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경구용 COX-2 억제제로 호전된 모반모양기저세포모반증후군 1예
염승돈,문종혁,고혜수,이시협,신정현,최광성,변지원 대한피부과학회 2016 대한피부과학회지 Vol.54 No.8
mg씩 7개월간 복용하였다. 7개월 간 복용 후 중단한지 6개월이 지난 현재까지 새로운 BCC 병변의 발생 없이 호전을 보였고 너무 작고 개수가 많아 국소적으로 치료하지 못한 BCC 병변들의 소실도 관찰되었다(Fig. 2A, B). 모반모양기저세포증후군은 Gorlin과 Goltz가 처음 기술한 질환으로 다수의 BCC, 수모 세포종, 손발바닥오목, 턱의 치아탓낭종 등이 특징이다1. Sonic hedgehog 신호계에서 종양억제 유전자로 작용하는 PATCHED 1 (PTCH1)의 돌연변이에 의해 발생하며 자외선 B가 BCC의 주요 유발인자로 작용한다1. 특히 고령의 피부에서는 자외선B에 조사된 후 COX-2의 발현이 증가하게 된다2. COX-2 발현의 증가는 세포괴사를 억제하는 유전자인 Mcl-1과 Bcl-2의 발현과 prostaglandin E2 (PGE2)의 분비를 증가시키고, PGE2는 혈관신생을 위한 basic fibroblast growth factor (bFGF)와 vascular endothelial growth factor (VEGF)-A의 분비를 유도하게 된다2,3. 이로 인하여 세포괴사의 억제 및 미세혈관밀도(microvessel density) 증가, 종양을 위한 신생혈관들의 증식이 일어나게 되고 이 과정에서 COX-2가 중심적인 역할을 담당하기에 COX-2를 억제하면 종양형성과 혈관신생 과정을 억제할 수 있다2-4. BCC의 치료방법은 단순절제술이나 모즈미세도식수술, 냉동수술, 레이저, 국소용 제제(imiquimod, 5-FU) 등으로 다양하다1,4. 최근에는 COX-2 억제제가 COX-2의 작용 및 PGE2의 발현을 억제하여 피부암의 치료에 효과가 있을 것으로 보고되었다4,5. BCC환자에게 COX-2 억제제를 투여할경우 placebo를 복용한 환자에 비해 새로운 BCC의 발생 및 tumor burden이 감소하였다고 보고되었으며, 18개월까지는 심혈관계 질환의 고위험군 환자(동맥경화 등 심장질환 과거력, 65세 이상, 흡연자, 고혈압, 고지혈증)에서도 placebo 에 비해 심혈관계 위험을 높이지 않고 안전하게 사용할 수있다4,5. 이에 저자들은 본 증례를 통해 경구용 COX-2 억제제가 모반모양기저세포암 증후군의 하나의 보조적 치료방법이 될 수 있음을 보고하는 바이다.
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윤희성 ( Hee Seong Yoon ),이시협 ( Si Hyub Lee ),염승돈 ( Seung Dohn Yeom ),한지영 ( Jeeyoung Han ),신정현 ( Jeonghyun Shin ),최광성 ( Gwang Seong Choi ),변지원 ( Ji Won Byun ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.9
Congenital hemangioma (CH) is a fully formed benign vascular tumor at the time of birth and do not proliferate in postnatal life. CH must be differentiated from infantile hemangioma. CH has three subtypes that are recognized based on their natural history: Rapidly involuting congenital hemangioma (RICH), non-involuting congenital hemangioma (NICH), and partially involuting congenital hemangioma (PICH). It is important to distinguish RICH from NICH because RICH spontaneously regresses but NICH does not. Herein, we report two patients diagnosed with RICH and NICH, respectively. We presented the clinical features as well as ultrasonographic and histologic findings to distinguish congenital from infantile hemangioma. (Korean J Dermatol 2018;56(9):556∼560)
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허지혜,이선복,윤희성,이시협,최석진,변지원,최광성,신정현 대한피부과학회 2020 대한피부과학회지 Vol.58 No.8
Primary cutaneous nodular amyloidosis is a rare variant of primary cutaneous amyloidosis and manifests as nodular, light-chain, amyloid deposits that are localized to the skin. The pathogenesis of the disease is still unclear. It usually originates in the lower extremities, face, scalp, and genitals and presents clinically as waxy, yellowish erythematous colored nodules. Histological characteristics include diffuse homogenous eosinophilic deposits in the dermis or subcutaneous regions along with interspersed plasma cells. We report a case of a 72-year-old man who presented with fissured, erythematous, waxy nodules on the bilateral lip angles. To the best of our knowledge, this is the first case report of primary cutaneous nodular amyloidosis of the lip angles in Korean dermatological literature.
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이선복,허지헤,윤희성,이시협,신정현,최광성,변지원 대한피부과학회 2020 대한피부과학회지 Vol.58 No.8
Lymphedema refers to inflammation that occurs in a part of the body owing to impaired lymphatic transport. Lymphedema arises as a consequence of a malformation or malfunction of the lymphatic system. It commonly occurs on the face, vulva, and penis and can cause superficial lesions known as lymphangiectasia. Common presenting symptoms include pain, pruritus, oozing of lymphatic fluid, sexual dysfunction, and infection. Prolonged lymphedema can lead to fibrosis and epidermal hyperplasia with verrucous hyperkeratosis. In rare cases, the lymphedema may mimic a skin tumor. We report the case of a 69-year-old woman who presented with erythematous oozing papules and hard nodules on the vulva, which mimicked a fibrous tumor.
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안드로겐성 탈모증 환자에서 폴리감마 글루탐산 하이드로겔 나노입자에 포집한 혼합복합발효추출물 도포제의 임상시험
이선복 ( Seon Bok Lee ),황혜원 ( Hye Won Hwang ),허지혜 ( Ji Hye Heo ),이시협 ( Si Hyub Lee ),신현태 ( Hyun-tae Shin ),변지원 ( Ji Won Byun ),신정현 ( Jeonghyun Shin ),최광성 ( Gwang Seong Choi ) 대한피부과학회 2021 대한피부과학회지 Vol.59 No.2
Background: Androgenetic alopecia (AGA) is the most common cause of hair loss in adults. Topical application of the fermented extract of medicinal plants promoted hair growth through stimulation of the telogen to anagen transition in a mouse model. However, controlled studies are necessary to evaluate the efficacy of the topical application of the fermented extract solution in humans. Objective: We aimed to assess the efficacy and safety of topical poly-gamma glutamic acid hydrogel nanoparticlebased fermented extract of a medicinal plant solution (PGA solution) in terms of the clinical improvements in patients with AGA. Methods: This 24-week, randomized, double-blinded, placebo-controlled, single-center clinical trial enrolled 50 patients with AGA (36 men and 14 women); the participants were treated with either PGA solution or placebo twice daily for 24 weeks. Efficacy was evaluated by a phototrichogram (total hair count per 1 cm<sup>2</sup>), patient’s subjective assessments, and investigator’s subjective assessments of clinical improvements in overall hair regrowth. Any adverse reactions were reported during the study. Results: At week 24, compared with baseline, the PGA solution group showed a significantly increased hair density compared to the placebo group (7.24±2.52/cm<sup>2</sup> vs. 1.53±1.39/cm<sup>2</sup>, p<0.0001). The average hair density after 24 weeks was 129.90±23.04/cm<sup>2</sup> and 115.32±20.35/cm<sup>2</sup> in the PGA solution group and the placebo group, respectively. There was no adverse reaction over the 24-week period. Conclusion: PGA solution may provide a safe and effective adjunctive treatment for patients with AGA. (Korean J Dermatol 2021;59(2):81∼87)
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