Neuroimmunological pathophysiology of pruritus

최지호 ( Jee Ho Choi ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

피부를 침범한 비강 원발성 CD56 양성 T/NK-세포 림프종의 임상 및 병리조직학적 고찰

최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh),장성은(Sung Eun Chang),윤길숙(Ghil Suk Yoon),허주령(Joo Ryung Huh) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.6

Background:There are recently increasing reported cases of patients with malignant lymphoma with unique characteristics, designated nasal-type T/natural killer (NK) cell lymphoma (NKTL), which usually expresses the NK cell marker and shows frequent extra-nodal involvement including skin and poor prognosis. The CD56+ NKTL can be divided into nasal and non-nasal types. Nasal and non-nasal (nasal type) CD56+ NKTL share the same pathologic features such as angiocentricity and necrosis. Objective:We have studied clinicopathologic features of 5 cases of nasal CD56+ NKTL with cutaneous involvement to further elucidate the behaviour of nasal CD56+ NKTL. Results:Clinically, the cutaneous lesions were variable. Four of the five cases died with rapidly progressive disease within 25 months. Histologically, variable sized pleomorphic lymphoid cells with or without prominent angiodestruction were observed. Severe necrosis was consistent features. The results of immunophenotypes(both CD56+ and CD3+) and TCR gene rearrangement study showed these 5 cases are of NK cell origin(4 cases) or NK-like T-cell origin (1 case). A firm association with Epstein-Barr virus (EBV) infection was confirmed in our study. Conclusion:Although the prognosis of nasal CD56+ NKTL was not so bad, higher stage of nasal CD56+ NKTL with cutaneous metastasis seemed to be very fatal. The term NKTL has to be further specified according to immunophenotypes such as CD56+ or true T-cell, NK-like T cell lymphoma since biologic behaviour of each subgroup can be different. (Korean J Dermatol 2000;38(6):713~720)

Cross-sectional study to assess the clinical profile of psoriatic patients in Korea

최지호 ( Jee Ho Choi ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Psoriasis is associated with serious physical, psychological and sociofunctional disorders, as well as increased medical cost and reduced productivity, having a major impact on health-related quality of life (HRQoL). The United States and several countries in Europe recently conducted HRQoL survey among psoriatic patients, but national large-scale study on clinical profiles of psoriatic patients, including their HRQoL, has not been studied in Korea. Objectives: This nationwide cross-sectional study was aimed at determining epidemiologic characteristics of psoriasis, disease severity and HRQoL among psoriatic patients in Korea. In addition, we also investigated demographic, disease-specific, socio-economic, therapeutic and clinical factors that may affect disease severity and HRQoL of psoriatic patients in Korea. Methods: This study was conducted from February 2013 to June 2013 in psoriatic patients, aged 20 or older, recruited from 25 centers across the country. Data were collected on demographic factors, such as age, sex, height, body weight, and waist circumference; disease-specific factors, such as PASI score, BSA, onset age, clinical types, area of lesion, family history, and past and present medical history; drinking and smoking histories; presence of comorbidity (blood pressure, CRP, LFT, BUN, creatinine, fasting glucose, TG, total cholesterol, HDL-C, LDL-C); and the rate of patients suggesting psoriatic arthritis (PASE questionnaire). SF-36, DLQI, WPAI:PSO, and MSQ were used to determine HRQoL of psoriatic patients. Statistical significance was analyzed by ANOVA, Kruskal-Wallis test, student`s t-test, chi-square test, and Fisher`s exact test. Results: 1,278 psoriatic patients were enrolled and 1,260 of them completed the study. 749 (59.4%) were male and 511 (40.6%) were female patients (sex ratio, 1.47:1). Mean age was 47.1±14.5 years (range, 20-89 years); 24.9% were in their 50s, 22.3% were 40s, 20.1% were 30s, 12.6% were 20s, 12.1% were 60s, and 7.9% were 70s. Onset age was below 30 in 33.8%, 30 and older in 66.2%; the percentage was greatest among 20s (22.4%), followed by 30s (19.8%), 40s (18.7%), 50s (14.7%), teens (11.4%), 60s (7.1%), 70s (3.3%), and below teens (2.6%). Mean duration of psoriasis was 109.2±122.0 months (range, 1.0-825). Mean BMI was 23.9±3.5 kg/m2. 602 (47.8%) were current drinkers; 389 (30.9%) were current smokers and their mean duration of smoking was 19.9±10.7 years. Mean PASI score was 7.5±7.1; 75.6% were less than 10 points, 18.4% were between 10 and 20 points, and 6.0% were 20 points or beyond. Mean BSA was 13.1±14.6%; 21.2% were below 3%, 41.4% were 3-10%, and 37.4% were 10% or beyond. Mean DLQI score was 12.0±7.2; 21.2% were 5 points or below, 24.7% were between 6 and 10 points, and 54.1% were 11 points or higher, indicating that more than half of the psoriasis patients had their quality of life severely affected by psoriasis. Mean SF-36 score was 48.8±8.0 for PCS and 42.6±11.2 for MCS. WPAI:PSO results were 6.4±15.1% for absenteeism, 28.9±27.5% for presenteeism, 31.6±28.3% for TWPI and 37.2±30.0% for TAI. Mean PASE score was 33.7±13.1; symptom subscale was 16.1±6.1 points and function subscale was 17.6±7.7 points. 301 (24.0%) out of 1,255 patients had PASE score 44 points or higher, suggesting active psoriatic arthritis. Patients were not satisfied with treatments in 16.1%, neutral in 25.3%, and satisfied in 58.6%. Clinical type of psoriasis was plaque type in 1,081 patients (85.8%), guttate in 106 (8.4%), pustular in 66 (5.2%), erythrodermic in 44 (3.5%), and others in 28 patients (2.2%). Systolic BP was 140mmHg or higher in 12.9% and diastolic BP was 90mmHg or higher in 15.2% of patients. Waist circumference was 90cm or beyond in 38.5% of male patients and 85cm or beyond in 29.1% of female patients. The rate of patients with greater-than-normal fasting glucose, TG, total cholesterol, LDL-C, creatinine, and CRP level was 27.6%, 23.4%, 27.5%, 27.0%, 10.5%, and 18.6%, respectively. When patients were categorized to mild (<10), moderate (10-20), or severe (>20) groups according to their PASI score, the more severe, the higher their mean DLQI was, with significant difference among each group (p<0.001). PCS and MSC of SF-36 were both significantly lower in the severe group compared to the other groups (p<0.001). The duration of psoriasis was also significantly different among the three groups (p=0.0175); the mild group had significantly shorter duration than the other two groups. Onset age was significantly different between mild group and moderate- severe group, and psoriasis was more severe among the patients with onset age of below 30 than those with onset age of 30 or older (p=0.0196). Medical cost was significantly higher in the severe group than in the mild group (p=0.0398). According to WPAI:PSO test, the severe group had significantly higher absenteeism than the other two groups (p=0.0066). Presenteeism and TWPI were significantly different among the three groups, with increasing tendency toward the severe group (p<0.0001 for all comparison). TAI was significantly lower in the mild group compared to the other two groups (p<0.0001). As for PASE, total score, symptom score, function score and the number of patients with 44 points or higher were all significantly higher in the severe group than in the other two groups (p=0.0001, p=0.0005, p=0.0001, and p<0.0001, respectively). The severe group had significantly higher systolic and diastolic BPs than the mild group (p=0.0007 and p=0.0006, respectively), significantly greater waist circumference than the mild group among female patients (p=0.0172), and significantly higher glucose and TG than the mild and moderate groups (p=0.0008 and p=0.0411, respectively). Conclusion: This is the first nationwide survey of psoriatic patients in Korea and shows epidemiologic characteristics and clinical profiles of Korean psoriatic patients. Psoriasis also has a profound impact on quality of life including physical and psychological well-being in Korean patients. *Support: This study was conducted with support from Janssen Korea Ltd.

구강내 궤양에서의 중합효소 연쇄반응을 이용한 단순포진 바이러스 DNA의 검색

최지호(Jee Ho Choi),김성범(Seong Beom Kim),이승철(Seung Chul Lee),서대헌(Dae Hun Suh),성경제(Kyung Jeh Sung),고재경(Jai Kyoung Koh) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.1

Background : The oral ulcer is a common oral disorder, but the precise etiology remains elusive despite of intensive clinical, immunological, hematological and microbiobgi,al investigations. Objective : The purpose of his study was to examine oral ulcers

Th17 immune response (초)

최지호 ( Jee Ho Choi ) 대한피부과학회 2009 초록집 Vol.47 No.20

피부과 영역에서의 레이저

최지호 (Jee Ho Choi) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.2

레이저의 기본 개념은 1917년 아인슈타인에 의해서 처음 기술되었으며 1960년대부터 의학 분야에 치료 목적으로 이용되기 시작하여 최근에는 다양한 종류의 레이저가 개발되어 사용되고 있다. 피부과 영역에서 현재 사용되고 있는 레이저는 이산화탄소 레이저(CO_2 laser), 색소 레이저(Dye laser), 구리증기 레이저(Copper vapor laser), Nd:YAG 레이저(Neodymium:Yttrium-Aluminum-Garnet laser), Q-switched 루비 레이저(Q-switched ruby laser). 아르곤 레이저(Argon laser), 알렉산드라이트 레이저(Alexandrite laser), He-Ne 레이저(Helium-Neon laser) 등이며 피부 혈관성 병변, 색소성 피부질환, 문신 및 양성 피부 종양의 제거에 이용되고 있다. 본 종설에서는 레이저의 특징, 생체조직과의 상호작용, 피부과에서 사용되고 있는 레이저의 특성 및 각종 피부질환의 치료에 대한 레이저의 응용, 레이저 치료시의 주의사항 등에 대하여 언급하고자 한다. The basic concept of the laser was first described by Einstein in 1917. Laser is an acronym for “Light Amplification by Stimulated Emission of Radiation”. The applications of laser light to the field of medicine were begun in 1960s. Since that time there has been a great increase in the development of laser technology and in the understanding of laser-target tissue interactions. The theory of selective photothermolysis means that a chromophore can be selectively damaged with a laser light of an appropriate wavelength and of a suitably short pulse duration that is shorter than the thermal relaxation time of the chromophore. The introduction of pulsed tunable dye lasers has considerably improved the treatment of vascular lesions, particularly light pink nevus flammeus in children. The argon pumped dye laser and copper vapor laser may be better for telangiectatic and the hypertrophic nevus falmmeus often seen in adults. Since the Q-switched and pulsed green light lasers are capable of selective photothermolysis of melanosomes and tattoo dyes, their efficacy has lasers are capable of selective photothermolysis of melanosomes and tottoo dyes, their efficacy has been under investigation for the treatment of pigmented lesions. The automated delivery of laser light and the risk of scarring is reduced. Further comparative study is needed to determine which lesions respond best to each laser system, and which treatment techniques are optimal. Treatment combining more than one of these laser systems may prove superior to any of them used alone.(Korean J Dermatol 1994;32(8):205~216)

중합효소 연쇄반응을 이용한 다형홍반 피부병변에서의 Herpes Simplex Virus DNA 검색에 관한 연구

최지호 (Jee Ho Choi) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.3

Herpes simplex virus(HSV) infection has long been considered as a cause of erythema multiform(EM), especially the recurrent type, although its exact role in the pathogenesis of herpes-associated erytherna multiforme(HAEM) is unknown. In this study, HSV DNA was detected in 8 of 29 cases of EM by the polymerase chain reaction(PCR) and in 19 of 29 cases by Southern blot hybridization with PCR products. In 4 cases of EM, we performed PCR & Southern blot hybridization in both lesional and normal skin. HSV DNA was found in 3 of 4 cases of lesional skin but not detected in normal skins by Southern blot hybridization with PCR products. These results confirm the presence of HSV DNA in lesions of HAEM and support the concept of and HSV-specific immune-mediated pathogenesis for this disease. (Kor J Dermatol 1992; 30(3): 325-333)

Th17 immune response

최지호 ( Jee Ho Choi ) 대한피부과학회 2009 대한피부과학회 학술발표대회집 Vol.61 No.2

좌측 전이개부 및 협부에 발생한 Accessory Auricles

최지호(Jee Ho Choi),양준모(Joon Mo Yang),윤재일(Jai Il Youn),이유신(Yoo Shin Lee) 대한피부과학회 1983 대한피부과학회지 Vol.21 No.4

Accessory auricle is a relatively rare congenital anomaly arised from the abnormaI development of the auricular tubercles or from the tissues surrounding the second, third and fourth branchial clefts. Clinically this anomaly is a small akin-colored tag or nodule, soft and globular or cartilaginous consistency on or near the tragus along a line drawn from the tragus to the angle of the mouth or along the anterior margin of the sternomastoid muscle. The lesion is usually solitary and located in the preauricular area but may be multiple and rarely bilateral. We present a typical caae of accessory auricles in 4-day-old female infant. The patient had two skin-colored firm nodules on the left preauricular area and well pedunculated one on the Ieft buccal area near the angle of the rnouth. Histopathologic find.ings showed numerous pilosebaceous units, abundant subcutaneous fat and cartilage tissue in the center of the lesion.

악성 농피증

최지호(Jee Ho Choi),윤재일(Jai Il Youn),이유신(Yoo Shin Lee) 대한피부과학회 1984 대한피부과학회지 Vol.22 No.4

Malignant pyoperma is a rare, chronic, progressive, destructive ulcerating skin disease of unknown cause that affects the head and neck region of young adults. The disease is progressive but responds to high doses of systemically administered steroids. We present a case of malignant pyoderma developed on the left retroauricular area in 67 year-old male. The patient died of rapidly progressive, desructive, 15cm x 20 cm sized, phagedenic ulcer on the left retroauricular and neck area despite of various extensive local and systemic treatment. Histopathologic findings of tissue from the edge of the ulcer were non-specific, showing upper dermal necrosis and mixed inflammatory cell infiltrate in the deep dermis.