간경변에서 관찰되는 피부 소견

이홍탁,윤태영,장승호 ( Hong Tak Lee,Tae Young Yoon,Seung Ho Chang ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.2

Background: The high level of susceptibility of patients with liver cirrhosis(LC) to septicemic infection is thought to be due to decreased reticuloendothelial function and irnpairment of several components of cell mediated and humoral immunity. It is well known that LC may cause many characteristic skin changes including jaundice, spider angioma, palmar erythema, xanthelasrna and nail changes such as clubbing and white nails. Objective and Methods : During a 7 month period frorn April to October 1995, 100 patients who had been diagnosed as having LC were evaluated for the duration of their LC, the associated diseases they had apart from LC and various skin manifestations. Also, we performed the tuberculin test in 20 patients with LC and evaluated the correlation of the tuberculin test with severity of LC divided into 3 groups according to the Childs classification. Results : The results are summarized as follows ; 1. The most frequent duration of LC was under 5 years(74%). 2. The most common associated disease of patients with LC was upper GI bleeding including esophageal varix(24 cases). Also, diabetes mellitus(13 cases) and hepatic coma(11 cases) were observed. 3. Jaundice(82 cases) was the most frequent skin rnanifestation of patients with LC. In addition, vascular changes(81 cases) and various nail changes(69 cases) were observed. Onychomychosis was the most common nail change of patients with LC. 4. 60% of the patients who were given the tuberculin test showed anergy, and the frequency of anergy increased in proport on to the severity of LC. However, it was not significant statistically(p> 0.05 ). Conclusions : Some of the skin manifestations help in the diagnosis of LC. Also, increased frequency of tuberculin test anergy in proportion to the severity of LC is thought to be related to decreased cell mediated immunity, although statistically it is not significant. (Kor J Dermatol 1997;35(2): 228-233)

Paget 병에서의 면역조직화학 염색

이홍탁 ( Hong Tak Lee ),장승호 ( Seung Ho Chang ),윤태영 ( Tae Young Yoon ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.5

Background: Generally, there are few problems in the diagnosis of Paget's disease(PD) using the H&E stain. However, the differentiation of PD from the clonal type of Bowens disease and superficial spreading melanoma in situ that shows pagetoid spreading of tumor cells, may present diagnostic difficulties. In addition, the specia1 stains used for demonstrating the presenee of Pagets cells, such as PAS and mucicarmim, are non-specific and not always sensitive. So, inenunohistochemical stains with monoclonal antibodies against various antigens may be helpful for differentiating PD from ather morphologically similar skin lesions. Objective : The purpose of this study was to investigate the diagnostic accuracy of immunohisto- chemical staining for diagnostic use in PD. Methods . Immunohistochemical stains used in the biotin streptavidin amplificxl technique with monoclonal antibodies to several low rnolecular weight cytokeratin(CK)s, EMA and CEA, were performed on formalin-fixed, paraffin-embedded tissue. Twelve cases of PD(10 cases of extranmmmary PD and 2 cases of mammary PD), five cases of superficial spreading melanoma in situ and five cases of Bowens disease were investigated. Results : The results were as follows. 1. Positive reactions with variable intensity using CK7, CKS, CK19 were seen in all cases(100%) of PD and the. staining intensity tor CK7 or CK19 was stronger than that of CKS. 2. Of the 12 cases of PD, both CK18 and CAM5.2 staining showed positivity in 11 cases(92%). 3. EMA and CEA staining showed positivity in 10(83%) and 9(75%) of 12 cases, respectively. 4. Some Pagets cells were negative for CK8, CK18 and EMA, although other positive cells were observed in the same sections. 5. All antigens were consistently negative in all cases of Bowens disease and superficial spreading melanoma in situ. Conclusion : The results show that moaoclonal antibodies to low molecular weight CKs are more sensitive than EMA or CEA in the demonstration of Pagets cells. Moreover, among the low molecular weight CK series, CK7 and CK19 are most useful for their high sensitivity and intensity. (Korean J Dermatol 1998;36(5): 796-803)

유아기 근섬유종증

이홍탁,장승호,윤태영 ( Hong Tak Lee,Seung Ho Chang,Tae Young Yoon ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

Infantile myofibromatosis is an uncornmon, benign, self-limiting, localized or generalized process, probably of hamartomatous origin, which consists to a large degree of cells having the characteristics of myofibroblasts and sometimes of pericytes. Both solitary and multicentric forms occur. Most lesions are present at birth or in early infancy, and some are familial in origin. A female newborn presented with a firm, round, red colored, 3 x 3 cm sized tumor with central necrosis on the left chest. Histological examination revealed well-circumscribed nodules consisting of short bundles of plump, spindle shaped cells displaying staining characteristics intermediate between fibroblasts and smooth muscle cells. The tumor was immunoreactive for actin but did not stain for desmin. A Follow-up examination at the age of 3 months revealed a moderate degree of spontaneous regressior of the lesion. (Kor J Dermatol 1997;35(1): 182~186)

Bednar 종양

이홍탁,김종구,장승호,윤태영 ( Hong Tak Lee,Jong Goo Kim,Seung Ho Chang,Tae Young Yoon ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.3

신경섬유종증의 임상 및 조직학적 고찰

이홍탁,김종구,윤태영,장승호 충북대학교 의과대학 충북대학교 의학연구소 1995 忠北醫大學術誌 Vol.5 No.2

신경섬유종증은 상염색체 우성유전 질환으로 뼈, 눈, 신경계 및 피부등 전신적으로 다양한 임상을 보이여 피부 증상으로는 과색소 침착과 신경섬유종증이 특징적으로 나타난다. 최근에 신경섬유종증의 유전자 위치가 밝혀짐에 따라 유전자 분석에 관심이 높아질 뿐 아니라 출생전이나 증상이 나타나기 전의 진단이 가능해지게 되었다. 본 교실에선 다양한 임상 양상을 나타내는 신경섬유종증에서의 가족력과 임상 증상을 정리하여 유전 양상과 체계적인 병형 분류를 알고자 연구를 시행하였으며, 신경섬유종증의 생검조직을 통해 조직 양상을 관찰하여 다음과 같은 결과를 얻었다. 신경섬유종증은 제 1형이 가장 흔한 유형임을 알 수 있었다. 가족력은 대부분 환자에서 얻을 수 있었고, 피부 증상으로는 밀크색 반점이 신경섬유종코다 먼저 나타남을 알 수 있었으며, 액와부 주근깨가 신경섬유종과 함께 신경섬유종 1형을 진단하는데 도움이 됨을 알 수 있었다. Lisch nodule은 제 1형 신경섬유종증에 특징적으로 나타났으며 색소성 질환과 연관이 있으리라 생각되었다. 조직학적 소견에서는 비반 세포가 많이 관찰되는 것이 특징이었다. Neurofibromatosis, inherited autosomal dominant, is manifested by developmental changes in the nervous system, bones, and the skin. Riccardi divided it into seven types, but types 1(NF-1) is the most common type, characterized by multiple cafe au lait spots and neurofibromas along peripheral nerves. We analyzed outpatients of neurofibromatosis according to clinical manifestation, familial history, and histopathological findings.

원발성 피부 모균증으로 생각되는 1예

이홍탁,양태호,윤태영,장승호 대한의진균학회 1999 대한의진균학회지 Vol.4 No.1

Mucormycosis is an invasive fungal infection, caused by members of the order Mucorales, that usually occurs in immunocompromised individuals. It manifests itself in a variety of ways and rarely may be confined to the cutaneous tissues. We report a case of primary cutaneous mucormycosis associated with longstanding diabetes mellitus and liver cirrhosis. A 53-year-old woman was presented because of cutaneous discoloration and bullae on the both lower extremities. Cutaneous lesions consisted of necrotic blackish discoloration with bullae and ill-defined margins with extending nature. A biopsy specimen from the cutaneous lesion revealed large, broad, nonseptate hyphae branched at right angles. Our patient was successfully treated with intravenous administration of amphotericin B and surgical debridement of necrotic tissue. [Kor J Med Mycol 4(1): 75∼78]

급성 및 만성 두드러기의 Azelastine HCL 효과 및 안정성에 대한 연구

장승호,이홍탁,윤태영 최신의학사 1995 最新醫學 Vol.38 No.8