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아토피피부염 환자에서 APDDR-0801 보습 제품의 병용을 통한 스테로이드 외용제제의 사용 절감 효능
노성민 ( Seong Min Noh ),정진영 ( Jin Young Jung ),박원석 ( Won Seok Park ),고현주 ( Hyun Ju Koh ),이광훈 ( Kwang Hoon Lee ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.3
Background: Defective skin barrier function is a well recognized feature in atopic dermatitis (AD) and causes symptoms such as xerosis, pruritus and erythematous lesions. Since moisturizers can strengthen a defective skin barrier and reduce the usage of corticosteroid cream, the choice of moisturizer is very significant for AD patients. Objective: This study was done to compare the steroid-sparing effects of a ceramide-containing moisturizer, APDDR-0801, with a control moisturizer without ceramide, for relieving symptoms associated with AD. Methods: A randomized, controlled, double-blinded 6-week study was conducted. Patients with mild to moderate AD topically applied APDDR-0801 or the control moisturizer on the whole body for 6 weeks. They also applied corticosteroid cream (Zemaderm(R)) on the lesion twice daily for 6 weeks. The amount of corticosteroid used was measured by weighing the tubes. Disease severity was evaluated by eczema severity, area index (EASI), and investigator global assessment (IGA). Transepidermal water loss (TEWL) and skin capacitance were also measured. Results: Of the 40 patients enrolled, 32 completed the protocol. The mean age was (12.95±1.92) and the average baseline EASI score was (10.45±1.17). EASI score, IGA, TEWL and skin capacitance improved in both groups at 3 weeks and 6 weeks. Compared to the control group, the amount of steroid cream used at 3 weeks and 6 weeks decreased by 0.14 g (-18.78%) and 0.76 g (-7.46%), respectively, in the test group. The difference was larger in patients with moderate AD. The consumption of steroids was lower in the test group at 3 weeks [2.65 g (-34.64%)] and at 6 weeks [2.60 g (-19.38%)], respectively. Conclusion: The moisturizer APDDR-0801 (Atobarrier cream(R)) which contains physiologic lipid granules including ceramide, has superior steroid-sparing effects than moisturizers without ceramide. (Korean J Dermatol 2011;49(3): 227∼233)
외인성 아토피피부염과 내인성 아토피피부염 환자의 말초혈액 단핵세포와 피부 병변에서 IL-3와 FcεRI 발현의 차이
김산 ( Shan Jin ),노성민 ( Seong Min Noh ),배병기 ( Byung Gi Bae ),박창욱 ( Chang Ook Park ),이광훈 ( Kwang Hoon Lee ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.6
Background: A small subgroup of atopic dermatitis (AD) patients show low total and allergen-specific immunoglobulin (IgE) levels. This subgroup has been termed ``intrinsic`` AD (IAD) as compared to its counterpart ``extrinsic`` AD (EAD). However, the difference of cytokine expression between IAD and EAD has not been fully understood. Objective: To compare the expression of various inflammatory cytokines in the peripheral blood mononuclear cells (PBMCs) and lesional skin of patients with IAD and EAD, which are known to be associated with AD pathophysiology. Methods: We assessed the protein levels of cytokines in the PBMCs and lesional skin. We evaluated the levels of IL-3, IL-4, IL-5, IL-6, IL-10, IL-13, FcεRI and FcεRII from the PBMCs and lesional skin of patients with IAD and EAD. Results: The patients with EAD had elevated levels of the IL-3 expression in their PBMCs and elevated levels of FcεRI in their lesional skin compared to that of the patients with IAD. The expression of other cytokines did not differ in the PBMCs and lesional skin from the two subgroups. Conclusion: This study suggests that IL-3 could be associated with the pathophysiology of EAD as compared to that of IAD, along with FcεRI which was previously shown to be highly expressed in EAD patients. (Korean J Dermatol 2011;49(6):491∼498)
TNF-alpha Antagonist (Etanercept)로 치료된 Acrodermatitis Continua of Hallopeau 1예
박지훈 ( Ji Hun Park ),이윤선 ( Yoon Sun Lee ),노성민 ( Seong Min Noh ),조수현 ( Su Hyun Cho ),박창욱 ( Chang Ook Park ),이광훈 ( Kwang Hoon Lee ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.1
Acrodermatitis continua of Hallopeau (ACH) is a rare form of acropustular eruption characterized by a presence of aseptic pustules on inflammatory periungual or subungual regions. Frequently accompanied by paronychia, atrophic skin changes, onychodystrophy, and osteolysis of distal phalanges of the digits, it is considered to be a variant of pustular psoriasis with a chronic relapsing course and refractoriness to many therapeutic modalities. Here, we present a case of a 45-year-old female who presented with multiple pustules pathologically diagnosed as pustular psoriasis on her left thumb. She suffered from ACH for over a decade, and in the process experienced frequent relapses and showed poor response to numerous treatment modalities such as narrow band UVB, topical steroid, steroid intralesional injection, oral retinoids, 308 nm excimer laser, and oral immune suppressants. However, the patient showed dramatic clinical improvements to administration of etanercept (TNF-alpha antagonist, twice a week) for a period of one month. The cessation of etanercept led to recurrence of symptoms and marked deterioration of the skin lesion within a month again, but the re-initiation of treatment soon relieved the problem. After completion of a three months trial of etanercept, the cutaneous lesion subsided, and the patient is now successfully controlled with topical steroid maintenance therapy. Hereby, we report a patient with ACH successfully treated with etanercept. (Korean J Dermatol 2012;50(1):92∼94)