레티노이드와 PUVA 병합요법으로 호전된 균상식육종 치험

공수득 ( Soo Deuk Kong ),김병천 ( Byung Chun Kim ),이규석 ( Kyu Suk Lee ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.4

급성 림프구성 백혈병환자에서 발생한 원발성 피부 아스페르길루스증

공수득(Soo Deuk Kong),김병천(Byung Chun Kim),이규석(Kyu Suk Lee) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.8

N/A

수포성 전신성 홍반성 루푸스

공수득,구본식,김병천,이규석 ( Soo Deuk Kong,Bon Sik Koo,Byung Chun Kim,Kyu Suk Lee ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.3

Vesiculobullous eruptions are a rare cutaneous manifestation of systemic lupus erythematosus (SLE). They are related to intense inflammation within the cutaneous lesions and subsequent blister formation. We report a case of vesiculobullous eruption of SLE in a 23-year-old male. The bullous eruptions were present ori the lip, forehead, both feet and hands. He met ARA(American Rheumatism Association) is criteria for a diagnosis of SLE and the eruptions developed during a systemic attack of the disease. Routine histology of the lesion showed subepidermal blisters with intact epidermis and dense neutrophilic infiltration in the upper dermis. Direct immunofluorescence of lesional skin showed a linear-granular pattern of immune deposits at the dermoepidermal junction. Electronmicroscopy of the lesional skin showing subepidermal bullae are located beneath the lamina densa. Combination therapy of prednisolone and hydrochloroquine showed complete clearing of the lesions within several weeks. We observed a good response without evidence of recurrence. (Kor J Dermatol 1997;35(3): 588-592)

냉동 외과술과 Q-switched Alexandrite 레이저로 병용 치료한 오타 모반 치험 1예

이규석,구본식,공수득 대한피부과학회 1998 大韓皮膚科學會誌 Vol.36 No.6

Ota's nevus is a mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly occurs unilaterally in areas innervated by the first and second division of the trigeminal nerve. We report a case of Ota's nevus treated by combination therapy with cryosurgery and a Q-switched Alexandrite laser. A 48-year-old female had had a type III Ota's nevus from birth. Cryosurgery was tried at first using hard chalk dry ice on the lesion of the forehead and cheek. After that, The Q-switched Alexandrite laser was used three times at twelve week intervals at the site of the eyelid. Good therapeutic effects were gained and our patient was very satisfied. There were no complications or scarring. A Biopsy of the area treated revealed a similar histological pattern with significantly less melanin indicating melanin removal. Combination therapy with cryosurgery and an Alexandrite laser on the Ota's nevus may be cheaper, more effective and a safer method. It may also reduce the limitation of the two methods when used individually.

Interleukin-1B와 Interleukin-10 이 탄력소 유전자 발현에 미치는 영향

이규석,최동원,송준영,공수득 대한피부과학회 1999 대한피부과학회지 Vol.37 No.7

Background: Elastic fibers are a major fibrillar component of the extracellular matrix of several organs, and their presence provides elastic properties to these tissues. Recent molecular biological studies also have revealed that accumulation of elastotic material in the skin reflects enhanced synthesis of not only elastin but also a fibrillin, an integral component of the elastic fibers, and steady-state levels of the elastin mRNA increased in photodamaged skin. Futhermore, a variety of cytokines, growth factors, and hormones have been shown to modulate elastin gene expression including transforming growth factor-�, tumor necrosis factor-�, insulin-like growth factor-I, glucoreorticoids, cyclic AMP, and vitamin D3. Recently, interleukin-1� (IL-1�) and IL-10 has been shown to up-regulatory function in elastin gene expression. Objective: The purpose of this study was to examine the effect of IL-1� and IL-10 on elastin gene expression in cultured human fibroblasts. Methods: Fibroblasts cultures were produced with DMEM medium. Cells were treated with IL-1� (1U/ml, 10U/ml) and IL-10(0.1ng/ml, 1ng/ml, 10ng/ml) nuclear proteins were extracted. Effect of IL-1� and IL-10 on elastin gene expression were measured by Northern blot analysis, chloram- phenicol acetyltransferase(CAT) assay, and laser confocal microscopy. Results: In Northern blot analysis, IL-1� and IL-10 showed an up-regulatory effect on elastin mRNA steady-state levels compared with controls incubated without IL-1� and IL-10. In CAT assay, the percentage of acetylation were increased in cultured fibroblasts. The promoter activities were increased 1.5 and 2.2-fold in IL-1� (1U/ml, 10U/ml) and 2.2-fold in IL-10(lng/ml, 10ng/ml) treated fibroblasts compared to control groups. In laser confocal microscopy, the results indicated significant increase in the elastin epitopes associated with the cells in cultured with IL-1� and IL-10. Conclusion: These results show that IL-1� and IL-10 increase elastin gene expression on transcriptional and protein levels of cultured fibroblasts. It suggests that they may effect on elastin synthesis by a stage up-regulater in human skin.

Q-switched Alexandrite 레이저를 이용한 오타모반 및 문신의 치료효과

이규석,류영욱,공수득,김병천,박재홍 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.1

저자들은 1997년 6월부터 1998년 12월까지 1년6개월간 계명대학교 동산의료원 피부과에서 여자 65명과 남자 31명 모두 96명의 오타모반 환자 및 문신환자를 대상으로 Q-switched alexandrite laser로 치료하여 89%의 예에서 good(51-95%)의 호전을 보여 매우 빠른 치료효과를 보았다. 이에 Q-switched alexandrite laser가 오타모반 및 문신제거 치료에 매우 효과가 있다고 사료된다. PURPOSE : The purpose of the study is to evaluate the clinical effect of the Q-switched alexandrite laser in the treatment of Ota's nevus and tattoo. MATERIAL AND METHODS : Ninety-six patients with Ota's nevus and tattoo were treated with a Q-switched alexandrite laser (model TL-1, Candela Laser Corporation. Wayland. U.S.A). The effects were examined by further photographs and telephone follow-up. The response was expressed as the percentage area cleared of the lesion. The clearance was graded as follows: clear, >95% ; excellent, 76-95% ; good, 51-75% ; fair, 26-50% ; poor <25%. The occurrence of adverse events was also examined. RESULTS : Treatment with energy that ranged from 6.0-10.0J/cm2 was given on average 1.8 times and 89% improvement was seen. No patient had permanent textual changes or scarring. CONCLUSION : The Q-switched alexandrite laser is an effective treatment for nevus of Ota's and tattoo with a low incidence of significant adverse effects and provides excellent cosmetic results.

호지킨씨 림프종 환자에서 발생한 Disseminated Herpes Zoster 1례

송준영,구본식,이규석,권호준,송홍석,공득수,허규찬 啓明大學校 醫科大學 1996 계명의대학술지 Vol.15 No.3

Herpes zoster is acute viral infection characterized by vesicular skin lesions which are usually distributed over several unilateral adjacent sensory dermatomes. In about 2% to 5% cases of zoster, hematogenous dissemination of virus apparently occurs. Among the associated malignancies, hematologic malignancy including Hodgkin's lymphoma, acute lymphocytic leukemia, and immunocompromised patient were frequently associated. We described the clinical manifestation of disseminated herpes zoster in patient with Hodgkin's lymphoma. A 15-years-old male patient was presented with painful grouped visicles on an erythematous base on left temporal head, right back, and right forearm. Tzanck smear revealed multinucleated giant cells, and histopathologic findings were consistent with herpetic infection. Moreover, Herpes Zoster Virus specific 220 KDDNA fragment was detected in PCR performed with vesicular fluid. Herpes Zoster Virus specific 220 KDDNA fragment was detected in PCR performed with vesicular fluid. He was successfully treated by administration of acyclovir without any significant complications.

모낭염 및 농가진 임상 양상을 보인 범발성 Trichophyton Rubrum 감염증 1례

구본식,김병천,김창욱,이규석,공수득,송준영 啓明大學校 醫科大學 1996 계명의대학술지 Vol.15 No.3

Trichophyton rubrum is anthropophilic, Ectothrix, and the most common dermatophyte of a man. The characteristic lesions are one or more circular, sharply circumscribed, slightly erythematous, dry, scaly, patches with elevated border. Other variants are reported, such as granulomatous, bullous or verrucous, versicolor like lesions. We present a case of Trichophyton rubrum infection presenting as folliculitis and impetigo in a 32 years old male who have been treated with Prednisolone (90mg/day) for minimal change nephrotic syndrome. The skin lesion showed widely distributed scaly plaques, crusts and plaques, crusts and pustules mimicking folliculitis and impetgo. On KOH mount and PAS stain, fungal hyphae were noted and Trichophyton rubrum was isolated on the fungus culture. He was successfully treated by application of itraconazole topical ointment for 6 weeks without recurred lesions.