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)

비전형적인 광택 태선

윤두희 ( Dou Hee Yoon ),조상현 ( Sang Hyun Cho ),김시용 ( Si Yong Kim ),조백기 ( Baik Kee Cho ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.4

Lichen nitidus, characterized by its typical clinical and histopathologic findings, is an uncomrnon chronic dermatosis of unknowned etiology. The distribution of this disease is most often localized, but in some cases it may becorne generalized. Some authors suggested that lichen nitidus is a variant of lichen planus in terms of its coincidence, ultrastructural and immunophenot,ypic studies. We report herein a case of lichen nitidus which presents dark brown linear, grouped, or confluent papules on the face, cheat, and upper extremities, accompanying with the histopathologic findings of pigmentary incontirence in the portion of claw clutching a ball appearance. This report suggests that lichen nitidus shows hyperpigmentation clinically and could be one of the dermatoses which exhibit pigmentavy incontinence in a histopathologic study. (Kor J Dermatol 1995;33(4): 794-797)

임신성 포진

윤두희 ( Dou Hee Yoon ),이동원 ( Dong Won Lee ),조백기 ( Baik Kee Cho ),이창우 ( Chang Woo Lee ) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.4

Herpes gestationis(HG) characterized by the development of autoantibodies to the basement membrane is a pruritic bullous dermatosis of pregnancy and the postpartum period. HG is diag nosed on the basis of clinical findings, and a direct or indirect immunofluorescent test including an assaying for the denmonstration of IgG autoantibody in the serum. We report a case of herpes gestationis in Korea which showed a typical clinical and histopathologic findings accuring in a 30-year old primiparous patient. We could confirm the diagnosis in this case by in vitro C3 staining, and immunoblot analysis which revealed the presence of antibodies in her sertim against 180kD antigen of epidermal protein. (Kor J Dermatol 1995;33(4): 727-732)

다발성 피지낭종을 동반한 발진성 연모낭종

윤두희(Dou Hee Yoon),최성우(Sung Woo Choi),조백기(Baik Kee Cho) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.1

Eruptive vellus hair cysts and steatocystoma multiplex have clinical similarities in terms of age of onset, location and appeararice of the lesions, but histopathologic feitures are distinctively differen-tiated. We present herein a 37-year-old woman with eruptive vellus hair cyst and steatocystoma multiplex as well. The histopathologic sections from 2 different lesions showed features of both eruptive vellus hair cyst with sebaceous gland in and near the cyst wall, and steatocy toma multiplex with rudimentary hair follicle near the cyst wall. This case may support the premie that eruptive vellus hair cyst and steatocystoma multiplex have a common developmental origin. (Kor J Dermatol 1994; 32(1): 149-152)

에크린 나선종 4예

윤두희(Dou Hee Yoon),김시용(Si Yong Kim),조상현(Sang Hyun Cho),허동(Dong Houh),조백기(Baik Kee Cho) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.1

Eccrine spiradenoma is a txnign, painful tumor of the skin, which probably originates in the coil of the eccrine sweat glands and presents a characteristic clinical and pa.hological picture. However recently, the weakness and inconsistency of the enzymes histochemican, actions and electron microscopic findings, and the presence of numerous undifferentiated and indetirn, inate cells suggest a rather low degree of differentiation. We present herein four cases of eccrine spiradenoma which show livrse histopat.hologic characteristics including typical rosette-like structure, ductal structure, vacuar structure and mixed type, respectively. This report may support the premise that eccrine spiridinoma is defived not only from the eccrine duct but also from pluripotential stem cells. (Kor J Dermatol 995; 33<1): 140-144)

제초제 Paraquat ( GramoxoneR ) 의 접촉에 의한 다형 홍반

윤두희(Dou Hee Yoon),이준영(Jun Young Lee),김형옥(Hyung Ok Kim),김정원(Chung Won Kim) 대한피부과학회 1993 대한피부과학회지 Vol.31 No.6

Paraquat is the most important bipyridyl herbicide, acting as a norselective herbicide with somewhat unique properties. The major acute local cutaneous side effects reslt from the caustic properties of paraquat, which produce local ulceration of the epithelial surface. Blistering of the skin and cracking and even loss of the fingernails have been reported. Its systemic taxic ties also include pulmonary fibrosis, cardiac failure, renal failure, and hepatotoxicity. We report a case of erytlema multiforme with transient heat-toxicity due to percutanious absorption of paraquat. A 31-year-old farmer was admitted to our de artment because of target-like bullous erythema on both thighs and buttocks following accidenta contact with paraquat. The histopathologic findings show d spongiesis, exocytosis, intercellular dema in the epidermis, degeneration of dermo-epidermal junction and inflammatory cell infiltrations in the dermis especially papillary and perivascular area. (Kor J Dermatol 1993;31(6):948-952)

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)

기본첩포검사에서 소실 및 자극반응의 발현빈도

김태윤,윤두희,이준영,김형옥,김정원 ( Tae Yoon Kim,Dou Hee Yoon,Jun Young Lee,Hyung Ok Kim,Chung Won Kim ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.6

Background: The patcl test is widely used for diagnosis of allergic contact dermatitis. However, it is sometimes difficiilt or even impossihle to differentiate between allergic and irritant reactions in patch test readings. The achievernent of valid results from the patch test require intelligent and careful patch testing and physirians with skills and experiences. Objective : The purpos of this study was to assess the frequency, age and sex distr ibution, and the seasonal variatioii of irritant. and lost reactions in standard patch tests. Methods : Patch test records of day 2 and day 4 were reviewed and analysed. Frequency of inritant and lost reactions were analysed by allergen, age, sex and season. Results : A total 212 c ses of standard patch test records(rnale 69, female 143) were analysed. The results were as follovs ; 1. The over all frequency of lost reactions in the standard patch test were 33.5 percents and that of irritant reactions were 8.0 perr.ents. 2. The frequency of lost reactions was lower in the age groups under twenty(7.7%) than in the older age groups(35.5%). However, there was no significant difference het,ween the age groups over the third dec ide. 3. The seasonal variation was evident in lost reactions. The order of frequency was summer(45. 0% ), winf,er(33.7% ), spri,ig and fall(2l.1% ). 4. The order of frequency of lost reactions in the stclndard patch allergen was captan(5.7%), potassium dichromate(5.2%), cobalt chloride(4.7%), mercury amrnoniurn chloride(3.8%) c3lld wool alcohol(3.8%) Conclusion : Our result, show a relatively high frequency of lost and irritant. reaction in the standird patch test, and uggest second readings in the patch test would he of value. (Korean J Dermatol 1997;35(6): 1095-1100)

Sodium Lauryl Sulfate 에 의해 유발된 건조피부의 D - SquameR Disc를 이용한 화상분석기적 측정

심재홍,윤두희,김태윤,김형옥,김정원 ( Jae Hong Shim,Dou Hee Yoon,Tae Yoon Kim ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

건조피부는 아토피피부염, 어린선 및 노인성 소양증 등과 같은 피부질환에서 흔히 볼 수 있는 증세이며, 당뇨, 뇨독증, 점액수종 등 전신질환 환자에서도 나타나고, 원발 질환이 없이도 흔히 관찰될 수 있다. 그 증상은, ‘피부에 윤기가 없고, 인설(鱗屑,scale)이 보이며, 조이고, 가렵다’등으로 다양하게 나타나며 환자들이 느끼는 개인차와 관찰자에 따른 오차로 객관적 평가가 어려우므로 이를 정략적으로 측정하는 방법이 요구된다. 건조피부의 발생기전은, 각질층 지질에 의해 형성되는 피부장벽대 기능(skin barrier function)의 손상에의한 것으로 생각되고 있다. 실제로 계면활성제(surfactants)나 유기용제에 의해 각질층내 지질이 제거되면 각질층내 수분감소를 특징으로하는 건조피부가 유발된다. 따라서 현재까지, 각질층내 수분함량과 수분의 증발정도를 corneometer나 evaporimeter 등으로 측정하여, 피부장벽대 기능을 평가함으로서 피부의 건조 정도를 간접적으로 측정하는 방법들이 많이 적용되어 왔다. 그러나 건조피부가 유발된 각질층의 형태학적 변화에 관하여는 연구가 부족한 실정이다. 또한 위에 기술한 기구를 이용하여 피부 장벽대 기능을 평가하는 측정은 기온, 상대습도 및 공기의 흐름 등 외부 조건에 의하여 측정값이 많은 영향을 받기 때문에 건조피부의 평가를 위한 좀더 편리한 방법이 요구된다. 최근 소개된 D-Squame은, 일정한 피부 크기에서 일정한 접착력으로 가장 표층의 각질층을 떼어낸 표본을 얻을 수 있는 방법으로, 이 표본을 직접 광확대하여 각질의 크기나 모양을 관찰할 수 있으며, 화상분석기를 이용하면 각질의 크기 및 분포면적을 객관적을 측정 할 수 있어 각질층의 형태학적 변화에 대한 연구에 유용하게 사용될 수 있다. 또한 이 방법은 접착력을 이용하는 것이므로, 외부 조건인 공기 흐름에 영향을 받지 않을 것으로 사료되었고 다른 외부 조건에도 덜 민감할 것으로 추정되었다. 본 실험에서 사용한 sodium lauryl sulfate(SLS)는 일상생활에 널리 쓰이는 대표적인 계면활성제로, 이의 첩포나 반복적인 접촉은 건조피부나 자극성 피부염을 유발시키는 것으로 알려져 있으며, 그 농도나 첩포방법에 따라 다양한 피부표면의 변화가 관찰된다. 이에 저자들은 건조피부를 유발시키기에 적합한 SLS의 농도와 건조피부에서 D-Squame을 이용한 측정법의 효용성을 알아보고자, 건강한 자원 성인 남녀를 대상으로 여러 농도의 SLS를 전박부 피부에 첩포하여 피부 건조증을 유발시킨 후, 임상적 변화, 각질층내 수분함량 및 경표피 수분손실을 측정한 후, D-Squame으로 표층의 각질층을 얻어 화상분석기적 관찰을 시행하여 각 SLS의 농도에 따른 각질의 형태학적 변화와 피부장벽대 기능의 변화를 조사하여 비교해 보았다. 또한 환경조건에 영향을 받지 않는 간편한 측정방법의 가능성을 알아보고자 동일한 대상에서 일정한 실내조건에 반응되기 전·후에 전박부의 각질층을 D-Squame으로 얻어 화상분석기적 비교 관찰을 시행하였다. Background:Dry skin is a common condition with or without various diseases but the clinical grading of it is very difficult because of its diverse symptoms. One of the causes of dry skin is thought to be the impairment of the skin barrier function and investigators have adopted many non-invasive bioengineering techniques to assess it by measuring epidermal hydration, However, studies about the morphological changes of dry skin are not yet complete. Sodium lauryl sulfate can induce irritant dermatitis and as well as dry skin, but the results are variable by applying different concentrations and methods. Objective:We performed this study in order to evaluate the optimal concentration of sodium lauryl sulfate to induce dry skin and the efficacy of assessing the dry skin by morphological changes. Methods:We applied sodium lauryl sulfate to the volar forearms of 12 healthy volunteers between 21 and 26 years of age at concentrations of 0.1, 0.5, 1.0 and 2.0% under occlusion for 24 hours. Then we evaluated the dryness by using an image analyzer with adhesive tape(D_Squame^? disc) which is a newly adopted method to collect the outer portion of the stratum corneum. The results were compared with those from other bioengineering techniques such as evaporimeter(EP-1) and corneometer(CM 820). Results: 1. The suitable concentration of sodium lauryl sulfate to induce the dry skin with minimal inflammatory reaction was between 0.1 and 0.5% under the 24 hour-occlusion period. 2. Both the percentage area covered by scales and the size of scales in the D-Squame^? disc were elevated by the irritation of sodium lauryl sulfate(p<0.05), and the values of the D-Squame^? disc were correlated with those from the evaporimeter(r=0.91) and corneometer(r=-0.79). 3. The values from the D-Squame^? disc with or without standardized conditions did not show significant differences. Comclusion:These results suggest that the D-Squame^? disc is adequate for the objective evaluation of dry skin. This is also simpler than other bioengineering methods so it could be used as a screening test of dry skin.(Kor J Dermatol 1997;35(4):611∼619)

특발성 골수섬유증을 동반한 괴저성 농피증

최태진,권윤희,윤두희,김태윤,김정원 ( Tae Jin Choi,Yoon Hee Kwon,Dou Hee Yoon,Tae yoon Kim,Chung Won Kim ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.4

Pyoderma gangrenosum is a rare, recurrent, painful and ulcerative skin disorder of unknown etiology, but is commonly associated with a variety of underlying systemic diseases of ulcerative colitis, rheumatoid arthritis, monoclonal gammopathies, Crohns disease, chronic active hepatitis and some hematologic diseases such as leukemia, thrombocythemia, dysglobulinemia and myeloma. We describe a 50 year-old woman who had pyoderma gangrenosum associated with idiopathic myelofibrosis. The findings of a bone marrow biopsy revealed proliferation of fibroblasts and a dense reticulin network, which were consistent with myelofibrosis. Steroid therapy resulted in a good response temporarily but, she died within a year after diagnosis. To our knowledge, our present case associated with idiopathic myelofibrosis is the first reported case in the Korean literature. (Kor J Dematol 1997;35(4): 781-785)