융합성 망상 유두종증의 병인에 있어 세균과의 관련성에 관한 연구

이현태 ( Hyun Tae Lee ),정태안 ( Tae Ahn Chung ),권경술 ( Kyung Sool Kwon ),장호선 ( Ho Sun Jang ),오창근 ( Chang Keun Oh ) 대한피부과학회 1998 大韓皮膚科學會誌 Vol.36 No.1

Background: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. Objective : The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. Methods : We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. Results : 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. Conclusion : Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects. (Korean 1 Dermatol 1998;36(1): 78-85)

황색종에 대한 임상 및 병리조직학적 관찰

이현태,권경술,장호선,정태안,오창근 ( Hyun Tae Lee,Kyung Sool Kwon,Ho Sun Jang,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5

Background: Xanthomas consist of localized infiltrates af lipid-containing histiocytic foam cells that are usually found within the dermis or tendons. They frequently arise in the presence of a disturbance of lipid metaholism. Objective : The purpose of this study was to elucidate the clinical and histopathological characteristics of xanthomas. Methods : Eighteen cases of xanthoma confirmed clinically and histopathologically were ana lyzed. Xanthelasma was excluded in this study. Results : The results were summarized as follows. 1. The incidence of xanthoma was 0.03% of the total number of dermatologic patients. 2. The ratio between male and female was 1:2.6 and the age distribution varied from 2 to 65 years old(mean age : 37.4 years-old), and the distribution of age of onset was from birth to 62 years old(mean age of onset: 32.9 years old). 3. The frequencies of elinical types, in descending order, were xanthoma tuberosum(XT) 44.4%, xanthoma planum(XP) 27.8%, Xanthoma eruptivum(XE) 22.2%, and xanthoma striatum palmare (XSF) 5.6 % . 4. The common sites were the knee, elbow and buttock in XT; The upper and lower extremities in XE, the cheek, neck and chest in XP; palmar creases in XSP. 5. Serum lipid abnormalities were detected in 88.9%(16/18). 6. The associated diseases were hypothyroidism, diabetes, hepatomegaly, psoriasis. 7. A family history was significant in 2 patients with XT. 8. The associated hyperlipoproteinemia was type IIa(4/8), IIb(2/8), III(1/8), IV(1/8) in XT, type IIa(2/5), IV(2/5) and normolipoproteinemia(1/5) in XP, type I(1/4), IV(1/4), V(1/4) and normolipoproteinmia(1/4) in XE, type III(1/1) in XSP, respectively. 9. Diet, alone or combination with antilipidemic drugs were used for treatment, and the lesions were cleared in 2(one XP and one XE) of 7 patients that could be followed up. 10. Histopathological features revealed that lipid-laden foamy histiocytes were observed in all cases of xanthomas and foreign body giant cells were more common than Touton giant cells. Conclusion : Xanthomas were not so common disorders compared with the incidence of hyperlipoproteinemia and were more common in females than males. The most common clinical type was XT except for xanthelasma. The most common associated hyperlipoproteinemia in each type of xanthoma was type II in XT, type IIa and IV in XP, variable types in XE, type III in XSP, respectively. Lipid-laden foamy histiocytes were observed in all cases of xanthomas and for eign body giant cells were more common than Touton giant cells. (Korean J Dermatol 1997;35(5): 940-946)

각화 극세포종과 편평 세포암에서 TGF - βs 발현에 관한 면역조직화학적 연구

권경술,이현태,장호선,정태안,오창근 ( Kyung Sool Kwon,Hyun Tae Lee,Ho Sun Jang,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5

Background: Because of the clinical and histological similarities of keratoacanthoma(KA) and squamous cell carcinoma(SCC), it is often difficult to differentiate. Transforming growth factor-bs (TGF-bs) are the multifunctional peptides that regulate the cellular growth and differentiation. It has been known that the isoforms of TGF-b(TGF-b1, TGF-b2, TGF-b3) are differently expressed in human cancers such as basal cell carcinoma, pancreatic cancer, thyroid cancer, etc. Objective : The purpose of this study was to examine the expression patterns of TGF-b isoforms on KA and SCC using the immunohistochemical staining method with anti-TGF-bs antibodies and to evaluate the usefulness of this method in distinguishing each other. Methods : We performed immunoperoxidase staining(LSAB technique) using polyclonal anti-TGF-b1, b2, and b3 antibodies from the formalin-fixed, paraffin-embedded biopsy specimens obtained from 11 patients with KA, 11 pntients with SCC, and 10 healthy volunteers. Results : In the normal skins, TGF-b1, b2 and b3 were almost negative or only weakly positive in the epidermis, whereas TGF-b3 was moderately to strongly positive in the suprabasal layer. In KAs, the expression patterns of TGF-b1, b2, and b3 were similar to those of the normal skins. In SCCs, however, the expression of TGF-b1 was increased and TGF-b3 was decreased compared with the normal skins. Conclusion : In these results, the immunohistochemical staining using the anti-TGF-bs antibodies, especially anti-TGF-b1 and b3, can be used for the differentiation of KA and SCC. Also, it can be suggested that the charige of expressions of TGF-b isoforms in the epidermis may play an important role in the carcinogenesis of SCC. (Korean J Dermatol 1997;35(5): 863-869)

카포시 육종과 동반된 Idiopathic CD4 + T Lymphocytopenia

이현태,장호선,권경술,정태안 ( Hyun Tae Lee,Ho Sun Jang,Kyung Sool Kwon,Tae Ahn Chung ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

Idiopathic CD4+ T lymphocytopenia(ICL) is a new disease entity characterized by depletion of helper T cells apparently without any evidence of HIV infection. We report a case of ICL associated with Kaposis sarcoma(KS) and pneumocystis carinii pneumonia(PCP) in a 34-year old woman. She developed violaceous, protruding masses on scalp, back, both extremities, palms, soles, left. first toe and peritonsillar region for 2 months. These lesions were confirmed as KS by histopathologic findings. Chest X-ray and HRCT findings represented PCP and KS. Absolute deficiency of CD4+ T cell was detected in the count of T cell subsets. Serologic tests for HIV-1, 2 and HTLV I, -II were negative. And she was absent any defined immunodeficiency or therapy associated with decreased levels of CD4+ T cells. By CDC criteria, a diagnosis of ICL was made. Because of aggravation of PCP and lung involuement of KS, she died at 22nd day after admission. (Kor J Dermatol 1997;35(1): 191-195)

전두부에 발생한 다발성 피지선암

이현태,장호선,권경술,정태안,오창근 ( Hyun Tae Lee,Ho Sun Jang,Kyung Sool Kwon,Tae Ahn Chung,Chang Keun Oh ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Sebaceous carcinoma is a rare, aggressive, malignant tumor derived from the adnexal epithelium of sebaceous glands. This tumor occurs most frequently on the eyelids, but may occur on the extraoccular sites. Clinically, it is presented as a solitary tumor in most cases and very rarely as multiple ones. We report a case of multiple. sebaceous carcinomas on the frontal region in a 73 year-old man. He had well-demarcated, reddish, asymptomatical, protruding masses on the frontal region for 2 months. The histopathologic findings showed irregular, variable sized, lobular tumor nests of the entire dermis, and each lobule was composed of foamy cytoplasmic atypical cells and undifferentiated cells containing, eosinophilic cytoplasm. He was treated with surgical excision and no recurrence was observed during 6 months. (Kor J Dermatol 1997;35(4): 824 - 829)