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Symposium 3-4 (SYP 3-4) : Management of facial erythema of rosacea
이미우 ( Mi Woo Lee ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Tetracyclines have the anti-inflammatory effects, such as inhibition of metalloproteinases, inhibition of collagenase (MMP1, MMP8, MMP13), inhibition of gelatinase (MMP-2, MMP-9), increase of TIMP, anti-angiogenesis, decreased expression of proinflammatory cytokines, inhibition of neutrophil chemotaxis and ROS, and decreased expression of nitric oxide. Recently a study reported doxycycline indirectly inhibits proteolytic activation of tryptic kallikrein-related peptidase and activation of cathelicidin. Topical calcineurin inhibitors selectively target T cells and mast cell, preventing the production of cytokine and inflammatory mediators. Side effects of TCI are immediate aggravation (1-3d), burning sensation, and calcineurin inhibitor induced rosacea. Azelaic acid showed decreased expression of TLR2, cathelicidin, and KLK-5 in vitro murine skin. Flushing can be induced by humural or neural stimuli, therefore a- adrenergic receptor agonist, such as oral clonidine and topical brimonidine tartrate and oxymetazoline can be used for treatment of rosacea. The use of β- adrenergic receptor blocker, such as oral nadolol, propranolol hydrochloride, and carvedilol were reported.
Acral Persistent Papular Mucinosis 2예
이미우(Mi Woo Lee),최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.2
We describe two cases of acral persistent papular mucinosis. The characteristic findings include discrete papules on the extensor surfaces of the hands and wrists, mucous deposits within the dermis, persistence or slow progression for several years. APPM may be considered as the disease entity in the same spectrum with lichen myxedematosus. (Korean J Dermatol 2000;38(2):236~239)
막낭성 변화를 보이는 지방층염에 대한 임상 및 병리조직학적 연구
이미우(Mi Woo Lee),최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh) 대한피부과학회 1999 大韓皮膚科學會誌 Vol.37 No.10
N/A Background : Membranocystic change represents a distinctive from of pathology in adipose tissue. It has been oberved in a variety of inflammatory and noninflammatory dermatoses. Objective : Our purpose was to find the clinical and histopathological features of membranocystic change in the panniculitis and we attempted to review the pathogenesis. Methods : We reviewed medical records, clinical photographs, and histopatoligic finding of 14 patients having membranocystic changes in biopsy specimen. Results : ① There was a female predominance (79%). ② The most common primary lesions were the subcutaneous nodules and the most predilection sites were the lower legs. ③ The underlying diseases were varible such as erythema nodosum, lipoatrophy, sparganosis, sportrichosis, accelerated nodulosis, necrobiosis lipoidica, periarteritis nodosa, artery stenosis, dermatomyositis, lupus erythematosus profundus, oil granuloma and nodulocystic fat necrosis. ④ The membranes of cyst were positive with periodic acid-Schiff stain with diastase and sudan black B. Fluorescence examination gave a yellow autofluorescence. These findings indicated the lining materials were ceroid. Conclusion : Membranocystic change appears to be entirely nonspecific and may be seen in many types of the subcutaneous inflammatory process. Although ischemic insult has received the most attention in dermatololgic literature as the primary cause, it is likely that this change results from various insults to adipose tissue, including infectious, autoimmune, and physical processes. (Korean J Dermatol 1999;37(10) : 1407∼1412)
이미우(Mi Woo Lee),최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh) 대한피부과학회 2002 大韓皮膚科學會誌 Vol.40 No.2
N/A Background : Scleredema is a rare connective disorder with unknown etiology. There were no comprehensive studies about the clinical and histopathological features of scleredema in Korea. Objective : Our purpose was to find the clinical and pathological features of scleredema. Methods : The 31 patients with scleredema at our institution over ten years were retrieved. We reviewed medical records, clinical photographs, and histopathology slides of these patients, retrospectively. Results 1. The male to female ratio was 23:8 (2.9:1). 2. Most of the patients had the insidious onset and chronic localized lesion on the nape and upper back. 3. In sixteen patients (16/31, 51.6%), the diabetes mellitus was accompanied. In these patients, the male predominance (14/16, 87.5%) was significant. 4. The positive staining was in 75%(15/20) of the tissues with alcian blue or mucicarmine staining. 5. In four patients, localized electron beam therapy markedly improved the skin lesion without serious adverse effects. Conclusion : A preceding respiratory infection was uncommon. Almost all patients had insidious onset and chronic course. Diabetes mellitus was commonly accompanied, especially in male patients. Electron beam therapy appears to be effective in the treatment of scleredema.
Cutaneous T-cell lymphoblastic lymphoma
이미우 ( Mi Woo Lee ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
1. Learning Objectives To describe the clinical and histopathological features of cutaneous T-cell lymphoblastic lymphoma 2. Clinical Presentation A 39-year man visited at department of internal medicine, presenting chest discomfort and dyspnea with history of 1 year`s duration. Four months previously, asymptomatic multiple subcutaneous nodules on scalp developed and increased in number. Computed tomography demonstrated mass-like lesions on mediastinum and lymph node enlargements on cardiophrenic and neck area. Punch 4mm biopsy was conducted to evaluate histopathologic findings of subcutaneous nodules on scalp. 3. Pathologic Presentation (or Surgical Presentation) Heavy neoplastic, monomorphous infiltrates in dermis were noted, which were composed of atypical lymphoid cells, scant cytoplasm, irregular nuclear contours, stippled chromatin, and prominent nucleoli. Tumor cells in the dermis infiltrated between collagen bundles, often resulting in the “Indian file” pattern. Skin adnexal structures were generally intact, although partial destruction was observed in some area. In immunohistochemical study, tumor cells were positive for terminal deoxynucleotidyl transferase (TdT), CD3, CD4 and CD 8, but negative for CD20 and CD79. 4. Discussion Lymphoblastic lymphoma accounts for roughly one-third of childhood and < 5% of adult non-Hodgkin`s lymphoma cases. Lymphoblastic lymphoma is a neoplasm of precursor lymphoid cells indistinguishable from those of acute lymphocytic leukemia. Most cases of acute lymphocytic leukemia are of immature B-cell phenotype. In contrast, approximately 90% of the lymphoblastic lymphoma patients express the immature T-cell phenotype. Lymphoblastic lymphoma predominantly affects children and young adults and seems to develop more frequently in males than in females, demonstrating an overall incidence ratio of 2.5:1. Patients with T-cell lymphoblastic lymphoma are usually adolescents or young adults and often present with a mediastinal mass and lymphadenopathy. In contrast, B-cell lymphoblastic lymphoma seems to commonly present in children or young adults and often involves extranodal organs, including the skin, breasts, liver, and bone. A previous study has reported that < 20% of lymphoblastic lymphoma patients demonstrate cutaneous presentation, with the majority of the patients diagnosed with B-cell lymphoblastic lymphoma. A review of the literature reveals that 80% of cases of cutaneous lymphoblastic lymphoma develop in skin lesions in the head and neck area. Lymphoblastic lymphoma is generally regarded as a high-grade lymphoma, demonstrating a 5-year survival rate of 26%. However, B-cell lymphoblastic lymphoma patients may demonstrate a less aggressive clinical course. Although there have been no multicenter studies that have evaluated survival outcomes in B-cell lymphoblastic lymphoma patients receiving standard treatment regimens, B-cell lymphoblastic lymphoma did demonstrate favorable complete remission rates compared with B-cell acute lymphocytic leukemia. In addition, it has been suggested that B-cell lymphoblastic lymphoma patients demonstrate improved survival compared with T-cell lymphoblastic lymphoma patients. Previous findings suggest that B-cell lymphoblastic lymphoma demonstrates a low propensity for leukemic involvement and is associated with a relatively favorable prognosis compared with T-cell lymphoblastic lymphoma. 5. References 1. Chimenti S, Fink-Puches R, Peris K, Pescarmona E, Putz B, Kerl H, et al. Cutaneous involvement in lymphoblastic lymphoma. J Cutan Pathol 1999;26:379-85 2. Sander CA, Medeiros LJ, Abruzzo LV, Horak ID, Jaffe ES. Lymphoblastic lymphoma presenting in cutaneous sites. A clinicopathologic analysis of six cases. J Am Acad Dermatol 1991;25:1023-31 3. Maitra A, McKenna RW, Weinberg AG, Schneider NR, Kroft SH. Precursor B-cell lymphoblastic lymphoma: a study of nine cases lacking blood and bone marrow involvement and review of the literature. Am J Clin Pathol 2001;115:868-75
한국인에서의 피부 림프종의 임상 및 병리조직학적 연구 - 대한피부과학회 피부병리연구분과위원회 공동연구 -
이미우 ( Mi-Woo Lee ),고재경 ( Jai-Kyoung Koh ),권경술 ( Kyung-Sool Kwon ),김낙인 ( Nack-In Kim ),김상원 ( Sang-Won Kim ),김수남 ( Soo-Nam Kim ),김방순 ( Bang-Soon Kim ),김유찬 ( You-Chan Kim ),김종민 ( Jong-Min Kim ),명기범 ( Ki- 대한피부과학회 2003 대한피부과학회지 Vol.41 No.1
Background: The relative frequency and clinicopathologic characteristics of lymphomas vary according to geography and race. Data on the features of cutaneous lymphoma in Korea are limited. Objective . The aim of this study was to document the relative occ
한국인에서의 악성 흑생종에 대한 임상 및 병리 조직학적 연구 - 대한피부과학회 피부병리연구분과위원회 공동연구 -
이미우 ( Mi-Woo Lee ),고재경 ( Jai-Kyoung Koh ),권경술 ( Kyung-Sool Kwon ),김낙인 ( Nack-In Kim ),김상원 ( Sang-Won Kim ),김수남 ( Soo-Nam Kim ),김방순 ( Bang-Soon Kim ),김유찬 ( You-Chan Kim ),김종민 ( Jong-Min Kim ),명기범 ( Ki- 대한피부과학회 2003 대한피부과학회지 Vol.41 No.1
Backgorund ; Malignant melanoma in Korean has been increasing as in other countries, but there is no nationwide survey of malignant melanoma in Korea. Objective : The aim of this study was to document the clinical and histopathological features of cutaneo