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CASE REPORT : Kaposi Sarcoma in a Patient with Chronic Renal Failure Undergoing Dialysis
( Deborah Lee ),( Ji Sung Chun ),( Soon Kwon Hong ),( Mi Seon Kang ),( Jong Keun Seo ),( Jae Kyoung Koh ),( Ho Suk Sung ) 대한피부과학회 2013 Annals of Dermatology Vol.25 No.4
Kaposi sarcoma (KS) is a multicentric proliferative vascular tumor involving the skin and other organs. Human herpesvirus 8 (HHV-8) has been detected in KS lesions and is considered the putative causative agent of KS. The relationship between chronic renal failure, HHV-8, and KS is not clear. KS appears to develop in association with renal transplantation, but is unlikely with dialysis, and there have been few reports on this. Here, we report the case of a 51-year-old man, who underwent peritoneal dialysis to treat chronic renal failure, and presented with multiple brownish plaques on his soles. On histopathological examination, abnormally proliferated vessels, vascular slits, and spindle- shaped cells were seen in the dermis. Immunohistochemical staining for HHV-8 was positive. This case is another example in which factors other than immunosuppression contributed to the development of KS, due to activation of HHV-8. (Ann Dermatol 25(4) 475∼478, 2013)
Deborah Lee 한국피부장벽학회 2009 한국피부장벽학회지 Vol.11 No.1
Aged epidermis displays altered drug permeability, increased susceptibility to irritant contact dermatitis, and severe xerosis suggesting compromise of aged epidermal barrier. However, cutaneous barrier function is normal or even supernormal under basal conditions in aged skin. Functional pathology of the epidermis is revealed only after an active insult. The aged barrier is perturbed more readily and recovered more slowly in aged than in young skin. Global reduction of all key stratum corneum (SC) lipids, most profoundly cholesterol, with reduced activity of key enzymes and decreased extracellular lamellar bilayers could explain the impaired barrier recovery in aged epidermis. That is, main cause of impaired barrier function of advanced age(>75 years) is reduction of synthesis of key species of epidermal lipid. On the other hand, epidermal lipid synthesis is normal and the defective permeability barrier is associated with defective SC acidity in moderately aged (50-80 years) skin. Decreased Na+/H+ antiporter (NHE1) accounts for the pH abnormality in moderately aged epidermis and lead to increased SC pH. The increased pH results in abnormal lipid-processing and delayed maturation of SC lamellar membrane. Moreover, increased pHdependent activation of serine protease accelerates corneodesmosome degradation leading to abnormal SC integrity. Delayed barrier recovery and abnormal lipid-processing in moderately aged mice were normalized by reacidification. Dry environment induces epidermal proliferation and scaling in both aged and young skin and no remarkable difference is found in skin barrier recovery of aged skin in a dry environment. Superimposition of photoaging on chronologically aged (CA) skin neither alter basal barrier function, nor cause a further abnormality in barrier integrity but, cause a further abnormality in permeability barrier homeostasis in aged skin. Functional disturbance of SC in UV irradiated skin is not due to direct effect of UV radiation on SC, but just reflect secondary changes possibly caused by UV damage on underlying viable skin tissue that induce an epidermal proliferative response.
Steatocystoma Multiplex Confined to the Scalp with Concurrent Alopecia
Deborah Lee,Ji-Sung Chun,Soon-Kwon Hong,서종근,Joon-Hee Choi,Jae-Kyoung Koh,,Ho-Suk Sung 대한피부과학회 2011 Annals of Dermatology Vol.23 No.-
Steatocystoma multiplex (SM) is an uncommon disorder of the pilosebaceous unit characterized by the development of numerous sebum-containing dermal cysts which rarely involves the scalp. Here, we report a case of a 50-year-old man with multiple cystic nodules and alopecic patches on his scalp. On histopathological examination, the folded cyst was found to be lined by stratified squamous epithelium,while flattened sebaceous gland cells were identified in the cystic wall. Pigment casts were present in the hair papillae and perifollicular regions, suggesting trichotillomania as a possible cause of the observed alopecia. This case appears to represent an unusual clinical manifestation of SM. (Ann Dermatol 23(S2) S258∼S260, 2011)
Case Reports : Steatocystoma Multiplex Confined to the Scalp with Concurrent Alopecia
( Deborah Lee ),( Ji Sung Chun ),( Soon Kwon Hong ),( Jong Keun Seo ),( Joon Hee Choi ),( Jae Kyoung Koh ),( Ho Suk Sung ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.2s
Steatocystoma multiplex (SM) is an uncommon disorder of the pilosebaceous unit characterized by the development of numerous sebum-containing dermal cysts which rarely involves the scalp. Here, we report a case of a 50-year-old man with multiple cystic nodules and alopecic patches on his scalp. On histopathological examination, the folded cyst was found to be lined by stratified squamous epithelium, while flattened sebaceous gland cells were identified in the cystic wall. Pigment casts were present in the hair papillae and perifollicular regions, suggesting trichotillomania as a possible cause of the observed alopecia. This case appears to represent an unusual clinical manifestation of SM. (Ann Dermatol 23(S2) S258~S260, 2011)
( Deborah Lee ),( Doo Jin Oh ),( Jung Wook Kim ),( Sung Wook Park ),( Min Kyung Oh ),( Ho Suk Sung ),( Seon Wook Hwang ) 대한피부과학회 2008 Annals of Dermatology Vol.20 No.4
Background: Combination therapy using cyclosporine A (CsA) together with low-dose corticosteroids has adequate efficacy with little toxicity for the treatment of severe alopecia areata (AA). Objective: We wanted to evaluate the clinical efficacy of combination therapy using CsA with low-dose corticosteroid for the treatment of severe AA and we also wanted to determine the safe therapeutic concentration of CsA in the peripheral blood. Methods: We treated 34 cases of severe AA with combination therapy for 24 weeks and we evaluated the efficacy at 12 and 24 weeks. We monitored the peripheral blood concentration of CsA to determine the therapeutic range of CsA that has the fewest side effects. Results: Of the patients, 77.4% (n=24) and 22.6% (n=10) were classified in the responder and poor-responder groups, respectively. The mean trough concentration of CsA was 95.1 and 101.2 ng/ml in the responder and poor-responder groups, respectively. For the patients with side effects associated with CsA, the mean CsA concentration was 195.8 ng/ml. Conclusion: We found that combination therapy with systemic CsA and low-dose corticosteroids effectively treats severe AA and this therapy results in a safe, therapeutic concentration of CsA in the peripheral blood. (Ann Dermatol (Seoul) 20(4) 172∼178, 2008)