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폐암 환자들에서 Gefitinib (Iressa)에 의한 피부 부작용
윤숙정 ( Sook Jung Yun ),이지범 ( Jee Bum Lee ),김규식 ( Kyu Sik Kim ),김영철 ( Young Chul Kim ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.2
배경: 최근 폐암 환자에서 사용하는 표적치료 항암약물인 gefitinib (Iressa)은 종양세포의 표피성장인자 수용체의 티로신 키나아제 활동을 선택적으로 억제하여 종양 세포의 성장에 관여하는 신호를 차단함으로써 치료효과를 나타낸다. Gefitinib 복용에 의한 피부 부작용으로 여드름양 발진, 피부 건조증, 모발 변화 등이 알려져 있다. 대상 및 방법: 2004년 10월부터 2005년 9월까지 화순전남대병원에서 비소세포 폐암으로 진단받고 gefitinib을 복용 중인 환자들 중 피부 부작용이 발생하여 피부과에 의뢰된 환자 23명을 대상으로 임상 양상을 분석하였다. 결과: 나이는 23-72세였고, 비소세포 폐암의 종류는 선암 17명, 편평상피세포 폐암 5명이었고, 여자 6명, 남자 17명이었다. 가장 흔한 부작용은 여드름양 발진으로 15명(65.2%)에서 발생하였으며, 주로 두피, 얼굴, 가슴, 등 부위에 무증상의 홍반성 구진으로 나타나며 대부분 gefitinib 복용 1달 이내에 발생하였다. 여드름양 발진의 빈도는 gefitinib 치료에 대한 반응과 유의한 상관관계를 보이지 않았고, 조직 형에 따른 차이도 관찰되지 않았다. 피부 소양증은 9명(39.1%)에서 발생하였으며 경도의 전신 소양증이 가장 많았고, 특히 눈 주변의 소양증을 호소하였다. 인설을 동반한 피부 건조증이 6명(26.1%)에서 발생하였고, 손발바닥의 홍반과 표피 박탈이 5명(21.7%), 손톱이나 발톱주변에 조갑주위염이 5명(21.7%)에서 발생하였다. 드물게 모발이 부러지거나 겨드랑이, 오금에 간찰진이 발생하였다. 결론: 본 연구에서 gefitinib에 의한 다양한 피부 부작용들을 관찰할 수 있었다. Gefitinib을 처방하는 의사들은 피부 부작용에 대한 관심이 필요하며 환자들에게 피부 관리에 대한 교육과 필요한 경우 피부과 의사와 함께 피부 부작용을 치료함으로써 부작용을 경감시킬 수 있었다. Background: Gefitinib (ZD 1839, Iressa) is a new anticancer agent; more specifically, it is a selective epidermal growth factor receptor tyrosine kinase inhibitor that is, widely used for various solid cancers, including lung cancer. Cutaneous adverse reactions induced by gefitinib have recently been reported; however, not much on this topic has been reported in the Korean literature. Method: We studied cutaneous adverse reactions of gefitinib in 23 patients who suffered with non-small cell lung cancer at Chonnam National University Hwasun Hospital from October 2004 to September 2005. Result: The patients ranged from 23-72 years old, and there were 17 patients with adenocarcinoma, 5 with squamous cell carcinoma and 1 with bronchioloalveolar carcinoma. The most common adverse reaction was acneiform eruptions in 15 patients (65.2%). This reaction appeared within 2 months after medication, and it didn`t correlate with the therapeutic response and tumor type. Pruritus was the second most common reaction (39.1%), which was mild and generalized, especially around eyelid area. Xerosis (26.1%), exfoliation on palm and sole (21.7%), and paronychia (21.7%) followed. Hair breakage and intertrigo were rare adverse reactions. Conclusion: Various cutaneous adverse reactions were observed in patients with non-small cell lung carcinoma after gefitinib treatment. The skin complications could be alleviated with dermatologic consultations and treatments, skin complications could be alleviated. (Tuberc Respir Dis 2006; 61: 150-156)
윤숙정 ( Sook Jung Yun ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
A 10-month-old baby presented with brownish to orange colored papules and plaques of the face. The lesion started from the face at 6 months old and spread. Physical examination revealed brownish to yellowish orange-colored plaques at symmetric distribution on the both cheeks and eyelids. There were also scattered yellowish papules on the face and scalp. The trunk and extremities showed similar scattered papules, and a few confluent palques. Histologic evaluation revealed granulomatous infiltrates with some giant cells, macrophages, lymphocytes, and eosinophils. Immunohistochemical stains including CD68, S100 and CD1a were performed. What is your diagnosis?
Skin tumors that dermatologists should know
윤숙정 ( Sook Jung Yun ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
As a dermatologist, all of us should know skin tumors. Especially, we should not mis-diagnose malignant skin tumors. However, in reality, there are lots of skin cancers that mimicking benign skin tumors or inflammatory skin diseases. In this talk, I want to show various interesting skin cancers that dermatologists should know. In addition, I will introduce various benign mimickers of each skin cancers. Epidermal skin cancers Actinic keratosis Squamous cell carcinoma in situ, Bowen’s disease Squamous cell carcinoma, Verrucous carcinoma Basal cell carcinoma Melanoma Skin appendage tumors Eccrine and apocrine tumors Sebaceous tumors Paget’s disease and extramammary Paget’s disease Mycosis fungoides and Lymphoma Leiomyosarcoma Kaposi’s sarcoma Angiosarcoma Dermatofibrosarcoma protuberans Metastatic carcinoma
Hydroxyurea 장기복용 환자에서 발생한 광범위한 피부궤양과 편평세포암
윤숙정 ( Sook Jung Yun ),이지범 ( Jee Bum Lee ),김성진 ( Seong Jin Kim ),이승철 ( Seung Chul Lee ),원영호 ( Young Ho Won ) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.4
Hydroxyurea, one of conventional chemotherapies in chronic myelogenous leukemia(CML) and polycythemia vera inhibits ribonucleotide reductase, which catalyzes the rate-limiting step in the de novo synthesis of deoxynucleotide triphosphates required for DNA synthesis. Various cutaneous side effects due to hydroxyurea have been reported as follows alopecia, diffuse hyperpigmentation, scaling, poikiloderma, atrophy of the skin and subcutaneous tissues, nail changes with multiple pigmented nail bands or brittleness, erythema and scaling of acral sites simulating chronic dermatomyositis, lichen plans-like lesions, or skin tumors on the UV-light exposed areas. A 72-year-old woman, receiving hydroxyurea for CML during 5 years, revealed hydroxyurea dermopathy such as scaly papules, poikilodermatous patches, and acral ulceration, and unusually developed squamous cell carcinoma. This is a rare case of hydroxyurea dermopathy, and the first case of squamous cell carcinoma by hydroxyurear in Korea.