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DIY 1 (DIY 1) : Receptors, channels and neural pathways of itch
김혜성 ( Hei Sung Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Itch (pruritus) is defined as an unpleasant sensation that evokes the desire to scratch. Older studies have interpreted itch as a type of pain. However, recent neurophysiological findings have provided evidence that itch is a separate sensory modality. A novel pruriceptive system has been proposed within which itch-producing peripheral mediators (pruritogens), itch-selective receptors (pruriceptors), sensory afferents and spinal cord neurons, and itch-processing central nervous system regions display complex, layered responses to itch. Recently, special attention has been attracted to the transient receptor potential (TRP) superfamily as a “player” in the pathogenesis of pruriceptive itch. My talk will be covering the basic mechanism of itch with special focus on thermosensitive TRP channels.
Symposium 2-2-13 (SYP 2-2-13) : A patient with purpura
김혜성 ( Hei Sung Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
1. Diagnosis Amyloid purpura 2. Clinical summary A 55-year-old male was referred to the department of dermatology for evaluation of asymptomatic, multiple, variably sized, purpuric lesions on the periocular area and the lower abdomen for months. The patient had chronic obstructive pulmonary disease (COPD) and was recently admitted to the department of pulmonary medicine due to breathing difficulty. A skin biopsy was performed from the abdomen for analysis. 3. Microscopic features Histology showed pale-pink amorphous material deposition in the upper dermis. Congo red staining showed apple-green birefringence under polarized light microscopy. 4. Discussion Bilateral periorbital purpura or ‘raccoon eyes’ has been described in association with skull trauma, and as in our case with primary amyloidosis. Amyloidosis is divided into three categories: primary, secondary and hereditary. Primary or AL amyloidosis results from an abnormal proliferation of plasma cells with deposition of fragments of monoclonal proteins (light chains) in tissues; the heart, kidneys, central nervous system and GI tract are the commonly involved organs. Other less common manifestations include cutaneous purpura. Amyloid purpura has a propensity for involving skin folds, such as the eyelids. Increased capillary fragility and infiltration of their walls with amyloid deposits can cause rupture of these small vessels with mild perturbations such as coughing, sneezing. Although a careful history and physical examination can guide clinicians toward the diagnosis of amyloidosis, it is confirmed on biopsy, by revealing amyloid fibril deposition in tissues. Congo red staining, which leads to the appearance of apple green birefringence is used as a diagnostic test. 5. References Eder L, Bitterman H. Amyloid purpura. New Engl J Med 2007; 356: 2406 Yucel A, Akman A, Denli YG, Acar MA, Karakas M, Hazar B, et al. A case of systemic amyloidosis associated with multiple myeloma presented as macroglossia and purpura. J Eur Acad Dermatol Venereol 2004; 18: 378-9