Broad Band Ultraviolet B 조사에 의해 유도된 피부 종양에 대한 Poly-gamma Glutamic Acid의 효과

허식 ( Sik Haw ),이진우 ( Jin Woo Lee ),신민경 ( Min Kyung Shin ),김낙인 ( Nack In Kim ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.9

Background: Poly-gamma glutamic acid (γ-PGA) is a natural polymer that is synthesized by Bacillus subtilis. Because of the reported anti-tumor effect, γ-PGA and its derivatives have attracted enormous interest in the past few years. Objective: The anti-tumor effects of γ-PGA against ultraviolet B (UVB) were evaluated by irradiating hairless mice with UVB. Methods: The experimental animals were 12-week-old male Albino hairless Skh:HR-1 mice. Thirty-two mice were divided into 4 groups: a chronologic aging (control); irradiation with UVB without γ-PGA administration (T1); irradiation with UVB and 2,000 kDa γ-PGA orally (T2); and irradiation with UVB and 5,000 kDa γ-PGA orally (T3). The irradiation period was 12 weeks. The anti-tumor effect of γ-PGA was evaluated with photographs and skin biopsy. A 51Cr release assay was performed to determine nutural killer cell (NK cell) activity. Results: After 20 weeks of UVB irradiation, seborrheic keratosis, actinic keratosis, Bowen`s disease, squamous cell carcinoma, and basal cell carcinoma were observed on the backs of mice. The most common skin lesion was seborrheic keratosis. γ-PGA showed inhibitory effects on the total number of skin tumors and the premalignant and malignant skin lesions induced by UVB. The NK cell activities showed a tendency to increase based on the molecular weight of γ-PGA. Conclusion: We suggest that γ-PGA shows anti-tumor effects that inhibit the tumor generation induced by UVB, and the antitumor effects are related to the molecular weight of γ-PGA. (Korean J Dermatol 2009;47(9):1012∼1018)

급격한 진행 양상을 보인 비특이적 말초 T-세포 림프종

허식 ( Sik Haw ),유박린 ( Bark Lynn Lew ),심우영 ( Woo Young Sim ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.2

Peripheral T-cell lymphoma, unspecified (PTCL-U) is an infrequent type of non-Hodgkin`s lymphoma (NHLs), which occurs mainly in adults. The common predilection sites is the peripheral lymph node; however, other sites, such as bone marrow, liver, spleen, and skin, may also be affected. PTCL-U and other types of PTCLs are the most aggressive types of the NHLs. Response to treatment is poor and the overall 5-year survival rates do not surpass 20%. A 57-year-old female presented with a 1-week-history of multiple and painful subcutaneous nodules. The shape and distribution of the nodules were similar to those of erythema nodosum. The histopathologic findings of the skin lesion fitted that described for PTCL-U. In spite of chemotherapy, she expired in 1 month after diagnosis. (Korean J Dermatol 2009;47(2):212∼216)

최근 8년간(2005∼2012) 경기 서북부 지역 주요 피부악성종양에 관한 임상적 고찰: 단일 기관에서의 경험

서지영 ( Ji Young Seo ),허식 ( Sik Haw ),박혜진 ( Hai Jin Park ),김성현 ( Seong Hyun Kim ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.10

Background: The incidence of cutaneous malignant tumors and premalignant lesions has continuously increased worldwide. Objective: The purpose of this study was to analyze recent changes in the incidence and clinical characteristics of precancerous lesions and cutaneous malignant tumors in North-western Gyeonggido Province and to compare them with other previously reported data. Methods: We reviewed 107 cases of premalignant lesions and 218 cases of cutaneous malignant tumors out of a total 38,926 new outpatients who had visited the Department of Dermatology at the Ilsan Paik Hospital from January 2005 to December 2012. Results: The average annual incidence of premalignant lesions among the total number of new outpatients was 0.27% and that of cutaneous malignant tumors was 0.56%. The annual incidence of premalignant lesions increased by an average of 1.136 times per year, and that of cutaneous malignant tumors increased by an average of 1.038 times per year for 8 years. The most common premalignant lesion was actinic keratosis (74.77%). Among cutaneous malignant tumors, basal cell carcinoma (42.64%), squamous cell carcinoma (21.32%) and malignant melanoma (8.63%) were common. The mean age of onset was 74.04 years in precancerous lesions and 67.00 years in cutaneous malignant tumors. The most common site for cutaneous malignant tumors was the face (52.75%). The nose (29.57%) was the most preferential site on the face. Conclusion: The incidence of premalignant lesions and cutaneous malignant tumors has continuously increased in North-western Gyeonggido Province. Over half of the cases of cutaneous malignancies involved the head and neck area in our studies. Dermatologists need to be aware of clinical presentations of cutaneous malignancies on the head and neck.

경기 서북부지역 옴 감염의 역학 및 임상적 연구: 입원환자와 외래환자의 비교 및 치료 효과 중심으로

김수진 ( Soo Jin Kim ),허식 ( Sik Haw ),박혜진 ( Hai Jin Park ),김성현 ( Seong Hyun Kim ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.11

Background: Scabies is a common parasitic infestation that is an important public-health problem in many resource-poor regions. The incidence of scabies decreased during the past 20 years, but it has been increasing with the increase in the number of elderly people and nursing hospitals in Korea. Objective: This study was performed to evaluate and compare the clinical aspects and etiologic factors between outpatients and inpatients diagnosed with scabies. Also, we tried to investigate the clinical efficacy of topical therapies for the treatment of scabies.Methods: We conducted a retrospective analysis of the medical records of 200 patients who were diagnosed with scabies with a mineral oil test or skin biopsy between September 2009 and August 2013. Results: Of 200 patients, 91 (45.5%) were men and 109 (54.5%) were women. The mean age of the patients was59.2±26.6 years (men: 54.9±27.6 years/women: 62.8±25.2 years), and 61% of patients were aged >60 years. There was no seasonal variation in occurrence. Common primary lesions were papules and burrows in both inpatients and outpatients. Also, hyperkeratotic lesions were more commonly observed in inpatients (60%) than in outpatients (16.4%). The majority of the suspected routes of infection were transmissions through the nursing homes or hospitals (outpatients: 37.6%, inpatients: 71.4%). The mean time to diagnosis was 59±85.1 days (outpatients: 62.97±92.11 days, inpatients: 40.6±32.2 days) and to complete treatment was 31.87±49.2 days (outpatients: 35.3±53.14 days, inpatients: 14.8±13.87 days). Conclusion: We confirmed that nursing homes or hospitals are sources of herd infection. Therefore, dermatologists should educate the medical team and caregivers who work in nursing homes and hospitals about the clinical aspects and treatments of scabies. (Korean J Dermatol 2014;52(11):783∼789)

피부과로 의뢰된 산부인과 입원환자의 임상 양상 분석

노태경 ( Tai Kyung Noh ),허식 ( Sik Haw ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.11

Background: Dermatologic comorbidities can be the clue for the diagnosis and treatment of systemic conditions and a need for dermatological expert opinion is increased. Objective: To analyze the patterns and to quantify the dermatologic consultations referred by the department of obstetrics and gynecology (OBGY). Methods: We retrospectively studied the data from 479 cases referred by OBGY for a dermatologic consultation during a three-year period in a tertiary hospital. Results: The most common skin disorder was pregnancy-related dermatoses (29.77%) in obstetric inpatients, while cutaneous infection (33.33%) was the most frequent in gynecologic inpatients. The distribution of the skin disorders in consulted OBGY inpatients was consistent with the previous reports. However, there were some differences, such as high proportion of infectious disease. Infectious skin diseases were significantly more frequent (p<0.001) in the chemotherapy group of gynecologic inpatients compared to that of the non-chemotherapy group, viral infection being the most common. In addition, superficial fungal infection accounted for the same proportion as the viral infection (37.50% each) among obstetrical inpatients. Maculopapular or urticarial eruption (51.52%) was the most common type of chemotherapy-related adverse drug reaction. Conclusion: This study revealed the distribution of skin disorders in patients referred by OBGY for dermatologic consultation. Furthermore, it could be helpful as an educational material to assist cooperation between dermatology and OBGY. (Korean J Dermatol 2012;50(11):951∼958)

레이저 시술 후 발생한 피부 장벽 손상과 자극 증상에 대한 APDDR-1001 제제 국소 도포의 효과

김명신 ( Myoung Shin Kim ),허식 ( Sik Haw ),이형민 ( Hyung Min Lee ),김정환 ( Jeong Hwan Kim ),정연수 ( Yeon Su Jeong ),신홍주 ( Hong-ju Shin ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Je 대한피부과학회 2012 대한피부과학회지 Vol.50 No.12

Background: Because cosmetic laser treatments are getting popular, post-laser wound care becomes more important.Currently, topical moisturizers are reported to be sufficient to accelerate re-epithelialization and reduce downtime inpost-laser wound care.Objective: This study was performed to evaluate the effects of the moisturizer APDDR-1001 for post-laser woundcare, after ablative fractional laser on the face.Methods: In this double-blind, split-face study, 41 patients with photo-aged face received ablative fractional laser.They were divided into two groups, APDDR-1001 and vehicle (group 1) or control moisturizer (group 2), whichwere applied to the opposite sides of the face for 1 week after the laser treatment. The treatment efficacy wasevaluated by the transepidermal water loss (TEWL), erythema index, investigator`s assessment for recovery inerythema and overall improvement of the wound. Subjects ranked irritating symptoms and overall satisfaction ratingsin the overall improvement.Results: APDDR-1001 was well-tolerated and showed improvement in the erythema index and TEWL during the 7days of treatment. In group 2, improvement in erythema graded by investigators was significantly higher forAPDDR-1001 on day 3 (p<0.05). The overall improvement of wound ranked by investigators was significantlyhigher for APDDR-1001, compared with the controls in both groups. Subjective assessment demonstratedsignificantly less erythema (p=0.043), edema (p=0.041) and overall satisfaction ratings in the overall improvement (p<0.048) with APDDR-1001; however, no differences were detected in pain and edema between APDDR-1001 andvehicle (group 1). In group 2, subjects ranked ``much or very much improved`` in 75 % of APDDR-1001 side and55% of control moisturizer side. No significant differences in erythema, edema, pain and itching were reportedbetween APDDR-1001 and control moisturizer in group 2.Conclusion: The moisturizer APDDR-1001 demonstrated effective improvements in wound healing and subjectivesymptoms after ablative fractional laser therapy. (Korean J Dermatol 2012;50(12):1017∼1026)

전신 스테로이드제 투여 환자에서 빠른 속도로 악화된 카포시육종 1예

이호열 ( Ho Yeol Lee ),우청하 ( Cheong Ha Woo ),박혜진 ( Hai-jin Park ),허식 ( Sik Haw ) 대한피부과학회 2017 大韓皮膚科學會誌 Vol.55 No.9

Kaposi’s sarcoma (KS) is a vascular neoplasm originating from vascular and lymphatic endothelial cells. Iatrogenic KS mainly develops in organ transplant patients or after receiving immunosuppressive therapy. An 81-year-old man presented with multiple dark-purplish nodules, plaques, and patches on the right leg for 3 weeks. Previously, the patient was treated with prednisolone 10∼30 mg/day for chronic obstructive pulmonary disease for 3 months, and percutaneous transluminal angioplasty was performed 1 month previously for the treatment of peripheral arterial occlusive disease. A biopsy specimen of the nodule showed closely packed spindle cells forming slit-like vascular structures, which were consistent with KS. Despite the dosage reduction of prednisolone for treatment, the skin lesions progressed aggressively throughout the entire body, and the patient died after 5 months. We report a case of iatrogenic prednisolone-associated KS rapidly progressing to the entire body shortly thereafter. (Korean J Dermatol 2017;55(9):606∼609)

관절염과 동반된 림프관내 조직구 증식증

박언재 ( Oun Jae Park ),노태경 ( Tai Kyung Noh ),허식 ( Sik Haw ),장경애 ( Kyoung Ae Jang ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.6

There have been a small number of recent case reports of patients with erythematous patches around the joints, which histopathologically showed histiocytic aggregations in the dermal vessels. Intralymphatic histiocytosis (ILH) is a rare group of skin diseases that are characterized by the proliferation of histiocytes in a lymphatic vessel lumen, and this is thought to arise as a benign reaction to certain stimuli such as rheumatoid arthritis. The pathogenesis of this intralymphatic proliferation of histiocytes and the reasons they commonly present on the arms are still unknown. We report on a case of ILH with arthritis in a 68-year old female who had no underlying disease, and the ILH presented as irregular erythematous patches on the left antecubital area and these patches demonstrated the distinctive histopathological features of intralymphatic histiocytosis. (Korean J Dermatol 2011;49(6):538∼541)

환형 배열을 보인 다발성 나선종 1예

서지영 ( Ji Young Seo ),김수진 ( Soo Jin Kim ),박혜진 ( Hai Jin Park ),허식 ( Sik Haw ),김성현 ( Seong Hyun Kim ) 대한피부과학회 2014 大韓皮膚科學會誌 Vol.52 No.8

Eccrine spiradenoma is a rare, benign, slow-growing adnexal neoplasm. It has been historically designated as an eccrine tumor, but is now considered an apocrine tumor. It typically presents as a single, tender, pink-to-blue, well-defined intradermal or deeply subcutaneous nodule on the head or trunk. In rare cases, multiple tumors are present and can be arranged in various patterns including zosteriform and/or linear distributions. A 40-year-old female patient presented with a 7-year history of multiple, small, tender nodules distributed in an annular pattern on her left shoulder. The diagnosis of eccrine spiradenoma was made by clinical and histopathological findings, and the larger nodules were surgically removed. We herein present an unusual case of multiple eccrine spiradenoma in an annular distribution. (Korean J Dermatol 2014;52(8):571∼573)

소아에서 발생한 구진성 황색종

서지영 ( Ji Young Seo ),신문섭 ( Moon Seub Shin ),김수진 ( Soo Jin Kim ),허식 ( Sik Haw ),김성현 ( Seong Hyun Kim ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.2

Papular xanthoma is a rare normolipemic xanthomatous skin disease that primarily occurs in adults. While this rare disorder has been documented in children before, all but one case reported in the literature involved a normal lipid profile. The skin lesions of adult papular xanthoma appear to be persistent, whereas in children they generally self-heal within 1∼5 years. Here, we describe a typical case of papular xanthoma in a 22-month-old boy who presented with numerous reddish-yellow papulonodules, 2∼8 mm in diameter, mainly on the face, but also on the upper and lower extremities, and trunk, for 15 months. The lipid profile was normal, and histological studies showed a diffuse monomorphous infiltrate of foamy cells, with some Touton giant cells, in the dermis. The foamy cells stained positive for Cluster of Differentiation (CD) 68, and the Periodic Acid Schiff (PAS) stain was negative. These findings are consistent with the diagnosis of papular xanthoma.