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성인과 소아 아토피피부염 환자에서 가려움증의 임상적 특징
심우행 ( Woo Haing Shim ),송창현 ( Chang Hyun Song ),박현제 ( Hyun Je Park ),김훈수 ( Hoon Soo Kim ),진현우 ( Hyun Woo Chin ),김수한 ( Su Han Kim ),고현창 ( Hyun Chang Ko ),김문범 ( Moon Bum Kim ),김도원 ( Do Won Kim ),김병수 ( By 대한피부과학회 2011 대한피부과학회지 Vol.49 No.4
Background: Itch is an essential feature of atopic dermatitis (AD). Active AD cannot be diagnosed without a history of itch. There has been no previous study delineating the different characteristics of itch according to age. Objective: We wanted to characterize and compare the clinical patterns and the sensory and affective dimensions of itch in adult and childhood AD patients. Methods: A face-to-face structured questionnaire based on the McGill pain questionnaire was given to 90 patients with AD. The patients were classified into two groups: adult AD patients (≥15 years old) and childhood AD patients (<15 years old). Results: Eighty-eight percent of the total AD patients experienced itch everyday. This itch was mostly aggravated during the summer and at night in both groups of AD patients. The antecubital fossae, popliteal fossae and neck were the major sites of involvement with itch. More patients perceived the characteristics of itch as crawling, burning and tickling rather than stinging, stabbing and pinching. The majority of AD patients answered that sweat and hot climate aggravated the itch and medications and cold climate alleviated the itch. However, compared with the childhood patients, more adult patients experienced the aggravation of itch by exposure to dust, and the itch was alleviated by taking medications and by concentrating on work. A burning sensation with itch was more frequently reported by the adult patients when compared to that of the childhood patients. Conclusion: This study highlights the detailed description and characteristics of itch in adult and childhood AD patients. The proper management of itch according to age may be prerequisite to improve AD patients` quality of life. (Korean J Dermatol 2011;49(4):318∼327)
봉침요법 부위에 발생한 Mycobacterium chelonae 감염
심우행 ( Woo Haing Shim ),박현제 ( Hyun Je Park ),김훈수 ( Hoon Soo Kim ),진현우 ( Hyun Woo Chin ),김수한 ( Su Han Kim ),고현창 ( Hyun Chang Ko ),김병수 ( Byung Soo Kim ),김문범 ( Moon Bum Kim ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.4
Mycobacterium chelonae is a rapidly growing atypical mycobacterium found in soil and water. In a healthy person, it causes cutaneous infection after an invasive procedure or surgery. Herein, we present a case of a 52-year-old man with multiple erythematous plaques and nodules on the back and left arm, and these occurred at the site of bee sting therapy by a herbal medical doctor. The histologic findings showed a granulomatous infiltration composed of numerous neutrophils, lymphocytes, eosinophils, histiocytes and multinucleated giant cells. Acid fast bacilli were detected by Ziehl-Neelsen stain and Mycobacterium chelonae infection was confirmed by an INNO-LiPA mycobacteria kit. The patient was treated with 1 g of clarithromycin and 200 mg of doxycycline for 6 months and his condition improved considerably. (Korean J Dermatol 2011;49(4):374∼378)
김원정 ( Won Jeong Kim ),박현제 ( Hyun Je Park ),김훈수 ( Hoon Soo Kim ),진현우 ( Hyun Woo Chin ),김수한 ( Su Han Kim ),고현창 ( Hyun Chang Ko ),김병수 ( Byung Soo Kim ),김문범 ( Moon Bum Kim ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.3
Epithelioid hemangioendothelioma (EHE) is an uncommon vascular neoplasm that is considered to be a low-grade malignancy with a severity between an angiolymphoid hyperplasia with eosinophilia and an epithelioid hemangiosarcoma. The appearance of cutaneous EHE is extremely rare and only about 20 cases have been reported in the Korean and English literatures. A 70-year-old man presented with an approximately 1-year history of an isolated painful subcutaneous nodule of the back. A histopathologic examination revealed nests and cords of epithelioid eosinophilic cells in hyalinized stroma with intracytoplasmic vacuoles. Tumor cells were strongly positive for the endothelial cell markers CD31 and CD34, and we didn`t find any metastatic lesions under radiologic examination. On the basis of these findings, the diagnosis of primary cutaneous EHE was made. To our knowledge, cutaneous EHEs were reported in only 2 cases in the Korean literature, and that of the trunk has not been published previously. Moreover, there is no meta-analytic study about cutaneous EHE. So, we report here a rare case of EHE of the back and review the relevant literature. (Korean J Dermatol 2011;49(3):269∼273)
이영석 ( Young Seok Lee ),최준희 ( Jun Hee Choi ),심현수 ( Hyun Soo Sim ),진현우 ( Hyun Woo Chin ),이숙경 ( Sook Kyung Lee ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.3
Eccrine hidrocystomas are benign tumors of the sweat glands that arise from cystic dilatation of the excretory sweat ducts. They may be solitary or multiple. Multiple lesions are observed as small papulonodules having prominent surfaces with a translucent intense bluish dome, localized predominantly to periorbital and malar areas. The diagnosis of multiple eccrine hidrocystomas is clinical, and surgery is the treatment of choice in the case of a single lesion. However, the treatment of multiple eccrine hidrocystomas is challenging and the outcome of conventional therapies varies. Botulinum toxin type-A (BTA) causes chemodenervation at the cholinergic nerve terminal of eccrine glands; accordingly our patient was given intradermal injections of BTA and the result was successful. Herein, we report a case of multiple eccrine hidrocystomas treated successfully with BTA; we believe that BTA can be a novel treatment option for this condition. (Korean J Dermatol 2011;49(3):283∼286)
선상 태선에서 Calcineurin 억제제 국소 도포의 치료 효과
김건욱 ( Gun Wook Kim ),김수한 ( Su Han Kim ),진현우 ( Hyun Woo Chin ),서상희 ( Sang Hee Seo ),정도상 ( Do Sang Jung ),고현창 ( Hyun Chang Ko ),김문범 ( Moon Bum Kim ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 2009 大韓皮膚科學會誌 Vol.47 No.10
Background: Lichen striatus is a well-known, acquired, self-healing, linear inflammatory dermatosis. The therapeutic approach that is usually adopted is topical steroid, even though the prolonged use of this may lead to several side-effects, and particularly cutaneous atrophy. Objective: The purpose of this study was to evaluate the efficacy of topical calcineurin inhibitors for the treatment of lichen striatus. Methods: Twenty nine patients received topical application of calcineurin inhibitors twice a day up to the marked disappearance of the cutaneous lesions. Results: Six (20.7%) of 29 patients achieved a complete response after a mean treatment period of 2.5 months. A good response was observed in 8 patients (27.6%) and a partial response was seen in 8 patients (27.6%). Of the 29 patients, 22 patients (75.9%) had more than a 50% response without any severe adverse effects. No significant differences in the therapeutic responses were found with regard to the patients` ages, the duration of the disease and the length of the treatment periods. Conclusion: Our results show that topical calcineurin inhibitors may well represent a useful therapeutic alternative for the treatment of lichen striatus. (Korean J Dermatol 2009;47(10):1135∼1140)