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파종혈관내응고와 동반된 Stewart-Treves 증후군
이중선 ( Joong Sun Lee ),이혜경 ( Hye Kyung Lee ),조인성 ( In Sung Cho ),조영훈 ( Young Hun Cho ),구대원 ( Dae Won Koo ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.1
Stewart-Treves syndrome is an angiosarcoma that develops in chronic lymphedematous skin. Kasabach-Merritt syndrome is characterized by the occurrence of disseminated intravascular coagulation (DIC) in combination with benign angiomatous tumors in most cases, but angiosarcoma has also been reported to be associated with DIC in rare cases. Here we report on a case of a 74-year-old woman who had angiosarcoma on a large area of the right trunk and arm around a previous mastectomy site. She developed DIC after laminoplasty, and she finally expired from multiorgan failure 3 months after the initial diagnosis of DIC. Her preoperative laboratory findings were normal, and she did not have any other underlying diseases that were possibly related with the development of DIC, except the large area of angiosarcoma. In conclusion, we report here on a rare case of Stewart-Treves syndrome that co-occurred with DIC and we believe that accurate evaluation of a skin lesion is important for Stewart-Treves syndrome patients who display systemic symptoms. (Korean J Dermatol 2010;48(1):65∼68)
이중선 ( Joong Sun Lee ),도정은 ( Jeong Eun Do ),김유찬 ( You Chan Kim ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.1
The blue nevus consists of papules or a plaque-like aggregate of aberrant dermal melanocytes actively producing melanin in the reticular dermis. The common blue nevus clinically presents as a 2~10 mm sized, well-demarcated, papular, bluish-black lesion, typically on the dorsal surface of the hands or feet. However, it has rarely been reported on the mucosal lesions such as the oral cavity. It is usually seen as an aquired form. We report a case of a large, congenital, common blue nevus on the upper lip. (Korean J Dermatol 2007;45(1):40~42)
이중선 ( Joong Sun Lee ),이혜경 ( Hye Kyung Lee ),구대원 ( Dae Won Koo ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.7
Non-Langerhans cell histiocytoses are classified according to the predominant mononuclear (vacuolated, spindle-shaped, xanthomatized, scalloped, and oncocytic) and/or multinucleate (Touton, ground-glass appearance, Langhans, and foreign body) histiocytic cell types. Spindle-shaped histiocytes are evident in spindle cell xanthogranuloma and progressive nodular histiocytosis. Clinically, a single brown-yellow papule or nodule is characteristic of solitary spindle cell xanthogranuloma. Solitary spindle cell xanthogranuloma occurs with decreasing frequency on the head, neck, upper trunk, and occasionally the extremities of young adults (20~40 years of age). Although there have been a few reports of spindle cell xanthogranuloma, there has only been one case of spindle cell xanthogranuloma described in the Korean literature. We report a rare case of solitary spindle cell xanthogranuloma that developed in childhood and suggest this be included in the differential diagnosis among spindle cell tumors.
만성 자발성 두드러기 환자에서 Omalizumab 치료 반응에 대한 예측 인자 분석
이현이 ( Hyun Yi Lee ),구대원 ( Dae Won Koo ),이중선 ( Joong Sun Lee ) 대한피부과학회 2021 大韓皮膚科學會誌 Vol.59 No.9
Background: The European Academy of Allergy and Clinical Immunology guideline for the management of urticaria published in 2018 recommends adding omalizumab as a third-line therapy. However, data on the potential predictive factors of a successful response to omalizumab are limited in Korea. Therefore, this study aimed to perform a retrospective clinical analysis of the effects of omalizumab in a Korean population of patients affected by chronic spontaneous urticaria (CSU). Objective: To investigate factors affecting the effect of omalizumab treatment and identify factors related to its clinical response. Methods: We retrospectively reviewed the clinical records of patients with CSU treated with omalizumab at the single-center dermatology department from February 2018 to August 2020. Omalizumab was administered at a single dose of 150 mg every 4 weeks. Clinical treatment response was assessed using the urticaria activity score summed over 7 days (UAS7) after the fourth, sixth, and 12th omalizumab injections. Results: Twenty-six patients were enrolled in this study. The mean UAS7 at baseline was 16.9 (range, 4∼28). Treatment was completed in seven patients (26.9%). Three patients (11.5%) discontinued treatment because of poor treatment response. Symptoms improved in all patients at the fourth injection (UAS7=3.9, range 0∼10). The second administration of omalizumab showed that the lower the body mass index (BMI), the better the response to treatment (p<0.05), and a similar trend after an additional injection. Conclusion: The symptoms improved after omalizumab treatment in most patients. Those with a lower BMI and higher total immunoglobulin E levels during long-term treatment showed significantly better treatment responses. (Korean J Dermatol 2021;59(9):685∼692)
임상적 아형 및 연령에 따른 선상태선의 임상 및 조직병리학적 고찰
이혜민 ( Hye Min Lee ),정경은 ( Kyung Eun Jung ),이혜경 ( Hye Kyung Lee ),구대원 ( Dae Won Koo ),이중선 ( Joong Sun Lee ) 대한피부과학회 2014 大韓皮膚科學會誌 Vol.52 No.9
Background: Lichen striatus is an uncommon, self-limiting, linear inflammatory disease occurring along the lines of Blaschko, mainly affecting children, and is diagnosed by clinical history and histopathological study of typical lesions. However, various aspects of the histopathologic findings have not yet been studied sufficiently. Objective: The aim of this study was to investigate the clinical and histopathologic characteristics of lichen striatus in Korea, according to age and clinical subtype. Methods: This retrospective study on lichen striatus was performed at our center; clinical and histopathologic findings from 32 patients were evaluated. Results: In all, 22 children and 10 adults were included. The lesions were predominantly distributed on the extremities (78.1%), including those that showed multiregional involvement. Twenty-four patients had erythematous papular lichen striatus (75%), and eight had hypopigmented macular type lesions (25%). All cases of hypopigmented macular subtypes had occurred in children. The histopathologic features of lichen striatus included basal vacuolar degeneration (93.3%), hyperkeratosis (83.3%), spongiosis (63.3%), and exocytosis of lymphocytes (63.3%) in the epidermis. Superficial and deep perivascular lymphocytic inflammatory infiltration (96.7%), lichenoid lymphohistiocytic infiltration (76.7%), and periappendageal involvement (53.3%) in the dermis were also observed. Papular lesions showed greater spongiosis, exocytosis, dyskeratosis, and vacuolar degeneration than hypopigmented lesions. Increased dyskeratosis and pigmentary incontinence as well as more severe lichenoid infiltration were observed in the adults. Conclusion: This study provides the first national data about the clinical and histopathologic characteristics of lichen striatus in adults and children. Some of the clinical and histopathologic characteristics differed according to the age group as well as clinical subtype. (Korean J Dermatol 2014;52(9):622∼630)