수종의 광독성 약물투여 후 시간에 따른 피부농도 및 최소 광독량에 관한 연구

박윤기,조무연,한승경,임성빈 ( Yoon Kee Park,Moo Yon Cho,Seung Kyung Hann,Sung Bin Im ) 대한피부과학회 1991 大韓皮膚科學會誌 Vol.29 No.5

N/A The Skin Concentration and Minimal Phototoxic Dose Following Administration of Phototoxic Drugs as a Function of Time Yoon-Kee Park, M.D., Moo Yon Cho, M.D., Saung Kyung Hann, M.D., Sungbin im, M.D. Department of Dermatology Yonsei Univeraity College of Medicine, Seoul, Korea Psoralen photochemotherapy(PUVA) is defined as a treatment that depends on the interaction of a photosensitizing substance, psoralen, and long wave jltraviolet(UVA) radiation that results in therapeutically beneficial effects. The rationale of its use is to clear skin disease by repeated controlled phototoxic reactions. The efficacy of PUVA depends on the drug, the UVA dose and wave length, the individual sensitivity to the phototoxic reaction and on the disease to be treated. However, the major factor is the amount of psoralen at the site of photochemical reaction in skin. Daspite the extensive experiences which have now accumulated in the use of PUVA, the relationship between the therapeutic response and phototoxicity as it occurs in normal skin is not established. Comparative data on different psoralen molecules and their skin sensitizing ability are required. From studies on the skin concentration using HPLC and minimal phototoxic dose following oral administration, intraperitoneal administration, a bath of phototoxic drugs as a function of time in guinea pigs, the following results are obtained. 1. The skin concentration of phototoxic drugs after oral administration peaked at 1.5 hours, and the concentration of 8-methoxypsoralen(8-MOP) was 3.7 times greater than that of 5-methoxypsoralen(5-MOP). The skin concetration of 4,5,8-trimethylpsoralen(TMP) was not detected in this study(limit of sensitivity 5ng/g). 2. The skin conentration of phototoxic drugs after intraperitoneal administration peaked at 30 minutes, and the concentration of 8-MOP was slightly greater than that of 5-MOP. The skin concentration of TMP was not detected in this study(limit of sensitivity 5ng/g). 3. The skin concentration of phototoxic drugs after bathing peaked immediately after bathing, and the skin concentrations of phototoxic drugs after bathing decreased in the order of 5-MOP, TMP, and 8-MOP. 4. The minimal phototoxic dose of phototoxic drugs after oral administration was lowest at 1.5 hours, and the minimal phototoxic dose of 8-MOP was 8 times less than 5-MOP, 24 times less than TMP. The phototoxicity of 8-Mop after oral administration was strongest. The time of lowest phototoxic dose and highest skin concentration was the same. 5. The minimal phototoxic dose of phototoxic drugs after intraperitoneal administration was lowest at 30 minutes, and the minimal phototoxic dose of 8-MOP was 1.3 times less than 5-MOP, 5.7 times less than TMP. The phototoxicity of 8-MOP after intraperitoneal administration was strongest. The time of lowest phototoxic dose and highest skin concentration was same. 6. The minimal phototoxic dose of phototoxic drugs after bathing was lowest at 15 minutes. The minimal phototoxic dose of 8-MOP was not significantly different but was significantly greater than that of 5-MOP.

백반증 환자에서 저용량 경구용 부신피질 호르몬제의 치료효과

문태기 ( Tae Kee Moon ),임성빈 ( Sung Bin Im ),한승경 ( Seung Kyung Hann ),조성환 ( Sung Hwan Cho ),박윤기 ( Yoon Kee Park ) 대한피부과학회 1995 大韓皮膚科學會誌 Vol.33 No.5

Background : One of the most, probable pathogenesis of vitiliga is autoimmune. Systemic cor tico st,eroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. Objective : We have assessed the clinical effect of a oral small oral dose of corticosteroid to minimize side effects in vitiligo patients. Methods : Thirty four patients(9;male, 25;female) with vitiligo were evaluated in this study. The patients took 7.5mg-20mg prednisolone initially for 2 months and then the dosage was tapered to half of the initial dosiat the 3rd month and half of dose of 3rd month for the last 4th month. We compared the effcct of treatment of vitiligo before and aft.er the study by photographs. and side efferts were issessed at. 1, 2, 3 and 4 month. Results : The arrest of the progression of vitiligo was noticed in 79% of patients and repigmentation was noticed in 59% of patients which is statistically significant. The effect, of treatment according to extent, duiation, type, and site of vitiligo were not statistically significant. The side effects of treatment were minimal and did not affect the course of treatment. Conclusion : Small doses of iral corticosteroids are effective without any significant side effects in preventing progression and loiiduce repigmentation of active spreading vitiligo and generalized type of vitiligo that is difficult to treat with topical corticosteroids. (Kor J Dermatol 1995;33(5): 880-885)

지속성 광선반응증

박경득(Kyung Deuk Park),임성빈(Sung Bin Im),한승경(Seung Kyung Hann),박윤기(Yoon Kee Park) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.6

Persistent light reaction is a condition of chronic photodermatitis in which photosensitive reaction persists even after the rernoval of all photosensilizers. A 56-year-old man had experienced a recurrent dermatitis involving primarily the face, neek, forearms and hands for 9 years, this condition was aggravated by sunexposure. Photopatch testing disclosed a strongly positive reaction to chloropromazine, promethazine, acid trichlorocarbanilide, Phototesting also revealed lowered MED with UVA and UVB thar norrmal mean value. (Kor J Dermatd 1992;30(8):901-905)

8 - methoxypsoralen ( 8 - MOP ) 에 의한 알레르기성 접촉 피부염

이인준(In Joon Lee),박윤기(Yoon Kee Park),임성빈(Sung Bin Im),한승경(Seung Kyung Hann) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.6

Allergic contact dermatitis due to 8-MOP is a rarely known si(ie effect of this widely used drug. Other known adverse reactions due to 8-MOP such as the oallergic dermatitis as well as some isolated cases of exanthema, papular eruptions, and astloma like symptoms are also sporadically reported. A 52-year-old man with vitiligo developed erythema to the UVA exposed 0.3% Oxoralen cream applied area. Prior to this episode, the patient had history of generalized burns after systernic PUVA therapy in 1983. Even after this experience, the patient had few more episodes of erythema at the site of 0.3%. Oxoralen cream application. We performed patch test and photopatch tests with Scandinavian series, 0.3% Oxoraler or am (as is), and diluted 8-MOP, 5-MOP, TMP solution. The result showed positive reactivity to 6-methylcoumarin, 8-MOP, as well as to 0.3% Oxoralen cream. The size of erythema was same in both irradiated areas which indicates an allergic contact dermatitis rather than photoallergic dermatitis or phototoxic dermatitis. (Kor J Dermatd 1992;30(8):897-900)

백반증 환자의 혈청내 항멜라닌세포 자가항체 검출과 멜라닌세포 표면의 백반증 항원 규명

김남수(Nam Soo Kim),한승경(Seung Kyung Hann),박윤기(Yoon Kee Park),임성빈(Sung Bin Im) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.2

Background : Recently, it has been suggested that autoantibodis face of melanocytes are prevent in the sera of vitiligo patients. However, these autoantibodies exist, whether they are specific for vitiligo a vitiligo patients possess them. In addition, the specificity of the iti lecular weight of the antigen are all unsolved areas demanding further. Objective : To investigate the possible role of autoimmune microvitiligo, this study was designed to verify the presence of auto and vitiligo antigen from the surface of melanocytes, the specificity of gene specific antigens on the sunever, it is not known whether ents, and what percentage of goantigen and the exact moier research. anisms in the development of bodies in vitiligo patients, the utoantibodies and vitiligo anti. Methods : Indirect immuvofluorescent microscopy, flow cytoriiety, and ELISA was done to compare the reactions between melanocytes and sera. SDS-PAC island immunoblotting were used for the identification of vitiligo antigen. Results : Vitiligo sera showed more prominent fluorescence and higher optical density on the surface of melanocytes than normal sera. Forty-four percent of vitiligo sera was directed to melanocytic surface antigen with a molecular weight of 65kDa. The sition assay using rabbit antimelanocytic antibody showed an inhibition of the reaction betw er vitiligo sera and melanocytes in ELISA and immunoblotting. Conclusion : A surface antigen of 65kd was identified from melanocytes and 44.4% of the vitiligo sera showed positive reactions to this antigen. (Kor J Dermatol 1995;33(2): 248-259)

색소레이저 ( Flashlamp Pulsed Tunable Dye Laser , SPTL - 1 ) 를 이용한 피부혈관병변의 치료

이석준 ( Seok June Lee ),이인준 ( In Joon Lee ),임성빈 ( Sung Bin Im ),박윤기 ( Yoon Kee Park ) 대한피부과학회 1995 大韓皮膚科學會誌 Vol.33 No.5

Background : Recent ad vances and innovation in laser technology encourages us to learn and use it experimentally and clinically. The pulsed dye laser(Candela SPTL-1) is a flashlamp excited dye laser, using the princ ples of selective photothermolysis that targets the abnormal microvascu lature of cutaneous lesions while sparing adjacent structures including the epidermis. The laseemits a 585nm wavelength, and has a pulse duration of 450 usec. It is now being widely used in the treatment of vascular diseases in the dermatology field. Objective & Method : Buring the period of about 3 years from August 1994 to March 1992, at the out patient clinin of Department of Dermatology of Yonsei University. 252 patients who were treated with SPTL was analyzed to evaluate the clinical effects of the pulsed dye laser. Patient di@st.ributition f the cutaneous vascular lesions included 1fil pat.ients with nevui flammeus, 68 with telangcetasia, 15 with spider angima, 5 with strawberry hemangiona and 2 with cavernous hemangior ia. Results : The results and summarized as follows : 1. Nevus flammeus 4b.7% of early childhood, 41.5% of late childhood and 47.3% of adults showed excellent or good results. 2. Telangiectasia 78.1% of patients she wed excellent or good results. 3. Spider angioma 66.7% of patients she wed excellent or good results. 4. Strawberry hemangioma and cavernous hemangioma Most, of the patients,howed fair or poor results. 5. Complications included hyperpigmentation(26.5%), hypopigmentation(1.6%) and atrophic scar(4.5% ). Conclusion : Our experince with pulsed dye laser during the last 3 years revealed that it was superior in treating vascular disease than other existing lasers. (Kor J Dermatol 1995;33(5): 859-866)