인간 면역결핍 바이러스 감염의 진단에 실마리가 된 양측성 이중성 대상포진 1예

류동진 ( Dong Jin Ryu ),정진영 ( Jin Young Jung ),이수현 ( Soo Hyun Lee ),이주희 ( Ju Hee Lee ) 대한피부과학회 2010 大韓皮膚科學會誌 Vol.48 No.4

The skin lesion of herpes zoster is typically limited to a single dermatome. The clinical appearance of herpes zoster in immunocompromised patients is usually identical to typical zoster, but lesions may be more severe and there can be multidermatomal involvement. The appearance of herpes zoster occurring in two non-contiguous dermatomes has been referred to as zoster duplex unilateralis or bilateralis. Herpes zoster duplex bilateralis is a rare manifestation of herpes zoster and almost all reported cases have in immunocompromised patients with hematologic cancer, patients taking immunosuppressant drugs for chronic illnesses and patients receiving chemotherapy for solid cancers. We report a case of herpes zoster duplex bilateralis, which was a diagnostic clue of human immunodeficiency virus infection. (Korean J Dermatol 2010;48(4):339~341)

손에 발생한 Myxoid Neurothekeoma 1예

류동진 ( Dong Jin Ryu ),김희정 ( Hee Jung Kim ),정진영 ( Jin Young Jung ),권연숙 ( Yeon Sook Kwon ),이주희 ( Ju Hee Lee ) 大韓皮膚科學會 2009 대한피부과학회지 Vol.47 No.8

Neurothekeoma is a benign dermal soft tissue tumor that is probably of nerve sheath origin. It usually presents as a slow-growing, solitary papule or nodule that is mainly located on the head and neck or upper extremities except for the hand. There are three histologic subtypes-myxoid, mixed and cellular type-depending on the amount of myxoid stroma. Immunohistochemical markers such as S-100, glial fibrillary acidic protein, nerve growth factor receptor, NK1C3 (CD57) and Ki-M1p can be applied to the tumor cells to distinguish among thesethree subtypes of neurothekeoma. Only one case has been previously reported on the hand in Korea. Herein, we report a rare case of myxoid neurothekeoma on the hand with a review of the related literature. (Korean J Dermatol 2009;47(8):982~985)

올브라이트 유전성 골이영양증의 진단에 실마리가 된 피부 골종

류동진 ( Dong Jin Ryu ),오상호 ( Sang Ho Oh ),한은천 ( Eun Chun Han ),배병기 ( Byung Gi Bae ),이주희 ( Ju Hee Lee ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.4

Albright`s hereditary osteodystrophy (AHO) has a broad spectrum of physical findings, including short stature, flattened nasal bridge, round facies, obesity, skeletal anomalies of the hands with brachydactyly, osteoma cutis, mental retardation, dental defects, cataracts, and calcification in the basal ganglia. It also includes endocrinologic abnormalities such as pseudohypoparathyroidism and pseudopseudohypoparathyroidism. Primary osteoma cutis, which can precede other physical findings of AHO, might be a diagnostic clue for AHO. Therefore, close follow-up and regular laboratory tests should be done to detect the early development of AHO in young children with primary osteoma cutis. Early diagnosis and treatment of AHO can prevent irreversible mental retardation and developmental delay. (Korean J Dermatol 2009;47(4):435~438)

침술 요법 부위에 발생한 Mycobacterium fortuitum 감염증 1예

최윤진 ( Yoon Jin Choi ),이희정 ( Hee Jung Lee ),이규엽 ( Kyu Yeop Lee ),류동진 ( Dong Jin Ryu ),이민걸 ( Min Geol Lee ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.6

Mycobacterial infections that are transmitted by acupuncture are an emerging problem. M. fortuitum is one of the rapid-growing atypical mycobacteria and this infection usually follows a puncture wound or a surgical procedure. We report here on a case of M. fortuitum infection following an acupuncture procedure. A 37-year-old woman presented with indurations and ulcerations of both popliteal fossae after undergoing acupuncture. The skin biopsy specimen showed suppurative inflammation with a lymphocytic infiltration, and the Ziehl-Neelsen stain for AFB was negative. Bacterial culture of the tissue fluid was negative. The culture of the tissue specimen and polymerase chain reaction revealed M. fortuitum. The infection responded to 10 weeks of treatment with isoniazid, rifampin and ethambutol, and four months of treatment with rifampin. Despite of the increasing popularity of acupuncture, the importance of infection control has not been adequately emphasized in oriental medicine. Education for proper infection control, including aseptic practice, is necessary for oriental medical doctors and practitioners. (Korean J Dermatol 2009; 47(6):755∼758)

성기 부위와 성기외 부위 경화 위축성 태선의 임상적, 조직학적 비교

오상호 ( Sang Ho Oh ),류동진 ( Dong Jin Ryu ),이광훈 ( Kwang Hoon Lee ),이주희 ( Ju Hee Lee ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.5

Background: Lichen sclerosus et atrophicus is a persistent inflammatory dermatosis of unknown etiology with a predilection for the genital area. Although there were many case reports in Korea, there are no studies regarding the clinicopathologic comparison of genital and extragenital lichen sclerosus et atrophicus. Objective: The aim of our study was to evaluate the clinicopathologic characteristics and differences between genital and extragenital lichen sclerosus et atrophicus. Methods: Retrospective analysis was performed by reviewing the clinicopatholgic records of 33 patients who were diagnosed with lichen sclerosus et atrophicus from 2000 to 2006 in Yonsei University Severance Hospital. Results: The most common clinical manifestation is a whitish patch with pruritus on labia minor. The ratio of male to female patients in genital and extragenital lichen sclerosus et atrophicus were 1:10.5 and 1:2.3 respectively. Disease onset ages were 49.9 years and 44.2 years respectively. The most common subjective symptom was pruritus. However, no symptom was more significant in extragenital lichen sclerosus et atrophicus compared to genital lichen sclerosus et atrophicus. Most of the lesions presented as whitish patches and plaques but atrophy, erythema and lichenification could also occur. Histopathologic findings of the extragenital lichen sclerosus et atrophicus showed more significant epidermal thinning and cleft formation compared to genital lichen sclerosus et atrophicus, which suggests that extragenital lichen sclerosus et atrophicus shows more evolved lesions. A few cases of genital lichen sclerosus et atrophicus showed spongiotic dermatitis, lichen simplex chronicus-like and lichen planus-like features in addition to typical pathology, which were suspected as secondary features or early lesions. All the patients were treated with high to mid-potency topical corticosteroid which were effective in both the genital and extragenital lichen sclerosus et atrophicus. There was no cases of squamous cell carcinoma arising in lichen sclerosus et atrophicus during the follow-up. Conclusion: Clinically, there were no symptoms significant to extragenital lichen sclerosus et atrophicus and pathologically extragenital lichen sclerosus et atrophicus showed more significant epidermal thinning and cleft formation. Further research regarding the characteristics and differences between genital and extragenital lichen sclerosus et atrophicus should be performed on larger number of cases. (Korean J Dermatol 2008;46(5):633∼640)

Bart 증후군

이규엽 ( Kyu Yeop Lee ),류동진 ( Dong Jin Ryu ),정혜진 ( Hye Jin Chung ),방동식 ( Dong Sik Bang ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.4

Aplasia cutis congenita is a rare congenital skin defect that presents with sharply outlined ulcerations. The most common site of this disease is the scalp, yet when other areas of the body are involved, there is higher incidence of concomitant congenital diseases or malformations. Bart`s syndrome is a rare inherited condition with congenital skin defects that are associated with epidermolysis bullosa. An infant presented with congenital skin defects on the leg, and the infant had recurrent bullous skin lesions on the both hands, feet, wrists and ankles. The skin defect caused only small scar formation and no handicap regarding function and appearance, yet continuously new bullous lesion developed and healed on the both distal extremities. He was diagnosed as suffering with epidermolysis bullosa with the histological findings of epidermal cleavage and negative direct immunofluorescence findings. Herein, we report on a case of Bart`s syndrome that displayed aplasia cutis congenita over the lower extremities and skin blistering. (Korean J Dermatol 2009;47(4):463~467)

두피의 미란성 농포성 피부염

배병기 ( Byung Gi Bae ),류동진 ( Dong Jin Ryu ),정기양 ( Kee Yang Chung ),김희정 ( Hee Jung Kim ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.6

Erosive pustular dermatosis of the scalp is a rare disorder of the elderly and it is characterized by pustular, erosive and crusted lesions of the scalp with progressive scarring alopecia. The predisposing factors have been reported to be trauma, including mechanical trauma, skin grafting, surgery and prolonged exposure of a bald scalp to UV light. Yet the laboratory data, the bacteriological and mycological investigations and the histopathologic findings of the previously reported cases were generally negative and not diagnostic. We herein present a case of erosive pustular dermatosis of the scalp that occurred after mechanical trauma on the previous skin graft site. This type of case has not been previously reported in the Korean dermatologic literature. (Korean J Dermatol 2009;47(6):702∼705)

Musculocutaneous Nerve Entrapment after Biceps Long Head Tendon Rupture

Tong Joo Lee(이동주),Dong Jin Ryu(류동진) 대한정형외과학회 2014 대한정형외과학회지 Vol.49 No.1

상완 이두근 장두건 파열은 비교적 흔하게 발생하며, 일반적인 치료로서 약 4주간의 부목고정을 요한다. 근피신경 손상은 일반적으로 과도한 운동이나 직접적인 외력에 의하여 발생한다. 근피신경 증후군은 드물게 보고되고 있으나, 상완 이두근 파열과 근피신경 포착 병증이 연관되어 보고된 바는 없다. 저자들이 경험한 환자는 70세 남자로 교통사고로 수상, 직접적인 외력에 의하여 발생한 견관절 통증 및 지연성으로 발생한 전완부 외측부 감각 저하, 주관절 굴곡력 저하를 주소로 내원하였다. 원인 파악을 위한 자기공명영상, 근전도 검사, 수술 소견 등을 종합하여 상완 이두근 장두건 파열 후 발생한 지연성 근피신경 포착병증으로 진단하였다. 수술적 치료로 통증과 감각, 주관절 굴곡력 감소는 회복되어 성공적인 치료 결과를 얻을 수 있었다. Biceps long head tendon rupture is relatively common and requires approximately four weeks of splintage as a general treatment. Musculocutaneous nerve entrapment is commonly caused by excessive exercise or direct external force. Musculocutaneous nerve syndrome has barely been reported; however, association of biceps long head tendon rupture and musculocutaneous nerve entrapment syndrome has never been reported. The authors experienced a 70-year-old male patient, who suffered a traffic accident and was hospitalized due to shoulder joint pain caused by direct external force, delayed forearm lateral aspect hypoesthesia and elbow flexion weakness. For identification of the cause, magnetic resonance imaging, electromyography, and surgical opinion were synthesized, resulting in diagnosis of delayed musculocutaneous nerve entrapment syndrome occurring after biceps long head tendon rupture. With surgical treatment, pain, sense, and elbow flexion weakness were recovered, a showing successful treatment result.

Captopril에 의해 유발된 것으로 생각되는 선상 IgA 수포성 피부병

권연숙 ( Yeon Sook Kwon ),오상호 ( Sang Ho Oh ),정진영 ( Jin Young Jung ),류동진 ( Dong Jin Ryu ),이주희 ( Ju Hee Lee ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.11

Linear IgA bullous dermatosis (LABD) is a rare autoimmune subepidermal bullous disease characterized by a linear pattern of IgA deposition along the basement membrane zone. The etiology of LABD is unknown but a minority of cases are drug-induced. Although vancomycin is the agent most commonly implicated in the pathogenesis of drug-induced LABD, association with other agents including phenytoin, piroxicam, captopril, diclofenac sodium and cyclosporine have also been reported. We describe a case of linear IgA bullous dermatosis which probably developed after captopril treatment in a 51-year-old male patient with infective endocarditis. (Korean J Dermatol 2007;45(11):1202∼1205)

만성 C형 간염환자에서 Interferon Alpha-2b와 Ribavirin 치료 중 발생한 범발성 습진 양상의 발진

권연숙 ( Yeon Sook Kwon ),김대석 ( Dae Suk Kim ),류동진 ( Dong Jin Ryu ),오상호 ( Sang Ho Oh ),이광훈 ( Kwang Hoon Lee ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.7

The combination of interferon alpha with ribavirin is currently recommended in the treatment of hepatitis C virus (HCV) infection. Commonly reported cutaneous reactions include localized reactions such as injection site inflammation and necrosis and worsening of other skin disorders, including psoriasis, lichen planus, vitiligo, or systemic lupus erythematosus. However, generalized eczematous reactions have been reported to occur uncommonly in patients treated with interferon and ribavirin, however such a case has not been described in the Korean literature. Herein, we describe a 49-year old female showing generalized eczema-like eruption after treatment of interferon alpha-2b and ribavirin for chronic HCV infection. (Korean J Dermatol 2008;46(7):915~918)