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( Han Saem Kim ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Ju Yeon Choi ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Background: A photoaged decollete skin may cause significant cosmetic disfigurement in the middle-aged. The photoaged area shows mottled red-brown dyschromia, telangiectasia, and fine wrinkles. Objectives: To evaluate the effectiveness of a combined treatment with 1,064 nm Neodymium:Yttrium Aluminum-Garnet laser (Nd:YAG) and high intensity focused ultrasonography (HIFU) for a photoaged decollete skin. Methods: Eight subjects, all women, were enrolled. All subjects were received 2 times of HIFU treatment at 0-week and 8-week, and 6 times of 1,064 nm Nd:YAG laser treatment at 2-, 4-, 6-, 10-, 12-, and 14-week. The last follow-up was at 16-week. The clinical outcome was evaluated with digital photograph, spectrophotometry and questionnaire. Results: Most of subjects showed improvement of erythema index (14.4 to 12.4 at 2- and 16-week) and melanin index (36.4 to 33.0 at 2- and 16-week), not statistically significant (p=0.093 and p=0.069, respectively). The subjects, showing greater than moderate response (> 25% improvement) in a physician assessment, were 87.5%, 87.5%, and 62.5% in dyschromia, telangiectasia, and fine wrinkles, respectively. Also, in the survey, 75.0% and 87.5% of subjects replied that they experienced greater than moderate response in pigmentation and wrinkles. Conclusion: A combined treatment with 1,064 nm Nd:YAG and HIFU may be an effective therapeutic option for a photoaged decollete skin in Korean female adults.
P073 Rosacea and its association with enteral microbiome and systemic diseases
( Han-saem Kim ),( Jung Yup Kim ),( Sunmin Yim ),( Jae Yun Lim ),( Ju-yeon Choi ),( Jung-in Kim ),( Jung Min ),( Ho Joo Jung ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga-young Lee ),( W 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Rosacea is a common chronic inflammatory skin disease. Recently, it is revealed that systemic diseases are associated with rosacea. Objectives: To investigate the relationship between gut microbiome, associated diseases and rosacea. Methods: A cross-sectional analysis was performed among healthy female subjects. Study data were obtained from 282 subjects who participated in a health check-up program. Rosacea was assessed by a questionnaire. Other medical illnesses were evaluated by thorough medical examination and history taking. Stool microbiota was analysed by QIIME (Quantitative Insights Into Microbial Ecology) software. Results: The study included 12 patients with rosacea and 270 subjects without rosacea (control group). After adjusting for age, body mass index (BMI) was significantly higher in rosacea patients as compared with the control group (odds ratio 1.20, 95% confidence interval 1.02-1.42). Seven metagenomic genera were correlated with rosacea: Peptococcaceae family unknown genus, Methanobrevibacter genus, Acidaminococcus genus, Megasphaera genus, Lactococcus genus, Eggerthella genus, Lactobacillales order unknown family unknown genus (p<0.05). Conclusion: This study shows that rosacea is associated with BMI and specific gut microbiota.
A case of symmetric lipomatosis of the tongue
( Ju Yeon Choi ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Han Saem Kim ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Symmetric lipomatosis of the tongue (SLT) characterizes the symmetric and nonencapsulated lipomas infiltrating muscle fibers. It is an extremely rare condition and considered as different disease from multiple symmetric lipomatosis in affected age, body region, and ethnic group and in the relevance to alcoholism. We report a case of a 56-year-old man presenting multiple symmetric yellowish nodules on both lateral borders of the tongue. There was no pain or discomfort on the tongue. He was a chronic alcoholic and afflicted with pellagra, hypertension, diabetes, and anemia. The histologic examination of the lesion showed mature adipose tissue infiltrating lingual muscles consistent with SLE. He did not want the surgical resection of the lesions. Therefore, lipomas were treated by four times of intralesional injection of triamcinolone (8mg/cc). However, there was no significant change in the size of the lipomas. Herein, we report a rare case of SLT comorbid with pellagra.
A case of penicillamine-induced dermopathy in Wilson`s disease
( Han Saem Kim ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Ju Yeon Choi ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Penicillamine is a copper chelator, clinically used in the treatment of Wilson’s disease and rheumatoid arthritis. Long-term penicillamine therapy can induce cutaneous adverse events including acute hypersensitivity reactions, autoimmune disorders, and elastic fiber abnormalities. Penicillamine-induced dermopathy, characterized by milia, purpura, skin fragility and wrinkling of the skin, results from inhibition of elastic and collagen metabolism by high cumulative dose of penicillamine. A 54-year-old female presented with well-demarcated 4 to 6 cm sized brown patches with tiny white papules on the both lateral pelvic areas. Recurrent hemorrhagic blisters and skin fragility were also observed in the lesions. She had been diagnosed with Wilson’s disease and treated with daily dosage of 2 g of penicillamine for 7 years. The histological examination showed organizing crust with regenerating epidermis, band-like granulation tissue, and edematous fibrotic upper dermis.Vascular ectasia and RBC extravasation were prominent. Moreover, a specimen demonstrated multiple milia containing laminated keratin. For clinical aspects, the patient had to continue to take penicillamine. After 3 months from her initial visit, similar skin lesions were developed on the malleolar area and both knees, particularly over points of pressure. Consequently, a diagnosis of penicillamine-induce dermopathy was made on the basis of the clinical and histological features
A case of the clinical and histological transition in lymphomatoid granulomatosis
( Han Saem Kim ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Ju Yeon Choi ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Lymphomatoid granulomatosis (LYG) is a rare B-cell lymphoproliferative disorder, predominantly involving the lungs and skin. LYG is associated with Ebstein-Barr virus (EBV) and characterized by angiocentric and angiodestructive atypical lymphoid infiltrate. An 84-year-old female presented with widespread erythematous papules and nodules in the whole body. No generalized symptoms and specific findings on the physical examination were observed. The histological findings showed mild lymphohistiocytic infiltrate around superficial vessels and sweat glands. The lesions were improved with systemic glucocorticoids. However, the lesions were aggravated after discontinuation of glucocorticoids. To confirm the diagnosis, a skin biopsy was repeated and the specimen revealed more significant lymphocytic collections and granulomatous change than the previous findings, with some atypical lymphocytes presenting positivity of CD3 and CD20. Nine months after her initial visit, she complained of severe dyspnea and generalized edema, presenting diffuse consolidation and ground glass opacity on the lungs in chest CT. The skin lesions were coalescent into plaques, and a biopsy was retried. The biopsy revealed massive angiocentric atypical lymphoid cells, showing positivity of EBV in situ hybridization. In conclusion, LYG, grade 3 was diagnosed on the basis of the clinical course and histological patterns.
[FCP 9] A case of non-familial generalized hypotrichosis simplex
( Ju-yeon Choi ),( Junghwa Yang ),( Yun Ho Lee ),( Jung Yup Kim ),( Sunmin Yim ),( Jae Yun Lim ),( Han-saem Kim ),( Joon Hong Min ),( Young Jun Choi ),( Jae-hui Nam ),( Ga-young Lee ),( Won-serk Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Hypotrichosis simplex is characterized by scanty or absent hair, which is not associated with ectodermal defects or systemic abnormalities. It is classified according to hereditary transmission, extent of affected area, and degrees of absence of hair. We report a case of an 18-year-old man presenting decreased hair density and woolly hair on the scalp. He recognized decreased hair density when he was 7 years old. There was no hair on the arms, legs, and axillary area. There were scanty hair on the eyebrow and pubic area. There was no family history of hereditary disorders affecting hair. Serum analysis revealed the increased level of dehydroepiandrosterone sulfate and progesterone. Low dose dexamethasone suppression test was negative and abdominopelvic computed tomography showed no adrenal incidentaloma or hyperplasia. The histologic examination of the scalp showed decreased number of hair follicles and mild perifollicular lymphohistiocytic and eosinophilic infiltration. Herein, we report a rare case of non-familial generalized hypotrichosis simplex.
[P417] A case of rheumatoid neutrophilic dermatosis mimicking herpes simplex infection
( Han-saem Kim ),( Junghwa Yang ),( Yun Ho Lee ),( Jung Yup Kim ),( Sunmin Yim ),( Jae Yun Lim ),( Ju-yeon Choi ),( Joon Hong Min ),( Young Jun Choi ),( Jae-hui Nam ),( Ga-young Lee ),( Won-serk Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1
Rheumatoid arthritis (RA) is an autoimmune inflammatory disorder. Various cutaneous manifestations are associated with RA, including rheumatoid nodule, vasculitis, palisading granulomatous dermatitis, and neutrophilic disorders. Rheumatoid neutrophilic dermatitis (RND) occurs in patients with active and severe RA, and vesicular-type RND is rarely reported, which predominantly involves the lower extremities. A 66-year-old female presented a 6-year history of RA. She had successfully treated with the combination of systemic prednisolone and methotrexate. At the beginning of 2015, erythematous vesicles with crust and erosion suddenly began to spread symmetrically on the both thighs. The lesion was accompanied with intermittent pain. The patient was initially treated with oral acyclovir and a mid-potent topical steroid, based on the diagnosis of herpes simplex. The lesions, however, were recurrent every month despite taking medications. A year later, a skin biopsy was performed. The histological examination showed intracorneal pustules and dense dermal inflammatory infiltrates, consisting mainly of adundant neutrophils. There were endothelial swelling and luekocytoclasis, but no vasculitis. The patient was then started on leflunomide for the control of RA with satisfactory preliminary skin response. The based on the clinical and histological features, RND was diagnosed.
A case of oral manifestation of cutaneous lupus erythematosus treated by alitretinoin
( Ju Yeon Choi ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Han Saem Kim ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Won Serk Kim ),( Ga Young Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Lupus erythematosus is an autoimmune disease with a broad spectrum of skin and multisystemic manifestations. Cutaneous lupus erythematosus (CLE) is referred to the lesions restricted to skin and/or mucous membranes. The prevalence of oral involvement ranges from 9 to 45% in patients with systemic lupus erythematosus and from 3 to 25% in patients with chronic cutaneous involvement. Thus far, antimalarial drugs, dapsone, and retinoids are considered as the first- and second-line treatment medicine in the treatment of CLE. In case of treatment failure or intolerance by the above drugs, vitamin A derivative, alitretinoin was reported as an effective alternative treatment option. We report a case of a 63-year-old woman presenting erythematous eroded plaques on the right buccal mucosa. She was diagnosed as CLE after punch biopsy and received alitretinoin (30 mg daily for 2 days and 10 mg daily for 4 weeks). For 1 month, the patient showed continuous improvement of buccal lesions and finally, the lesions were nearly cleared. She experienced headache and vomiting when she took alitretinoin 30 mg at the first time and those symptoms were disappeared after the dose reduction of alitretinoin. There was no other adverse effect. Herein, we report a case of oral manifestation of CLE treated by alitretinoin and suggest that alitretinoin could be an effective treatment option for CLE.
A case of lupus panniculitis triggered by human papillomavirus quadrivalent vaccine injection
( Ju Yeon Choi ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Han Saem Kim ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Won Serk Kim ),( Ga Young Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Lupus panniculitis usually manifests deep nodules and plaques involving the skin of trunk and proximal extremities, such as the lateral aspects of the upper arms, thighs, and buttocks. Hereditary character and sunlight are well-known predisposing factors. Rarely, lupus panniculitis was exacerbated following anti-hepatitis B vaccination and a lupus profundus like nodule at the site of numerous vaccinations was reported. Also, lupus erythematosus is probably related to trauma induced process, even though the correlation is poor or questionable. We report a case of a 25-year-old woman presenting erythematous patches on the both upper arms and left buttock. She recognized a palpable nodule on an erythematous base on the left upper arm occurred exactly at the site of the first human papillomavirus (HPV) quadrivalent vaccine injection (Gardasil^{®}). Thirty two months later, erythematous to brownish patches were observed on the right upper arm into which the third HPV vaccine was injected and the left buttock. Serum analysis revealed the presence of antinuclear autoantibodies of 1/640. The histologic examination of three cutaneous lesions showed lymphocytic infiltration in the fat lobules and perivascular area, a lymphoid follicle, and loose edematous stroma around fatty lobules consistent with lupus panniculitis. Herein, we report a rare case of lupus panniculitis triggered by HPV vaccination.