비성기부 지루각화증에서 HPV DNA Chip을 이용한 Human Papillomavirus DNA 검색

이운하 ( Un Ha Lee ),최우석 ( Woo Seok Choi ),김성우 ( Sung Woo Kim ),박현수 ( Hyun Su Park ),장상재 ( Sang Jai Jang ),황선욱 ( Seon Wook Hwang ),이혜경 ( Hye Kyung Lee ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.10

Background: The precise etiology of seborrheic keratosis (SK) is unknown. Genetics, sun exposure and infection have all been implicated as possible factors. Because of its clinical and histopathological similarities to verrucae vulgaris and condyloma acuminatum, human papillomavirus (HPV) has been suggested as a possible causative agent. In the previous studies, HPV were frequently detected in the genital lesions or hair follicles of immunocompromised hosts. Objective: A newly introduced HPV detection technique, the HPV DNA Chip analysis, contains 24 HPV probes and it has the advantage of being able to detect 24 types of HPV at once. The purpose of this study was to evaluate the presence of HPV DNA in the nongenital SK of immunocompetant individuals. Methods: We analyzed 31 biopsy specimens that were taken from patients with nongenital SK, and these specimens were compared with genital warts (the positive control) and distilled water in place of DNA (the negative control) with using HPV DNA Chip analysis and a polymerase chain reaction-based DNA microarray system as the HPV genotyping method. Results: By polymerase chain reaction (PCR), HPV DNA was detected in 2 of the 31 nongenital SK biopsies (6.5%). HPV DNA Chip analysis revealed that 3 of 31 nongenital SKs (9.7%) contained HPV DNA. Two distinct HPV genotypes were detected: HPV type 16 (n=2) and HPV type 42 (n=1). The duration of SK in the HPV positive group was longer than that of the SK in the negative group. The mean age of the patients in the HPV positive group was also older than the mean age of the negative group. There were no different histopathologic findings between the HPV positive and negative SK. Conclusion: This study did not provide any concrete evidence that HPV infection might directly play a part in the pathogenesis of nongenital SK. However, two distinct HPV DNA types were identified as types that have never been reported before. Further studies with a larger number of cases of SK are needed to confirm the presence of HPV DNA in nongenital SK and also to determine the role of HPV in the origin of nongenital SK. (Korean J Dermatol 2008;46(10):1321∼1327)

편평 사마귀에 대한 5% Imiquimod 크림의 임상적 치료효과

이운하 ( Un Ha Lee ),최정철 ( Jung Chul Choi ),전덕규 ( Duk Kyu Chun ) 대한피부과학회 2005 大韓皮膚科學會誌 Vol.43 No.1

진행성 체모양 대상포진모양 과색소침착증: 증례보고와 문헌고찰

이수경 ( Soo Kyung Lee ),서중헌 ( Joong Heon Suh ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.5

Progressive cribriform and zosteriform hyperpigmentation (PCZH) is a distinctive pigmentary disorder observed along the lines of Blaschko. Clinically, the lesions appear as uniformly tan, cribriform macular hyperpigmentation with a zosteriform distribution, without a history of rash, injury, inflammation, or other associated cutaneous or internal abnormalities. Histopathological specimens show increased melanin pigmentation in the basal cell layer with a complete absence of nevus cells. We report 8 cases of PCZH and review the literature on this peculiar disorder. (Korean J Dermatol 2018;56(5):338∼342)

정신건강의학과 입원 중 피부과로 의뢰된 환자에 대한 분석

이동엽 ( Dong Yeup Lee ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ),함정희 ( Jeong Hee Hahm ) 대한피부과학회 2015 大韓皮膚科學會誌 Vol.53 No.8

Background: The need for dermatological consultations for hospitalized patients has gradually increased and there are a number of dermatoses caused by underlying psychological conditions. However, the data regarding the analyses of these consultations for psychiatric inpatients are limited. Objective: To analyze the demographics and the type of dermatoses among inpatients with primary psychiatric diseases. Methods: We retrospectively reviewed 581 consultation reports for inpatients referred by the Department of Psychiatry between January 1, 2009 and December 31, 2014. Results: The proportion of the consulted patients from the Department of Psychiatry was 25.9% (331 consulted inpatients/1279 psychiatric inpatients). The most common age group was the 40∼49 year-old group (19.3%) and the male to female ratio was 1:1.14. There were no remarkable findings regarding the annual or seasonal distribution. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the most common underlying psychiatric disorders were mood disorders (41.0%), followed by schizophrenia and other psychotic disorders (25.0%), and substance-related disorders (12.1%). The most frequent skin disorders were eczematous dermatoses (34.6%) and infectious dermatoses (32.2%); dermatomycosis (20.8%) was especially common.The most common reasons for consultation were new-onset dermatologic problems (68.5%), followed by persistence or aggravation of pre-existing dermatologic disorders (28.7%). Conclusion: This study reports the dermatologic characteristics of psychiatric inpatients. We conclude that dermatologists and psychiatrists need to be concerned about the education and continuous management of various skin diseases in psychiatric patients. (Korean J Dermatol 2015;53(8):585∼593)

한국인 백반증 환자의 삶의 질 평가

김동주 ( Dong Joo Kim ),이운하 ( Un Ha Lee ),김명신 ( Myoung Shin Kim ) 대한피부과학회 2016 대한피부과학회지 Vol.54 No.6

Background: Vitiligo is a chronic disfiguring dermatosis and can cause significant psychosocial burden that affects quality of life (QOL). Objective: The purpose of this study was to compare the QOL in patients with vitiligo and healthy controls by using general and dermatology-specific (DLQI) questionnaires: World Health Organization QOL Scale (WHOQOLBREF) and Dermatology QOL Index (DLQI), respectively. Methods: Vitiligo patients and healthy controls (104 of each) were recruited, all of whom completed the WHOQOL-BREF and DLQI. Total scores and scores of domains of the WHOQOL-BREF and DLQI in the two groups were compared. Results: The scores of total DLQI and categories of symptoms and feelings, daily activities, and leisure of vitiligo patients were significantly higher than those of healthy controls (p<0.05). The QOL score and domains of physical, psychological health, and social relationships of the WHOQOL-BREF in patients with vitiligo were decreased compared with those in healthy controls (p<0.05). Clinical characteristics, including disease duration, treatment duration, vitiligo area, exposed site, self-reported severity, treatment unsatisfaction, Beck Depression Inventory, and Beck Anxiety Inventory showed significant impairment in the QOL of vitiligo patients according to the DLQI and WHOQOL-BREF (p<0.05). High disease activity and Koebner’s phenomenon showed a negative correlation with QOL in patients with vitiligo according to the DLQI only (p<0.05). There was no association between the total DLQI and the QOL scores. Conclusion: In our study, QOL in patients with vitiligo was poorer than that of healthy controls. The severity of depression and anxiety was the most important predictor of QOL. Therefore, in managing patients with vitiligo, it is important for the dermatologist to consider the psychological aspects of QOL to provide satisfaction of life. (Korean J Dermatol 2016;54(6):409∼421)

서혜부에 발생한 크론병

이동엽 ( Dong Yeup Lee ),홍광철 ( Kwang Cheol Hong ),백종헌 ( Jong Heon Baek ),김동주 ( Dong Joo Kim ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.10

Crohn`s disease is a systemic inflammatory and granulomatous disease, mainly involving the gastrointestinal tract with extraintestinal manifestations such as the skin, liver and bone. Cutaneous manifestations of Crohn`s disease are relatively common; however, the groin is an unusual site for cutaneous Crohn`s disease. A 36-year-old male presented with mild pruritic nodules on the left groin for 2 months. Nine years ago, he was diagnosed with intestinal Crohn`s disease by endoscopic biopsy. Histopathologic examination of the cutaneous lesion showed non caseating granulomatous reactions composed of multinucleated giant cells with lymphohistiocytic infiltration in the dermis. Staining for periodic acid-Schiff and acid-fast bacilli was negative. From these findings, we diagnosed these lesions as cutaneous Crohn`s disease. The lesions were markedly improved with three rounds of intralesional steroid injection. (Korean J Dermatol 2013;51(10):825∼828)

전신성 광택태선에 대한 임상적 연구

김성우 ( Sung Woo Kim ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ),장상재 ( Sang Jai Jang ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.9

Background: Generalized lichen nitidus is a rare subtype of lichen nitidus characterized by multiple, flesh-colored, shiny papules occurring over the entire body. Objective: We investigated the clinical features of generalized lichen nitidus in patients followed up at our institution. Methods: The patients with generalized lichen nitidus diagnosed clinically and histopathologically between 1998 and 2007 were reviewed. Results: Twelve patients (9 males and 3 females) were enrolled in this study and the mean age at onset was 10.3 (range: 4~27) years. Of the 12 patients, 5 (41.7%) experienced pruritus and 4 (33.3%) had atopic dermatitis. None of the patients had a family history of lichen nitidus. Nine patients were treated with topical steroids, systemic steroids, oral antihistamines, or narrow-band UVB. We propose that narrow band UVB is an effective treatment modality for generalized lichen nitidus. The mean duration to clearance was 37.7 (range: 7~120) months and the disease was relapsing in 2 patients. The duration to clearance was correlated to the age at onset (p=0.0005) and to the duration at the first visit (p=0.0000), whereas it was not related to the sex of the patient, pruritus or the accompanying atopic dermatitis. Conclusion: Generalized lichen nitidus is often associated with varying degrees of pruritus and the clinical course of the disease tends to be chronic. We propose that onset at an early age and the short duration of disease at the first visit are good prognostic factors, and that narrow band UVB is an effective treatment modality for generalized lichen nitidus. (Korean J Dermatol 2008;46(9):1201~1207)

성기능 개선제 복용 후 발생한 고정약진 1예

이수경 ( Soo Kyung Lee ),김동주 ( Dong Joo Kim ),서중헌 ( Joong Heon Suh ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ) 대한피부과학회 2018 大韓皮膚科學會誌 Vol.56 No.4

Fixed drug eruption is a commonly reported mucocutaneous drug eruption. A 61-year-old male presented to our clinic with a complaint of an itchy round erythematous patch on the left hand dorsum with myalgia. On taking medical history, the patient correlated the episode with the intake of an oral sexual enhancer that he had obtained over the counter. We found the medicine contained tadalafil and sildenafil in combination with herbal ingredients. A short course of oral corticosteroid therapy resulted in the complete resolution of the lesion leaving residual hyperpigmentation of the skin involved. Various sexual enhancers with fancy names and attractive packaging are available without requiring a doctor’s prescription. Most contain phosphodiesterase-5 inhibitors in various concentrations, often with herbal additions. These drugs are used erratically by the lay public, and often produce side effects. Herein, we report a case of fixed drug rash related to a sexual enhancer, which we believe to be the first report in Korea. (Korean J Dermatol 2018;56(4):269∼272)

입술에 발생한 염증성 병변에 대한 임상적 병리조직학적 분석

신문섭 ( Moon Seub Shin ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ),박혜진 ( Hai Jin Park ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.8

Background: Inflammatory labial lesions are quite common in dermatology. However, a few studies have been performed regarding the clinical and histopathological findings of inflammatory labial diseases. Objective: The purpose of this study was to investigate the clinical and histopathological features of inflammatory labial diseases. Methods: We retrospectively reviewed the data of 48 patients who underwent biopsy for inflammatory labial lesions between June 2005 and December 2012. Clinical features and histopathological findings of the lesions were investigated, and they were compared to each other for differential diagnosis. Results: The most frequent inflammatory labial diseases were actinic cheilitis (25%), oral lichen planus (23%), plasma cell cheilitis (23%), oral lichenoid lesion (17%), and eczema (12%). Most of the labial lesions were located on the lower lip (87%). We found a broad overlap in the clinical features of lesions with each other, and in many cases, clinical impressions were inconsistent with their final diagnosis. Histopathologically, the degree of eosinophilic infiltrates in actinic cheilitis was comparable to those in eczema. Oral lichen planus showed orthokeratotic hyperkeratosis rather than parakeratosis, and oral lichenoid lesion displayed more frequent perivascular and deep inflammatory cell infiltrates than oral lichen planus. Conclusion: The diagnosis of inflammatory labial diseases may be challenging, because inflammatory labial diseases often show similar clinical features and have a broad overlap in histological features. Therefore, clinico-pathologic correlation is necessary to confirm the diagnosis and for proper management. (Korean J Dermatol 2013;51(8):608∼ 615)

세균에 의한 피부 감염증에서 항생제 감수성과 임상적 특징에 관한 연구

이재호 ( Jae-ho Lee ),이수경 ( Soo-kyung Lee ),김명신 ( Myoung-shin Kim ),이운하 ( Un-ha Lee ) 대한피부과학회 2021 대한피부과학회지 Vol.59 No.5

Background: Bacterial skin soft-tissue infection is a common clinical manifestation in dermatology. The treatment of bacterial skin infections is often challenging due to antibiotic resistance, including methicillin resistance. Objective: The aim of this study was to investigate the isolation rate of bacteria, antibiotic susceptibility, clinical features, and factors associated with treatment response in bacterial skin infections. Methods: We retrospectively reviewed the medical records of patients who underwent ordinary bacterial skin cultures of the site of superficial skin infections between 2010 and 2019. Results: A total of 1,298 patients were included in the study. The most commonly isolated bacteria were Staphylococcus aureus (31.3%), followed by coagulase-negative staphylococci (22.0%) and Pseudomonas species (4.2%). The methicillin-resistance rate of S. aureus was 22.7%. Crusted lesions (p=0.025), treatment with steroids (p=0.035), duration over 7 days (p=0.009), and isolation of Pseudomonas (p<0.001) or other uncommon species (non-Staphylococcus, Streptococcus, and Pseudomonas species, p<0.001) were significantly associated with treatment response. Conclusion: The methicillin-resistance rate of S. aureus was similar to that of the past 5 years, but the mupirocin-resistance rate significantly increased. Lesions with crust or those that were treated with steroids showed good treatment responses, but longer disease durations of over 7 days and skin infections caused by Pseudomonas or other uncommon species were poor prognostic factors that should receive more attention. (Korean J Dermatol 2021;59(5):348∼362)