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노태경 ( Tai Kyung Noh ),허식 ( Sik Haw ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.11
Background: Dermatologic comorbidities can be the clue for the diagnosis and treatment of systemic conditions and a need for dermatological expert opinion is increased. Objective: To analyze the patterns and to quantify the dermatologic consultations referred by the department of obstetrics and gynecology (OBGY). Methods: We retrospectively studied the data from 479 cases referred by OBGY for a dermatologic consultation during a three-year period in a tertiary hospital. Results: The most common skin disorder was pregnancy-related dermatoses (29.77%) in obstetric inpatients, while cutaneous infection (33.33%) was the most frequent in gynecologic inpatients. The distribution of the skin disorders in consulted OBGY inpatients was consistent with the previous reports. However, there were some differences, such as high proportion of infectious disease. Infectious skin diseases were significantly more frequent (p<0.001) in the chemotherapy group of gynecologic inpatients compared to that of the non-chemotherapy group, viral infection being the most common. In addition, superficial fungal infection accounted for the same proportion as the viral infection (37.50% each) among obstetrical inpatients. Maculopapular or urticarial eruption (51.52%) was the most common type of chemotherapy-related adverse drug reaction. Conclusion: This study revealed the distribution of skin disorders in patients referred by OBGY for dermatologic consultation. Furthermore, it could be helpful as an educational material to assist cooperation between dermatology and OBGY. (Korean J Dermatol 2012;50(11):951∼958)
원발성 피부 변연부 B-세포 림프종으로 오인된 피부 Rosai-Dorfman Disease
노태경 ( Tai Kyung Noh ),원광희 ( Kwang Hee Won ),이도영 ( Do Young Rhee ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.10
Rosai-Dorfman disease or sinus histiocytosis with massive lymphadenopathy is an idiopathic, benign, histiocytic proliferative disease involving lymph nodes and extranodal sites. A 52-year-old woman presented with a 2-year history of multiple non-tender, erythematous nodules on her face. The initial punch biopsy showed lymphoid follicle-like aggregation of CD20 positive lymphocytes in the papillary dermis consisting of primary cutaneous marginal zone B-cell lymphoma. She underwent a 3-month course of radiotherapy, but the lesions progressed. The re-biopsy specimen revealed marked histiocytes with positive CD68 and S-100 proteins. The patient was treated with prednisolone and isotretinoin to which she responded slightly. Repeated histopathologic examinations enable us to make a definite diagnosis. Differentiating these two disorders as early as possible is crucial for appropriate treatment. (Korean J Dermatol 2013;51(10):809∼813)
Connective and bullous diseases
노태경 ( Tai Kyung Noh ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
I. Connective tissue diseases A. Lupus erythematosus i. Pathogenesis : HLA association, drugs ii. Clinical findings iii. LE-specific/LE-nonspecific skin disease 1. acute/subacute/chronic cutaneous LE 2. subtypes of CCLE 3. drug-induced LE, neonatal LE iv. Autoantibodies High disease specificity for SLE: dsDNA (LE nephritis), Sm, rRNP (CNS LE), PCNA v. Histopathology, immunohistology vi. Antimalarials vii. Risk factors for the development of SLE : Low-grade anemia, leucopenia, false (+) for syphilis (VDRL rapid plasma reagent), positive rheumatoid factor tests, serum complement level↓, hypergammaglobulinemia B. Dermatomyositis i. Hallmark skin lesions ii. Diagnostic criteria iii. Laboratory test: autoantibodies, muscle enzymes, muscle biopsy iv. Differential diagnosis from LE v. Complications and internal malignancy Relative risk of internal malignancy: 2.4 in male, 3.4 in female Risk for ovarian cancer in female pts: 16.7-fold higher Risk factor for internal malignancy : Older age, Greater extent and severity of skin disease, Elevated CK Interstitial lung disease is negatively correlated. vi. Prognostic factors C. Scleroderma i. Pathogenesis : immune events, vasculopathy, fibrosis ii. Localized scleroderma vs. systemic scleroderma : Raynaud phenomenon, internal organ involvement iii. Limited SSc vs. Diffuse SSc II. Bullous diseases A. Basic concepts: DEJ B. Immunofluorescence IgG deposits in a linear pattern at the epidermal BM : BP, CP, PG, EBA, paraneoplastic pemphigus IgG on the keratinocyte cell surface : PV, PF, paraneoplastic pemphigus IgA deposits -Linear pattern at BM: linear IgA bullous dermatosis -Granular dermal papillary deposits: Dermatitis herpetiformis -Keratinocyte cell surface: IgA pemphigus C. EBA vs BP D. Paraneoplastic pemphigus Intractable stomatitis, involving non-stratified squamous epithelium Serum autoantibodies directed against plakin proteins (envoplakin, periplakin) Associated malignancies: non-Hodgkin lymphoma, chronic lymphocytic leukemia, Castleman disease, thymoma Marked elevated IL-6 - Tumor cells of NHLs, CLL, Castleman disease secrete massive amounts of IL-6 - B-cell differentiation and immunoglobulin production
박언재 ( Oun Jae Park ),노태경 ( Tai Kyung Noh ),허식 ( Sik Haw ),장경애 ( Kyoung Ae Jang ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.6
There have been a small number of recent case reports of patients with erythematous patches around the joints, which histopathologically showed histiocytic aggregations in the dermal vessels. Intralymphatic histiocytosis (ILH) is a rare group of skin diseases that are characterized by the proliferation of histiocytes in a lymphatic vessel lumen, and this is thought to arise as a benign reaction to certain stimuli such as rheumatoid arthritis. The pathogenesis of this intralymphatic proliferation of histiocytes and the reasons they commonly present on the arms are still unknown. We report on a case of ILH with arthritis in a 68-year old female who had no underlying disease, and the ILH presented as irregular erythematous patches on the left antecubital area and these patches demonstrated the distinctive histopathological features of intralymphatic histiocytosis. (Korean J Dermatol 2011;49(6):538∼541)
이미혜 ( Mi Hye Lee ),노태경 ( Tai Kyung Noh ),이종희 ( Jong Hee Lee ),노미령 ( Mi Ryung Roh ),나정임 ( Jung Im Na ),정의창 ( Eui Chang Jung ),고주연 ( Joo Yeon Ko ),장성은 ( Sung Eun Chang ) 대한피부과학회 2016 대한피부과학회지 Vol.54 No.7
Background: Melasma is a common acquired hyperpigmentation disorder that predominantly affects the face. It frequently occurs in women with darker skin types and severely impacts quality of life. Objective: To characterize the clinicoepidemiological features and triggering or aggravating factors of melasma in Korean patients. Methods: This cross-sectional study was conducted at the dermatology clinics of five university hospitals in Korea. Between January 2011 and August 2012, 411 patients with melasma completed a questionnaire about the clinical and aggravating factors associated with their melasma. Results: The study population consisted of 400 women and 11 men aged 22∼73 years (mean age, 42.8±9.92 years). Triggering or aggravating factors were sun exposure (68.4%), pregnancy (27.0%), and emotional stress (24.8%). Interestingly, 61.1% of patients complained of sensitive/inflammatory features such as erythema, itching, and a stinging sensation. Dryness was the most common aggravating factor, followed by erythema/redness and itching/stinging. Concomitant pigmentary disorders included post-inflammatory hyperpigmentation in 15.1% of patients, followed by pigmented contact dermatitis, and acquired bilateral nevus of Ota-like macules. Conclusion: It is well known that sun exposure and hormonal changes are the most common triggers of melasma; however, sensitive/inflammatory features may aggravate melasma in East Asian patients. Therefore, these individual and racial differences should be considered in the prevention and treatment of melasma. (Korean J Dermatol 2016;54(7):532∼537)
강성민 ( Seong Min Kang ),노태경 ( Tai Kyung Noh ),원종현 ( Chong Hyun Won ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),문기찬 ( Kee Chan Moon ) 대한피부과학회 2011 大韓皮膚科學會誌 Vol.49 No.4
Dermatofibroma is a common benign fibrohistiocytic tumor. It can occur anywhere on the body surface, but it has a propensity for the extremities. However, dermatofibroma may show a wide variety of clinicopathologic variants and so it is often misdiagnosed. Our case was a 13-year-old male who presented with a 1-year history of a solitary skin-colored hyperkeratotic nodule on the right sole. The nodule had recurred after topical therapy for viral wart. Histopathologic examination of the patient`s lesion revealed a poorly circumscribed nodular tumor composed of collagen bundles, fibroblasts and histocytes, which was all consistent with plantar dermatofibroma. (Korean J Dermatol 2011;49(4):388∼391)
피부 흑색종과 색소성 모반에서 Syndecan-2의 발현에 관한 면역조직화학적 연구
윤우진 ( Woo Jin Yoon ),최소라 ( So Ra Choi ),노태경 ( Tai Kyung Noh ),박호영 ( Ho Young Park ),최정란 ( Jung Ran Choi ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.10
Background: Melanoma is a malignant neoplasm originating from melanocytes. It has been recently suggested that syndecan-2 may contribute to the aggressive phenotype and metastatic potential of melanoma in cell line studies. However, there is no quantitative analysis of syndecan-2 expression using human melanoma tissue. Objective: This study aimed to examine the specific expression of syndecan-2 in human melanoma tissue. Methods: A total of 35 sections of formalin-fixed, paraffin-embedded tissues were investigated for syndecan 2 expression using immunohistochemical staining. Also, a total of 6 tissues and two kinds of cell lines were analyzed by reverse-transcriptase polymerase chain reaction (RT-PCR) and western blot. Results: Immunohistochemical staining of 23 cases of melanoma tissue was done, and in 5 cases (21.7%), strong expression of syndecan-2 was seen. Also, syndecan-2 was detected in human melanoma tissue and MNT-1 melanoma cells by RT-PCR and western blot analysis. Conclusion: We suggest that syndecan-2 expression is increased in melanoma compared to nevus. The results of this study may help to explain the clinical features of melanoma and syndecan-2. (Korean J Dermatol 2013;51(10): 776∼781)