Pyoderma-Pyostomatitis Vegetans

최윤석 ( Yoon Seok Choe ),이재철 ( Jae Chul Lee ),박병철 ( Byung Cheol Park ),나건연 ( Gun Yoen Na ),이원주 ( Woen Ju Lee ),이석종 ( Seok Jong Lee ),김도원 ( Do Won Kim ) 대한피부과학회 2006 대한피부과학회지 Vol.44 No.8

Pyoderma-pyostomatitis vegetans (PD-PSV) is a rare, benign, eosinophilic pustular and vegetating mucocutaneous disease characterized by skin lesions which typically involve the axillary and genital regions, the face and the scalp. PD-PSV was at first regarded as a subtype of bullous disease. However, due to the lack of abnormality under a immunofluorescent microscope, it could be diffentiated from bullous disease. A 48-year woman presented with a 6-month history of sharply-outlined, exudative, papillomatous and vesiculopustular vegetating plaques on the perioral, umbilicus and nasal mucosa, tips of her fingers and toes and perianal region. A skin biopsy taken from the lip and umbilicus showed papillary dermal edema and focal inflammatory cell infiltration composed of many eosinophils, intraepithelial microabscesses, focal spongiosis, and exocytosis. No abnormalities were found during an immunofluorescence study. The lesions were almost cleared with 20㎎ of triamcinolone and 200㎎ of cyclosporine medication during a 3-month treatment period. (Korean J Dermatol 2006;44(8):991~994)

화폐상 습진의 임상적 관찰

최윤석 ( Yoon Seok Choe ),이석종 ( Seok Jong Lee ),나건연 ( Gun Yoen Na ),김도원 ( Do Won Kim ) 대한피부과학회 2005 대한피부과학회지 Vol.43 No.8

메조테라피 약제가 모낭의 기관배양 및 모유두 세포배양에 미치는 효과

이원주 ( Weon Ju Lee ),최윤석 ( Yoon Seok Choe ),이재철 ( Jae Chul Lee ),이석종 ( Seok Jong Lee ),김도원 ( Do Won Kim ),민복기 ( Pok Kee Min ) 대한피부과학회 2006 대한피부과학회지 Vol.44 No.10

Background: Hair loss including androgenetic alopecia and chronic telogen effluvium is recognized increasingly as a physically and psychologically harmful medical condition. Mesotherapy is considered as a new therapeutic modality for hair loss. Objective: We studied to determine the effect of medications used in mesotherapy on hair organ culture and culture of dermal papilla cells. Methods: First, occipital hair follicles were collected from patients with androgentic alopecia and separated into single hair follicles. The single hair follicles were cultured in William E media mixed with mesotherapy medications such as lidocaine, placental extract, Pondil(R), CRP-1000(R), and mixture of all these medications at different concentrations (1, 10, 50㎕). On the 8th day, the cultured single hairs were stained with H&E and the length of those was measured under a microscope to compare with control group. Immunofluorescent study was performed to check expression of Ki-67, Bcl-2 and Bax on the hairs. Second, dermal papilla cells were isolated from occipital anagen hairs of patients with androgenetic alopecia and cultured in Dulbeco`s modified Eagle`s medium (DMEM). The mesotherapy medicines were added to the medium with one and two thousand dermal papilla cells, respectively. At the 3rd day, survival of the cells was evaluated with ELISA method comparing with control group. Results: There were no statistical differences of the length of the hairs and the survival of the dermal papilla cells between experimental and control groups. With Bcl-2, we couldn`t see any differences between experimental and control groups. With Ki-67, experimental groups showed less expression than control group. On the contrary, experimental groups showed more expression than control group in case of Bax. Conclusion: We can conclude from the results that the four medications used in mesotherapy are not effective for growth of cultured hair follicles and survival of cultured dermal papilla cells. However, more study would be needed for the establishment of objective and scientific evidences supporting mesotherapy and we should be in search for new medications for mesotherapy. (Korean J Dermatol 2006;44(10):1178~1185)

고령자의 피부과 질환에 대한 임상적 고찰

박병철 ( Byung Cheol Park ),최윤석 ( Yoon Seok Choe ),김도원 ( Do Won Kim ),이원주 ( Weon Ju Lee ),이석종 ( Seok Jong Lee ),나건연 ( Gun Yoen Na ) 대한피부과학회 2006 대한피부과학회지 Vol.44 No.7

Background: With the advance of socioeconomy and medical sciences, geriatric health care has become a world wide concern and disease of the skin is no exception. Objective: The aim of this study was to investigate the epidemiology, past history and the prevalence of various skin disorders of the elderly. Methods: In this trial, a total of 1082 new patients older than 65 years, who visited the Department of Dermatology, Kyungpook National University Hospital in Daegu, Korea in the last 3 years (2002~2004), were selected. The data was studied on the basis of a retrospective survey of hospital records. Results: Of total patients who were seen at the dermatologic outpatient department, 10.1% were 65 years and older. The male to female ratio was 1 to 1.01. The patients between 65 and 74 years old compromised the majority (72.8%), and the patients older than 85 years old were 4.1%. They visited hospital most frequently in summer. Of the common complaints recorded, pruritic rash was the most frequent. The commonly diagnosed disorders were herpes zoster followed by senile pruritus, tinea/onychomycosis, and seborrheic dermatitis in decreasing order. The most common dermatologic disease was hespes zoster and postherpetic neuralgia for all three age groups : 65~74 years old, 75~84 years old, and over 85 years old. A total of 901 patients, which constituted 83.3% of the total patients, had at least more than one underlying disease, of which cardiovascular disease was the most common. Conclusion: This study is expected to be of help to understand the characteristics and the distribution of dermatologic diseases in the elderly. (Korean J Dermatol 2006;44(7):818~823)

Nasalis Island Pedicle Flap을 이용한 코 하부의 결손부 재건

지성근 ( Seong Geun Chi ),정홍대 ( Hong Dae Jung ),이석종 ( Seok Jong Lee ),최윤석 ( Yoon Seok Choe ),김병수 ( Byung Soo Kim ),김도원 ( Do Won Kim ),박병철 ( Byung Cheol Park ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.12

Reconstruction of surgical defects of the nose, particularly the lower one third, is often challenging. The skin of this area is less mobile and fixed on lower structures without a subcutaneous fatty layer. Thus, dissection of tissues is rather difficult and more bleeding can occur during dissection. Furthermore, flap surgery will fail if the flap extends too far. Local flap surgery is one of the more useful techniques that maintains the function and aesthetics of a normal nose. Among these, the nasalis muscle is relatively easy and provides better outcomes. More importantly, vascular supplies from the underlying muscular structure provide greater viability. Additional movement can be achieved by either dissecting under the transverse nasalis or by dividing the transverse nasalis beyond the midline. We report 5 cases of nasalis island pedicle flaps using nasalis muscles. The final results were relatively satisfactory for both functional and cosmetic aspects. (Korean J Dermatol 2008;46(12):1634∼1639)

켈로이드와 비대흉터에서 스테로이드, 5-fluorouracil 병변내 주사 및 색소 레이저 병용요법에 관한 비교 연구

김호연 ( Ho Youn Kim ),임현정 ( Hyun Jung Lim ),전재헌 ( Jae Hun Jun ),최윤석 ( Yoon Seok Choe ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),이석종 ( Seok Jong Lee ),김도원 ( Do Won Kim ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.6

Background: Despite the physical disfigurement, bothersome symptoms and psychological problemsfrom the proliferative scarring process of keloids and hypertrophic scars, there is currently no consensus regarding the best management of these lesions. Objective: The purpose of this study was to determine the therapeutic efficacy and safety of intralesional corticosteroid injection combined with 5-fluorouracil (5-FU) and/or pulsed dye laser (PDL) in Koreans with keloids or hypertrophic scars. Methods: Twenty-five patients with keloids and/or hypertrophic scars over 2 cm in size or who had more than 3 separated lesions were included in this study. Each scar was divided equally into 2 or more segments and these were treated with 1 of the following 3 different modalities: (1) intralesional injection of triamcinolone acetonide (TCA: 20 mg/ml weekly), (2) intralesional injection of TCA 0.1 ml (40 mg/ml) mixed with 5-FU 0.9 ml (50 mg/ml) weekly and (3) treatment #2 combined with PDL (585 nm, 5∼7.5 J/cm2) at baseline and at the 3rd and 7th weeks. We estimated the change of the height, the erythema, the pliability, the pruritus, the pain/tenderness scores, the patient-self assessment and the complications. This study was an 8-week prospective study and the assessment of relapse was done at 4 and 12 weeks after the last treatment. Results: There was a statistically significant improvement of the clinical signs and symptoms in all the treated groups. However, the 5-FU-treated groups had more sustained effects compared to the group that underwent TCA monotherapy with respect to flattening and pliability. Complications such as ulcerations, crusts and hyperpigmentation were more frequent in the 5-FU-treated groups. Conclusion: Although 5-FU may be preferable to TCA for improving the symptoms of keloids and hypertrophic scars, we believe it is prone to induce more complications in Koreans. (Korean J Dermatol 2009;47(6):658∼666)

정맥,림프관기형에서의 혈관경화요법의 효과와 안전성: 장기간 추적관찰

이재철 ( Jae Chul Lee ),김호연 ( Ho Youn Kim ),최윤석 ( Yoon Seok Choe ),이석종 ( Seok Jong Lee ),김도원 ( Do Won Kim ),정호윤 ( Ho Yun Chung ),백승국 ( Seung Kug Baik ),이종민 ( Jong Min Lee ),허승 ( Seung Huh ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.9

Background: Surgical excision and alcohol sclerotherapy have been used to treat congenital vascular malformations (CVM) with a significant success rate but the methods have also left marked morbidity. The alternative, sclerotherapy using ordinary sclerosants, although resulting in trivial complications, has a relatively low cure rate and is rarely used in Korea for CVM management. Objective: To evaluate the effects and side effects of sclerotherapy using ordinary sclerosants such as polidocanol (POL) and sodium tetradecyl sulfate (STS) for the treatment of CVM of a venous and lymphatic type. Methods: To confirm the long-term effects and safety with at least a 3-year follow-up, we chose a total of 26 patients who had undergone sclerotherapy between 2000 to 2004. There were 22 venous malformations (VMs) and 4 lymphatic malformations (LMs) which were rather small and superficial, not beyond muscular fascia. Sclerotherapy using POL and STS was performed by blind intraluminal and/or intralesional injection without the aid of imaging methods such as ultrasound examination. The results were evaluated by the patients` subjective satisfaction, physical examination, comparison of photographs and/or radiological examinations, then they were classified into 4 groups; excellent (improvement >75%), good (50~75%), fair (25~49%) and poor (<25%). Results: Twenty two VMs comprised 14 in the excellent group (66.7%), 6 in the good group (25.0%), 1 in the fair group (4.2%) and 1 in the poor group (4.2%). Two LMs of macrocystic type revealed excellent results but the other two showing microcystic type revealed poor results. The dose of sclerosant was 0.1 to 2 ml in every session and a total of 1 to 6 sessions (average: 2.2) were performed. Only one VM showed hyperpigmentation as a side effect. Conclusion: Sclerosants for ordinary varicose vein eradication can be used on the treatment of small and superficial venous malformations and macrocystic-lymphatic malformations with relative efficacy and safety. (Korean J Dermatol 2008;46(9):1194~1200)

전초림프절생검에서 림프절 전이가 확인된 편평세포암

지성근 ( Seong Geun Chi ),김호연 ( Ho Youn Kim ),박병철 ( Byung Cheol Park ),이석종 ( Seok Jong Lee ),최윤석 ( Yoon Seok Choe ),김병수 ( Byung Soo Kim ),김도원 ( Do Won Kim ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.10

Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer and the majority of such patients can be easily treated with a relatively low risk of recurrence and metastasis. However, there are subgroups of SCC that are at a higher risk, depending on patient`s or tumor`s characteristics. A greater part of the metastases from these high-risked SCCs spread towards the regional lymph nodes, whereas distant metastases are relatively uncommon. Early identification of nodal metastasis can allow the selective and timely inclusion of possible high-risked SCC patients into more aggressive treatments and meticulous follow-up protocols for achieving potential survival benefit. Therefore, sentinel lymph node biopsy (SLNB) is popular in the management of malignant melanoma, and it may also be useful to detect regional metastasis of high-risked SCCs. This procedure could also spare node-negative patients the morbidity of unnecessary additional therapy, like elective lymph node dissection. We report herein on a case of SCC with regional nodal metastasis, which is confirmed by SLNB. (Korean J Dermatol 2008;46(10):1387∼1390)

사마귀양혈관종과 혈관각화종: 임상병리조직학적 유사점과 차이점

정홍대 ( Hong Dae Jung ),박경덕 ( Kyung Duck Park ),지성근 ( Seong Geun Chi ),이석종 ( Seok Jong Lee ),최윤석 ( Yoon Seok Choe ),김병수 ( Byung Soo Kim ),김도원 ( Do Won Kim ),정호윤 ( Ho Yun Chung ),윤길숙 ( Ghil Suk Yoon ) 대한피부과학회 2009 大韓皮膚科學會誌 Vol.47 No.4

Background: Verrucous hemangioma (VH) and angiokeratoma (AK) are vascular birthmarks of an unclear nosology and these birthmarks commonly show a superficial hyperkeratotic vascular component. There are both similarilities and differences between VH and AK with some confusion concerning their overlapping features. Objective: This study was undertaken to review the clinicopathological features of VHs and AKs and to determine the similarilities and differences between them. Methods: We retrospectively reviewed 11 VHs and 7 AKs at the Vascular Anomaly Clinic of our hospital over the past 10 years. They were evaluated from the clinicopathologic point of view for factors such as the age of onset, location, size, symptoms, the histopathological epithelial change and involvement of deeper tissue. Results: These birthmarks share common clinical features with the exception of gender and lesion size. Histopathologically, hyperkeratosis, acanthosis and capillary dilatation in the upper dermis were commonly seen. Yet lobular proliferation and dilatation of blood vessels in the deep dermis, or more importantly, the subcutis were detected in VH only. Furthermore there was a case of VH that showed diffusely scattered increased blood vessels in the subcutis, suggesting an evolving stage of VH and there was another case of VH that was erroneously diagnosed as AK via the initial biopsy, and the final diagnosis was changed according to the excised lesion. Conclusion: The two diseases share most of their clinicopathological features, but small parts of features like gender, the clinical size and the histological deep dermis/subcutis involvement were differences. Making the correct differential diagnosis between VH and AK through a deep biopsy with appropriate timing and long term follow up and/or radiological examination is helpful to avoid erroneous management. (Korean J Dermatol 2009;47(4):419~424)

내시경하 고실성형술

손수준,박찬민,최세호,최윤석,권성우 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.6