피부결핵의 조직에서 중합효소 연쇄반응을 이용한 Mycobacterium tuberculosis DNA의 검색에 관한 연구

신항계(Hang Kye Shin),권경술(Kyung Sool Kwon),정태안(Tae Ahn Chung) 대한피부과학회 1994 大韓皮膚科學會誌 Vol.32 No.6

Beckground : A presumptive diagnosis of cutaneous tuberuisis can be made on the basis of patients history, clinical and histologic findings. However, isolation of Mycabecterum tuberculosis is required for a defimitive diagnosis and confirmation carke difficult with traditional techniques, including the direct visoalization in tissue and growth culture. Objective : We used polymerase chain reaction(PCR) for the detection of mycobacterial DNA from routinely prepared formalin-fixed, paraffin-embedded skin specimens to evaluate its usefulness as a diagnrstic tool Method : We studied typical cases of localized cutaneous rerculosis. Ten paraffin-embedded biopsy samples obtained from 2 patients with scrofulo lupus vulgaris and tuberculosis verrucosa cutis were analyzed by PCR, respectively. Result : M. tubereuloeis DNA was demonstrated in all 10 specimens. Cenclusion : This study shows that the PCR will be a useful method for the confirmation of the diagnosis in localizeted cutaneous tuberculosis and many sl in lesions thought to be related fo tuberculosia infection. (Kor J Dermatol 1994; 32(6): 990-997)

대뇌상 진피내 멜라닌세포성 모반

신항계(Hang Kye Shin),한을희(Eul Hee Han),권경술(Kyung Sool Kwon),정태안(Tae Ahn Chung) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.3

Cerebriform intradermal melanocytic nevus is a cause of cutis veticis gyrata, a morphologic term which describes the hypertrophy and folding of the skin, typically occurring on the scslp, to present a gyrate or cerebriform appearance. We report a 37-year-old woman with a 17 x 22cm soft, convoluted mass over most of the occipital, parietal, and temporal scalp. At birth, she had a small brownish macide on the occipital scalp that enlarged to form this extensive lesion. Histologically, nests of nevus cells were shown in the upper and the mid dermis. (Kor J Oermatol 1994; 32(3): 488-492)

범발성 색소이상증 - 4대에 걸쳐 상염색체 우성 유전 양상을 보인 1가족예 -

신항계(Hang Kye Shin),한을희(Eul Hee Han),권경술(Kyung Sool Kwon),정태안(Tae Ahn Chung) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.3

Dyschromatosis universalis hereditaria is a rare pigmentary disorder characterized by widespread mothed hyperpigmentation and hypopigmentation. We report a 40-year-old male patient with numerous hyperpigmenter, and hypopigmented macules all over the body except on the palms and soles. The family history revealed similar pigmentary changes in 5 other members through 4 generations, and we could guess the hereditary pattern of the disease of this family to be autosomal dominant inheritance. (Kor J Dermatol 1994; 32(3): 493-497)

전신 광화학요법 ( PUVA ) 이 멜라닌세포 성장 및 백반증 환자의 항멜라닌세포 자가항체가의 변화에 미치는 영향

한승경,신항계,송민석,박윤기 ( Seung Kyung Hann,Hang Kye Shin,Min Seok Song,Yoon Kee Park ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

Background: PUVA has been used effectively in the treat,ment of vitiligo, but the mechanism by which PUVA stimulat.es melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. Objective : To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and t,he incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. Methods : The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. Results : 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo. (Kor J Dermatol 1997;35(1): 57-70)

만성 광선 피부염에서 Cyclosporine 치료의 효과 및 의의

조흔정,한승경,신항계,박윤기,이광훈 ( Heun Jung Cho,Seung Kyung Hann,Hang Kye Shin,Yoon Kee Park,Kwang Hoon Lee ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.3

Background: Chronic actinic dermatitis comprises a spectrum of chronic photosensitivity disorders. Treatment includes avoidance of UV light, application of broad-spectrum topical sunscreens, PUVA therapy, corticosteroid, azathioprine and cyclosporine. Objective : Our purpose was to determine the efficacy of cyclosporine in the treatment of chronic actinic dermatitis. Methods : Six patients with chronic actinic dermatitis refractory to conventional treatment were treated with cyclosporine 100-200mg a day for four to eighteen weeks. Results . In all six patients improvement of the skin lesions and itching were dramatic, but in three of them hyperterision developed during the cyclosporine treatment. After stopping the cyclosporine therapy, their blood pressures normalized within two to five weeks. Other side effects of cyclosporine were not found. Although the skin lesions of all of the six patients were aggravated more or less after stopping the cyclosporine therapy, we could maintain their improved states with topical corticosteroids and oral antihistamines. Conclusion 1. Cyclosporine is a good alternative in treating chronic actinic dermatitis patients who are suffering from severe symptoms refractory to conventional therapy. 2. Hypertension is the frequent side effect of cyclosporine. (Kor J Dermatol 1997;36(3): 458-464)

육아종성 입주위염

권경술(Kyung Sool Kwon),한을희(Eul Hee Han),정태안(Tae Ahn Chung),신항계(Hang Kye Shin),김천기(Cheon Gi Kim) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.1

A 51-year-old female developed a distinctive perioral rash, conisting of discrete or confluent erythematous papules for one and a half years. Histopathologic examiriation revealed upper dermal granulomas admixed with lymphoytes. Pieces of hair shaft were staincd peri-dish by AFB in the center of granuloma, which might play a role in the formation of the granuloma She also had used corticosteroid ointment intermittently duririg this time. There were no associated systemic abnormalities. The lesions resolved after two month treatment with oral corticosteroid and tetrac cline. (Kor J Dermatol 1994; 32(1): 182-185)

주사전자현미경을 이용한 피부사상균의 형태학적 관찰

윤경한,정태석,신항계,방동식,이광훈 대한의진균학회 1997 대한의진균학회지 Vol.2 No.2

Background: It is important to understand the morphologic characteristics for the identification of a microorganism. Electron microscopy has contributed a great deal to the field of mycology. Scanning electron microscope(SEM) has become a useful tool to study three-dimensional images of fungi. Vacuum dessicator aqueous fixation is useful sample preparation technique for SEM examination of fungal specimens without surface distortions. Objective : This study was done to observe the three-dimensional structures of dermatophytes preserving their natural growth characteristics. Methods : Trichophyton rubrum, T. mentagrophytes, Microsporum canis, M. gypseum, and Epidermophyton floccosum were isolated and cultured on Sabouraud agar, corn meal agar, or rice agar plate. Vacuum dessicator aqueous fixation was utilized as a preparation technique for SEM examinations of the fungi. Results : Vacuum dessicator aqueous fixation led us to examine the aerial mycelia including conidia of the dermatophytes under SEM. The five species of dermatophytes showed their own characteristic structures especially on microconidia and macroconidia. Conclusion : The use of ultrastructural research has made it possible to identify the species of fungi and can be expaned and improved along with the development of SEM and specimen preparation techniques.