홍색음선의 발생 빈도 및 배양에 관한 연구

서경형 ( Kyung Hyung Seo ),장호선 ( Ho Sun Jang ),권경술 ( Kyung Sool Kwon ),정태안 ( Tae Ahn Chung ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.4

Background: The authors did not find any study about erythrasma in Korea, where as there are several studies about the incidence and bacteriology of erythrasma in some areas. Failure to differentially diagnose the clinical entities of tinea pedis versus erythrasma can lead to mistreatment and disability because of the clinical similarities. Objective : This study was carried out to investigate the incidence of erythrasma according to the seasons and sites, to determine the useful culture media, and to evaluate the antibiotic sensitivities and the treatment responses. Methods : The incidence of erythrasma was investigated among the unselected dermatologic patients. The axillae, groins and toewebs were examined under Wood's light. The scale showing characteristic coral-red fborescence was Gram-stained and Corynebacterium minutissimnm was cultured using Loeffler slant media, Brucella blood agar plates and usual blood agar plates. Results : Clinical erythrasma was found in 26.7% of the 240 patients examined. The incidences of erythrasma in summer and fall were higher than winter. In the bacteriologic study Gram positive cocco-bacilli were found in all erythrasma patients and Corynebacterium minutissimum was cultured and identified in 24 0%. Most of cultured causative organisms were sensitive to usual antibiotics in the clinical uses. The average interval from the oral administration of erythrasma to the loss of coral-red fluorescence was 4.1 weeks, and the patients in severe erythrasma group were needed more time(2.2 weeks) for clinical improvement than the patients in mild one. Conclusion : Erythrasma is common in the dermatologic patients and it is important to differentially cliagnose the clinical entities of tinea pedis versus erythrasma. (Kor J Dermatol 1996;34(4): 546-554)

경구용 중쇄중성지방으로 치유된 위글로카곤종 증후군

서경형,박정흠,장호선,권경술,정태안 ( Kyung Hyung Seo,Jung Hum Park,Ho Sun Jang,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.3

Necrolytic migratory erythema is a rare, distinctive, necrotizing cutaneous eruption usually associated with glucagonoma, an alpha-cell tumor of the pancreas. Other clinical features include ane- mia, diabetes mellitus and weight loss. However, it also occurrs without the pancreatic glucagonoma. So this rare condition is called pseudoglucagonoma syndrome, and has been described in association with chronic hepatic diseases, malabsorption with villous atrophy, chronic pancreatitis, celiac sprue, hypoproteinemia and odontogenic infection. We report a case of pseudoglucagonoma syndrome induced by malnutrition without glucagonoma. A 28-year-old Korean female was referred to our department complaining of multiple erythematous, desquamative, crusted and erosive patches on the extremities, and diffuse scalp alopecia for 5 years. She also had perianal erosion, angular cheilitis without glossitis, amenorrhea, axillary and pubic hair loss, and weight loss. Six years previously she had had Whipples operation for a pancreatic solid and papillary neoplasm. The laboratory data showed hypoalbuminemia, essential fatty acid deficiency, diabetes mellitus and slightly high levels of zinc and glucagon. A skin biopsy showed irregular acanthosis, epidermal edema and pallor, dyskeratosis, areas of superficial epidermal necrosis and vascular dilatation of the papillary dermis. The patient improved dramatically after intravenous hyperalimentation and oral intake of mediurn chain triglyceride. For 2.5 years she has taken medium-chain triglycerides without any other treatment, and no side effects on recurrence has been observed. (Kor J Dermatol 1997;35(3): 593-599)

두피에 동반된 유경 색소성 에크린 한공종과 선천성 멜라닌세포성 모반

서경형,장호선,권경술,정태안 ( Kyung Hyung Seo,Ho Sun Jang,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

It has been generally assum d that eccrine poroma arises from acrosyringium, the epidermal sweat duct unit. Eccrine poroma mainly involves the non hairy surfaces of t,he skin, but it has also been found on hair-bearing areas. One of the characteristics of this structure is absence of melanocytes and melanin granules arnong its cells. However, a complete absence of melanocytes and melanin granules in eccrine poroma is not invariable and a few reports of such an occurrence have been presented. The authors report herein a case of unusual and rare eccrine poroma. The eccrine poroma had melanin pigment and melanocytes, was pedunculated and occurred on the parietal scalp which was the unusual site of involvement. The eccrine poroma was also combined with a pedunculated congenital melanocytic nevus on the supraauricular scalp. (Kor J Dermatol 1997;35(1): 169-173)

모공성 홍색 비강진 30예에 대한 임상적 고찰

권경술 ( Kyung Sook Kwon ),서경형 ( Kyung Hyung Seo ),장호선 ( Ho Sun Jang ),정태안 ( Tae Ahn Chung ) 대한피부과학회 1996 大韓皮膚科學會誌 Vol.34 No.6

Background: Pityriasis rubra pilaris (PRP) is a rare disease characterized by widespread follicular acuminate papules. Traditionally, two forms have been described : hereditary (juvenile) and acquired (generally aduIrt). A.substantial contribution, however, suggests that further subdivision is appropriate. Objective : The purpose of this study was to investigate clinicopathologic features of PRP and to compare the results of clinical classification with Griffiths classification. Methods . The retrospective clinicopathologic study carried out in 30 cases of PRP over the last 30 years. Results : 1. The incidence of type lV was 38.5%. For both type I and III it was 30.8%. The onset ages of the type I, III, and lV were 36.1, 6.0, and 9.6 years respectively. 2. The most common site of initial involvement was the palms, and the most common involvement site during the diease course was the dorsa of palms and feet. The incidence involved in the whole body was 46.6%. 3. The incidences of insidious and acute onset were 60% and 40% respectively. No case had the family history of PBP. 4. In the histopathologic study, diffuse hyperkeratosis, acanthosis, and mild dermal infiltrations were found in all cases. Follicular pluggings were observed in 93.3% of cases. Conclusion : We investigated the clinical classifications and clinicopathologic features of PRP. We think that more studies such as prognosis and t,reatment of PRP should be achieved in the near future. (Kor J Detmatol 1996;34(6): 924 932)

수장족저 농포증에서 골관절병증의 임상적 연구

장호선,서경형,권경술,정태안,오창근 ( Ho Sun Jang,Kyung Hyung Seo,Kyung Sool Kwon,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.6

Background: Palmopl ntar pustulosis(PPP) is often associated with osteo arthropathy, especially sternocostoclavicular iiyperostosis(SCCH). The relation between PPP and SCCH or other types of seronegative arthropathy remains unclear. Objective : The purpose of this study was to investigate the distribution and the frequency of osteo-arthropathy in patients with PPP. Methods : Twenty fiv patients with PPP were included in this study, and checked for clinical symptoms and signs, labiratory findings, and radiologic findings including plain X-ray, 99mTc-MDP bone scan, and computeI t,omography. Results : The incidenc of osteo arthropathy in PPP was 64%. The prevalent age at onset of osteo arthropathy was the forth decade in males, and the sixth decade in females. The frequent, sites of osteo arthralgia were st,ernocostoclavicular areas, spines, shoulders, knees, and sacroiliac joints, and the frequent sites of increased radioisotope uptake were similar to t,he distribution of sites of osteoarthropathy. Tc-MDP bone scan was more sensitive in detecting osteo-arthropathy than plain X ray and commputed tomography. In laboratory findings, we observed an increase in the erythrocyte sedimentation rate, leukocyte counts, alkaine phosphatase, and the positivity of C-reactive pr otein. Conclusions : The frequent involvement of the anterior chest, wall, knees, spines, and sacroiliac joints was noted in pati .nt.s with PPP. 99mTc MDP bone scan may be the most helpful in making a diagnosis of osteo-arthropathy accompanied with PPP. (Korean J Dermatol 1997;35(6): 1143-1150)

다발성 모낭상피종의 임상 및 병리조직학적 관찰

정태안,서경형,장호선,권경술,오창근 ( Tae Ahn Chung,Kyung Hyung Seo,Ho Sun Jang,Kyung Sool Kwon,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5

Background: The diagnostic dilemma in differentiation between multiple and solitary trichoepitheliomas from basal cell carcinoma(BCC) is well documented. Some authors reported that up to 35% of trichoepitheliomas were misdiagnosed initially as BCC, especially the keratinizing variant. Objective : The purpose of this study was to review the clinicopathological characteristics of the multiple trichoepitheliomas and to suggest specific findings and useful special staining methods for differentiating from BCC. Methods : We reviewed 14 cases of multiple trichoepitheliomas from a clinicopathological aspect. We performed H&E, periodic acid Schiff, Giemsa, Fite, and alcian blue staining using the formalin-fixed paraffin-embedded samples of multiple trichoepitheliomas. Results : The average age at onset was 24.7 and 78.6% of the cases showed autosomal dominant inheritance patterns. The sites of frequent involvement were the nasolabial folds and nose, and the average size of the lesions was 4.3x4.3 mm. The most important histopathological finding in differentiation was papillary mesenchymal tissue, and this was well observed with the Giemsa stain. Several other findings were also useful in differentiation, such as stellate structures in cystic walls, parakeratosis and eosinophilic necrotic bodies in the cystic walls, primitive hair follicles, epidermal connections, and mast cell infiltration. Conclusion : Several staining methods, such as the Giemsa, periodic acid Schiff, Fite, and alcian blue stains, were useful in differentiating the trichoepitheliomas from BCCs. (Korean J Dermatol 1997.35(5): 909-914)

유경성 지방섬유종의 임상 및 병리조직학적 관찰 - 표재성 피부지방종성 모반과의 비교 관찰 -

권경술,서경형,장호선,정태안,오창근 ( Kyung Sool Kwon,Kyung Hyung Seo,Ho Sun Jang,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5

유경성 지방섬유종(pedunculated lipofibroma)은 진피내 이소성 지방조직(ectopic fatty tissue)을 특징으로 하는 비교적 드문 결체조직 이상으로 병리조직학적 소견은 표재성 피부지방종성 모반(nevus lipomatosus cutaneous superficialis, 이하 NLCS)과 거의 유사하다. NLCS는 다발형과 단발형 병변으로 분류할 수 있는데 Mehregan 등은 단발형이 다발형에 비해 임상 및 조직학적으로 많은 차이점을 보인다는 점에서 유경성 지방섬유종으로 부를 것을 제안했다. 국내에서는 유경성 지지방섬유종에 대해 본 교실에서 처음 발표한 증례를 포함해 2예가 보고되었다. 이에 저자들은 본 교실에서 경험한 12예의 유경성 지방 섬유종에 대해 이들의 임상양상 및 병리조직학적 특징을 관찰하고, 본 교실의 NLCS 증례와 국내에 발표된 NLCS 증례를 문헌고찰하여 유경성 지방섬유종과 비교분석하였다. Background:Nevus lipomatosus cutaneous superficialis(NLCS) was originally classified into two clinical types:a multiple form and a solitary one. Mehregan et al proposed the term pedunculated lipofibroma for the solitary form of NLCS in view of its distinctive clinicopathological features. Objective:Pedunculated lipofibroma is a relatively rare benign connective tissue proliferation abnormality characterized by ectopic adipose tissue in the dermis. The purpose of this study was to investigate the differences in clinicopathological findings between pedunculated lipofibroma and NLCSs. Methods:we performed the comparative clinicopathological studies of pedunculated lipofibromas and NLCSs among 9,940 patients who had skin biopsies for hisitopathological diagnosis during a recent 20 yeat period. In addition, we reviewed the NLCS cases previously reported in Korea. Results:We found 12 cases(0.12%) of pedunculated lipofibromas which showed a female preponderance. The lesions usually appeared as large, solitary, slow-growing, pedunculated to dome-shaped, skin-colored nodules or masses showng predilection for the buttock and upper thigh. However, 33.3% of lesions were present on non-pelvic girdle areas such as the back, upper arm, scalp, axilla and anterior chest. Most of the patients had a solitary lesion except for two patients who had two lesions. Histopathologically, all of the lesions were characterized by the presence of a central fatty core of mature adipose tissue infiltration admixing with dense stromal collagen. Several appendageal structures, perivascular and periappendageal deposition of mucin, and perivascular infiltration of mast cells were present in all of the lesions. Otherwise obvious acanthosis or papillomatosis were not present in the epidermis. We found 4 cases(0.04%) of NLCSs and reviewed 9 reported cases of NLCSs, which did not show the sexual differences in incidence. The lisions usually appeared as skin-colored confluent nodules which formed the zosteriform or cerebriform plaques. The majority of lesions(92.3%) were present on the pelvic girdle area except for one case with shoulder lesions. Histopathologically, all of the lesions showed the mature adipose tissues, epidermal hyperkeratoses, acanthoses, follicular pluggings and well-developed pilo-sebaceous units. Conclusion:Because of the distinctive clinicopathological differences between the solitary and multiple forms of NLCS, we agree with Mehregan’s proposal of nominating this solitary lesion as pedunculated lipofibroma.(Korean J Dermatol 1997;35(5):854∼862)

건선 환자에서 혈청 지질 및 지질단백 검사 소견에 대한 연구

권경술 ( Kyung Sool Kwon ),서경형 ( Kyung Hyung Seo ),장호선 ( Ho Sun Jang ),정태안 ( Tae Ahn Chung ) 대한피부과학회 1996 大韓皮膚科學會誌 Vol.34 No.1

Background: Previous studies have demonstrated that patients with psoriasis may have an increased risk of contacting a variety of noncutaneous diseases, including arterial and venous occlusive diseases. Changes in plasma lipid and lipoprotein composition in patients with psoriasis may be the reason for the increased risk of atherosclerosis in these patients. Objective : This study was carried out to investigate the differences of serurn lipid, lipoprotein and apolipoprotein levels between the psoriasis patients and control groups and to suggest which are related with atherogenic risk in the psoriasis. Methods : Serum lipid, lipoprotein and apolipoprotein levels were measured in 100 patient with psoriasis and in 30 healthy people. Results : In the serum lipids study total cholesterol, TG, LDL-C and VLDL-C levels were lower and HDL-C level was higher in the psoriasis group than in the control group. Statistical significant differences were noticed in total cholesterol levels between the female psoriasis patients and the female control groups. In the serum lipoproteins study apolipoprotein B and lipoprotein (a) levels were higher and apolipoprotein A I level was lower in the psoriasis group than in the control group, and statistical significant differences of apolipoprotein B and lipoprotein (a) levels were noticed in the atherogenic risk group and severe psoriasis group compared with the control group. Conclusion : These findings suggest that the atherogenic risk in psoriasis is related with the high level of apolipoproteins especially apolipoprotein B, and is not related with serum lipid. (Kor J Dermatol 1996;34(1): 102-108)

두피 건선의 모낭 피지선계 변화에 관한 병리조직학적 연구

오창근,권경술,한을희,장호선,서경형,임채성,정태안 대한피부과학회 1999 대한피부과학회지 Vol.37 No.2

Background : Although there have been many studies on psoriasis, only a few studies have been conducted on pilosebaceous changes and even those results are controversial. While a few studies have been conducted on the morphological changes of the pilosebaceous unit in scalp psoriasis, comparative studies on the morphometric changes of pilosebaceous structures with a normal control group have not been conducted. Objective : The purpose of this study is to elucidate the morphological change of the pilosebaecous unit in scalp psoriasis. Methods : We conducted a comparative study on the marphometric changes of the pilosebaceous structure in 10 cases of scalp psoriasis with a normal control group. Results : The results of this study ate summarized as follows : 1. Total hair counts, telogen hair counks, telogen hair counts, and the sizes of hairs and follicles in the lesianal scalp showed no statistically significant increase than in the normal control. 2. The intrafollicular hyperkeratasis in infundibulum and sebaceous atrophy were more prominet in the lesional area than in the normal control area. These findings were also significantly prominent in the uninvolved normal-appearing area than in the normal control area. 3. Perifollicular inflammation, squamous metaplasia of the sebaceous gland and telangiectasia in the lesional and tminvolved areas were prominent, and these findings were not found in the normal control areas. Conclusion : The sebaceous atrophy and squamous metaplasia are very important findings of morphologic changes in psoriasis, and this paradoxical change may be an important clue to clarify the pathogenesis of psoriasis.