 weeks and 12 weeks after treatment. Immunohistochemistry of PIGF, Tie-2 and factor-VIII was performed to elucidate the anti-angiogenetic effect of tazarotene. Results: At the completion of 12 weeks of treatment, the OLA score of tazarotene-treated lesions was more reduced than that of calcitriol-treated lesions combined with phototherapy, it was more effective. Several histologic features such as epidermal hyperplasia, inflammatory cell infiltration and vessel dilation/tortousity were improved with decreased PIGF and Tie-2 expressions. Conclusion: These results indicate that tazarotene is an effective topical agent for psoriasis by blocking inflammatory angiogenesis. (Korean J Dermatol 2007;45(9):898∼907)
이영규 ( Yeong Kyu Lee ),구본석 ( Bon Seok Ku ),김영훈 ( Young Hun Kim ),이채욱 ( Chae Wook Lee ),김기호 ( Ki Ho Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.4
Pigmented neurofibroma is a rare cutaneous tumor accounting for less than 1% of all neurofibroma. It is characterized histologically by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiation. The origin of these tumors are unknown, and they show a storifom pattern. In our case, the patient had giant cafe au lait patches on the left trunk which had been present since birth, freckles on both axilla, and two dark-red colored plaques which had appeared 2 years ago. Histologic examination revealed pigmented neurofibromas showing the melanin-laden, pigmented cells within the upper dermis and plexiform neurofibromas in the subcutaneous tissue. We describe a case of pigmented neurofbroma in a 13-year-old male patient. (Korean J Dermatol 2007;45(4):387~390)
Margin Strip Method를 이용한 미세도식 수술의 결과 및 환자 만족도
김영훈 ( Young Hun Kim ),구본석 ( Bon Seok Ku ),이영규 ( Yeong Kyu Lee ),최규원 ( Kyu Won Choi ),송기훈 ( Ki Hoon Song ),김기호 ( Ki Ho Kim ),이채욱 ( Chae Wook Lee ) 대한피부과학회 2007 大韓皮膚科學會誌 Vol.45 No.12
Background: Mohs micrographic surgery (MMS) was known as an ideal treatment for non-melanocytic skin cancers. Recently, various modified MMS methods have been introduced. Margin strip method is a modified micrographic surgery technique that makes operation and reconstruction more easy. Objective: The aim of this study was to evaluate the treatment results and patients` satisfaction of micrographic surgery using margin strip method. Methods: We reviewed 72 cases of basal cell carcinomas (BCCs) and 36 cases of squamous cell carcinomas (SCCs) treated with micrographic surgery using margin strip method from January 2001 to December 2004. We analyzed them in aspects of the sex, age, duration, location, size and histological types of tumor. They were also evaluated in aspects of surgical margin, depth, stage, defect size and reconstruction methods. We also analyzed follow-up data concerning recurrence rate, complications and patients` satisfaction. Results: SCCs were more common in older age groups, and BCCs were showing centrofacial distribution. Mean numbers of stage was 1.5 in BCC and 1.3 in SCC, and safety excised margins were 0.72 cm in BCC and 1.03 cm in SCC. Infiltrative type of BCC, the numbers of stage and size of safety excised margin were increased. The transposition and rotation flap were most commonly used in BCC and SCC, respectively. Patients` satisfaction were 8.06 in BCC and 7.76 in SCC. 6. Recurrence rate were 0% in BCC and 5.6% in SCC. Conclusion: Micrographic surgery using margin strip method may be a useful and satisfactory method for the treatment of non-melanocytic skin cancers. (Korean J Dermatol 2007;45(12):1246∼1252)
이영규 ( Yeong Kyu Lee ),구본석 ( Bon Seok Ku ),김영훈 ( Young Hun Kim ),이채욱 ( Chae Wook Lee ),김기호 ( Ki Ho Kim ) 대한피부과학회 2007 大韓皮膚科學會誌 Vol.45 No.5
Pseudocyst of the auricle is an uncommon condition, which typically presents as an asymptomatic, noninflammatory swelling of the external ear. Most of the patients are usually young, healthy males without trauma. Histological examination is characterized by the intracartilaginous accumulation of serous fluid without an epithelial lining. The pathogenesis is unknown. Some theories about the release of lysosomal enzymes or inflammatory mediators and embryologic dysplasia of the auricle cartilage have been suggested. Treatment of pseudocyst of the auricle has usually involved a simple aspiration and compressive dressing, but this may often cause the fluid to reaccumulate. Treatment by surgical excision may result in a permanent deformity and scar of the auricle. Therefore, various treatments have been suggested. We report a case of pseudocyst of the auricle successfully treated by incisional biopsy only. (Korean J Dermatol 2007;45(5):518~520)