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안면부 대상포진의 임상적 특징에 따른 안과적 합병증과 포진 후 신경통의 위험인자 분석
정한힘 ( Han Him Jeong ),오신엽 ( Shin Yeop Oh ),이현주 ( Hyun Joo Lee ),허은필 ( Eun Phil Heo ),고재완 ( Jae Wan Go ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.4
Background: Facial herpes zoster can be accompanied by several complications. In particular, postherpetic neuralgia (PHN) and ocular complications (OCs) are relatively common. Both PHN and OC are of interest because they can lower the quality of life. Objective: This study aimed to evaluate the clinical features of facial herpes zoster and to assess the risk factors of OCs and PHN. Methods: We analyzed the medical records of 146 patients with facial herpes zoster from January 2014 to May 2019. We assessed the proportion of OCs and PHN in patients with facial herpes zoster according to several clinical factors, including age, sex, dermatomal distribution, delayed time to treatment, and associated systemic conditions. OCs were divided into mild and severe ocular complications (SOC) by ophthalmologic diagnosis. Results: The incidence rate of OCs (83.8%) and SOC (37.8%) were highest in patients in their 70s. Herpes zoster involving the ophthalmic and maxillary branches of the trigeminal nerves showed a significantly higher incidence rate of OCs and SOC than those involving only the ophthalmic branch (p=0.031, p=0.025). Patients who received antiviral treatment within 4 days showed lower rates of OCs and SOC than patients who received treatment after 5 days (p<0.001, p=0.003). The incidence of PHN was significantly higher in those over 60 years old, when both the ophthalmic and maxillary branches were involved, and for those treated more than 4 days after the onset. Conclusion: To decrease the risk of OCs and PHN in facial herpes zoster, it is important to provide early antiviral treatment and appropriate ophthalmologic consultation. (Korean J Dermatol 2020;58(4):245∼253)
정한힘 ( Han Him Jeong ),김창일 ( Chang Il Kim ),정홍필 ( Hong Pil Jeong ),조선영 ( Sun Young Jo ),고재완 ( Jae Wan Go ),허은필 ( Eun Phil Heo ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.10
Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made. (Korean J Dermatol 2020;58(10):697∼700)
홍승기 ( Seung Gi Hong ),조선영 ( Sun Young Jo ),정한힘 ( Han Him Jeong ),정홍필 ( Hong Pil Jeong ),이현주 ( Hyun Joo Lee ),허은필 ( Eun Phil Heo ),고재완 ( Jae Wan Go ) 대한피부과학회 2020 大韓皮膚科學會誌 Vol.58 No.4
Metastatic skin cancers are a relatively uncommon malignant tumor. Visceral tumors such as breast, lung, and colon cancers are commonly found to be the primary origin. Cutaneous metastasis with esophageal cancer is exceedingly rare, accounting for less than one percent of all skin metastasis. Here, we report a case of cutaneous metastatic squamous cell carcinoma that originated from esophageal carcinoma. The patient was a 48-year-old male who complained of a 2-cm-sized non-tender, skin-colored nodule on his left lower back. Positron emission tomography-computed tomography (PET-CT) showed focal fluorodeoxyglucose (FDG) uptake in the lesion. In the histopathological examination, the tumor cells stained positive for epithelial membrane antigen (EMA) and cytokeratin 5/6 (CK5/6), which was consistent with squamous cell carcinoma. This case suggests that patients who have been treated for primary esophageal carcinoma should undergo a skin biopsy to rule out metastatic skin cancer if the tumor appears to be suspicious. (Korean J Dermatol 2020;58(4):269∼272)