편평 사마귀에 대한 5% Imiquimod 크림의 임상적 치료효과

이운하 ( Un Ha Lee ),최정철 ( Jung Chul Choi ),전덕규 ( Duk Kyu Chun ) 대한피부과학회 2005 大韓皮膚科學會誌 Vol.43 No.1

비성기부 지루각화증에서 HPV DNA Chip을 이용한 Human Papillomavirus DNA 검색

이운하 ( Un Ha Lee ),최우석 ( Woo Seok Choi ),김성우 ( Sung Woo Kim ),박현수 ( Hyun Su Park ),장상재 ( Sang Jai Jang ),황선욱 ( Seon Wook Hwang ),이혜경 ( Hye Kyung Lee ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.10

Background: The precise etiology of seborrheic keratosis (SK) is unknown. Genetics, sun exposure and infection have all been implicated as possible factors. Because of its clinical and histopathological similarities to verrucae vulgaris and condyloma acuminatum, human papillomavirus (HPV) has been suggested as a possible causative agent. In the previous studies, HPV were frequently detected in the genital lesions or hair follicles of immunocompromised hosts. Objective: A newly introduced HPV detection technique, the HPV DNA Chip analysis, contains 24 HPV probes and it has the advantage of being able to detect 24 types of HPV at once. The purpose of this study was to evaluate the presence of HPV DNA in the nongenital SK of immunocompetant individuals. Methods: We analyzed 31 biopsy specimens that were taken from patients with nongenital SK, and these specimens were compared with genital warts (the positive control) and distilled water in place of DNA (the negative control) with using HPV DNA Chip analysis and a polymerase chain reaction-based DNA microarray system as the HPV genotyping method. Results: By polymerase chain reaction (PCR), HPV DNA was detected in 2 of the 31 nongenital SK biopsies (6.5%). HPV DNA Chip analysis revealed that 3 of 31 nongenital SKs (9.7%) contained HPV DNA. Two distinct HPV genotypes were detected: HPV type 16 (n=2) and HPV type 42 (n=1). The duration of SK in the HPV positive group was longer than that of the SK in the negative group. The mean age of the patients in the HPV positive group was also older than the mean age of the negative group. There were no different histopathologic findings between the HPV positive and negative SK. Conclusion: This study did not provide any concrete evidence that HPV infection might directly play a part in the pathogenesis of nongenital SK. However, two distinct HPV DNA types were identified as types that have never been reported before. Further studies with a larger number of cases of SK are needed to confirm the presence of HPV DNA in nongenital SK and also to determine the role of HPV in the origin of nongenital SK. (Korean J Dermatol 2008;46(10):1321∼1327)

Sitagliptin에 의해 발생한 DRESS 증후군 1예

이재호 ( Jae-ho Lee ),김중호 ( Joong-ho Kim ),김호영 ( Ho-young Kim ),서중헌 ( Joong-heon Suh ),이수경 ( Soo-kyung Lee ),김명신 ( Myoung-shin Kim ),이운하 ( Un-ha Lee ) 대한피부과학회 2020 大韓皮膚科學會誌 Vol.58 No.5

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse drug reaction that is difficult to predict. It is characterized by fever, skin rash, and internal organ involvement that usually manifests 2∼6 weeks after use of the culprit drug. The antihyperglycemic agent sitagliptin is commonly used for treating diabetes mellitus, and sitagliptin-induced DRESS syndrome has not been previously reported in Korea. Herein, we report a case of DRESS syndrome after sitagliptin use; these observations may contribute to the timely diagnosis of sitagliptin induced DRESS syndrome and help reduce associated complications or morbidities. (Korean J Dermatol 2020;58(5):330∼333)

악성 흑색종과 동반된 Leser-Trelat 징후

이동엽 ( Dong Yeup Lee ),백종헌 ( Jong Heon Baek ),김동주 ( Dong Joo Kim ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.12

Leser-Trelat sign is a rare paraneoplastic dermatosis that is characterized by the eruptive and rapid development of multiple seborrheic keratosis that coincides with an internal malignancy. Eruptive seborrheic keratosis can be pruritic and appear in a “Christmas-tree pattern.” This sign occurs in association with a number of cancers, such as adenocarcinoma of the gastrointestinal tract and various lymphoproliferative disorders. However, Leser-Trelat sign associated with a malignant melanoma is very rare. A 58-year-old male patient presented with an asymptomatic black mass on the penile orifice and patch on the glans penis. He complained of gross hematuria. At the same time, he developed asymptomatic multiple brown papules and plaques on the back. The histopathologic findings of the glans and back lesions were consistent with malignant melanoma and seborrheic keratosis, respectively. Here, we describe a rare case of Leser-Trelat sign associated with malignant melanoma. (Korean J Dermatol 2014;52(11):895∼ 899)

입술에 발생한 염증성 병변에 대한 임상적 병리조직학적 분석

신문섭 ( Moon Seub Shin ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ),박혜진 ( Hai Jin Park ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.8

Background: Inflammatory labial lesions are quite common in dermatology. However, a few studies have been performed regarding the clinical and histopathological findings of inflammatory labial diseases. Objective: The purpose of this study was to investigate the clinical and histopathological features of inflammatory labial diseases. Methods: We retrospectively reviewed the data of 48 patients who underwent biopsy for inflammatory labial lesions between June 2005 and December 2012. Clinical features and histopathological findings of the lesions were investigated, and they were compared to each other for differential diagnosis. Results: The most frequent inflammatory labial diseases were actinic cheilitis (25%), oral lichen planus (23%), plasma cell cheilitis (23%), oral lichenoid lesion (17%), and eczema (12%). Most of the labial lesions were located on the lower lip (87%). We found a broad overlap in the clinical features of lesions with each other, and in many cases, clinical impressions were inconsistent with their final diagnosis. Histopathologically, the degree of eosinophilic infiltrates in actinic cheilitis was comparable to those in eczema. Oral lichen planus showed orthokeratotic hyperkeratosis rather than parakeratosis, and oral lichenoid lesion displayed more frequent perivascular and deep inflammatory cell infiltrates than oral lichen planus. Conclusion: The diagnosis of inflammatory labial diseases may be challenging, because inflammatory labial diseases often show similar clinical features and have a broad overlap in histological features. Therefore, clinico-pathologic correlation is necessary to confirm the diagnosis and for proper management. (Korean J Dermatol 2013;51(8):608∼ 615)

정신건강의학과 입원 중 피부과로 의뢰된 환자에 대한 분석

이동엽 ( Dong Yeup Lee ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ),함정희 ( Jeong Hee Hahm ) 대한피부과학회 2015 大韓皮膚科學會誌 Vol.53 No.8

Background: The need for dermatological consultations for hospitalized patients has gradually increased and there are a number of dermatoses caused by underlying psychological conditions. However, the data regarding the analyses of these consultations for psychiatric inpatients are limited. Objective: To analyze the demographics and the type of dermatoses among inpatients with primary psychiatric diseases. Methods: We retrospectively reviewed 581 consultation reports for inpatients referred by the Department of Psychiatry between January 1, 2009 and December 31, 2014. Results: The proportion of the consulted patients from the Department of Psychiatry was 25.9% (331 consulted inpatients/1279 psychiatric inpatients). The most common age group was the 40∼49 year-old group (19.3%) and the male to female ratio was 1:1.14. There were no remarkable findings regarding the annual or seasonal distribution. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the most common underlying psychiatric disorders were mood disorders (41.0%), followed by schizophrenia and other psychotic disorders (25.0%), and substance-related disorders (12.1%). The most frequent skin disorders were eczematous dermatoses (34.6%) and infectious dermatoses (32.2%); dermatomycosis (20.8%) was especially common.The most common reasons for consultation were new-onset dermatologic problems (68.5%), followed by persistence or aggravation of pre-existing dermatologic disorders (28.7%). Conclusion: This study reports the dermatologic characteristics of psychiatric inpatients. We conclude that dermatologists and psychiatrists need to be concerned about the education and continuous management of various skin diseases in psychiatric patients. (Korean J Dermatol 2015;53(8):585∼593)

성기능 개선제 복용 후 발생한 고정약진 1예

이수경 ( Soo Kyung Lee ),김동주 ( Dong Joo Kim ),서중헌 ( Joong Heon Suh ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ) 대한피부과학회 2018 大韓皮膚科學會誌 Vol.56 No.4

Fixed drug eruption is a commonly reported mucocutaneous drug eruption. A 61-year-old male presented to our clinic with a complaint of an itchy round erythematous patch on the left hand dorsum with myalgia. On taking medical history, the patient correlated the episode with the intake of an oral sexual enhancer that he had obtained over the counter. We found the medicine contained tadalafil and sildenafil in combination with herbal ingredients. A short course of oral corticosteroid therapy resulted in the complete resolution of the lesion leaving residual hyperpigmentation of the skin involved. Various sexual enhancers with fancy names and attractive packaging are available without requiring a doctor’s prescription. Most contain phosphodiesterase-5 inhibitors in various concentrations, often with herbal additions. These drugs are used erratically by the lay public, and often produce side effects. Herein, we report a case of fixed drug rash related to a sexual enhancer, which we believe to be the first report in Korea. (Korean J Dermatol 2018;56(4):269∼272)

이산화탄소 레이저로 치료한 Papular Acantholytic Dyskeratosis 1예

이수경 ( Soo Kyung Lee ),김동주 ( Dong Joo Kim ),서중헌 ( Joong Heon Suh ),이운하 ( Un Ha Lee ),김명신 ( Myoung Shin Kim ) 대한피부과학회 2017 大韓皮膚科學會誌 Vol.55 No.8

Papular acantholytic dyskeratosis is a collection of papular skin lesions that occur in the intertriginous and genital area. They show a characteristic histology of focal suprabasal acantholysis that distinguishes it from Hailey-Hailey disease or Darier disease. We describe a 50-year-old man with an asymptomatic papular eruption on the perianal area for several years. Histologically, a biopsy specimen showed diffuse hyperkeratosis and irregular acantholysis throughout the epidermis. We used carbon dioxide laser therapy as a therapeutic option. Despite causing a long and painful healing process, a considerable reduction of the symptoms was achieved. Although we do not know the precise nature or the incidence of this disease, papular acantholytic dyskeratosis should be included in the differential diagnosis of verrucous papules in perineal or perianal areas and carbon dioxide laser may represent a good therapeutic option. (Korean J Dermatol 2017;55(8):518∼521)

서혜부에 발생한 크론병

이동엽 ( Dong Yeup Lee ),홍광철 ( Kwang Cheol Hong ),백종헌 ( Jong Heon Baek ),김동주 ( Dong Joo Kim ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.10

Crohn`s disease is a systemic inflammatory and granulomatous disease, mainly involving the gastrointestinal tract with extraintestinal manifestations such as the skin, liver and bone. Cutaneous manifestations of Crohn`s disease are relatively common; however, the groin is an unusual site for cutaneous Crohn`s disease. A 36-year-old male presented with mild pruritic nodules on the left groin for 2 months. Nine years ago, he was diagnosed with intestinal Crohn`s disease by endoscopic biopsy. Histopathologic examination of the cutaneous lesion showed non caseating granulomatous reactions composed of multinucleated giant cells with lymphohistiocytic infiltration in the dermis. Staining for periodic acid-Schiff and acid-fast bacilli was negative. From these findings, we diagnosed these lesions as cutaneous Crohn`s disease. The lesions were markedly improved with three rounds of intralesional steroid injection. (Korean J Dermatol 2013;51(10):825∼828)

선상 편평태선의 경구 스테로이드 치료

강유석 ( Yoo Seok Kang ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ),장상재 ( Sang Jai Jang ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.5

Background: Lichen planus is a chronic papulosquamous disease characterized by various clinical manifestations of the skin, mucosa, hair, and nails. Various drugs or physical treatments for lichen planus have been proposed, but the efficacies are often disappointing and controversial. Linear lichen planus is a rare variant of lichen planus, which accounts for 0.2∼0.6% of all patients with lichen planus. Systemic corticosteroids remain the most widely used treatment for lichen planus. However, there have been no clinical studies on the effectiveness of this therapy on linear lichen planus despite the fact that linear lichen planus usually lasts for more than 1 year and occasionally results in cosmetic problems. Objective: This study evaluated the efficacy and safety of oral methylprednisolone therapy for linear lichen planus. Methods: Retrospective study was performed by reviewing the medical records and clinical photographs of 12 linear lichen planus patients treated with oral methylprednisolone. The analyses of treatment response to oral methylprednisolone therapy, adverse effects, and recurrence were performed. Results: All the 12 patients who completed the oral methylprednisolone therapy achieved complete response. Most patients showed a marked improvement 1 to 2 weeks after starting oral methylprednisolone therapy. Three of the 12 patients showed recurrence at 9 to 14 weeks after cessation of the treatment. Oral methylprednisolone therapy was generally well-tolerated and no serious adverse effects were observed. Conclusion: Oral methylprednisolone therapy is an efficacious, safe, and tolerable treatment modality for linear lichen planus. (Korean J Dermatol 2008;46(5):587∼595)