In search of unregarded paths amid the maze of psoriasis: my log for future explorers

송해준 ( Hae Jun Song ) 대한피부과학회 2022 대한피부과학회 학술발표대회집 Vol.73 No.2

Baboon 증후군 3예

송해준(Hae Jun Song),문기찬(Kee Chan Moon),김수남(Soo Nam Kim) 대한피부과학회 1986 대한피부과학회지 Vol.24 No.6

The baboon sydrome is the term used to denote a characteristic distribution pattern of systemic allergic contact dermatitis. Such skin manifestation is described as mercury exanthem in Japan. Until now, mercury, ampicillin, nickel is reported to produce this condition. We report herein 3 cases of the baboon syndrome. Among 3 cases, 2 cases were associated with mercury, but in the other we could not demonstrate the allergen.

Focus 2-3 (FS 2-3) : Psoriasis as an auto-inflammatory disease

송해준 ( Hae Jun Song ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Psoriasis is an immune-mediated heterogeneous inflammatory disease that is genetically predetermined and strongly influenced by various endogenous and exogenous trigger factors. In its evolving process, psoriasis is showing different pictures in the activity of immune cells. Innate immune cells such as neutrophils, mast cells and macrophages are predominant in early stage, then followed by Th17 cells and finally Th1 cells are dominant in later stage. These features suggests bimodal immunopathogenesis of psoriasis; alternative activation of either innate (autoinflammatory) or adaptive (autoimmune) mechanism. These mechanisms may be closely related with the variability of clinical pictures and treatment responses in psoriasis. Though the adaptive immune dysregulation by activated Th1 cells has been suggested autoimmunity as a basic mechanism of psoriasis, analysis of the variable phenotypes and courses with periodic outbreaks of psoriasis extended disease concept into auto-inflmmatory disease recently. Psoriasis have been called “autoimmune”, but the evidence for atuoimmunity is limited in general sense. Classic autoimmune diseases usually have adaptive immune genetic association including PTPN22, and CTLA4 with autoantibody and MHC class II associations. But there are no shared genetic risk factor PTPN22 polymorphisms, B-cell activation, disease-specific antibodies, and defined autoantigens in psoriasis. Meanwhile psoriasis have the immune components linked to autoflammation. Neutrophile migration is one of the common factors shared with other autoflammatory diseases. Chronic persistent inflammation of psoriasis is mediated by a link between innate and adaptive immune system by the DCs. The involvement of Th17 cells are another link to autoflammation and play significant role in initiating and maintaining psoriasis. Inflammasomes, a typical component of autoinflammation, also have role in psoriasis. Cytosolic DNA triggers the release of IL-1β, there by initiating innate (autoinflammatory) response. These findings place psoriasis, especially the pustular types (GPP), on the list of autoinflammatory diseases. In conclusion, psoriasis is an inflammatory disease showing dysregulated innate immunity and is distinct from autoimmunity genetically with combined adaptive and innate immune response.

Symposium 6-2 (SYP 6-2) : The meaning of psoriatic arthritis in dermatological perspective

송해준 ( Hae Jun Song ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Psoriatic arthritis (PsA) is one of the most important and representative comorbid disease in psoriasis. Although prevalence of PsA is has been estimated between 6% to 42% of psoriasis patients world widely, it was reported as 10.4% in Korean. Psoriatic skin manifestations has been known to precede joint disease by a mean of 9-12 years in most PsA cases (75-84%). In our country, where prevalence of psoriasis itself is expected to be relatively low, level of awareness on PsA arthritis has been low not only in psoriasis patients but also in dermatologist and even to rheumatologist. It seems that PsA is underdiagnosed or misdiagnosed currently in Korea. Unrecognized PsA is progressing to result in irreversible joint destruction and will give severe impacts on the function and the life quality of patients. Moreover PsA patients may also have other extra-articular problems simultaneously. Dermatologists, who meets most of hidden, latent PsA patient have a pivotal roles and are in a unique strategic position to detect and manage PsA and other comorbidities early as possible to prevent extra-cutaneous systemic problems. Dermatologist should monitor joint involvement of their psoriasis patients for any joint symptoms and signs and vigorous use of screening questionnaires is recommended. It is worth to notice that, unlike other countries, spondyloarthritis type comprised to 50% among clinical types of PsA in Korea. So dermatologists should pay attention not only to peripheral joint symptoms but also to manifestations of axial involvement. In order to provide ideal service for psoriasis patient, dermatologists should prepare themselves for this not so familiar entity and need to establishreasonable collaborating referral connection with the rheumatogists.

Why do dermatologists under-estimate severity of psoriasis?: patients` perspective

송해준 ( Hae Jun Song ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Due to its chronicity, difficulties in management and complete cure, psoriasis has been a big burden to patients and even to dermatologists. Dermatologists has been evaluated the severity psoriasis by using objective measures such as PASI or BSA. And DLQI instrument was also applied to evaluate its impact on quality of patient`s life. Recently novel concept of treatment goal, which was defined by scores of PASI and DLQI, was introduced to manage psoriasis more vigorously. But despite these implementation, many of patients think that the severity of their disease is underestimated yet. Why estimation of the dermatologists, who know psoriasis well, is different from that of patients`? It may be attributed to inappreciation of dermatologists for patients` real perspective on psoriasis. Patients recognize psoriasis as something incomprehensible, uncurable, and uncontrollable. The half of the patients are irritating for inconvenience in their life from psoriasis. Unlike our expectation, the most affected aspect was the clothing and the limitation in social relationship was the next. Patients generally make much importance on the changes in skin appearance, abnormal sensation from skin and time factors such as speediness and duration of alleviation. But dermatologist usually count on the status of lesion itself only and did not pay attention to other elements on which patients set high value. Considering difficulties in evaluating such subjective elements, there has been insufficient effort to sympathize what patients really experienced. Although it is well known that many patients have secondary psychological problem due to psoriasis, serious quest for finding specific constituents causing problems and solutions to reduce it was not enough. Patients wish that dermatologists may communicate with them in more simple language and listen to what they really want. It is noteworthy fact that the efficacy of treatment took priority over the safety profile for patients and patients think there are large room for improvements for the treatment modalities other than biologics. Many dermatologists tend to hesitate adopting more fast and strong regimen to avoid complication which may follow it. As a result, patients may feel that they are not treated well and think dermatologist underestimate their disease severity. To overcome those conflicting views, first of all, dermatologist should reinterpret what they have been thought as objective parameters only. It should be interpreted how and how much that elements affect the patients` life. Also some elements, so far not included in evaluating disease severity of psoriasis, should be counted to match the patients` priorities. Secondly, to deepen the understanding of patients on psoriasis, more chance of education for patients should be given. With these effort, more desirable patient-doctor relationship will be set and lead us more satisfactory outcome for both of us.

Symposium 1-4 (SYP 1-4) : Strategies for minimizing adverse effects of corticosteroid

송해준 ( Hae Jun Song ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Glucocorticoids (GCs) are one of the most important and frequently used class of anti-inflammatory drugs in dermatology. Long standing use of GCs resulted in many kinds side effects in various system of the body. Atrophy, acne, erythema, telangiectasia, hypertrichosis is frequently developed on the skin by topical or systemic therapy. Osteoporosis and muscle atrophy in musculoskeletal system, provoking glaucoma and cataract in the eye, steroid psychosis, diabetes, hypertension, suppression of HPX, peptic ulcer and gastrointestinal bleeding, increased risk of infections are well known typical problems to consider in the other parts of body. Clinicians should be aware of appearance of these side effects during GC therapy. The strategies helpful for minimizing adverse effects of GC are reviewed in this talk.

수포성 피부 질환의 Tzanck 검사에 관한 연구

송해준(Hae Jun Song),김수남(Soo Nam Kim) 대한피부과학회 1987 大韓皮膚科學會誌 Vol.25 No.1

For the more practical and convenient application of the Tzanck test, we evaluated several staining methods and cytological findings 98 cases of vesicobullous skin diseases. Fixation by air-drying of specimen aad modified Giemsa staining method were thought to be the most appropriate procedure in clinical use. The disease studied were chickenpox, herpes zoster & simplex, contact dermatitis, Id reaction, tinea pedis, urticaria pigmentosa, incontinentia pigmenti, farnilial benign pemphigus, hand-foot-mouth disease, erytherna multiforme, toxic epiderrzal necrolysis, fixed drug eruption, and septic vesicle. Among these, herpes and chickenpox vesicles shawed the most characteristic and specific findings. And degenerating giant cell could be added as an useful diagnostic marker for these diseases in relatively old lesions. In the other diseases, cytological findings were neither charcteristic nor specific. But these findings suggested the possibility of picking up useful findings by more elaborated study including more large number of cases.

Interactions between keratinocytes and somatosensory neurons in itch

송해준 ( Hae Jun Song ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

피부 유육종증

송해준(Hae Jun Song),조진호(Jin Ho Cho),김수남(Soo Nam Kim) 대한피부과학회 1985 대한피부과학회지 Vol.23 No.2

A case of cutaneous sarcoidosis in the 66 year-old Korean female patient is presented. She shows typical skin manifestations of plaque type in the absence of other common objective evidence of systemic involvement. Diagnosis was confirmed by charcteristic histological findings and positive Kveim test with the support of other compatible clinical and biochemical findings. She had been followed up for 3 years since the first visiting. Recently chest X-ray, slit lamp examination and skin biopsies were taken again, but failed to reveal any significant interval changes,

블록체인 및 DID Auth 기반 스마트홈 월패드 보안 개선 기법

임준혁(Im Jun Hyuk),송해준(Song Hae Jun),최재호(Choi Jae Ho),김기형(Kim Ki Hyung) 한국통신학회 2023 한국통신학회 학술대회논문집 Vol.2023 No.6