프락셔널 레이저 치료 후에 발생한 외상성 지방층염 1예 (A Case of Traumatic Panniculitis Following Fractional Laser Therapy)

서지정보

· 발행기관 : 대한피부과학회
· 수록지 정보 : 대한피부과학회지 / 47권 / 3호 / 354 ~ 357페이지
· 저자명 : 김태환, 이가영, 김원석, 김계정

초록

Traumatic panniculitis can be induced through the injection of various substances into the subcutaneous fat,
especially in patients with psychiatric problems. This condition can also be caused through the subcutaneous
implantation of different materials for cosmetic or therapeutic reasons or through mechanical or physical means. The
diagnosis is always worth considering in those patients with bizarre clinical lesions and inflammatory changes in the
subcutaneous fat that defy ready classification. There have been reported cases of traumatic panniculitis induced by
acupuncture, but no reported cases associated with laser therapy. Fractional photothermolysis is the newest approach
to laser therapy, with multiple micro-laser beams that target water-containing tissues to cause photocoagulation of
narrow columns of skin. The penetration depth of the multiple micro-laser beams is up to 900μm, generally to the
reticular dermis level. A 19-year-old female patient presented with a tender 4×7 cm sized erythematous to brownish,
irregularly shaped, atrophic plaque on the right shin. She was treated for a leg scar using a 1,550 nm erbium fiber
laser. Histopathologic examination showed moderate inflammatory infiltration and lipomembranous fat necrosis in the
subcutaneous septa with mild inflammation in the overlying dermis. The tissue proved to be infiltrated by
lymphohistiocytic cells and a few eosinophils. The patient was treated with systemic and topical corticosteroids; she
has experienced no recurrence. We report an interesting case of traumatic panniculitis following fractional laser
therapy.

영어초록

Traumatic panniculitis can be induced through the injection of various substances into the subcutaneous fat,
especially in patients with psychiatric problems. This condition can also be caused through the subcutaneous
implantation of different materials for cosmetic or therapeutic reasons or through mechanical or physical means. The
diagnosis is always worth considering in those patients with bizarre clinical lesions and inflammatory changes in the
subcutaneous fat that defy ready classification. There have been reported cases of traumatic panniculitis induced by
acupuncture, but no reported cases associated with laser therapy. Fractional photothermolysis is the newest approach
to laser therapy, with multiple micro-laser beams that target water-containing tissues to cause photocoagulation of
narrow columns of skin. The penetration depth of the multiple micro-laser beams is up to 900μm, generally to the
reticular dermis level. A 19-year-old female patient presented with a tender 4×7 cm sized erythematous to brownish,
irregularly shaped, atrophic plaque on the right shin. She was treated for a leg scar using a 1,550 nm erbium fiber
laser. Histopathologic examination showed moderate inflammatory infiltration and lipomembranous fat necrosis in the
subcutaneous septa with mild inflammation in the overlying dermis. The tissue proved to be infiltrated by
lymphohistiocytic cells and a few eosinophils. The patient was treated with systemic and topical corticosteroids; she
has experienced no recurrence. We report an interesting case of traumatic panniculitis following fractional laser
therapy.

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