A Case of Erythrodermic Psoriasis

홍피성 건선 환자의 한방 치험 1례

  • Yu, Seung-Min (Department of Ophthalmology, Otolaryngology and Dermatology, College of Oriental Medicine, Kyung Hee University) ;
  • Son, Byeong-Kook (Department of Ophthalmology, Otolaryngology and Dermatology, College of Oriental Medicine, Kyung Hee University) ;
  • Yun, Young-Hee (Department of Ophthalmology, Otolaryngology and Dermatology, College of Oriental Medicine, Kyung Hee University) ;
  • Choi, In-Hwa (Department of Ophthalmology, Otolaryngology and Dermatology, College of Oriental Medicine, Kyung Hee University)
  • 유승민 (경희대학교 한의과대학 동서신의학병원 안이비인후피부과교실) ;
  • 손병국 (경희대학교 한의과대학 동서신의학병원 안이비인후피부과교실) ;
  • 윤영희 (경희대학교 한의과대학 동서신의학병원 안이비인후피부과교실) ;
  • 최인화 (경희대학교 한의과대학 동서신의학병원 안이비인후피부과교실)
  • Received : 2010.08.04
  • Accepted : 2010.09.06
  • Published : 2010.09.30

Abstract

There is now growing evidence that psoriasis, like other inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus, is a systemic disorder that is associated with enhanced atherosclerosis and risk of coronary artery disease. Erythrodermic psoriasis is a severe form of psoriasis that can be challenging to treat, and carries with it substantial morbidity and an increased risk of mortality compared with other forms of psoriasis. We experienced a case of an erythrodermic psoriasis patient with heart disease. The patient was suffering from whole body erythema, scale, edema and pain. She was admitted to the hospital, and herbal medication, acupuncture, herbal wet dressing and herbal ointment were applied. After 10 days, her edema and pain were remarkably improved, and the patient was discharged and treated through the outpatient clinic. Almost all symptoms were improved after approximately 3 months. We suggest that herbal medicines can be a choice for severe psoriasis patients and can also be helpful for cardiovascular disease.

임상에서 치료가 어려운 건선을 오래 앓아온 환자가 홍피성 건선이 발생하여 집중적인 입원치료 후 꾸준한 외래진료를 거쳐 호전된 경과를 볼 수 있었기에 보고하는 바이다. 상기 환자는 심장 질환을 동반하고 있었으며 그와 관련된 부종 등의 증상에도 한방치료로 긍정적인 효과를 얻었다. 앞으로 홍피성 건선의 한방치료에 대한 치료의 기준을 마련할 필요가 있을 것으로 생각된다.

Keywords

References

  1. Kaye JA, Li L, Jick SS. Incidence of risk factors for myocardial infarction and other vascular diseases in patients with psoriasis. Br J Dermatol 2008;159(4):895-902. https://doi.org/10.1111/j.1365-2133.2008.08707.x
  2. Kremers HM, McEvoy MT, Dann FJ, Gabriel SE. Heart disease in psoriasis. J Am Acad Dermatol. 2007;57(2):347-354. https://doi.org/10.1016/j.jaad.2007.02.007
  3. Mallbris L, Akre O, Granath F, Yin L, Lindelof B, Ekbom A, et al. Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients. Eur J Epidemiol 2004;19:225-230.
  4. Marks J. Psoriasis: proceedings of the international symposium. 1st ed. Stanford:Stanford University Press. 1971:89-98.
  5. Burton JL, Rook A, Wilkinson DS. Textbook of dermatology. 4th ed. Boston:Blackwell. 1986: 367-418.
  6. Rosenbach M, Hsu S, Korman NJ, Lebwohl MG, Young M, Bebo BF Jr, et al. Treatment of erythrodermic psoriasis: From the medical board of the National Psoriasis Foundation. J Am Acad Dermatol 2010;62(4):655-662. https://doi.org/10.1016/j.jaad.2009.05.048
  7. Park OS, Kim YB. One case report of expoliative dermatitis due to psoriasis. The Journal of Korean Oriental Medical Opthalmology & Otolaryngology & Dermatology 2004;17(3):131-137.
  8. Yoon HJ. Kam CW. A case of psoriasis treated with aromatherapy. Korean J. Oriental physiology & Pathology 2004;18(3):935-938.
  9. Fredriksson T, Pettersson U. Severe psoriasis: oral therapy with a new retinoid. Dermatologica 1978;157(4):238-244. https://doi.org/10.1159/000250839
  10. Boyman O, Conrad C, Tonel G, Gilliet M, Nestle FO. The pathogenic role of tissueresident immune cells in psoriasis. Trends Immunol. 2007;28 (2):51-57. https://doi.org/10.1016/j.it.2006.12.005
  11. McDonald CJ, Calabresi P. Occlusive vascular disease in psoriatic patients. N Engl J Med 1973;288(17):912.
  12. 윤재일. 건선. 1판. 서울:고려의학. 1996:11-53, 63.
  13. Boyd AS, Menter A. Erythrodermic psoriasis: precipitating factors, course, and prognosis in 50 patients. J Am Acad Dermatol 1989;21:985-991. https://doi.org/10.1016/S0190-9622(89)70287-5
  14. Gupta AK, Goldfarb MT, Ellis CN, Voorhees JJ. Side-effect profile of acitretin therapy in psoriasis. J Am Acad Dermatol 1989;20(6): 1088-1093. https://doi.org/10.1016/S0190-9622(89)70138-9
  15. Berth-Jones J. The use of ciclosporin in psoriasis. J Dermatolog Treat 2005;16:258-277. https://doi.org/10.1080/09546630500423914
  16. Jun SK, Kim JH, Kim MH, Shin SH, Yoon Hj, Ko WS, et al. The study of a case about dermatitis exfoliativa by drug eruption. The Journal of Korean Oriental Medical Opthalmology & Otolaryngology & Dermatology 2006;19(1): 145-154.
  17. Oh EY, Jee SY, Gu DM. A reports on chronic dermatitis treated by fasting therapy. The Journal of Oriental Medical Surgery, Opthalmology & Otolaryngology 2001;14(1):94-104.
  18. Park SY, Kim DS, Choi JH, Kim JH. A case of the systemic psoriasis. The Journal of Korean Oriental Medical Opthalmology & Otolaryngology & Dermatology 2007;20(3):251-259.
  19. De Paepe K, Hachem JP, Vanpee E, Roseeuw D, Rogiers V. Effect of rice starch as a bath additive on the barrier function of healthy but SLS-damaged skin and skin of atopic patients. Acta Derm Venereol 2002;82(3):184-186. https://doi.org/10.1080/00015550260132460
  20. Prodanovich S, Kirsner RS, Kravetz JD, Ma F, Martinez L, Federman DG. Association of psoriasis with coronary artery, cerebrovascular, and peripheral vascular diseases and mortality. Arch Dermatol. 2009 Jun;145(6):700-703 https://doi.org/10.1001/archdermatol.2009.94
  21. Alexandroff AB, Pauriah M, Camp RD, Lang CC, Struthers AD, Armstrong DJ. More than skin deep: atherosclerosis as a systemic manifestation of psoriasis. Br J Dermatol. 2009 Jul;161(1):1-7. https://doi.org/10.1111/j.1365-2133.2009.09281.x
  22. Nam HS, Cho CS, Kim CJ. A study on the healing mechanism of herbal medicine, Oryoungsan. The Journal of Dept of Oriental Internal Medicine, Daejeon University. 2001;10(1):157- 166.