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A case of bullous pemphigoid induced by clobazam
( Howard Chu ),( Jae Won Lee ),( Dongyun Shin ),( Hee Ju Kim ),( Min Geol Lee ),( Daesuk Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Bullous pemphigoid (BP) is an acquired autoimmunebullous dermatosis resulting in subepidermal blistering. Although usually idiopathic, certain medications are known to be associated, which is referred as drug-induced BP. Herein, we report a novel case of a patient who developed BP after taking clobazam, an anticonvulsant agent. A 50-year-old female presented with a 1cm-sized tense yellowish bulla and few 3mm-sized vesicles on her right shin. When she was six, she started to havedevelopmental delay on her left face and arm. Also, she has a prolonged history of recurrent episodes of seizures since she was 30 years old, and had continuously taken anti-epileptic medications since then. Her seizures were relatively well-controlled until May, 2014, when she arrived at the emergency room with another episode of seizure, and clobazam was added. After taking clobazam for about a month, she visited our dermatology clinic with the skin lesions described above. Biopsy was done and it revealed subepidermal blister containing eosinophils and neutrophils. Although the result for direct immunofluorescence was negative, her clinical features and histological results were highly suggestive of BP. This adverse reaction of clobazam has never been reported before.Further studies are required to clearly determine this drug as the causative agent, yet cautions should be taken before starting treatment with clobazam.
P039 : Analysis of human blood follicular helper T cells in patients with psoriasis
( Dongyun Shin ),( Dae Suk Kim ),( Jung Hwan Lee ),( Sung Hee Kim ),( Hee Joo Kim ),( Do Young Kim ),( Soo Min Kim ),( Min Geol Lee ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Background: Follicular helper T (Tfh) cell is a recently characterized subset of helper T cells, with a distinct gene expression and a specialized role in supporting antibody response. Recently, blood Tfh cells are reported to be altered in patients with autoimmune disorders. However, there is no report about Tfh cell in patients with psoriasis. Objectives: To analyze the human blood Tfh cells in patients with psoriasis. Methods: Peripheral blood mononuclear cells from 16 psoriasis patients (PSO) and 11 healthy controls (HC) werestained with antibodies against CD4, CXCR5, PD-1, ICOS and analyzed with flow cytometry. Clinical and laboratory parameters were also measured. Results: The portions of CD4+CXCR5+ T cells in CD4+ T cells were not significantly different between PSO and HC. However, interestingly, the portions of CXCR5+PD-1 T cells in CD4+ T cells were significantly lower in PSO than HC (4.45% vs 2.14%, p=0.0421, respectively). The portions of CXCR5+PD-1 T cells in CD4+ T cells were also negatively correlated with ESR (p=0.0238, r=-0.5188), and significantly lower in patients with higher ASO titer (p=0.0445). Conclusion: CD4+CXCR5+PD-1+ T cells, which are known as activated subsets of Tfh cells, were significantly less expressed in PSO compared to HC, and negatively correlated with laboratory parameters of psoriasis. These results suggest that Tfh cells and B cell immunity could be altered in psoriasis.
The Grid-Cluster Combination Routing algorithm for Wireless Sensor Networks
Dongyun Shin,Byungrak Son,Dongkyu Kim,Junggyu Kim 대한전자공학회 2008 ICEIC:International Conference on Electronics, Inf Vol.1 No.1
In this research, we have developed an algorithm called GCCR(Grid Cluster Coupling Routing) to solve the problem relating with TTDD(Two-Tier Data Dissemination) which does not provide a movement of sink nod It creates a cluster with location information of sensor node. GCCR has a good energy efficiency on whole network because it is possible to reduce the number of hops by using the shortest path of data forwarding from source nodes to sink nodes. It also does not take part in the limited path on formation of grid. We have evaluated the total energy consumption and the rates of data transmission with various number of sink nodes and source nodes. As a result of this research, we could recognize that the total energy consumption can be reduced about 2 to 5 times on GCCR with α; the size cell of TTDD.
Large unstained cell values can be a valuable marker to aid in diagnosis of Sezary syndrome
( Dongyun Shin ),( Jimyung Seo ),( Minseok Lee ),( Hee Joo Kim ),( Min Geol Lee ),( Dae Suk Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2
Background: Erythroderma is caused by many factors. Although the majority of erythroderma are caused by benign diseases, it is very important to differentiate malignancy-related erythroderma, especially Sezary syndrome(SS). Therefore, it is important to find differentiating markers for SS among the patients with erythroderma. Objectives: We have evaluated the results of complete blood cell tests in patients with erythroderma to find whether it can be a useful marker for differentiating erythroderma patinets. Methods: We evaluated the number and the percentages of white blood cells, basophils, neutrophils and LUC of 63 erythroderma patients. Results: In multivariate binary logistic regression analysis, #LUC and %basophils showed significant association with the presence of SS. #LUC was the strongest predictor for the presence of SS in erythroderma patients(OR 1334.9, 95% CI 2.934-607446.629, P=0.021) and %basophils was also significant predictor(OR 7.951, 95% CI 1.036-61.014, P=0.046), too. ROC curve was created and the area under the curve(AUC) of #LUC was 97.76%(95% CI 94.24-101.3%, P=0.0004), and AUC of %basophils was 93.97%(95% CI 86.79-101.1%, P=0.0012). ROC curve analysis suggested that the optimal cut-off points for predicting SS were 0.33x103/レL for #LUC(100% sensitivity, 93.1% specificity) and 1.05% for %basophils(80% sensitivity, 94.83% specificity). Conclusion: We suggest that #LUC and %basophils can be a useful marker for differentiating SS from erythroderma.
( Dongyun Shin ),( Do Young Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Background: Histologic findings of verruca plana in“regressing phase” are considered different with those of the classic verruca plana, but there are just anecdotal reports in the literature. Objectives: To analyze the clinical and histopathological characteristics of spontaneously regressing verruca plana. Methods: A retrospective single-center analysis. A total 25 patients who showed typical clinical features of verruca plana, and the lesions disappeared spontaneously within 4 weeks after skin biopsy was included. Clinical characteristics evaluated based on review of medical records and photographs, and histological characteristics were analyzed. Results: Most common involved area was face(60%), followed by arms(36%) and legs(20%). Eight patients (32%) had been treated with recent ablating procedure. Histopathological findings include superficial perivascular lymphocytic infiltrations(96%), spongiosis and exocytosis(84%), focal basal vacuolization(64%), parakeratosis(64%), apoptotic keratinocytes(56%), and band-like lichenoid infiltration(28%). These pathological findings were more compatible with pityriasis rosea or pityriasis lichenoides chronica, rather than classic verruca plana. Conclusion: The histopathologic findings of spontaneously regressing verruca plana were different with those of classic verruca plana. Therefore, if clinically typical verruca plana showed superficial spongiotic dermatitis in histology, observation could be a treatment of choice.