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김삼형,강훈,손숙자 ( Sam Hyeong Kim,Hoon Kang,Sook Ja Son ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.5
We report a case of follicular mucinosis which oecurred in a 28-year old female. She had an adult fist-sized erythemlatous indurated infiltrative plaque with an ill-defined border on the left cheek area. Histopatholcigical findings, including mucin stains, showed characteristic reticular degeneration and cystic spece formation in hair follicles and sebaceous glands with mucinous degeneration and infiltration of abundant eosinophiles. The present case should be differentiated from plaque type eosinophilic pustular folliculitis clinically and histologically. (Korean J Dermatol 1997;35(5): 1022-1026)
김삼형,강훈,손숙자 ( Sam Hyeong Kim,Hoon Kang,Sook Ja Son ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.5
신생물 성장에 관여하는 유전자를 크게 나누어보면 세포의 증식과 성장을 촉진시키는 유전자, 세포고사(細胞枯死, apoptosis) 과정을 차단함으로써 신생물 성장을 가능케하는 유전자, 종양 억제 유전자의 범주가 있다고 알려져 있다. bcl-2 유전자는 B 세포 림프종에서 처음으로 밝혀진 원종양유전자(protooncogene)의 일종으로 세포고사 과정을 차단함으로써 세포의 수명을 연장시켜 신생물 생성을 가능케 한다. 문헌고찰에 의하면 정상표피 내에서 bcl-2 단백이 발현되는 세포는 오직 멜라닌세포라고 기술한 보고가 있는 반면, 기저층의 각지세포라고 보고하는 등 다양한 의견이 있다. 원발성 피부 종양 세포에서도 기저세포암, 편평세포암, 보웬병 등 대부분의 각질세포 기원의 종양세포에서 bcl-2 단백이 강하게 발현된다고 한 보고가 있는 반면, 편평세포암에서는 발현되지 않지만 기저세포암의 종양세포에서는 강하게 발현된다고 하는 등 외국문헌에서는 원발성 피부 악성종양에서 bcl-2 단백 발현에 대한 보고가 비교적 많은 반면 국내에서는 이에 대한 연구가 아직 미비한 실정이다. 이에 저자들은 국내에서 악성흑색종을 제외한 원발성 피부 악성종양의 전반에 걸쳐 bcl-2 단백이 발현되는 양상에 대해 알아보고, bcl-2 단백 발현과 종양 발생기전과의 연관성에 대해 알아보고자 면역조직화학염색법을 이용하여 비교 관찰하고자 한다. Background:bcl-2 is the best understood gene in the cell death pathway and functions as a repressor of programmed cell death, but it′s expression pattern in non-melanoma primary skin cancers is unknown. Objective:We investigated the expression of bcl-2 protein in non-melanoma primary skin cancers. Methods:Paraffin blocks of 27 cases of primary cutaneous malignancies, 12 cases of precancerous lesion, 5 cases of normal skin were retrieved from the files of the surgical pathology division of National Medical Center. Hematoxylin and eosin stained sections were re-examined by two dermatologists independently. Immunohistochemical stains using mouse anti-human bcl-2 oncoprotein were done. Results: 1. In the normal epidermis, prominent staining with anti-bcl-2 oncoprotein was confined to the basal keratinocytes and melanocytes. 2. All 13 specimens of basal cell carcinoma were positive to anti-bcl-2 oncoprotein. 3. Among 14 specimens of squamous cell carcinoma, 3 specimens were weakly positive to anti-bcl-2 oncoprotein, 11 specimens were negative. 4. 4 among 7 specimens of actinic keratosis and 4 among 5 specimens of Bowem’s disease were weakly to moderately positive. Conclusion:It has been known that bcl-2 protein inhibit apoptosis. Our results that the expression of bcl-2 protein is present quite consistently in basal cell carcinomas, a few in Bowen’s diseases and actinic keratoses, but rarely in squamous cell carcinomas. We postulate that bcl-2 protein may mainly contribute to oncogenesis of basal cell carcinoma, which may explain that this tumor is mainly composed of cells which occur by inhibition of apoptosis. Whereas bcl-2 protein rarely contribute to oncogenesis of squamous cell carcinomas, which may explain that this tumor is composed of cells which occur by the other main protooncogene rather than bcl-2 protein. In Bowen’s diseases and actinic keratoses, bcl-2 may role partially in oncogenesis.(Korean J Dermatol 1997;35(5):847∼853)
Pseudallescheria boydii에 의한 진균종
김삼형 ( Sam Hyeong Kim ),홍석진 ( Seok Jin Hong ),강훈 ( Hoon Kang ),손숙자 ( Sook Ja Son ),송계용 ( Kyae Yong Song ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.2
Pseudallescheria (P.) boydii is a true fungus that is ubiquitous in nature, and has a world-wide distribution. It has been isolated from soil, plant debris, polluted water and sewage. Infection may occur via direct inoculation or inhalation, and usually affects the extremities. It is a common cause of mycetoma characterized by tumefaction, draining sinuses and grains. It has polymorphism due to a complicated life cycle which undergoes teleomorph as well as anamorph stages. Cleistothecia, ascocarp and ascospore may be seen during the teleomorph stages, whereas scedosporium and graphium type may be seen during the anamorph stages. We report a case of P. boydii mycetoma occurring in a 69-year old male. He had multiple nodules with a discharging fistula on a dark red plaque at the dorsum of the right forearm. Cultural isolation for definitive diagnosis showed typical P. boydii. The lesion responded well to daily itraconazole. (Korean J Dermatol 1998;36(2): 341-345)
김삼형 ( Sam Hyoung Kim ),이승연 ( Seung Yeon Lee ),강훈 ( Hoon Kang ),손숙자 ( Sook Ja Son ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.6
We report a case of a 53-year-old woman with squamous cell carcinoma with lymph node me- tastasis who has had a recurrent painful bleeding papule on the right toe nail bed with resultant nail plate shedding over the past two years. X-ray and computer tomography examinations showed nearly total dcstruction of the distal phalanx of the right fifth toe and right inguinal lymph node enlargemer it. A nail bed biopsy specimen disclosed invading tumor masses composed of atypical squamous cells and multiple horn pearls. While squamous cell carcinoma of the nail bed is not usually aggresive and local removal is usually adequate, the possibility that metastasis or invasion of the adjacent phalanx or joint can occur should be kept in mind. (Kor J Dermatol 1996;34(6): 1048-1052)
비전형적인 임상 양상을 보인 호산구성 농포성 모낭염 4예
홍석진,김삼형,강훈,손숙자 ( Seok Jin Hong,Sam Hyeong Kim,Hoon Kang,Sook Ja Son ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.6
We report three cases of u.iiusual eosinophilic pustular folliculit is whose initial manifestation is indurated plaque rather than papule and pustule and one case of eosinophilic pustular folliculitis was found in an infant. None of the adult patients in these cases complained of any suhjective syrnptoms other t.han the skin lesion, but an itching sensation might be present in the case of the infant. In laborat ory test, eos nophilia was observed in only one case and any other abnormal results were not observed. In all cases, histopathologic study revealed numerous eosinophilic infil tration around the follicles ext.i nding to the periappendageal and perivacscular area, that is consistent with the finfings of eosinophilic pustuar folliculitis. All adult patients relatively responded well to dapsone and topical stroid and the infant patient resporided well to topical steroids, But they had a chronic course with remission and exacerhation (Korean J Dermatol 1997;35(6): 1244-1249)
비특이적 임상 소견을 보인 Gianotti - Crosti 증후군
홍석진,김삼형,강훈,손숙자 ( Seok Jin Hong,Sam Hyeong Kim,Hoon Kang,Sook Ja Son ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4
We report herein a case of Gianotti-Crosti syndrome showing unusual features. A 12-month-old male patient presented with papular skin lesions on his face and papulovesicular skin lesions on the trunk, upper and lower extremities, which were distributed symmetrically. Three days before the skin eruptions, he had been immunized with a measles vaccination. Serologically, antigens of the type B hepatitis virus and antibodies to coxsackie virus B-4, Epstein-Barr virus, and varicella-zoster virus were all negative and antibodies to the measles virus (IgG, IgM) and the type B hepatitis virus were positive. After conservative treatment the skin lesions subsided with exfoliation within 4 weeks. An association with the measles vaccination and the initial papulovesicular skin lesions are considered as peculiar features of this case. (Kor J Dermatol 1997;35(4): 830-834)