농포성 이상각화증 ( Parakeratosis Pustulosa )

박철종(Chul Jong Park),조상현(Sang Hyun Cho),김태윤(Tae Yoon Kim),조백기(Baik Kee Cho),허원(Won Houh),이상배(Sang Bae Lee) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.5

Parakeratosis pustulrisa occurs most often on the upper cxtiemities of girls and that is considered to be a variant of either eczema or psoriasis. It presents with scaling of the tip of the finger, subungual hyperkeratosis, and irregular t.hickening and rumblirg of the distal nail plate. We report a 4-year-old female child patient, who showed spon.aneous nail extraction with erythematous scaly path with pustule formation on the left thumb, ring finger and right middle finger nails. The microbiologic and mycologic examinaiors revealed negative results. Histopathologic examination showed focal parakeratosis of the nail bed and the lower part of the nail plate. We treated her with etretinate(Tigason, 0.6mg/kg/day). (Kor J Dermatol 19g2;30(5):701-704)

Symposium 8-2 (SYP 8-2) : Practical phototherapy for vitiligo

박철종 ( Chul Jong Park ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Narrowband UV (NB-UVB) light, with peak emission at 311 nm, is considered the most effective and safest current therapy for vitiligo, and thus is currently the treatment of choice for patients with moderate to severe vitiligo. Recent studies evaluating psoralen and UVA (PUVA) versus NB-UVB indicate that NB-UVB produces higher repigmentation rates and better color matching. NB-UVB has fewer short-term adverse reactions such as painful erythema and appears to have fewer long-term side effects such as epidermal thickening, atrophy, and photocarcinogenesis than PUVA. Several clinical studies have reported high rates (75%) of repigmentation in at least 40% of patients treated with NB-UVB. The most commonly used NB-UVB protocol involves twice-weekly administration of a fixed starting dose of 0.21J/cm2 increasing the dose by 20% at each session until the minimal erythema dose (the lowest dose that results in visible erythema on depigmented skin at 24 hours) has been reached. Approximately 9 months of therapy are required to achieve maximal repigmentation; at least 3 months of treatment are warranted before the condition can be classified as nonresponsive. The most responsive sites are face, trunk, and limbs, and the least responsive sites are the hands and feet.

Why do we fail in the topical treatment?

박철종 ( Chul Jong Park ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Psoriasis produces significant morbidity and has profound effects on patient`s quality of life. Psoriasis broadly affects day-to-day activities and personal social interactions. Topical treatment represents the mainstay of therapy for patients with mild to moderate psoriasis and is recommended as first line intervention in this group of patients. The efficacy of topical therapy is variable with a treatment success rate between 4% and 40.7% for vitamin D analogues, and between 27.2% and 55.3% for the association between vitamin D analogues and topical steroids. Topical therapy has an important role in psoriasis treatment. It is efficacious and has a favorable safety profile as demonstrated in clinical trials. However, poor treatment outcomes from topical therapy regimens likely result from poor adherence and ineffective use of the medication. Frustration with medication efficacy, inconvenience, time constraints, and fear of side effects are among the most important reasons patients do not use their medication as directed, along with cost, the way the medication feels, unclear instructions, and directions that are just too complicated By understanding and manipulating the factors that affect treatment adherence, improvement in adherence is possible and hence better control and outcomes in the topical treatment of psoriasis are likely. References 1. Feldman SR, Horn EJ, Balkrishnan R, et al: Psoriasis: improving adherence to topical therapy. J Am Acad Dermatol. 2008 Dec;59(6):1009-1016 2. Devaux S, Castela A, Archier E, et al: Adherence to topicaltreatment in psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2012;26 Suppl 3:61-67

모낭을 통한 피지선 소엽 배출 - 3 증례 보고 -

박철종(Chul Jong Park),이종육(Jong Yuk Yi),변대규(Dae Gyoo Byun),조백기(Baik Kee Cho),허원(Won Houh),이일수(Eil Soo Lee) 대한피부과학회 1991 대한피부과학회지 Vol.29 No.1

Transfollicular extrusion of sebaceous gland lobules was observed in a case of actinic keratosis and 2 cases of sebaceous hyperplasia. The patient of act.inic keratosis was a 44-year-old white man and the patients of sebaceous hvperplasia were a i3-year-old Korean girl and a 28-year-old Korean man. The sebaceous gland lobules located within the dilated infundibular area and partly between separated granular layers were intact and partly surrounded by keratin materjal. No histopathologic overlapping of sebaceous gland lobules was observed. We suppose that transfollicular ext,rusion of sebaceous gland lobules may not be artifact.. but one of natural phenomena. But further study will be necessary to evaluate the significance of this peculiar histopathologic findings. (Kor J Dermatol 29(1):126 129, 1991)

Focus 1-3 (FS 1-3) : TNF-α inhibitors [Etanercept, Adalimumab, Infliximab]

박철종 ( Chul Jong Park ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Based on the continuous progress in psoriasis research and advances in molecular biology, a new class of agents (targeted biologic therapies) has emerged. These agents are designed to block specific molecular steps important in the pathogenesis of psoriasis or have been transferred to the psoriasis arena after being developed for other inflammatory diseases. Using internationally acknowledged safety and efficacy endpoints, the overall utility and benefit of biologics have been demonstrated based on the percentage of patients achieving at least a 50% improvement in PASI (PASI-50), a 75% improvement in PASI (PASI-75), the impact of treatment on quality of life, and safety and tolerability. However, they are far more expensive, carry risks of immunosuppression, infusion reactions, and antibody formation, and their long-term safety remains to be evaluated. TNF-α is a homotrimeric protein that exists in both transmembrane and soluble forms, the latter resulting from proteolytic cleavage and release. Currently, three anti-TNF biologics are available in Korea. Etanercept is a human recombinant, soluble, TNF-α receptor-Fc IgG fusion protein that binds TNF-α and neutralizes its activity. Adalimumab is fully human recombinant IgG1 monoclonal antibody and specifically targets TNF-α. Infliximab is a chimeric monoclonal antibody that has high specificity, affinity, and avidity for TNF- α. Clinical trials have shown that each of these agents is well tolerated and appears suitable for long-term use in chronic plaque psoriasis. However, like all the targeted biologic therapies, they carry risks of immunosuppression, and their long-term safety requires further study. Clinical studies have found infliximab and adalimumab to be slightly more effective than etanercept in the treatment of psoriasis. It is likely that the differential effects of these agents are associated with selectivity in their ability to perturb these receptor ligand interactions. It is known that infliximab, adalimumab, and etanercept bind TNF differently; infliximab and adalimumab bind to both soluble and membrane-bound TNF, whereas etanercept binds primarily to soluble TNF. Direct and indirect comparison of the efficacy and safety of etanercept, adalimumab, and infliximab in psoriasis will be discussed.

Sponsored Lecture 4 : Secukinumab in moderate to severe plaque psoriasis

박철종 ( Chul Jong Park ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Based on the continuous progress in psoriasis research and advances in molecular biology, a new class of agents (targeted biologic therapies) has emerged. These agents are designed to block specific molecular steps important in the pathogenesis of psoriasis or have been transferred to the psoriasis arena after being developed for other inflammatory diseases. Currently, three types of biologics are approved or are in development for psoriasis: (1) recombinant human cytokines, (2) fusion proteins, and (3) monoclonal antibodies, which may be chimeric or humanized. Due to the risk of the development of antibodies to mouse sequences, humanized or fully human antibodies are preferred for clinical use. Using internationally acknowledged safety and efficacy endpoints, the overall utility and benefit of biologics have been demonstrated based on the percentage of patients achieving at least a 50% improvement in PASI (PASI-50), a 75% improvement in PASI (PASI-75), a 90% improvement in PASI (PASI-90), a 100% improvement in PASI (clear skin ,PASI-100), the impact of treatment on quality of life, and safety and tolerability. A 90% improvement from baseline PASI score, however, is now defined as the threshold of treatment success per the European Medicines Agency and a "measure of optimal response" by the American Academy of Dermatology. Achieving PASI-90 to PASI-100 responses in patients with psoriasis is highly clinically relevant, given the direct relationship between PASI score improvement and health-related quality of life (HRQoL). Tumor necrosis factor-α antagonists, anti-p40 (IL-12/IL-23 antagonist), and numerous new drugs are currently in clinical trials for treatment of psoriasis. Our understanding of the pathogenesis of psoriasis was advanced by the discovery of the class of type 17 helper T (Th17) cells, which regulates innate and adaptive immunity. The proinflammatory cytokine IL-17A is the primary effector of Th17 cells, but it is also produced by other cell types in psoriatic lesions, including γδ T cells, neutrophils, and possibly mast cells. IL-17A stimulates keratinocytes to secrete chemokines and other proinflammatory mediators that recruit additional inflammatorycells, including neutrophils, Th17 cells, dendritic cells, and innate lymphoid cells. IL-17A thus potentially acts as a master cytokine in the pathogenesis of psoriasis. Secukinumab (Cosentyx, Novartis Pharma AG, Basel, Switzerland) is a recombinant, high-affinity, fully human immunoglobulin G1κ monoclonal antibody that selectively binds and neutralizes IL-17A. The importance of IL-17A in psoriasis pathogenesis has been validated by the clinical efficacy of secukinumab in phase III trials (ERASURE, FIXTURE and CLEAR study).

표피성장인자의 창상치유에 대한 효과

박철종(Chul Jong Park),김조용(Jo Yong Kim),이종육(Jong Yuk Yi),김태윤(Tae Yoon Kim),김정원(Chung Won Kim),김동재(Dong Jae Kim) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.1

Backgound : Epidermal growth factor(EGF), a potent stimuant of epithelialization, has been noted to increase the thickness of the epidermis, increase the epithelial cell proliferartion and keratinization, and accelerate wound contraction. Objective : Our purpose was to evaluate the efficacy of topic 1 application of recombinant human epidermal growth factor(rhEGF) in the healing of full-theckness excision and burn wound. Methods : Full-thickness excision and burn wound were male in the back of the male Wistar rat. Recombinant human epidermal growth factor was apolied twice a day and the size of the wound was measured with planimetry every other day for 21 days. The keratinocytes of the circumcised foreskir were cultured in different concentrations of recombinant human epidermal growth factor and proliferation of the keratinocytes was evaluated. Results : 1. Regardless of wound types or base types, wound heal in the experimental groups (rhEGF 10, 30, 50 g/g) was generally better than that in the control or vehicle group. 2. The duration of wound healing was decreased as followa in order, in full-thickness excision wound, rhEGF 50 g/g, group, rhEGF 30 g/g group, rhEGF 10 g/g group, vehicle group, and control group and in full-thickness burn wound, rhEGF 30 g/g group, rhEGF 50g/g group, rhEGF 10g/g group, vehicb group, and control group. 3. In the biopsy specimen taken from the wound at 9th and 13th day, neodermis, neovascularization, the thicknesa and maturation of the collagen bundes and reepithelialization were more increased in the experimental groups than in the control or vehicle group. 4. In vitro culture of epidermal cells showed similar proheration in the concentration of rhEGF higher than 10 ng/rnl. Conclusion . These findings suggest that topical application of ecombinant humanepidermal growth factor is effective in the healing of full-thickness exoision and burn wound.(Kor J Dermatol 1995; 33(1): 76-84)

팔십여 회의 색소 레이저 치료는 멜라닌 세포 모반의 어느 깊이까지 영향을 미칠까?

박효진 ( Hyo Jin Park ),박철종 ( Chul Jong Park ),이경호 ( Kyung Ho Lee ) 대한피부과학회 2021 대한피부과학회지 Vol.59 No.6

Total excision is the treatment of choice of congenital melanocytic nevus. However, it is often infeasible, laser therapy is being explored as a useful therapeutic approach. A 26-year-old woman presented with a solitary, skin-colored plaque surrounded by whitish patches on her right calf. She was diagnosed with a congenital melanocytic nevus and underwent 84 laser treatment sessions using a 1,064 nm Nd:YAG laser over 7 years. Histopathological examination of the whitish plaque revealed small foci of nevus cells that penetrated the tissue to a depth that was 12-fold higher than the epidermal depth (1,260 μm). No report in the literature describes histopathological findings of a congenital melanocytic nevus treated with 84 sessions of laser therapy. This case report highlights the depth of penetration of pigment laser to treat a congenital melanocytic nevus. Our findings will serve as useful clinical guidelines to perform laser treatment for congenital melanocytic nevi. (Korean J Dermatol 2021;59(6):474∼476)

발한성 외배엽 이형성

박철종,김진우,김시용,김형옥,김정원 ( Chul Jong Park,Jin Wou Kim,Si Yong Kim,Hyung Ok Kim,Chung Won Kim ) 대한피부과학회 1991 대한피부과학회지 Vol.29 No.6

애완견에서 귀진드기 및 옴진드기에 의한 피부질환

박철종,백승철,장미숙,이종육,오영진,조백기,조준행,Park Chul-Jong,Baek Seung-Chul,Chang Mi-Sook,Yi Jong-Yuk,Oh Young-Jin,Cho Baik-Kee,Cho Joon-Heang 대한수의사회 1990 대한수의사회지 Vol.26 No.7

This study was performed in order to investigate the incidence of the canine dermatoses caused by mites and the relativity of the causative mites of canine dermatoses to the pruritic dermatoses of the families posessing the pet dogs. Samples were collecte