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Recent Updates in Skin Barrier Research
신기혁 ( Kihyuk Shin ) 한국피부장벽학회 2020 한국피부장벽학회지 Vol.22 No.1
The skin barrier function is critical for skin homeostasis due to continuous exposure to external pathogens. An impaired skin barrier allows increased penetration of external antigens and tends to induce skin inflammation. In addition, it is obvious that chronic skin inflammation, in turn, triggers attenuation of the skin barrier. Recently, our knowledge on the complexity of skin barrier biology, chemistry and immunology has grown rapidly. This review highlights recent updates in skin barrier research.
중등증 및 중증의 한국인 건선 환자에서 Ixekizumab의 효과와 안전성에 관한 연구
원상현 ( Sang-hyeon Won ),신기혁 ( Kihyuk Shin ),김훈수 ( Hoon-soo Kim ),고현창 ( Hyun-chang Ko ),김문범 ( Moon-bum Kim ),김병수 ( Byung-soo Kim ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.6
Background: Ixekizumab is a humanized IgG4 monoclonal antibody that selectively binds to the IL-17A cytokine and inhibits its interaction with the IL-17 receptor. It has emerged as an effective treatment for moderate to severe psoriasis. However, to date, there are no real-world data for the use of ixekizumab in the treatment of psoriasis in Korean patients. Objective: To evaluate the effectiveness and safety of ixekizumab in the treatment of moderate to severe psoriasis in Korean patients. Methods: This was a retrospective single-center study. Thirty psoriasis patients who were treated with ixekizumab were analyzed. All patients’ medical records, Psoriasis Area and Severity Index (PASI) score, body surface area (BSA), Physicians’ Global Assessment (PGA), and adverse events were investigated. Results: A significant reduction in mean (±standard deviation) baseline PASI score (14.1±2.6) was detected at 4 weeks of ixekizumab therapy (3.8±2.7, p<0.001), with a further improvement at weeks 12 and 24 (0.9±0.7 and 0.5±0.5, respectively) (p<0.001). Our analysis showed that 100%, 87.5%, and 50% of patients achieved PASI 75, 90, and 100 responses, respectively, after 48 weeks of therapy. However, nine patients (30%) experienced a mild adverse event such as injection site reaction, urticaria, upper respiratory tract infection, and stomatitis. No serious adverse events were observed. Conclusion: This study provides evidence for the use of ixekizumab in real-world clinical practice and confirm that it is effective and safe in treating Korean patients with moderate to severe psoriasis. (Korean J Dermatol 2020;58(6):389∼396)
Brentuximab Vedotin로 치료한 CD30 양성 대세포 이행을 보인 균상식육종 1예
신준오 ( Jun-oh Shin ),배경남 ( Kyung-nam Bae ),손진화 ( Jin-hwa Son ),신기혁 ( Kihyuk Shin ),김훈수 ( Hoon-soo Kim ),고현창 ( Hyun-chang Ko ),김문범 ( Moon-bum Kim ),김병수 ( Byungsoo Kim ) 대한피부과학회 2022 대한피부과학회지 Vol.60 No.2
Large-cell transformation of mycosis fungoides (LCT-MF) is an advanced stage of primary cutaneous T-cell lymphoma with a poor prognosis. Therapeutic options for these patients are often limited, and so far, they are not promising. An 81-year-old woman with a previous history of mycosis fungoides presented with aggravation of generalized erythematous scaly patches and new onset of ulcerated tumor on the abdomen for 3 months. Histopathological examination revealed a dense dermal infiltrate composed of atypical large lymphocytes. Immunohistochemically, the tumor cells were positive for CD30 expression. A diagnosis of CD30<sup>+</sup> LCT-MF was established. She was intensively treated with methotrexate (1 month), acitretin (1 month), and rituximab with dose-modified cyclophosphamide, doxorubicin, and prednisone (1 cycle). Despite such treatments, the improvement was minimal. Subsequently, the patient was started on brentuximab vedotin, 1.8 mg/kg intravenously once every 3 weeks. She responded well to brentuximab therapy, and the skin lesions completely subsided within 12 weeks of treatment. (Korean J Dermatol 2022;60(2):106∼110)
피어싱에 의한 귀 가성림프종 4예: 임상적 특징 분석 및 문헌고찰
배경남 ( Kyungnam Bae ),신기혁 ( Kihyuk Shin ),고현창 ( Hyun-chang Ko ),김병수 ( Byung Soo Kim ),김문범 ( Moon-bum Kim ),김훈수 ( Hoon-soo Kim ) 대한피부과학회 2021 대한피부과학회지 Vol.59 No.7
Cutaneous pseudolymphoma, also referred to as cutaneous lymphoid hyperplasia or lymphocytoma cutis, is an uncommon lymphoproliferative condition. Most lesions are idiopathic in origin; however, triggers such as tattoos, acupuncture, or venipuncture are known to be associated with pseudolymphomas. Owing to the widespread popularity of cosmetic piercings, post-piercing pseudolymphomas are being reported in recent times. Anatomically, most lesions appear on the ears and present with a variety of morphological features, although diagnosis is based on distinctive clinical findings. In this case series, we report four cases of post-piercing pseudolymphoma on the earlobe together with a literature review. We emphasize close and careful monitoring to differentiate this rare condition from other lesions of the earlobe. In view of the diverse clinical presentations and treatment approaches available for pseudolymphomas, we highlight some preliminary clinical indicators to enable early diagnosis and prompt treatment of this condition. (Korean J Dermatol 2021;59(7):544∼549)
BCG 예방 접종 후 발생한 특이 피부 이상반응에 대한 임상 연구
원상현 ( Sang-hyeon Won ),신기혁 ( Kihyuk Shin ),김우일 ( Woo-il Kim ),양민영 ( Min-young Yang ),이원구 ( Won-ku Lee ),김훈수 ( Hoon-soo Kim ),김병수 ( Byung-soo Kim ),김문범 ( Moon-bum Kim ),고현창 ( Hyun-chang Ko ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.7
Background: Bacille Calmette-Guérin (BCG) vaccination has been widely used to prevent severe infections caused by Mycobacterium tuberculosis. Although BCG vaccination is generally safe, some cutaneous complications may occur. However, cutaneous complications related to BCG infection have been rarely investigated in Korea. Objective: This study aimed to investigate the clinical characteristics of cutaneous complications following BCG vaccination in Korean patients. Methods: We identified 18 patients with cutaneous complications following BCG vaccination in the Pusan National University Hospitals (Busan and Yangsan) from 2002 to 2019. Clinical manifestations and course were examined by the review of medical records and photographs. Results: Among BCG-vaccinated persons, 18 patients manifested with BCG-specific cutaneous complications. The mean age of the patients was 10.6±10.1 months, and 10 (55.6%) were female. The specific cutaneous complications following BCG vaccination were local abscess (7, 38.9%), lymphadenitis (4, 22.2%), BCG reactivation in incomplete Kawasaki disease (4, 22.2%), tuberculid (3, 16.7%), and scrofuloderma (1, 5.6%). Disseminated BCG infection was detected in 2 brothers (11.1%) who had an immunocompromised state and a family history of BCG complication. Conclusion: Specific cutaneous complications after BCG vaccination are rare, but may occur in various manifestations. (Korean J Dermatol 2020;58(7):453∼458)