화농육아종에 대한 1% Sodium Tetradecyl Sulfate 경화요법의 치료 효과

채수열 ( Soo Yuhl Chae ),심현보 ( Hyun Bo Sim ),장용현 ( Yong Hyun Jang ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),이석종 ( Seok Jong Lee ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.10

Background: For the treatment of pyogenic granuloma (PG), surgical excision, electrocautery, and laser therapy have been employed, apart from other methods. Sodium tetradecyl sulfate (STS) sclerotherapy, as a minimally invasive treatment for vascular lesion, is frequently used for vascular malformations with considerable efficacy and safety. However, there have been a few reports about its use in the treatment of PG. Objective: This study was conducted to evaluate the efficacy, recurrence, and side effects of sclerotherapy using 1% STS in the treatment of PG. Methods: We evaluated 72 patients with PG who were treated with 1% STS from January 2008 to December 2014. Sclerotherapy using 1% STS was performed by “blind” intralesional injection without the aid of imaging such as ultrasonography. The results were evaluated by physical examination, photographic evaluation, and the patient`s subjective satisfaction, and then they were classified into 3 groups: complete remission, partial remission, and no change. Recurrence and side effects were also evaluated. Results: Complete remission of PG was achieved in 65 (90.3%) of patients after 1.23 average sessions (range, 1∼5 sessions). The remaining patients showed partial remission, with no instances of the treatment resulting in no change. One case of recurrence (1.4%) from partial remission group was seen after 3 months. Clinically, side effects such as pain, tenderness, hyperpigmentation, ulcer, numbness, scarring, and hair loss patches were noted in 18 (25%) patients, but these were all mild and transient. Conclusion: 1% STS sclerotherapy can be recommended as an effective therapeutic modality for the treatment of PG with insignificant adverse effects and low recurrence rate.

무색소성 흑색종 6예 조기 감별진단의 어려움

채수열 ( Soo Yuhl Chae ),이규채 ( Kyou Chae Lee ),박태인 ( Tae In Park ),정호윤 ( Ho Yun Chung ),장용현 ( Yong Hyun Jang ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),이석종 ( Seok Jong Lee ) 대한피부과학회 2016 대한피부과학회지 Vol.54 No.1

Amelanotic melanoma comprises only 1.8∼8.1% of malignant melanomas, and is difficult to diagnose clinically due to the lack of the diagnostic evidence of clinical pigmentation. To our knowledge, it is rarely reported, and only 10 cases have been reported in the Korean dermatological literature. It presents rather conflicting features such as a pink or red macule, papule, plaque, or nodule mimicking various benign and malignant conditions; therefore, it is difficult to diagnose. We performed a review of six patients with amelanotic melanoma focusing on differential diagnosis, particularly at the time of the initial visit. Clinical impressions included pyogenic granuloma, dermatofibrosarcoma protuberans, eccrine poroma, epidermal cyst, keloid, pilomatricoma, and squamous cell carcinoma in addition to malignant melanoma. The biopsy specimens were consistent with malignant melanoma with little or no melanin pigment on hematoxylin and eosin and Fontana-Masson stains. Four of the six patients were positive for S-100 and HMB-45, but two patients were positive for S-100 only. We report these cases to remind clinicians of the necessity of including malignant melanoma in the differential diagnosis process when patients show poor and unpredictable responses to treatment after a clinical diagnosis of other benign and malignant conditions. (Korean J Dermatol 2016;54(1):62∼68)

최근 20년간 대구-경북 지역 피부악성종양에 관한 임상적 특징에 관한 고찰: 전반기 10년(1994∼2003)과 후반기 10년(2004∼2013)간 비교

이규채 ( Kyouchae Lee ),김민지 ( Min Ji Kim ),채수열 ( Soo Yuhl Chae ),차현욱 ( Hyun Wuk Cha ),장용현 ( Yong Hyun Jang ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),이석종 ( Seok Jong Lee ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.7

Background: Although skin cancer incidence has recently increased, there has been little research into the incidence, clinical manifestations, and prognosis of skin cancers in Korea, especially in Daegu City and the Kyungpook Province. Objective: To analyze changes over the recent two decades in incidence and clinical patterns, including recurrence of skin cancers diagnosed at a university hospital in Daegu City. Methods: We reviewed 1,566 skin cancer cases from 1994 to 2013 at the Department of Dermatology in Kyungpook National University Hospital (KNUH). We also divided them into first (1994∼2003) and second group (2004∼2013) to examine changes over the years. Results: The average incidence of skin cancers among the total number of outpatients was 1.39% through whole study period including 0.38% in the first and 2.10% in the second decade. Basal cell carcinoma (BCC) was the most commonly diagnosed skin cancer (total:1st:2nd=0.60%:0.16%:0.91%), followed by squamous cell carcinoma (SCC) (0.43%:0.12%:0.65%) and malignant melanoma (MM) (0.22%:0.05%:0.34%). The most common skin cancer site was the face in each decade. The recurrence of three major skin cancers (BCC, SCC and MM) was diagnosed in 49 of the 1,402 patients (3.50%). In each disease, the recurrence rate (1st:2nd) was 1.64% (BCC, 4.11%:1.34%), 3.51% (SCC, 11.11%:2.55%), and 8.57% (MM, 4.35%:9.01%). Conclusion: This epidemiological study provided useful information about the incidence and prognosis of skin tumors in Korea, especially in Daegu City and Kyungpook Province. (Korean J Dermatol 2015;53(7):505∼514)

다발성 전이를 동반한 심부 양성 섬유조직구종

심현보 ( Hyun Bo Sim ),김민지 ( Min Ji Kim ),채수열 ( Soo Yuhl Chae ),이원주 ( Weon Ju Lee ),이석종 ( Seok-jong Lee ),김도원 ( Do Won Kim ),장용현 ( Yong Hyun Jang ) 대한피부과학회 2017 大韓皮膚科學會誌 Vol.55 No.5

Some morphological variants of benign fibrous histiocytoma (dermatofibroma) present with distinct clinical features. In particular, atypical, aneurysmal, and cellular fibrous histiocytoma are associated with a significant risk of local recurrence. Furthermore, very rarely, cutaneous fibrous histiocytoma can lead to metastatic disease. Deep benign fibrous histiocytoma is an uncommon and poorly recognized clinical subtype that arises in subcutaneous or deep soft tissue. Deep benign fibrous histiocytoma has many histologic features in common with cellular fibrous histiocytoma. Deep benign fibrous histiocytoma recurs in approximately 20% of cases and may rarely metastasize. We report a rare case of deep benign fibrous histiocytoma with metastatic potential in a 38-year-old man who presented with a 2-year history of a recurrent hard mass on his left shoulder. (Korean J Dermatol 2017;55(5):301∼304)

급성기 대상포진에 시행한 중재적 통증 치료술의 효과

장용현 ( Yong Hyun Jang ),문선영 ( Sun Young Moon ),채수열 ( Soo Yuhl Chae ),이원주 ( Weon Ju Lee ),이석종 ( Seok Jong Lee ),김신우 ( Shin Woo Kim ),박기범 ( Ki Bum Park ),전영훈 ( Young Hoon Jeon ),김도원 ( Do Won Kim ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.5

Background: Although several interventional pain management procedures (IPs) for reducing the acute herpes zoster (HZ)-related pain have shown some level of effectiveness on early pain relief and the prevention of postherpetic neuralgia (PHN), no conclusive evidence has been presented to support their effectiveness. Objective: We evaluated the effectiveness of IPs during the acute phase of HZ for reducing HZ-related pain. Methods: Sixty-one patients with acute HZ were assessed using the pain visual analogue scale (VAS) that ranges from 0 to 10 at the initial visit and after 1, 3 and 6 months. Changes in pain VAS and the incidence of PHN (pain after 1 month) were compared between 2 patient groups: those who received standard therapy with oral antivirals and analgesics (ST, n=38) and those who received standard therapy with IPs (STIPs, n=23). PHN was defined as either “pain of 1 or higher in pain VAS” or “clinically meaningful PHN (pain of 3 or higher in pain VAS).” Results: Although the initial pain VAS level of patients treated with STIPs (5.74) was higher than that of patients receiving ST (4.09), no significant difference in pain VAS number was seen between the 2 groups at 3 months (0.13 vs. 0.17) and 6 months (0.09 vs. 0.03) of follow-up. The incidence of PHN also was not statistically significant different between the 2 groups at 3 (9.5% vs. 8.3%) and 6 months (9.5% vs. 4.2%). A similar trend was observed in the analysis of HZ patients whose pain VAS level was 3 or higher at the initial assessment. Conclusion: Standard therapy with early IPs is effective for rapidly reducing HZ-related pain. (Korean J Dermatol 2015;53(5):351∼358)