• IMMUNE NETWORK
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• v.20 no.1
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• pp.9.1-9.21
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• 2020

Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.

• Journal of Korean Traditional Oncology
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• v.16 no.1
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• pp.55-61
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• 2011

Objectives : Epidermal growth factor receptor-inhibitors have demonstrated improved overall survival in patients with non-small cell lung cancer, but their use is associated with dermatologic adverse reactions that often require symptomatic treatment. Methods : A 44-year-old woman, who started the chemotherapy of Iressa$^{(R)}$ on August 2010, developed cutaneous symptoms such as papulopustular rash, dry skin, and pruritus on her face and scalp after taking Iressa$^{(R)}$ for four weeks. The patient visited our clinic with such symptoms on March 2011 and underwent herebal remedy targeted to alleviate the skin reactions. The severity of dermatologic symptoms was evaluated with the numeric rating scale and the Common Terminology Criteria for Adverse Events version 4.0. Results : Noticeable changes on the skin lesion were observed after the two months of treatment, without any dose modification of the Iressa$^{(R)}$. The cutaneous symptoms as papulopustular rash, dry skin and pruritus were improved and there was no adverse event induced by the treatment with herbal medicine. Conclusions : This case report suggests that the treatment with a herbal medicine, Samultang-gagambang be considered as a useful treatment to relieve EGFR-inhibitor induced dermatologic adverse reactions.

• Medical Lasers
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• v.8 no.1
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• pp.32-34
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• 2019

Postinflammatory hyperpigmentation (PIH) is a reactive hypermelanosis of the skin that occurs as a result of variable inflammatory processes, such as trauma, and many inflammatory conditions. Although a range of modalities of managing PIH have been reported, the treatment of PIH is challenging. In this report, a patient with PIH was treated using picosecond-domain Nd:YAG lasers. After three sessions of 1,064-nm picosecond-domain Nd:YAG laser treatment, the patient showed almost complete improvement with no remarkable side effects or recurrence over the duration of six months. Overall, 1,064-nm picosecond-domain Nd:YAG laser can be used effectively and safely for treating pigmented lesions in the dermis, particularly PIH, in Asian patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.3
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• pp.152-164
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• 2005

Purpose : A survey was conducted to investigate the intake pattern of health food by using questionnaire. Methods : This study was carried out to patients visiting OB&GY clinic in Jaseng and Dongseo hospital of oriental medicine during 2005.3.4-2005.5.13. Results : 1. Among the 114 respondents, most respondents(66.6%) were located between 3rd and 4th decade. 2. Among the respondents, 107(93.9%) persons had the experience of intake of health foods and 7(6.1%) persons not. 3. Among the health foods, the natural foods(48.0%) were most frequently taken. 4. Two major reasons for the intake of the health food were 'for relieving easy fatigability'(24.8%) and 'for the prevention of disease'(23.0%). 5. Most respondents felt that the effects of health foods were 'intermideate'(65.8%). Positive responses to the effect were 24.6%, and negative ones were 3.5%. 6. The discussion with medical personnel about taking health foods was present in fractionary population (13.2% ). 7. Among 107 respondents who had taken health food, 7 respondents(6.1%) experienced side effect of health food. Side effects were gastrointestinal disturbance in 4 cases, dermatologic problems in 2 cases. Conclusion : A study on analysis of health food in Oriental Medicine is necessary to make a guide for efficient use of that.

• 대한상한금궤의학회지
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• v.8 no.1
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• pp.53-65
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• 2016

Objective : The purpose of this paper is to report the improved contact dermatitis(CD) treated with the herbal medication based on Shanghanlun disease pattern identification diagnostic system. The level V steroid ointments were no use to the patient 3weeks before the treatment. Methods : In this case, the patient was diagnosed according to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions' and took Mahwang-tang for 36days since the final diagnosis was Taeyang-byung, number 46 provision. The photographs of patient's hands were taken to observe the process of the skin status and the discomfort from CD was measured with DLQI(Dermatologic Life Quality Index) and NRS(Numeric Rating Scale). Results : The DLQI score changed from 24 to 7 and NRS of itching changed form 8 to under 4. Conclusions : This case report shows that the herbal medication through the diagnostic system could be a remedy on CD, dealing with the skin status with no use of the level V steroid ointments. It is needed proving an alternative possibility of Korean Medicine, on other skin diseases, with later studies since there are many reports on the side-effects after some long-term steroid treatments.

• Journal of Chest Surgery
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• v.36 no.10
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• pp.794-797
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• 2003

Photodynamic therapy (PDT) is a local, endoscopically controlled nonoperative therapeutic technique based on selective sensitization of mucosal, malignant and precancerous lesions of the esophagus, trachea and bronchus prior to light-induced tissue destruction in the department of thoracic and cardiovascular surgery. PDT is effective and safe for palliative treatment of neoplasms in the stomach, esophagus, and lung. But skin phototoxicity is unsatisfactory, therefore optimization of management of post-PDT is necessary for preventing phototoxic side effects of skin. Careful patient education in photoprotection techniques, close patient follow-up, early dermatologic referral and medical treatment are recommended. We performed PDT in a patient with intrathoracic constructed stomach. We report this case with a brief review of literatures, therefore.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.31 no.3
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• pp.50-59
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• 2018

Objectives : The aim of this review is to investigate studies on skin adverse reactions and to demonstrate subjects related to the adverse effects in dermatology. Methods : Electric searches were performed with KISS(Korean studies Information Search System) and the key words were combination of 'skin' and 'adverse effect'. 87 literatures investigated in this review were issued from 1900 to 2016. Results : Among the 87 papers, dermatologic adverse reactions were reported in 83 papers in medicine, accounting for 95.4%. Of the adverse effects seen on the skin, 84 discoloration such as erythema, pigmentation and hemotelangiosis were the most common, accounting for 21%. Among the medical adverse reactions not seen on the skin, 21 infection were the most common, accounting for 25%. Among the subjective adverse reactions, of which 32 pruritus were the most common, accounting for 43%. Among the 87 papers, there were 3 cases with underlying diabetes and 3 cases with underlying hypertension, followed by 2 cases with chronic renal failure, HBV, atopic dermatitis and respectively 1 case with alcoholism, depression addiction, multiple myeloma, arthritis and psoriasis. The most frequent period until adverse reactions appeared was within 2 weeks, accounting for 13 papers. And 4 were the most frequent adverse reactions lasting less than 1 month, and 4 were more than 3 months and less than 6 months. There were 48 cases where adverse reactions were caused by nonmedical practioner's treatment. The adverse reactions by the pharmacist were the highest at 11 cases (23%). There were 17 cases of adverse reactions due to medical treatment, among which dermatologists and nondermatologists accounted for the majority of 5 cases, 29%. The most common cause of adverse reactions was the application of external medicine (41 cases), followed by 36 cases of foreign body implantation, eyebrow tattooing, ear piercing, etc. Conclusions : In this report, we demonstrated patterns of adverse reactions in the medical field of dermatology caused by non-medical personnel than medical personnel. We suggest that more effort should be followed by medical personnel to establish clear awareness of skin disease and by patients to be aware of the risks of the illegal medical treatment by non-medical personnel.