마이봄샘촬영술을 이용한 콩다래끼절개술 전후의 마이봄샘 변화 관찰

정세윤(Se Yoon Chung),황호식(Ho Sik Hwang),신민철(Min Chul Shin),조범주(Bum-Joo Cho),한소영(So Young Han) 대한안과학회 2018 대한안과학회지 Vol.59 No.2

Purpose: To examine changes in meibomian glands by indirect meibography after incision and curettage of the chalazion, and to examine the relationship between meibomian gland drop out and meibomian gland dysfunction. Methods: We performed a prospective study of 16 patients, <5 years of age, who underwent incision and curettage of the chalazion between March 2017 and June 2017. We performed indirect meibography before incision and curettage of the chalazion, and 1 week and 1 month after the procedure. Photographs of meibomian glands were rated according to their meiboscore, the break-up time (BUT) was measured, and Schirmer’s test was performed. Results: Sixteen eyes of 16 patients were included in this study. Fifteen patients visited 1 week after incision and curettage of the chalazion, and eleven patients visited at 1 month after the procedure. The mean patient age was 32.9 ± 21.9 years. There were no significant changes in the meiboscore (p = 0.092), BUT (p = 0.068), and Schirmer’s test results (p = 0.972) after incision and curettage of the chalazion. In meibography, there were inflammatory changes and partial meibomian gland drop outs at the chalazion lesion before its incision and curettage. At 1 month after the procedure, only scarring remained in the chalazion lesion, and normal surrounding meibomian glands were found near the old lesions. When comparing meibography of the baseline with meibography at 1 month after incision and curettage of the chalazion, the normal area of the meibomian gland significantly increased(p = 0.041). Conclusions: In patients with chalazions, scarring was found after incision and curettage of the lesions, and surrounding meibomian glands were well preserved when determined by indirect meibography. There was no significant correlation between meibomian gland changes after incision and curettage of the chalazion and meibomian gland dysfunction.

콩다래끼로 오인된 아래 눈꺼풀 테두리의 피지샘상피종 1예

이학준(Hak Jun Lee),민수기(Soo Kee Min),이민정(Min Joung Lee) 대한안과학회 2016 대한안과학회지 Vol.57 No.8

목적: 우안 아래 눈꺼풀 테두리에 발생한 다래끼로 오인된 피지샘상피종을 경험하였기에 이를 보고하고자 한다. 증례요약: 52세 여자 환자가 2년 전 발생한 우안 아래 눈꺼풀 테두리 종괴를 주소로 내원하였다. 이전에 다래끼로 절개배농술을 받았으나 호전되지 않았다. 우안 아래 눈꺼풀테의 바깥쪽 부분에 융기된, 단단한 종괴가 관찰되었고 눈꺼풀을 뒤집었을 때 눈꺼풀결막 밑으로 황백색의 병터가 확인되었다. 국소마취하에 절제생검하였으며 병리조직학 검사에서 피지샘상피종이 진단되었다. 추가로 시행한 면역화학검사에서 mutator L homologue 1 (MLH1), mutator S homologue 2 (MSH2), mutator S homologue 6 (MSH6) 모두 양성으로 판정되었고 본인 및 가족의 내부장기 악성종양의 과거력이 없었기 때문에 Muir-Torre syndrome의 가능성은 낮을 것으로 판단되었다. 결론: 잘 치료되지 않는 다래끼의 감별진단으로 피지샘상피종을 염두에 두어야 한다. Purpose: To report a rare case of sebaceoma misdiagnosed as chalazion. Case summary: A 42-year-old female presented with a visible mass in her right lower eyelid. An elevated, hard mass was located at the margin of the right lower eyelid, and she had a history of incision and curettage under the clinical impression of chalazion. On eversion of the lower eyelid, the tarsal portion of the mass was visible as a white-yellowish lesion. The mass was excised under local anesthesia. A sebaceoma was diagnosed based on histopathological examinations. Immunohistochemical studies showed positive staining results for mutator L homologue 1 (MLH1), mutator S homologue 2 (MSH2), and mutator S homologue 6 (MSH6), and she had no past medical history or family history of internal malignancy, suggesting a low possibility of Muir-Torre syndrome. Conclusions: Eyelid sebaceoma should be considered as a differential diagnosis for refractory chalazion.

콩다래끼로 오인되었던 8세 여아의 합성섬유육아종

안재홍(Jae Hong An),정혜라(Hye Ra Jung),전종화(Jong Hwa Jun) 대한안과학회 2021 대한안과학회지 Vol.62 No.7

목적: 콩다래끼로 오인되었던 결막 합성섬유육아종 1예의 증례를 경험하고 치료하였기에 이에 대해 보고하고자 한다. 증례요약: 특별한 내과병력 및 외상력이 없는 8세 여아가 좌안 하안검 결막에 지속되는 종괴로 본원으로 의뢰되었다. 환아의 시력 및 안압은 정상이었고 평소 자주 인형 머리카락을 가위로 자르며 놀았다고 하였다. 결막종괴는 개인의원 내원 1주일 전에 처음 발생하여 콩다래끼 진단하에 안약 점안치료를 시행하였으나 호전이 없어 절개 및 소파술을 시행하였고, 그 이후에도 결막내 종괴가 지속되는 양상으로 조직검사를 위해 본원으로 전원되었다. 본원 내원 후 시행한 세극등현미경검사상 종괴 내부에 섬유 가닥의 엉김과 같은 양상이 관찰되었다. 전신마취하에 절제생검을 시행하였고 조직병리학적 검사상 복굴절의 섬유 이물과 그를 둘러싼 육아종성 염증이 관찰되어 합성섬유육아종이 진단되었다. 결론: 결막 합성섬유육아종은 콩다래끼로 오인되기 쉬우며 세극등현미경검사상 종괴 내부에 특이적인 섬유 가닥의 엉김이 관찰될 경우 임상적 의심하에 치료적 절제생검을 통한 진단 및 치료가 필요하다. Purpose: We report a case of conjunctival synthetic fiber granuloma, which was misdiagnosed as chalazion. Case summary: An 8-year-old female patient, without any previous medical illness or ocular trauma history, visited our hospital with a prolonged mass-like lesion in the left lower palpebral conjunctiva. In her detailed medical history, she said that she often played with her doll s hair. The conjunctival mass first occurred 1 week before her visit to the private clinic. At that time, eye drop treatment was initiated under the diagnosis of chalazion. The child showed no improvement; thus, incision and curettage were performed. The mass in the conjunctiva continued to persist, so she was transferred to the hospital for a biopsy. Slit-lamp examination revealed a patterned agglomeration of fiber strands inside the mass. Complete excisional biopsy was performed under general anesthesia. Histopathological examination revealed a fibrous foreign body in the birefringence, with granulomatous inflammation surrounding it. The patient was diagnosed with synthetic fiber granuloma. Conclusions: Conjunctival synthetic fiber granulomas are easily mistaken as chalazion. If specific fibrous strands are entangled inside the mass on slit-lamp examination, diagnosis and treatment through therapeutic excisional biopsy are required under clinical suspicion.

콩다래끼 병소 내 스테로이드 국소 주사 시 스테로이드 농도에 따른 치료 효과 비교

김은주,유성,정병진,이규원,문홍재,Eun Joo Kim,Sung Yu,Byung Jin Jeong,Kyoo Won Lee,Hong Jae Mun 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To compare the efficacy of an intralesional steroid injection in the treatment of chalazion according to triamcinolone acetonide (TA) concentrations. Methods: A total of 108 patients with 120 chalazia received an intralesional injection of TA. Patients were divided into 3 groups according to the concentrations of TA: 5 mg/ml, 10 mg/ml, and 40 mg/ml. A regular follow-up was performed and the size of lesion and recurrence were evaluated. Results: Success was defined as a minimum of 80% decrease in size with no recurrence. The success rate was 78.1% in the 5 mg/ml group, 76.2% in the 10 mg/ml group, and 78.4% in the 40 mg/ml group. These results were not statistically significant (p = 0.999, Fisher’s exact test). Yellow deposits developed in 4 out of 37 lesions in the 40mg/ml group, and in 1 out of 42 lesions in the 10 mg/ml group. Skin depigmentation was observed in 1 case in the 5 mg/ml group. Conclusions: Intralesional TA injection is an effective treatment for chalazion. There is no significant difference in success rates according to the concentrations of TA. However, caution is advised in cases of high injection concentrations of TA to prevent yellow deposits.

콩다래끼로 오인된 안와 기질화 혈종 1예

김은우,이민정,Eun Woo Kim,Min Joung Lee 대한안과학회 2013 대한안과학회지 Vol.54 No.12

Purpose: Organizing hematomas (hematic pseudocysts) of the orbit are usually the consequence of direct blunt trauma and are important in the differential diagnosis of orbital cystic lesion. Herein, we report a case of orbital organizing hematoma masquerading as a chalazion. <br /> Case summary: A 12‐year‐old female visited our clinic complaining of left lower eyelid swelling. CT scan and MR imaging showed a mass detected in the inferomedial space of her left orbit, which did not invade the adjacent tissue. Excisional biopsy of the orbital mass was performed. Histological examination showed the accumulation of blood‐breakdown products within a thick fibrous capsule without epithelial or endothelial lining. The mass was diagnosed as an organizing hematoma.<br /> Conclusions: An orbital organizing hematoma can present, although rare, as a chalazion‐like eyelid mass. Careful clinical and radiological examinations can help in making a differential diagnosis.<br /> J Korean Ophthalmol Soc 2013;54(12):1918-1922

콩다래끼로 오인된 눈꺼풀의 파라핀종

권진영(Jin Young Kwon),한지상(Ji Sang Han) 대한안과학회 2015 대한안과학회지 Vol.56 No.12

Purpose: Paraffinoma is a granulomatous reaction to paraffin or oily substances. We report delayed diagnosis of paraffinoma that was misdiagnosed as chalazion. Case summary: A 49-year-old male presented with masses, swelling, and erythema in the right lower eyelid, masses and swelling in the right upper eyelid, and intermittent conjunctival injection that had appeared 3 months ago. The patient admitted having received paraffin injection to the right lateral canthal area and nasal bridge for cosmetic purposes by non-medical personnel 17 years prior to presentation. The mass showed partial response to intralesional triamcinolone injection but did not respond to systemic steroid. Conclusions: Paraffinoma can present diagnostic confusion given its protracted latency period and discordance of injection area and mass location. Detailed history taking is required and the possibility of paraffinoma should be considered for mass lesions of the eyelid. 목적: 파라핀종은 신체부위에 삽입된 파라핀이나 기름성분의 이물에 대한 육아종성 조직반응에 의해 발생한다. 콩다래끼로 오인되어 진단이 늦어진 파라핀종을 경험하였기에 이를 보고하고자 한다. 증례요약: 17년 전에 눈가 주름을 없애고 콧등을 높이기 위해 비의료인에게 우측 외안각 부위와 콧등에 파라핀 주입술을 시행 받은 49세 남자 환자가 3달 전부터 생긴 우안 아래눈꺼풀의 종괴, 부종, 발적 및 우안 위눈꺼풀의 종괴와 부종을 주소로 내원하여, 조직검사상 파라핀종으로 진단되었다. 스테로이드 국소주사로 병변은 일부 호전되었고 전신 스테로이드 치료에는 반응하지 않았다. 결론: 눈꺼풀테에 생긴 파라핀종은 다래끼로 오인될 수 있으며, 주사 후 오랜 시간이 지난 후에 발생할 수 있고 주사부위에서 이동하여 발생할 수 있으므로 자세한 병력청취가 요구된다.

산립종 및 맥립종에 관한 임상적 고찰

조병주 건국대학교 의과학연구소 1991 건국의과학학술지 Vol.1 No.-

1987년 3월부터 1990년 12월까지 건국대학교 부속 민중병원 안과에 내원한 환자중 산립종과 맥립종으로 진단을 받고 치료를 받았던 409안에 대하여 임상적으로 분석한 결과 산립종이 236안, 맥립종이 173안이었다. 산립종과 맥립종 모두 20대에서 가장 발생 빈도가 높았고, 90% 이상이 30대 이하였으며, 상안검에서 더 많이 발생하였다. The author clinically analyzed the data of chalazion(236 eyes) and hordeolum(173 eyes) from March 1987 to December 1990 in the department of Ophthalmology, Min Joong Hospital The results were as follows : 1. The peak incidence of chalazion and hordeolum was 20∼29 year of age. 2. Most cases of the chalazion and hordeolum(90.2%) occurred under the age of 40. 3. The upper eyelid is more commonly affected than the lower eyelid.

나이와 크기에 따른 콩다래끼 병소 내 스테로이드 국소주사의 치료 효과 비교

송도윤,노주헌 대한안과학회 2021 대한안과학회지 Vol.62 No.1

Purpose: The purpose of this study was to compare the efficacy of intralesional triamcinolone acetonide injection in the treatment of chalazion according to age and size of the lesion. Methods: We performed a retrospective chart review of 108 patients (108 lesions) who underwent intralesional triamcinolone acetonide injections between January 2017 and February 2018. Patients were divided into three groups according to their age and size of the lesion and evaluated with respect to the treatment success and complications. Results: Cumulative treatment success of intralesional triamcinolone acetonide injection was 69.4% with the first injection and 80.6% with the second injection in 108 lesions. With respect to age, 30 lesions were observed in patients under the age of 7 years, 22 lesions were found in patients aged 7 to 16 years, and 56 lesions were observed in patients who were 17 years or older; cumulative treatment success percentages with second injections were 86.7%, 81.8%, and 76.8% respectively. Twenty-seven lesions were under 10 mm in size, 70 lesions ranged from 10 to 15 mm, and 11 lesions were sized 16 to 20 mm; cumulative treatment success percentages were 85.2%, 80%, and 72.7% respectively. Although the results were not statistically significant. Conclusions: Intralesional triamcinolone acetonide injection in chalazion is more effective for smaller lesions and younger pediatric patients. 목적: 나이와 크기에 따른 콩다래끼 병소 내에 시행한 스테로이드 국소주사의 효과에 대하여 비교연구해보고자 하였다. 대상과 방법: 2017년 1월부터 2018년 2월까지 본원에서 콩다래끼로 진단 받고 스테로이드 국소 주입술을 시행 받은 108명의 환자를 대상으로 하였다. 환자를 나이 및 병소의 크기에 따라 세 군으로 나누어 다래끼 크기에 따라 사용한 약제의 치료 성공률, 합병증 등을 후향적으로 조사하였다. 결과: 전체 108병소의 콩다래끼 치료 누적 성공률은 1회 주사로 69.4%, 2회 주사로 80.6%였으며, 2회 주사까지 고려한 7세 미만의 환자 30병소, 7세 이상 17세 미만의 22병소, 17세 이상의 56병소에서 각각 누적 성공률은 86.7%, 81.8%, 76.8%였다. 콩다래끼 병소의 지름 10 mm 미만 27병소, 10 mm 이상 15 mm 미만 70병소, 15 mm 이상 20 mm 미만 11병소에서 누적 성공률을 보면 85.2%, 80%, 72.7%로 각각 확인되었으나, 통계적으로 유의한 차이는 보이지 않았다. 결론: 콩다래끼의 치료에 있어서 스테로이드 국소주사는 매우 유용하며 특히 나이가 어릴수록, 크기가 작을수록 치료 효과가 좋다.

Upper eyelid Merkel cell carcinoma treated with neoadjuvant chemotherapy and surgical excision

Toto, Vito,Colapietra, Alfredo,Alessandri-Bonetti, Mario,Vincenzi, Bruno,Devirgiliis, Valeria,Panasiti, Vincenzo,Persichetti, Paolo Korean Cleft Palate-Craniofacial Association 2019 Archives of Craniofacial Surgery Vol.20 No.2

Merkel cell carcinoma is a rare cutaneous carcinoma, featured by an aggressive clinical course and a mortality rate of 28% at 2 years. A 71-year-old female was affected by a 4.1-cm-wide locally advanced Merkel cell carcinoma of the upper eyelid, previously misdiagnosed as chalazion, with involvement of the extraocular muscles. Although the tumor showed a macroscopic spontaneous regression in size after the incisional biopsy, the mass was treated with neoadjuvant chemotherapy and surgical excision. Good functional and aesthetic result with preservation of the eyeball and absence of tumor recurrence were achieved at 3-year follow-up. In our experience, the combination of the inflammatory cascade due to the incisional biopsy and neoadjuvant chemotherapy led to the regression of a locally advanced large Merkel cell carcinoma of the eyelid.

결막낭에 발생한 과립구육종 1예

이현수,박주완,양석우,Hyun Soo Lee,Joo Wan Park,Suk Woo Yang 대한안과학회 2006 대한안과학회지 Vol.47 No.6

Purpose: We report a case of the granulocytic sarcoma located at the conjunctival fornix in a 10-year-old girl with acute myeloid leukemia, who was in complete remission after bone marrow transplantation. Methods: A 10-year-old girl had a 1-week history of firm, dark brown conjunctival mass at lower fornix and mild lid swelling of the right eye. Several months previously she had had some chalazions at lower lid and a history of acute myeloid leukemia that was currently in complete remission after bone marrow transplantation. Other ocular manifestations were not specific. Excision of the conjunctival mass and a biopsy for diagnostic and therapeutic purposes were performed. Results: The 12×6×5 mm-sized mass was totally excised. The pathologic examination was consistent with granulocytic sarcoma. Three weeks after the biopsy, the patient had a relapse of acute myeloid leukemia. She died 2 months later while undergoing intensive therapy. Conclusions: This condition should be considered in the diagnosis of granulocytic sarcoma in patients with a history of acute myeloid leukemia.