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대상포진과 대상포진 수막염의 임상 및 혈청학적 검사에 대한 비교 분석
나찬호 ( Chan Ho Na ),정병훈 ( Byung Hoon Jeong ),김민성 ( Min Sung Kim ),신봉석 ( Bong Seok Shin ),최훈 ( Hoon Choi ) 대한피부과학회 2023 대한피부과학회지 Vol.61 No.10
Background: Herpes zoster is a viral infection caused by reactivation of the varicella-zoster virus (VZV). VZV can also cause infection of the central nervous system, such as meningitis. There are relatively few studies investigating the clinical features and serological findings differentiating herpes zoster and zoster meningitis. Objective: To compare clinical features and serological findings of zoster meningitis and herpes zoster without meningitis. Methods: We retrospectively analyzed the medical records of 473 patients with herpes zoster or zoster meningitis admitted in our hospital between May 2017 to June 2022. We investigated the patients’ underlying comorbidities, clinical features and laboratory findings including fever, headache, nausea/vomiting, dizziness, meningeal irritation sign, dermatomal distribution, skin inflammation severity, initial pain numeric rating scale (NRS) at the initial visit, serum VZV immunoglobulin M (IgM) and G (IgG) titer, serum VZV polymerase chain reaction (PCR) and cerebrospinal fluid (CSF) analysis. Results: Overall, 410 patients with herpes zoster and 63 patients with zoster meningitis were included. No significant differences in age, serum VZV IgM, VZV PCR and skin inflammation severity were found between groups. Initial pain NRS was higher significantly in zoster meningitis group (herpes zoster group: 4.8±2.1, zoster meningitis group: 5.7±2.2) (p=0.003) and mean VZV IgG was lower in zoster meningitis group (herpes zoster group: 2,506±1,345.8, zoster meningitis group: 1,712±1,796.3 mIU/mL) (p=0.028). Conclusion: No typical symptoms of meningitis are found in case of trigeminal nerve involvement. Moreover, if there is severe initial pain or low levels of serum VZV IgG are detected, further evaluations such as CSF tapping may be necessary to differentiate zoster meningitis from herpes zoster. (Korean J Dermatol 2023;61(10):612∼619)
Narrowband Ultraviolet B 광선치료에 의해 치유된 소아의 전신성 색소침착자색반
나찬호 ( Chan Ho Na ),송상현 ( Sang Hyun Song ),김민성 ( Min Sung Kim ),신봉석 ( Bong Seok Shin ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.1
Pigmented purpuric dermatosis (PPD) represents a group of cutaneous lesions exhibiting petechiae, pigmentation, andoccasionally telangiectasia in the absence of an associated venous insufficiency or hematological disorder. PPD mayresolve spontaneously but tends to persist for months to years. Various treatment modalities such as oralgriseofulvin, pentoxifylline, cyclosporine, ascorbic acid, topical corticosteroids, and PUVA therapy have been usedwith unsatisfactory results. Recently, some studies reported that PPD showed a dramatic response to narrowbandultraviolet B (UVB) phototherapy. In these studies, narrowband UVB phototherapy was an effective treatmentmethod with few side effects. Here, we present the case of a 7-year-old boy with generalized PPD that improvedrapidly following narrowband UVB phototherapy. (Korean J Dermatol 2015;53(1):49∼52)
건선환자의 말초혈액 내 Th17세포와 Regulatory T세포의 균형에 관한 연구
나찬호 ( Chan Ho Na ),김동진 ( Dong Jin Kim ),김민성 ( Min Sung Kim ),신봉석 ( Bong Seok Shin ) 대한피부과학회 2016 大韓皮膚科學會誌 Vol.54 No.4
Background: Although the pathogenesis of psoriasis is not fully understood, recent studies suggest that an imbalance of T-helper 17 cells (Th17) and CD4+CD25+Foxp3+ regulatory T cells (Treg) is associated with psoriasis. However, the association between the imbalance of Th17 and Treg cells and psoriasis still remains controversial. Objective: In this study, the proportion of Th17 and Treg cells from peripheral blood were evaluated in patients with psoriasis and normal controls. Methods: The proportion of Th17 and Treg cells from peripheral blood were examined by flow cytometry in psoriasis patients (n=20) and age-matched healthy controls (n=23). The correlation between Th17 and Treg cells and the clinical parameters in psoriasis patients were also analyzed. Results: There were significant increases in the proportion of circulating Th17 cells and the ratio of Th17 to Treg cells in psoriasis patients compared to control (p=0.001 and p=0.002, respectively). In contrast to the Th17 cells, there was no significant difference in the proportion of Treg cells in psoriasis patients compared to control (p=0.310). The ratio of Th17 to Treg cells was positively correlated with body surface area (BSA) (p=0.038). In addition, although the ratio of Th17 to Treg cells increased along with psoriasis area severity index (PASI) score, there was no significant correlation (p=0.062). Conclusion: These findings show that there exists an imbalance in Th17 and Treg cells in psoriasis, which may contribute to its pathogenesis and involved surface area. (Korean J Dermatol 2016;54(4):268~274)
Symposium 2-2-11 (SYP 2-2-11) : Solitary nodule developed on the forehead in a 31-year-old male
나찬호 ( Chan Ho Na ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
A 31-year-old male presented with solitary nodule on the forehead of 3-years duration. Physical examination revealed a 0.7x0.7 cm sized skin-colored dome-shaped nodule on the right forehead. He stated that it had gradually increased without any other symptoms. There were no remarkable medical history, family history, and trauma history. A punch biopsy of the lesion was taken, and H&E and immunohistochemical staining were performed.
경구 Mini-pulse Steroid Therapy로 치료한 안면파종좁쌀루푸스 2예
나찬호 ( Chan Ho Na ),이예선 ( Yea Son Lee ),최훈 ( Hoon Choi ),신봉석 ( Bong Seok Shin ),김민성 ( Min Sung Kim ) 대한피부과학회 2019 大韓皮膚科學會誌 Vol.57 No.1
Lupus miliaris disseminatus faciei (LMDF) is a rare granulomatous skin disease mainly affecting the central area of the face. A variety of treatments are reportedly of some benefit; however, controlled studies to establish the best treatment are lacking. Here, we report the cases of a 33-year-old man who presented with multiple, various-sized, erythematous maculopapules on the face and a 19-year-old man who presented multiple, reddish papuloplaques distributed on the face. Histopathological examinations of the two cases revealed large clear-boundary epithelioid cell granulomas with central necrosis surrounded by lymphocytic infiltration. Based on the clinical and histological findings, diagnoses of LMDF were made. As oral tetracycline and antimalarials were not fully effective in our cases, oral mini-pulse steroid therapy (dexamethasone, 5 mg bid for 2 days per week) was initiated. After several months, the eruption significantly improved, and most lesions were resolved. Here, we report two cases of LMDF successfully treated with oral mini-pulse steroid therapy. (Korean J Dermatol 2019;57(1):20∼23)
나찬호 ( Chan Ho Na ),송상현 ( Sang Hyun Song ),김민성 ( Min Sung Kim ),신봉석 ( Bong Seok Shin ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.11
Background: A collagenoma or connective tissue nevus of the collagen type is a hamartoma consisting predominantly of collagen. Collagenomas are divided into the inherited and acquired types. The acquired forms include eruptive and isolated collagenoma. However, few studies have assessed the characteristics of patients with acquired collagenoma.Objective: The aim of this study was to analyze the clinical characteristics of patients with acquired collagenoma. Methods: We reviewed the medical records and clinical photographs of 23 patients who had been diagnosed histopathologically with acquired collagenoma by biopsy during the last 12 years, from January 2002 to December 2013. In addition, 11 cases of eruptive or isolated collagenomas previously reported in the Korean literature were added. Results: In total, 34 cases of acquired collagenoma were assessed. Of the 34 cases, 53% were men and 47% were women. The mean age at diagnosis was 20.0 years for the patients with eruptive collagenoma and 29.1 years for the patients with isolated collagenoma. In the cases of eruptive collagenoma, multiple, flesh-colored or whitishpapules on the trunk were predominant. On the other hand, in the cases of isolated collagenoma, solitary, flesh-colored plaques on the palms or soles were common features. Collagenomas in most cases were asymptomatic (79.4%). However, some patients with collagenomas had other symptoms such as tenderness or pruritus. There was no traumatic history in any case. Conclusion: Our study showed that the clinical features of patients with acquired collagenoma share manysimilarities with those in previously reported studies, with some differences. This study is expected to help us understand and obtain more information on the clinical diagnosis of acquired collagenoma. (Korean J Dermatol 2014;52(11):776∼782)
나찬호 ( Chan Ho Na ),송상현 ( Sang Hyun Song ),김민성 ( Min Sung Kim ),신봉석 ( Bong Seok Shin ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.10
Cutaneous metastasis of papillary thyroid carcinoma is very rare and is a marker for wide dissemination. A 62-year-old woman presented with an asymptomatic, solitary, bean sized bluish nodule on the right anterior neck. She noticed the lesion 2 years ago and the nodule had been steadily enlarging. Five years ago, she underwent fine needle aspiration biopsy, right lobectomy, and total thyroidectomy and was diagnosed with papillary thyroid carcinoma. Since then, she has received radioactive iodine treatment three times and gone through whole body PET-CT scan twice, which revealed nonspecific findings. A biopsy specimen showed a well demarcated nodule consisting of many tumor cells with multiple follicular structures in the dermis. Tumor cells had ground glass nuclei, nuclear pseudoinclusions and nuclear grooves, and stained positive for thyroid transcription factor-1 and thyroglobulin. Herein, we report a case of cutaneous metastasis of papillary thyroid carcinoma suspected of iatrogenic cause. (Korean J Dermatol 2013;51(10):797∼800)