금속작업유 취급 근로자의 직업성 피부질환에 관한 연구

허광회,김희옥,박시룡,오칠환 ( Kwang Hoi Hur,Hee Ok Kim,See Ryong Park,Chil Hwan Oh ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.3

최근 과학의 발전으로 각종 신소재 물질이 개발되고 직업도 다양화함에 따라 각종 직업병이 문제되고 있으며, 이중 직업성 피부병에 의한 경제적 손실이 직업병 중 가장 큰 것으로 알려져 있다. 특히 금속작업자에서 발생되는 직업성 피부병은 비교적 발생빈도가 높은 것으로 알려져 있으나 이에 대한 연구는 미진한 실정이고, 국내에서도 아직 보고된 바 없다. 금속작업자가 금속을 가공시 각종 금속작업유(metal working fluid)가 사용되며 이들 금속작업유는 공구와 피가공물 사이에서 냉각작용과 윤활작용을 통해 가공물의 변형을 막고 공구의 마모를 방지하는 역할을 한다. 과거에는 이런 작용을 위해 물이나 기름만을 사용했으나 점차 여러 성분들이 첨가되고 합성화됨에 따라 다양한 금속작업유 제품들이 등장했다. 금속작업유에는 비수용성 금속작업유(neat 또는 insoluble oil), 수용성 금속작업유(conventional soluble oil), 반합성 금속작업유(semi-synthetic fluid), 합성 금속작업유(synthetic fluid) 등이 있는데 비수용성 금속작업유를 제외한 3가지 금속작업유를 수용성 금속작업유(water-based cutting fluid, WBF)라 하며 이들의 성분을 표1에 요약하였다. 수용성 금속작업유에는 비수용성 금속작업유와 달리 물, 유화제, 살균제 등의 성분이 포함되어 있다. 저자들은 금속작업자에서 직업성 피부병에 대한 역학적 조사와 함께 금속작업유와 관련된 피부병의 유병률을 알아보기 위하여 국내 최초로 본 연구를 시도하였다. Background:Occupational skin disease is one of the most prevalent occupational health problems, resulting in long period of discomfort and loss of earning. The size of the problem is probably underestimated and no exact datas are available about the prevalence of skin problems in metal workers(MWs) exposed to metal working fluid(MWF). Objective:This study was done to determine the prevalence of skin abnormalities in relation to exposure to MWF. Materials & Methods:An epidemiological study was performed using questionnaire in 771 workers in 9 departments of motor company. A questionnaire was designed to ascertain information about working procedures, the way of handling MWF, degreasers and soap, the extent and duration of individual exposure, and any history of dermatoses. 278 workers out of 771 workers are actually contacted with MWF. A selection was made on 315 metal workers who have experienced past or present dermatitis in questionnaire. A detailed history from each workers via interview with 315 workers about past or present occupational exposure, dermatoses, atopy and injury preceded a dermatological examination by dermatologist. Patch test: Patch tests were performed in 73 metal workers who were suspected dermatitis in relation to exposure of MWF during interviews and dermatologic examination. Patch tests were included with a routine series and common components of MWF(material obtained from chemotechnique, sweden) and solvent seried. Workers were also tested with the various crude metalworking fluids(8 species. The concentrations of crude MWFs were determined after testing the various dilutions of MWF. Results: 1. Out of 278 metalworkers who exposed to MWF, dermatitis was detected in 106 metalworkers(38%). Primary irritant dermatitis was established in 92 persons(33% of 278 metalworkers) and allergic contact dermatitis in 14 persons(5% of 278 metalworkers). 2. Workers with exposure to soluble oil showed primary irritant contact dermatitis significantly more often than workers exposed with neat oil(p<0.05). 3. Workers with frequent of variable exposure to soluble oil showed primary irritant dermatitis significantly more often than did workers with infrequent exposure(p<0.05). 4. The occurrence of primary irritant dermatitis showed a tendency towards a higher incidence of primary irritant dermatitis relation to duration of work.(p<0.05, X2-test for linear trend) 5. Primary irritant dermatitis was significantly more often present in atopics than in nonatopics(p<0.05). 6. The severity of primary irritant dermatitis was not significantly influenced by the type of MWF or the extent of exposure 7. Exposure to soluble oils lead more often to the occurrence of chronic paronychia than exposure to neat oil(p<0.05). 8. The occurrence of acne & folliculitis was more often in metal workers exposed to neat oil than soluble oil. Conclusion:The results showed that primary irritant dermatitis was the most common skin disorder of workers handling MWF and the prevalence of primary irritant dermatitis had a correlation with the types of MWF, the frequency and the duration of exposure to MWF and atopy history of each workers. Although the prevalence was low, other occupational skin problems-chronic paronychia, oil acne, folliculitis-were showed. Oil acne and folliculitis chiefly developed in workers handling insoluble-MWF and chronic paronychia chiefly developed in workers handling soluble-MWF.

에크린 혈관종성 과오종

이재철,박진주,정은정,박시룡 ( Jae Chul Lee,Jin Joo Park,Eun Chyung Jung,See Ryong Park ) 대한피부과학회 1988 대한피부과학회지 Vol.26 No.2

Eccrine angiomatous hamartoma or sudoriparous angioma is a hamartoma in which histologically, hyperplasia of eccrine sweat apparatus and vascular elements is present in the same lesion and clinically has tenderness and hyperhidrosis over the lesion. We present a case of eccrine angiomatous hamartoma developed on the medial side of the right knee in a 5-year-old female patient.

담마진 환자의 문진 및 일반 검사 성적 고찰

박진주(Jin Joo Park),정은정(Eun Jung Chyung),박시룡(See Ryong Park) 대한피부과학회 1988 대한피부과학회지 Vol.26 No.1

Any type of urticaria may affect as many as 20% person during their lifetimes, yet the causes of this disorder is established in no more than 20% of cases. So, 308 patients with urticaria(acute ; 73, factitial; 120, chronic;115) were evaluated for results of historical and laboratory tests. The results were summerized as follows,' 1. The disesse primarily affected 2nd % 3rd decade(46.2%) with predominance of woman than man (M: F=1: 1.4). 2. Ninety-seven(31.5%) had at least one abnormal finding in the laboratory tests but, may be twenty-three(7.5%) would have causal relationship. 3. We sought serologic markers of Hepatitis B virus infection in serum from 8(14%) of 57 patients with urticaria. Of these, 4 were found to have abnormal liver function. 4. Sixty-five had taken at least one sort of drug previously or just before urticaria developed, but, may be forty-six(14.9%) would have a causal relationship and the predisposing drugs were analgesics, antibiotics, common cold medication & vitamin etc. 5. The predisposing conditions were as follows ; pulmory tuberculosis, viral hepatitis, hyperthyroidism, tonsillitis & ascariasis, etc. Of these, eleven(3.6%) of this patients were newly found to have underlying diseases. 6. This study showed inciting factors of urticaria in 27.2%(84/308).

편평 황색종 , 건 황색종 , 결절성 황색종을 동반한 제 IIa형 과지질단백혈증

박종일,허광회,김희옥,박시룡 ( Jong Il Park,Kwang Hoi Hur,Hee Ok Kim,See Ryong Park ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

We report a case of a 59 year-old female with hyperlipoproteinernia who had xanthoma tuberosum, xanthoma tendinosurn and xanthoma planum. Yellowish nodules appeared on the right elbow 26 years ago and the lesions gradually increased in size and spread to the elbow, hand, knee, foot and achilles tendon. Except for the skin lesion, she was normal on physical examination. The laboratory findings showed that the serum cholesterol, beta lipoprotein and total lipid were increased. The beta band was rnarkedly elevated on electrophoresis, which suggested type IIa hyperlipoproteinemia. Histopathological findings shc wed many aggregates of foam cells and foreign body giant cells were seen in the dermis. (Kor J Dermatol 1997;35(1): 144-149)

급성 백혈병이 동반된 괴저성 농피증

박진주(Jin Joo Park),정은정(Eun Chyung Jung),박시룡(See Ryong Park) 대한피부과학회 1987 대한피부과학회지 Vol.25 No.6

A 16-year-old girl developed pyoderma gangrenosum without underlying disease at first. She was treated with local cutaneous dressing and systemic oral prednisolone and minocycline for 10 months, imtermittently. After that, acute leukemia, which was undeterminated type, was developed 4 years after first onset. Since pyoderma gangrenosum may be a preindication of underlying disease, continual follow up check for systemic disease is required.

금속작업자의 피부질환에 관한 연구 ( II . 알레르기성 접촉피부염 )

박종일 ( Jong Il Park ),김희옥 ( Hee Ok Kim ),박시룡 ( See Ryong Park ),오칠환 ( Chil Hwan Oh ),김순덕 ( Soon Duck Kim ),염용태 ( Yong Tae Yeum ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.2

Background: Skin contact with metalworking fluid(MWF) remains a frequent cause of occupational dermatitis. However, no precise data is available about sensitization in metalworkers exposed to MWF in Korea. Objectives : The purpose of this study was to evaluate the prevalence of contact sensitivity among metalwokers who handle MWFs and to investigate the suitability of a screening test with MWFs being actually used in metalworkers. Methods: An epidemiological study was performed using a ' questionnaire in 771 workers in 9 derpartments of a motor company. 278 out of 771 workers had actual contact with MWF. Patch tests were performed in 73 metalworkers who had suspected dermatits in relation to exposure of MWF, which was selected via interviews and dermatologic examinations. Patch tests were included with a routine series of common components of MWF(materials obtained from Chemotechnique, Sweden), a solvent series and several dilutions of various crude MWFs(8 species) Results : Contact sensitization was established in 14 metalworkers(5% of 278). Sensitising substances were biocide(6 cases), corrosion inhibitors(2 cases), emulsifiers(2 cases), biostatic substances(1 cses) and others(4 cases). Therefore 10 out of 14 metalworkers had true occupational allergic contact dermatitis. 10 out of 73 screening patch tests showed positive reactions to MWF elements, and 9 people who were positive to MWF elements showed positive reactions to crude MWF, but 1 person did not. Conclusion : The prevalence of occupational allergic contact dermatitis(3.5% of 278) was low. The screening patch test by crude MWFs actually used in metalworkers may give false negatives. Therefore for the purpose of diagnosis of allergic contact dermatitis, we need a process of patch tests with MWF elements. (Korean J Dermatol 1998;36(2) 246-251)

태아 피부에서 Glutathione S-transferase 태반형 (GST-pi)의 면역조직화학적 발현양상

손호찬 ( Ho Chan Son ),이나영 ( See Ryong Park ),박시룡 ( Mi Kyung Kim ),김미경 ( Kye Yong Song ),송계용 대한피부과학회 2003 大韓皮膚科學會誌 Vol.41 No.2

Background: Glutathione S-transferases(GST) are a family of multi-functional enzymes involved in cellular detoxification and excretion of a variety of exogenous and endogenous toxic or carcinogenic compounds. The GST family has been divided into three cla

고엽제에 노출된 베트남전 참전군인들의 피부질환에 대한 임상적 고찰

노진혁 ( Jin Hyuk Rho ),조옥자 ( Ok Ja Joh ),박시룡 ( See Ryong Park ),허충림 ( Choong Rim Haw ),한지윤 ( Jee Yoon Han ) 대한피부과학회 2005 대한피부과학회지 Vol.43 No.4

Etretinate와 Tretinoin Cream을 병용 치료하여 빠른 호전을 보인 Darier병

허광회 ( Kwang Hoi Hur ),김희옥 ( Hee Ok Kim ),박시룡 ( See Ryong Park ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.4

We report a case of Dariers disease which showed a more effective result using a combined treatment with oral etretinate and topical tretinoin cream than treatment with oral etretinate alone in a 17-year old male patient. Oral etretinate 40mg was given daily and topical therapy with tretinoin cream was applied to lesions of neck and face. Two weeks later, lesions of neck and face showed good improvement compared with the not applied lesions. Topical therapy was then extended to other lesions. Six weeks after treatment, there was a marked improvement. Three months after treatment, most of lesions were nearly gon. (Kor J Denllatol 1995;33(4): 764 768)

증례 : 에크린 한공종 2 예 ( Cases Report : Two Cases of Eccrine Poroma )

이재철(Jae Chul Lee),안철현(Chul Hyun Ahn),박시룡(See Ryong Park),김낙인(Nack In Kim) 경희대학교 경희의료원 1988 慶熙醫學 Vol.4 No.3