직업성 크롬 궤양 1예

원태혁 ( Tai Hyok Won ),김현대 ( Hyun Dai Kim ),서필승 ( Phil Seung Seo ),윤녕훈 ( Nyung Hoon Yoon ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 大韓皮膚科學會誌 Vol.45 No.5

Chrome may have a corrosive, necrotizing effect on tissue, so repeated skin contact to chromate might induce perforations or ulcers on the skin. This condition is called a "chrome ulcer" or "chrome hole". It appears as a small, punched-out mark with a rolled-out border. It is rarely associated with pain, but a severe itching sensation is common. We report a case of a 33-year-old man who presented with a 3 month history of several ulcers on his abdomen. He was employed at a chromate alloying process. He had several hole-like atrophic scars and unbearable pruritus. After changing his occupation, plus treatment with oral corticosteroids and antihistamines, the lesions were healed and the itching sensation faded away. However, atrophic scarring remained. (Korean J Dermatol 2007;45(5): 524~527)

뺨에 발생한 원발성 피부 점막유표피암

원태혁 ( Tai Hyok Won ),김보석 ( Bo Suk Kim ),서필승 ( Phil Seung Seo ),박석돈 ( Seok Don Park ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.8

Mucoepidermoid carcinoma is a rare disease that usually occurs in the salivary gland. In extremely rare cases, it can originate from the skin. These cases are more aggressive than the usual mucoepidermoid carcinoma, so they have high mortality and high recurrence rates. Herein we report a case of primary cutaneous mucoepidermoid carcinoma on the cheek. A 34-year-old man had a 1.0×1.0 cm sized cystic lesion. This lesion displayed central erosion and oily discharge. He had been operated on 4 times at a private hospital, but the lesion had recurred. Histopathologically, there were many tumor islands that consisted of mucoid cells, epidermoid cells, intermediate cells and clear cells. The tumor islets showed mild positivity for Alcian blue (pH 2.5), PAS, and d-PAS stain. There was no parotid tumor on the neck-CT scan, nor on positron emission tomography. We therefore diagnosed this cheek lesion as primary cutaneous mucoepidermoid carcinoma, and it was removed completely. (Korean J Dermatol 2008; 46(8):1083~1086)

동측 하지 단축을 동반한 패리-롬버그 증후군

원태혁 ( Tai Hyok Won ),박석돈 ( Seok Don Park ),서필승 ( Phil Seung Seo ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.9

Parry-Romberg syndrome is an extremely rare connective tissue disorder. It might be a form of linear scleroderma, and it manifests as progressive hemifacial atrophy, epilepsy, exophthalmos or alopecia. Herein we report a case of Parry-Romberg syndrome. A 68-year-old woman had left hemifacial atrophy, shortening and deformity of the left leg, and deformities to her side fingers that occurred from her 1st decade to 2nd decade. Sclerotic change had stopped spontaneously when she was 20 years old. Histopathologically, there were a few signs of skin appendages, but no sclerotic change. On autoimmune antibody test, no positivity was shown. X-ray showed shrinkage of the lung field, elevation of the left diaphragm, shortening of length and reduction of bone mass in the left femur, tibia, and fibula. And there were multiple melorheostasis. Neck CT showed left facial sclerotic change, bone mass loss, and multiple melorheostasis. Because the progression of sclerosis had stopped the patient did not receive any treatment. (Korean J Dermatol 2008;46(9):1216~1220)

국소 털과다증을 동반한 외상성 지방층염

원태혁 ( Tai Hyok Won ),박석돈 ( Seok Don Park ),서필승 ( Phil Seung Seo ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.6

A 32-year-old woman had a brownish hard plaque with localized hypertrichosis. She had fallen down some stairs 1 year previously, and the injury had left a scar on her right shin. Even though pain and the scar had gone, the brown patch had remained. During that time hair had been grown on the site. Histologic examination showed lobular panniculitis, fat necrosis, fibrotic change and lipomembranous change. We diagnosed the patient as a traumatic panniculitis with localized hypertrichosis, based on the trauma history, skin lesion and histologic findings. We report a case of traumatic panniculitis with localized hypertrichosis. (Korean J Dermatol 2008;46(6):812∼814)

흰쥐에 대한 생옻의 생물학적 효과

원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ),박석돈 ( Seok Don Park ) 대한피부과학회 2009 大韓皮膚科學會誌 Vol.47 No.3

Background: Exposure to Rhus (Japanese lacquer) can cause many adverse effects such as contact dermatitis, pruritus, rash and even hepatitis in human, and these effects can be caused by contact or ingestion of Japanese lacquer. Many Koreans currently eat Japanese lacquer boiled with chicken although it has many side effects. Koreans believe that Rhus will improve their health. However, they don`t known its adverse effects, and there is no experimental report on this topic. Objective: The principle objective of this study was to gather evidence on the toxicity and negative effects of Japanese lacquer through an experimental study with rats. Methods: A total of 60 Sprague-Dawley rats were included in the study; 30 rats (experimental group) were given 0.1 ml of Japanese lacquer sap extract, water and food, and 30 rats (control group) were given only food and water. The WBC, the Hgb, ALT, AST, BUN and creatinine levels, the presence of pruritis and skin eruption, the skin biopsy findings and the liver biopsy findings were all checked at 5, 10, and 15 days. Results: The rats that were given Japanese lacquer sap showed a higher WBC and higher ALT and AST levels and only these rats demonstrated erythroderma (5th day: 30%, 10th day: 40%, 15th day: 70%). In addition, they exhibited frequently scratching behavior. On histological examination of the skin of the rats given Rhus, dermal edema and mild inflammatory cell infiltration were found. On histological examination of the liver of the rats given Rhus, there was no significant change as compared with the rats that weren`t given lacquer. Conclusion: In this experimental study, it was proven that Rhus could induce pruritis, erythroderma, skin inflammation and hepatotoxicity. (Korean J Dermatol 2009;47(3):251∼258)

옻닭에 의한 전신성 접촉 피부염 147예의 임상적 고찰

원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ),박석돈 ( Seok Don Park ),김동림 ( Dong Lim Kim ),박재훈 ( Jae Hun Park ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.6

Background: Systemic contact dermatitis (SCD) due to the ingestion of Japanese lacquer tree (Rhus verniciflua) is pretty common in Korea, and it is on a trend of increment. It is thought that the increase in ingestion of chickens boiled with the lacquer tree has been caused by the regard of the lacquer tree as a health food or herbal medicine for gastrointestinal disease. Objective: To review the clinical findings and laboratory findings, and to make people aware of the harmful effects of the lacquer tree. Methods: We retrospectively reviewed the medical records of 147 patients who had SCD due to chicken boiled with lacquer tree, 98 patients in Wonkwang University Hospital over the last 20 years (1998∼2007) and 49 patients in Areumdaun Dermatology Clinic over the past 5 months (August∼December, 2007). Results: The sex ratio of patients (male to female) was 1.3:1 and the average age was 44.0 years old (range: 11∼76). They ate chicken boiled with lacquer tree as a health food (42.9%) and for the treatment of gastrointestinal disease (22.4%). The mean incubation period was 47.7 hours (range: 30 min∼16 days). The first symptoms they had were erythematous maculopapules (42.9%), itching without rash (33.7%), and edematous change (16.3%). The skin lesions developed as maculopapules (50.6%), erythroderma (40.9%), and erythema multiforme-like lesion (8.4%), vesicles, wheals, purpura, and pustules. On laboratory findings, some people had leukocytosis (61.2%), increment of Ig E (26.4%), abnormalities of liver function test (ALT:16.3%, AST:4.1%). Sixty percent of patients had a history of contact dermititous contracted via chicken boiled with rhus lacquer ingestion (36.7%) or contact with the lacquer tree. Clinical symptoms were developed by 29.5% who ate chicken boiled with lacquer. Mainly they had been treated with corticosteroids, antihistamines. The mean period needed for treatment was 8±2.4 days. Conclusion: Systemic contact dermatitis due to ingestion of the lacquer tree was developed in either sensitized or non-sensitized persons. It is suggested that SCD is caused by the highly allergic and toxic effects of lacquer. Physicians need to make people aware of the harmful effects of the lacquer tree and educate people not to ingest it. (Korean J Dermatol 2008;46(6):761∼768)

손가락으로 전이된 Vater씨 팽대부암

원태혁 ( Tai Hyok Won ),김현대 ( Hyun Dai Kim ),서필승 ( Phil Seung Seo ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.6

Skin metastasis from internal malignancy is relatively rare. Skin metastasis from biliary tract cancer is known to be extremely uncommon (around 0.4∼0.7%). In most cases, biliary tract cancer metastasizes into neighboring organs or other internal organs, but rarely into the skin. The authors have experienced a case of skin metastasis into a finger of a patient with carcinoma of Ampulla of Vater. This is thought to be the first case reported in Korea. (Korean J Dermatol 2007;45(6):596∼598)

항결핵약에 의한 전신 과색소침착

김보석 ( Bo Suk Kim ),원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ),박석돈 ( Seok Don Park ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.11

Hyperpigmentation caused by medication or toxic agents accounts for 10∼20% of all the cases of acquired hyperpigmentations. Nonsteroidal anti-inflammatory drugs, antimalarials, amiodarone, cytotoxic drugs, tetracyclines, heavy metals and psychotropic drugs are most commonly responsible for hyperpigmentation. A 74-year-old man who had taken antituberculosis drugs (rifampin and isoniazid) for 4 months developed generalized hyperpigmentation. The histopathologic finding revealed an increased number of dermal melanophages with pigment incontinence. Eight months after termination of the antituberculosis medication, his skin lesion improved without any treatment. To the best of our knowledge, this is the first reported case of generalized hyperpigmentation due to rifampin and isoniazid in a patient without adrenal insufficiency in the dermatological literature. (Korean J Dermatol 2008; 46(11): 1513∼1516)

골수 이식 후 백반증양 병변과 경피증양 병변이 동반된

김현대 ( Hyun Dai Kim ),원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ),윤녕훈 ( Nyung Hoon Yoon ),박석돈 ( Seok Don Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8

Vitiligo and morphea are two distinct entities of unknown etiology, although their existence implies that the immune system and/or the central or peripheral nervous system has been incriminated. Only a few reports of their simultaneous occurrence are on record. Here we report a case of a 39 year old woman affected with both vitiligo of the face, chest and hand and morphea of shoulder and trunk. Since the two diseases appeared after bone marrow transplantation, if could be deduced that there is a possible association between them. Two diseases observed simultaneously in this patient may be derived from the common pathomechanism. An autoimmune etiology is thought to play a part in both of these diseases. (Korean J Dermatol 2007;45(8):832∼835)

OK-432 (Picibanil(R)) 경화요법으로 치료한 림프관종

김보석 ( Bo Suk Kim ),원태혁 ( Tai Hyok Won ),서필승 ( Phil Seung Seo ),박석돈 ( Seok Don Park ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.10

Lymphangioma is an uncommon, benign hyperproliferation of the lymphatic vessels, and this consists of dilated lymphatic channels lined by a normal, single layer of endothelial cells. Various methods have been tried for the treatment of lymphangioma, including cryotherapy, electrocauterization, surgical excision, laser therapy, radiotherapy and itralesional injection of sclerosing agents. Yet these methods have shown low success rates and various side effects. It has recently been reported that intralesional injection of OK-432 is a safe and effective alternative therapy for lymphangioma, and especially for macrocystic lesion. In this report, we describe a patient with lymphangioma on the upper labial mucosa and this patient was successfully treated with intralesional injection of OK-432 without any serious complications. To the best of our knowledge, this is the first such case reported on in the Korean dermatological literature. (Korean J Dermatol 2008;46(10):1398∼1401)