Blaschko 선을 따라 선상으로 발생하는 과색소침착의 임상 및 병리조직학적 고찰

김형옥 ( Hyung Ok Kim ),김은경 ( Eun Kyung Kim ),정경은 ( Kyung Eun Jung ),김혜성 ( Hei Sung Kim ),이준영 ( Jun Young Lee ),박영민 ( Young Min Park ) 대한피부과학회 2012 大韓皮膚科學會誌 Vol.50 No.12

Background: Many pigmentary disorders can be manifested as linear streaks of hyperpigmentation, along theBlaschko`s line. These include progressive cribriform and zosteriform hyperpigmentation (PCZH) and linear andwhorled nevoid hyperpigmentation (LWNH). There have been debates on the universally accepted diagnostic criteriadifferentiating these disease entities.Objective: To determine the clinicopathologic characteristics of hyperpigmentation along the line of Blaschko and toexamine the acceptability of PCZH or LWNH criteria as a diagnostic tool for differentiating these diseases.Methods: A retrospective study was conducted on 13 patients who presented with linear hyperpigmentation alongthe Blaschko`s line. The patients` clinicopathologic characteristics were analyzed and matched with the PCZH/LWNH diagnostic criteria.Results: Age of onset widely ranged from birth to 61 years, but predominantly before the age of 4 years. Themale-female ratio was 1:1.2. Trunk was the most common site of involvement. Histologic examination commonlyshowed a basal layer hyperpigmentation in all patients and pigmentary incontinence was observed in 2 patients. Fourpatients who satisfied all the diagnostic criteria for PCZH also fulfilled the diagnostic criteria for LWNH, except forthe timing of onset. An additional 4 patients satisfied all the diagnostic criteria for LWNH and also fulfilled thediagnostic criteria for PCZH, except for the timing of onset. Excluding the age of onset criteria, the other 3 patientsfulfilled both diagnostic criteria for PCZH and LWNH.Conclusion: These results demonstrate that PCZH and LWNH should not be considered as a different disease entityand that supports the idea that these are part of the same disease spectrum. (Korean J Dermatol 2012;50(12):1027∼1035)

다발성 골수종과 동반된 한냉글로불린혈증

김건우(Kun Woo Kim),김진우(Jin Wou Kim),오영진(Young Jin Oh),김형옥(Hyung Ok Kim),김정원(Chung Won Kim) 대한피부과학회 1989 대한피부과학회지 Vol.27 No.6

Cryoglobulinernia occurs in about 5% of the cases of multiple myeloma. The most common finding in patient with cryoglobulinemia is ulceraticn that oceurs about ankle, hands, and occasionally the ears, upon prolonged exposue to cold. A 59-year old male had had 5 years of pain in his ears. There were black or dark brown colored ischemic ulcerations on his both helix. He also had mottled purpuric patches on his both ankles. A test for cryoglobulinema was positive. X-ray examination of the skull showed multiple punched but lesions. The bone marrow study revealed myeloma cell infiltration.

자외선 B가 무모생쥐의 피부 장벽대 기능에 미치는 영향 - 경피적 수분소실과 피부각질층 지질의 변화 -

윤두희,김형옥,김태윤,김정원,송계용 ( Dou Hee Yoon,Hyung Ok Kim,Tae Yoon Kim,Chung Won Kim,Kyae Yong Song ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.4

피부 각질층은 피부의 가장 바깥층으로 포유동물에서 외부의 유해 자극으로 부터 자신을 보호하고 외부 물질의 피부 흡수 조절과 건조한 주위환경으로 포피에서의 과도한 수분증발을 방지하는 등 매우 중요한 기능을 담당한다. 각질층 지질이 피부장벽대(skin barrier function)의 주 역할인 각질층내 수분 유지기능(water holding function)과 함께 외부 수분 유입에 대한 투과 장벽대(water permeability barrier)등의 중요한 역할을 함이 알려져 있다. 이런 각질층 지질은 ceramide가 80%인 sphingolipid와 유리 지방산(free fatty acid) 및 콜레스테롤(cholesterol)이 주인 중성 지질(neutral lipid)등이 대부분이며, 각질화가 진행될수록 그 양의 증가를 보이는 sphingolipid와 유리 지방산(free fatty acid) 및 콜레스테롤(cholesterol)이 주인 중성 지질(neutral lipid)등이 대부분이며, 각질화가 진행될수록 그 양의 증가를 보이는 sphingolipid 계열의 지질들이 강력한 수소 결합력을 가져 수분 유지기능에 가장 중요한 역할을 한다. 자외선 조사는 피부의 물리적 생화학적 성상의 변화를 초래하여 홍반의 발생, 상피세포의 증식, 과색소 침착, DNA 손상, 각종 효소와 단백질의 활성 내지는 비활성, 유리 산소(oxygen radical)의 형성과 Vitamin-D_3합성 등이 있다. 자외선 조사후의 각질층 지질의 변화는 각 보고자의 실험 대상, 자외선 조사의 차이와 지질 분석의 방법에 따라서 다른 결과를 나타내기도 하였다. 본 실험에서 저자들은 정상 피부에 자극 반응을 일으키지 않는 저용량(suberythemal dose, SED)과 자극을 일으키기 시작하는 최소 홍반량(minimal srythemal dose, MED)의 자외선 B를 1주에 이틀간격으로 3회씩 3주간 반복조사함으로써 지속적인 자외선의 조사가 피부 장벽대에 시간대별로 미치는 영향과 고용량의 자외선 B를 일시에 조사하여 피부 장벽대에 손상을 입힌 후와 그 회복과정에서의 피부장벽대의 변화를 시간대별로 evaporimeter를 이용한 transepidermal water loss(TEWL)의 측정과 high performance thin layer chromatography(HPTLC)의 방법으로 각질층 지질 분석을 통하여 자외선 B가 피부 장벽대에 미치는 영향을 알아보고자 본 연구를 시도하였다. Background:Stratum corneum lipids serve as a water retainer as well as permeability barrier by forming a multi-lamellae structure in the stratum corneum. The major constituent of these lipids, ceramides, have been shown to be predominantly associated with both functions. Objective:Exposure of human epidermis to ultraviolet(UV) irradiation leads to changes in the physiologic and biochemical features of the skin. In order to investigate the effect of UVB irradiation on the skin barrier function in hairless mice, transepidermal water loss(TEWL) and lipid composition of stratum corneum were evaluated in hairless mice. Methods:Hairless mice were irradiated 3 times weekly for 3 weeks with suberythemal dose(0.6MED, Group Ⅰ) and minimal erythemal dose(MED, Group Ⅱ) of UVB. The mice of Group Ⅲ recieved high dose of UVB(3MED) on the back in a single exposure. The control was Group Ⅳ. TEWL measured by evaporimeter and lipid composition of stratum corneum appraised by high performance thin layer chromatography(HPTLC) were evaluated weekly for 3 weeks. Results: 1. Each time it was measured, the values of TEWL in group Ⅰ were lower than group Ⅳ, but the difference was not significant. The peak value of REWL in group Ⅱ was 8.2±1.56 g/㎠/h on the 7th day. The increase in TEWL was markedly significant at this point(P<0.001). Although the values of TEWL on the 14th and 21th day in group Ⅱ increased compared with those of the control group, the significance of the values decreased(P<0.05). 2. The peak value of TEWL in group Ⅲ was 9.88±1.13 g/㎠/h on the 2nd day, showed a markedly significant increase compared with that of the control group(P<0.001). The values of TEWL decreased to the level of the control group on the 14th day. 3. The lipid(cholesterol sulface, ceramide and neutral lipid) and total lipid mass in group Ⅰ were insignificantly larger than that of the group Ⅳ measured each time. On the 7th and 14th day, the amount of each three lipid and total lipid mass significantly increased(<0.05), furthermore the total lipid mass increased pronouncedly(P<0.01) in group Ⅱ. 4. The amount of the 3 kinds of lipid and total lipid mass in group Ⅲ significantly increased compared with those of the control group on the 2nd day(P<0.05). After the 7th day, no significant difference of the lipid mass except neutral lipid compared with that of the control group was seen. Comparing the 2nd and 14th day, there was a significant decrease in the amount of ceramide and total lipid mass(P<0.05). comclusion:These results suggest that considerable amount of UVB irradiation given in single or repeated exposure causes the disruption of skin barrier function, but a compensatory increase of skin lipid, sepecially ceramide, protects it from further damage and also improves skin barrier function.(Kor J Dermatol 1995;33(4):669∼678)

Melamine - formaldehyde resin에 의한 직업성 알레르기성 접촉피부염

홍진경,박철종,김형옥,김정원 ( Jin Kyung Hong,Chul Jong Park,Hyung Ok Kim,Chung Won Kim ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.2

Melamine-formaldehyde resin is widely used in manufactur ing plastics, tableware, t,extile and paper finishing, laminates, electrical insulations, and adhesives throughout the world, Allergic contact dermatitis to this resin has rarely been reported worldwide and has not been reported in Korean literature. We report a case of occupational allergic contact dermatitis to melamine-formaldehyde resin in a 38-year-old man. He had been working for a month in a textile factory when pruritic multiple erythematous patches and placjues developed on the face, both forearms and dorsa of the hands. In the factory melamine-forrnldehyde resin was used for crease resistant finishing. A Patch test revealed a positive reaction to rnelamine-formaldehyde resin. (Kor J Dermatol 1997;35(2): 369-373)

골화를 동반한 연골성 한관종

장미숙,김진우,김형옥,김정원 ( Mi Sook Chang,Kun Woo Kim,Hyung Ok Kim,Chung Won Kim ) 대한피부과학회 1988 대한피부과학회지 Vol.26 No.3

무모생쥐에서 용매의 극성에 따른 피부장벽대의 변화

최태진,윤두희,김형옥,김정원 ( Tae Jin Choi,Dou Hee Yoon,Hyung Ok Kim,Chung Won Kim ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Background: The stratom corneum lipids, responsible for the epidermal water bar rier, consist mainly of ceramides, cholesterol and free fatty acids. However, little has been studied about the effects of non-polar, polar and mixed organic solvents on the changes of the stratum corneum lipids bilayer. Objective : We designed this study in order to investigate the effect of non-polar, polar and mixed organic solvents on the lipids bilayer in hairless mice Methods : Twenty four hairless mice were evenly divided into 4 groups; a control group, chloroform treated group, methanol treated group and mixed solvent(chloroform/methanol(2: 1) ) treated gr oup. The changes in transepidermal water loss, as measured with an evaporimeter, were recorded after topical application of either chloroform, methanol or mixed solvents at 0, 3, 6, 12, 24 and 48 hours respectiveh. For electron microscopy, the skin samples taken from the mice of ea.:h group were t.rented with osmium tetroxide and ruthenium tetroxide after the treatment with each solvent. Results . The results were as follows ; 1. From 0 to 24 hours after treatment with each solvent transepidermal water loss was significantly increased in the chloroform and the mixed solvent[chloroform/methanol(2:1)] treated groups, compared to the methanol treated group and control group(p<0.001). 2. 48 hours after treatment with each solvent,, the differences in the values of transepidermal water loss in all groups were insignificant. 3. On electronmicroscopic examination, separation of intercellular lipid bilayers and a decrease in the numher of lamellar bodies were more severe in the chloroform treated and mixed solvent (chloroforrn,'methanol(2:1)] treated groups than in the methanol treated group. Application of non-polar organic solvents, especially mixed solvents[chloroform/methanol(2:1)] resulted in an increase in transepidermal water loss and greater structural changes than with polar organic solvents. Conclusion : Our results suggest that non-polar lipids may play a more important role in the protection of water vaporization of the stratum corneum lipids barrier than polar lipids. (Kor J Dermatol 1997;35(4): 660-666)

Herpetic syringitis on the vulva associated with eccrine squamous syringometaplasia in malignant Lymphoma

채경옥 ( Kyung Ok Chae ),이하린 ( Ha Rin Lee ),최성우 ( Sung Woo Choi ),김태윤 ( Tae Yoon Kim ),김형옥 ( Hyung Ok Kim ) 대한피부과학회 1999 초록집 Vol.37 No.10

만성 특발성 두드러기 환자에서 Cyclosporine의 치료 효과와 안전성 및 장기 추적 관찰 결과

김민주 ( Min Joo Kim ),김혜성 ( Hei Sung Kim ),김형옥 ( Hyung Ok Kim ),박영민 ( Young Min Park ) 대한피부과학회 2009 大韓皮膚科學會誌 Vol.47 No.7

Background: The efficacy and safety of cyclosporine for the treatment of chronic idiopathic urticaria (CIU) have been studied in numerous trials, but there have been few studies on the long-term effect of cyclosporine. Objective: This study was aimed to assess the efficacy and safety of low-dose cyclosporine for treating CIU. Furthermore, its long-term effect on the natural course of CIU was investigated. Methods: Thirty patients who suffered from persistent CIU despite conventional treatments received 2~3 mg/kg/day of cyclosporine for 12 weeks. The severity score was assessed by means of the urticaria activity score and the visual analogue score at baseline and at weeks 2, 4, 8 and 12. The safety assessments consisted of reporting the side effects and monitoring the laboratory parameters. After a follow-up period of at least 1 year, the patients were asked whether they had any remaining or new symptoms and whether they still used antihistamines or any other drugs. Results: Twenty seven patients completed the trial medication, and the respective symptom scores significantly improved after 12 weeks. Four (14.8%) patients reported adverse events during the trial period, but the events were not severe enough to require withdrawal from the study. Of the twenty one patients who were followed for at least 1 year (range: 12~45 months) after the completion of cyclosporine administration, eight patients (38.1%) were symptom free, and seven patients (33.3%) used only antihistamines. Conclusion: This study shows that low-dose cyclosporine is an efficacious and safe treatment option for treating CIU. In addition, the preliminary results suggest that low-dose cyclosporine might be helpful for the long-term control of this disease. (Korean J Dermatol 2009;47(7):759~764)

옻나무 접촉 후에 발생한 다형 홍반양 발진

장미숙(Mi Sook Chang),김형옥(Hyung Ok Kim),김정원(Chung Won Kim) 대한피부과학회 1989 대한피부과학회지 Vol.27 No.4

Irritant or allergic contact dermatitis presents usually eczematous process or occasionally noneczematous lesions like in this case. We report a case of erythema rnultiforme-like eruptions in a 40-year-old female who presented multiple iris or annular shaped maculopapular eruptions on both hands and forearms after contact of lacquer tree. Being performed with standard patch test screening series, lacquer tree extracts and urushiol, she showed significant reactions to the lacquer tree and urushiol. Histopathologic findings showed both features of erythema multiforme and suh acute contact dermatitis.

성인에서 발생한 단발성 근섬유종

최성우,박종갑,김태윤,김형옥,김정원,강석진 ( Sung Woo Choi,Jong Gap Park,Tae Yoon Kim,Hyung Ok Kim,Chung Won Kim,Seok Jin Kang ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.5

Myofibroma and myofibromaiosis are uncommon, benign, mostly self-limiting, probably hamartomatous proliferation of myofibroblasts. These tumors are most often present at birth or before the age of 2 years with multiple ot solitary lesion. Adult cases are rare and most,ly showed as a solitary lesion. We present a case of solitary myofibroma that developed on the vertex of scalp in a 51-year-old man. The lesion was a mild tender and intermittent pruritic firm, pedunclated 1 1cm sized tumor. The iumor was diagnosed as myofibroma by light microscopy and immunohistochemistry. (Korean J Dermatol 1907;35(5): 1031-1035)