성인형 모공성 홍색 비강진에 대한 한방치료 증례 보고 1례
A Case Report of Korean Medicine Treatment for Adult-type Pityriasis Rubra Pilaris
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: Pityriasis rubra pilaris (PRP) is a rare papulosquamous disorder with unknown etiology. Studies on adults have not been conducted yet in Korean medicine. We report the progress of Korean medicine treatment for adult-type pityriasis rubra pilaris. Methods: A 62-year-old female patient was diagnosed with PRP in June 2019. After the diagnosis of PRP, retinoid treatment was continued for about 6 months, and then the drug was switched to an oral immunosuppressant. However, the patient's symptoms did not improve, but instead worsened. The patient was treated with Mihudeungsikjang-tang and acupuncture therapy. We evaluated her treatment progress based on the Dermatology Life Quality Index (DLQI), a visual analogue scale (VAS), and the changes in the patient's subjective symptoms. Results: After Korean medicine treatment, the DLQI and VAS scores improved from 18 points to 16 points and from 6 points to 4 points, respectively. The whole-body itching and scaling were reduced by 30% compared to pretreatment. The itching and pain in the neck, which had been severely symptomatic, decreased by 50%. The pain and dysesthesia in the upper and lower extremities disappeared, but the erythema still remained. Conclusions: Conventional treatments for PRP have limitations due to adverse effects and difficulty in treating refractory forms. Korean medicine treatment is worth considering as it can complement the limitations of conventional treatments, although more studies will be needed.
Abstract
Objectives: Pityriasis rubra pilaris (PRP) is a rare papulosquamous disorder with unknown etiology. Studies on adults have not been conducted yet in Korean medicine. We report the progress of Korean medicine treatment for adult-type pityriasis rubra pilaris. Methods: A 62-year-old female patient was diagnosed with PRP in June 2019. After the diagnosis of PRP, retinoid treatment was continued for about 6 months, and then the drug was switched to an oral immunosuppressant. However, the patient's symptoms did not improve, but instead worsened. The patient was treated with Mihudeungsikjang-tang and acupuncture therapy. We evaluated her treatment progress based on the Dermatology Life Quality Index (DLQI), a visual analogue scale (VAS), and the changes in the patient's subjective symptoms. Results: After Korean medicine treatment, the DLQI and VAS scores improved from 18 points to 16 points and from 6 points to 4 points, respectively. The whole-body itching and scaling were reduced by 30% compared to pretreatment. The itching and pain in the neck, which had been severely symptomatic, decreased by 50%. The pain and dysesthesia in the upper and lower extremities disappeared, but the erythema still remained. Conclusions: Conventional treatments for PRP have limitations due to adverse effects and difficulty in treating refractory forms. Korean medicine treatment is worth considering as it can complement the limitations of conventional treatments, although more studies will be needed.
참고문헌 (49)
- Korean Dermatological Society Textbook Compilation Committee, "Text of Dermatology", pp.316~318 (2014), Sungbo Medical booke store
- Griffiths WA, "Pityriasis rubra pilaris", Clin Exp Dermatol, 5(1), pp.105~112 (1980)
- Klein A, "Pityriasis rubra pilaris : a review of diagnosis and treatment", Am J Clin Dermatol, 11(3), pp.157~170 (2010)
- Christian K, "Systemic therapies of Pityriasis rubra pilaris:a systematic review. Treatment of Pityriasis rubra pilaris type I:a systematic review Pityriasis rubra pilaris--a retrospective single center analysis over eight years", J Dtsch Dermatol Ges, 17(3), pp.243~259 (2019)
- Jeong JT, "A Clinical and Histopathologic Study of Pityriasis rubra pilaris", Ann Dermatol, 40(4), pp.363~374 (2002)
- 심성용, "호뇨자 : 모공성 홍색 비강진 치험례", 한방안이비인후피부과학회지, 28(4), pp.215~220 (2015), 대한한방안이비인후피부과학회
- Tarral C, "Traite theorique et pratique des maladies de la peau 2", pp.158~159 (1835), Bailliere
- Devergie A, "Traite pratique des maladies de la peau", pp.454~464 (1857), Masson
- Besnier E, "Observation pour server a historic clinique du, Pityriasis rubra pilaris", Am Dermatol Syphil, 10, pp.253~287 (1889)
- Griffiths WA, "Pityriasis rubra pilaris : the problem of its classification", J Am Acad Dermatol, 26(1), pp.140~142 (1992)
- Tarral C, "A theoretical and practical treatise on the diseases of the skin", pp.648~649 (1835), Baillere
- Griffiths WA, "Text Book of dermatology", pp.1539~1545 (1988), lackwell Science
- Gold Smith LA, "Dermatology in general medicine 1", pp.442~444 (2003), Mc-Graw Hill Publication
- Mortimer PS, "Dermatologic disease of the nail unit other than psoriasis and lichen planus", Dermatol Clin, 3(3), pp.401~407 (1985)
- Lambert DG, "Nail changes in type 5 Pityriasis rubra pilaris", J Am Acad Dermatol, 21(4), pp.811~812 (1989)
- Sehgal VN, "(Juvenile)Pityriasis rubra pilaris", Int J Dermatol, 45(4), pp.438~446 (2006)
- Bragg J, "Pityriasis rubra pilaris, type IV", Dermatol Online J, 11(4), pp.14~ (2005)
- Caldarola G, "Circumscribed Pityriasis rubra pilaris type IV", Clin Exp Dermatol, 32(4), pp.471~472 (2007)
- Misery I, "Pityriasis rubra pilaris and human immunodeficiency virus infection-type 6 Pityriasis rubra pilaris?", Br J Dermatol, 135(6), pp.1008~1009 (1996)
- Fung PM, "Pityriasis rubra pilaris : an Update Review", Hong Kong J Dermatol, 9(1), pp.10~16 (2001)
- Soeprono FF, "Histologic criteria for the diagnosis of Pityriasis rubra pilaris", Am J Dermatopathol, 8(4), pp.277~283 (1986)
- Klein A, "Pityriasis rubra pilaris : a review of diagnosis and treatment", Am J Clin Dermatol, 11(3), pp.157~170 (2010)
- Eastham AB, "Treatment options for Pityriasis rubra pilaris including biologic agents : a retrospective analysis from an academic medical center", JAMA Dermatol, 150(1), pp.92~94 (2014)
- Gemmeke A, "Pityriasis rubra pilaris-a retrospective single center analysis over eight years", J Dtsch Dermatol Ges, 8(6), pp.439~444 (2010)
- Goldsmith LA, "Pityriasis rubra pilaris response to 13-cis-retinoic acid(isotretinoin)", J Am Acad Dermatol, 6(4), pp.710~715 (1982)
- Dicken CH, "Treatment of classic Pityriasis rubra pilaris", J Am Acad Dermatol, 994(31), pp.997~999
- Molin S, "Treatment of refractory Pityriasis rubra pilaris with oral alitretinoin : case report", Br J Dermatol, 163(1), pp.221~223 (2010)
- Schmitt L, "Oral alitretinoin for the treatment of recalcitrant Pityriasis rubra pilaris", Case Rep Dermatol, 3(1), pp.85~88 (2011)
- Amann PM, "Alitretinoin(9-cis retinoic acid)is effective against Pityriasis rubra pilaris : a retrospective clinical study", Acta Derm Venereol, 95(3), pp.329~331 (2015)
- Pampín A, "Successful treatment of atypical adult Pityriasis rubra pilaris with oral alitretinoin", J Am Acad Dermatol, 69(2), pp.105~106 (2013)
- Kromer C, "Systemic therapies of Pityriasis rubra pilaris : a systematic review", J Dtsch Dermatol Ges, 17(3), pp.243~259 (2019)
- Moretta G, "Management of refractory Pityriasis rubra pilaris : challenges and solutions", Clin Cosmet Investig Dermatol, 9(10), pp.451~457 (2017)
- Hsu DC, "Long-term management of patients taking immunosuppressive drugs", Aust Prescr, 32(3), pp.68~71 (2009)
- "Corticosteroid Adverse Effects" (2020)[URL]
- Wang CX, "Experience of TCM differentiation and treatment of pityriasis pilaris", Journal of Sichuan Traditional Chinese Medicine, 27(5), pp.35~ (2009)
- Yang Z, "Current status of TCM treatment of Pityriasis rubra pilaris", JBUTCM, 13(6), pp.45~46 (2006)
- Ma JM, "Pityriasis rubra pilaris", Shandong Journal of Traditional Chinese Medicine, 13(5), pp.49~ (1993)
- Department of Sasang constitutional medicine, Collage of national Korean medicine, "Sasang constitutional medicine", pp.670692~670710 (2016), Jipmoondang
- 손정민, "아토피 피부염에서 유전자 연구와 사상체질의학적 접근의 상관성에 관한 문헌적 고찰", 한방안이비인후피부과학회지, 18(2), pp.1~9 (2005), 대한한방안이비인후피부과학회
- 박혜선, "태양인체질병증 임상진료지침", 사상체질의학회지, 27(1), pp.71~81 (2015), 사상체질의학회
- 송대욱, "가미미후등식장탕이 DNCB 유도 아토피 피부염 동물모델에 미치는 효과", 대한한의학회지, 40(1), pp.63~77 (2019), 대한한의학회[DOI]
- 김영준, "LPS로 유도된 RAW264.7 염증모델에서 미후등의 항염증효과", Korean Journal of Acupuncture, 30(4), pp.243~251 (2013), 경락경혈학회
- 김윤희, "오가피열수추출물이DNCB로 유도된 알레르기성 접촉피부염 흰쥐의지질대사, 항산화능 및 표피회복능에 미치는 영향", 한국식품과학회지, 38(5), pp.668~673 (2006), 한국식품과학회
- 안상미, "국산 생약 추출물의 항염증 활성 스크리닝", 대한화장품학회지, 40(1), pp.95~108 (2014), 사단법인 대한화장품학회[DOI]
- 류한우, "모과(木瓜) 물추출물의 항염증 효능에 관한 실험적 연구", 대한한방부인과학회지, 25(3), pp.1~15 (2012), 대한한방부인과학회[DOI]
- 김현수, "임자잎과 모과 에탄올 추출물의 피부 가려움증 억제 효과", 동의생리병리학회지, 26(3), pp.314~319 (2012), 한의병리학회[DOI]
- Fuchs-Telem D, "Familial Pityriasis rubra pilaris Is Caused by Mutations in CARD14", Am J Hum Genet, 91(1), pp.163~170 (2012)
- Koch L, "Methotrexate treatment for Pityriasis rubra pilaris : a case series and literature review", Acta Derm Venereol, 98(5), pp.501~505 (2018)
- Pärna E, "Quality of life and emotional state in chronic skin disease", Acta Derm Venereol, 95(3), pp.312~316 (2015)