후천성 면역결핍 증후군(AIDS) 환자에서 비전형적이고 심한 양상으로 나타난 전염성 연속종 2예

윤춘식(Chun Sik Youn),서대헌(Dae Hun Suh),권오상(Oh Sang Kwon),박병순(Byung Soon Park),조광현(Kwang Hyun Cho),오명돈(Myung Don Oh),최강원(Kang Won Choe) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.10

Molluscum contagiosum is caused by a DNA virus from the poxvirus family. with the advent of new populations of immunocompromised individuals-especially those infected with HIV-molluscum contagiosum has emerged as an important cause of morbidity and disfigurement. Molluscum contagiosum in AIDS, although not life-threatening, is often a marker of late-stage disease and may lead to atypical clinical features and a progressive course that is recalcitrant to treatment. We report two cases of AIDS-related molluscum contagiosum in a 45 year-old male and a 30 year-old male. They were diagnosed as HIV-positive 3 years ago and 1 year ago, respectively. Physical examination revealed asymptomatic numerous skin-colored papules, nodules and tumorous masses on the face and neck. The histopathological finding showed characteristic features of molluscum contagiosum. We think that this is the first report of severe AIDS-related molluscum contagiosum in Korean literature. (Korean J Dermatol 1999;37(10) : 1507∼1511)

피부과학 실습에 대한 설문지 통한 학생 평가

이종희(Jong Hee Lee),채수진(Su Jin Chae),최용범(Yong Beom Choi),윤춘식(Chun Sik Youn),한원석(Won Seok Han),은희철(Hee Chul Eun) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.9

N/A Background: As part of medicines shift in emphasis toward primary patient care, clinical curriculum is very important in the education of medical students, There are excellent opportunities for general 1earning of clinical skills especially in dermatological clinical clerkship course, Objective: The purpose of this study is to evaluate the dermatological clerkship with questionnaire by students. We would like to find out and look into the way how to improve the clerkship course. Methods: 103 students filled in well-structured questionnaires after they had finished a 2 week-clinical clerkship course of Department of Dermatology. The questionnaire consisted of overall evaluation of clinical clerkship, of subtypes of clinical clerkship course, and the way how to evaluate students. After finishing the clinical clerkship course, 10 students were interviewed with the results of the questionnaire. Results: Most students were generally pleased with the didactic quality of clerkship. The course of observation of outpatient clinic among various subtypes of clinical clerkship were favored most by the students. The newly developed educational contents revealed not to be properly used. Faculty activity was also scored to be better than average. The test for clinical clerkship was regarded a little difficult to the students. Conclusion: The evaluation of didactic quality of clinical clerkship seems very important in the improvement of medical education. The development of the more valid and reliable questionnaire is needed. The overall evaluation of clerkship by various perspectives such as students, faculties, patients and institutions will provide more improvement of quality of clerkship at Dermatology department. (Korean J Dermatol 2002;40(9) : 1089~1099)

화장품에 의한 접촉피부염 환자에서의 첩포시험 결과에 대한 고찰

은희철(Hee Chul Eun),권오상(Oh Sang Kwon),서구일(Koo Il Seo),윤춘식(Chun Sik Youn),한원석(Won Seok Han),서대헌(Dae Hun Suh) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.8

화장품은 1993년 유럽연합(EU)에 의하여 정의된 바에 의하면, 표피와 모발, 조갑, 구순 및 이음부와 같은 체표면과 구강내 치아 및 구강점막에 대하여 청결히 하거나 향기를 좋게 하고 보호하는 목적이외에, 모습을 바꾸거나 체취를 교정하는 목적으로 이용되는 모든 물질과 제품들을 의미하는 용어로 기술된 바 있다. 화장품에 의한 피부 질환은 일반인에서 흔히 발생하는데, 사용자의 2%미만으로 보고되고 있으며, 이중 알레르기성 접촉피부염은 화장품에 의한 부작용의 5-10%를 차지하며, 피부과를 방문하는 환자의 0.3-3%정도로 보고되고 있다. 이와 같은 화장품에 의한 피부염에 대해, 피부과 의사와 화장품 회사들에 의하여, 화자품의 성분표시(cosmetic labelling), 원인 항원의 발견 및 조절(allergen controlled system), 저알러지성 화장품(hypoallergic cosmetics)의 이용 등으로 발생빈도를 줄이려는 노력이 있어 왔다. 국내에서는 최근 20여년간 화장품에 의한 접촉피부염에 대한 여러 역학적 연구가 이루어졌으며 다수의 화장품과 관련된 증례보고가 있어왔다. 저자들은 최근의 화장품 산업의 발전과 시대의 변화에 따른 화장품의 성분 및 종류의 다양화와 화장품을 사용하는 인구가 늘어남에 따른 화장품에 의한 알레르기성 접촉피부염의 변화된 양상을 관찰하고자 하였다. 이를 위하여, 시기를 구분하고 이에 따른 첩포시험 성적의 양성률의 변화과정과 알레르겐의 양성빈도를 시기별로 비교하였다. Background:Contact dermatitis is frequently caused by cosmetics. Detection of causative allergens is important in prevention and treatment of cosmetic contact dermatitis. Patch test has been accepted as the only reliable diagnostic method to detect allergens. Objective:The objectives of this study were to clarify evoluting trends of positive patch tests and to compare the positive frequencies of various allergens between different time sequences. Materials and methods:We reviewed patch test results of the 806 cosmetic contact dermatitis patients, who had visited our clinic from 1982 to 1997. We divided the patients into three groups as follows;Ⅰgroup:1982-1987, Ⅱ group:1988-1992, Ⅲ group :1993-1997 and compared the test results. The patch tests were performed with standard batteries, cosmetic-related allergens and the patients’s own cosmetics. Results:The results of the studies were summarized as follows; 1. Trends of increasing positivity in cosmetic-induced dermatitis was noted in a chronologic point of view. Among the patients, an increased proportion of males was notable. 2. In age distribution, a decreasing proportion of patients at the third & the fourth decades was observed. Contrary to this, the proportion of patients over the fifth decades was increased. 3. Among standard allergens, nickel sulphate showed the highest positive rate in all defined triple periods, whereas positive rates of neomycin sulphate & balsam the highest positive rate in all defined triple periods, whereas positive rates of meomycin sulphate & balsam of Peru were diminishing sequentially. Among fragrance allergens, cinnamic alcohol & cinnamic aldehyde revealed the highest positive rates. 4. In as is test, skin care products showed the highest positive rate, followed by toiletries and makeup products. Increasing positive rates of the toiletry products were observed in order of time. In fragrance products, positive rates reached their peak in the second period and declined in the third period. Conclusion:This study showed that perfume components were the most frequent allergens in cosmetics followed by preservative agents. Our study showed that cosmetic allergies in men seems to have increased.(Korean J Dermatol 1999;37(8):1009~1016)

당뇨병 환자에 있어서 소양증에 대한 임상적 관찰 및 Hydrometer와 Corneometer를 이용한 피부 수분량의 측정

서대헌,은희철,신찬수,윤재일,박석범,김상덕,윤춘식 대한피부과학회 1999 대한피부과학회지 Vol.37 No.3

Background: Diabetes mellitus is a common condition, and the majority of patients have one or more cutaneous complications. Among them, xerosis is well known to be closely related to diabetics. The xerosis is inversely reflected upon skin surface hydration, the state of which can be exactly assessed with various investigating instruments, such as a hydrometer and corneometer. Objective: Our purpose was to compare the hydration state of diabetics with normal persons by the use of a corneometer and hydrometer. Methods: A total of 267 diabetics were asked whether they felt xerosis or pruritus. In a subgroup of 31 patients, the water content was evaluated and compared by the parameters of diabetic severity. Forty-one non-diabetics were selected for the normal control. Results : There was a significant difference in water contents between diabetics and non-diabetics. In diabetics, patients with shin spots and altered renal function showed lower values, revealing decreased water contents. Other parameters, including age of patients duration of diseases, status of microangiopathic complications, insulin dosage, HbAlc and c-peptide, were not related to the water contents. Conclusion ; This data indicates that xerosis is closely associated with diabetics and related to clinical and laboratory fidings revealing the disease severity. The hydrometer and corneometer are recommended for the use of the evaluaton and management of xerosis.