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임세웅 ( Se Woong Lim ),임주영 ( Ju Young Lim ),윤숙정 ( Sook Jung Yun ),김성진 ( Seong Jin Kim ),이승철 ( Seung Chul Lee ),원영호 ( Young Ho Won ),이지범 ( Jee Bum Lee ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.4
We describe a 56-year-old Korean man with paraneoplastic pemphigus (PNP) associated with persistent generalized exfoliative dermatitis (GED). He developed multiple scattered flaccid bullae on the erythematous base with scales over his face, upper trunk and extremities, with mucosal involvement for 4 months. Due to myasthenia gravis he also suffered from ptosis, general weakness, and weight loss of 10 kg for a month. A computed tomography and histopathological examination of the chest revealed a mass in the anterior mediastinum which was confirmed as thymoma. During the course of disease, his erythematous patch with crust lesions became confluent, and then GED developed. After total thymectomy, GED waxed and waned for 2-years and eventually disappeared. Herein, we report an interesting case of PNP associated with persistent GED for at least 2 years, even though the patient had been treated with surgery and medication. (Korean J Dermatol 2008;46(4):494~498)
급성 골수성 백혈병 환자에서 발생한Fusarium solani에 의한 전신 감염증
임세웅 ( Se Woong Lim ),김형준 ( Hyung Joon Kim ),신명근 ( Myung Geun Shin ),이재혁 ( Jae Hyuk Lee ),윤숙정 ( Sook Jung Yun ),이지범 ( Jee Bum Lee ),김성진 ( Seong Jin Kim ),원영호 ( Young Ho Won ),이승철 ( Seung Chul Lee ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.6
Fusarium species are known as ubiquitous soil saprophytes and human skin contaminants. Infections caused by Fusarium species are increasing in frequency among immunocompromised hosts. We report a rare case of fatal disseminated infection caused by Fusarium solani in an acute myeloid leukemia patient. Skin biopsy specimen revealed multiple branched hyphae and spores in the vessel with thrombus formation, and fungal culture showed a fuzzy, whitish colony. Direct sequencing of 28S rRNA gene confirmed the isolate as Fusarium solani. (Korean J Dermatol 2008;46(6):846∼850)
악성 흑색종과 유사한 조직학적 소견을 보인 다발성 황색육아종
임세웅 ( Se Woong Lim ),윤숙정 ( Sook Jung Yun ),이지범 ( Jee Bum Lee ),김성진 ( Seong Jin Kim ),이승철 ( Seung Chul Lee ),원영호 ( Young Ho Won ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.11
Juvenile xanthogranuloma (JXG) is a benign histiocytic proliferative disorder in which one, several, or occasionally numerous red to yellow nodules are present. The lesion may be present at birth, but usually arises in early infancy. Adult-onset xanthogranuloma differs clinically from juvenile xanthogranuloma in that the lesion is usually solitary, does not involve internal organs and generally does not resolve spontaneously. We report a case of multiple xanthogranuloma in an adult which occurred on the scalp, face and trunk of a 37-year-old. This report describes the clinical, histologic and immunochemical findings of xanthogranuloma that mimic malignant melanoma. (Korean J Dermatol 2007;45(11):1191∼1194)
급성 골수성 백혈병에서 이식 편대 숙주반응 치료 중 발생한 노르웨이 옴
임세웅 ( Se Woong Lim ),윤숙정 ( Sook Jung Yun ),최우연 ( Woo Yeon Choi ),백희조 ( Hee Jo Baek ),국훈 ( Hoon Kook ),이지범 ( Jee Bum Lee ),김성진 ( Seong Jin Kim ),원영호 ( Young Ho Won ),이승철 ( Seung Chul Lee ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8
Norwegian scabies is a crusted non-itchy rash caused by massive infestation with the mite Sarcoptes scabiei. It is usually associated with immunosuppression or neurologic impairment, although it has rarely been reported in normal persons. We report a case of Norwegian scabies in 6-year old girl with acute myeloid leukemia associated graft-versus-host disease. The lesion showed pruritic, hyperkeratotic scaly plaques and fissures on the entire body. Application of a mineral oil preparation from hyperkeratotic areas showed numerous scabies mites. Treatment with 10% crotamiton cream for two weeks resulted in marked regression of the skin lesions, but finally she died of sepsis due to deterioration of her systemic conditions. (Korean J Dermatol 2007;45(8):836∼839)
환자 피부 비늘 및 임상주에서 이중 중합효소 연쇄반응(Nested PCR)을 이용한 Malassezia 균종의 동정
임세웅 ( Se Woong Lim ),신명근 ( Myung Geun Shin ),임주영 ( Ju Young Lim ),윤숙정 ( Sook Jung Yun ),김성진 ( Seong Jin Kim ),이승철 ( Seung Chul Lee ),원영호 ( Young Ho Won ),이지범 ( Jee Bum Lee ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.4
Background: Due to recent identification of new Malassezia (M.) species, M. dermatis, and M. equi, the genus Malassezia was revised into eleven species that have been isolated from human and animal skin. This has further substantiated the need for molecular techniques to distinguish the various Malassezia species. Objective: We aimed to make the nested polymerase chain reaction (PCR) using species-specific primers with specificity and sensitivity as a diagnostic tool for differentiating the various Malassezia species from skin scales and fungal cells rapidly and accurately. In addition, we evaluated the common causative Malassezia species in the patients with seborreheic dermatitis, pityriasis versicolor or pityrisporum folliculitis. Methods: Malassezia species-specific primers were designed based on DNA sequencing of the ribosomal RNA gene. The standard strains of eight members of the genus Malassezia such M. pachydermatis, M. furfur, M. sympodialis, M. globosa, M. obtuse, M. restricta, M. slooffiae, and M. dermatis were used for positive control. Each Malassezia species was cultured separately and two or three standard species were cultured together on Modified Leeming and Notman agar (MLNA) media plates. In addition, twenty-five clinical strains of Malassezia species isolated from the skin of patients with dermatological conditions and twenty-three samples of skin scale were used as well. Results: The nested PCR assay with primers for all eight Malassezia species were species-specific since it amplified DNA only from the target Malassezia species, and could differentiate mixed, that is, the two or three Malassezia species of all standard strains grown on MLNA medium precisely. Detection of Malassezia species from clinical strains and patient skin scales using the nested PCR assay was 96% (24/25) and 87% (20/23), respectively. M. globosa, M. sympodialis, M. restricta were the most common causative Malassezia species in patients with pityriasis versicolor, pityrosporum folliculitis, seborrheic dermatitis, respectively. Conclusion: Nested PCR using species-specific primers is useful and reliable in the detection of various Malassezia species from patient skin scales as well as cultured fungal cells. (Korean J Dermatol 2008;46(4):446~452)