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Vancomycin 에 의해 유발된 선상 IgA 수포성 피부병 1 예
도기승(Ki Seung Doh),김승희(Sung Hee Kim),최태식(Tae Sik Choi),장민수(Min Soo Jang),서기석(Kee Suck Suh),김상태(Sang Tae Kim) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.9
Linear IgA bullous dermatosis (LAD) is a subepidermal blistering disease characterized by linear IgA deposits in the basement membrane zone when visualized on direct immunofluorescence microscopy. Intravenous vancomycin has been the drug most implicated, and this disease has been termed vancomycin-induced LAD. Vancomycin-induced LAD tends to spontaneously resolve upon discontinuation of the offending drug. A 70-year-old male patient developed septic knee. Bacterial cultures from this lesion grew methicillin- resistant Staphylococcus aureus. He was treated with vancomycin. Eight days after vancomycin injection, painful bullae appeared on the trunk, feet, and genitalia. A skin biopsy showed a subepidermal blister with an infiltrate composed of neutrophils and eosinophils. Direct immunofluorescence of perilesional skin showed linear IgA deposition at dermo-epidermal junction. The vancomycin was stopped; teicoplanin was substituted. He was treated with dapsone. The use of vancomycin is increasing in Korea and therefore it is important for dermatologist to be aware of the association with LAD. (Korean J Dermatol 2002;40(9):1132~1135)
심형준,김승희,도기승,장민수,서기석,김상태 대한피부과학회 2004 대한피부과학회지 Vol.42 No.1
Amyloidosis is a disorder of protein metabolism characterized by the extracellular deposition of abnormal protein fibrils. We report a case of macular amyloidosis due to nylon towel on his back. A 61-year-old male presented with asymptomatic hyperpigmented macules on the scapulae for 6 years. He had a habit of scrubbing his back for many years with a rough nylon towel while taking a bath. The histologic examination revealed liquefaction degeneration and homogenous eosinophilic deposition in the papillary dermis. In Congo red, amyloid material stained positively and in anti-keratin antibody staining. He had neither clinical nor laboratory evidence of systemic amyloidosis. A diagnosis of friction amyloidosis was made on histological and immunohistopathological findings. (Korean J Dermatol 2004;42(1):119~121)