癩患者에서 Clofazimine 治療後 皮膚變化

鄭祥立,金仁珠 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.2

癩病 및 癩反應治療自的으로 clofazimine을 服用한 患者를 對象으로 皮膚色의 變化, 魚鱗癬樣皮膚의 發生 및 組織學的 變化를 관찰한 結果를 다음과 같이 要約한다. 對象患者는 總 102名으로 病歷期間은 10年 以上이 73例(71.6%)로 가장 많았으며 年齡은 40∼49歲가 30例(29.4%)로 가장 많았다. Clofazimine의 服用期間은 1∼2年이 41例(40.2%)로 가장 많았고 服用量은 癩病治療 目的인 경우가 34例(33.3%), 癩反應治療인 경우가 68例(66.7%)로 後者가 2倍나 많았다. Clofazimine 服用後 皮膚色의 變化는 2週부터가 53例(52.0%)로 가장 많았고 色素沈着은 4週부터가 49例(48.0%)로 가장 많았으며 大量服用할수록 빨리 나타났다. 各種 染色에 依한 病理組織學的인 變化로는 眞皮內에 황갈색의 結晶體와 脂肪物質을 볼 수 있었고 基底部에 melanin 色素가 增加되어 있었다. 魚鱗癬樣皮膚는 90例에서 發生하였으며 服用後 2個月부터가 37例(41.1%)로 가장 많았고 12例에서는 전혀 發生하지 않았다. Clofazimine (Lamprene or B663) is a phenazine congener that is used in leprosy, especially sulphone resistance and lepra reaction. Patients treated with the drug may develop red discoloration and dark brown pigmentation of the skin and ichthyosis. The author observed one hundred and two leprosy patients who had developed discoloration, pigmentation and ichthyotic skin after initiating clofazimine therapy, as well as the histopathological findings of those changes. The results are summarized as follows: The duration of the leprosy was mostly more than 10 years (71.6%). Males (75.5%) predominated over females (24.5%) by 3 times, and the highest incidence occurred in the age group between 40 and 49 years (29.4%). For 40.2% of the patients, the duration of the clofazimine treatment was between 1 and 2 years. The number of patients receving a higher dosage, 100-300㎎ per day, for control of a lepra reaction was two times more than those receiving a lower dosage, 300-400㎎ per week, for the general treatment of leprosy. Reddish discoloration was most frequently observed 2 weeks after beginning treatment in 53 patients (52.0%), and 12 of 14 patients who showed discoloration earlier(a week after treatment) were in the higher dosage group. Dark brown pigmentation was most frequently observed 4 weeks after beginning treatment in 49 patients (48.0%), and by the third month, 64 of 68 patients (94.1%) in the higher dosage group showed pigmentation compared to 25 of 34 patients (74.5%) in the lower dosage group. For histopathological evaluation of color-changed skin, various staining methods were used on unstained frozen sections, yellow brown crystals were scattered in the dermis of both discolored and pigmented skin, being more remarkable in the latter. With H & E stain, melanin pigments were markedly increased in the epidermal basal layer, and a faint yellow brown ghost was seen in the pigmented skin. With fat stains using oil-red-O and Sudan Ⅲ, reddish amorphous materials were scattered in and around the cytoplasm of the macrophages of the pigmented skin. Ichthyotic skin was observed in 90 patients, and most frequently 2 months after beginning treatment in 37 patients (41.1%), but it was never observed in 12 of all patients in spite of a continuous intake of the drug for more than a year, thus showing no significant difference between the different dosage groups.

月經週期와 관련된다고 推定되는 癩反應 1例

金仁珠,金成華,鄭祥立 大韓癩學會 1982 癩學 會誌 Vol.15 No.1

건선 병변부 및 병변주위부 피부의 Cytokines 유전자 발현

윤기성,김도원,정상립,김문규,김정철 경북대학교 병원 1997 경북대학교병원의학연구소논문집 Vol.1 No.1

It has been proposed that cytokines may be involved in mediating the characteristic pathological changes in psoriasis, including epidermal hyperplasia, compromised keratinocyte differentiation, and dermal and epidermal infiltration by polymorphonuclear leukocytes and mononuclear cells. The purpose of this study os to assess the pattern of cytokine gene expression in psoriatic skin lesion. To investigate the cytokine expression pattern, we examined the transcripts of cytokine genes using reverse transcription and polymerase chain reaction (RT-PCR) method with 13 cytokine-specific primers. The Results were as follow; 1. Only the TGF-β gene was expressed in the normal skin. 2. IL-1α, IL-1β, IL-8, and TGF-β were detected in both lesional and perilesional psoriatic skin. The lesions showed more prominent expression. 3. IL-10 and GM-CSF were weakly detectable in three lesional psoriatic skin respectively, and IL-2R in two lesional psoriatic skin. 4. IL-2,IL-4,IL-5,IL-6 TNF-α, IFN-γ were not detectable on both lesional and perilesional psoriatic skin. Therefore, distinct differences in the cytokines gene expression were noted between normal and psoriatic skin. The patterns of cytokines gene expression in perilesional skin were similiar to those of lesional psoriatic skin.

지루피부염에 대한 ketoconazole 샴푸의 효과

이석종,전재복,김도원,정상립 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.4

목적 : Pityrosporum ovale는 지루피부염의 발생에 중요한 역할을 하며 이 친지성 진균은ketoconazole제재에 감수성이 있다고 알려져 있다. 이에 저자들은 두피에 사용하기 편리한 2% ketoconazole 샴푸로 지루피부염을 치료하여 그 효과를 확인하고자 본 조사를 실시하였다. 대상 및 방법 : 두피의 지루피부염 환자 52명에게 소양감의 정도를 설문조사하고 피부과 의사의 육안으로 인설의 양을 검사한 후 광학현미경 고배율하에서 진균학적 검사를 실시하였다. 결과 : 지루피부염 환자의 소양감과 인설의 양은 치료전에 비해 치료 2주와 4주 모두에서 유의하게 감소하였으며(p<0.05) 이들 환자에서 실시한 Pityrosporum ovale의 평균 포자수 역시 치료전에 비해 치료 2주와 4주 모두에서 유의하게 감소하였다(p<0.05). 결론 : ketoconazole 샴푸는 지루피부염의 임상 및 진균학적인 면 모두에서 치료효과가 있는 것으로 판단되며 간접적으로나마 Pityrosporum ovale가 지루피부염의 발생에 관여한다는 사실을 알 수 있었다. It is suggested that Pityrosporum ovale may play an important role in the pathogenesis of seborrheic dermatitis and this organism is sensitive to ketoconazole compound. So the efficacy of 2% ketoconazole shampoo in the treatment of seborrheic dermatitis was tested and was calculated by mean scores of scale, itching and yeast cells. We interviewed fifty two patients with seborrheic dermatitis about the degree of itching and examined with naked eyes the scale of scalp of them. In a group of the patients, mycological study of P. ovale was also performed by direct smear with 20% KOH solution containng 1 : 1 Parker-ink^R The results were as follows : As for itching and scale of the scalp, the scores were significantly decreased at week 2 and week 4 as the duration of treatment prolonged in comparison with that of week 0. The mean yeast cell score at the two points of time was also significantly decreased in comparison with that of week 0. There was no significant difference in the response from the view of age, sex and duration of seborrheic dermatitis. It is suggested that the shampooing with ketoconazole 2% shampoo every three other days gave a good result clinically and mycologically.

개선 (疥癬) 에 있어서 직접면역형광법 (直接免疫螢光法) 의 관찰

정상립(Sang Lip Chung),오수희(Su Hee Oh) 대한피부과학회 1984 大韓皮膚科學會誌 Vol.22 No.4

There are many reports about the deposition of immunoglobulins and complement by direct immunofluorescence(DIF) in the lesion of scabies. The authors investigated the immunoglobulins and C, for the purpose of studying the immunologic reactivity of the host to scabies mites by DIF. The results are summerized as follows: Total number of the cases investigated were 20 (18 males, 2 females), of whom 11 were in their third decade of age. The clinical forms of the tested lesions were papular type (7 cases), nodular type (12 cases), and Norwegian type (1 case). The durations of the patients were mostly within 2 months, but was 9 months in 1 case of nodular type, Deposition of immunoglobulin and C, was demonstrated by DIF in 10 of 12 cases (83. 3%) of nodular type, and 1 of 7 cases (14. 3%) of papular type. The Norwegian type showed negative results. There seemed to be no relation between the duration of scabies and positive rates. Of 20 cases tested, immunoglobulin and C, were deposited in the vascular wall in 11 lesions (55%), and at the dermoepidermal junction in 3 lesions (15%). While in 1 of 7 cases of papular type both IgM and C, were observed, IgM and C, were noted in 7 and 9, respectively, in 12 cases of nodular type.

수종 악성종양 환자 및 정상인 혈청내의 표피세포질 항체에 관한 연구

정상립(Sang Lip Chung),서무규(Moo Gyu Suh) 대한피부과학회 1985 대한피부과학회지 Vol.23 No.6

For the purpose of studying the compiarson of normal persons with patients with malignant tumors, the author investigated the incidence of epidermal cytoplasmic antibodies (EC-Ab) with sera taken from 15 normal persons, 38 patients with malignant tumors, and 2 patients with miscellaneous disorders by method of indirect immunofluorescence. The results were as follow: 1) .Positive reactions of EC-Ab were found in 2(13%) of 15 normal persons and 9 (24%) of 38 patients with malignant tumors. 2)Incidence of positive reactions of EC-Ab in various types of malignant turnors were found in 3(75%) of 4 patients with lung cancer, 2(40%) of 5 patients with rectal cancer, 3(13%) of 24 patients with stomach cancer, and 1(100%) patient with Hodgkins lymphoma. 3) Among 9 patients with malignant tumors of positive EC-Ab, 5 patients yielded the upper epiderrnaI cytoplasrnic (UEC) antibodies, 3 patients the general epidermal cytoplasmic (GEC) antibodies, and 1 patient basal cell layer (BCL) antibody. 4) A.mong 9 patients with malignant tumors of positive, the deposition of IgG was discovered in 7 patients, IgA in 1 patient and C, in 1 patient.

건선 병변에 대한 직접 면역형광 검사의 관찰

정상립(Sang Lip Chung),강수찬(Soo Chan Kang) 대한피부과학회 1986 대한피부과학회지 Vol.24 No.5

In order to study immunological responses in psoriatic lesions, direct immunofluorescence(DIF) findings in stratum corneum of psoriatic lesions are compared with histopathological changes. The results are summerized as follows: 1) Deposition of Igs or C 3 in stratum corneum of psoriatic lesions was demonstrated in 14(56%) of 25 psoriasis patients. IgG was present in 40% IgA in 48%, IgM in 24%, and C 3 in 32%. However, DIF findings are negative in the str,atum corneum in the uninvolved skin of psoriasiis. In control groups of 12 cases of various skin diseases, DIF findings were negative in the stratum corneum except 1 case of a patient with acne rosacea. 2)DIF findings in 22 cases of histopathologic changes of psoriatic lesions were found in 50% of hyperkeratosis in 48% of parakeratosis in 50% of Munro microabscess, in 50%, of spongiform pustule, and in 57% of the absence of stratum granulosum: ie, about only 50% were positive in DIF results. Histopathologic changes in 11 cases of positive DIF finding in psoriatic lesions were hyperkeratosis in 100%, parakeratosis in 91%, Munro microabscess in 64%, spongiform pustule in 55%, and the absence of stratum granulosum in 73%.

건선환자와 정상인 혈청에서 각질층 항체 및 상부표피세포질 항체의 출현빈도에 관한 연구

정상립(Sang Lip Chung),서기석(Kee Suck Suh) 대한피부과학회 1988 大韓皮膚科學會誌 Vol.26 No.5

The authors investigated the incidence of stratum corneum and upper epidermal cytoplasmic antibodies with 30 untreated and 20 treated psoriasis sera, and normal human sera using normal human skins of 5 different sites and psoriatic lesion by the method of indirect immunofluorescence in order to evaluate immunologic responses i n psoreasis. The results are summarized as follows . I) The positivity of stratum corneum antibodies in untreated psoriasis sera(78.7%) was si, nificantly higher than that in normal sera(64.0%). The incidence of stratum corneum antibodies in untreated psoriasis sera was found to be the highest in the arm, followed by the scalp, leg, abdomen, and face as substrate. 2) The positivity of stratum corneum antibodies in psoriasis and normal human sera was significantly higher when tested with the psoriatic lesion as substrate than norma! skin as substrate, 3) The titer of stratum corneum antibodies in 5 sera using human skin obtained from 5 different sites on the body as substrate are the highest in the arm, and leg, and(in decreasing order of frequency) the scalp, abdomen, and face. 4) The positivity of upper epidermal cytoplhsmic antibodies in normal human sera (40.7%) was significa.ntly higher than that in untreated psoriasis sera(21.3%). 5) Ir.. the majority of cases, upper epidermal cytoplasmic antibodies coexisted with straturn corneum antibodies in the sera of patients with psoriasis and in the sera of normal humans.

청년기 지루피부염 환자의 아토피 증상 조직 조사 및 혈중 IgE치와 호산구수 측정

정상립(Sang Lip Chung),김도원(Do Won Kim),이석종(Seok Jong Lee),권순백(Soon Baek Kwon),장재원(Jae Won Chang) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.9

N/A Background : Seborrheic dermatits and atopic dermatitis are clinically different diseases, but symptoms and signs of atopic dermatitis often can be found simultaneously in patients with seborrheic dermatitis. Objective : The aim of this study was to investigate if patients with seborrheic dermatitis have the symptoms and sign of atopic dermatitis at the same time, and to measure the levels of serum IgE and eosinophil counts. Methods : Sevently eight patients with seborrheic dermatitis on the scalp and face, 64 patients with atopic dermatitis and 88 normal subjects were observed clinically by the dermatologist and studide statistically using questionnaires. Levels of total IgE and eosinophil counts were measured by blood sampling in the total number of subjects. Results : Among 20 items of the questionnaire regarding the symptoms and signs of atopic dermatitis, 6 items were more frequent in only the atopic patients than in the normal control, 2 items were more frequent in only the seborrheic dermatitis patients and 8 in both diseases. The mean levels of serum IgE in seborrheic dermatitis patients were lower than in atopic patients, but significantly higher than that of the normal control and 21.3% of those had IgE levels above the normal range. When we classified the seborrheic dermatitis patients according to the combined skin diseases, the mean levels of IgE were highest in the patients with dermatitis and male pattern bladness, but the value was not significant compared to that of the normal control. The mean levels of eosinophil counts in seborrheic dermatitis patients were higher than in the normal control, but it was not significant statistically. Conclusion : According to the results of the study, the patients with seborrheic dermatitis showed a higher incidence of symptoms and signs of atopic dermatitis and higher levels of serum IgE than the normal subjects. Further studies will be needed to elucidate the relationship between seborrheic dermatitis and atopic dermatitis. (Korea J Dermatol 1999;37(9) : 1269∼1275)

홍반성(紅斑性)루푸스에서의 Lupus Band Test 관(關)한 연구(硏究)

정상립 ( Sang Lip Chung ),김성화 ( Sung Hwa Kim ) 대한피부과학회 1983 大韓皮膚科學會誌 Vol.21 No.6